|
HC X-RAY EXAM HIP UNI 2-3 VIEWS RT
|
Facility
|
OP
|
$476.79
|
|
|
Service Code
|
CPT 73502 RT
|
| Hospital Charge Code |
11613510
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$443.41 |
| Rate for Payer: Aetna Commercial |
$402.41
|
| Rate for Payer: Aetna Medicare |
$152.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$20.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$147.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$273.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$298.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$20.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$175.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$167.83
|
| Rate for Payer: Cash Price |
$286.07
|
| Rate for Payer: Cash Price |
$286.07
|
| Rate for Payer: Centivo All Commercial |
$259.37
|
| Rate for Payer: Cigna All Commercial |
$411.47
|
| Rate for Payer: CORVEL All Commercial |
$443.41
|
| Rate for Payer: Coventry All Commercial |
$419.58
|
| Rate for Payer: Encore All Commercial |
$438.89
|
| Rate for Payer: Frontpath All Commercial |
$438.65
|
| Rate for Payer: Humana ChoiceCare |
$411.80
|
| Rate for Payer: Humana Medicare |
$152.57
|
| Rate for Payer: Lucent All Commercial |
$259.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$429.11
|
| Rate for Payer: Managed Health Services Medicaid |
$20.73
|
| Rate for Payer: MDWise Medicaid |
$20.73
|
| Rate for Payer: PHCS All Commercial |
$357.59
|
| Rate for Payer: PHP All Commercial |
$361.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$185.95
|
| Rate for Payer: Sagamore Health Network All Products |
$368.08
|
| Rate for Payer: Signature Care EPO |
$395.74
|
| Rate for Payer: Signature Care PPO |
$419.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$405.27
|
| Rate for Payer: United Healthcare Commercial |
$375.71
|
| Rate for Payer: United Healthcare Medicare |
$152.57
|
|
|
HC X-RAY EXAM HIP UNI 2-3 VIEWS RT
|
Facility
|
IP
|
$476.79
|
|
|
Service Code
|
CPT 73502 RT
|
| Hospital Charge Code |
11613510
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$357.59 |
| Max. Negotiated Rate |
$443.41 |
| Rate for Payer: Aetna Commercial |
$411.95
|
| Rate for Payer: Cash Price |
$286.07
|
| Rate for Payer: Cigna All Commercial |
$411.47
|
| Rate for Payer: CORVEL All Commercial |
$443.41
|
| Rate for Payer: Coventry All Commercial |
$419.58
|
| Rate for Payer: Encore All Commercial |
$438.89
|
| Rate for Payer: Frontpath All Commercial |
$438.65
|
| Rate for Payer: Humana ChoiceCare |
$411.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$429.11
|
| Rate for Payer: PHCS All Commercial |
$357.59
|
| Rate for Payer: PHP All Commercial |
$361.60
|
| Rate for Payer: Sagamore Health Network All Products |
$368.08
|
| Rate for Payer: Signature Care EPO |
$395.74
|
| Rate for Payer: Signature Care PPO |
$419.58
|
| Rate for Payer: United Healthcare Commercial |
$375.71
|
|
|
HC X-RAY EXAM OF ELBOW 2 VIEWS LT LTD
|
Facility
|
OP
|
$402.89
|
|
|
Service Code
|
CPT 73070 LT,52
|
| Hospital Charge Code |
1618032
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$374.69 |
| Rate for Payer: Aetna Commercial |
$340.04
|
| Rate for Payer: Aetna Medicare |
$128.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$124.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$231.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$251.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$148.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$141.82
|
| Rate for Payer: Cash Price |
$241.73
|
| Rate for Payer: Cash Price |
$241.73
|
| Rate for Payer: Centivo All Commercial |
$219.17
|
| Rate for Payer: Cigna All Commercial |
$347.69
|
| Rate for Payer: CORVEL All Commercial |
$374.69
|
| Rate for Payer: Coventry All Commercial |
$354.54
|
| Rate for Payer: Encore All Commercial |
$370.86
|
| Rate for Payer: Frontpath All Commercial |
$370.66
|
| Rate for Payer: Humana ChoiceCare |
$347.98
|
| Rate for Payer: Humana Medicare |
$128.92
|
| Rate for Payer: Lucent All Commercial |
$219.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$362.60
|
| Rate for Payer: Managed Health Services Medicaid |
$14.28
|
| Rate for Payer: MDWise Medicaid |
$14.28
|
| Rate for Payer: PHCS All Commercial |
$302.17
|
| Rate for Payer: PHP All Commercial |
$305.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$157.13
|
| Rate for Payer: Sagamore Health Network All Products |
$311.03
|
| Rate for Payer: Signature Care EPO |
$334.40
|
| Rate for Payer: Signature Care PPO |
$354.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$342.46
|
| Rate for Payer: United Healthcare Commercial |
$317.48
|
| Rate for Payer: United Healthcare Medicare |
$128.92
|
|
|
HC X-RAY EXAM OF ELBOW 2 VIEWS LT LTD
|
Facility
|
IP
|
$402.89
|
|
|
Service Code
|
CPT 73070 LT,52
|
| Hospital Charge Code |
1618032
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$302.17 |
| Max. Negotiated Rate |
$374.69 |
| Rate for Payer: Aetna Commercial |
$348.10
|
| Rate for Payer: Cash Price |
$241.73
|
| Rate for Payer: Cigna All Commercial |
$347.69
|
| Rate for Payer: CORVEL All Commercial |
$374.69
|
| Rate for Payer: Coventry All Commercial |
$354.54
|
| Rate for Payer: Encore All Commercial |
$370.86
|
| Rate for Payer: Frontpath All Commercial |
$370.66
|
| Rate for Payer: Humana ChoiceCare |
$347.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$362.60
|
| Rate for Payer: PHCS All Commercial |
$302.17
|
| Rate for Payer: PHP All Commercial |
$305.55
|
| Rate for Payer: Sagamore Health Network All Products |
$311.03
|
| Rate for Payer: Signature Care EPO |
$334.40
|
| Rate for Payer: Signature Care PPO |
$354.54
|
| Rate for Payer: United Healthcare Commercial |
$317.48
|
|
|
HC X-RAY EXAM OF ELBOW 2 VIEWS RT LTD
|
Facility
|
OP
|
$402.89
|
|
|
Service Code
|
CPT 73070 RT,52
|
| Hospital Charge Code |
11618032
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$374.69 |
| Rate for Payer: Aetna Commercial |
$340.04
|
| Rate for Payer: Aetna Medicare |
$128.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$124.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$231.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$251.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$148.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$141.82
|
| Rate for Payer: Cash Price |
$241.73
|
| Rate for Payer: Cash Price |
$241.73
|
| Rate for Payer: Centivo All Commercial |
$219.17
|
| Rate for Payer: Cigna All Commercial |
$347.69
|
| Rate for Payer: CORVEL All Commercial |
$374.69
|
| Rate for Payer: Coventry All Commercial |
$354.54
|
| Rate for Payer: Encore All Commercial |
$370.86
|
| Rate for Payer: Frontpath All Commercial |
$370.66
|
| Rate for Payer: Humana ChoiceCare |
$347.98
|
| Rate for Payer: Humana Medicare |
$128.92
|
| Rate for Payer: Lucent All Commercial |
$219.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$362.60
|
| Rate for Payer: Managed Health Services Medicaid |
$14.28
|
| Rate for Payer: MDWise Medicaid |
$14.28
|
| Rate for Payer: PHCS All Commercial |
$302.17
|
| Rate for Payer: PHP All Commercial |
$305.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$157.13
|
| Rate for Payer: Sagamore Health Network All Products |
$311.03
|
| Rate for Payer: Signature Care EPO |
$334.40
|
| Rate for Payer: Signature Care PPO |
$354.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$342.46
|
| Rate for Payer: United Healthcare Commercial |
$317.48
|
| Rate for Payer: United Healthcare Medicare |
$128.92
|
|
|
HC X-RAY EXAM OF ELBOW 2 VIEWS RT LTD
|
Facility
|
IP
|
$402.89
|
|
|
Service Code
|
CPT 73070 RT,52
|
| Hospital Charge Code |
11618032
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$302.17 |
| Max. Negotiated Rate |
$374.69 |
| Rate for Payer: Aetna Commercial |
$348.10
|
| Rate for Payer: Cash Price |
$241.73
|
| Rate for Payer: Cigna All Commercial |
$347.69
|
| Rate for Payer: CORVEL All Commercial |
$374.69
|
| Rate for Payer: Coventry All Commercial |
$354.54
|
| Rate for Payer: Encore All Commercial |
$370.86
|
| Rate for Payer: Frontpath All Commercial |
$370.66
|
| Rate for Payer: Humana ChoiceCare |
$347.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$362.60
|
| Rate for Payer: PHCS All Commercial |
$302.17
|
| Rate for Payer: PHP All Commercial |
$305.55
|
| Rate for Payer: Sagamore Health Network All Products |
$311.03
|
| Rate for Payer: Signature Care EPO |
$334.40
|
| Rate for Payer: Signature Care PPO |
$354.54
|
| Rate for Payer: United Healthcare Commercial |
$317.48
|
|
|
HC X-RAY EXAM OF FOREARM 2 VIEWS LT LTD
|
Facility
|
OP
|
$298.87
|
|
|
Service Code
|
CPT 73090 LT,52
|
| Hospital Charge Code |
1618033
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$277.95 |
| Rate for Payer: Aetna Commercial |
$252.25
|
| Rate for Payer: Aetna Medicare |
$95.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$92.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$171.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$186.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$109.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$105.20
|
| Rate for Payer: Cash Price |
$179.32
|
| Rate for Payer: Cash Price |
$179.32
|
| Rate for Payer: Centivo All Commercial |
$162.59
|
| Rate for Payer: Cigna All Commercial |
$257.92
|
| Rate for Payer: CORVEL All Commercial |
$277.95
|
| Rate for Payer: Coventry All Commercial |
$263.01
|
| Rate for Payer: Encore All Commercial |
$275.11
|
| Rate for Payer: Frontpath All Commercial |
$274.96
|
| Rate for Payer: Humana ChoiceCare |
$258.13
|
| Rate for Payer: Humana Medicare |
$95.64
|
| Rate for Payer: Lucent All Commercial |
$162.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$268.98
|
| Rate for Payer: Managed Health Services Medicaid |
$13.79
|
| Rate for Payer: MDWise Medicaid |
$13.79
|
| Rate for Payer: PHCS All Commercial |
$224.15
|
| Rate for Payer: PHP All Commercial |
$226.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.56
|
| Rate for Payer: Sagamore Health Network All Products |
$230.73
|
| Rate for Payer: Signature Care EPO |
$248.06
|
| Rate for Payer: Signature Care PPO |
$263.01
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$254.04
|
| Rate for Payer: United Healthcare Commercial |
$235.51
|
| Rate for Payer: United Healthcare Medicare |
$95.64
|
|
|
HC X-RAY EXAM OF FOREARM 2 VIEWS LT LTD
|
Facility
|
IP
|
$298.87
|
|
|
Service Code
|
CPT 73090 LT,52
|
| Hospital Charge Code |
1618033
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$224.15 |
| Max. Negotiated Rate |
$277.95 |
| Rate for Payer: Aetna Commercial |
$258.22
|
| Rate for Payer: Cash Price |
$179.32
|
| Rate for Payer: Cigna All Commercial |
$257.92
|
| Rate for Payer: CORVEL All Commercial |
$277.95
|
| Rate for Payer: Coventry All Commercial |
$263.01
|
| Rate for Payer: Encore All Commercial |
$275.11
|
| Rate for Payer: Frontpath All Commercial |
$274.96
|
| Rate for Payer: Humana ChoiceCare |
$258.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$268.98
|
| Rate for Payer: PHCS All Commercial |
$224.15
|
| Rate for Payer: PHP All Commercial |
$226.66
|
| Rate for Payer: Sagamore Health Network All Products |
$230.73
|
| Rate for Payer: Signature Care EPO |
$248.06
|
| Rate for Payer: Signature Care PPO |
$263.01
|
| Rate for Payer: United Healthcare Commercial |
$235.51
|
|
|
HC X-RAY EXAM OF FOREARM 2 VIEWS RT LTD
|
Facility
|
OP
|
$298.87
|
|
|
Service Code
|
CPT 73090 RT,52
|
| Hospital Charge Code |
11618033
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$277.95 |
| Rate for Payer: Aetna Commercial |
$252.25
|
| Rate for Payer: Aetna Medicare |
$95.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$92.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$171.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$186.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$109.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$105.20
|
| Rate for Payer: Cash Price |
$179.32
|
| Rate for Payer: Cash Price |
$179.32
|
| Rate for Payer: Centivo All Commercial |
$162.59
|
| Rate for Payer: Cigna All Commercial |
$257.92
|
| Rate for Payer: CORVEL All Commercial |
$277.95
|
| Rate for Payer: Coventry All Commercial |
$263.01
|
| Rate for Payer: Encore All Commercial |
$275.11
|
| Rate for Payer: Frontpath All Commercial |
$274.96
|
| Rate for Payer: Humana ChoiceCare |
$258.13
|
| Rate for Payer: Humana Medicare |
$95.64
|
| Rate for Payer: Lucent All Commercial |
$162.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$268.98
|
| Rate for Payer: Managed Health Services Medicaid |
$13.79
|
| Rate for Payer: MDWise Medicaid |
$13.79
|
| Rate for Payer: PHCS All Commercial |
$224.15
|
| Rate for Payer: PHP All Commercial |
$226.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.56
|
| Rate for Payer: Sagamore Health Network All Products |
$230.73
|
| Rate for Payer: Signature Care EPO |
$248.06
|
| Rate for Payer: Signature Care PPO |
$263.01
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$254.04
|
| Rate for Payer: United Healthcare Commercial |
$235.51
|
| Rate for Payer: United Healthcare Medicare |
$95.64
|
|
|
HC X-RAY EXAM OF FOREARM 2 VIEWS RT LTD
|
Facility
|
IP
|
$298.87
|
|
|
Service Code
|
CPT 73090 RT,52
|
| Hospital Charge Code |
11618033
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$224.15 |
| Max. Negotiated Rate |
$277.95 |
| Rate for Payer: Aetna Commercial |
$258.22
|
| Rate for Payer: Cash Price |
$179.32
|
| Rate for Payer: Cigna All Commercial |
$257.92
|
| Rate for Payer: CORVEL All Commercial |
$277.95
|
| Rate for Payer: Coventry All Commercial |
$263.01
|
| Rate for Payer: Encore All Commercial |
$275.11
|
| Rate for Payer: Frontpath All Commercial |
$274.96
|
| Rate for Payer: Humana ChoiceCare |
$258.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$268.98
|
| Rate for Payer: PHCS All Commercial |
$224.15
|
| Rate for Payer: PHP All Commercial |
$226.66
|
| Rate for Payer: Sagamore Health Network All Products |
$230.73
|
| Rate for Payer: Signature Care EPO |
$248.06
|
| Rate for Payer: Signature Care PPO |
$263.01
|
| Rate for Payer: United Healthcare Commercial |
$235.51
|
|
|
HC X-RAY EXAM OF HUMERUS 2+ VIEWS LT LTD
|
Facility
|
IP
|
$320.50
|
|
|
Service Code
|
CPT 73060 LT,52
|
| Hospital Charge Code |
1618031
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$240.38 |
| Max. Negotiated Rate |
$298.06 |
| Rate for Payer: Aetna Commercial |
$276.91
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cigna All Commercial |
$276.59
|
| Rate for Payer: CORVEL All Commercial |
$298.06
|
| Rate for Payer: Coventry All Commercial |
$282.04
|
| Rate for Payer: Encore All Commercial |
$295.02
|
| Rate for Payer: Frontpath All Commercial |
$294.86
|
| Rate for Payer: Humana ChoiceCare |
$276.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$288.45
|
| Rate for Payer: PHCS All Commercial |
$240.38
|
| Rate for Payer: PHP All Commercial |
$243.07
|
| Rate for Payer: Sagamore Health Network All Products |
$247.43
|
| Rate for Payer: Signature Care EPO |
$266.01
|
| Rate for Payer: Signature Care PPO |
$282.04
|
| Rate for Payer: United Healthcare Commercial |
$252.55
|
|
|
HC X-RAY EXAM OF HUMERUS 2+ VIEWS LT LTD
|
Facility
|
OP
|
$320.50
|
|
|
Service Code
|
CPT 73060 LT,52
|
| Hospital Charge Code |
1618031
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$298.06 |
| Rate for Payer: Aetna Commercial |
$270.50
|
| Rate for Payer: Aetna Medicare |
$102.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$184.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$200.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$117.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$112.82
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Centivo All Commercial |
$174.35
|
| Rate for Payer: Cigna All Commercial |
$276.59
|
| Rate for Payer: CORVEL All Commercial |
$298.06
|
| Rate for Payer: Coventry All Commercial |
$282.04
|
| Rate for Payer: Encore All Commercial |
$295.02
|
| Rate for Payer: Frontpath All Commercial |
$294.86
|
| Rate for Payer: Humana ChoiceCare |
$276.82
|
| Rate for Payer: Humana Medicare |
$102.56
|
| Rate for Payer: Lucent All Commercial |
$174.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$288.45
|
| Rate for Payer: Managed Health Services Medicaid |
$14.28
|
| Rate for Payer: MDWise Medicaid |
$14.28
|
| Rate for Payer: PHCS All Commercial |
$240.38
|
| Rate for Payer: PHP All Commercial |
$243.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$125.00
|
| Rate for Payer: Sagamore Health Network All Products |
$247.43
|
| Rate for Payer: Signature Care EPO |
$266.01
|
| Rate for Payer: Signature Care PPO |
$282.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$272.43
|
| Rate for Payer: United Healthcare Commercial |
$252.55
|
| Rate for Payer: United Healthcare Medicare |
$102.56
|
|
|
HC X-RAY EXAM OF HUMERUS 2+ VIEWS RT LTD
|
Facility
|
IP
|
$320.51
|
|
|
Service Code
|
CPT 73060 RT,52
|
| Hospital Charge Code |
11618031
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$240.38 |
| Max. Negotiated Rate |
$298.07 |
| Rate for Payer: Aetna Commercial |
$276.92
|
| Rate for Payer: Cash Price |
$192.31
|
| Rate for Payer: Cigna All Commercial |
$276.60
|
| Rate for Payer: CORVEL All Commercial |
$298.07
|
| Rate for Payer: Coventry All Commercial |
$282.05
|
| Rate for Payer: Encore All Commercial |
$295.03
|
| Rate for Payer: Frontpath All Commercial |
$294.87
|
| Rate for Payer: Humana ChoiceCare |
$276.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$288.46
|
| Rate for Payer: PHCS All Commercial |
$240.38
|
| Rate for Payer: PHP All Commercial |
$243.07
|
| Rate for Payer: Sagamore Health Network All Products |
$247.43
|
| Rate for Payer: Signature Care EPO |
$266.02
|
| Rate for Payer: Signature Care PPO |
$282.05
|
| Rate for Payer: United Healthcare Commercial |
$252.56
|
|
|
HC X-RAY EXAM OF HUMERUS 2+ VIEWS RT LTD
|
Facility
|
OP
|
$320.51
|
|
|
Service Code
|
CPT 73060 RT,52
|
| Hospital Charge Code |
11618031
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$298.07 |
| Rate for Payer: Aetna Commercial |
$270.51
|
| Rate for Payer: Aetna Medicare |
$102.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$184.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$200.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$117.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$112.82
|
| Rate for Payer: Cash Price |
$192.31
|
| Rate for Payer: Cash Price |
$192.31
|
| Rate for Payer: Centivo All Commercial |
$174.36
|
| Rate for Payer: Cigna All Commercial |
$276.60
|
| Rate for Payer: CORVEL All Commercial |
$298.07
|
| Rate for Payer: Coventry All Commercial |
$282.05
|
| Rate for Payer: Encore All Commercial |
$295.03
|
| Rate for Payer: Frontpath All Commercial |
$294.87
|
| Rate for Payer: Humana ChoiceCare |
$276.82
|
| Rate for Payer: Humana Medicare |
$102.56
|
| Rate for Payer: Lucent All Commercial |
$174.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$288.46
|
| Rate for Payer: Managed Health Services Medicaid |
$14.28
|
| Rate for Payer: MDWise Medicaid |
$14.28
|
| Rate for Payer: PHCS All Commercial |
$240.38
|
| Rate for Payer: PHP All Commercial |
$243.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$125.00
|
| Rate for Payer: Sagamore Health Network All Products |
$247.43
|
| Rate for Payer: Signature Care EPO |
$266.02
|
| Rate for Payer: Signature Care PPO |
$282.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$272.43
|
| Rate for Payer: United Healthcare Commercial |
$252.56
|
| Rate for Payer: United Healthcare Medicare |
$102.56
|
|
|
HC X-RAY-EYE-FOREIGN BODY
|
Facility
|
OP
|
$485.24
|
|
|
Service Code
|
CPT 70030 50
|
| Hospital Charge Code |
1610030
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$451.27 |
| Rate for Payer: Aetna Commercial |
$409.54
|
| Rate for Payer: Aetna Medicare |
$155.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$150.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$278.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$303.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$178.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$170.80
|
| Rate for Payer: Cash Price |
$291.14
|
| Rate for Payer: Cash Price |
$291.14
|
| Rate for Payer: Centivo All Commercial |
$263.97
|
| Rate for Payer: Cigna All Commercial |
$418.76
|
| Rate for Payer: CORVEL All Commercial |
$451.27
|
| Rate for Payer: Coventry All Commercial |
$427.01
|
| Rate for Payer: Encore All Commercial |
$446.66
|
| Rate for Payer: Frontpath All Commercial |
$446.42
|
| Rate for Payer: Humana ChoiceCare |
$419.10
|
| Rate for Payer: Humana Medicare |
$155.28
|
| Rate for Payer: Lucent All Commercial |
$263.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$436.72
|
| Rate for Payer: Managed Health Services Medicaid |
$14.78
|
| Rate for Payer: MDWise Medicaid |
$14.78
|
| Rate for Payer: PHCS All Commercial |
$363.93
|
| Rate for Payer: PHP All Commercial |
$368.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$189.24
|
| Rate for Payer: Sagamore Health Network All Products |
$374.61
|
| Rate for Payer: Signature Care EPO |
$402.75
|
| Rate for Payer: Signature Care PPO |
$427.01
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$412.45
|
| Rate for Payer: United Healthcare Commercial |
$382.37
|
| Rate for Payer: United Healthcare Medicare |
$155.28
|
|
|
HC X-RAY-EYE-FOREIGN BODY
|
Facility
|
IP
|
$485.24
|
|
|
Service Code
|
CPT 70030 50
|
| Hospital Charge Code |
1610030
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$363.93 |
| Max. Negotiated Rate |
$451.27 |
| Rate for Payer: Aetna Commercial |
$419.25
|
| Rate for Payer: Cash Price |
$291.14
|
| Rate for Payer: Cigna All Commercial |
$418.76
|
| Rate for Payer: CORVEL All Commercial |
$451.27
|
| Rate for Payer: Coventry All Commercial |
$427.01
|
| Rate for Payer: Encore All Commercial |
$446.66
|
| Rate for Payer: Frontpath All Commercial |
$446.42
|
| Rate for Payer: Humana ChoiceCare |
$419.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$436.72
|
| Rate for Payer: PHCS All Commercial |
$363.93
|
| Rate for Payer: PHP All Commercial |
$368.01
|
| Rate for Payer: Sagamore Health Network All Products |
$374.61
|
| Rate for Payer: Signature Care EPO |
$402.75
|
| Rate for Payer: Signature Care PPO |
$427.01
|
| Rate for Payer: United Healthcare Commercial |
$382.37
|
|
|
HC X-RAY-FACIAL BONES < 3 VIEWS
|
Facility
|
OP
|
$538.90
|
|
|
Service Code
|
CPT 70140
|
| Hospital Charge Code |
1610140
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.04 |
| Max. Negotiated Rate |
$501.18 |
| Rate for Payer: Aetna Commercial |
$454.83
|
| Rate for Payer: Aetna Medicare |
$172.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$167.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$309.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$336.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$198.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$189.69
|
| Rate for Payer: Cash Price |
$323.34
|
| Rate for Payer: Cash Price |
$323.34
|
| Rate for Payer: Centivo All Commercial |
$293.16
|
| Rate for Payer: Cigna All Commercial |
$465.07
|
| Rate for Payer: CORVEL All Commercial |
$501.18
|
| Rate for Payer: Coventry All Commercial |
$474.23
|
| Rate for Payer: Encore All Commercial |
$496.06
|
| Rate for Payer: Frontpath All Commercial |
$495.79
|
| Rate for Payer: Humana ChoiceCare |
$465.45
|
| Rate for Payer: Humana Medicare |
$172.45
|
| Rate for Payer: Lucent All Commercial |
$293.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$485.01
|
| Rate for Payer: Managed Health Services Medicaid |
$14.04
|
| Rate for Payer: MDWise Medicaid |
$14.04
|
| Rate for Payer: PHCS All Commercial |
$404.18
|
| Rate for Payer: PHP All Commercial |
$408.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$210.17
|
| Rate for Payer: Sagamore Health Network All Products |
$416.03
|
| Rate for Payer: Signature Care EPO |
$447.29
|
| Rate for Payer: Signature Care PPO |
$474.23
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$458.06
|
| Rate for Payer: United Healthcare Commercial |
$424.65
|
| Rate for Payer: United Healthcare Medicare |
$172.45
|
|
|
HC X-RAY-FACIAL BONES < 3 VIEWS
|
Facility
|
IP
|
$538.90
|
|
|
Service Code
|
CPT 70140
|
| Hospital Charge Code |
1610140
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$404.18 |
| Max. Negotiated Rate |
$501.18 |
| Rate for Payer: Aetna Commercial |
$465.61
|
| Rate for Payer: Cash Price |
$323.34
|
| Rate for Payer: Cigna All Commercial |
$465.07
|
| Rate for Payer: CORVEL All Commercial |
$501.18
|
| Rate for Payer: Coventry All Commercial |
$474.23
|
| Rate for Payer: Encore All Commercial |
$496.06
|
| Rate for Payer: Frontpath All Commercial |
$495.79
|
| Rate for Payer: Humana ChoiceCare |
$465.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$485.01
|
| Rate for Payer: PHCS All Commercial |
$404.18
|
| Rate for Payer: PHP All Commercial |
$408.70
|
| Rate for Payer: Sagamore Health Network All Products |
$416.03
|
| Rate for Payer: Signature Care EPO |
$447.29
|
| Rate for Payer: Signature Care PPO |
$474.23
|
| Rate for Payer: United Healthcare Commercial |
$424.65
|
|
|
HC X-RAY-FACIAL BONES 3+ VIEWS
|
Facility
|
OP
|
$622.16
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
1610150
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$20.97 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare |
$199.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$20.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$192.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$357.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$20.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$228.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$219.00
|
| Rate for Payer: Cash Price |
$373.30
|
| Rate for Payer: Cash Price |
$373.30
|
| Rate for Payer: Centivo All Commercial |
$338.46
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Humana Medicare |
$199.09
|
| Rate for Payer: Lucent All Commercial |
$338.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: Managed Health Services Medicaid |
$20.97
|
| Rate for Payer: MDWise Medicaid |
$20.97
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.64
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.84
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
| Rate for Payer: United Healthcare Medicare |
$199.09
|
|
|
HC X-RAY-FACIAL BONES 3+ VIEWS
|
Facility
|
IP
|
$622.16
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
1610150
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$466.62 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$537.55
|
| Rate for Payer: Cash Price |
$373.30
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
|
|
HC X-RAY-FEMUR 1 VIEW BILATERAL
|
Facility
|
OP
|
$575.79
|
|
|
Service Code
|
CPT 73551 50
|
| Hospital Charge Code |
21613551
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$13.29 |
| Max. Negotiated Rate |
$535.48 |
| Rate for Payer: Aetna Commercial |
$485.97
|
| Rate for Payer: Aetna Medicare |
$184.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$178.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$330.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$359.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$211.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$202.68
|
| Rate for Payer: Cash Price |
$345.47
|
| Rate for Payer: Cash Price |
$345.47
|
| Rate for Payer: Centivo All Commercial |
$313.23
|
| Rate for Payer: Cigna All Commercial |
$496.91
|
| Rate for Payer: CORVEL All Commercial |
$535.48
|
| Rate for Payer: Coventry All Commercial |
$506.70
|
| Rate for Payer: Encore All Commercial |
$530.01
|
| Rate for Payer: Frontpath All Commercial |
$529.73
|
| Rate for Payer: Humana ChoiceCare |
$497.31
|
| Rate for Payer: Humana Medicare |
$184.25
|
| Rate for Payer: Lucent All Commercial |
$313.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$518.21
|
| Rate for Payer: Managed Health Services Medicaid |
$13.29
|
| Rate for Payer: MDWise Medicaid |
$13.29
|
| Rate for Payer: PHCS All Commercial |
$431.84
|
| Rate for Payer: PHP All Commercial |
$436.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$224.56
|
| Rate for Payer: Sagamore Health Network All Products |
$444.51
|
| Rate for Payer: Signature Care EPO |
$477.91
|
| Rate for Payer: Signature Care PPO |
$506.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$489.42
|
| Rate for Payer: United Healthcare Commercial |
$453.72
|
| Rate for Payer: United Healthcare Medicare |
$184.25
|
|
|
HC X-RAY-FEMUR 1 VIEW BILATERAL
|
Facility
|
IP
|
$575.79
|
|
|
Service Code
|
CPT 73551 50
|
| Hospital Charge Code |
21613551
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$431.84 |
| Max. Negotiated Rate |
$535.48 |
| Rate for Payer: Aetna Commercial |
$497.48
|
| Rate for Payer: Cash Price |
$345.47
|
| Rate for Payer: Cigna All Commercial |
$496.91
|
| Rate for Payer: CORVEL All Commercial |
$535.48
|
| Rate for Payer: Coventry All Commercial |
$506.70
|
| Rate for Payer: Encore All Commercial |
$530.01
|
| Rate for Payer: Frontpath All Commercial |
$529.73
|
| Rate for Payer: Humana ChoiceCare |
$497.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$518.21
|
| Rate for Payer: PHCS All Commercial |
$431.84
|
| Rate for Payer: PHP All Commercial |
$436.68
|
| Rate for Payer: Sagamore Health Network All Products |
$444.51
|
| Rate for Payer: Signature Care EPO |
$477.91
|
| Rate for Payer: Signature Care PPO |
$506.70
|
| Rate for Payer: United Healthcare Commercial |
$453.72
|
|
|
HC X-RAY-FEMUR 1 VIEW LT
|
Facility
|
OP
|
$383.87
|
|
|
Service Code
|
CPT 73551 LT
|
| Hospital Charge Code |
1613551
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$13.29 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$323.99
|
| Rate for Payer: Aetna Medicare |
$122.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$119.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$220.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$239.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$141.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$135.12
|
| Rate for Payer: Cash Price |
$230.32
|
| Rate for Payer: Cash Price |
$230.32
|
| Rate for Payer: Centivo All Commercial |
$208.83
|
| Rate for Payer: Cigna All Commercial |
$331.28
|
| Rate for Payer: CORVEL All Commercial |
$357.00
|
| Rate for Payer: Coventry All Commercial |
$337.81
|
| Rate for Payer: Encore All Commercial |
$353.35
|
| Rate for Payer: Frontpath All Commercial |
$353.16
|
| Rate for Payer: Humana ChoiceCare |
$331.55
|
| Rate for Payer: Humana Medicare |
$122.84
|
| Rate for Payer: Lucent All Commercial |
$208.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$345.48
|
| Rate for Payer: Managed Health Services Medicaid |
$13.29
|
| Rate for Payer: MDWise Medicaid |
$13.29
|
| Rate for Payer: PHCS All Commercial |
$287.90
|
| Rate for Payer: PHP All Commercial |
$291.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$149.71
|
| Rate for Payer: Sagamore Health Network All Products |
$296.35
|
| Rate for Payer: Signature Care EPO |
$318.61
|
| Rate for Payer: Signature Care PPO |
$337.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$326.29
|
| Rate for Payer: United Healthcare Commercial |
$302.49
|
| Rate for Payer: United Healthcare Medicare |
$122.84
|
|
|
HC X-RAY-FEMUR 1 VIEW LT
|
Facility
|
IP
|
$383.87
|
|
|
Service Code
|
CPT 73551 LT
|
| Hospital Charge Code |
1613551
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$287.90 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$331.66
|
| Rate for Payer: Cash Price |
$230.32
|
| Rate for Payer: Cigna All Commercial |
$331.28
|
| Rate for Payer: CORVEL All Commercial |
$357.00
|
| Rate for Payer: Coventry All Commercial |
$337.81
|
| Rate for Payer: Encore All Commercial |
$353.35
|
| Rate for Payer: Frontpath All Commercial |
$353.16
|
| Rate for Payer: Humana ChoiceCare |
$331.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$345.48
|
| Rate for Payer: PHCS All Commercial |
$287.90
|
| Rate for Payer: PHP All Commercial |
$291.13
|
| Rate for Payer: Sagamore Health Network All Products |
$296.35
|
| Rate for Payer: Signature Care EPO |
$318.61
|
| Rate for Payer: Signature Care PPO |
$337.81
|
| Rate for Payer: United Healthcare Commercial |
$302.49
|
|
|
HC X-RAY-FEMUR 1 VIEW RT
|
Facility
|
OP
|
$383.87
|
|
|
Service Code
|
CPT 73551 RT
|
| Hospital Charge Code |
11613551
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$13.29 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$323.99
|
| Rate for Payer: Aetna Medicare |
$122.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$119.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$220.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$239.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$141.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$135.12
|
| Rate for Payer: Cash Price |
$230.32
|
| Rate for Payer: Cash Price |
$230.32
|
| Rate for Payer: Centivo All Commercial |
$208.83
|
| Rate for Payer: Cigna All Commercial |
$331.28
|
| Rate for Payer: CORVEL All Commercial |
$357.00
|
| Rate for Payer: Coventry All Commercial |
$337.81
|
| Rate for Payer: Encore All Commercial |
$353.35
|
| Rate for Payer: Frontpath All Commercial |
$353.16
|
| Rate for Payer: Humana ChoiceCare |
$331.55
|
| Rate for Payer: Humana Medicare |
$122.84
|
| Rate for Payer: Lucent All Commercial |
$208.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$345.48
|
| Rate for Payer: Managed Health Services Medicaid |
$13.29
|
| Rate for Payer: MDWise Medicaid |
$13.29
|
| Rate for Payer: PHCS All Commercial |
$287.90
|
| Rate for Payer: PHP All Commercial |
$291.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$149.71
|
| Rate for Payer: Sagamore Health Network All Products |
$296.35
|
| Rate for Payer: Signature Care EPO |
$318.61
|
| Rate for Payer: Signature Care PPO |
$337.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$326.29
|
| Rate for Payer: United Healthcare Commercial |
$302.49
|
| Rate for Payer: United Healthcare Medicare |
$122.84
|
|
