|
HC X-RAY-HAND 2 VIEWS RT
|
Facility
|
OP
|
$394.49
|
|
|
Service Code
|
CPT 73120 RT
|
| Hospital Charge Code |
11613120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$13.54 |
| Max. Negotiated Rate |
$366.88 |
| Rate for Payer: Aetna Commercial |
$332.95
|
| Rate for Payer: Aetna Medicare |
$126.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$122.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$226.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$246.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$145.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$138.86
|
| Rate for Payer: Cash Price |
$236.69
|
| Rate for Payer: Cash Price |
$236.69
|
| Rate for Payer: Centivo All Commercial |
$214.60
|
| Rate for Payer: Cigna All Commercial |
$340.44
|
| Rate for Payer: CORVEL All Commercial |
$366.88
|
| Rate for Payer: Coventry All Commercial |
$347.15
|
| Rate for Payer: Encore All Commercial |
$363.13
|
| Rate for Payer: Frontpath All Commercial |
$362.93
|
| Rate for Payer: Humana ChoiceCare |
$340.72
|
| Rate for Payer: Humana Medicare |
$126.24
|
| Rate for Payer: Lucent All Commercial |
$214.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$355.04
|
| Rate for Payer: Managed Health Services Medicaid |
$13.54
|
| Rate for Payer: MDWise Medicaid |
$13.54
|
| Rate for Payer: PHCS All Commercial |
$295.87
|
| Rate for Payer: PHP All Commercial |
$299.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$153.85
|
| Rate for Payer: Sagamore Health Network All Products |
$304.55
|
| Rate for Payer: Signature Care EPO |
$327.43
|
| Rate for Payer: Signature Care PPO |
$347.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$335.32
|
| Rate for Payer: United Healthcare Commercial |
$310.86
|
| Rate for Payer: United Healthcare Medicare |
$126.24
|
|
|
HC X-RAY-HAND MIN 3 VIEWS BI
|
Facility
|
IP
|
$674.24
|
|
|
Service Code
|
CPT 73130 50
|
| Hospital Charge Code |
21613130
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$505.68 |
| Max. Negotiated Rate |
$627.04 |
| Rate for Payer: Aetna Commercial |
$582.54
|
| Rate for Payer: Cash Price |
$404.54
|
| Rate for Payer: Cigna All Commercial |
$581.87
|
| Rate for Payer: CORVEL All Commercial |
$627.04
|
| Rate for Payer: Coventry All Commercial |
$593.33
|
| Rate for Payer: Encore All Commercial |
$620.64
|
| Rate for Payer: Frontpath All Commercial |
$620.30
|
| Rate for Payer: Humana ChoiceCare |
$582.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$606.82
|
| Rate for Payer: PHCS All Commercial |
$505.68
|
| Rate for Payer: PHP All Commercial |
$511.34
|
| Rate for Payer: Sagamore Health Network All Products |
$520.51
|
| Rate for Payer: Signature Care EPO |
$559.62
|
| Rate for Payer: Signature Care PPO |
$593.33
|
| Rate for Payer: United Healthcare Commercial |
$531.30
|
|
|
HC X-RAY-HAND MIN 3 VIEWS BI
|
Facility
|
OP
|
$674.24
|
|
|
Service Code
|
CPT 73130 50
|
| Hospital Charge Code |
21613130
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$627.04 |
| Rate for Payer: Aetna Commercial |
$569.06
|
| Rate for Payer: Aetna Medicare |
$215.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$209.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$387.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$421.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$248.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$237.33
|
| Rate for Payer: Cash Price |
$404.54
|
| Rate for Payer: Cash Price |
$404.54
|
| Rate for Payer: Centivo All Commercial |
$366.79
|
| Rate for Payer: Cigna All Commercial |
$581.87
|
| Rate for Payer: CORVEL All Commercial |
$627.04
|
| Rate for Payer: Coventry All Commercial |
$593.33
|
| Rate for Payer: Encore All Commercial |
$620.64
|
| Rate for Payer: Frontpath All Commercial |
$620.30
|
| Rate for Payer: Humana ChoiceCare |
$582.34
|
| Rate for Payer: Humana Medicare |
$215.76
|
| Rate for Payer: Lucent All Commercial |
$366.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$606.82
|
| Rate for Payer: Managed Health Services Medicaid |
$17.01
|
| Rate for Payer: MDWise Medicaid |
$17.01
|
| Rate for Payer: PHCS All Commercial |
$505.68
|
| Rate for Payer: PHP All Commercial |
$511.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$262.95
|
| Rate for Payer: Sagamore Health Network All Products |
$520.51
|
| Rate for Payer: Signature Care EPO |
$559.62
|
| Rate for Payer: Signature Care PPO |
$593.33
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$573.10
|
| Rate for Payer: United Healthcare Commercial |
$531.30
|
| Rate for Payer: United Healthcare Medicare |
$215.76
|
|
|
HC X-RAY-HAND MIN 3 VIEWS LT
|
Facility
|
IP
|
$449.48
|
|
|
Service Code
|
CPT 73130 LT
|
| Hospital Charge Code |
1613130
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$337.11 |
| Max. Negotiated Rate |
$418.02 |
| Rate for Payer: Aetna Commercial |
$388.35
|
| Rate for Payer: Cash Price |
$269.69
|
| Rate for Payer: Cigna All Commercial |
$387.90
|
| Rate for Payer: CORVEL All Commercial |
$418.02
|
| Rate for Payer: Coventry All Commercial |
$395.54
|
| Rate for Payer: Encore All Commercial |
$413.75
|
| Rate for Payer: Frontpath All Commercial |
$413.52
|
| Rate for Payer: Humana ChoiceCare |
$388.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$404.53
|
| Rate for Payer: PHCS All Commercial |
$337.11
|
| Rate for Payer: PHP All Commercial |
$340.89
|
| Rate for Payer: Sagamore Health Network All Products |
$347.00
|
| Rate for Payer: Signature Care EPO |
$373.07
|
| Rate for Payer: Signature Care PPO |
$395.54
|
| Rate for Payer: United Healthcare Commercial |
$354.19
|
|
|
HC X-RAY-HAND MIN 3 VIEWS LT
|
Facility
|
OP
|
$449.48
|
|
|
Service Code
|
CPT 73130 LT
|
| Hospital Charge Code |
1613130
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$418.02 |
| Rate for Payer: Aetna Commercial |
$379.36
|
| Rate for Payer: Aetna Medicare |
$143.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$139.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$258.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$280.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$165.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$158.22
|
| Rate for Payer: Cash Price |
$269.69
|
| Rate for Payer: Cash Price |
$269.69
|
| Rate for Payer: Centivo All Commercial |
$244.52
|
| Rate for Payer: Cigna All Commercial |
$387.90
|
| Rate for Payer: CORVEL All Commercial |
$418.02
|
| Rate for Payer: Coventry All Commercial |
$395.54
|
| Rate for Payer: Encore All Commercial |
$413.75
|
| Rate for Payer: Frontpath All Commercial |
$413.52
|
| Rate for Payer: Humana ChoiceCare |
$388.22
|
| Rate for Payer: Humana Medicare |
$143.83
|
| Rate for Payer: Lucent All Commercial |
$244.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$404.53
|
| Rate for Payer: Managed Health Services Medicaid |
$17.01
|
| Rate for Payer: MDWise Medicaid |
$17.01
|
| Rate for Payer: PHCS All Commercial |
$337.11
|
| Rate for Payer: PHP All Commercial |
$340.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$175.30
|
| Rate for Payer: Sagamore Health Network All Products |
$347.00
|
| Rate for Payer: Signature Care EPO |
$373.07
|
| Rate for Payer: Signature Care PPO |
$395.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$382.06
|
| Rate for Payer: United Healthcare Commercial |
$354.19
|
| Rate for Payer: United Healthcare Medicare |
$143.83
|
|
|
HC X-RAY-HAND MIN 3 VIEWS RT
|
Facility
|
OP
|
$449.48
|
|
|
Service Code
|
CPT 73130 RT
|
| Hospital Charge Code |
11613130
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$418.02 |
| Rate for Payer: Aetna Commercial |
$379.36
|
| Rate for Payer: Aetna Medicare |
$143.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$139.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$258.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$280.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$165.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$158.22
|
| Rate for Payer: Cash Price |
$269.69
|
| Rate for Payer: Cash Price |
$269.69
|
| Rate for Payer: Centivo All Commercial |
$244.52
|
| Rate for Payer: Cigna All Commercial |
$387.90
|
| Rate for Payer: CORVEL All Commercial |
$418.02
|
| Rate for Payer: Coventry All Commercial |
$395.54
|
| Rate for Payer: Encore All Commercial |
$413.75
|
| Rate for Payer: Frontpath All Commercial |
$413.52
|
| Rate for Payer: Humana ChoiceCare |
$388.22
|
| Rate for Payer: Humana Medicare |
$143.83
|
| Rate for Payer: Lucent All Commercial |
$244.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$404.53
|
| Rate for Payer: Managed Health Services Medicaid |
$17.01
|
| Rate for Payer: MDWise Medicaid |
$17.01
|
| Rate for Payer: PHCS All Commercial |
$337.11
|
| Rate for Payer: PHP All Commercial |
$340.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$175.30
|
| Rate for Payer: Sagamore Health Network All Products |
$347.00
|
| Rate for Payer: Signature Care EPO |
$373.07
|
| Rate for Payer: Signature Care PPO |
$395.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$382.06
|
| Rate for Payer: United Healthcare Commercial |
$354.19
|
| Rate for Payer: United Healthcare Medicare |
$143.83
|
|
|
HC X-RAY-HAND MIN 3 VIEWS RT
|
Facility
|
IP
|
$449.48
|
|
|
Service Code
|
CPT 73130 RT
|
| Hospital Charge Code |
11613130
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$337.11 |
| Max. Negotiated Rate |
$418.02 |
| Rate for Payer: Aetna Commercial |
$388.35
|
| Rate for Payer: Cash Price |
$269.69
|
| Rate for Payer: Cigna All Commercial |
$387.90
|
| Rate for Payer: CORVEL All Commercial |
$418.02
|
| Rate for Payer: Coventry All Commercial |
$395.54
|
| Rate for Payer: Encore All Commercial |
$413.75
|
| Rate for Payer: Frontpath All Commercial |
$413.52
|
| Rate for Payer: Humana ChoiceCare |
$388.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$404.53
|
| Rate for Payer: PHCS All Commercial |
$337.11
|
| Rate for Payer: PHP All Commercial |
$340.89
|
| Rate for Payer: Sagamore Health Network All Products |
$347.00
|
| Rate for Payer: Signature Care EPO |
$373.07
|
| Rate for Payer: Signature Care PPO |
$395.54
|
| Rate for Payer: United Healthcare Commercial |
$354.19
|
|
|
HC X-RAY-HIP AP ONLY LT
|
Facility
|
OP
|
$329.07
|
|
|
Service Code
|
CPT 73501 LT
|
| Hospital Charge Code |
1613500
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.04 |
| Max. Negotiated Rate |
$306.04 |
| Rate for Payer: Aetna Commercial |
$277.74
|
| Rate for Payer: Aetna Medicare |
$105.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$102.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$188.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$205.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$121.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$115.83
|
| Rate for Payer: Cash Price |
$197.44
|
| Rate for Payer: Cash Price |
$197.44
|
| Rate for Payer: Centivo All Commercial |
$179.01
|
| Rate for Payer: Cigna All Commercial |
$283.99
|
| Rate for Payer: CORVEL All Commercial |
$306.04
|
| Rate for Payer: Coventry All Commercial |
$289.58
|
| Rate for Payer: Encore All Commercial |
$302.91
|
| Rate for Payer: Frontpath All Commercial |
$302.74
|
| Rate for Payer: Humana ChoiceCare |
$284.22
|
| Rate for Payer: Humana Medicare |
$105.30
|
| Rate for Payer: Lucent All Commercial |
$179.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$296.16
|
| Rate for Payer: Managed Health Services Medicaid |
$14.04
|
| Rate for Payer: MDWise Medicaid |
$14.04
|
| Rate for Payer: PHCS All Commercial |
$246.80
|
| Rate for Payer: PHP All Commercial |
$249.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$128.34
|
| Rate for Payer: Sagamore Health Network All Products |
$254.04
|
| Rate for Payer: Signature Care EPO |
$273.13
|
| Rate for Payer: Signature Care PPO |
$289.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$279.71
|
| Rate for Payer: United Healthcare Commercial |
$259.31
|
| Rate for Payer: United Healthcare Medicare |
$105.30
|
|
|
HC X-RAY-HIP AP ONLY LT
|
Facility
|
IP
|
$329.07
|
|
|
Service Code
|
CPT 73501 LT
|
| Hospital Charge Code |
1613500
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$246.80 |
| Max. Negotiated Rate |
$306.04 |
| Rate for Payer: Aetna Commercial |
$284.32
|
| Rate for Payer: Cash Price |
$197.44
|
| Rate for Payer: Cigna All Commercial |
$283.99
|
| Rate for Payer: CORVEL All Commercial |
$306.04
|
| Rate for Payer: Coventry All Commercial |
$289.58
|
| Rate for Payer: Encore All Commercial |
$302.91
|
| Rate for Payer: Frontpath All Commercial |
$302.74
|
| Rate for Payer: Humana ChoiceCare |
$284.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$296.16
|
| Rate for Payer: PHCS All Commercial |
$246.80
|
| Rate for Payer: PHP All Commercial |
$249.57
|
| Rate for Payer: Sagamore Health Network All Products |
$254.04
|
| Rate for Payer: Signature Care EPO |
$273.13
|
| Rate for Payer: Signature Care PPO |
$289.58
|
| Rate for Payer: United Healthcare Commercial |
$259.31
|
|
|
HC X-RAY-HIP AP ONLY RT
|
Facility
|
OP
|
$329.07
|
|
|
Service Code
|
CPT 73501 RT
|
| Hospital Charge Code |
11613500
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.04 |
| Max. Negotiated Rate |
$306.04 |
| Rate for Payer: Aetna Commercial |
$277.74
|
| Rate for Payer: Aetna Medicare |
$105.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$102.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$188.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$205.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$121.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$115.83
|
| Rate for Payer: Cash Price |
$197.44
|
| Rate for Payer: Cash Price |
$197.44
|
| Rate for Payer: Centivo All Commercial |
$179.01
|
| Rate for Payer: Cigna All Commercial |
$283.99
|
| Rate for Payer: CORVEL All Commercial |
$306.04
|
| Rate for Payer: Coventry All Commercial |
$289.58
|
| Rate for Payer: Encore All Commercial |
$302.91
|
| Rate for Payer: Frontpath All Commercial |
$302.74
|
| Rate for Payer: Humana ChoiceCare |
$284.22
|
| Rate for Payer: Humana Medicare |
$105.30
|
| Rate for Payer: Lucent All Commercial |
$179.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$296.16
|
| Rate for Payer: Managed Health Services Medicaid |
$14.04
|
| Rate for Payer: MDWise Medicaid |
$14.04
|
| Rate for Payer: PHCS All Commercial |
$246.80
|
| Rate for Payer: PHP All Commercial |
$249.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$128.34
|
| Rate for Payer: Sagamore Health Network All Products |
$254.04
|
| Rate for Payer: Signature Care EPO |
$273.13
|
| Rate for Payer: Signature Care PPO |
$289.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$279.71
|
| Rate for Payer: United Healthcare Commercial |
$259.31
|
| Rate for Payer: United Healthcare Medicare |
$105.30
|
|
|
HC X-RAY-HIP AP ONLY RT
|
Facility
|
IP
|
$329.07
|
|
|
Service Code
|
CPT 73501 RT
|
| Hospital Charge Code |
11613500
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$246.80 |
| Max. Negotiated Rate |
$306.04 |
| Rate for Payer: Aetna Commercial |
$284.32
|
| Rate for Payer: Cash Price |
$197.44
|
| Rate for Payer: Cigna All Commercial |
$283.99
|
| Rate for Payer: CORVEL All Commercial |
$306.04
|
| Rate for Payer: Coventry All Commercial |
$289.58
|
| Rate for Payer: Encore All Commercial |
$302.91
|
| Rate for Payer: Frontpath All Commercial |
$302.74
|
| Rate for Payer: Humana ChoiceCare |
$284.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$296.16
|
| Rate for Payer: PHCS All Commercial |
$246.80
|
| Rate for Payer: PHP All Commercial |
$249.57
|
| Rate for Payer: Sagamore Health Network All Products |
$254.04
|
| Rate for Payer: Signature Care EPO |
$273.13
|
| Rate for Payer: Signature Care PPO |
$289.58
|
| Rate for Payer: United Healthcare Commercial |
$259.31
|
|
|
HC X-RAY-HUMERUS MIN 2 VIEWS BI
|
Facility
|
IP
|
$641.01
|
|
|
Service Code
|
CPT 73060 50
|
| Hospital Charge Code |
21613060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$480.76 |
| Max. Negotiated Rate |
$596.14 |
| Rate for Payer: Aetna Commercial |
$553.83
|
| Rate for Payer: Cash Price |
$384.61
|
| Rate for Payer: Cigna All Commercial |
$553.19
|
| Rate for Payer: CORVEL All Commercial |
$596.14
|
| Rate for Payer: Coventry All Commercial |
$564.09
|
| Rate for Payer: Encore All Commercial |
$590.05
|
| Rate for Payer: Frontpath All Commercial |
$589.73
|
| Rate for Payer: Humana ChoiceCare |
$553.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$576.91
|
| Rate for Payer: PHCS All Commercial |
$480.76
|
| Rate for Payer: PHP All Commercial |
$486.14
|
| Rate for Payer: Sagamore Health Network All Products |
$494.86
|
| Rate for Payer: Signature Care EPO |
$532.04
|
| Rate for Payer: Signature Care PPO |
$564.09
|
| Rate for Payer: United Healthcare Commercial |
$505.12
|
|
|
HC X-RAY-HUMERUS MIN 2 VIEWS BI
|
Facility
|
OP
|
$641.01
|
|
|
Service Code
|
CPT 73060 50
|
| Hospital Charge Code |
21613060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$596.14 |
| Rate for Payer: Aetna Commercial |
$541.01
|
| Rate for Payer: Aetna Medicare |
$205.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$198.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$368.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$400.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$235.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.64
|
| Rate for Payer: Cash Price |
$384.61
|
| Rate for Payer: Cash Price |
$384.61
|
| Rate for Payer: Centivo All Commercial |
$348.71
|
| Rate for Payer: Cigna All Commercial |
$553.19
|
| Rate for Payer: CORVEL All Commercial |
$596.14
|
| Rate for Payer: Coventry All Commercial |
$564.09
|
| Rate for Payer: Encore All Commercial |
$590.05
|
| Rate for Payer: Frontpath All Commercial |
$589.73
|
| Rate for Payer: Humana ChoiceCare |
$553.64
|
| Rate for Payer: Humana Medicare |
$205.12
|
| Rate for Payer: Lucent All Commercial |
$348.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$576.91
|
| Rate for Payer: Managed Health Services Medicaid |
$14.28
|
| Rate for Payer: MDWise Medicaid |
$14.28
|
| Rate for Payer: PHCS All Commercial |
$480.76
|
| Rate for Payer: PHP All Commercial |
$486.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$249.99
|
| Rate for Payer: Sagamore Health Network All Products |
$494.86
|
| Rate for Payer: Signature Care EPO |
$532.04
|
| Rate for Payer: Signature Care PPO |
$564.09
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$544.86
|
| Rate for Payer: United Healthcare Commercial |
$505.12
|
| Rate for Payer: United Healthcare Medicare |
$205.12
|
|
|
HC X-RAY-HUMERUS MIN 2 VIEWS LT
|
Facility
|
IP
|
$427.33
|
|
|
Service Code
|
CPT 73060 LT
|
| Hospital Charge Code |
1613060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$320.50 |
| Max. Negotiated Rate |
$397.42 |
| Rate for Payer: Aetna Commercial |
$369.21
|
| Rate for Payer: Cash Price |
$256.40
|
| Rate for Payer: Cigna All Commercial |
$368.79
|
| Rate for Payer: CORVEL All Commercial |
$397.42
|
| Rate for Payer: Coventry All Commercial |
$376.05
|
| Rate for Payer: Encore All Commercial |
$393.36
|
| Rate for Payer: Frontpath All Commercial |
$393.14
|
| Rate for Payer: Humana ChoiceCare |
$369.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$384.60
|
| Rate for Payer: PHCS All Commercial |
$320.50
|
| Rate for Payer: PHP All Commercial |
$324.09
|
| Rate for Payer: Sagamore Health Network All Products |
$329.90
|
| Rate for Payer: Signature Care EPO |
$354.68
|
| Rate for Payer: Signature Care PPO |
$376.05
|
| Rate for Payer: United Healthcare Commercial |
$336.74
|
|
|
HC X-RAY-HUMERUS MIN 2 VIEWS LT
|
Facility
|
OP
|
$427.33
|
|
|
Service Code
|
CPT 73060 LT
|
| Hospital Charge Code |
1613060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$397.42 |
| Rate for Payer: Aetna Commercial |
$360.67
|
| Rate for Payer: Aetna Medicare |
$136.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$132.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$245.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$267.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$157.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$150.42
|
| Rate for Payer: Cash Price |
$256.40
|
| Rate for Payer: Cash Price |
$256.40
|
| Rate for Payer: Centivo All Commercial |
$232.47
|
| Rate for Payer: Cigna All Commercial |
$368.79
|
| Rate for Payer: CORVEL All Commercial |
$397.42
|
| Rate for Payer: Coventry All Commercial |
$376.05
|
| Rate for Payer: Encore All Commercial |
$393.36
|
| Rate for Payer: Frontpath All Commercial |
$393.14
|
| Rate for Payer: Humana ChoiceCare |
$369.08
|
| Rate for Payer: Humana Medicare |
$136.75
|
| Rate for Payer: Lucent All Commercial |
$232.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$384.60
|
| Rate for Payer: Managed Health Services Medicaid |
$14.28
|
| Rate for Payer: MDWise Medicaid |
$14.28
|
| Rate for Payer: PHCS All Commercial |
$320.50
|
| Rate for Payer: PHP All Commercial |
$324.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$166.66
|
| Rate for Payer: Sagamore Health Network All Products |
$329.90
|
| Rate for Payer: Signature Care EPO |
$354.68
|
| Rate for Payer: Signature Care PPO |
$376.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$363.23
|
| Rate for Payer: United Healthcare Commercial |
$336.74
|
| Rate for Payer: United Healthcare Medicare |
$136.75
|
|
|
HC X-RAY-HUMERUS MIN 2 VIEWS RT
|
Facility
|
IP
|
$427.33
|
|
|
Service Code
|
CPT 73060 RT
|
| Hospital Charge Code |
11613060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$320.50 |
| Max. Negotiated Rate |
$397.42 |
| Rate for Payer: Aetna Commercial |
$369.21
|
| Rate for Payer: Cash Price |
$256.40
|
| Rate for Payer: Cigna All Commercial |
$368.79
|
| Rate for Payer: CORVEL All Commercial |
$397.42
|
| Rate for Payer: Coventry All Commercial |
$376.05
|
| Rate for Payer: Encore All Commercial |
$393.36
|
| Rate for Payer: Frontpath All Commercial |
$393.14
|
| Rate for Payer: Humana ChoiceCare |
$369.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$384.60
|
| Rate for Payer: PHCS All Commercial |
$320.50
|
| Rate for Payer: PHP All Commercial |
$324.09
|
| Rate for Payer: Sagamore Health Network All Products |
$329.90
|
| Rate for Payer: Signature Care EPO |
$354.68
|
| Rate for Payer: Signature Care PPO |
$376.05
|
| Rate for Payer: United Healthcare Commercial |
$336.74
|
|
|
HC X-RAY-HUMERUS MIN 2 VIEWS RT
|
Facility
|
OP
|
$427.33
|
|
|
Service Code
|
CPT 73060 RT
|
| Hospital Charge Code |
11613060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$397.42 |
| Rate for Payer: Aetna Commercial |
$360.67
|
| Rate for Payer: Aetna Medicare |
$136.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$132.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$245.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$267.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$157.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$150.42
|
| Rate for Payer: Cash Price |
$256.40
|
| Rate for Payer: Cash Price |
$256.40
|
| Rate for Payer: Centivo All Commercial |
$232.47
|
| Rate for Payer: Cigna All Commercial |
$368.79
|
| Rate for Payer: CORVEL All Commercial |
$397.42
|
| Rate for Payer: Coventry All Commercial |
$376.05
|
| Rate for Payer: Encore All Commercial |
$393.36
|
| Rate for Payer: Frontpath All Commercial |
$393.14
|
| Rate for Payer: Humana ChoiceCare |
$369.08
|
| Rate for Payer: Humana Medicare |
$136.75
|
| Rate for Payer: Lucent All Commercial |
$232.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$384.60
|
| Rate for Payer: Managed Health Services Medicaid |
$14.28
|
| Rate for Payer: MDWise Medicaid |
$14.28
|
| Rate for Payer: PHCS All Commercial |
$320.50
|
| Rate for Payer: PHP All Commercial |
$324.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$166.66
|
| Rate for Payer: Sagamore Health Network All Products |
$329.90
|
| Rate for Payer: Signature Care EPO |
$354.68
|
| Rate for Payer: Signature Care PPO |
$376.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$363.23
|
| Rate for Payer: United Healthcare Commercial |
$336.74
|
| Rate for Payer: United Healthcare Medicare |
$136.75
|
|
|
HC X-RAY-IVP WITHOUT TOMO
|
Facility
|
IP
|
$1,263.77
|
|
|
Service Code
|
CPT 74410
|
| Hospital Charge Code |
1618410
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$947.83 |
| Max. Negotiated Rate |
$1,175.31 |
| Rate for Payer: Aetna Commercial |
$1,091.90
|
| Rate for Payer: Cash Price |
$758.26
|
| Rate for Payer: Cigna All Commercial |
$1,090.63
|
| Rate for Payer: CORVEL All Commercial |
$1,175.31
|
| Rate for Payer: Coventry All Commercial |
$1,112.12
|
| Rate for Payer: Encore All Commercial |
$1,163.30
|
| Rate for Payer: Frontpath All Commercial |
$1,162.67
|
| Rate for Payer: Humana ChoiceCare |
$1,091.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,137.39
|
| Rate for Payer: PHCS All Commercial |
$947.83
|
| Rate for Payer: PHP All Commercial |
$958.44
|
| Rate for Payer: Sagamore Health Network All Products |
$975.63
|
| Rate for Payer: Signature Care EPO |
$1,048.93
|
| Rate for Payer: Signature Care PPO |
$1,112.12
|
| Rate for Payer: United Healthcare Commercial |
$995.85
|
|
|
HC X-RAY-IVP WITHOUT TOMO
|
Facility
|
OP
|
$1,263.77
|
|
|
Service Code
|
CPT 74410
|
| Hospital Charge Code |
1618410
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$61.35 |
| Max. Negotiated Rate |
$1,175.31 |
| Rate for Payer: Aetna Commercial |
$1,066.62
|
| Rate for Payer: Aetna Medicare |
$404.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$61.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$391.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$725.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$789.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$61.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$465.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$444.85
|
| Rate for Payer: Cash Price |
$758.26
|
| Rate for Payer: Cash Price |
$758.26
|
| Rate for Payer: Centivo All Commercial |
$687.49
|
| Rate for Payer: Cigna All Commercial |
$1,090.63
|
| Rate for Payer: CORVEL All Commercial |
$1,175.31
|
| Rate for Payer: Coventry All Commercial |
$1,112.12
|
| Rate for Payer: Encore All Commercial |
$1,163.30
|
| Rate for Payer: Frontpath All Commercial |
$1,162.67
|
| Rate for Payer: Humana ChoiceCare |
$1,091.52
|
| Rate for Payer: Humana Medicare |
$404.41
|
| Rate for Payer: Lucent All Commercial |
$687.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,137.39
|
| Rate for Payer: Managed Health Services Medicaid |
$61.35
|
| Rate for Payer: MDWise Medicaid |
$61.35
|
| Rate for Payer: PHCS All Commercial |
$947.83
|
| Rate for Payer: PHP All Commercial |
$958.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$492.87
|
| Rate for Payer: Sagamore Health Network All Products |
$975.63
|
| Rate for Payer: Signature Care EPO |
$1,048.93
|
| Rate for Payer: Signature Care PPO |
$1,112.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,074.20
|
| Rate for Payer: United Healthcare Commercial |
$995.85
|
| Rate for Payer: United Healthcare Medicare |
$404.41
|
|
|
HC X-RAY-KNEE - 4 VWS OR MORE BI
|
Facility
|
IP
|
$892.30
|
|
|
Service Code
|
CPT 73564 50
|
| Hospital Charge Code |
21613564
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$669.23 |
| Max. Negotiated Rate |
$829.84 |
| Rate for Payer: Aetna Commercial |
$770.95
|
| Rate for Payer: Cash Price |
$535.38
|
| Rate for Payer: Cigna All Commercial |
$770.05
|
| Rate for Payer: CORVEL All Commercial |
$829.84
|
| Rate for Payer: Coventry All Commercial |
$785.22
|
| Rate for Payer: Encore All Commercial |
$821.36
|
| Rate for Payer: Frontpath All Commercial |
$820.92
|
| Rate for Payer: Humana ChoiceCare |
$770.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$803.07
|
| Rate for Payer: PHCS All Commercial |
$669.23
|
| Rate for Payer: PHP All Commercial |
$676.72
|
| Rate for Payer: Sagamore Health Network All Products |
$688.86
|
| Rate for Payer: Signature Care EPO |
$740.61
|
| Rate for Payer: Signature Care PPO |
$785.22
|
| Rate for Payer: United Healthcare Commercial |
$703.13
|
|
|
HC X-RAY-KNEE - 4 VWS OR MORE BI
|
Facility
|
OP
|
$892.30
|
|
|
Service Code
|
CPT 73564 50
|
| Hospital Charge Code |
21613564
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$22.21 |
| Max. Negotiated Rate |
$829.84 |
| Rate for Payer: Aetna Commercial |
$753.10
|
| Rate for Payer: Aetna Medicare |
$285.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$22.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$276.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$512.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$557.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$22.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$328.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$314.09
|
| Rate for Payer: Cash Price |
$535.38
|
| Rate for Payer: Cash Price |
$535.38
|
| Rate for Payer: Centivo All Commercial |
$485.41
|
| Rate for Payer: Cigna All Commercial |
$770.05
|
| Rate for Payer: CORVEL All Commercial |
$829.84
|
| Rate for Payer: Coventry All Commercial |
$785.22
|
| Rate for Payer: Encore All Commercial |
$821.36
|
| Rate for Payer: Frontpath All Commercial |
$820.92
|
| Rate for Payer: Humana ChoiceCare |
$770.68
|
| Rate for Payer: Humana Medicare |
$285.54
|
| Rate for Payer: Lucent All Commercial |
$485.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$803.07
|
| Rate for Payer: Managed Health Services Medicaid |
$22.21
|
| Rate for Payer: MDWise Medicaid |
$22.21
|
| Rate for Payer: PHCS All Commercial |
$669.23
|
| Rate for Payer: PHP All Commercial |
$676.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$348.00
|
| Rate for Payer: Sagamore Health Network All Products |
$688.86
|
| Rate for Payer: Signature Care EPO |
$740.61
|
| Rate for Payer: Signature Care PPO |
$785.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$758.46
|
| Rate for Payer: United Healthcare Commercial |
$703.13
|
| Rate for Payer: United Healthcare Medicare |
$285.54
|
|
|
HC X-RAY-KNEE - 4 VWS OR MORE LT
|
Facility
|
OP
|
$594.86
|
|
|
Service Code
|
CPT 73564 LT
|
| Hospital Charge Code |
1613564
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$22.21 |
| Max. Negotiated Rate |
$553.22 |
| Rate for Payer: Aetna Commercial |
$502.06
|
| Rate for Payer: Aetna Medicare |
$190.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$22.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$184.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$341.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$371.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$22.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$218.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$209.39
|
| Rate for Payer: Cash Price |
$356.92
|
| Rate for Payer: Cash Price |
$356.92
|
| Rate for Payer: Centivo All Commercial |
$323.60
|
| Rate for Payer: Cigna All Commercial |
$513.36
|
| Rate for Payer: CORVEL All Commercial |
$553.22
|
| Rate for Payer: Coventry All Commercial |
$523.48
|
| Rate for Payer: Encore All Commercial |
$547.57
|
| Rate for Payer: Frontpath All Commercial |
$547.27
|
| Rate for Payer: Humana ChoiceCare |
$513.78
|
| Rate for Payer: Humana Medicare |
$190.36
|
| Rate for Payer: Lucent All Commercial |
$323.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$535.37
|
| Rate for Payer: Managed Health Services Medicaid |
$22.21
|
| Rate for Payer: MDWise Medicaid |
$22.21
|
| Rate for Payer: PHCS All Commercial |
$446.14
|
| Rate for Payer: PHP All Commercial |
$451.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$232.00
|
| Rate for Payer: Sagamore Health Network All Products |
$459.23
|
| Rate for Payer: Signature Care EPO |
$493.73
|
| Rate for Payer: Signature Care PPO |
$523.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$505.63
|
| Rate for Payer: United Healthcare Commercial |
$468.75
|
| Rate for Payer: United Healthcare Medicare |
$190.36
|
|
|
HC X-RAY-KNEE - 4 VWS OR MORE LT
|
Facility
|
IP
|
$594.86
|
|
|
Service Code
|
CPT 73564 LT
|
| Hospital Charge Code |
1613564
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$446.14 |
| Max. Negotiated Rate |
$553.22 |
| Rate for Payer: Aetna Commercial |
$513.96
|
| Rate for Payer: Cash Price |
$356.92
|
| Rate for Payer: Cigna All Commercial |
$513.36
|
| Rate for Payer: CORVEL All Commercial |
$553.22
|
| Rate for Payer: Coventry All Commercial |
$523.48
|
| Rate for Payer: Encore All Commercial |
$547.57
|
| Rate for Payer: Frontpath All Commercial |
$547.27
|
| Rate for Payer: Humana ChoiceCare |
$513.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$535.37
|
| Rate for Payer: PHCS All Commercial |
$446.14
|
| Rate for Payer: PHP All Commercial |
$451.14
|
| Rate for Payer: Sagamore Health Network All Products |
$459.23
|
| Rate for Payer: Signature Care EPO |
$493.73
|
| Rate for Payer: Signature Care PPO |
$523.48
|
| Rate for Payer: United Healthcare Commercial |
$468.75
|
|
|
HC X-RAY-KNEE - 4 VWS OR MORE RT
|
Facility
|
IP
|
$594.86
|
|
|
Service Code
|
CPT 73564 RT
|
| Hospital Charge Code |
11613564
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$446.14 |
| Max. Negotiated Rate |
$553.22 |
| Rate for Payer: Aetna Commercial |
$513.96
|
| Rate for Payer: Cash Price |
$356.92
|
| Rate for Payer: Cigna All Commercial |
$513.36
|
| Rate for Payer: CORVEL All Commercial |
$553.22
|
| Rate for Payer: Coventry All Commercial |
$523.48
|
| Rate for Payer: Encore All Commercial |
$547.57
|
| Rate for Payer: Frontpath All Commercial |
$547.27
|
| Rate for Payer: Humana ChoiceCare |
$513.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$535.37
|
| Rate for Payer: PHCS All Commercial |
$446.14
|
| Rate for Payer: PHP All Commercial |
$451.14
|
| Rate for Payer: Sagamore Health Network All Products |
$459.23
|
| Rate for Payer: Signature Care EPO |
$493.73
|
| Rate for Payer: Signature Care PPO |
$523.48
|
| Rate for Payer: United Healthcare Commercial |
$468.75
|
|
|
HC X-RAY-KNEE - 4 VWS OR MORE RT
|
Facility
|
OP
|
$594.86
|
|
|
Service Code
|
CPT 73564 RT
|
| Hospital Charge Code |
11613564
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$22.21 |
| Max. Negotiated Rate |
$553.22 |
| Rate for Payer: Aetna Commercial |
$502.06
|
| Rate for Payer: Aetna Medicare |
$190.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$22.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$184.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$341.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$371.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$22.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$218.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$209.39
|
| Rate for Payer: Cash Price |
$356.92
|
| Rate for Payer: Cash Price |
$356.92
|
| Rate for Payer: Centivo All Commercial |
$323.60
|
| Rate for Payer: Cigna All Commercial |
$513.36
|
| Rate for Payer: CORVEL All Commercial |
$553.22
|
| Rate for Payer: Coventry All Commercial |
$523.48
|
| Rate for Payer: Encore All Commercial |
$547.57
|
| Rate for Payer: Frontpath All Commercial |
$547.27
|
| Rate for Payer: Humana ChoiceCare |
$513.78
|
| Rate for Payer: Humana Medicare |
$190.36
|
| Rate for Payer: Lucent All Commercial |
$323.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$535.37
|
| Rate for Payer: Managed Health Services Medicaid |
$22.21
|
| Rate for Payer: MDWise Medicaid |
$22.21
|
| Rate for Payer: PHCS All Commercial |
$446.14
|
| Rate for Payer: PHP All Commercial |
$451.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$232.00
|
| Rate for Payer: Sagamore Health Network All Products |
$459.23
|
| Rate for Payer: Signature Care EPO |
$493.73
|
| Rate for Payer: Signature Care PPO |
$523.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$505.63
|
| Rate for Payer: United Healthcare Commercial |
$468.75
|
| Rate for Payer: United Healthcare Medicare |
$190.36
|
|
