|
HC Z PSN FEM 5 CR STD R
|
Facility
|
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607947
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 6 CMT STD R
|
Facility
|
IP
|
$13,680.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,260.00 |
| Max. Negotiated Rate |
$12,722.40 |
| Rate for Payer: Aetna Commercial |
$11,819.52
|
| Rate for Payer: Cash Price |
$8,208.00
|
| Rate for Payer: Cigna All Commercial |
$11,805.84
|
| Rate for Payer: CORVEL All Commercial |
$12,722.40
|
| Rate for Payer: Coventry All Commercial |
$12,038.40
|
| Rate for Payer: Encore All Commercial |
$12,592.44
|
| Rate for Payer: Frontpath All Commercial |
$12,585.60
|
| Rate for Payer: Humana ChoiceCare |
$11,815.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,312.00
|
| Rate for Payer: PHCS All Commercial |
$10,260.00
|
| Rate for Payer: PHP All Commercial |
$10,374.91
|
| Rate for Payer: Sagamore Health Network All Products |
$10,560.96
|
| Rate for Payer: Signature Care EPO |
$11,354.40
|
| Rate for Payer: Signature Care PPO |
$12,038.40
|
| Rate for Payer: United Healthcare Commercial |
$10,779.84
|
|
|
HC Z PSN FEM 6 CMT STD R
|
Facility
|
OP
|
$13,680.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$12,722.40 |
| Rate for Payer: Aetna Commercial |
$11,545.92
|
| Rate for Payer: Aetna Medicare |
$4,377.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,240.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$7,856.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,551.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,034.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,815.36
|
| Rate for Payer: Cash Price |
$8,208.00
|
| Rate for Payer: Cash Price |
$8,208.00
|
| Rate for Payer: Centivo All Commercial |
$7,441.92
|
| Rate for Payer: Cigna All Commercial |
$11,805.84
|
| Rate for Payer: CORVEL All Commercial |
$12,722.40
|
| Rate for Payer: Coventry All Commercial |
$12,038.40
|
| Rate for Payer: Encore All Commercial |
$12,592.44
|
| Rate for Payer: Frontpath All Commercial |
$12,585.60
|
| Rate for Payer: Humana ChoiceCare |
$11,815.42
|
| Rate for Payer: Humana Medicare |
$4,377.60
|
| Rate for Payer: Lucent All Commercial |
$7,441.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,312.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$10,260.00
|
| Rate for Payer: PHP All Commercial |
$10,374.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,335.20
|
| Rate for Payer: Sagamore Health Network All Products |
$10,560.96
|
| Rate for Payer: Signature Care EPO |
$11,354.40
|
| Rate for Payer: Signature Care PPO |
$12,038.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,628.00
|
| Rate for Payer: United Healthcare Commercial |
$10,779.84
|
| Rate for Payer: United Healthcare Medicare |
$4,377.60
|
|
|
HC Z PSN FEM 6 CR NRW COCR R
|
Facility
|
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608238
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,733.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,585.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,443.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,206.57
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Centivo All Commercial |
$8,046.52
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$4,733.24
|
| Rate for Payer: Lucent All Commercial |
$8,046.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,733.24
|
|
|
HC Z PSN FEM 6 CR NRW COCR R
|
Facility
|
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608238
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 6 CR NRW R
|
Facility
|
OP
|
$12,478.61
|
|
|
Service Code
|
CPT C1778
|
| Hospital Charge Code |
41608536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$11,605.11 |
| Rate for Payer: Aetna Commercial |
$10,531.95
|
| Rate for Payer: Aetna Medicare |
$3,993.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,868.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$7,166.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,800.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,592.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,392.47
|
| Rate for Payer: Cash Price |
$7,487.17
|
| Rate for Payer: Cash Price |
$7,487.17
|
| Rate for Payer: Centivo All Commercial |
$6,788.36
|
| Rate for Payer: Cigna All Commercial |
$10,769.04
|
| Rate for Payer: CORVEL All Commercial |
$11,605.11
|
| Rate for Payer: Coventry All Commercial |
$10,981.18
|
| Rate for Payer: Encore All Commercial |
$11,486.56
|
| Rate for Payer: Frontpath All Commercial |
$11,480.32
|
| Rate for Payer: Humana ChoiceCare |
$10,777.78
|
| Rate for Payer: Humana Medicare |
$3,993.16
|
| Rate for Payer: Lucent All Commercial |
$6,788.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,230.75
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$9,358.96
|
| Rate for Payer: PHP All Commercial |
$9,463.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,866.66
|
| Rate for Payer: Sagamore Health Network All Products |
$9,633.49
|
| Rate for Payer: Signature Care EPO |
$10,357.25
|
| Rate for Payer: Signature Care PPO |
$10,981.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,606.82
|
| Rate for Payer: United Healthcare Commercial |
$9,833.14
|
| Rate for Payer: United Healthcare Medicare |
$3,993.16
|
|
|
HC Z PSN FEM 6 CR NRW R
|
Facility
|
IP
|
$12,478.61
|
|
|
Service Code
|
CPT C1778
|
| Hospital Charge Code |
41608536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,358.96 |
| Max. Negotiated Rate |
$11,605.11 |
| Rate for Payer: Aetna Commercial |
$10,781.52
|
| Rate for Payer: Cash Price |
$7,487.17
|
| Rate for Payer: Cigna All Commercial |
$10,769.04
|
| Rate for Payer: CORVEL All Commercial |
$11,605.11
|
| Rate for Payer: Coventry All Commercial |
$10,981.18
|
| Rate for Payer: Encore All Commercial |
$11,486.56
|
| Rate for Payer: Frontpath All Commercial |
$11,480.32
|
| Rate for Payer: Humana ChoiceCare |
$10,777.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,230.75
|
| Rate for Payer: PHCS All Commercial |
$9,358.96
|
| Rate for Payer: PHP All Commercial |
$9,463.78
|
| Rate for Payer: Sagamore Health Network All Products |
$9,633.49
|
| Rate for Payer: Signature Care EPO |
$10,357.25
|
| Rate for Payer: Signature Care PPO |
$10,981.18
|
| Rate for Payer: United Healthcare Commercial |
$9,833.14
|
|
|
HC Z PSN FEM 6 CR NRW R
|
Facility
|
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608099
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 6 CR NRW R
|
Facility
|
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608099
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,733.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,585.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,443.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,206.57
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Centivo All Commercial |
$8,046.52
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$4,733.24
|
| Rate for Payer: Lucent All Commercial |
$8,046.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,733.24
|
|
|
HC Z PSN FEM 6 CR STD L
|
Facility
|
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 6 CR STD L
|
Facility
|
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,733.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,585.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,443.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,206.57
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Centivo All Commercial |
$8,046.52
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$4,733.24
|
| Rate for Payer: Lucent All Commercial |
$8,046.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,733.24
|
|
|
HC Z PSN FEM 6 CR STD R
|
Facility
|
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608084
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,733.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,585.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,443.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,206.57
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Centivo All Commercial |
$8,046.52
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$4,733.24
|
| Rate for Payer: Lucent All Commercial |
$8,046.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,733.24
|
|
|
HC Z PSN FEM 6 CR STD R
|
Facility
|
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608084
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 7 CR COCR NRW
|
Facility
|
OP
|
$14,051.81
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608493
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$13,068.18 |
| Rate for Payer: Aetna Commercial |
$11,859.73
|
| Rate for Payer: Aetna Medicare |
$4,496.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,356.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8,069.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,783.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,171.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,946.24
|
| Rate for Payer: Cash Price |
$8,431.09
|
| Rate for Payer: Cash Price |
$8,431.09
|
| Rate for Payer: Centivo All Commercial |
$7,644.18
|
| Rate for Payer: Cigna All Commercial |
$12,126.71
|
| Rate for Payer: CORVEL All Commercial |
$13,068.18
|
| Rate for Payer: Coventry All Commercial |
$12,365.59
|
| Rate for Payer: Encore All Commercial |
$12,934.69
|
| Rate for Payer: Frontpath All Commercial |
$12,927.67
|
| Rate for Payer: Humana ChoiceCare |
$12,136.55
|
| Rate for Payer: Humana Medicare |
$4,496.58
|
| Rate for Payer: Lucent All Commercial |
$7,644.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,646.63
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$10,538.86
|
| Rate for Payer: PHP All Commercial |
$10,656.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,480.21
|
| Rate for Payer: Sagamore Health Network All Products |
$10,848.00
|
| Rate for Payer: Signature Care EPO |
$11,663.00
|
| Rate for Payer: Signature Care PPO |
$12,365.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,944.04
|
| Rate for Payer: United Healthcare Commercial |
$11,072.83
|
| Rate for Payer: United Healthcare Medicare |
$4,496.58
|
|
|
HC Z PSN FEM 7 CR COCR NRW
|
Facility
|
IP
|
$14,051.81
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608493
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,538.86 |
| Max. Negotiated Rate |
$13,068.18 |
| Rate for Payer: Aetna Commercial |
$12,140.76
|
| Rate for Payer: Cash Price |
$8,431.09
|
| Rate for Payer: Cigna All Commercial |
$12,126.71
|
| Rate for Payer: CORVEL All Commercial |
$13,068.18
|
| Rate for Payer: Coventry All Commercial |
$12,365.59
|
| Rate for Payer: Encore All Commercial |
$12,934.69
|
| Rate for Payer: Frontpath All Commercial |
$12,927.67
|
| Rate for Payer: Humana ChoiceCare |
$12,136.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,646.63
|
| Rate for Payer: PHCS All Commercial |
$10,538.86
|
| Rate for Payer: PHP All Commercial |
$10,656.89
|
| Rate for Payer: Sagamore Health Network All Products |
$10,848.00
|
| Rate for Payer: Signature Care EPO |
$11,663.00
|
| Rate for Payer: Signature Care PPO |
$12,365.59
|
| Rate for Payer: United Healthcare Commercial |
$11,072.83
|
|
|
HC Z PSN FEM 7 CR NRW L
|
Facility
|
OP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607848
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$12,215.91 |
| Rate for Payer: Aetna Commercial |
$11,086.27
|
| Rate for Payer: Aetna Medicare |
$4,203.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,071.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$7,543.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,210.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,833.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,623.66
|
| Rate for Payer: Cash Price |
$7,881.23
|
| Rate for Payer: Cash Price |
$7,881.23
|
| Rate for Payer: Centivo All Commercial |
$7,145.65
|
| Rate for Payer: Cigna All Commercial |
$11,335.84
|
| Rate for Payer: CORVEL All Commercial |
$12,215.91
|
| Rate for Payer: Coventry All Commercial |
$11,559.14
|
| Rate for Payer: Encore All Commercial |
$12,091.13
|
| Rate for Payer: Frontpath All Commercial |
$12,084.56
|
| Rate for Payer: Humana ChoiceCare |
$11,345.04
|
| Rate for Payer: Humana Medicare |
$4,203.32
|
| Rate for Payer: Lucent All Commercial |
$7,145.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,821.85
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$9,851.54
|
| Rate for Payer: PHP All Commercial |
$9,961.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,122.80
|
| Rate for Payer: Sagamore Health Network All Products |
$10,140.52
|
| Rate for Payer: Signature Care EPO |
$10,902.37
|
| Rate for Payer: Signature Care PPO |
$11,559.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,165.08
|
| Rate for Payer: United Healthcare Commercial |
$10,350.69
|
| Rate for Payer: United Healthcare Medicare |
$4,203.32
|
|
|
HC Z PSN FEM 7 CR NRW L
|
Facility
|
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,733.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,585.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,443.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,206.57
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Centivo All Commercial |
$8,046.52
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$4,733.24
|
| Rate for Payer: Lucent All Commercial |
$8,046.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,733.24
|
|
|
HC Z PSN FEM 7 CR NRW L
|
Facility
|
IP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607848
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,851.54 |
| Max. Negotiated Rate |
$12,215.91 |
| Rate for Payer: Aetna Commercial |
$11,348.98
|
| Rate for Payer: Cash Price |
$7,881.23
|
| Rate for Payer: Cigna All Commercial |
$11,335.84
|
| Rate for Payer: CORVEL All Commercial |
$12,215.91
|
| Rate for Payer: Coventry All Commercial |
$11,559.14
|
| Rate for Payer: Encore All Commercial |
$12,091.13
|
| Rate for Payer: Frontpath All Commercial |
$12,084.56
|
| Rate for Payer: Humana ChoiceCare |
$11,345.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,821.85
|
| Rate for Payer: PHCS All Commercial |
$9,851.54
|
| Rate for Payer: PHP All Commercial |
$9,961.88
|
| Rate for Payer: Sagamore Health Network All Products |
$10,140.52
|
| Rate for Payer: Signature Care EPO |
$10,902.37
|
| Rate for Payer: Signature Care PPO |
$11,559.14
|
| Rate for Payer: United Healthcare Commercial |
$10,350.69
|
|
|
HC Z PSN FEM 7 CR NRW L
|
Facility
|
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 7 CR NRW R
|
Facility
|
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,733.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,585.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,443.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,206.57
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Centivo All Commercial |
$8,046.52
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$4,733.24
|
| Rate for Payer: Lucent All Commercial |
$8,046.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,733.24
|
|
|
HC Z PSN FEM 7 CR NRW R
|
Facility
|
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 7 CR STD L
|
Facility
|
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607881
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,733.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,585.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,443.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,206.57
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Centivo All Commercial |
$8,046.52
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$4,733.24
|
| Rate for Payer: Lucent All Commercial |
$8,046.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,733.24
|
|
|
HC Z PSN FEM 7 CR STD L
|
Facility
|
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607881
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 7 CR STD R
|
Facility
|
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607687
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,733.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,585.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,443.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,206.57
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Centivo All Commercial |
$8,046.52
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$4,733.24
|
| Rate for Payer: Lucent All Commercial |
$8,046.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,733.24
|
|
|
HC Z PSN FEM 7 CR STD R
|
Facility
|
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607687
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$8,874.83
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
