|
HC SN SCREW 7.0X120 32 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,552.50 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,788.48
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
|
HC SN SCREW 7.0X120 32 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Centivo All Commercial |
$1,055.70
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Humana Medicare |
$1,055.70
|
| Rate for Payer: Lucent All Commercial |
$1,055.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
| Rate for Payer: United Healthcare Medicare |
$683.10
|
|
|
HC SN SCREW 7.0X120 SS CANN FT
|
Facility
OP
|
$1,985.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603166
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,846.05 |
| Rate for Payer: Aetna Commercial |
$1,675.34
|
| Rate for Payer: Aetna Medicare |
$655.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$655.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,139.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,240.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$753.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$720.56
|
| Rate for Payer: Cash Price |
$1,230.70
|
| Rate for Payer: Cash Price |
$1,230.70
|
| Rate for Payer: Centivo All Commercial |
$1,012.35
|
| Rate for Payer: Cigna All Commercial |
$1,713.06
|
| Rate for Payer: CORVEL All Commercial |
$1,846.05
|
| Rate for Payer: Coventry All Commercial |
$1,746.80
|
| Rate for Payer: Encore All Commercial |
$1,827.19
|
| Rate for Payer: Frontpath All Commercial |
$1,826.20
|
| Rate for Payer: Humana ChoiceCare |
$1,714.44
|
| Rate for Payer: Humana Medicare |
$1,012.35
|
| Rate for Payer: Lucent All Commercial |
$1,012.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,786.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,488.75
|
| Rate for Payer: PHP All Commercial |
$1,505.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$774.15
|
| Rate for Payer: Sagamore Health Network All Products |
$1,532.42
|
| Rate for Payer: Signature Care EPO |
$1,647.55
|
| Rate for Payer: Signature Care PPO |
$1,746.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,687.25
|
| Rate for Payer: United Healthcare Commercial |
$1,564.18
|
| Rate for Payer: United Healthcare Medicare |
$655.05
|
|
|
HC SN SCREW 7.0X120 SS CANN FT
|
Facility
IP
|
$1,985.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603166
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,488.75 |
| Max. Negotiated Rate |
$1,846.05 |
| Rate for Payer: Aetna Commercial |
$1,715.04
|
| Rate for Payer: Cash Price |
$1,230.70
|
| Rate for Payer: Cigna All Commercial |
$1,713.06
|
| Rate for Payer: CORVEL All Commercial |
$1,846.05
|
| Rate for Payer: Coventry All Commercial |
$1,746.80
|
| Rate for Payer: Encore All Commercial |
$1,827.19
|
| Rate for Payer: Frontpath All Commercial |
$1,826.20
|
| Rate for Payer: Humana ChoiceCare |
$1,714.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,786.50
|
| Rate for Payer: PHCS All Commercial |
$1,488.75
|
| Rate for Payer: PHP All Commercial |
$1,505.42
|
| Rate for Payer: Sagamore Health Network All Products |
$1,532.42
|
| Rate for Payer: Signature Care EPO |
$1,647.55
|
| Rate for Payer: Signature Care PPO |
$1,746.80
|
| Rate for Payer: United Healthcare Commercial |
$1,564.18
|
|
|
HC SN SCREW 7.0X125 16 SS CANN PT
|
Facility
OP
|
$1,848.75
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,719.34 |
| Rate for Payer: Aetna Commercial |
$1,560.34
|
| Rate for Payer: Aetna Medicare |
$610.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$610.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,061.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,155.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$701.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$671.10
|
| Rate for Payer: Cash Price |
$1,146.23
|
| Rate for Payer: Cash Price |
$1,146.23
|
| Rate for Payer: Centivo All Commercial |
$942.86
|
| Rate for Payer: Cigna All Commercial |
$1,595.47
|
| Rate for Payer: CORVEL All Commercial |
$1,719.34
|
| Rate for Payer: Coventry All Commercial |
$1,626.90
|
| Rate for Payer: Encore All Commercial |
$1,701.77
|
| Rate for Payer: Frontpath All Commercial |
$1,700.85
|
| Rate for Payer: Humana ChoiceCare |
$1,596.77
|
| Rate for Payer: Humana Medicare |
$942.86
|
| Rate for Payer: Lucent All Commercial |
$942.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,663.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,386.56
|
| Rate for Payer: PHP All Commercial |
$1,402.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$721.01
|
| Rate for Payer: Sagamore Health Network All Products |
$1,427.24
|
| Rate for Payer: Signature Care EPO |
$1,534.46
|
| Rate for Payer: Signature Care PPO |
$1,626.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,571.44
|
| Rate for Payer: United Healthcare Commercial |
$1,456.82
|
| Rate for Payer: United Healthcare Medicare |
$610.09
|
|
|
HC SN SCREW 7.0X125 16 SS CANN PT
|
Facility
IP
|
$1,848.75
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,386.56 |
| Max. Negotiated Rate |
$1,719.34 |
| Rate for Payer: Aetna Commercial |
$1,597.32
|
| Rate for Payer: Cash Price |
$1,146.23
|
| Rate for Payer: Cigna All Commercial |
$1,595.47
|
| Rate for Payer: CORVEL All Commercial |
$1,719.34
|
| Rate for Payer: Coventry All Commercial |
$1,626.90
|
| Rate for Payer: Encore All Commercial |
$1,701.77
|
| Rate for Payer: Frontpath All Commercial |
$1,700.85
|
| Rate for Payer: Humana ChoiceCare |
$1,596.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,663.88
|
| Rate for Payer: PHCS All Commercial |
$1,386.56
|
| Rate for Payer: PHP All Commercial |
$1,402.09
|
| Rate for Payer: Sagamore Health Network All Products |
$1,427.24
|
| Rate for Payer: Signature Care EPO |
$1,534.46
|
| Rate for Payer: Signature Care PPO |
$1,626.90
|
| Rate for Payer: United Healthcare Commercial |
$1,456.82
|
|
|
HC SN SCREW 7.0X125 32 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,552.50 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,788.48
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
|
HC SN SCREW 7.0X125 32 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Centivo All Commercial |
$1,055.70
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Humana Medicare |
$1,055.70
|
| Rate for Payer: Lucent All Commercial |
$1,055.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
| Rate for Payer: United Healthcare Medicare |
$683.10
|
|
|
HC SN SCREW 7.0X125 SS CANN FT
|
Facility
IP
|
$1,985.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,488.75 |
| Max. Negotiated Rate |
$1,846.05 |
| Rate for Payer: Aetna Commercial |
$1,715.04
|
| Rate for Payer: Cash Price |
$1,230.70
|
| Rate for Payer: Cigna All Commercial |
$1,713.06
|
| Rate for Payer: CORVEL All Commercial |
$1,846.05
|
| Rate for Payer: Coventry All Commercial |
$1,746.80
|
| Rate for Payer: Encore All Commercial |
$1,827.19
|
| Rate for Payer: Frontpath All Commercial |
$1,826.20
|
| Rate for Payer: Humana ChoiceCare |
$1,714.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,786.50
|
| Rate for Payer: PHCS All Commercial |
$1,488.75
|
| Rate for Payer: PHP All Commercial |
$1,505.42
|
| Rate for Payer: Sagamore Health Network All Products |
$1,532.42
|
| Rate for Payer: Signature Care EPO |
$1,647.55
|
| Rate for Payer: Signature Care PPO |
$1,746.80
|
| Rate for Payer: United Healthcare Commercial |
$1,564.18
|
|
|
HC SN SCREW 7.0X125 SS CANN FT
|
Facility
OP
|
$1,985.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,846.05 |
| Rate for Payer: Aetna Commercial |
$1,675.34
|
| Rate for Payer: Aetna Medicare |
$655.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$655.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,139.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,240.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$753.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$720.56
|
| Rate for Payer: Cash Price |
$1,230.70
|
| Rate for Payer: Cash Price |
$1,230.70
|
| Rate for Payer: Centivo All Commercial |
$1,012.35
|
| Rate for Payer: Cigna All Commercial |
$1,713.06
|
| Rate for Payer: CORVEL All Commercial |
$1,846.05
|
| Rate for Payer: Coventry All Commercial |
$1,746.80
|
| Rate for Payer: Encore All Commercial |
$1,827.19
|
| Rate for Payer: Frontpath All Commercial |
$1,826.20
|
| Rate for Payer: Humana ChoiceCare |
$1,714.44
|
| Rate for Payer: Humana Medicare |
$1,012.35
|
| Rate for Payer: Lucent All Commercial |
$1,012.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,786.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,488.75
|
| Rate for Payer: PHP All Commercial |
$1,505.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$774.15
|
| Rate for Payer: Sagamore Health Network All Products |
$1,532.42
|
| Rate for Payer: Signature Care EPO |
$1,647.55
|
| Rate for Payer: Signature Care PPO |
$1,746.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,687.25
|
| Rate for Payer: United Healthcare Commercial |
$1,564.18
|
| Rate for Payer: United Healthcare Medicare |
$655.05
|
|
|
HC SN SCREW 7.0X30 16 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Centivo All Commercial |
$1,055.70
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Humana Medicare |
$1,055.70
|
| Rate for Payer: Lucent All Commercial |
$1,055.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
| Rate for Payer: United Healthcare Medicare |
$683.10
|
|
|
HC SN SCREW 7.0X30 16 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,552.50 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,788.48
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
|
HC SN SCREW 7.0X30 SS CANN FT
|
Facility
IP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,552.50 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,788.48
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
|
HC SN SCREW 7.0X30 SS CANN FT
|
Facility
OP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Centivo All Commercial |
$1,055.70
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Humana Medicare |
$1,055.70
|
| Rate for Payer: Lucent All Commercial |
$1,055.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
| Rate for Payer: United Healthcare Medicare |
$683.10
|
|
|
HC SN SCREW 7.0X35 16 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603114
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,552.50 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,788.48
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
|
HC SN SCREW 7.0X35 16 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603114
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Centivo All Commercial |
$1,055.70
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Humana Medicare |
$1,055.70
|
| Rate for Payer: Lucent All Commercial |
$1,055.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
| Rate for Payer: United Healthcare Medicare |
$683.10
|
|
|
HC SN SCREW 7.0X35 SS CANN FT
|
Facility
OP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Centivo All Commercial |
$1,055.70
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Humana Medicare |
$1,055.70
|
| Rate for Payer: Lucent All Commercial |
$1,055.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
| Rate for Payer: United Healthcare Medicare |
$683.10
|
|
|
HC SN SCREW 7.0X35 SS CANN FT
|
Facility
IP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,552.50 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,788.48
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
|
HC SN SCREW 7.0X40 16 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Centivo All Commercial |
$1,055.70
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Humana Medicare |
$1,055.70
|
| Rate for Payer: Lucent All Commercial |
$1,055.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
| Rate for Payer: United Healthcare Medicare |
$683.10
|
|
|
HC SN SCREW 7.0X40 16 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,552.50 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,788.48
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
|
HC SN SCREW 7.0X40 SS CANN FT
|
Facility
OP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603150
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Centivo All Commercial |
$1,055.70
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Humana Medicare |
$1,055.70
|
| Rate for Payer: Lucent All Commercial |
$1,055.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
| Rate for Payer: United Healthcare Medicare |
$683.10
|
|
|
HC SN SCREW 7.0X40 SS CANN FT
|
Facility
IP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603150
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,552.50 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,788.48
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
|
HC SN SCREW 7.0X45 16 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603116
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,552.50 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,788.48
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
|
HC SN SCREW 7.0X45 16 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603116
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Centivo All Commercial |
$1,055.70
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Humana Medicare |
$1,055.70
|
| Rate for Payer: Lucent All Commercial |
$1,055.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
| Rate for Payer: United Healthcare Medicare |
$683.10
|
|
|
HC SN SCREW 7.0X45 32 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Centivo All Commercial |
$1,055.70
|
| Rate for Payer: Cigna All Commercial |
$1,786.41
|
| Rate for Payer: CORVEL All Commercial |
$1,925.10
|
| Rate for Payer: Coventry All Commercial |
$1,821.60
|
| Rate for Payer: Encore All Commercial |
$1,905.44
|
| Rate for Payer: Frontpath All Commercial |
$1,904.40
|
| Rate for Payer: Humana ChoiceCare |
$1,787.86
|
| Rate for Payer: Humana Medicare |
$1,055.70
|
| Rate for Payer: Lucent All Commercial |
$1,055.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,552.50
|
| Rate for Payer: PHP All Commercial |
$1,569.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
| Rate for Payer: Signature Care EPO |
$1,718.10
|
| Rate for Payer: Signature Care PPO |
$1,821.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
| Rate for Payer: United Healthcare Commercial |
$1,631.16
|
| Rate for Payer: United Healthcare Medicare |
$683.10
|
|
