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Service Code CPT C1713
Hospital Charge Code 41603131
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
Service Code CPT C1713
Hospital Charge Code 41603151
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
Service Code CPT C1713
Hospital Charge Code 41603151
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
Service Code CPT C1713
Hospital Charge Code 41603117
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
Service Code CPT C1713
Hospital Charge Code 41603117
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
Service Code CPT C1713
Hospital Charge Code 41603132
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
Service Code CPT C1713
Hospital Charge Code 41603132
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
Service Code CPT C1713
Hospital Charge Code 41603152
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
Service Code CPT C1713
Hospital Charge Code 41603152
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
Service Code CPT C1713
Hospital Charge Code 41603118
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
Service Code CPT C1713
Hospital Charge Code 41603118
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
Service Code CPT C1713
Hospital Charge Code 41603133
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
Service Code CPT C1713
Hospital Charge Code 41603133
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
Service Code CPT C1713
Hospital Charge Code 41603153
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
Service Code CPT C1713
Hospital Charge Code 41603153
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
Service Code CPT C1713
Hospital Charge Code 41603119
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
Service Code CPT C1713
Hospital Charge Code 41603119
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
Service Code CPT C1713
Hospital Charge Code 41603134
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
Service Code CPT C1713
Hospital Charge Code 41603134
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
Service Code CPT C1713
Hospital Charge Code 41603154
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
Service Code CPT C1713
Hospital Charge Code 41603154
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
Service Code CPT C1713
Hospital Charge Code 41603120
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
Service Code CPT C1713
Hospital Charge Code 41603120
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
Service Code CPT C1713
Hospital Charge Code 41603135
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
Service Code CPT C1713
Hospital Charge Code 41603135
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