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Service Code CPT C1713
Hospital Charge Code 41606284
Hospital Revenue Code 278
Min. Negotiated Rate $349.96
Max. Negotiated Rate $433.96
Rate for Payer: Aetna Commercial $403.16
Rate for Payer: Cash Price $279.97
Rate for Payer: Cigna All Commercial $402.69
Rate for Payer: CORVEL All Commercial $433.96
Rate for Payer: Coventry All Commercial $410.63
Rate for Payer: Encore All Commercial $429.52
Rate for Payer: Frontpath All Commercial $429.29
Rate for Payer: Humana ChoiceCare $403.02
Rate for Payer: Lutheran Preferred All Commercial $419.96
Rate for Payer: PHCS All Commercial $349.96
Rate for Payer: PHP All Commercial $353.88
Rate for Payer: Sagamore Health Network All Products $360.23
Rate for Payer: Signature Care EPO $387.29
Rate for Payer: Signature Care PPO $410.63
Rate for Payer: United Healthcare Commercial $367.70
Service Code CPT C1713
Hospital Charge Code 41606284
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $433.96
Rate for Payer: Aetna Commercial $393.83
Rate for Payer: Aetna Medicare $149.32
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $144.65
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $267.98
Rate for Payer: Anthem Blue Cross of IN Traditional $291.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $171.72
Rate for Payer: CareSource Indiana of IN Medicare $164.25
Rate for Payer: Cash Price $279.97
Rate for Payer: Cash Price $279.97
Rate for Payer: Centivo All Commercial $253.84
Rate for Payer: Cigna All Commercial $402.69
Rate for Payer: CORVEL All Commercial $433.96
Rate for Payer: Coventry All Commercial $410.63
Rate for Payer: Encore All Commercial $429.52
Rate for Payer: Frontpath All Commercial $429.29
Rate for Payer: Humana ChoiceCare $403.02
Rate for Payer: Humana Medicare $149.32
Rate for Payer: Lucent All Commercial $253.84
Rate for Payer: Lutheran Preferred All Commercial $419.96
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $349.96
Rate for Payer: PHP All Commercial $353.88
Rate for Payer: Plain Church Group Ministry All Commercial $181.98
Rate for Payer: Sagamore Health Network All Products $360.23
Rate for Payer: Signature Care EPO $387.29
Rate for Payer: Signature Care PPO $410.63
Rate for Payer: Three Rivers Preferred All Commercial $396.63
Rate for Payer: United Healthcare Commercial $367.70
Rate for Payer: United Healthcare Medicare $149.32
Service Code CPT C1713
Hospital Charge Code 41605877
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $723.26
Rate for Payer: Aetna Commercial $656.38
Rate for Payer: Aetna Medicare $248.86
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $241.09
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $446.63
Rate for Payer: Anthem Blue Cross of IN Traditional $486.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $286.19
Rate for Payer: CareSource Indiana of IN Medicare $273.75
Rate for Payer: Cash Price $466.62
Rate for Payer: Cash Price $466.62
Rate for Payer: Centivo All Commercial $423.07
Rate for Payer: Cigna All Commercial $671.16
Rate for Payer: CORVEL All Commercial $723.26
Rate for Payer: Coventry All Commercial $684.38
Rate for Payer: Encore All Commercial $715.87
Rate for Payer: Frontpath All Commercial $715.48
Rate for Payer: Humana ChoiceCare $671.70
Rate for Payer: Humana Medicare $248.86
Rate for Payer: Lucent All Commercial $423.07
Rate for Payer: Lutheran Preferred All Commercial $699.93
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $583.27
Rate for Payer: PHP All Commercial $589.81
Rate for Payer: Plain Church Group Ministry All Commercial $303.30
Rate for Payer: Sagamore Health Network All Products $600.38
Rate for Payer: Signature Care EPO $645.49
Rate for Payer: Signature Care PPO $684.38
Rate for Payer: Three Rivers Preferred All Commercial $661.04
Rate for Payer: United Healthcare Commercial $612.83
Rate for Payer: United Healthcare Medicare $248.86
Service Code CPT C1713
Hospital Charge Code 41605877
Hospital Revenue Code 278
Min. Negotiated Rate $583.27
Max. Negotiated Rate $723.26
Rate for Payer: Aetna Commercial $671.93
Rate for Payer: Cash Price $466.62
Rate for Payer: Cigna All Commercial $671.16
Rate for Payer: CORVEL All Commercial $723.26
Rate for Payer: Coventry All Commercial $684.38
Rate for Payer: Encore All Commercial $715.87
Rate for Payer: Frontpath All Commercial $715.48
Rate for Payer: Humana ChoiceCare $671.70
Rate for Payer: Lutheran Preferred All Commercial $699.93
Rate for Payer: PHCS All Commercial $583.27
Rate for Payer: PHP All Commercial $589.81
Rate for Payer: Sagamore Health Network All Products $600.38
Rate for Payer: Signature Care EPO $645.49
Rate for Payer: Signature Care PPO $684.38
Rate for Payer: United Healthcare Commercial $612.83
Service Code CPT C1713
Hospital Charge Code 41606300
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $746.74
Rate for Payer: Aetna Commercial $677.69
Rate for Payer: Aetna Medicare $256.94
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $248.91
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $461.13
Rate for Payer: Anthem Blue Cross of IN Traditional $501.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $295.49
Rate for Payer: CareSource Indiana of IN Medicare $282.64
Rate for Payer: Cash Price $481.77
Rate for Payer: Cash Price $481.77
Rate for Payer: Centivo All Commercial $436.80
Rate for Payer: Cigna All Commercial $692.95
Rate for Payer: CORVEL All Commercial $746.74
Rate for Payer: Coventry All Commercial $706.60
Rate for Payer: Encore All Commercial $739.12
Rate for Payer: Frontpath All Commercial $738.71
Rate for Payer: Humana ChoiceCare $693.51
Rate for Payer: Humana Medicare $256.94
Rate for Payer: Lucent All Commercial $436.80
Rate for Payer: Lutheran Preferred All Commercial $722.65
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $602.21
Rate for Payer: PHP All Commercial $608.96
Rate for Payer: Plain Church Group Ministry All Commercial $313.15
Rate for Payer: Sagamore Health Network All Products $619.88
Rate for Payer: Signature Care EPO $666.45
Rate for Payer: Signature Care PPO $706.60
Rate for Payer: Three Rivers Preferred All Commercial $682.51
Rate for Payer: United Healthcare Commercial $632.72
Rate for Payer: United Healthcare Medicare $256.94
Service Code CPT C1713
Hospital Charge Code 41606300
Hospital Revenue Code 278
Min. Negotiated Rate $602.21
Max. Negotiated Rate $746.74
Rate for Payer: Aetna Commercial $693.75
Rate for Payer: Cash Price $481.77
Rate for Payer: Cigna All Commercial $692.95
Rate for Payer: CORVEL All Commercial $746.74
Rate for Payer: Coventry All Commercial $706.60
Rate for Payer: Encore All Commercial $739.12
Rate for Payer: Frontpath All Commercial $738.71
Rate for Payer: Humana ChoiceCare $693.51
Rate for Payer: Lutheran Preferred All Commercial $722.65
Rate for Payer: PHCS All Commercial $602.21
Rate for Payer: PHP All Commercial $608.96
Rate for Payer: Sagamore Health Network All Products $619.88
Rate for Payer: Signature Care EPO $666.45
Rate for Payer: Signature Care PPO $706.60
Rate for Payer: United Healthcare Commercial $632.72
Service Code CPT C1713
Hospital Charge Code 41605879
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $433.96
Rate for Payer: Aetna Commercial $393.83
Rate for Payer: Aetna Medicare $149.32
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $144.65
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $267.98
Rate for Payer: Anthem Blue Cross of IN Traditional $291.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $171.72
Rate for Payer: CareSource Indiana of IN Medicare $164.25
Rate for Payer: Cash Price $279.97
Rate for Payer: Cash Price $279.97
Rate for Payer: Centivo All Commercial $253.84
Rate for Payer: Cigna All Commercial $402.69
Rate for Payer: CORVEL All Commercial $433.96
Rate for Payer: Coventry All Commercial $410.63
Rate for Payer: Encore All Commercial $429.52
Rate for Payer: Frontpath All Commercial $429.29
Rate for Payer: Humana ChoiceCare $403.02
Rate for Payer: Humana Medicare $149.32
Rate for Payer: Lucent All Commercial $253.84
Rate for Payer: Lutheran Preferred All Commercial $419.96
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $349.96
Rate for Payer: PHP All Commercial $353.88
Rate for Payer: Plain Church Group Ministry All Commercial $181.98
Rate for Payer: Sagamore Health Network All Products $360.23
Rate for Payer: Signature Care EPO $387.29
Rate for Payer: Signature Care PPO $410.63
Rate for Payer: Three Rivers Preferred All Commercial $396.63
Rate for Payer: United Healthcare Commercial $367.70
Rate for Payer: United Healthcare Medicare $149.32
Service Code CPT C1713
Hospital Charge Code 41605879
Hospital Revenue Code 278
Min. Negotiated Rate $349.96
Max. Negotiated Rate $433.96
Rate for Payer: Aetna Commercial $403.16
Rate for Payer: Cash Price $279.97
Rate for Payer: Cigna All Commercial $402.69
Rate for Payer: CORVEL All Commercial $433.96
Rate for Payer: Coventry All Commercial $410.63
Rate for Payer: Encore All Commercial $429.52
Rate for Payer: Frontpath All Commercial $429.29
Rate for Payer: Humana ChoiceCare $403.02
Rate for Payer: Lutheran Preferred All Commercial $419.96
Rate for Payer: PHCS All Commercial $349.96
Rate for Payer: PHP All Commercial $353.88
Rate for Payer: Sagamore Health Network All Products $360.23
Rate for Payer: Signature Care EPO $387.29
Rate for Payer: Signature Care PPO $410.63
Rate for Payer: United Healthcare Commercial $367.70
Service Code CPT C1713
Hospital Charge Code 41606226
Hospital Revenue Code 278
Min. Negotiated Rate $583.27
Max. Negotiated Rate $723.26
Rate for Payer: Aetna Commercial $671.93
Rate for Payer: Cash Price $466.62
Rate for Payer: Cigna All Commercial $671.16
Rate for Payer: CORVEL All Commercial $723.26
Rate for Payer: Coventry All Commercial $684.38
Rate for Payer: Encore All Commercial $715.87
Rate for Payer: Frontpath All Commercial $715.48
Rate for Payer: Humana ChoiceCare $671.70
Rate for Payer: Lutheran Preferred All Commercial $699.93
Rate for Payer: PHCS All Commercial $583.27
Rate for Payer: PHP All Commercial $589.81
Rate for Payer: Sagamore Health Network All Products $600.38
Rate for Payer: Signature Care EPO $645.49
Rate for Payer: Signature Care PPO $684.38
Rate for Payer: United Healthcare Commercial $612.83
Service Code CPT C1713
Hospital Charge Code 41606226
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $723.26
Rate for Payer: Aetna Commercial $656.38
Rate for Payer: Aetna Medicare $248.86
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $241.09
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $446.63
Rate for Payer: Anthem Blue Cross of IN Traditional $486.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $286.19
Rate for Payer: CareSource Indiana of IN Medicare $273.75
Rate for Payer: Cash Price $466.62
Rate for Payer: Cash Price $466.62
Rate for Payer: Centivo All Commercial $423.07
Rate for Payer: Cigna All Commercial $671.16
Rate for Payer: CORVEL All Commercial $723.26
Rate for Payer: Coventry All Commercial $684.38
Rate for Payer: Encore All Commercial $715.87
Rate for Payer: Frontpath All Commercial $715.48
Rate for Payer: Humana ChoiceCare $671.70
Rate for Payer: Humana Medicare $248.86
Rate for Payer: Lucent All Commercial $423.07
Rate for Payer: Lutheran Preferred All Commercial $699.93
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $583.27
Rate for Payer: PHP All Commercial $589.81
Rate for Payer: Plain Church Group Ministry All Commercial $303.30
Rate for Payer: Sagamore Health Network All Products $600.38
Rate for Payer: Signature Care EPO $645.49
Rate for Payer: Signature Care PPO $684.38
Rate for Payer: Three Rivers Preferred All Commercial $661.04
Rate for Payer: United Healthcare Commercial $612.83
Rate for Payer: United Healthcare Medicare $248.86
Service Code CPT C1713
Hospital Charge Code 41606301
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $746.74
Rate for Payer: Aetna Commercial $677.69
Rate for Payer: Aetna Medicare $256.94
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $248.91
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $461.13
Rate for Payer: Anthem Blue Cross of IN Traditional $501.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $295.49
Rate for Payer: CareSource Indiana of IN Medicare $282.64
Rate for Payer: Cash Price $481.77
Rate for Payer: Cash Price $481.77
Rate for Payer: Centivo All Commercial $436.80
Rate for Payer: Cigna All Commercial $692.95
Rate for Payer: CORVEL All Commercial $746.74
Rate for Payer: Coventry All Commercial $706.60
Rate for Payer: Encore All Commercial $739.12
Rate for Payer: Frontpath All Commercial $738.71
Rate for Payer: Humana ChoiceCare $693.51
Rate for Payer: Humana Medicare $256.94
Rate for Payer: Lucent All Commercial $436.80
Rate for Payer: Lutheran Preferred All Commercial $722.65
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $602.21
Rate for Payer: PHP All Commercial $608.96
Rate for Payer: Plain Church Group Ministry All Commercial $313.15
Rate for Payer: Sagamore Health Network All Products $619.88
Rate for Payer: Signature Care EPO $666.45
Rate for Payer: Signature Care PPO $706.60
Rate for Payer: Three Rivers Preferred All Commercial $682.51
Rate for Payer: United Healthcare Commercial $632.72
Rate for Payer: United Healthcare Medicare $256.94
Service Code CPT C1713
Hospital Charge Code 41606301
Hospital Revenue Code 278
Min. Negotiated Rate $602.21
Max. Negotiated Rate $746.74
Rate for Payer: Aetna Commercial $693.75
Rate for Payer: Cash Price $481.77
Rate for Payer: Cigna All Commercial $692.95
Rate for Payer: CORVEL All Commercial $746.74
Rate for Payer: Coventry All Commercial $706.60
Rate for Payer: Encore All Commercial $739.12
Rate for Payer: Frontpath All Commercial $738.71
Rate for Payer: Humana ChoiceCare $693.51
Rate for Payer: Lutheran Preferred All Commercial $722.65
Rate for Payer: PHCS All Commercial $602.21
Rate for Payer: PHP All Commercial $608.96
Rate for Payer: Sagamore Health Network All Products $619.88
Rate for Payer: Signature Care EPO $666.45
Rate for Payer: Signature Care PPO $706.60
Rate for Payer: United Healthcare Commercial $632.72
Service Code CPT C1713
Hospital Charge Code 41606285
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $433.96
Rate for Payer: Aetna Commercial $393.83
Rate for Payer: Aetna Medicare $149.32
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $144.65
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $267.98
Rate for Payer: Anthem Blue Cross of IN Traditional $291.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $171.72
Rate for Payer: CareSource Indiana of IN Medicare $164.25
Rate for Payer: Cash Price $279.97
Rate for Payer: Cash Price $279.97
Rate for Payer: Centivo All Commercial $253.84
Rate for Payer: Cigna All Commercial $402.69
Rate for Payer: CORVEL All Commercial $433.96
Rate for Payer: Coventry All Commercial $410.63
Rate for Payer: Encore All Commercial $429.52
Rate for Payer: Frontpath All Commercial $429.29
Rate for Payer: Humana ChoiceCare $403.02
Rate for Payer: Humana Medicare $149.32
Rate for Payer: Lucent All Commercial $253.84
Rate for Payer: Lutheran Preferred All Commercial $419.96
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $349.96
Rate for Payer: PHP All Commercial $353.88
Rate for Payer: Plain Church Group Ministry All Commercial $181.98
Rate for Payer: Sagamore Health Network All Products $360.23
Rate for Payer: Signature Care EPO $387.29
Rate for Payer: Signature Care PPO $410.63
Rate for Payer: Three Rivers Preferred All Commercial $396.63
Rate for Payer: United Healthcare Commercial $367.70
Rate for Payer: United Healthcare Medicare $149.32
Service Code CPT C1713
Hospital Charge Code 41606285
Hospital Revenue Code 278
Min. Negotiated Rate $349.96
Max. Negotiated Rate $433.96
Rate for Payer: Aetna Commercial $403.16
Rate for Payer: Cash Price $279.97
Rate for Payer: Cigna All Commercial $402.69
Rate for Payer: CORVEL All Commercial $433.96
Rate for Payer: Coventry All Commercial $410.63
Rate for Payer: Encore All Commercial $429.52
Rate for Payer: Frontpath All Commercial $429.29
Rate for Payer: Humana ChoiceCare $403.02
Rate for Payer: Lutheran Preferred All Commercial $419.96
Rate for Payer: PHCS All Commercial $349.96
Rate for Payer: PHP All Commercial $353.88
Rate for Payer: Sagamore Health Network All Products $360.23
Rate for Payer: Signature Care EPO $387.29
Rate for Payer: Signature Care PPO $410.63
Rate for Payer: United Healthcare Commercial $367.70
Service Code CPT C1713
Hospital Charge Code 41606227
Hospital Revenue Code 278
Min. Negotiated Rate $583.27
Max. Negotiated Rate $723.26
Rate for Payer: Aetna Commercial $671.93
Rate for Payer: Cash Price $466.62
Rate for Payer: Cigna All Commercial $671.16
Rate for Payer: CORVEL All Commercial $723.26
Rate for Payer: Coventry All Commercial $684.38
Rate for Payer: Encore All Commercial $715.87
Rate for Payer: Frontpath All Commercial $715.48
Rate for Payer: Humana ChoiceCare $671.70
Rate for Payer: Lutheran Preferred All Commercial $699.93
Rate for Payer: PHCS All Commercial $583.27
Rate for Payer: PHP All Commercial $589.81
Rate for Payer: Sagamore Health Network All Products $600.38
Rate for Payer: Signature Care EPO $645.49
Rate for Payer: Signature Care PPO $684.38
Rate for Payer: United Healthcare Commercial $612.83
Service Code CPT C1713
Hospital Charge Code 41606227
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $723.26
Rate for Payer: Aetna Commercial $656.38
Rate for Payer: Aetna Medicare $248.86
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $241.09
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $446.63
Rate for Payer: Anthem Blue Cross of IN Traditional $486.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $286.19
Rate for Payer: CareSource Indiana of IN Medicare $273.75
Rate for Payer: Cash Price $466.62
Rate for Payer: Cash Price $466.62
Rate for Payer: Centivo All Commercial $423.07
Rate for Payer: Cigna All Commercial $671.16
Rate for Payer: CORVEL All Commercial $723.26
Rate for Payer: Coventry All Commercial $684.38
Rate for Payer: Encore All Commercial $715.87
Rate for Payer: Frontpath All Commercial $715.48
Rate for Payer: Humana ChoiceCare $671.70
Rate for Payer: Humana Medicare $248.86
Rate for Payer: Lucent All Commercial $423.07
Rate for Payer: Lutheran Preferred All Commercial $699.93
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $583.27
Rate for Payer: PHP All Commercial $589.81
Rate for Payer: Plain Church Group Ministry All Commercial $303.30
Rate for Payer: Sagamore Health Network All Products $600.38
Rate for Payer: Signature Care EPO $645.49
Rate for Payer: Signature Care PPO $684.38
Rate for Payer: Three Rivers Preferred All Commercial $661.04
Rate for Payer: United Healthcare Commercial $612.83
Rate for Payer: United Healthcare Medicare $248.86
Service Code CPT C1713
Hospital Charge Code 41606302
Hospital Revenue Code 278
Min. Negotiated Rate $602.21
Max. Negotiated Rate $746.74
Rate for Payer: Aetna Commercial $693.75
Rate for Payer: Cash Price $481.77
Rate for Payer: Cigna All Commercial $692.95
Rate for Payer: CORVEL All Commercial $746.74
Rate for Payer: Coventry All Commercial $706.60
Rate for Payer: Encore All Commercial $739.12
Rate for Payer: Frontpath All Commercial $738.71
Rate for Payer: Humana ChoiceCare $693.51
Rate for Payer: Lutheran Preferred All Commercial $722.65
Rate for Payer: PHCS All Commercial $602.21
Rate for Payer: PHP All Commercial $608.96
Rate for Payer: Sagamore Health Network All Products $619.88
Rate for Payer: Signature Care EPO $666.45
Rate for Payer: Signature Care PPO $706.60
Rate for Payer: United Healthcare Commercial $632.72
Service Code CPT C1713
Hospital Charge Code 41606302
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $746.74
Rate for Payer: Aetna Commercial $677.69
Rate for Payer: Aetna Medicare $256.94
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $248.91
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $461.13
Rate for Payer: Anthem Blue Cross of IN Traditional $501.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $295.49
Rate for Payer: CareSource Indiana of IN Medicare $282.64
Rate for Payer: Cash Price $481.77
Rate for Payer: Cash Price $481.77
Rate for Payer: Centivo All Commercial $436.80
Rate for Payer: Cigna All Commercial $692.95
Rate for Payer: CORVEL All Commercial $746.74
Rate for Payer: Coventry All Commercial $706.60
Rate for Payer: Encore All Commercial $739.12
Rate for Payer: Frontpath All Commercial $738.71
Rate for Payer: Humana ChoiceCare $693.51
Rate for Payer: Humana Medicare $256.94
Rate for Payer: Lucent All Commercial $436.80
Rate for Payer: Lutheran Preferred All Commercial $722.65
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $602.21
Rate for Payer: PHP All Commercial $608.96
Rate for Payer: Plain Church Group Ministry All Commercial $313.15
Rate for Payer: Sagamore Health Network All Products $619.88
Rate for Payer: Signature Care EPO $666.45
Rate for Payer: Signature Care PPO $706.60
Rate for Payer: Three Rivers Preferred All Commercial $682.51
Rate for Payer: United Healthcare Commercial $632.72
Rate for Payer: United Healthcare Medicare $256.94
Service Code CPT C1713
Hospital Charge Code 41606286
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $433.96
Rate for Payer: Aetna Commercial $393.83
Rate for Payer: Aetna Medicare $149.32
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $144.65
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $267.98
Rate for Payer: Anthem Blue Cross of IN Traditional $291.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $171.72
Rate for Payer: CareSource Indiana of IN Medicare $164.25
Rate for Payer: Cash Price $279.97
Rate for Payer: Cash Price $279.97
Rate for Payer: Centivo All Commercial $253.84
Rate for Payer: Cigna All Commercial $402.69
Rate for Payer: CORVEL All Commercial $433.96
Rate for Payer: Coventry All Commercial $410.63
Rate for Payer: Encore All Commercial $429.52
Rate for Payer: Frontpath All Commercial $429.29
Rate for Payer: Humana ChoiceCare $403.02
Rate for Payer: Humana Medicare $149.32
Rate for Payer: Lucent All Commercial $253.84
Rate for Payer: Lutheran Preferred All Commercial $419.96
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $349.96
Rate for Payer: PHP All Commercial $353.88
Rate for Payer: Plain Church Group Ministry All Commercial $181.98
Rate for Payer: Sagamore Health Network All Products $360.23
Rate for Payer: Signature Care EPO $387.29
Rate for Payer: Signature Care PPO $410.63
Rate for Payer: Three Rivers Preferred All Commercial $396.63
Rate for Payer: United Healthcare Commercial $367.70
Rate for Payer: United Healthcare Medicare $149.32
Service Code CPT C1713
Hospital Charge Code 41606286
Hospital Revenue Code 278
Min. Negotiated Rate $349.96
Max. Negotiated Rate $433.96
Rate for Payer: Aetna Commercial $403.16
Rate for Payer: Cash Price $279.97
Rate for Payer: Cigna All Commercial $402.69
Rate for Payer: CORVEL All Commercial $433.96
Rate for Payer: Coventry All Commercial $410.63
Rate for Payer: Encore All Commercial $429.52
Rate for Payer: Frontpath All Commercial $429.29
Rate for Payer: Humana ChoiceCare $403.02
Rate for Payer: Lutheran Preferred All Commercial $419.96
Rate for Payer: PHCS All Commercial $349.96
Rate for Payer: PHP All Commercial $353.88
Rate for Payer: Sagamore Health Network All Products $360.23
Rate for Payer: Signature Care EPO $387.29
Rate for Payer: Signature Care PPO $410.63
Rate for Payer: United Healthcare Commercial $367.70
Service Code CPT C1713
Hospital Charge Code 41606273
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $723.26
Rate for Payer: Aetna Commercial $656.38
Rate for Payer: Aetna Medicare $248.86
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $241.09
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $446.63
Rate for Payer: Anthem Blue Cross of IN Traditional $486.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $286.19
Rate for Payer: CareSource Indiana of IN Medicare $273.75
Rate for Payer: Cash Price $466.62
Rate for Payer: Cash Price $466.62
Rate for Payer: Centivo All Commercial $423.07
Rate for Payer: Cigna All Commercial $671.16
Rate for Payer: CORVEL All Commercial $723.26
Rate for Payer: Coventry All Commercial $684.38
Rate for Payer: Encore All Commercial $715.87
Rate for Payer: Frontpath All Commercial $715.48
Rate for Payer: Humana ChoiceCare $671.70
Rate for Payer: Humana Medicare $248.86
Rate for Payer: Lucent All Commercial $423.07
Rate for Payer: Lutheran Preferred All Commercial $699.93
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $583.27
Rate for Payer: PHP All Commercial $589.81
Rate for Payer: Plain Church Group Ministry All Commercial $303.30
Rate for Payer: Sagamore Health Network All Products $600.38
Rate for Payer: Signature Care EPO $645.49
Rate for Payer: Signature Care PPO $684.38
Rate for Payer: Three Rivers Preferred All Commercial $661.04
Rate for Payer: United Healthcare Commercial $612.83
Rate for Payer: United Healthcare Medicare $248.86
Service Code CPT C1713
Hospital Charge Code 41606273
Hospital Revenue Code 278
Min. Negotiated Rate $583.27
Max. Negotiated Rate $723.26
Rate for Payer: Aetna Commercial $671.93
Rate for Payer: Cash Price $466.62
Rate for Payer: Cigna All Commercial $671.16
Rate for Payer: CORVEL All Commercial $723.26
Rate for Payer: Coventry All Commercial $684.38
Rate for Payer: Encore All Commercial $715.87
Rate for Payer: Frontpath All Commercial $715.48
Rate for Payer: Humana ChoiceCare $671.70
Rate for Payer: Lutheran Preferred All Commercial $699.93
Rate for Payer: PHCS All Commercial $583.27
Rate for Payer: PHP All Commercial $589.81
Rate for Payer: Sagamore Health Network All Products $600.38
Rate for Payer: Signature Care EPO $645.49
Rate for Payer: Signature Care PPO $684.38
Rate for Payer: United Healthcare Commercial $612.83
Service Code CPT C1713
Hospital Charge Code 41606287
Hospital Revenue Code 278
Min. Negotiated Rate $349.96
Max. Negotiated Rate $433.96
Rate for Payer: Aetna Commercial $403.16
Rate for Payer: Cash Price $279.97
Rate for Payer: Cigna All Commercial $402.69
Rate for Payer: CORVEL All Commercial $433.96
Rate for Payer: Coventry All Commercial $410.63
Rate for Payer: Encore All Commercial $429.52
Rate for Payer: Frontpath All Commercial $429.29
Rate for Payer: Humana ChoiceCare $403.02
Rate for Payer: Lutheran Preferred All Commercial $419.96
Rate for Payer: PHCS All Commercial $349.96
Rate for Payer: PHP All Commercial $353.88
Rate for Payer: Sagamore Health Network All Products $360.23
Rate for Payer: Signature Care EPO $387.29
Rate for Payer: Signature Care PPO $410.63
Rate for Payer: United Healthcare Commercial $367.70
Service Code CPT C1713
Hospital Charge Code 41606287
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $433.96
Rate for Payer: Aetna Commercial $393.83
Rate for Payer: Aetna Medicare $149.32
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $144.65
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $267.98
Rate for Payer: Anthem Blue Cross of IN Traditional $291.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $171.72
Rate for Payer: CareSource Indiana of IN Medicare $164.25
Rate for Payer: Cash Price $279.97
Rate for Payer: Cash Price $279.97
Rate for Payer: Centivo All Commercial $253.84
Rate for Payer: Cigna All Commercial $402.69
Rate for Payer: CORVEL All Commercial $433.96
Rate for Payer: Coventry All Commercial $410.63
Rate for Payer: Encore All Commercial $429.52
Rate for Payer: Frontpath All Commercial $429.29
Rate for Payer: Humana ChoiceCare $403.02
Rate for Payer: Humana Medicare $149.32
Rate for Payer: Lucent All Commercial $253.84
Rate for Payer: Lutheran Preferred All Commercial $419.96
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $349.96
Rate for Payer: PHP All Commercial $353.88
Rate for Payer: Plain Church Group Ministry All Commercial $181.98
Rate for Payer: Sagamore Health Network All Products $360.23
Rate for Payer: Signature Care EPO $387.29
Rate for Payer: Signature Care PPO $410.63
Rate for Payer: Three Rivers Preferred All Commercial $396.63
Rate for Payer: United Healthcare Commercial $367.70
Rate for Payer: United Healthcare Medicare $149.32
Service Code CPT C1713
Hospital Charge Code 41606793
Hospital Revenue Code 278
Min. Negotiated Rate $291.64
Max. Negotiated Rate $361.63
Rate for Payer: Aetna Commercial $335.97
Rate for Payer: Cash Price $233.31
Rate for Payer: Cigna All Commercial $335.58
Rate for Payer: CORVEL All Commercial $361.63
Rate for Payer: Coventry All Commercial $342.19
Rate for Payer: Encore All Commercial $357.94
Rate for Payer: Frontpath All Commercial $357.74
Rate for Payer: Humana ChoiceCare $335.85
Rate for Payer: Lutheran Preferred All Commercial $349.96
Rate for Payer: PHCS All Commercial $291.64
Rate for Payer: PHP All Commercial $294.90
Rate for Payer: Sagamore Health Network All Products $300.19
Rate for Payer: Signature Care EPO $322.75
Rate for Payer: Signature Care PPO $342.19
Rate for Payer: United Healthcare Commercial $306.41