Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code CPT C1713
Hospital Charge Code 41605681
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $473.15
Rate for Payer: Aetna Commercial $429.39
Rate for Payer: Aetna Medicare $162.80
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $157.72
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $292.18
Rate for Payer: Anthem Blue Cross of IN Traditional $318.03
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $187.22
Rate for Payer: CareSource Indiana of IN Medicare $179.08
Rate for Payer: Cash Price $305.26
Rate for Payer: Cash Price $305.26
Rate for Payer: Centivo All Commercial $276.77
Rate for Payer: Cigna All Commercial $439.06
Rate for Payer: CORVEL All Commercial $473.15
Rate for Payer: Coventry All Commercial $447.71
Rate for Payer: Encore All Commercial $468.31
Rate for Payer: Frontpath All Commercial $468.06
Rate for Payer: Humana ChoiceCare $439.42
Rate for Payer: Humana Medicare $162.80
Rate for Payer: Lucent All Commercial $276.77
Rate for Payer: Lutheran Preferred All Commercial $457.88
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $381.57
Rate for Payer: PHP All Commercial $385.84
Rate for Payer: Plain Church Group Ministry All Commercial $198.42
Rate for Payer: Sagamore Health Network All Products $392.76
Rate for Payer: Signature Care EPO $422.27
Rate for Payer: Signature Care PPO $447.71
Rate for Payer: Three Rivers Preferred All Commercial $432.45
Rate for Payer: United Healthcare Commercial $400.90
Rate for Payer: United Healthcare Medicare $162.80
Service Code CPT C1713
Hospital Charge Code 41606718
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 41606718
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 41603799
Hospital Revenue Code 278
Min. Negotiated Rate $699.93
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $806.32
Rate for Payer: Cash Price $559.94
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: United Healthcare Commercial $735.39
Service Code CPT C1713
Hospital Charge Code 41603799
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $787.65
Rate for Payer: Aetna Medicare $298.64
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $289.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $535.96
Rate for Payer: Anthem Blue Cross of IN Traditional $583.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $343.43
Rate for Payer: CareSource Indiana of IN Medicare $328.50
Rate for Payer: Cash Price $559.94
Rate for Payer: Cash Price $559.94
Rate for Payer: Centivo All Commercial $507.68
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Humana Medicare $298.64
Rate for Payer: Lucent All Commercial $507.68
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Plain Church Group Ministry All Commercial $363.96
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: Three Rivers Preferred All Commercial $793.25
Rate for Payer: United Healthcare Commercial $735.39
Rate for Payer: United Healthcare Medicare $298.64
Service Code CPT C1713
Hospital Charge Code 41606678
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $878.25
Rate for Payer: Aetna Commercial $797.03
Rate for Payer: Aetna Medicare $302.19
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $292.75
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $542.34
Rate for Payer: Anthem Blue Cross of IN Traditional $590.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $347.52
Rate for Payer: CareSource Indiana of IN Medicare $332.41
Rate for Payer: Cash Price $566.61
Rate for Payer: Cash Price $566.61
Rate for Payer: Centivo All Commercial $513.73
Rate for Payer: Cigna All Commercial $814.97
Rate for Payer: CORVEL All Commercial $878.25
Rate for Payer: Coventry All Commercial $831.03
Rate for Payer: Encore All Commercial $869.27
Rate for Payer: Frontpath All Commercial $868.80
Rate for Payer: Humana ChoiceCare $815.64
Rate for Payer: Humana Medicare $302.19
Rate for Payer: Lucent All Commercial $513.73
Rate for Payer: Lutheran Preferred All Commercial $849.91
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $708.26
Rate for Payer: PHP All Commercial $716.20
Rate for Payer: Plain Church Group Ministry All Commercial $368.30
Rate for Payer: Sagamore Health Network All Products $729.04
Rate for Payer: Signature Care EPO $783.81
Rate for Payer: Signature Care PPO $831.03
Rate for Payer: Three Rivers Preferred All Commercial $802.70
Rate for Payer: United Healthcare Commercial $744.15
Rate for Payer: United Healthcare Medicare $302.19
Service Code CPT C1713
Hospital Charge Code 41606678
Hospital Revenue Code 278
Min. Negotiated Rate $708.26
Max. Negotiated Rate $878.25
Rate for Payer: Aetna Commercial $815.92
Rate for Payer: Cash Price $566.61
Rate for Payer: Cigna All Commercial $814.97
Rate for Payer: CORVEL All Commercial $878.25
Rate for Payer: Coventry All Commercial $831.03
Rate for Payer: Encore All Commercial $869.27
Rate for Payer: Frontpath All Commercial $868.80
Rate for Payer: Humana ChoiceCare $815.64
Rate for Payer: Lutheran Preferred All Commercial $849.91
Rate for Payer: PHCS All Commercial $708.26
Rate for Payer: PHP All Commercial $716.20
Rate for Payer: Sagamore Health Network All Products $729.04
Rate for Payer: Signature Care EPO $783.81
Rate for Payer: Signature Care PPO $831.03
Rate for Payer: United Healthcare Commercial $744.15
Service Code CPT C1713
Hospital Charge Code 41603798
Hospital Revenue Code 278
Min. Negotiated Rate $699.93
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $806.32
Rate for Payer: Cash Price $559.94
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: United Healthcare Commercial $735.39
Service Code CPT C1713
Hospital Charge Code 41603798
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $787.65
Rate for Payer: Aetna Medicare $298.64
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $289.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $535.96
Rate for Payer: Anthem Blue Cross of IN Traditional $583.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $343.43
Rate for Payer: CareSource Indiana of IN Medicare $328.50
Rate for Payer: Cash Price $559.94
Rate for Payer: Cash Price $559.94
Rate for Payer: Centivo All Commercial $507.68
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Humana Medicare $298.64
Rate for Payer: Lucent All Commercial $507.68
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Plain Church Group Ministry All Commercial $363.96
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: Three Rivers Preferred All Commercial $793.25
Rate for Payer: United Healthcare Commercial $735.39
Rate for Payer: United Healthcare Medicare $298.64
Service Code CPT C1713
Hospital Charge Code 41603797
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $787.65
Rate for Payer: Aetna Medicare $298.64
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $289.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $535.96
Rate for Payer: Anthem Blue Cross of IN Traditional $583.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $343.43
Rate for Payer: CareSource Indiana of IN Medicare $328.50
Rate for Payer: Cash Price $559.94
Rate for Payer: Cash Price $559.94
Rate for Payer: Centivo All Commercial $507.68
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Humana Medicare $298.64
Rate for Payer: Lucent All Commercial $507.68
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Plain Church Group Ministry All Commercial $363.96
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: Three Rivers Preferred All Commercial $793.25
Rate for Payer: United Healthcare Commercial $735.39
Rate for Payer: United Healthcare Medicare $298.64
Service Code CPT C1713
Hospital Charge Code 41603797
Hospital Revenue Code 278
Min. Negotiated Rate $699.93
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $806.32
Rate for Payer: Cash Price $559.94
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: United Healthcare Commercial $735.39
Service Code CPT C1713
Hospital Charge Code 41603792
Hospital Revenue Code 278
Min. Negotiated Rate $699.93
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $806.32
Rate for Payer: Cash Price $559.94
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: United Healthcare Commercial $735.39
Service Code CPT C1713
Hospital Charge Code 41603792
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $787.65
Rate for Payer: Aetna Medicare $298.64
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $289.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $535.96
Rate for Payer: Anthem Blue Cross of IN Traditional $583.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $343.43
Rate for Payer: CareSource Indiana of IN Medicare $328.50
Rate for Payer: Cash Price $559.94
Rate for Payer: Cash Price $559.94
Rate for Payer: Centivo All Commercial $507.68
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Humana Medicare $298.64
Rate for Payer: Lucent All Commercial $507.68
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Plain Church Group Ministry All Commercial $363.96
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: Three Rivers Preferred All Commercial $793.25
Rate for Payer: United Healthcare Commercial $735.39
Rate for Payer: United Healthcare Medicare $298.64
Service Code CPT C1713
Hospital Charge Code 41603791
Hospital Revenue Code 278
Min. Negotiated Rate $699.93
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $806.32
Rate for Payer: Cash Price $559.94
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: United Healthcare Commercial $735.39
Service Code CPT C1713
Hospital Charge Code 41603791
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $787.65
Rate for Payer: Aetna Medicare $298.64
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $289.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $535.96
Rate for Payer: Anthem Blue Cross of IN Traditional $583.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $343.43
Rate for Payer: CareSource Indiana of IN Medicare $328.50
Rate for Payer: Cash Price $559.94
Rate for Payer: Cash Price $559.94
Rate for Payer: Centivo All Commercial $507.68
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Humana Medicare $298.64
Rate for Payer: Lucent All Commercial $507.68
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Plain Church Group Ministry All Commercial $363.96
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: Three Rivers Preferred All Commercial $793.25
Rate for Payer: United Healthcare Commercial $735.39
Rate for Payer: United Healthcare Medicare $298.64
Service Code CPT C1713
Hospital Charge Code 41603790
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $787.65
Rate for Payer: Aetna Medicare $298.64
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $289.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $535.96
Rate for Payer: Anthem Blue Cross of IN Traditional $583.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $343.43
Rate for Payer: CareSource Indiana of IN Medicare $328.50
Rate for Payer: Cash Price $559.94
Rate for Payer: Cash Price $559.94
Rate for Payer: Centivo All Commercial $507.68
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Humana Medicare $298.64
Rate for Payer: Lucent All Commercial $507.68
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Plain Church Group Ministry All Commercial $363.96
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: Three Rivers Preferred All Commercial $793.25
Rate for Payer: United Healthcare Commercial $735.39
Rate for Payer: United Healthcare Medicare $298.64
Service Code CPT C1713
Hospital Charge Code 41603790
Hospital Revenue Code 278
Min. Negotiated Rate $699.93
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $806.32
Rate for Payer: Cash Price $559.94
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: United Healthcare Commercial $735.39
Service Code CPT C1713
Hospital Charge Code 41603789
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $787.65
Rate for Payer: Aetna Medicare $298.64
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $289.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $535.96
Rate for Payer: Anthem Blue Cross of IN Traditional $583.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $343.43
Rate for Payer: CareSource Indiana of IN Medicare $328.50
Rate for Payer: Cash Price $559.94
Rate for Payer: Cash Price $559.94
Rate for Payer: Centivo All Commercial $507.68
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Humana Medicare $298.64
Rate for Payer: Lucent All Commercial $507.68
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Plain Church Group Ministry All Commercial $363.96
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: Three Rivers Preferred All Commercial $793.25
Rate for Payer: United Healthcare Commercial $735.39
Rate for Payer: United Healthcare Medicare $298.64
Service Code CPT C1713
Hospital Charge Code 41603789
Hospital Revenue Code 278
Min. Negotiated Rate $699.93
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $806.32
Rate for Payer: Cash Price $559.94
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: United Healthcare Commercial $735.39
Service Code CPT C1713
Hospital Charge Code 41603788
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $787.65
Rate for Payer: Aetna Medicare $298.64
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $289.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $535.96
Rate for Payer: Anthem Blue Cross of IN Traditional $583.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $343.43
Rate for Payer: CareSource Indiana of IN Medicare $328.50
Rate for Payer: Cash Price $559.94
Rate for Payer: Cash Price $559.94
Rate for Payer: Centivo All Commercial $507.68
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Humana Medicare $298.64
Rate for Payer: Lucent All Commercial $507.68
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Plain Church Group Ministry All Commercial $363.96
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: Three Rivers Preferred All Commercial $793.25
Rate for Payer: United Healthcare Commercial $735.39
Rate for Payer: United Healthcare Medicare $298.64
Service Code CPT C1713
Hospital Charge Code 41603788
Hospital Revenue Code 278
Min. Negotiated Rate $699.93
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $806.32
Rate for Payer: Cash Price $559.94
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: United Healthcare Commercial $735.39
Service Code CPT C1713
Hospital Charge Code 41603787
Hospital Revenue Code 278
Min. Negotiated Rate $699.93
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $806.32
Rate for Payer: Cash Price $559.94
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: United Healthcare Commercial $735.39
Service Code CPT C1713
Hospital Charge Code 41603787
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $787.65
Rate for Payer: Aetna Medicare $298.64
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $289.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $535.96
Rate for Payer: Anthem Blue Cross of IN Traditional $583.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $343.43
Rate for Payer: CareSource Indiana of IN Medicare $328.50
Rate for Payer: Cash Price $559.94
Rate for Payer: Cash Price $559.94
Rate for Payer: Centivo All Commercial $507.68
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Humana Medicare $298.64
Rate for Payer: Lucent All Commercial $507.68
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Plain Church Group Ministry All Commercial $363.96
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: Three Rivers Preferred All Commercial $793.25
Rate for Payer: United Healthcare Commercial $735.39
Rate for Payer: United Healthcare Medicare $298.64
Service Code CPT C1713
Hospital Charge Code 41603786
Hospital Revenue Code 278
Min. Negotiated Rate $699.93
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $806.32
Rate for Payer: Cash Price $559.94
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: United Healthcare Commercial $735.39
Service Code CPT C1713
Hospital Charge Code 41603786
Hospital Revenue Code 278
Min. Negotiated Rate $134.40
Max. Negotiated Rate $867.91
Rate for Payer: Aetna Commercial $787.65
Rate for Payer: Aetna Medicare $298.64
Rate for Payer: Anthem Blue Cross of IN Medicaid $134.40
Rate for Payer: Anthem Blue Cross of IN Medicare $289.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway $535.96
Rate for Payer: Anthem Blue Cross of IN Traditional $583.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP $134.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $343.43
Rate for Payer: CareSource Indiana of IN Medicare $328.50
Rate for Payer: Cash Price $559.94
Rate for Payer: Cash Price $559.94
Rate for Payer: Centivo All Commercial $507.68
Rate for Payer: Cigna All Commercial $805.39
Rate for Payer: CORVEL All Commercial $867.91
Rate for Payer: Coventry All Commercial $821.25
Rate for Payer: Encore All Commercial $859.05
Rate for Payer: Frontpath All Commercial $858.58
Rate for Payer: Humana ChoiceCare $806.04
Rate for Payer: Humana Medicare $298.64
Rate for Payer: Lucent All Commercial $507.68
Rate for Payer: Lutheran Preferred All Commercial $839.92
Rate for Payer: Managed Health Services Medicaid $134.40
Rate for Payer: MDWise Medicaid $134.40
Rate for Payer: PHCS All Commercial $699.93
Rate for Payer: PHP All Commercial $707.77
Rate for Payer: Plain Church Group Ministry All Commercial $363.96
Rate for Payer: Sagamore Health Network All Products $720.46
Rate for Payer: Signature Care EPO $774.59
Rate for Payer: Signature Care PPO $821.25
Rate for Payer: Three Rivers Preferred All Commercial $793.25
Rate for Payer: United Healthcare Commercial $735.39
Rate for Payer: United Healthcare Medicare $298.64