|
HC SSB(LA) AB IGG
|
Facility
OP
|
$128.52
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
63001884
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$119.52 |
| Rate for Payer: Aetna Commercial |
$108.47
|
| Rate for Payer: Aetna Medicare |
$42.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$59.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$59.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$17.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.65
|
| Rate for Payer: Cash Price |
$79.68
|
| Rate for Payer: Cash Price |
$79.68
|
| Rate for Payer: Centivo All Commercial |
$65.55
|
| Rate for Payer: Cigna All Commercial |
$110.91
|
| Rate for Payer: CORVEL All Commercial |
$119.52
|
| Rate for Payer: Coventry All Commercial |
$113.10
|
| Rate for Payer: Encore All Commercial |
$118.30
|
| Rate for Payer: Frontpath All Commercial |
$118.24
|
| Rate for Payer: Humana ChoiceCare |
$111.00
|
| Rate for Payer: Humana Medicare |
$65.55
|
| Rate for Payer: Lucent All Commercial |
$65.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$115.67
|
| Rate for Payer: Managed Health Services Medicaid |
$17.93
|
| Rate for Payer: MDWise Medicaid |
$17.93
|
| Rate for Payer: PHCS All Commercial |
$96.39
|
| Rate for Payer: PHP All Commercial |
$97.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.12
|
| Rate for Payer: Sagamore Health Network All Products |
$99.22
|
| Rate for Payer: Signature Care EPO |
$106.67
|
| Rate for Payer: Signature Care PPO |
$113.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$109.24
|
| Rate for Payer: United Healthcare Commercial |
$101.27
|
| Rate for Payer: United Healthcare Medicare |
$42.41
|
|
|
HC S SCREW 5X35 T2 FT LOCK
|
Facility
OP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607120
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$430.47 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,100.96
|
| Rate for Payer: Aetna Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$749.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$495.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$473.52
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Centivo All Commercial |
$665.27
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Humana Medicare |
$665.27
|
| Rate for Payer: Lucent All Commercial |
$665.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$508.74
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,108.78
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
| Rate for Payer: United Healthcare Medicare |
$430.47
|
|
|
HC S SCREW 5X35 T2 FT LOCK
|
Facility
IP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607120
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$978.34 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,127.04
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
|
|
HC S SCREW 5X37.5 T2 FT LOCK
|
Facility
OP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$430.47 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,100.96
|
| Rate for Payer: Aetna Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$749.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$495.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$473.52
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Centivo All Commercial |
$665.27
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Humana Medicare |
$665.27
|
| Rate for Payer: Lucent All Commercial |
$665.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$508.74
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,108.78
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
| Rate for Payer: United Healthcare Medicare |
$430.47
|
|
|
HC S SCREW 5X37.5 T2 FT LOCK
|
Facility
IP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$978.34 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,127.04
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
|
|
HC S SCREW 5X60 T2 FT LOCK
|
Facility
OP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$430.47 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,100.96
|
| Rate for Payer: Aetna Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$749.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$495.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$473.52
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Centivo All Commercial |
$665.27
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Humana Medicare |
$665.27
|
| Rate for Payer: Lucent All Commercial |
$665.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$508.74
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,108.78
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
| Rate for Payer: United Healthcare Medicare |
$430.47
|
|
|
HC S SCREW 5X60 T2 FT LOCK
|
Facility
IP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$978.34 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,127.04
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
|
|
HC S SCREW 5X65 T2 FT LOCK
|
Facility
OP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$430.47 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,100.96
|
| Rate for Payer: Aetna Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$749.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$495.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$473.52
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Centivo All Commercial |
$665.27
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Humana Medicare |
$665.27
|
| Rate for Payer: Lucent All Commercial |
$665.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$508.74
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,108.78
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
| Rate for Payer: United Healthcare Medicare |
$430.47
|
|
|
HC S SCREW 5X65 T2 FT LOCK
|
Facility
IP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$978.34 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,127.04
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
|
|
HC S SCREW 5X75 T2 FT LOCK
|
Facility
IP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607124
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$978.34 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,127.04
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
|
|
HC S SCREW 5X75 T2 FT LOCK
|
Facility
OP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607124
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$430.47 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,100.96
|
| Rate for Payer: Aetna Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$749.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$495.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$473.52
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Centivo All Commercial |
$665.27
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Humana Medicare |
$665.27
|
| Rate for Payer: Lucent All Commercial |
$665.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$508.74
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,108.78
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
| Rate for Payer: United Healthcare Medicare |
$430.47
|
|
|
HC S SCREW 5X80 T2 FT LOCK
|
Facility
OP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$430.47 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,100.96
|
| Rate for Payer: Aetna Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$430.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$749.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$495.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$473.52
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Centivo All Commercial |
$665.27
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Humana Medicare |
$665.27
|
| Rate for Payer: Lucent All Commercial |
$665.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$508.74
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,108.78
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
| Rate for Payer: United Healthcare Medicare |
$430.47
|
|
|
HC S SCREW 5X80 T2 FT LOCK
|
Facility
IP
|
$1,304.45
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$978.34 |
| Max. Negotiated Rate |
$1,213.14 |
| Rate for Payer: Aetna Commercial |
$1,127.04
|
| Rate for Payer: Cash Price |
$808.76
|
| Rate for Payer: Cigna All Commercial |
$1,125.74
|
| Rate for Payer: CORVEL All Commercial |
$1,213.14
|
| Rate for Payer: Coventry All Commercial |
$1,147.92
|
| Rate for Payer: Encore All Commercial |
$1,200.75
|
| Rate for Payer: Frontpath All Commercial |
$1,200.09
|
| Rate for Payer: Humana ChoiceCare |
$1,126.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,174.00
|
| Rate for Payer: PHCS All Commercial |
$978.34
|
| Rate for Payer: PHP All Commercial |
$989.29
|
| Rate for Payer: Sagamore Health Network All Products |
$1,007.04
|
| Rate for Payer: Signature Care EPO |
$1,082.69
|
| Rate for Payer: Signature Care PPO |
$1,147.92
|
| Rate for Payer: United Healthcare Commercial |
$1,027.91
|
|
|
HC S SUT ANCHOR ICONIX 2.3
|
Facility
IP
|
$2,176.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607522
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,632.60 |
| Max. Negotiated Rate |
$2,024.42 |
| Rate for Payer: Aetna Commercial |
$1,880.76
|
| Rate for Payer: Cash Price |
$1,349.62
|
| Rate for Payer: Cigna All Commercial |
$1,878.58
|
| Rate for Payer: CORVEL All Commercial |
$2,024.42
|
| Rate for Payer: Coventry All Commercial |
$1,915.58
|
| Rate for Payer: Encore All Commercial |
$2,003.74
|
| Rate for Payer: Frontpath All Commercial |
$2,002.66
|
| Rate for Payer: Humana ChoiceCare |
$1,880.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,959.12
|
| Rate for Payer: PHCS All Commercial |
$1,632.60
|
| Rate for Payer: PHP All Commercial |
$1,650.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,680.49
|
| Rate for Payer: Signature Care EPO |
$1,806.74
|
| Rate for Payer: Signature Care PPO |
$1,915.58
|
| Rate for Payer: United Healthcare Commercial |
$1,715.32
|
|
|
HC S SUT ANCHOR ICONIX 2.3
|
Facility
OP
|
$2,176.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607522
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,024.42 |
| Rate for Payer: Aetna Commercial |
$1,837.22
|
| Rate for Payer: Aetna Medicare |
$718.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$718.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,250.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,360.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$826.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$790.18
|
| Rate for Payer: Cash Price |
$1,349.62
|
| Rate for Payer: Cash Price |
$1,349.62
|
| Rate for Payer: Centivo All Commercial |
$1,110.17
|
| Rate for Payer: Cigna All Commercial |
$1,878.58
|
| Rate for Payer: CORVEL All Commercial |
$2,024.42
|
| Rate for Payer: Coventry All Commercial |
$1,915.58
|
| Rate for Payer: Encore All Commercial |
$2,003.74
|
| Rate for Payer: Frontpath All Commercial |
$2,002.66
|
| Rate for Payer: Humana ChoiceCare |
$1,880.10
|
| Rate for Payer: Humana Medicare |
$1,110.17
|
| Rate for Payer: Lucent All Commercial |
$1,110.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,959.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,632.60
|
| Rate for Payer: PHP All Commercial |
$1,650.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$848.95
|
| Rate for Payer: Sagamore Health Network All Products |
$1,680.49
|
| Rate for Payer: Signature Care EPO |
$1,806.74
|
| Rate for Payer: Signature Care PPO |
$1,915.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,850.28
|
| Rate for Payer: United Healthcare Commercial |
$1,715.32
|
| Rate for Payer: United Healthcare Medicare |
$718.34
|
|
|
HC S SUT ANCHOR ICONIX 2.3 INTEL
|
Facility
OP
|
$2,092.10
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,945.65 |
| Rate for Payer: Aetna Commercial |
$1,765.73
|
| Rate for Payer: Aetna Medicare |
$690.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$690.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,201.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,307.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$793.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$759.43
|
| Rate for Payer: Cash Price |
$1,297.10
|
| Rate for Payer: Cash Price |
$1,297.10
|
| Rate for Payer: Centivo All Commercial |
$1,066.97
|
| Rate for Payer: Cigna All Commercial |
$1,805.48
|
| Rate for Payer: CORVEL All Commercial |
$1,945.65
|
| Rate for Payer: Coventry All Commercial |
$1,841.05
|
| Rate for Payer: Encore All Commercial |
$1,925.78
|
| Rate for Payer: Frontpath All Commercial |
$1,924.73
|
| Rate for Payer: Humana ChoiceCare |
$1,806.95
|
| Rate for Payer: Humana Medicare |
$1,066.97
|
| Rate for Payer: Lucent All Commercial |
$1,066.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,882.89
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,569.08
|
| Rate for Payer: PHP All Commercial |
$1,586.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$815.92
|
| Rate for Payer: Sagamore Health Network All Products |
$1,615.10
|
| Rate for Payer: Signature Care EPO |
$1,736.44
|
| Rate for Payer: Signature Care PPO |
$1,841.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,778.28
|
| Rate for Payer: United Healthcare Commercial |
$1,648.57
|
| Rate for Payer: United Healthcare Medicare |
$690.39
|
|
|
HC S SUT ANCHOR ICONIX 2.3 INTEL
|
Facility
IP
|
$2,092.10
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,569.08 |
| Max. Negotiated Rate |
$1,945.65 |
| Rate for Payer: Aetna Commercial |
$1,807.57
|
| Rate for Payer: Cash Price |
$1,297.10
|
| Rate for Payer: Cigna All Commercial |
$1,805.48
|
| Rate for Payer: CORVEL All Commercial |
$1,945.65
|
| Rate for Payer: Coventry All Commercial |
$1,841.05
|
| Rate for Payer: Encore All Commercial |
$1,925.78
|
| Rate for Payer: Frontpath All Commercial |
$1,924.73
|
| Rate for Payer: Humana ChoiceCare |
$1,806.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,882.89
|
| Rate for Payer: PHCS All Commercial |
$1,569.08
|
| Rate for Payer: PHP All Commercial |
$1,586.65
|
| Rate for Payer: Sagamore Health Network All Products |
$1,615.10
|
| Rate for Payer: Signature Care EPO |
$1,736.44
|
| Rate for Payer: Signature Care PPO |
$1,841.05
|
| Rate for Payer: United Healthcare Commercial |
$1,648.57
|
|
|
HC S SUT ANCHOR OMEGA 3.9
|
Facility
IP
|
$2,899.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607521
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,174.85 |
| Max. Negotiated Rate |
$2,696.81 |
| Rate for Payer: Aetna Commercial |
$2,505.43
|
| Rate for Payer: Cash Price |
$1,797.88
|
| Rate for Payer: Cigna All Commercial |
$2,502.53
|
| Rate for Payer: CORVEL All Commercial |
$2,696.81
|
| Rate for Payer: Coventry All Commercial |
$2,551.82
|
| Rate for Payer: Encore All Commercial |
$2,669.27
|
| Rate for Payer: Frontpath All Commercial |
$2,667.82
|
| Rate for Payer: Humana ChoiceCare |
$2,504.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,609.82
|
| Rate for Payer: PHCS All Commercial |
$2,174.85
|
| Rate for Payer: PHP All Commercial |
$2,199.21
|
| Rate for Payer: Sagamore Health Network All Products |
$2,238.65
|
| Rate for Payer: Signature Care EPO |
$2,406.83
|
| Rate for Payer: Signature Care PPO |
$2,551.82
|
| Rate for Payer: United Healthcare Commercial |
$2,285.04
|
|
|
HC S SUT ANCHOR OMEGA 3.9
|
Facility
OP
|
$2,899.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607521
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,696.81 |
| Rate for Payer: Aetna Commercial |
$2,447.43
|
| Rate for Payer: Aetna Medicare |
$956.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$956.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,665.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,812.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,100.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,052.63
|
| Rate for Payer: Cash Price |
$1,797.88
|
| Rate for Payer: Cash Price |
$1,797.88
|
| Rate for Payer: Centivo All Commercial |
$1,478.90
|
| Rate for Payer: Cigna All Commercial |
$2,502.53
|
| Rate for Payer: CORVEL All Commercial |
$2,696.81
|
| Rate for Payer: Coventry All Commercial |
$2,551.82
|
| Rate for Payer: Encore All Commercial |
$2,669.27
|
| Rate for Payer: Frontpath All Commercial |
$2,667.82
|
| Rate for Payer: Humana ChoiceCare |
$2,504.56
|
| Rate for Payer: Humana Medicare |
$1,478.90
|
| Rate for Payer: Lucent All Commercial |
$1,478.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,609.82
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,174.85
|
| Rate for Payer: PHP All Commercial |
$2,199.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,130.92
|
| Rate for Payer: Sagamore Health Network All Products |
$2,238.65
|
| Rate for Payer: Signature Care EPO |
$2,406.83
|
| Rate for Payer: Signature Care PPO |
$2,551.82
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,464.83
|
| Rate for Payer: United Healthcare Commercial |
$2,285.04
|
| Rate for Payer: United Healthcare Medicare |
$956.93
|
|
|
HC S SUT ANCHOR OMEGA 4.75
|
Facility
IP
|
$2,899.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607523
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,174.85 |
| Max. Negotiated Rate |
$2,696.81 |
| Rate for Payer: Aetna Commercial |
$2,505.43
|
| Rate for Payer: Cash Price |
$1,797.88
|
| Rate for Payer: Cigna All Commercial |
$2,502.53
|
| Rate for Payer: CORVEL All Commercial |
$2,696.81
|
| Rate for Payer: Coventry All Commercial |
$2,551.82
|
| Rate for Payer: Encore All Commercial |
$2,669.27
|
| Rate for Payer: Frontpath All Commercial |
$2,667.82
|
| Rate for Payer: Humana ChoiceCare |
$2,504.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,609.82
|
| Rate for Payer: PHCS All Commercial |
$2,174.85
|
| Rate for Payer: PHP All Commercial |
$2,199.21
|
| Rate for Payer: Sagamore Health Network All Products |
$2,238.65
|
| Rate for Payer: Signature Care EPO |
$2,406.83
|
| Rate for Payer: Signature Care PPO |
$2,551.82
|
| Rate for Payer: United Healthcare Commercial |
$2,285.04
|
|
|
HC S SUT ANCHOR OMEGA 4.75
|
Facility
OP
|
$2,899.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607523
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,696.81 |
| Rate for Payer: Aetna Commercial |
$2,447.43
|
| Rate for Payer: Aetna Medicare |
$956.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$956.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,665.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,812.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,100.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,052.63
|
| Rate for Payer: Cash Price |
$1,797.88
|
| Rate for Payer: Cash Price |
$1,797.88
|
| Rate for Payer: Centivo All Commercial |
$1,478.90
|
| Rate for Payer: Cigna All Commercial |
$2,502.53
|
| Rate for Payer: CORVEL All Commercial |
$2,696.81
|
| Rate for Payer: Coventry All Commercial |
$2,551.82
|
| Rate for Payer: Encore All Commercial |
$2,669.27
|
| Rate for Payer: Frontpath All Commercial |
$2,667.82
|
| Rate for Payer: Humana ChoiceCare |
$2,504.56
|
| Rate for Payer: Humana Medicare |
$1,478.90
|
| Rate for Payer: Lucent All Commercial |
$1,478.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,609.82
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,174.85
|
| Rate for Payer: PHP All Commercial |
$2,199.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,130.92
|
| Rate for Payer: Sagamore Health Network All Products |
$2,238.65
|
| Rate for Payer: Signature Care EPO |
$2,406.83
|
| Rate for Payer: Signature Care PPO |
$2,551.82
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,464.83
|
| Rate for Payer: United Healthcare Commercial |
$2,285.04
|
| Rate for Payer: United Healthcare Medicare |
$956.93
|
|
|
HC S SUTURE XBRAID 2 ST-1
|
Facility
OP
|
$504.00
|
|
| Hospital Charge Code |
41607671
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$468.72 |
| Rate for Payer: Aetna Commercial |
$425.38
|
| Rate for Payer: Aetna Medicare |
$166.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$166.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$289.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$315.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$191.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$182.95
|
| Rate for Payer: Cash Price |
$312.48
|
| Rate for Payer: Cash Price |
$312.48
|
| Rate for Payer: Centivo All Commercial |
$257.04
|
| Rate for Payer: Cigna All Commercial |
$434.95
|
| Rate for Payer: CORVEL All Commercial |
$468.72
|
| Rate for Payer: Coventry All Commercial |
$443.52
|
| Rate for Payer: Encore All Commercial |
$463.93
|
| Rate for Payer: Frontpath All Commercial |
$463.68
|
| Rate for Payer: Humana ChoiceCare |
$435.30
|
| Rate for Payer: Humana Medicare |
$257.04
|
| Rate for Payer: Lucent All Commercial |
$257.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$453.60
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$378.00
|
| Rate for Payer: PHP All Commercial |
$382.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$196.56
|
| Rate for Payer: Sagamore Health Network All Products |
$389.09
|
| Rate for Payer: Signature Care EPO |
$418.32
|
| Rate for Payer: Signature Care PPO |
$443.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$428.40
|
| Rate for Payer: United Healthcare Commercial |
$397.15
|
| Rate for Payer: United Healthcare Medicare |
$166.32
|
|
|
HC S SUTURE XBRAID 2 ST-1
|
Facility
IP
|
$504.00
|
|
| Hospital Charge Code |
41607671
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$378.00 |
| Max. Negotiated Rate |
$468.72 |
| Rate for Payer: Aetna Commercial |
$435.46
|
| Rate for Payer: Cash Price |
$312.48
|
| Rate for Payer: Cigna All Commercial |
$434.95
|
| Rate for Payer: CORVEL All Commercial |
$468.72
|
| Rate for Payer: Coventry All Commercial |
$443.52
|
| Rate for Payer: Encore All Commercial |
$463.93
|
| Rate for Payer: Frontpath All Commercial |
$463.68
|
| Rate for Payer: Humana ChoiceCare |
$435.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$453.60
|
| Rate for Payer: PHCS All Commercial |
$378.00
|
| Rate for Payer: PHP All Commercial |
$382.23
|
| Rate for Payer: Sagamore Health Network All Products |
$389.09
|
| Rate for Payer: Signature Care EPO |
$418.32
|
| Rate for Payer: Signature Care PPO |
$443.52
|
| Rate for Payer: United Healthcare Commercial |
$397.15
|
|
|
HC S SUTURE XBRAID TT 2.0
|
Facility
IP
|
$838.81
|
|
| Hospital Charge Code |
41607672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$629.11 |
| Max. Negotiated Rate |
$780.09 |
| Rate for Payer: Aetna Commercial |
$724.73
|
| Rate for Payer: Cash Price |
$520.06
|
| Rate for Payer: Cigna All Commercial |
$723.89
|
| Rate for Payer: CORVEL All Commercial |
$780.09
|
| Rate for Payer: Coventry All Commercial |
$738.15
|
| Rate for Payer: Encore All Commercial |
$772.12
|
| Rate for Payer: Frontpath All Commercial |
$771.71
|
| Rate for Payer: Humana ChoiceCare |
$724.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$754.93
|
| Rate for Payer: PHCS All Commercial |
$629.11
|
| Rate for Payer: PHP All Commercial |
$636.15
|
| Rate for Payer: Sagamore Health Network All Products |
$647.56
|
| Rate for Payer: Signature Care EPO |
$696.21
|
| Rate for Payer: Signature Care PPO |
$738.15
|
| Rate for Payer: United Healthcare Commercial |
$660.98
|
|
|
HC S SUTURE XBRAID TT 2.0
|
Facility
OP
|
$838.81
|
|
| Hospital Charge Code |
41607672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$780.09 |
| Rate for Payer: Aetna Commercial |
$707.96
|
| Rate for Payer: Aetna Medicare |
$276.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$276.81
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$481.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$524.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$318.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$304.49
|
| Rate for Payer: Cash Price |
$520.06
|
| Rate for Payer: Cash Price |
$520.06
|
| Rate for Payer: Centivo All Commercial |
$427.79
|
| Rate for Payer: Cigna All Commercial |
$723.89
|
| Rate for Payer: CORVEL All Commercial |
$780.09
|
| Rate for Payer: Coventry All Commercial |
$738.15
|
| Rate for Payer: Encore All Commercial |
$772.12
|
| Rate for Payer: Frontpath All Commercial |
$771.71
|
| Rate for Payer: Humana ChoiceCare |
$724.48
|
| Rate for Payer: Humana Medicare |
$427.79
|
| Rate for Payer: Lucent All Commercial |
$427.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$754.93
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$629.11
|
| Rate for Payer: PHP All Commercial |
$636.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$327.14
|
| Rate for Payer: Sagamore Health Network All Products |
$647.56
|
| Rate for Payer: Signature Care EPO |
$696.21
|
| Rate for Payer: Signature Care PPO |
$738.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$712.99
|
| Rate for Payer: United Healthcare Commercial |
$660.98
|
| Rate for Payer: United Healthcare Medicare |
$276.81
|
|
