|
HC Z SCREW T15 3.5X48 M-D LOCK
|
Facility
|
IP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603828
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$685.54 |
| Max. Negotiated Rate |
$850.07 |
| Rate for Payer: Aetna Commercial |
$789.74
|
| Rate for Payer: Cash Price |
$548.43
|
| Rate for Payer: Cigna All Commercial |
$788.83
|
| Rate for Payer: CORVEL All Commercial |
$850.07
|
| Rate for Payer: Coventry All Commercial |
$804.36
|
| Rate for Payer: Encore All Commercial |
$841.38
|
| Rate for Payer: Frontpath All Commercial |
$840.93
|
| Rate for Payer: Humana ChoiceCare |
$789.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$822.64
|
| Rate for Payer: PHCS All Commercial |
$685.54
|
| Rate for Payer: PHP All Commercial |
$693.22
|
| Rate for Payer: Sagamore Health Network All Products |
$705.65
|
| Rate for Payer: Signature Care EPO |
$758.66
|
| Rate for Payer: Signature Care PPO |
$804.36
|
| Rate for Payer: United Healthcare Commercial |
$720.27
|
|
|
HC Z SCREW T15 3.5X48 M-D LOCK
|
Facility
|
OP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603828
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$850.07 |
| Rate for Payer: Aetna Commercial |
$771.46
|
| Rate for Payer: Aetna Medicare |
$292.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$524.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$571.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$336.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$321.75
|
| Rate for Payer: Cash Price |
$548.43
|
| Rate for Payer: Cash Price |
$548.43
|
| Rate for Payer: Centivo All Commercial |
$497.24
|
| Rate for Payer: Cigna All Commercial |
$788.83
|
| Rate for Payer: CORVEL All Commercial |
$850.07
|
| Rate for Payer: Coventry All Commercial |
$804.36
|
| Rate for Payer: Encore All Commercial |
$841.38
|
| Rate for Payer: Frontpath All Commercial |
$840.93
|
| Rate for Payer: Humana ChoiceCare |
$789.46
|
| Rate for Payer: Humana Medicare |
$292.50
|
| Rate for Payer: Lucent All Commercial |
$497.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$822.64
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$685.54
|
| Rate for Payer: PHP All Commercial |
$693.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$356.48
|
| Rate for Payer: Sagamore Health Network All Products |
$705.65
|
| Rate for Payer: Signature Care EPO |
$758.66
|
| Rate for Payer: Signature Care PPO |
$804.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$776.94
|
| Rate for Payer: United Healthcare Commercial |
$720.27
|
| Rate for Payer: United Healthcare Medicare |
$292.50
|
|
|
HC Z SCREW T15 3.5X52 M-D LOCK
|
Facility
|
IP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$685.54 |
| Max. Negotiated Rate |
$850.07 |
| Rate for Payer: Aetna Commercial |
$789.74
|
| Rate for Payer: Cash Price |
$548.43
|
| Rate for Payer: Cigna All Commercial |
$788.83
|
| Rate for Payer: CORVEL All Commercial |
$850.07
|
| Rate for Payer: Coventry All Commercial |
$804.36
|
| Rate for Payer: Encore All Commercial |
$841.38
|
| Rate for Payer: Frontpath All Commercial |
$840.93
|
| Rate for Payer: Humana ChoiceCare |
$789.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$822.64
|
| Rate for Payer: PHCS All Commercial |
$685.54
|
| Rate for Payer: PHP All Commercial |
$693.22
|
| Rate for Payer: Sagamore Health Network All Products |
$705.65
|
| Rate for Payer: Signature Care EPO |
$758.66
|
| Rate for Payer: Signature Care PPO |
$804.36
|
| Rate for Payer: United Healthcare Commercial |
$720.27
|
|
|
HC Z SCREW T15 3.5X52 M-D LOCK
|
Facility
|
OP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$850.07 |
| Rate for Payer: Aetna Commercial |
$771.46
|
| Rate for Payer: Aetna Medicare |
$292.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$524.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$571.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$336.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$321.75
|
| Rate for Payer: Cash Price |
$548.43
|
| Rate for Payer: Cash Price |
$548.43
|
| Rate for Payer: Centivo All Commercial |
$497.24
|
| Rate for Payer: Cigna All Commercial |
$788.83
|
| Rate for Payer: CORVEL All Commercial |
$850.07
|
| Rate for Payer: Coventry All Commercial |
$804.36
|
| Rate for Payer: Encore All Commercial |
$841.38
|
| Rate for Payer: Frontpath All Commercial |
$840.93
|
| Rate for Payer: Humana ChoiceCare |
$789.46
|
| Rate for Payer: Humana Medicare |
$292.50
|
| Rate for Payer: Lucent All Commercial |
$497.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$822.64
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$685.54
|
| Rate for Payer: PHP All Commercial |
$693.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$356.48
|
| Rate for Payer: Sagamore Health Network All Products |
$705.65
|
| Rate for Payer: Signature Care EPO |
$758.66
|
| Rate for Payer: Signature Care PPO |
$804.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$776.94
|
| Rate for Payer: United Healthcare Commercial |
$720.27
|
| Rate for Payer: United Healthcare Medicare |
$292.50
|
|
|
HC Z SCREW T15 3.5X58 M-D LOCK
|
Facility
|
OP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$850.07 |
| Rate for Payer: Aetna Commercial |
$771.46
|
| Rate for Payer: Aetna Medicare |
$292.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$524.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$571.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$336.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$321.75
|
| Rate for Payer: Cash Price |
$548.43
|
| Rate for Payer: Cash Price |
$548.43
|
| Rate for Payer: Centivo All Commercial |
$497.24
|
| Rate for Payer: Cigna All Commercial |
$788.83
|
| Rate for Payer: CORVEL All Commercial |
$850.07
|
| Rate for Payer: Coventry All Commercial |
$804.36
|
| Rate for Payer: Encore All Commercial |
$841.38
|
| Rate for Payer: Frontpath All Commercial |
$840.93
|
| Rate for Payer: Humana ChoiceCare |
$789.46
|
| Rate for Payer: Humana Medicare |
$292.50
|
| Rate for Payer: Lucent All Commercial |
$497.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$822.64
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$685.54
|
| Rate for Payer: PHP All Commercial |
$693.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$356.48
|
| Rate for Payer: Sagamore Health Network All Products |
$705.65
|
| Rate for Payer: Signature Care EPO |
$758.66
|
| Rate for Payer: Signature Care PPO |
$804.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$776.94
|
| Rate for Payer: United Healthcare Commercial |
$720.27
|
| Rate for Payer: United Healthcare Medicare |
$292.50
|
|
|
HC Z SCREW T15 3.5X58 M-D LOCK
|
Facility
|
IP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$685.54 |
| Max. Negotiated Rate |
$850.07 |
| Rate for Payer: Aetna Commercial |
$789.74
|
| Rate for Payer: Cash Price |
$548.43
|
| Rate for Payer: Cigna All Commercial |
$788.83
|
| Rate for Payer: CORVEL All Commercial |
$850.07
|
| Rate for Payer: Coventry All Commercial |
$804.36
|
| Rate for Payer: Encore All Commercial |
$841.38
|
| Rate for Payer: Frontpath All Commercial |
$840.93
|
| Rate for Payer: Humana ChoiceCare |
$789.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$822.64
|
| Rate for Payer: PHCS All Commercial |
$685.54
|
| Rate for Payer: PHP All Commercial |
$693.22
|
| Rate for Payer: Sagamore Health Network All Products |
$705.65
|
| Rate for Payer: Signature Care EPO |
$758.66
|
| Rate for Payer: Signature Care PPO |
$804.36
|
| Rate for Payer: United Healthcare Commercial |
$720.27
|
|
|
HC Z SF SCREW HEX 3.5X34
|
Facility
|
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.36 |
| Max. Negotiated Rate |
$160.41 |
| Rate for Payer: Aetna Commercial |
$149.02
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
|
|
HC Z SF SCREW HEX 3.5X34
|
Facility
|
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.47 |
| Max. Negotiated Rate |
$160.41 |
| Rate for Payer: Aetna Commercial |
$145.57
|
| Rate for Payer: Aetna Medicare |
$55.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$53.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$99.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$107.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$63.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$60.71
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Centivo All Commercial |
$93.83
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Humana Medicare |
$55.19
|
| Rate for Payer: Lucent All Commercial |
$93.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.27
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$146.61
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
| Rate for Payer: United Healthcare Medicare |
$55.19
|
|
|
HC Z SF SCREW HEX 3.5X40
|
Facility
|
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604184
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.47 |
| Max. Negotiated Rate |
$160.41 |
| Rate for Payer: Aetna Commercial |
$145.57
|
| Rate for Payer: Aetna Medicare |
$55.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$53.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$99.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$107.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$63.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$60.71
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Centivo All Commercial |
$93.83
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Humana Medicare |
$55.19
|
| Rate for Payer: Lucent All Commercial |
$93.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.27
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$146.61
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
| Rate for Payer: United Healthcare Medicare |
$55.19
|
|
|
HC Z SF SCREW HEX 3.5X40
|
Facility
|
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604184
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.36 |
| Max. Negotiated Rate |
$160.41 |
| Rate for Payer: Aetna Commercial |
$149.02
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
|
|
HC Z SF SCREW HEX 3.5X50
|
Facility
|
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.47 |
| Max. Negotiated Rate |
$160.41 |
| Rate for Payer: Aetna Commercial |
$145.57
|
| Rate for Payer: Aetna Medicare |
$55.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$53.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$99.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$107.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$63.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$60.71
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Centivo All Commercial |
$93.83
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Humana Medicare |
$55.19
|
| Rate for Payer: Lucent All Commercial |
$93.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.27
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$146.61
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
| Rate for Payer: United Healthcare Medicare |
$55.19
|
|
|
HC Z SF SCREW HEX 3.5X50
|
Facility
|
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.36 |
| Max. Negotiated Rate |
$160.41 |
| Rate for Payer: Aetna Commercial |
$149.02
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
|
|
HC Z SF T-PLATE 3.5 6-H 8
|
Facility
|
OP
|
$1,830.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,702.78 |
| Rate for Payer: Aetna Commercial |
$1,545.32
|
| Rate for Payer: Aetna Medicare |
$585.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$567.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,051.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,144.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$673.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$644.49
|
| Rate for Payer: Cash Price |
$1,098.57
|
| Rate for Payer: Cash Price |
$1,098.57
|
| Rate for Payer: Centivo All Commercial |
$996.04
|
| Rate for Payer: Cigna All Commercial |
$1,580.11
|
| Rate for Payer: CORVEL All Commercial |
$1,702.78
|
| Rate for Payer: Coventry All Commercial |
$1,611.24
|
| Rate for Payer: Encore All Commercial |
$1,685.39
|
| Rate for Payer: Frontpath All Commercial |
$1,684.47
|
| Rate for Payer: Humana ChoiceCare |
$1,581.39
|
| Rate for Payer: Humana Medicare |
$585.90
|
| Rate for Payer: Lucent All Commercial |
$996.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,647.86
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,373.21
|
| Rate for Payer: PHP All Commercial |
$1,388.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$714.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,413.49
|
| Rate for Payer: Signature Care EPO |
$1,519.69
|
| Rate for Payer: Signature Care PPO |
$1,611.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,556.31
|
| Rate for Payer: United Healthcare Commercial |
$1,442.79
|
| Rate for Payer: United Healthcare Medicare |
$585.90
|
|
|
HC Z SF T-PLATE 3.5 6-H 8
|
Facility
|
IP
|
$1,830.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,373.21 |
| Max. Negotiated Rate |
$1,702.78 |
| Rate for Payer: Aetna Commercial |
$1,581.94
|
| Rate for Payer: Cash Price |
$1,098.57
|
| Rate for Payer: Cigna All Commercial |
$1,580.11
|
| Rate for Payer: CORVEL All Commercial |
$1,702.78
|
| Rate for Payer: Coventry All Commercial |
$1,611.24
|
| Rate for Payer: Encore All Commercial |
$1,685.39
|
| Rate for Payer: Frontpath All Commercial |
$1,684.47
|
| Rate for Payer: Humana ChoiceCare |
$1,581.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,647.86
|
| Rate for Payer: PHCS All Commercial |
$1,373.21
|
| Rate for Payer: PHP All Commercial |
$1,388.59
|
| Rate for Payer: Sagamore Health Network All Products |
$1,413.49
|
| Rate for Payer: Signature Care EPO |
$1,519.69
|
| Rate for Payer: Signature Care PPO |
$1,611.24
|
| Rate for Payer: United Healthcare Commercial |
$1,442.79
|
|
|
HC Z SM AUG BASEPLATE
|
Facility
|
IP
|
$8,694.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607139
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,520.50 |
| Max. Negotiated Rate |
$8,085.42 |
| Rate for Payer: Aetna Commercial |
$7,511.62
|
| Rate for Payer: Cash Price |
$5,216.40
|
| Rate for Payer: Cigna All Commercial |
$7,502.92
|
| Rate for Payer: CORVEL All Commercial |
$8,085.42
|
| Rate for Payer: Coventry All Commercial |
$7,650.72
|
| Rate for Payer: Encore All Commercial |
$8,002.83
|
| Rate for Payer: Frontpath All Commercial |
$7,998.48
|
| Rate for Payer: Humana ChoiceCare |
$7,509.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,824.60
|
| Rate for Payer: PHCS All Commercial |
$6,520.50
|
| Rate for Payer: PHP All Commercial |
$6,593.53
|
| Rate for Payer: Sagamore Health Network All Products |
$6,711.77
|
| Rate for Payer: Signature Care EPO |
$7,216.02
|
| Rate for Payer: Signature Care PPO |
$7,650.72
|
| Rate for Payer: United Healthcare Commercial |
$6,850.87
|
|
|
HC Z SM AUG BASEPLATE
|
Facility
|
OP
|
$8,694.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607139
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$8,085.42 |
| Rate for Payer: Aetna Commercial |
$7,337.74
|
| Rate for Payer: Aetna Medicare |
$2,782.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,695.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$4,992.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,434.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,199.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,060.29
|
| Rate for Payer: Cash Price |
$5,216.40
|
| Rate for Payer: Cash Price |
$5,216.40
|
| Rate for Payer: Centivo All Commercial |
$4,729.54
|
| Rate for Payer: Cigna All Commercial |
$7,502.92
|
| Rate for Payer: CORVEL All Commercial |
$8,085.42
|
| Rate for Payer: Coventry All Commercial |
$7,650.72
|
| Rate for Payer: Encore All Commercial |
$8,002.83
|
| Rate for Payer: Frontpath All Commercial |
$7,998.48
|
| Rate for Payer: Humana ChoiceCare |
$7,509.01
|
| Rate for Payer: Humana Medicare |
$2,782.08
|
| Rate for Payer: Lucent All Commercial |
$4,729.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,824.60
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$6,520.50
|
| Rate for Payer: PHP All Commercial |
$6,593.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,390.66
|
| Rate for Payer: Sagamore Health Network All Products |
$6,711.77
|
| Rate for Payer: Signature Care EPO |
$7,216.02
|
| Rate for Payer: Signature Care PPO |
$7,650.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,389.90
|
| Rate for Payer: United Healthcare Commercial |
$6,850.87
|
| Rate for Payer: United Healthcare Medicare |
$2,782.08
|
|
|
HC Z STEM HUM 160 MICRO
|
Facility
|
IP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608198
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,420.00 |
| Max. Negotiated Rate |
$15,400.80 |
| Rate for Payer: Aetna Commercial |
$14,307.84
|
| Rate for Payer: Cash Price |
$9,936.00
|
| Rate for Payer: Cigna All Commercial |
$14,291.28
|
| Rate for Payer: CORVEL All Commercial |
$15,400.80
|
| Rate for Payer: Coventry All Commercial |
$14,572.80
|
| Rate for Payer: Encore All Commercial |
$15,243.48
|
| Rate for Payer: Frontpath All Commercial |
$15,235.20
|
| Rate for Payer: Humana ChoiceCare |
$14,302.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,904.00
|
| Rate for Payer: PHCS All Commercial |
$12,420.00
|
| Rate for Payer: PHP All Commercial |
$12,559.10
|
| Rate for Payer: Sagamore Health Network All Products |
$12,784.32
|
| Rate for Payer: Signature Care EPO |
$13,744.80
|
| Rate for Payer: Signature Care PPO |
$14,572.80
|
| Rate for Payer: United Healthcare Commercial |
$13,049.28
|
|
|
HC Z STEM HUM 160 MICRO
|
Facility
|
OP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608198
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$15,400.80 |
| Rate for Payer: Aetna Commercial |
$13,976.64
|
| Rate for Payer: Aetna Medicare |
$5,299.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,133.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$9,510.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,351.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,094.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,829.12
|
| Rate for Payer: Cash Price |
$9,936.00
|
| Rate for Payer: Cash Price |
$9,936.00
|
| Rate for Payer: Centivo All Commercial |
$9,008.64
|
| Rate for Payer: Cigna All Commercial |
$14,291.28
|
| Rate for Payer: CORVEL All Commercial |
$15,400.80
|
| Rate for Payer: Coventry All Commercial |
$14,572.80
|
| Rate for Payer: Encore All Commercial |
$15,243.48
|
| Rate for Payer: Frontpath All Commercial |
$15,235.20
|
| Rate for Payer: Humana ChoiceCare |
$14,302.87
|
| Rate for Payer: Humana Medicare |
$5,299.20
|
| Rate for Payer: Lucent All Commercial |
$9,008.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,904.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$12,420.00
|
| Rate for Payer: PHP All Commercial |
$12,559.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,458.40
|
| Rate for Payer: Sagamore Health Network All Products |
$12,784.32
|
| Rate for Payer: Signature Care EPO |
$13,744.80
|
| Rate for Payer: Signature Care PPO |
$14,572.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,076.00
|
| Rate for Payer: United Healthcare Commercial |
$13,049.28
|
| Rate for Payer: United Healthcare Medicare |
$5,299.20
|
|
|
HC Z STEM PRIMARY 13 MICRO
|
Facility
|
IP
|
$11,823.84
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607505
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,867.88 |
| Max. Negotiated Rate |
$10,996.17 |
| Rate for Payer: Aetna Commercial |
$10,215.80
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Cigna All Commercial |
$10,203.97
|
| Rate for Payer: CORVEL All Commercial |
$10,996.17
|
| Rate for Payer: Coventry All Commercial |
$10,404.98
|
| Rate for Payer: Encore All Commercial |
$10,883.84
|
| Rate for Payer: Frontpath All Commercial |
$10,877.93
|
| Rate for Payer: Humana ChoiceCare |
$10,212.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,641.46
|
| Rate for Payer: PHCS All Commercial |
$8,867.88
|
| Rate for Payer: PHP All Commercial |
$8,967.20
|
| Rate for Payer: Sagamore Health Network All Products |
$9,128.00
|
| Rate for Payer: Signature Care EPO |
$9,813.79
|
| Rate for Payer: Signature Care PPO |
$10,404.98
|
| Rate for Payer: United Healthcare Commercial |
$9,317.19
|
|
|
HC Z STEM PRIMARY 13 MICRO
|
Facility
|
OP
|
$11,823.84
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607505
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$10,996.17 |
| Rate for Payer: Aetna Commercial |
$9,979.32
|
| Rate for Payer: Aetna Medicare |
$3,783.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,665.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6,790.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,391.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,351.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,161.99
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Centivo All Commercial |
$6,432.17
|
| Rate for Payer: Cigna All Commercial |
$10,203.97
|
| Rate for Payer: CORVEL All Commercial |
$10,996.17
|
| Rate for Payer: Coventry All Commercial |
$10,404.98
|
| Rate for Payer: Encore All Commercial |
$10,883.84
|
| Rate for Payer: Frontpath All Commercial |
$10,877.93
|
| Rate for Payer: Humana ChoiceCare |
$10,212.25
|
| Rate for Payer: Humana Medicare |
$3,783.63
|
| Rate for Payer: Lucent All Commercial |
$6,432.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,641.46
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$8,867.88
|
| Rate for Payer: PHP All Commercial |
$8,967.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,611.30
|
| Rate for Payer: Sagamore Health Network All Products |
$9,128.00
|
| Rate for Payer: Signature Care EPO |
$9,813.79
|
| Rate for Payer: Signature Care PPO |
$10,404.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,050.26
|
| Rate for Payer: United Healthcare Commercial |
$9,317.19
|
| Rate for Payer: United Healthcare Medicare |
$3,783.63
|
|
|
HC Z STEM PRIMARY 14 MICRO
|
Facility
|
OP
|
$11,823.84
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$10,996.17 |
| Rate for Payer: Aetna Commercial |
$9,979.32
|
| Rate for Payer: Aetna Medicare |
$3,783.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,665.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6,790.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,391.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,351.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,161.99
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Centivo All Commercial |
$6,432.17
|
| Rate for Payer: Cigna All Commercial |
$10,203.97
|
| Rate for Payer: CORVEL All Commercial |
$10,996.17
|
| Rate for Payer: Coventry All Commercial |
$10,404.98
|
| Rate for Payer: Encore All Commercial |
$10,883.84
|
| Rate for Payer: Frontpath All Commercial |
$10,877.93
|
| Rate for Payer: Humana ChoiceCare |
$10,212.25
|
| Rate for Payer: Humana Medicare |
$3,783.63
|
| Rate for Payer: Lucent All Commercial |
$6,432.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,641.46
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$8,867.88
|
| Rate for Payer: PHP All Commercial |
$8,967.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,611.30
|
| Rate for Payer: Sagamore Health Network All Products |
$9,128.00
|
| Rate for Payer: Signature Care EPO |
$9,813.79
|
| Rate for Payer: Signature Care PPO |
$10,404.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,050.26
|
| Rate for Payer: United Healthcare Commercial |
$9,317.19
|
| Rate for Payer: United Healthcare Medicare |
$3,783.63
|
|
|
HC Z STEM PRIMARY 14 MICRO
|
Facility
|
IP
|
$11,823.84
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,867.88 |
| Max. Negotiated Rate |
$10,996.17 |
| Rate for Payer: Aetna Commercial |
$10,215.80
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Cigna All Commercial |
$10,203.97
|
| Rate for Payer: CORVEL All Commercial |
$10,996.17
|
| Rate for Payer: Coventry All Commercial |
$10,404.98
|
| Rate for Payer: Encore All Commercial |
$10,883.84
|
| Rate for Payer: Frontpath All Commercial |
$10,877.93
|
| Rate for Payer: Humana ChoiceCare |
$10,212.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,641.46
|
| Rate for Payer: PHCS All Commercial |
$8,867.88
|
| Rate for Payer: PHP All Commercial |
$8,967.20
|
| Rate for Payer: Sagamore Health Network All Products |
$9,128.00
|
| Rate for Payer: Signature Care EPO |
$9,813.79
|
| Rate for Payer: Signature Care PPO |
$10,404.98
|
| Rate for Payer: United Healthcare Commercial |
$9,317.19
|
|
|
HC Z STEM PRIMARY 16 MICRO
|
Facility
|
IP
|
$11,823.84
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607138
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,867.88 |
| Max. Negotiated Rate |
$10,996.17 |
| Rate for Payer: Aetna Commercial |
$10,215.80
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Cigna All Commercial |
$10,203.97
|
| Rate for Payer: CORVEL All Commercial |
$10,996.17
|
| Rate for Payer: Coventry All Commercial |
$10,404.98
|
| Rate for Payer: Encore All Commercial |
$10,883.84
|
| Rate for Payer: Frontpath All Commercial |
$10,877.93
|
| Rate for Payer: Humana ChoiceCare |
$10,212.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,641.46
|
| Rate for Payer: PHCS All Commercial |
$8,867.88
|
| Rate for Payer: PHP All Commercial |
$8,967.20
|
| Rate for Payer: Sagamore Health Network All Products |
$9,128.00
|
| Rate for Payer: Signature Care EPO |
$9,813.79
|
| Rate for Payer: Signature Care PPO |
$10,404.98
|
| Rate for Payer: United Healthcare Commercial |
$9,317.19
|
|
|
HC Z STEM PRIMARY 16 MICRO
|
Facility
|
OP
|
$11,823.84
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607138
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$10,996.17 |
| Rate for Payer: Aetna Commercial |
$9,979.32
|
| Rate for Payer: Aetna Medicare |
$3,783.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,665.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6,790.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,391.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,351.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,161.99
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Centivo All Commercial |
$6,432.17
|
| Rate for Payer: Cigna All Commercial |
$10,203.97
|
| Rate for Payer: CORVEL All Commercial |
$10,996.17
|
| Rate for Payer: Coventry All Commercial |
$10,404.98
|
| Rate for Payer: Encore All Commercial |
$10,883.84
|
| Rate for Payer: Frontpath All Commercial |
$10,877.93
|
| Rate for Payer: Humana ChoiceCare |
$10,212.25
|
| Rate for Payer: Humana Medicare |
$3,783.63
|
| Rate for Payer: Lucent All Commercial |
$6,432.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,641.46
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$8,867.88
|
| Rate for Payer: PHP All Commercial |
$8,967.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,611.30
|
| Rate for Payer: Sagamore Health Network All Products |
$9,128.00
|
| Rate for Payer: Signature Care EPO |
$9,813.79
|
| Rate for Payer: Signature Care PPO |
$10,404.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,050.26
|
| Rate for Payer: United Healthcare Commercial |
$9,317.19
|
| Rate for Payer: United Healthcare Medicare |
$3,783.63
|
|
|
HC Z STEM PRIMARY 17 MICRO
|
Facility
|
OP
|
$11,823.84
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$10,996.17 |
| Rate for Payer: Aetna Commercial |
$9,979.32
|
| Rate for Payer: Aetna Medicare |
$3,783.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,665.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6,790.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,391.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,351.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,161.99
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Cash Price |
$7,094.30
|
| Rate for Payer: Centivo All Commercial |
$6,432.17
|
| Rate for Payer: Cigna All Commercial |
$10,203.97
|
| Rate for Payer: CORVEL All Commercial |
$10,996.17
|
| Rate for Payer: Coventry All Commercial |
$10,404.98
|
| Rate for Payer: Encore All Commercial |
$10,883.84
|
| Rate for Payer: Frontpath All Commercial |
$10,877.93
|
| Rate for Payer: Humana ChoiceCare |
$10,212.25
|
| Rate for Payer: Humana Medicare |
$3,783.63
|
| Rate for Payer: Lucent All Commercial |
$6,432.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,641.46
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$8,867.88
|
| Rate for Payer: PHP All Commercial |
$8,967.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,611.30
|
| Rate for Payer: Sagamore Health Network All Products |
$9,128.00
|
| Rate for Payer: Signature Care EPO |
$9,813.79
|
| Rate for Payer: Signature Care PPO |
$10,404.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,050.26
|
| Rate for Payer: United Healthcare Commercial |
$9,317.19
|
| Rate for Payer: United Healthcare Medicare |
$3,783.63
|
|
