|
HC Z STEM PRIMARY 17 MICRO
|
Facility
|
IP
|
$11,823.84
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607392
|
|
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 9 MICRO
|
Facility
|
OP
|
$11,823.84
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607482
|
|
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 9 MICRO
|
Facility
|
IP
|
$11,823.84
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607482
|
|
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 SUBSCAP REPAIR KIT SM
|
Facility
|
OP
|
$1,831.25
|
|
| Hospital Charge Code |
41608105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,703.06 |
| Rate for Payer: Aetna Commercial |
$1,545.58
|
| Rate for Payer: Aetna Medicare |
$586.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$567.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,051.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,144.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$673.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$644.60
|
| Rate for Payer: Cash Price |
$1,098.75
|
| Rate for Payer: Cash Price |
$1,098.75
|
| Rate for Payer: Centivo All Commercial |
$996.20
|
| Rate for Payer: Cigna All Commercial |
$1,580.37
|
| Rate for Payer: CORVEL All Commercial |
$1,703.06
|
| Rate for Payer: Coventry All Commercial |
$1,611.50
|
| Rate for Payer: Encore All Commercial |
$1,685.67
|
| Rate for Payer: Frontpath All Commercial |
$1,684.75
|
| Rate for Payer: Humana ChoiceCare |
$1,581.65
|
| Rate for Payer: Humana Medicare |
$586.00
|
| Rate for Payer: Lucent All Commercial |
$996.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,648.12
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,373.44
|
| Rate for Payer: PHP All Commercial |
$1,388.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$714.19
|
| Rate for Payer: Sagamore Health Network All Products |
$1,413.72
|
| Rate for Payer: Signature Care EPO |
$1,519.94
|
| Rate for Payer: Signature Care PPO |
$1,611.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,556.56
|
| Rate for Payer: United Healthcare Commercial |
$1,443.03
|
| Rate for Payer: United Healthcare Medicare |
$586.00
|
|
|
HC Z SUBSCAP REPAIR KIT SM
|
Facility
|
IP
|
$1,831.25
|
|
| Hospital Charge Code |
41608105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,373.44 |
| Max. Negotiated Rate |
$1,703.06 |
| Rate for Payer: Aetna Commercial |
$1,582.20
|
| Rate for Payer: Cash Price |
$1,098.75
|
| Rate for Payer: Cigna All Commercial |
$1,580.37
|
| Rate for Payer: CORVEL All Commercial |
$1,703.06
|
| Rate for Payer: Coventry All Commercial |
$1,611.50
|
| Rate for Payer: Encore All Commercial |
$1,685.67
|
| Rate for Payer: Frontpath All Commercial |
$1,684.75
|
| Rate for Payer: Humana ChoiceCare |
$1,581.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,648.12
|
| Rate for Payer: PHCS All Commercial |
$1,373.44
|
| Rate for Payer: PHP All Commercial |
$1,388.82
|
| Rate for Payer: Sagamore Health Network All Products |
$1,413.72
|
| Rate for Payer: Signature Care EPO |
$1,519.94
|
| Rate for Payer: Signature Care PPO |
$1,611.50
|
| Rate for Payer: United Healthcare Commercial |
$1,443.03
|
|
|
HC Z TAP 6.5 CANC
|
Facility
|
IP
|
$944.35
|
|
| Hospital Charge Code |
41607866
|
|
Hospital Revenue Code
|
272
|
| 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
|
|
|
HC Z TAP 6.5 CANC
|
Facility
|
OP
|
$944.35
|
|
| Hospital Charge Code |
41607866
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| 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 |
$31.20
|
| 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 |
$31.20
|
| 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 |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| 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
|
|
|
HC Z TAPE BRDBAND 2PK
|
Facility
|
IP
|
$735.00
|
|
| Hospital Charge Code |
41608011
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$551.25 |
| Max. Negotiated Rate |
$683.55 |
| Rate for Payer: Aetna Commercial |
$635.04
|
| Rate for Payer: Cash Price |
$441.00
|
| Rate for Payer: Cigna All Commercial |
$634.30
|
| Rate for Payer: CORVEL All Commercial |
$683.55
|
| Rate for Payer: Coventry All Commercial |
$646.80
|
| Rate for Payer: Encore All Commercial |
$676.57
|
| Rate for Payer: Frontpath All Commercial |
$676.20
|
| Rate for Payer: Humana ChoiceCare |
$634.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$661.50
|
| Rate for Payer: PHCS All Commercial |
$551.25
|
| Rate for Payer: PHP All Commercial |
$557.42
|
| Rate for Payer: Sagamore Health Network All Products |
$567.42
|
| Rate for Payer: Signature Care EPO |
$610.05
|
| Rate for Payer: Signature Care PPO |
$646.80
|
| Rate for Payer: United Healthcare Commercial |
$579.18
|
|
|
HC Z TAPE BRDBAND 2PK
|
Facility
|
OP
|
$735.00
|
|
| Hospital Charge Code |
41608011
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$683.55 |
| Rate for Payer: Aetna Commercial |
$620.34
|
| Rate for Payer: Aetna Medicare |
$235.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$227.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$422.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$459.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$270.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$258.72
|
| Rate for Payer: Cash Price |
$441.00
|
| Rate for Payer: Cash Price |
$441.00
|
| Rate for Payer: Centivo All Commercial |
$399.84
|
| Rate for Payer: Cigna All Commercial |
$634.30
|
| Rate for Payer: CORVEL All Commercial |
$683.55
|
| Rate for Payer: Coventry All Commercial |
$646.80
|
| Rate for Payer: Encore All Commercial |
$676.57
|
| Rate for Payer: Frontpath All Commercial |
$676.20
|
| Rate for Payer: Humana ChoiceCare |
$634.82
|
| Rate for Payer: Humana Medicare |
$235.20
|
| Rate for Payer: Lucent All Commercial |
$399.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$661.50
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$551.25
|
| Rate for Payer: PHP All Commercial |
$557.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$286.65
|
| Rate for Payer: Sagamore Health Network All Products |
$567.42
|
| Rate for Payer: Signature Care EPO |
$610.05
|
| Rate for Payer: Signature Care PPO |
$646.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$624.75
|
| Rate for Payer: United Healthcare Commercial |
$579.18
|
| Rate for Payer: United Healthcare Medicare |
$235.20
|
|
|
HC Z TAPER ADAPTOR 25
|
Facility
|
OP
|
$986.70
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605638
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$917.63 |
| Rate for Payer: Aetna Commercial |
$832.77
|
| Rate for Payer: Aetna Medicare |
$315.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$305.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$566.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$616.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$363.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$347.32
|
| Rate for Payer: Cash Price |
$592.02
|
| Rate for Payer: Cash Price |
$592.02
|
| Rate for Payer: Centivo All Commercial |
$536.76
|
| Rate for Payer: Cigna All Commercial |
$851.52
|
| Rate for Payer: CORVEL All Commercial |
$917.63
|
| Rate for Payer: Coventry All Commercial |
$868.30
|
| Rate for Payer: Encore All Commercial |
$908.26
|
| Rate for Payer: Frontpath All Commercial |
$907.76
|
| Rate for Payer: Humana ChoiceCare |
$852.21
|
| Rate for Payer: Humana Medicare |
$315.74
|
| Rate for Payer: Lucent All Commercial |
$536.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$888.03
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$740.02
|
| Rate for Payer: PHP All Commercial |
$748.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$384.81
|
| Rate for Payer: Sagamore Health Network All Products |
$761.73
|
| Rate for Payer: Signature Care EPO |
$818.96
|
| Rate for Payer: Signature Care PPO |
$868.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$838.70
|
| Rate for Payer: United Healthcare Commercial |
$777.52
|
| Rate for Payer: United Healthcare Medicare |
$315.74
|
|
|
HC Z TAPER ADAPTOR 25
|
Facility
|
IP
|
$986.70
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605638
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$740.02 |
| Max. Negotiated Rate |
$917.63 |
| Rate for Payer: Aetna Commercial |
$852.51
|
| Rate for Payer: Cash Price |
$592.02
|
| Rate for Payer: Cigna All Commercial |
$851.52
|
| Rate for Payer: CORVEL All Commercial |
$917.63
|
| Rate for Payer: Coventry All Commercial |
$868.30
|
| Rate for Payer: Encore All Commercial |
$908.26
|
| Rate for Payer: Frontpath All Commercial |
$907.76
|
| Rate for Payer: Humana ChoiceCare |
$852.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$888.03
|
| Rate for Payer: PHCS All Commercial |
$740.02
|
| Rate for Payer: PHP All Commercial |
$748.31
|
| Rate for Payer: Sagamore Health Network All Products |
$761.73
|
| Rate for Payer: Signature Care EPO |
$818.96
|
| Rate for Payer: Signature Care PPO |
$868.30
|
| Rate for Payer: United Healthcare Commercial |
$777.52
|
|
|
HC Z TIB STM 5 DEG C R
|
Facility
|
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605240
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB STM 5 DEG C R
|
Facility
|
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605240
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,907.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,848.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,193.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,098.48
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Centivo All Commercial |
$3,243.11
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$1,907.71
|
| Rate for Payer: Lucent All Commercial |
$3,243.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,907.71
|
|
|
HC Z TIB STM 5 DEG D L
|
Facility
|
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605241
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB STM 5 DEG D L
|
Facility
|
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605241
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,907.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,848.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,193.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,098.48
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Centivo All Commercial |
$3,243.11
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$1,907.71
|
| Rate for Payer: Lucent All Commercial |
$3,243.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,907.71
|
|
|
HC Z TIB STM 5 DEG D R
|
Facility
|
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB STM 5 DEG D R
|
Facility
|
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,907.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,848.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,193.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,098.48
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Centivo All Commercial |
$3,243.11
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$1,907.71
|
| Rate for Payer: Lucent All Commercial |
$3,243.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,907.71
|
|
|
HC Z TIB STM 5 DEG E L
|
Facility
|
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB STM 5 DEG E L
|
Facility
|
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,907.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,848.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,193.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,098.48
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Centivo All Commercial |
$3,243.11
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$1,907.71
|
| Rate for Payer: Lucent All Commercial |
$3,243.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,907.71
|
|
|
HC Z TIB STM 5 DEG E R
|
Facility
|
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,907.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,848.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,193.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,098.48
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Centivo All Commercial |
$3,243.11
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$1,907.71
|
| Rate for Payer: Lucent All Commercial |
$3,243.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,907.71
|
|
|
HC Z TIB STM 5 DEG E R
|
Facility
|
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB STM 5 DEG G L
|
Facility
|
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605247
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB STM 5 DEG G L
|
Facility
|
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605247
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,907.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,848.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,193.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,098.48
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Centivo All Commercial |
$3,243.11
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$1,907.71
|
| Rate for Payer: Lucent All Commercial |
$3,243.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,907.71
|
|
|
HC Z TIB STM 5 DEG H R
|
Facility
|
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB STM 5 DEG H R
|
Facility
|
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,907.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,848.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,193.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,098.48
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Cash Price |
$3,576.96
|
| Rate for Payer: Centivo All Commercial |
$3,243.11
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$1,907.71
|
| Rate for Payer: Lucent All Commercial |
$3,243.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,907.71
|
|
