|
HC S TIBIAL BRG 6X14 TRI
|
Facility
OP
|
$4,865.47
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607725
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,524.89 |
| Rate for Payer: Aetna Commercial |
$4,106.46
|
| Rate for Payer: Aetna Medicare |
$1,605.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,605.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,794.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,041.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,846.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,766.17
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Centivo All Commercial |
$2,481.39
|
| Rate for Payer: Cigna All Commercial |
$4,198.90
|
| Rate for Payer: CORVEL All Commercial |
$4,524.89
|
| Rate for Payer: Coventry All Commercial |
$4,281.61
|
| Rate for Payer: Encore All Commercial |
$4,478.67
|
| Rate for Payer: Frontpath All Commercial |
$4,476.23
|
| Rate for Payer: Humana ChoiceCare |
$4,202.31
|
| Rate for Payer: Humana Medicare |
$2,481.39
|
| Rate for Payer: Lucent All Commercial |
$2,481.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,378.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,649.10
|
| Rate for Payer: PHP All Commercial |
$3,689.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,897.53
|
| Rate for Payer: Sagamore Health Network All Products |
$3,756.14
|
| Rate for Payer: Signature Care EPO |
$4,038.34
|
| Rate for Payer: Signature Care PPO |
$4,281.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,135.65
|
| Rate for Payer: United Healthcare Commercial |
$3,833.99
|
| Rate for Payer: United Healthcare Medicare |
$1,605.61
|
|
|
HC S TIBIAL BRG 6X14 TRI
|
Facility
IP
|
$4,865.47
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607725
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,649.10 |
| Max. Negotiated Rate |
$4,524.89 |
| Rate for Payer: Aetna Commercial |
$4,203.77
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Cigna All Commercial |
$4,198.90
|
| Rate for Payer: CORVEL All Commercial |
$4,524.89
|
| Rate for Payer: Coventry All Commercial |
$4,281.61
|
| Rate for Payer: Encore All Commercial |
$4,478.67
|
| Rate for Payer: Frontpath All Commercial |
$4,476.23
|
| Rate for Payer: Humana ChoiceCare |
$4,202.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,378.92
|
| Rate for Payer: PHCS All Commercial |
$3,649.10
|
| Rate for Payer: PHP All Commercial |
$3,689.97
|
| Rate for Payer: Sagamore Health Network All Products |
$3,756.14
|
| Rate for Payer: Signature Care EPO |
$4,038.34
|
| Rate for Payer: Signature Care PPO |
$4,281.61
|
| Rate for Payer: United Healthcare Commercial |
$3,833.99
|
|
|
HC S TIBIAL BRG 6X9 TRI
|
Facility
IP
|
$4,865.47
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607642
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,649.10 |
| Max. Negotiated Rate |
$4,524.89 |
| Rate for Payer: Aetna Commercial |
$4,203.77
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Cigna All Commercial |
$4,198.90
|
| Rate for Payer: CORVEL All Commercial |
$4,524.89
|
| Rate for Payer: Coventry All Commercial |
$4,281.61
|
| Rate for Payer: Encore All Commercial |
$4,478.67
|
| Rate for Payer: Frontpath All Commercial |
$4,476.23
|
| Rate for Payer: Humana ChoiceCare |
$4,202.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,378.92
|
| Rate for Payer: PHCS All Commercial |
$3,649.10
|
| Rate for Payer: PHP All Commercial |
$3,689.97
|
| Rate for Payer: Sagamore Health Network All Products |
$3,756.14
|
| Rate for Payer: Signature Care EPO |
$4,038.34
|
| Rate for Payer: Signature Care PPO |
$4,281.61
|
| Rate for Payer: United Healthcare Commercial |
$3,833.99
|
|
|
HC S TIBIAL BRG 6X9 TRI
|
Facility
OP
|
$4,865.47
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607642
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,524.89 |
| Rate for Payer: Aetna Commercial |
$4,106.46
|
| Rate for Payer: Aetna Medicare |
$1,605.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,605.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,794.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,041.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,846.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,766.17
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Centivo All Commercial |
$2,481.39
|
| Rate for Payer: Cigna All Commercial |
$4,198.90
|
| Rate for Payer: CORVEL All Commercial |
$4,524.89
|
| Rate for Payer: Coventry All Commercial |
$4,281.61
|
| Rate for Payer: Encore All Commercial |
$4,478.67
|
| Rate for Payer: Frontpath All Commercial |
$4,476.23
|
| Rate for Payer: Humana ChoiceCare |
$4,202.31
|
| Rate for Payer: Humana Medicare |
$2,481.39
|
| Rate for Payer: Lucent All Commercial |
$2,481.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,378.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,649.10
|
| Rate for Payer: PHP All Commercial |
$3,689.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,897.53
|
| Rate for Payer: Sagamore Health Network All Products |
$3,756.14
|
| Rate for Payer: Signature Care EPO |
$4,038.34
|
| Rate for Payer: Signature Care PPO |
$4,281.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,135.65
|
| Rate for Payer: United Healthcare Commercial |
$3,833.99
|
| Rate for Payer: United Healthcare Medicare |
$1,605.61
|
|
|
HC S TIBIAL BRG 7X11 TRI
|
Facility
OP
|
$4,865.47
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607907
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,524.89 |
| Rate for Payer: Aetna Commercial |
$4,106.46
|
| Rate for Payer: Aetna Medicare |
$1,605.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,605.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,794.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,041.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,846.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,766.17
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Centivo All Commercial |
$2,481.39
|
| Rate for Payer: Cigna All Commercial |
$4,198.90
|
| Rate for Payer: CORVEL All Commercial |
$4,524.89
|
| Rate for Payer: Coventry All Commercial |
$4,281.61
|
| Rate for Payer: Encore All Commercial |
$4,478.67
|
| Rate for Payer: Frontpath All Commercial |
$4,476.23
|
| Rate for Payer: Humana ChoiceCare |
$4,202.31
|
| Rate for Payer: Humana Medicare |
$2,481.39
|
| Rate for Payer: Lucent All Commercial |
$2,481.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,378.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,649.10
|
| Rate for Payer: PHP All Commercial |
$3,689.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,897.53
|
| Rate for Payer: Sagamore Health Network All Products |
$3,756.14
|
| Rate for Payer: Signature Care EPO |
$4,038.34
|
| Rate for Payer: Signature Care PPO |
$4,281.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,135.65
|
| Rate for Payer: United Healthcare Commercial |
$3,833.99
|
| Rate for Payer: United Healthcare Medicare |
$1,605.61
|
|
|
HC S TIBIAL BRG 7X11 TRI
|
Facility
IP
|
$4,865.47
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607907
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,649.10 |
| Max. Negotiated Rate |
$4,524.89 |
| Rate for Payer: Aetna Commercial |
$4,203.77
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Cigna All Commercial |
$4,198.90
|
| Rate for Payer: CORVEL All Commercial |
$4,524.89
|
| Rate for Payer: Coventry All Commercial |
$4,281.61
|
| Rate for Payer: Encore All Commercial |
$4,478.67
|
| Rate for Payer: Frontpath All Commercial |
$4,476.23
|
| Rate for Payer: Humana ChoiceCare |
$4,202.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,378.92
|
| Rate for Payer: PHCS All Commercial |
$3,649.10
|
| Rate for Payer: PHP All Commercial |
$3,689.97
|
| Rate for Payer: Sagamore Health Network All Products |
$3,756.14
|
| Rate for Payer: Signature Care EPO |
$4,038.34
|
| Rate for Payer: Signature Care PPO |
$4,281.61
|
| Rate for Payer: United Healthcare Commercial |
$3,833.99
|
|
|
HC S TIBIAL COMP 3 TRI
|
Facility
OP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$4,927.74
|
| Rate for Payer: Aetna Medicare |
$1,926.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,926.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,353.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,649.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,215.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,119.39
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Centivo All Commercial |
$2,977.66
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Humana Medicare |
$2,977.66
|
| Rate for Payer: Lucent All Commercial |
$2,977.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,277.03
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,962.77
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
| Rate for Payer: United Healthcare Medicare |
$1,926.72
|
|
|
HC S TIBIAL COMP 3 TRI
|
Facility
IP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,378.91 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$5,044.51
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.70
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
|
|
HC S TIBIAL COMP 4 TRI
|
Facility
OP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$4,927.74
|
| Rate for Payer: Aetna Medicare |
$1,926.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,926.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,353.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,649.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,215.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,119.39
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Centivo All Commercial |
$2,977.66
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Humana Medicare |
$2,977.66
|
| Rate for Payer: Lucent All Commercial |
$2,977.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,277.03
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,962.77
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
| Rate for Payer: United Healthcare Medicare |
$1,926.72
|
|
|
HC S TIBIAL COMP 4 TRI
|
Facility
IP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,378.91 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$5,044.51
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.70
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
|
|
HC S TIBIAL COMP 5 TRI
|
Facility
IP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,378.91 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$5,044.51
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.70
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
|
|
HC S TIBIAL COMP 5 TRI
|
Facility
OP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$4,927.74
|
| Rate for Payer: Aetna Medicare |
$1,926.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,926.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,353.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,649.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,215.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,119.39
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Centivo All Commercial |
$2,977.66
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Humana Medicare |
$2,977.66
|
| Rate for Payer: Lucent All Commercial |
$2,977.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,277.03
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,962.77
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
| Rate for Payer: United Healthcare Medicare |
$1,926.72
|
|
|
HC S TIBIAL COMP 6 TRI
|
Facility
OP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607643
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$4,927.74
|
| Rate for Payer: Aetna Medicare |
$1,926.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,926.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,353.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,649.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,215.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,119.39
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Centivo All Commercial |
$2,977.66
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Humana Medicare |
$2,977.66
|
| Rate for Payer: Lucent All Commercial |
$2,977.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,277.03
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,962.77
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
| Rate for Payer: United Healthcare Medicare |
$1,926.72
|
|
|
HC S TIBIAL COMP 6 TRI
|
Facility
IP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607643
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,378.91 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$5,044.51
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.70
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
|
|
HC S TIBIAL COMP 7 TRI
|
Facility
IP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607908
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,378.91 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$5,044.51
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.70
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
|
|
HC S TIBIAL COMP 7 TRI
|
Facility
OP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607908
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$4,927.74
|
| Rate for Payer: Aetna Medicare |
$1,926.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,926.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,353.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,649.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,215.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,119.39
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Cash Price |
$3,619.90
|
| Rate for Payer: Centivo All Commercial |
$2,977.66
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Humana Medicare |
$2,977.66
|
| Rate for Payer: Lucent All Commercial |
$2,977.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,277.03
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,962.77
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
| Rate for Payer: United Healthcare Medicare |
$1,926.72
|
|
|
HC STIMULAN RAPID CURE
|
Facility
OP
|
$5,220.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,854.60 |
| Rate for Payer: Aetna Commercial |
$4,405.68
|
| Rate for Payer: Aetna Medicare |
$1,722.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,722.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,997.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,263.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,980.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,894.86
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Centivo All Commercial |
$2,662.20
|
| Rate for Payer: Cigna All Commercial |
$4,504.86
|
| Rate for Payer: CORVEL All Commercial |
$4,854.60
|
| Rate for Payer: Coventry All Commercial |
$4,593.60
|
| Rate for Payer: Encore All Commercial |
$4,805.01
|
| Rate for Payer: Frontpath All Commercial |
$4,802.40
|
| Rate for Payer: Humana ChoiceCare |
$4,508.51
|
| Rate for Payer: Humana Medicare |
$2,662.20
|
| Rate for Payer: Lucent All Commercial |
$2,662.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,698.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,915.00
|
| Rate for Payer: PHP All Commercial |
$3,958.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,035.80
|
| Rate for Payer: Sagamore Health Network All Products |
$4,029.84
|
| Rate for Payer: Signature Care EPO |
$4,332.60
|
| Rate for Payer: Signature Care PPO |
$4,593.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,437.00
|
| Rate for Payer: United Healthcare Commercial |
$4,113.36
|
| Rate for Payer: United Healthcare Medicare |
$1,722.60
|
|
|
HC STIMULAN RAPID CURE
|
Facility
IP
|
$5,220.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,915.00 |
| Max. Negotiated Rate |
$4,854.60 |
| Rate for Payer: Aetna Commercial |
$4,510.08
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cigna All Commercial |
$4,504.86
|
| Rate for Payer: CORVEL All Commercial |
$4,854.60
|
| Rate for Payer: Coventry All Commercial |
$4,593.60
|
| Rate for Payer: Encore All Commercial |
$4,805.01
|
| Rate for Payer: Frontpath All Commercial |
$4,802.40
|
| Rate for Payer: Humana ChoiceCare |
$4,508.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,698.00
|
| Rate for Payer: PHCS All Commercial |
$3,915.00
|
| Rate for Payer: PHP All Commercial |
$3,958.85
|
| Rate for Payer: Sagamore Health Network All Products |
$4,029.84
|
| Rate for Payer: Signature Care EPO |
$4,332.60
|
| Rate for Payer: Signature Care PPO |
$4,593.60
|
| Rate for Payer: United Healthcare Commercial |
$4,113.36
|
|
|
HC STOCKING KNEE LARGE/LONG
|
Facility
OP
|
$33.74
|
|
| Hospital Charge Code |
41601101
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$81.94 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$11.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$19.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$81.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.25
|
| Rate for Payer: Cash Price |
$20.92
|
| Rate for Payer: Cash Price |
$20.92
|
| Rate for Payer: Centivo All Commercial |
$17.21
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Humana Medicare |
$17.21
|
| Rate for Payer: Lucent All Commercial |
$17.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: Managed Health Services Medicaid |
$81.94
|
| Rate for Payer: MDWise Medicaid |
$81.94
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.16
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28.68
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
| Rate for Payer: United Healthcare Medicare |
$11.13
|
|
|
HC STOCKING KNEE LARGE/LONG
|
Facility
IP
|
$33.74
|
|
| Hospital Charge Code |
41601101
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$29.15
|
| Rate for Payer: Cash Price |
$20.92
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
|
|
HC STOCKING KNEE LARGE/REGULAR
|
Facility
OP
|
$33.74
|
|
| Hospital Charge Code |
41601102
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$81.94 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$11.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$19.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$81.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.25
|
| Rate for Payer: Cash Price |
$20.92
|
| Rate for Payer: Cash Price |
$20.92
|
| Rate for Payer: Centivo All Commercial |
$17.21
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Humana Medicare |
$17.21
|
| Rate for Payer: Lucent All Commercial |
$17.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: Managed Health Services Medicaid |
$81.94
|
| Rate for Payer: MDWise Medicaid |
$81.94
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.16
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28.68
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
| Rate for Payer: United Healthcare Medicare |
$11.13
|
|
|
HC STOCKING KNEE LARGE/REGULAR
|
Facility
IP
|
$33.74
|
|
| Hospital Charge Code |
41601102
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$29.15
|
| Rate for Payer: Cash Price |
$20.92
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
|
|
HC STOCKING KNEE MEDIUM/LONG
|
Facility
IP
|
$24.93
|
|
| Hospital Charge Code |
41601103
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.70 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Aetna Commercial |
$21.54
|
| Rate for Payer: Cash Price |
$15.46
|
| Rate for Payer: Cigna All Commercial |
$21.51
|
| Rate for Payer: CORVEL All Commercial |
$23.18
|
| Rate for Payer: Coventry All Commercial |
$21.94
|
| Rate for Payer: Encore All Commercial |
$22.95
|
| Rate for Payer: Frontpath All Commercial |
$22.94
|
| Rate for Payer: Humana ChoiceCare |
$21.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$22.44
|
| Rate for Payer: PHCS All Commercial |
$18.70
|
| Rate for Payer: PHP All Commercial |
$18.91
|
| Rate for Payer: Sagamore Health Network All Products |
$19.25
|
| Rate for Payer: Signature Care EPO |
$20.69
|
| Rate for Payer: Signature Care PPO |
$21.94
|
| Rate for Payer: United Healthcare Commercial |
$19.64
|
|
|
HC STOCKING KNEE MEDIUM/LONG
|
Facility
OP
|
$24.93
|
|
| Hospital Charge Code |
41601103
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$81.94 |
| Rate for Payer: Aetna Commercial |
$21.04
|
| Rate for Payer: Aetna Medicare |
$8.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$8.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$14.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$15.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$81.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$9.05
|
| Rate for Payer: Cash Price |
$15.46
|
| Rate for Payer: Cash Price |
$15.46
|
| Rate for Payer: Centivo All Commercial |
$12.71
|
| Rate for Payer: Cigna All Commercial |
$21.51
|
| Rate for Payer: CORVEL All Commercial |
$23.18
|
| Rate for Payer: Coventry All Commercial |
$21.94
|
| Rate for Payer: Encore All Commercial |
$22.95
|
| Rate for Payer: Frontpath All Commercial |
$22.94
|
| Rate for Payer: Humana ChoiceCare |
$21.53
|
| Rate for Payer: Humana Medicare |
$12.71
|
| Rate for Payer: Lucent All Commercial |
$12.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$22.44
|
| Rate for Payer: Managed Health Services Medicaid |
$81.94
|
| Rate for Payer: MDWise Medicaid |
$81.94
|
| Rate for Payer: PHCS All Commercial |
$18.70
|
| Rate for Payer: PHP All Commercial |
$18.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$9.72
|
| Rate for Payer: Sagamore Health Network All Products |
$19.25
|
| Rate for Payer: Signature Care EPO |
$20.69
|
| Rate for Payer: Signature Care PPO |
$21.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21.19
|
| Rate for Payer: United Healthcare Commercial |
$19.64
|
| Rate for Payer: United Healthcare Medicare |
$8.23
|
|
|
HC STOCKING KNEE MEDIUM/REGULAR
|
Facility
OP
|
$33.74
|
|
| Hospital Charge Code |
41601104
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$81.94 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$11.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$19.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$81.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.25
|
| Rate for Payer: Cash Price |
$20.92
|
| Rate for Payer: Cash Price |
$20.92
|
| Rate for Payer: Centivo All Commercial |
$17.21
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Humana Medicare |
$17.21
|
| Rate for Payer: Lucent All Commercial |
$17.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: Managed Health Services Medicaid |
$81.94
|
| Rate for Payer: MDWise Medicaid |
$81.94
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.16
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28.68
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
| Rate for Payer: United Healthcare Medicare |
$11.13
|
|
