|
PR APPENDECTOMY,RUPT APPENDX+ABSCESS
|
Professional
|
Both
|
$1,588.00
|
|
|
Service Code
|
CPT 44960
|
| Hospital Charge Code |
z44960
|
| Min. Negotiated Rate |
$780.60 |
| Max. Negotiated Rate |
$1,261.23 |
| Rate for Payer: Aetna Commercial |
$813.70
|
| Rate for Payer: Aetna Medicare |
$813.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$780.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$935.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$895.07
|
| Rate for Payer: Cash Price |
$952.80
|
| Rate for Payer: Centivo All Commercial |
$1,261.23
|
| Rate for Payer: Cigna All Commercial |
$813.70
|
| Rate for Payer: CORVEL All Commercial |
$813.70
|
| Rate for Payer: Coventry All Commercial |
$976.44
|
| Rate for Payer: Encore All Commercial |
$813.70
|
| Rate for Payer: Frontpath All Commercial |
$1,163.60
|
| Rate for Payer: Humana ChoiceCare |
$810.99
|
| Rate for Payer: Humana Medicare |
$813.70
|
| Rate for Payer: Lucent All Commercial |
$1,139.18
|
| Rate for Payer: Managed Health Services Medicaid |
$780.60
|
| Rate for Payer: MDWise Medicaid |
$780.60
|
| Rate for Payer: PHCS All Commercial |
$813.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$813.70
|
| Rate for Payer: Sagamore Health Network All Products |
$813.70
|
| Rate for Payer: United Healthcare Commercial |
$923.29
|
| Rate for Payer: United Healthcare Medicare |
$781.48
|
|
|
PR APPENDECTOMY,W OTHR PROC
|
Professional
|
Both
|
$150.28
|
|
|
Service Code
|
CPT 44955
|
| Hospital Charge Code |
z44955
|
| Min. Negotiated Rate |
$73.91 |
| Max. Negotiated Rate |
$10,700.00 |
| Rate for Payer: Aetna Commercial |
$76.95
|
| Rate for Payer: Aetna Commercial |
$76.95
|
| Rate for Payer: Aetna Medicare |
$76.95
|
| Rate for Payer: Aetna Medicare |
$76.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$134.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$134.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$134.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$134.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$134.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$134.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.91
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$88.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$88.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$84.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$84.64
|
| Rate for Payer: Cash Price |
$90.17
|
| Rate for Payer: Cash Price |
$89.15
|
| Rate for Payer: Centivo All Commercial |
$119.27
|
| Rate for Payer: Centivo All Commercial |
$119.27
|
| Rate for Payer: Cigna All Commercial |
$76.95
|
| Rate for Payer: Cigna All Commercial |
$76.95
|
| Rate for Payer: CORVEL All Commercial |
$76.95
|
| Rate for Payer: CORVEL All Commercial |
$76.95
|
| Rate for Payer: Coventry All Commercial |
$92.34
|
| Rate for Payer: Coventry All Commercial |
$92.34
|
| Rate for Payer: Encore All Commercial |
$76.95
|
| Rate for Payer: Encore All Commercial |
$76.95
|
| Rate for Payer: Frontpath All Commercial |
$109.72
|
| Rate for Payer: Frontpath All Commercial |
$109.72
|
| Rate for Payer: Humana ChoiceCare |
$95.56
|
| Rate for Payer: Humana ChoiceCare |
$95.56
|
| Rate for Payer: Humana Medicare |
$76.95
|
| Rate for Payer: Humana Medicare |
$76.95
|
| Rate for Payer: Lucent All Commercial |
$107.73
|
| Rate for Payer: Lucent All Commercial |
$107.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$114.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$114.00
|
| Rate for Payer: Managed Health Services Medicaid |
$73.91
|
| Rate for Payer: Managed Health Services Medicaid |
$73.91
|
| Rate for Payer: MDWise Medicaid |
$73.91
|
| Rate for Payer: MDWise Medicaid |
$73.91
|
| Rate for Payer: PHCS All Commercial |
$76.95
|
| Rate for Payer: PHCS All Commercial |
$76.95
|
| Rate for Payer: PHP All Commercial |
$130.02
|
| Rate for Payer: PHP All Commercial |
$130.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$76.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$76.95
|
| Rate for Payer: Sagamore Health Network All Products |
$76.95
|
| Rate for Payer: Sagamore Health Network All Products |
$76.95
|
| Rate for Payer: Signature Care EPO |
$120.70
|
| Rate for Payer: Signature Care EPO |
$120.70
|
| Rate for Payer: Signature Care PPO |
$120.70
|
| Rate for Payer: Signature Care PPO |
$120.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,700.00
|
| Rate for Payer: United Healthcare Commercial |
$93.41
|
| Rate for Payer: United Healthcare Commercial |
$93.41
|
| Rate for Payer: United Healthcare Medicare |
$74.29
|
| Rate for Payer: United Healthcare Medicare |
$74.29
|
|
|
PR APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM
|
Professional
|
Both
|
$2,093.22
|
|
|
Service Code
|
CPT 20692
|
| Hospital Charge Code |
z20692
|
| Min. Negotiated Rate |
$448.91 |
| Max. Negotiated Rate |
$156,800.00 |
| Rate for Payer: Aetna Commercial |
$1,045.25
|
| Rate for Payer: Aetna Commercial |
$1,045.25
|
| Rate for Payer: Aetna Medicare |
$1,045.25
|
| Rate for Payer: Aetna Medicare |
$1,045.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,264.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,264.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,264.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,264.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,264.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,264.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,264.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,264.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,029.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,029.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,202.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,202.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,149.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,149.78
|
| Rate for Payer: Cash Price |
$1,255.93
|
| Rate for Payer: Cash Price |
$1,224.12
|
| Rate for Payer: Centivo All Commercial |
$1,620.14
|
| Rate for Payer: Centivo All Commercial |
$1,620.14
|
| Rate for Payer: Cigna All Commercial |
$1,045.25
|
| Rate for Payer: Cigna All Commercial |
$1,045.25
|
| Rate for Payer: CORVEL All Commercial |
$1,045.25
|
| Rate for Payer: CORVEL All Commercial |
$1,045.25
|
| Rate for Payer: Coventry All Commercial |
$1,254.30
|
| Rate for Payer: Coventry All Commercial |
$1,254.30
|
| Rate for Payer: Encore All Commercial |
$1,045.25
|
| Rate for Payer: Encore All Commercial |
$1,045.25
|
| Rate for Payer: Frontpath All Commercial |
$1,447.67
|
| Rate for Payer: Frontpath All Commercial |
$1,447.67
|
| Rate for Payer: Humana ChoiceCare |
$448.91
|
| Rate for Payer: Humana ChoiceCare |
$448.91
|
| Rate for Payer: Humana Medicare |
$1,045.25
|
| Rate for Payer: Humana Medicare |
$1,045.25
|
| Rate for Payer: Lucent All Commercial |
$1,463.35
|
| Rate for Payer: Lucent All Commercial |
$1,463.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,673.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,673.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,029.53
|
| Rate for Payer: Managed Health Services Medicaid |
$1,029.53
|
| Rate for Payer: MDWise Medicaid |
$1,029.53
|
| Rate for Payer: MDWise Medicaid |
$1,029.53
|
| Rate for Payer: PHCS All Commercial |
$1,045.25
|
| Rate for Payer: PHCS All Commercial |
$1,045.25
|
| Rate for Payer: PHP All Commercial |
$1,774.98
|
| Rate for Payer: PHP All Commercial |
$1,774.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,045.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,045.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,045.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,045.25
|
| Rate for Payer: Signature Care EPO |
$913.47
|
| Rate for Payer: Signature Care EPO |
$913.47
|
| Rate for Payer: Signature Care PPO |
$913.47
|
| Rate for Payer: Signature Care PPO |
$913.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$156,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$156,800.00
|
| Rate for Payer: United Healthcare Commercial |
$1,107.26
|
| Rate for Payer: United Healthcare Commercial |
$1,107.26
|
| Rate for Payer: United Healthcare Medicare |
$1,020.10
|
| Rate for Payer: United Healthcare Medicare |
$1,020.10
|
|
|
PR APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP
|
Professional
|
Both
|
$21.98
|
|
|
Service Code
|
CPT 99188
|
| Hospital Charge Code |
z99188
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$19.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$19.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$19.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$19.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$19.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$19.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$19.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$19.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$10.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$10.93
|
| Rate for Payer: Cash Price |
$13.34
|
| Rate for Payer: Cash Price |
$13.19
|
| Rate for Payer: Frontpath All Commercial |
$10.30
|
| Rate for Payer: Frontpath All Commercial |
$10.30
|
| Rate for Payer: Humana ChoiceCare |
$11.77
|
| Rate for Payer: Humana ChoiceCare |
$11.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12.00
|
| Rate for Payer: Managed Health Services Medicaid |
$10.93
|
| Rate for Payer: Managed Health Services Medicaid |
$10.93
|
| Rate for Payer: MDWise Medicaid |
$10.93
|
| Rate for Payer: MDWise Medicaid |
$10.93
|
| Rate for Payer: PHP All Commercial |
$7.80
|
| Rate for Payer: PHP All Commercial |
$7.80
|
| Rate for Payer: Signature Care EPO |
$22.58
|
| Rate for Payer: Signature Care EPO |
$22.58
|
| Rate for Payer: Signature Care PPO |
$22.58
|
| Rate for Payer: Signature Care PPO |
$22.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.00
|
| Rate for Payer: United Healthcare Commercial |
$12.60
|
| Rate for Payer: United Healthcare Commercial |
$12.60
|
| Rate for Payer: United Healthcare Medicare |
$10.99
|
| Rate for Payer: United Healthcare Medicare |
$10.99
|
|
|
PR APPL MLT-LAYER VENOUS WOUND COMPRESS BELOW KNEE
|
Professional
|
Both
|
$164.88
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
z29581
|
| Min. Negotiated Rate |
$13.84 |
| Max. Negotiated Rate |
$82.04 |
| Rate for Payer: Aetna Commercial |
$26.69
|
| Rate for Payer: Aetna Commercial |
$26.69
|
| Rate for Payer: Aetna Medicare |
$26.69
|
| Rate for Payer: Aetna Medicare |
$26.69
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$13.84
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$13.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$81.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$81.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$30.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$30.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.36
|
| Rate for Payer: Cash Price |
$98.45
|
| Rate for Payer: Cash Price |
$98.93
|
| Rate for Payer: Centivo All Commercial |
$41.37
|
| Rate for Payer: Centivo All Commercial |
$41.37
|
| Rate for Payer: Cigna All Commercial |
$26.69
|
| Rate for Payer: Cigna All Commercial |
$26.69
|
| Rate for Payer: CORVEL All Commercial |
$26.69
|
| Rate for Payer: CORVEL All Commercial |
$26.69
|
| Rate for Payer: Coventry All Commercial |
$32.03
|
| Rate for Payer: Coventry All Commercial |
$32.03
|
| Rate for Payer: Encore All Commercial |
$26.69
|
| Rate for Payer: Encore All Commercial |
$26.69
|
| Rate for Payer: Frontpath All Commercial |
$35.37
|
| Rate for Payer: Frontpath All Commercial |
$35.37
|
| Rate for Payer: Humana ChoiceCare |
$34.86
|
| Rate for Payer: Humana ChoiceCare |
$34.86
|
| Rate for Payer: Humana Medicare |
$26.69
|
| Rate for Payer: Humana Medicare |
$26.69
|
| Rate for Payer: Lucent All Commercial |
$37.37
|
| Rate for Payer: Lucent All Commercial |
$37.37
|
| Rate for Payer: Managed Health Services Medicaid |
$81.09
|
| Rate for Payer: Managed Health Services Medicaid |
$81.09
|
| Rate for Payer: MDWise Medicaid |
$81.09
|
| Rate for Payer: MDWise Medicaid |
$81.09
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$13.84
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$13.84
|
| Rate for Payer: PHCS All Commercial |
$26.69
|
| Rate for Payer: PHCS All Commercial |
$26.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$26.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$26.69
|
| Rate for Payer: Sagamore Health Network All Products |
$26.69
|
| Rate for Payer: Sagamore Health Network All Products |
$26.69
|
| Rate for Payer: United Healthcare Commercial |
$37.93
|
| Rate for Payer: United Healthcare Commercial |
$37.93
|
| Rate for Payer: United Healthcare Medicare |
$82.04
|
| Rate for Payer: United Healthcare Medicare |
$82.04
|
|
|
PR APPLY FINGER SPLINT,STATIC
|
Professional
|
Both
|
$78.54
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
z29130
|
| Min. Negotiated Rate |
$23.18 |
| Max. Negotiated Rate |
$4,100.00 |
| Rate for Payer: Aetna Commercial |
$27.16
|
| Rate for Payer: Aetna Commercial |
$27.16
|
| Rate for Payer: Aetna Medicare |
$27.16
|
| Rate for Payer: Aetna Medicare |
$27.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$51.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$51.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$51.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$51.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$51.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$51.33
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$23.18
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$23.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$38.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$38.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.88
|
| Rate for Payer: Cash Price |
$45.58
|
| Rate for Payer: Cash Price |
$47.12
|
| Rate for Payer: Centivo All Commercial |
$42.10
|
| Rate for Payer: Centivo All Commercial |
$42.10
|
| Rate for Payer: Cigna All Commercial |
$27.16
|
| Rate for Payer: Cigna All Commercial |
$27.16
|
| Rate for Payer: CORVEL All Commercial |
$27.16
|
| Rate for Payer: CORVEL All Commercial |
$27.16
|
| Rate for Payer: Coventry All Commercial |
$32.59
|
| Rate for Payer: Coventry All Commercial |
$32.59
|
| Rate for Payer: Encore All Commercial |
$27.16
|
| Rate for Payer: Encore All Commercial |
$27.16
|
| Rate for Payer: Frontpath All Commercial |
$38.01
|
| Rate for Payer: Frontpath All Commercial |
$38.01
|
| Rate for Payer: Humana ChoiceCare |
$29.70
|
| Rate for Payer: Humana ChoiceCare |
$29.70
|
| Rate for Payer: Humana Medicare |
$27.16
|
| Rate for Payer: Humana Medicare |
$27.16
|
| Rate for Payer: Lucent All Commercial |
$38.02
|
| Rate for Payer: Lucent All Commercial |
$38.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$44.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$44.00
|
| Rate for Payer: Managed Health Services Medicaid |
$38.63
|
| Rate for Payer: Managed Health Services Medicaid |
$38.63
|
| Rate for Payer: MDWise Medicaid |
$38.63
|
| Rate for Payer: MDWise Medicaid |
$38.63
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$23.18
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$23.18
|
| Rate for Payer: PHCS All Commercial |
$27.16
|
| Rate for Payer: PHCS All Commercial |
$27.16
|
| Rate for Payer: PHP All Commercial |
$46.17
|
| Rate for Payer: PHP All Commercial |
$46.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.16
|
| Rate for Payer: Sagamore Health Network All Products |
$27.16
|
| Rate for Payer: Sagamore Health Network All Products |
$27.16
|
| Rate for Payer: Signature Care EPO |
$54.40
|
| Rate for Payer: Signature Care EPO |
$54.40
|
| Rate for Payer: Signature Care PPO |
$54.40
|
| Rate for Payer: Signature Care PPO |
$54.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,100.00
|
| Rate for Payer: United Healthcare Commercial |
$32.03
|
| Rate for Payer: United Healthcare Commercial |
$32.03
|
| Rate for Payer: United Healthcare Medicare |
$37.98
|
| Rate for Payer: United Healthcare Medicare |
$37.98
|
|
|
PR APPLY FOREARM CAST
|
Professional
|
Both
|
$164.76
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
z29075
|
| Min. Negotiated Rate |
$49.50 |
| Max. Negotiated Rate |
$8,700.00 |
| Rate for Payer: Aetna Commercial |
$56.93
|
| Rate for Payer: Aetna Commercial |
$56.93
|
| Rate for Payer: Aetna Medicare |
$56.93
|
| Rate for Payer: Aetna Medicare |
$56.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$106.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$106.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$106.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$106.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$106.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$106.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$106.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$106.73
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$49.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$49.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$81.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$81.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$65.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$65.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.62
|
| Rate for Payer: Cash Price |
$95.56
|
| Rate for Payer: Cash Price |
$98.86
|
| Rate for Payer: Centivo All Commercial |
$88.24
|
| Rate for Payer: Centivo All Commercial |
$88.24
|
| Rate for Payer: Cigna All Commercial |
$56.93
|
| Rate for Payer: Cigna All Commercial |
$56.93
|
| Rate for Payer: CORVEL All Commercial |
$56.93
|
| Rate for Payer: CORVEL All Commercial |
$56.93
|
| Rate for Payer: Coventry All Commercial |
$68.32
|
| Rate for Payer: Coventry All Commercial |
$68.32
|
| Rate for Payer: Encore All Commercial |
$56.93
|
| Rate for Payer: Encore All Commercial |
$56.93
|
| Rate for Payer: Frontpath All Commercial |
$78.49
|
| Rate for Payer: Frontpath All Commercial |
$78.49
|
| Rate for Payer: Humana ChoiceCare |
$62.99
|
| Rate for Payer: Humana ChoiceCare |
$62.99
|
| Rate for Payer: Humana Medicare |
$56.93
|
| Rate for Payer: Humana Medicare |
$56.93
|
| Rate for Payer: Lucent All Commercial |
$79.70
|
| Rate for Payer: Lucent All Commercial |
$79.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$93.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$93.00
|
| Rate for Payer: Managed Health Services Medicaid |
$81.03
|
| Rate for Payer: Managed Health Services Medicaid |
$81.03
|
| Rate for Payer: MDWise Medicaid |
$81.03
|
| Rate for Payer: MDWise Medicaid |
$81.03
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$49.50
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$49.50
|
| Rate for Payer: PHCS All Commercial |
$56.93
|
| Rate for Payer: PHCS All Commercial |
$56.93
|
| Rate for Payer: PHP All Commercial |
$98.20
|
| Rate for Payer: PHP All Commercial |
$98.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$56.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$56.93
|
| Rate for Payer: Sagamore Health Network All Products |
$56.93
|
| Rate for Payer: Sagamore Health Network All Products |
$56.93
|
| Rate for Payer: Signature Care EPO |
$112.20
|
| Rate for Payer: Signature Care EPO |
$112.20
|
| Rate for Payer: Signature Care PPO |
$112.20
|
| Rate for Payer: Signature Care PPO |
$112.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,700.00
|
| Rate for Payer: United Healthcare Commercial |
$65.95
|
| Rate for Payer: United Healthcare Commercial |
$65.95
|
| Rate for Payer: United Healthcare Medicare |
$79.63
|
| Rate for Payer: United Healthcare Medicare |
$79.63
|
|
|
PR APPLY FOREARM SPLINT,STATIC
|
Professional
|
Both
|
$125.82
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
z29125
|
| Min. Negotiated Rate |
$31.44 |
| Max. Negotiated Rate |
$5,600.00 |
| Rate for Payer: Aetna Commercial |
$36.82
|
| Rate for Payer: Aetna Commercial |
$36.82
|
| Rate for Payer: Aetna Medicare |
$36.82
|
| Rate for Payer: Aetna Medicare |
$36.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$95.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$95.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$95.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$95.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$95.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$95.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$95.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$95.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$31.44
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$31.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$61.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$61.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$42.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$42.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$40.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$40.50
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cash Price |
$75.49
|
| Rate for Payer: Centivo All Commercial |
$57.07
|
| Rate for Payer: Centivo All Commercial |
$57.07
|
| Rate for Payer: Cigna All Commercial |
$36.82
|
| Rate for Payer: Cigna All Commercial |
$36.82
|
| Rate for Payer: CORVEL All Commercial |
$36.82
|
| Rate for Payer: CORVEL All Commercial |
$36.82
|
| Rate for Payer: Coventry All Commercial |
$44.18
|
| Rate for Payer: Coventry All Commercial |
$44.18
|
| Rate for Payer: Encore All Commercial |
$36.82
|
| Rate for Payer: Encore All Commercial |
$36.82
|
| Rate for Payer: Frontpath All Commercial |
$50.75
|
| Rate for Payer: Frontpath All Commercial |
$50.75
|
| Rate for Payer: Humana ChoiceCare |
$42.52
|
| Rate for Payer: Humana ChoiceCare |
$42.52
|
| Rate for Payer: Humana Medicare |
$36.82
|
| Rate for Payer: Humana Medicare |
$36.82
|
| Rate for Payer: Lucent All Commercial |
$51.55
|
| Rate for Payer: Lucent All Commercial |
$51.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$60.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$60.00
|
| Rate for Payer: Managed Health Services Medicaid |
$61.88
|
| Rate for Payer: Managed Health Services Medicaid |
$61.88
|
| Rate for Payer: MDWise Medicaid |
$61.88
|
| Rate for Payer: MDWise Medicaid |
$61.88
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$31.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$31.44
|
| Rate for Payer: PHCS All Commercial |
$36.82
|
| Rate for Payer: PHCS All Commercial |
$36.82
|
| Rate for Payer: PHP All Commercial |
$63.46
|
| Rate for Payer: PHP All Commercial |
$63.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$36.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$36.82
|
| Rate for Payer: Sagamore Health Network All Products |
$36.82
|
| Rate for Payer: Sagamore Health Network All Products |
$36.82
|
| Rate for Payer: Signature Care EPO |
$89.25
|
| Rate for Payer: Signature Care EPO |
$89.25
|
| Rate for Payer: Signature Care PPO |
$89.25
|
| Rate for Payer: Signature Care PPO |
$89.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,600.00
|
| Rate for Payer: United Healthcare Commercial |
$45.88
|
| Rate for Payer: United Healthcare Commercial |
$45.88
|
| Rate for Payer: United Healthcare Medicare |
$60.27
|
| Rate for Payer: United Healthcare Medicare |
$60.27
|
|
|
PR APPLY HAND/WRIST CAST
|
Professional
|
Both
|
$180.94
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
z29085
|
| Min. Negotiated Rate |
$53.43 |
| Max. Negotiated Rate |
$9,300.00 |
| Rate for Payer: Aetna Commercial |
$62.12
|
| Rate for Payer: Aetna Commercial |
$62.12
|
| Rate for Payer: Aetna Medicare |
$62.12
|
| Rate for Payer: Aetna Medicare |
$62.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$113.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$113.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$113.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$113.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$113.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$113.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$113.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$113.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$53.43
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$53.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$88.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$88.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$71.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$71.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$68.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$68.33
|
| Rate for Payer: Cash Price |
$104.94
|
| Rate for Payer: Cash Price |
$108.56
|
| Rate for Payer: Centivo All Commercial |
$96.29
|
| Rate for Payer: Centivo All Commercial |
$96.29
|
| Rate for Payer: Cigna All Commercial |
$62.12
|
| Rate for Payer: Cigna All Commercial |
$62.12
|
| Rate for Payer: CORVEL All Commercial |
$62.12
|
| Rate for Payer: CORVEL All Commercial |
$62.12
|
| Rate for Payer: Coventry All Commercial |
$74.54
|
| Rate for Payer: Coventry All Commercial |
$74.54
|
| Rate for Payer: Encore All Commercial |
$62.12
|
| Rate for Payer: Encore All Commercial |
$62.12
|
| Rate for Payer: Frontpath All Commercial |
$86.11
|
| Rate for Payer: Frontpath All Commercial |
$86.11
|
| Rate for Payer: Humana ChoiceCare |
$65.57
|
| Rate for Payer: Humana ChoiceCare |
$65.57
|
| Rate for Payer: Humana Medicare |
$62.12
|
| Rate for Payer: Humana Medicare |
$62.12
|
| Rate for Payer: Lucent All Commercial |
$86.97
|
| Rate for Payer: Lucent All Commercial |
$86.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$99.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$99.00
|
| Rate for Payer: Managed Health Services Medicaid |
$88.99
|
| Rate for Payer: Managed Health Services Medicaid |
$88.99
|
| Rate for Payer: MDWise Medicaid |
$88.99
|
| Rate for Payer: MDWise Medicaid |
$88.99
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$53.43
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$53.43
|
| Rate for Payer: PHCS All Commercial |
$62.12
|
| Rate for Payer: PHCS All Commercial |
$62.12
|
| Rate for Payer: PHP All Commercial |
$105.53
|
| Rate for Payer: PHP All Commercial |
$105.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$62.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$62.12
|
| Rate for Payer: Sagamore Health Network All Products |
$62.12
|
| Rate for Payer: Sagamore Health Network All Products |
$62.12
|
| Rate for Payer: Signature Care EPO |
$119.85
|
| Rate for Payer: Signature Care EPO |
$119.85
|
| Rate for Payer: Signature Care PPO |
$119.85
|
| Rate for Payer: Signature Care PPO |
$119.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,300.00
|
| Rate for Payer: United Healthcare Commercial |
$71.15
|
| Rate for Payer: United Healthcare Commercial |
$71.15
|
| Rate for Payer: United Healthcare Medicare |
$87.45
|
| Rate for Payer: United Healthcare Medicare |
$87.45
|
|
|
PR APPLY LONG ARM CAST
|
Professional
|
Both
|
$182.50
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
z29065
|
| Min. Negotiated Rate |
$54.34 |
| Max. Negotiated Rate |
$9,400.00 |
| Rate for Payer: Aetna Commercial |
$62.90
|
| Rate for Payer: Aetna Commercial |
$62.90
|
| Rate for Payer: Aetna Medicare |
$62.90
|
| Rate for Payer: Aetna Medicare |
$62.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$115.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$115.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$115.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$115.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$115.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$115.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$115.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$115.37
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$54.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$54.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$89.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$89.76
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$72.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$72.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$69.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$69.19
|
| Rate for Payer: Cash Price |
$109.50
|
| Rate for Payer: Cash Price |
$105.49
|
| Rate for Payer: Centivo All Commercial |
$97.50
|
| Rate for Payer: Centivo All Commercial |
$97.50
|
| Rate for Payer: Cigna All Commercial |
$62.90
|
| Rate for Payer: Cigna All Commercial |
$62.90
|
| Rate for Payer: CORVEL All Commercial |
$62.90
|
| Rate for Payer: CORVEL All Commercial |
$62.90
|
| Rate for Payer: Coventry All Commercial |
$75.48
|
| Rate for Payer: Coventry All Commercial |
$75.48
|
| Rate for Payer: Encore All Commercial |
$62.90
|
| Rate for Payer: Encore All Commercial |
$62.90
|
| Rate for Payer: Frontpath All Commercial |
$87.42
|
| Rate for Payer: Frontpath All Commercial |
$87.42
|
| Rate for Payer: Humana ChoiceCare |
$70.50
|
| Rate for Payer: Humana ChoiceCare |
$70.50
|
| Rate for Payer: Humana Medicare |
$62.90
|
| Rate for Payer: Humana Medicare |
$62.90
|
| Rate for Payer: Lucent All Commercial |
$88.06
|
| Rate for Payer: Lucent All Commercial |
$88.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$101.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$101.00
|
| Rate for Payer: Managed Health Services Medicaid |
$89.76
|
| Rate for Payer: Managed Health Services Medicaid |
$89.76
|
| Rate for Payer: MDWise Medicaid |
$89.76
|
| Rate for Payer: MDWise Medicaid |
$89.76
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$54.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$54.34
|
| Rate for Payer: PHCS All Commercial |
$62.90
|
| Rate for Payer: PHCS All Commercial |
$62.90
|
| Rate for Payer: PHP All Commercial |
$106.85
|
| Rate for Payer: PHP All Commercial |
$106.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$62.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$62.90
|
| Rate for Payer: Sagamore Health Network All Products |
$62.90
|
| Rate for Payer: Sagamore Health Network All Products |
$62.90
|
| Rate for Payer: Signature Care EPO |
$121.55
|
| Rate for Payer: Signature Care EPO |
$121.55
|
| Rate for Payer: Signature Care PPO |
$121.55
|
| Rate for Payer: Signature Care PPO |
$121.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,400.00
|
| Rate for Payer: United Healthcare Commercial |
$73.08
|
| Rate for Payer: United Healthcare Commercial |
$73.08
|
| Rate for Payer: United Healthcare Medicare |
$87.91
|
| Rate for Payer: United Healthcare Medicare |
$87.91
|
|
|
PR APPLY LONG ARM SPLINT
|
Professional
|
Both
|
$155.42
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
z29105
|
| Min. Negotiated Rate |
$38.66 |
| Max. Negotiated Rate |
$5,800.00 |
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Medicare |
$38.66
|
| Rate for Payer: Aetna Medicare |
$38.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$112.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$112.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$112.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$112.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$112.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$112.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$112.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$112.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$42.22
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$42.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$76.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$76.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$44.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$44.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$42.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$42.53
|
| Rate for Payer: Cash Price |
$90.24
|
| Rate for Payer: Cash Price |
$93.25
|
| Rate for Payer: Centivo All Commercial |
$59.92
|
| Rate for Payer: Centivo All Commercial |
$59.92
|
| Rate for Payer: Cigna All Commercial |
$38.66
|
| Rate for Payer: Cigna All Commercial |
$38.66
|
| Rate for Payer: CORVEL All Commercial |
$38.66
|
| Rate for Payer: CORVEL All Commercial |
$38.66
|
| Rate for Payer: Coventry All Commercial |
$46.39
|
| Rate for Payer: Coventry All Commercial |
$46.39
|
| Rate for Payer: Encore All Commercial |
$38.66
|
| Rate for Payer: Encore All Commercial |
$38.66
|
| Rate for Payer: Frontpath All Commercial |
$54.38
|
| Rate for Payer: Frontpath All Commercial |
$54.38
|
| Rate for Payer: Humana ChoiceCare |
$60.43
|
| Rate for Payer: Humana ChoiceCare |
$60.43
|
| Rate for Payer: Humana Medicare |
$38.66
|
| Rate for Payer: Humana Medicare |
$38.66
|
| Rate for Payer: Lucent All Commercial |
$54.12
|
| Rate for Payer: Lucent All Commercial |
$54.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$62.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$62.00
|
| Rate for Payer: Managed Health Services Medicaid |
$76.44
|
| Rate for Payer: Managed Health Services Medicaid |
$76.44
|
| Rate for Payer: MDWise Medicaid |
$76.44
|
| Rate for Payer: MDWise Medicaid |
$76.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$42.22
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$42.22
|
| Rate for Payer: PHCS All Commercial |
$38.66
|
| Rate for Payer: PHCS All Commercial |
$38.66
|
| Rate for Payer: PHP All Commercial |
$65.86
|
| Rate for Payer: PHP All Commercial |
$65.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.66
|
| Rate for Payer: Sagamore Health Network All Products |
$38.66
|
| Rate for Payer: Sagamore Health Network All Products |
$38.66
|
| Rate for Payer: Signature Care EPO |
$117.30
|
| Rate for Payer: Signature Care EPO |
$117.30
|
| Rate for Payer: Signature Care PPO |
$117.30
|
| Rate for Payer: Signature Care PPO |
$117.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,800.00
|
| Rate for Payer: United Healthcare Commercial |
$64.40
|
| Rate for Payer: United Healthcare Commercial |
$64.40
|
| Rate for Payer: United Healthcare Medicare |
$75.20
|
| Rate for Payer: United Healthcare Medicare |
$75.20
|
|
|
PR APPLY LONG LEG CAST
|
Professional
|
Both
|
$253.22
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
z29345
|
| Min. Negotiated Rate |
$51.21 |
| Max. Negotiated Rate |
$13,800.00 |
| Rate for Payer: Aetna Commercial |
$91.73
|
| Rate for Payer: Aetna Commercial |
$91.73
|
| Rate for Payer: Aetna Medicare |
$91.73
|
| Rate for Payer: Aetna Medicare |
$91.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$168.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$168.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$168.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$168.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$168.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$168.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.73
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$51.21
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$51.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$124.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$124.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$105.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$105.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$100.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$100.90
|
| Rate for Payer: Cash Price |
$147.73
|
| Rate for Payer: Cash Price |
$151.93
|
| Rate for Payer: Centivo All Commercial |
$142.18
|
| Rate for Payer: Centivo All Commercial |
$142.18
|
| Rate for Payer: Cigna All Commercial |
$91.73
|
| Rate for Payer: Cigna All Commercial |
$91.73
|
| Rate for Payer: CORVEL All Commercial |
$91.73
|
| Rate for Payer: CORVEL All Commercial |
$91.73
|
| Rate for Payer: Coventry All Commercial |
$110.08
|
| Rate for Payer: Coventry All Commercial |
$110.08
|
| Rate for Payer: Encore All Commercial |
$91.73
|
| Rate for Payer: Encore All Commercial |
$91.73
|
| Rate for Payer: Frontpath All Commercial |
$127.61
|
| Rate for Payer: Frontpath All Commercial |
$127.61
|
| Rate for Payer: Humana ChoiceCare |
$107.62
|
| Rate for Payer: Humana ChoiceCare |
$107.62
|
| Rate for Payer: Humana Medicare |
$91.73
|
| Rate for Payer: Humana Medicare |
$91.73
|
| Rate for Payer: Lucent All Commercial |
$128.42
|
| Rate for Payer: Lucent All Commercial |
$128.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$147.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$147.00
|
| Rate for Payer: Managed Health Services Medicaid |
$124.54
|
| Rate for Payer: Managed Health Services Medicaid |
$124.54
|
| Rate for Payer: MDWise Medicaid |
$124.54
|
| Rate for Payer: MDWise Medicaid |
$124.54
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$51.21
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$51.21
|
| Rate for Payer: PHCS All Commercial |
$91.73
|
| Rate for Payer: PHCS All Commercial |
$91.73
|
| Rate for Payer: PHP All Commercial |
$156.04
|
| Rate for Payer: PHP All Commercial |
$156.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$91.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$91.73
|
| Rate for Payer: Sagamore Health Network All Products |
$91.73
|
| Rate for Payer: Sagamore Health Network All Products |
$91.73
|
| Rate for Payer: Signature Care EPO |
$177.65
|
| Rate for Payer: Signature Care EPO |
$177.65
|
| Rate for Payer: Signature Care PPO |
$177.65
|
| Rate for Payer: Signature Care PPO |
$177.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,800.00
|
| Rate for Payer: United Healthcare Commercial |
$110.58
|
| Rate for Payer: United Healthcare Commercial |
$110.58
|
| Rate for Payer: United Healthcare Medicare |
$123.11
|
| Rate for Payer: United Healthcare Medicare |
$123.11
|
|
|
PR APPLY LONG LEG CAST,CYLINDER
|
Professional
|
Both
|
$233.62
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
z29365
|
| Min. Negotiated Rate |
$70.49 |
| Max. Negotiated Rate |
$12,100.00 |
| Rate for Payer: Aetna Commercial |
$80.20
|
| Rate for Payer: Aetna Commercial |
$80.20
|
| Rate for Payer: Aetna Medicare |
$80.20
|
| Rate for Payer: Aetna Medicare |
$80.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$150.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$150.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$150.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$150.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$150.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$150.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$150.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$150.95
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$70.49
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$70.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$114.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$114.91
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$92.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$92.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$88.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$88.22
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$140.17
|
| Rate for Payer: Centivo All Commercial |
$124.31
|
| Rate for Payer: Centivo All Commercial |
$124.31
|
| Rate for Payer: Cigna All Commercial |
$80.20
|
| Rate for Payer: Cigna All Commercial |
$80.20
|
| Rate for Payer: CORVEL All Commercial |
$80.20
|
| Rate for Payer: CORVEL All Commercial |
$80.20
|
| Rate for Payer: Coventry All Commercial |
$96.24
|
| Rate for Payer: Coventry All Commercial |
$96.24
|
| Rate for Payer: Encore All Commercial |
$80.20
|
| Rate for Payer: Encore All Commercial |
$80.20
|
| Rate for Payer: Frontpath All Commercial |
$111.72
|
| Rate for Payer: Frontpath All Commercial |
$111.72
|
| Rate for Payer: Humana ChoiceCare |
$92.90
|
| Rate for Payer: Humana ChoiceCare |
$92.90
|
| Rate for Payer: Humana Medicare |
$80.20
|
| Rate for Payer: Humana Medicare |
$80.20
|
| Rate for Payer: Lucent All Commercial |
$112.28
|
| Rate for Payer: Lucent All Commercial |
$112.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.00
|
| Rate for Payer: Managed Health Services Medicaid |
$114.91
|
| Rate for Payer: Managed Health Services Medicaid |
$114.91
|
| Rate for Payer: MDWise Medicaid |
$114.91
|
| Rate for Payer: MDWise Medicaid |
$114.91
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$70.49
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$70.49
|
| Rate for Payer: PHCS All Commercial |
$80.20
|
| Rate for Payer: PHCS All Commercial |
$80.20
|
| Rate for Payer: PHP All Commercial |
$136.53
|
| Rate for Payer: PHP All Commercial |
$136.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$80.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$80.20
|
| Rate for Payer: Sagamore Health Network All Products |
$80.20
|
| Rate for Payer: Sagamore Health Network All Products |
$80.20
|
| Rate for Payer: Signature Care EPO |
$158.95
|
| Rate for Payer: Signature Care EPO |
$158.95
|
| Rate for Payer: Signature Care PPO |
$158.95
|
| Rate for Payer: Signature Care PPO |
$158.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,100.00
|
| Rate for Payer: United Healthcare Commercial |
$95.85
|
| Rate for Payer: United Healthcare Commercial |
$95.85
|
| Rate for Payer: United Healthcare Medicare |
$112.50
|
| Rate for Payer: United Healthcare Medicare |
$112.50
|
|
|
PR APPLY LONG LEG SPLINT
|
Professional
|
Both
|
$168.90
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
z29505
|
| Min. Negotiated Rate |
$39.96 |
| Max. Negotiated Rate |
$7,200.00 |
| Rate for Payer: Aetna Commercial |
$47.45
|
| Rate for Payer: Aetna Commercial |
$47.45
|
| Rate for Payer: Aetna Medicare |
$47.45
|
| Rate for Payer: Aetna Medicare |
$47.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$100.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$100.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$100.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$100.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$100.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$100.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$100.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$100.66
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$39.96
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$39.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$83.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$83.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$52.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$52.20
|
| Rate for Payer: Cash Price |
$96.50
|
| Rate for Payer: Cash Price |
$101.34
|
| Rate for Payer: Centivo All Commercial |
$73.55
|
| Rate for Payer: Centivo All Commercial |
$73.55
|
| Rate for Payer: Cigna All Commercial |
$47.45
|
| Rate for Payer: Cigna All Commercial |
$47.45
|
| Rate for Payer: CORVEL All Commercial |
$47.45
|
| Rate for Payer: CORVEL All Commercial |
$47.45
|
| Rate for Payer: Coventry All Commercial |
$56.94
|
| Rate for Payer: Coventry All Commercial |
$56.94
|
| Rate for Payer: Encore All Commercial |
$47.45
|
| Rate for Payer: Encore All Commercial |
$47.45
|
| Rate for Payer: Frontpath All Commercial |
$65.21
|
| Rate for Payer: Frontpath All Commercial |
$65.21
|
| Rate for Payer: Humana ChoiceCare |
$49.44
|
| Rate for Payer: Humana ChoiceCare |
$49.44
|
| Rate for Payer: Humana Medicare |
$47.45
|
| Rate for Payer: Humana Medicare |
$47.45
|
| Rate for Payer: Lucent All Commercial |
$66.43
|
| Rate for Payer: Lucent All Commercial |
$66.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.00
|
| Rate for Payer: Managed Health Services Medicaid |
$83.07
|
| Rate for Payer: Managed Health Services Medicaid |
$83.07
|
| Rate for Payer: MDWise Medicaid |
$83.07
|
| Rate for Payer: MDWise Medicaid |
$83.07
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$39.96
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$39.96
|
| Rate for Payer: PHCS All Commercial |
$47.45
|
| Rate for Payer: PHCS All Commercial |
$47.45
|
| Rate for Payer: PHP All Commercial |
$81.75
|
| Rate for Payer: PHP All Commercial |
$81.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$47.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$47.45
|
| Rate for Payer: Sagamore Health Network All Products |
$47.45
|
| Rate for Payer: Sagamore Health Network All Products |
$47.45
|
| Rate for Payer: Signature Care EPO |
$103.70
|
| Rate for Payer: Signature Care EPO |
$103.70
|
| Rate for Payer: Signature Care PPO |
$103.70
|
| Rate for Payer: Signature Care PPO |
$103.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,200.00
|
| Rate for Payer: United Healthcare Commercial |
$51.89
|
| Rate for Payer: United Healthcare Commercial |
$51.89
|
| Rate for Payer: United Healthcare Medicare |
$80.42
|
| Rate for Payer: United Healthcare Medicare |
$80.42
|
|
|
PR APPLY LOWER LEG SPLINT
|
Professional
|
Both
|
$136.24
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
z29515
|
| Min. Negotiated Rate |
$39.99 |
| Max. Negotiated Rate |
$6,900.00 |
| Rate for Payer: Aetna Commercial |
$45.72
|
| Rate for Payer: Aetna Commercial |
$45.72
|
| Rate for Payer: Aetna Medicare |
$45.72
|
| Rate for Payer: Aetna Medicare |
$45.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$94.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$94.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$94.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$94.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$94.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$94.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$94.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$94.00
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$39.99
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$39.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$67.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$67.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$52.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$52.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$50.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$50.29
|
| Rate for Payer: Cash Price |
$78.38
|
| Rate for Payer: Cash Price |
$81.74
|
| Rate for Payer: Centivo All Commercial |
$70.87
|
| Rate for Payer: Centivo All Commercial |
$70.87
|
| Rate for Payer: Cigna All Commercial |
$45.72
|
| Rate for Payer: Cigna All Commercial |
$45.72
|
| Rate for Payer: CORVEL All Commercial |
$45.72
|
| Rate for Payer: CORVEL All Commercial |
$45.72
|
| Rate for Payer: Coventry All Commercial |
$54.86
|
| Rate for Payer: Coventry All Commercial |
$54.86
|
| Rate for Payer: Encore All Commercial |
$45.72
|
| Rate for Payer: Encore All Commercial |
$45.72
|
| Rate for Payer: Frontpath All Commercial |
$62.89
|
| Rate for Payer: Frontpath All Commercial |
$62.89
|
| Rate for Payer: Humana ChoiceCare |
$51.78
|
| Rate for Payer: Humana ChoiceCare |
$51.78
|
| Rate for Payer: Humana Medicare |
$45.72
|
| Rate for Payer: Humana Medicare |
$45.72
|
| Rate for Payer: Lucent All Commercial |
$64.01
|
| Rate for Payer: Lucent All Commercial |
$64.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$74.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$74.00
|
| Rate for Payer: Managed Health Services Medicaid |
$67.01
|
| Rate for Payer: Managed Health Services Medicaid |
$67.01
|
| Rate for Payer: MDWise Medicaid |
$67.01
|
| Rate for Payer: MDWise Medicaid |
$67.01
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$39.99
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$39.99
|
| Rate for Payer: PHCS All Commercial |
$45.72
|
| Rate for Payer: PHCS All Commercial |
$45.72
|
| Rate for Payer: PHP All Commercial |
$78.02
|
| Rate for Payer: PHP All Commercial |
$78.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$45.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$45.72
|
| Rate for Payer: Sagamore Health Network All Products |
$45.72
|
| Rate for Payer: Sagamore Health Network All Products |
$45.72
|
| Rate for Payer: Signature Care EPO |
$90.10
|
| Rate for Payer: Signature Care EPO |
$90.10
|
| Rate for Payer: Signature Care PPO |
$90.10
|
| Rate for Payer: Signature Care PPO |
$90.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,900.00
|
| Rate for Payer: United Healthcare Commercial |
$54.38
|
| Rate for Payer: United Healthcare Commercial |
$54.38
|
| Rate for Payer: United Healthcare Medicare |
$65.32
|
| Rate for Payer: United Healthcare Medicare |
$65.32
|
|
|
PR APPLY OF CLUBFOOT CAST
|
Professional
|
Both
|
$274.80
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
z29450
|
| Min. Negotiated Rate |
$57.97 |
| Max. Negotiated Rate |
$15,900.00 |
| Rate for Payer: Aetna Commercial |
$107.77
|
| Rate for Payer: Aetna Commercial |
$107.77
|
| Rate for Payer: Aetna Medicare |
$107.77
|
| Rate for Payer: Aetna Medicare |
$107.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$187.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$187.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$187.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$187.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$187.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$187.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$187.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$187.54
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$57.97
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$57.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$135.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$135.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$123.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$123.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$118.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$118.55
|
| Rate for Payer: Cash Price |
$159.88
|
| Rate for Payer: Cash Price |
$164.88
|
| Rate for Payer: Centivo All Commercial |
$167.04
|
| Rate for Payer: Centivo All Commercial |
$167.04
|
| Rate for Payer: Cigna All Commercial |
$107.77
|
| Rate for Payer: Cigna All Commercial |
$107.77
|
| Rate for Payer: CORVEL All Commercial |
$107.77
|
| Rate for Payer: CORVEL All Commercial |
$107.77
|
| Rate for Payer: Coventry All Commercial |
$129.32
|
| Rate for Payer: Coventry All Commercial |
$129.32
|
| Rate for Payer: Encore All Commercial |
$107.77
|
| Rate for Payer: Encore All Commercial |
$107.77
|
| Rate for Payer: Frontpath All Commercial |
$147.77
|
| Rate for Payer: Frontpath All Commercial |
$147.77
|
| Rate for Payer: Humana ChoiceCare |
$139.06
|
| Rate for Payer: Humana ChoiceCare |
$139.06
|
| Rate for Payer: Humana Medicare |
$107.77
|
| Rate for Payer: Humana Medicare |
$107.77
|
| Rate for Payer: Lucent All Commercial |
$150.88
|
| Rate for Payer: Lucent All Commercial |
$150.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$170.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$170.00
|
| Rate for Payer: Managed Health Services Medicaid |
$135.16
|
| Rate for Payer: Managed Health Services Medicaid |
$135.16
|
| Rate for Payer: MDWise Medicaid |
$135.16
|
| Rate for Payer: MDWise Medicaid |
$135.16
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$57.97
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$57.97
|
| Rate for Payer: PHCS All Commercial |
$107.77
|
| Rate for Payer: PHCS All Commercial |
$107.77
|
| Rate for Payer: PHP All Commercial |
$180.46
|
| Rate for Payer: PHP All Commercial |
$180.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$107.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$107.77
|
| Rate for Payer: Sagamore Health Network All Products |
$107.77
|
| Rate for Payer: Sagamore Health Network All Products |
$107.77
|
| Rate for Payer: Signature Care EPO |
$202.30
|
| Rate for Payer: Signature Care EPO |
$202.30
|
| Rate for Payer: Signature Care PPO |
$202.30
|
| Rate for Payer: Signature Care PPO |
$202.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,900.00
|
| Rate for Payer: United Healthcare Commercial |
$139.55
|
| Rate for Payer: United Healthcare Commercial |
$139.55
|
| Rate for Payer: United Healthcare Medicare |
$133.23
|
| Rate for Payer: United Healthcare Medicare |
$133.23
|
|
|
PR APPLY SHORT LEG CAST
|
Professional
|
Both
|
$151.38
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
z29405
|
| Min. Negotiated Rate |
$47.61 |
| Max. Negotiated Rate |
$8,200.00 |
| Rate for Payer: Aetna Commercial |
$53.91
|
| Rate for Payer: Aetna Commercial |
$53.91
|
| Rate for Payer: Aetna Medicare |
$53.91
|
| Rate for Payer: Aetna Medicare |
$53.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$110.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$110.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$110.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$110.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$110.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$110.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$110.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$110.29
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$47.61
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$47.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$74.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$74.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$62.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$62.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$59.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$59.30
|
| Rate for Payer: Cash Price |
$87.49
|
| Rate for Payer: Cash Price |
$90.83
|
| Rate for Payer: Centivo All Commercial |
$83.56
|
| Rate for Payer: Centivo All Commercial |
$83.56
|
| Rate for Payer: Cigna All Commercial |
$53.91
|
| Rate for Payer: Cigna All Commercial |
$53.91
|
| Rate for Payer: CORVEL All Commercial |
$53.91
|
| Rate for Payer: CORVEL All Commercial |
$53.91
|
| Rate for Payer: Coventry All Commercial |
$64.69
|
| Rate for Payer: Coventry All Commercial |
$64.69
|
| Rate for Payer: Encore All Commercial |
$53.91
|
| Rate for Payer: Encore All Commercial |
$53.91
|
| Rate for Payer: Frontpath All Commercial |
$73.93
|
| Rate for Payer: Frontpath All Commercial |
$73.93
|
| Rate for Payer: Humana ChoiceCare |
$68.29
|
| Rate for Payer: Humana ChoiceCare |
$68.29
|
| Rate for Payer: Humana Medicare |
$53.91
|
| Rate for Payer: Humana Medicare |
$53.91
|
| Rate for Payer: Lucent All Commercial |
$75.47
|
| Rate for Payer: Lucent All Commercial |
$75.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$87.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$87.00
|
| Rate for Payer: Managed Health Services Medicaid |
$74.45
|
| Rate for Payer: Managed Health Services Medicaid |
$74.45
|
| Rate for Payer: MDWise Medicaid |
$74.45
|
| Rate for Payer: MDWise Medicaid |
$74.45
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$47.61
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$47.61
|
| Rate for Payer: PHCS All Commercial |
$53.91
|
| Rate for Payer: PHCS All Commercial |
$53.91
|
| Rate for Payer: PHP All Commercial |
$92.27
|
| Rate for Payer: PHP All Commercial |
$92.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$53.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$53.91
|
| Rate for Payer: Sagamore Health Network All Products |
$53.91
|
| Rate for Payer: Sagamore Health Network All Products |
$53.91
|
| Rate for Payer: Signature Care EPO |
$116.45
|
| Rate for Payer: Signature Care EPO |
$116.45
|
| Rate for Payer: Signature Care PPO |
$116.45
|
| Rate for Payer: Signature Care PPO |
$116.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,200.00
|
| Rate for Payer: United Healthcare Commercial |
$70.28
|
| Rate for Payer: United Healthcare Commercial |
$70.28
|
| Rate for Payer: United Healthcare Medicare |
$72.91
|
| Rate for Payer: United Healthcare Medicare |
$72.91
|
|
|
PR APPLY SHORT LEG CAST,WALKER
|
Professional
|
Both
|
$142.42
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
z29425
|
| Min. Negotiated Rate |
$45.18 |
| Max. Negotiated Rate |
$7,600.00 |
| Rate for Payer: Aetna Commercial |
$50.47
|
| Rate for Payer: Aetna Commercial |
$50.47
|
| Rate for Payer: Aetna Medicare |
$50.47
|
| Rate for Payer: Aetna Medicare |
$50.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$119.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$119.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$119.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$119.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$119.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$119.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$119.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$119.94
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$45.18
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$45.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$70.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$70.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.52
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cash Price |
$85.45
|
| Rate for Payer: Centivo All Commercial |
$78.23
|
| Rate for Payer: Centivo All Commercial |
$78.23
|
| Rate for Payer: Cigna All Commercial |
$50.47
|
| Rate for Payer: Cigna All Commercial |
$50.47
|
| Rate for Payer: CORVEL All Commercial |
$50.47
|
| Rate for Payer: CORVEL All Commercial |
$50.47
|
| Rate for Payer: Coventry All Commercial |
$60.56
|
| Rate for Payer: Coventry All Commercial |
$60.56
|
| Rate for Payer: Encore All Commercial |
$50.47
|
| Rate for Payer: Encore All Commercial |
$50.47
|
| Rate for Payer: Frontpath All Commercial |
$68.85
|
| Rate for Payer: Frontpath All Commercial |
$68.85
|
| Rate for Payer: Humana ChoiceCare |
$76.22
|
| Rate for Payer: Humana ChoiceCare |
$76.22
|
| Rate for Payer: Humana Medicare |
$50.47
|
| Rate for Payer: Humana Medicare |
$50.47
|
| Rate for Payer: Lucent All Commercial |
$70.66
|
| Rate for Payer: Lucent All Commercial |
$70.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$81.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$81.00
|
| Rate for Payer: Managed Health Services Medicaid |
$70.05
|
| Rate for Payer: Managed Health Services Medicaid |
$70.05
|
| Rate for Payer: MDWise Medicaid |
$70.05
|
| Rate for Payer: MDWise Medicaid |
$70.05
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$45.18
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$45.18
|
| Rate for Payer: PHCS All Commercial |
$50.47
|
| Rate for Payer: PHCS All Commercial |
$50.47
|
| Rate for Payer: PHP All Commercial |
$85.96
|
| Rate for Payer: PHP All Commercial |
$85.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.47
|
| Rate for Payer: Sagamore Health Network All Products |
$50.47
|
| Rate for Payer: Sagamore Health Network All Products |
$50.47
|
| Rate for Payer: Signature Care EPO |
$118.63
|
| Rate for Payer: Signature Care EPO |
$118.63
|
| Rate for Payer: Signature Care PPO |
$118.63
|
| Rate for Payer: Signature Care PPO |
$118.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,600.00
|
| Rate for Payer: United Healthcare Commercial |
$77.73
|
| Rate for Payer: United Healthcare Commercial |
$77.73
|
| Rate for Payer: United Healthcare Medicare |
$68.68
|
| Rate for Payer: United Healthcare Medicare |
$68.68
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/>100SCM 1ST 100SCM
|
Professional
|
Both
|
$567.96
|
|
|
Service Code
|
CPT 15273
|
| Hospital Charge Code |
z15273
|
| Min. Negotiated Rate |
$100.71 |
| Max. Negotiated Rate |
$284.56 |
| Rate for Payer: Aetna Commercial |
$183.59
|
| Rate for Payer: Aetna Commercial |
$183.59
|
| Rate for Payer: Aetna Medicare |
$183.59
|
| Rate for Payer: Aetna Medicare |
$183.59
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$100.71
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$100.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$279.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$279.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$211.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$211.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$201.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$201.95
|
| Rate for Payer: Cash Price |
$337.96
|
| Rate for Payer: Cash Price |
$340.78
|
| Rate for Payer: Centivo All Commercial |
$284.56
|
| Rate for Payer: Centivo All Commercial |
$284.56
|
| Rate for Payer: Cigna All Commercial |
$183.59
|
| Rate for Payer: Cigna All Commercial |
$183.59
|
| Rate for Payer: CORVEL All Commercial |
$183.59
|
| Rate for Payer: CORVEL All Commercial |
$183.59
|
| Rate for Payer: Coventry All Commercial |
$220.31
|
| Rate for Payer: Coventry All Commercial |
$220.31
|
| Rate for Payer: Encore All Commercial |
$183.59
|
| Rate for Payer: Encore All Commercial |
$183.59
|
| Rate for Payer: Frontpath All Commercial |
$258.04
|
| Rate for Payer: Frontpath All Commercial |
$258.04
|
| Rate for Payer: Humana ChoiceCare |
$195.84
|
| Rate for Payer: Humana ChoiceCare |
$195.84
|
| Rate for Payer: Humana Medicare |
$183.59
|
| Rate for Payer: Humana Medicare |
$183.59
|
| Rate for Payer: Lucent All Commercial |
$257.03
|
| Rate for Payer: Lucent All Commercial |
$257.03
|
| Rate for Payer: Managed Health Services Medicaid |
$279.34
|
| Rate for Payer: Managed Health Services Medicaid |
$279.34
|
| Rate for Payer: MDWise Medicaid |
$279.34
|
| Rate for Payer: MDWise Medicaid |
$279.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$100.71
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$100.71
|
| Rate for Payer: PHCS All Commercial |
$183.59
|
| Rate for Payer: PHCS All Commercial |
$183.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$183.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$183.59
|
| Rate for Payer: Sagamore Health Network All Products |
$183.59
|
| Rate for Payer: Sagamore Health Network All Products |
$183.59
|
| Rate for Payer: United Healthcare Commercial |
$258.55
|
| Rate for Payer: United Healthcare Commercial |
$258.55
|
| Rate for Payer: United Healthcare Medicare |
$281.63
|
| Rate for Payer: United Healthcare Medicare |
$281.63
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM
|
Professional
|
Both
|
$285.58
|
|
|
Service Code
|
CPT 15271
|
| Hospital Charge Code |
z15271
|
| Min. Negotiated Rate |
$43.75 |
| Max. Negotiated Rate |
$140.46 |
| Rate for Payer: Aetna Commercial |
$78.50
|
| Rate for Payer: Aetna Commercial |
$78.50
|
| Rate for Payer: Aetna Medicare |
$78.50
|
| Rate for Payer: Aetna Medicare |
$78.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$43.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$43.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$140.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$140.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$90.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$90.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$86.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$86.35
|
| Rate for Payer: Cash Price |
$167.75
|
| Rate for Payer: Cash Price |
$171.35
|
| Rate for Payer: Centivo All Commercial |
$121.67
|
| Rate for Payer: Centivo All Commercial |
$121.67
|
| Rate for Payer: Cigna All Commercial |
$78.50
|
| Rate for Payer: Cigna All Commercial |
$78.50
|
| Rate for Payer: CORVEL All Commercial |
$78.50
|
| Rate for Payer: CORVEL All Commercial |
$78.50
|
| Rate for Payer: Coventry All Commercial |
$94.20
|
| Rate for Payer: Coventry All Commercial |
$94.20
|
| Rate for Payer: Encore All Commercial |
$78.50
|
| Rate for Payer: Encore All Commercial |
$78.50
|
| Rate for Payer: Frontpath All Commercial |
$108.71
|
| Rate for Payer: Frontpath All Commercial |
$108.71
|
| Rate for Payer: Humana ChoiceCare |
$82.35
|
| Rate for Payer: Humana ChoiceCare |
$82.35
|
| Rate for Payer: Humana Medicare |
$78.50
|
| Rate for Payer: Humana Medicare |
$78.50
|
| Rate for Payer: Lucent All Commercial |
$109.90
|
| Rate for Payer: Lucent All Commercial |
$109.90
|
| Rate for Payer: Managed Health Services Medicaid |
$140.46
|
| Rate for Payer: Managed Health Services Medicaid |
$140.46
|
| Rate for Payer: MDWise Medicaid |
$140.46
|
| Rate for Payer: MDWise Medicaid |
$140.46
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$43.75
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$43.75
|
| Rate for Payer: PHCS All Commercial |
$78.50
|
| Rate for Payer: PHCS All Commercial |
$78.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$78.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$78.50
|
| Rate for Payer: Sagamore Health Network All Products |
$78.50
|
| Rate for Payer: Sagamore Health Network All Products |
$78.50
|
| Rate for Payer: United Healthcare Commercial |
$108.73
|
| Rate for Payer: United Healthcare Commercial |
$108.73
|
| Rate for Payer: United Healthcare Medicare |
$139.79
|
| Rate for Payer: United Healthcare Medicare |
$139.79
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/>100SCM ADL 100SCM
|
Professional
|
Both
|
$148.90
|
|
|
Service Code
|
CPT 15274
|
| Hospital Charge Code |
z15274
|
| Min. Negotiated Rate |
$23.19 |
| Max. Negotiated Rate |
$74.45 |
| Rate for Payer: Aetna Commercial |
$41.79
|
| Rate for Payer: Aetna Commercial |
$41.79
|
| Rate for Payer: Aetna Medicare |
$41.79
|
| Rate for Payer: Aetna Medicare |
$41.79
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$23.19
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$23.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$72.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$72.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$45.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$45.97
|
| Rate for Payer: Cash Price |
$89.02
|
| Rate for Payer: Cash Price |
$89.34
|
| Rate for Payer: Centivo All Commercial |
$64.77
|
| Rate for Payer: Centivo All Commercial |
$64.77
|
| Rate for Payer: Cigna All Commercial |
$41.79
|
| Rate for Payer: Cigna All Commercial |
$41.79
|
| Rate for Payer: CORVEL All Commercial |
$41.79
|
| Rate for Payer: CORVEL All Commercial |
$41.79
|
| Rate for Payer: Coventry All Commercial |
$50.15
|
| Rate for Payer: Coventry All Commercial |
$50.15
|
| Rate for Payer: Encore All Commercial |
$41.79
|
| Rate for Payer: Encore All Commercial |
$41.79
|
| Rate for Payer: Frontpath All Commercial |
$59.63
|
| Rate for Payer: Frontpath All Commercial |
$59.63
|
| Rate for Payer: Humana ChoiceCare |
$41.88
|
| Rate for Payer: Humana ChoiceCare |
$41.88
|
| Rate for Payer: Humana Medicare |
$41.79
|
| Rate for Payer: Humana Medicare |
$41.79
|
| Rate for Payer: Lucent All Commercial |
$58.51
|
| Rate for Payer: Lucent All Commercial |
$58.51
|
| Rate for Payer: Managed Health Services Medicaid |
$72.97
|
| Rate for Payer: Managed Health Services Medicaid |
$72.97
|
| Rate for Payer: MDWise Medicaid |
$72.97
|
| Rate for Payer: MDWise Medicaid |
$72.97
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$23.19
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$23.19
|
| Rate for Payer: PHCS All Commercial |
$41.79
|
| Rate for Payer: PHCS All Commercial |
$41.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.79
|
| Rate for Payer: Sagamore Health Network All Products |
$41.79
|
| Rate for Payer: Sagamore Health Network All Products |
$41.79
|
| Rate for Payer: United Healthcare Commercial |
$55.33
|
| Rate for Payer: United Healthcare Commercial |
$55.33
|
| Rate for Payer: United Healthcare Medicare |
$74.45
|
| Rate for Payer: United Healthcare Medicare |
$74.45
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM
|
Professional
|
Both
|
$45.68
|
|
|
Service Code
|
CPT 15272
|
| Hospital Charge Code |
z15272
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$25.23 |
| Rate for Payer: Aetna Commercial |
$16.28
|
| Rate for Payer: Aetna Commercial |
$16.28
|
| Rate for Payer: Aetna Medicare |
$16.28
|
| Rate for Payer: Aetna Medicare |
$16.28
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$9.00
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$9.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$22.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$22.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.91
|
| Rate for Payer: Cash Price |
$26.50
|
| Rate for Payer: Cash Price |
$27.41
|
| Rate for Payer: Centivo All Commercial |
$25.23
|
| Rate for Payer: Centivo All Commercial |
$25.23
|
| Rate for Payer: Cigna All Commercial |
$16.28
|
| Rate for Payer: Cigna All Commercial |
$16.28
|
| Rate for Payer: CORVEL All Commercial |
$16.28
|
| Rate for Payer: CORVEL All Commercial |
$16.28
|
| Rate for Payer: Coventry All Commercial |
$19.54
|
| Rate for Payer: Coventry All Commercial |
$19.54
|
| Rate for Payer: Encore All Commercial |
$16.28
|
| Rate for Payer: Encore All Commercial |
$16.28
|
| Rate for Payer: Frontpath All Commercial |
$23.22
|
| Rate for Payer: Frontpath All Commercial |
$23.22
|
| Rate for Payer: Humana ChoiceCare |
$16.47
|
| Rate for Payer: Humana ChoiceCare |
$16.47
|
| Rate for Payer: Humana Medicare |
$16.28
|
| Rate for Payer: Humana Medicare |
$16.28
|
| Rate for Payer: Lucent All Commercial |
$22.79
|
| Rate for Payer: Lucent All Commercial |
$22.79
|
| Rate for Payer: Managed Health Services Medicaid |
$22.47
|
| Rate for Payer: Managed Health Services Medicaid |
$22.47
|
| Rate for Payer: MDWise Medicaid |
$22.47
|
| Rate for Payer: MDWise Medicaid |
$22.47
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$9.00
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$9.00
|
| Rate for Payer: PHCS All Commercial |
$16.28
|
| Rate for Payer: PHCS All Commercial |
$16.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16.28
|
| Rate for Payer: Sagamore Health Network All Products |
$16.28
|
| Rate for Payer: Sagamore Health Network All Products |
$16.28
|
| Rate for Payer: United Healthcare Commercial |
$21.75
|
| Rate for Payer: United Healthcare Commercial |
$21.75
|
| Rate for Payer: United Healthcare Medicare |
$22.08
|
| Rate for Payer: United Healthcare Medicare |
$22.08
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US
|
Professional
|
Both
|
$102.80
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
z20605
|
| Min. Negotiated Rate |
$34.95 |
| Max. Negotiated Rate |
$5,200.00 |
| Rate for Payer: Aetna Commercial |
$34.95
|
| Rate for Payer: Aetna Commercial |
$34.95
|
| Rate for Payer: Aetna Commercial |
$34.95
|
| Rate for Payer: Aetna Commercial |
$34.95
|
| Rate for Payer: Aetna Medicare |
$34.95
|
| Rate for Payer: Aetna Medicare |
$34.95
|
| Rate for Payer: Aetna Medicare |
$34.95
|
| Rate for Payer: Aetna Medicare |
$34.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.24
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$36.82
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$36.82
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$36.82
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$36.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$50.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$50.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$50.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$50.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$40.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$40.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$40.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$40.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.45
|
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cash Price |
$61.68
|
| Rate for Payer: Cash Price |
$123.36
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Centivo All Commercial |
$54.17
|
| Rate for Payer: Centivo All Commercial |
$54.17
|
| Rate for Payer: Centivo All Commercial |
$54.17
|
| Rate for Payer: Centivo All Commercial |
$54.17
|
| Rate for Payer: Cigna All Commercial |
$34.95
|
| Rate for Payer: Cigna All Commercial |
$34.95
|
| Rate for Payer: Cigna All Commercial |
$34.95
|
| Rate for Payer: Cigna All Commercial |
$34.95
|
| Rate for Payer: CORVEL All Commercial |
$34.95
|
| Rate for Payer: CORVEL All Commercial |
$34.95
|
| Rate for Payer: CORVEL All Commercial |
$34.95
|
| Rate for Payer: CORVEL All Commercial |
$34.95
|
| Rate for Payer: Coventry All Commercial |
$41.94
|
| Rate for Payer: Coventry All Commercial |
$41.94
|
| Rate for Payer: Coventry All Commercial |
$41.94
|
| Rate for Payer: Coventry All Commercial |
$41.94
|
| Rate for Payer: Encore All Commercial |
$34.95
|
| Rate for Payer: Encore All Commercial |
$34.95
|
| Rate for Payer: Encore All Commercial |
$34.95
|
| Rate for Payer: Encore All Commercial |
$34.95
|
| Rate for Payer: Frontpath All Commercial |
$48.16
|
| Rate for Payer: Frontpath All Commercial |
$48.16
|
| Rate for Payer: Frontpath All Commercial |
$48.16
|
| Rate for Payer: Frontpath All Commercial |
$48.16
|
| Rate for Payer: Humana ChoiceCare |
$45.45
|
| Rate for Payer: Humana ChoiceCare |
$45.45
|
| Rate for Payer: Humana ChoiceCare |
$45.45
|
| Rate for Payer: Humana ChoiceCare |
$45.45
|
| Rate for Payer: Humana Medicare |
$34.95
|
| Rate for Payer: Humana Medicare |
$34.95
|
| Rate for Payer: Humana Medicare |
$34.95
|
| Rate for Payer: Humana Medicare |
$34.95
|
| Rate for Payer: Lucent All Commercial |
$48.93
|
| Rate for Payer: Lucent All Commercial |
$48.93
|
| Rate for Payer: Lucent All Commercial |
$48.93
|
| Rate for Payer: Lucent All Commercial |
$48.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.00
|
| Rate for Payer: Managed Health Services Medicaid |
$50.56
|
| Rate for Payer: Managed Health Services Medicaid |
$50.56
|
| Rate for Payer: Managed Health Services Medicaid |
$50.56
|
| Rate for Payer: Managed Health Services Medicaid |
$50.56
|
| Rate for Payer: MDWise Medicaid |
$50.56
|
| Rate for Payer: MDWise Medicaid |
$50.56
|
| Rate for Payer: MDWise Medicaid |
$50.56
|
| Rate for Payer: MDWise Medicaid |
$50.56
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$36.82
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$36.82
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$36.82
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$36.82
|
| Rate for Payer: PHCS All Commercial |
$34.95
|
| Rate for Payer: PHCS All Commercial |
$34.95
|
| Rate for Payer: PHCS All Commercial |
$34.95
|
| Rate for Payer: PHCS All Commercial |
$34.95
|
| Rate for Payer: PHP All Commercial |
$58.62
|
| Rate for Payer: PHP All Commercial |
$58.62
|
| Rate for Payer: PHP All Commercial |
$58.62
|
| Rate for Payer: PHP All Commercial |
$58.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.95
|
| Rate for Payer: Sagamore Health Network All Products |
$34.95
|
| Rate for Payer: Sagamore Health Network All Products |
$34.95
|
| Rate for Payer: Sagamore Health Network All Products |
$34.95
|
| Rate for Payer: Sagamore Health Network All Products |
$34.95
|
| Rate for Payer: Signature Care EPO |
$80.90
|
| Rate for Payer: Signature Care EPO |
$80.90
|
| Rate for Payer: Signature Care EPO |
$80.90
|
| Rate for Payer: Signature Care EPO |
$80.90
|
| Rate for Payer: Signature Care PPO |
$80.90
|
| Rate for Payer: Signature Care PPO |
$80.90
|
| Rate for Payer: Signature Care PPO |
$80.90
|
| Rate for Payer: Signature Care PPO |
$80.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,200.00
|
| Rate for Payer: United Healthcare Commercial |
$46.89
|
| Rate for Payer: United Healthcare Commercial |
$46.89
|
| Rate for Payer: United Healthcare Commercial |
$46.89
|
| Rate for Payer: United Healthcare Commercial |
$46.89
|
| Rate for Payer: United Healthcare Medicare |
$50.25
|
| Rate for Payer: United Healthcare Medicare |
$50.25
|
| Rate for Payer: United Healthcare Medicare |
$50.25
|
| Rate for Payer: United Healthcare Medicare |
$50.25
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US
|
Professional
|
Both
|
$167.76
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
z20606
|
| Min. Negotiated Rate |
$40.89 |
| Max. Negotiated Rate |
$7,300.00 |
| Rate for Payer: Aetna Commercial |
$49.15
|
| Rate for Payer: Aetna Commercial |
$49.15
|
| Rate for Payer: Aetna Commercial |
$49.15
|
| Rate for Payer: Aetna Commercial |
$49.15
|
| Rate for Payer: Aetna Medicare |
$49.15
|
| Rate for Payer: Aetna Medicare |
$49.15
|
| Rate for Payer: Aetna Medicare |
$49.15
|
| Rate for Payer: Aetna Medicare |
$49.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$86.95
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$40.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$40.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$40.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$40.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$82.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$82.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$82.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$82.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.06
|
| Rate for Payer: Cash Price |
$195.91
|
| Rate for Payer: Cash Price |
$100.66
|
| Rate for Payer: Cash Price |
$201.31
|
| Rate for Payer: Cash Price |
$97.96
|
| Rate for Payer: Centivo All Commercial |
$76.18
|
| Rate for Payer: Centivo All Commercial |
$76.18
|
| Rate for Payer: Centivo All Commercial |
$76.18
|
| Rate for Payer: Centivo All Commercial |
$76.18
|
| Rate for Payer: Cigna All Commercial |
$49.15
|
| Rate for Payer: Cigna All Commercial |
$49.15
|
| Rate for Payer: Cigna All Commercial |
$49.15
|
| Rate for Payer: Cigna All Commercial |
$49.15
|
| Rate for Payer: CORVEL All Commercial |
$49.15
|
| Rate for Payer: CORVEL All Commercial |
$49.15
|
| Rate for Payer: CORVEL All Commercial |
$49.15
|
| Rate for Payer: CORVEL All Commercial |
$49.15
|
| Rate for Payer: Coventry All Commercial |
$58.98
|
| Rate for Payer: Coventry All Commercial |
$58.98
|
| Rate for Payer: Coventry All Commercial |
$58.98
|
| Rate for Payer: Coventry All Commercial |
$58.98
|
| Rate for Payer: Encore All Commercial |
$49.15
|
| Rate for Payer: Encore All Commercial |
$49.15
|
| Rate for Payer: Encore All Commercial |
$49.15
|
| Rate for Payer: Encore All Commercial |
$49.15
|
| Rate for Payer: Frontpath All Commercial |
$67.24
|
| Rate for Payer: Frontpath All Commercial |
$67.24
|
| Rate for Payer: Frontpath All Commercial |
$67.24
|
| Rate for Payer: Frontpath All Commercial |
$67.24
|
| Rate for Payer: Humana ChoiceCare |
$59.03
|
| Rate for Payer: Humana ChoiceCare |
$59.03
|
| Rate for Payer: Humana ChoiceCare |
$59.03
|
| Rate for Payer: Humana ChoiceCare |
$59.03
|
| Rate for Payer: Humana Medicare |
$49.15
|
| Rate for Payer: Humana Medicare |
$49.15
|
| Rate for Payer: Humana Medicare |
$49.15
|
| Rate for Payer: Humana Medicare |
$49.15
|
| Rate for Payer: Lucent All Commercial |
$68.81
|
| Rate for Payer: Lucent All Commercial |
$68.81
|
| Rate for Payer: Lucent All Commercial |
$68.81
|
| Rate for Payer: Lucent All Commercial |
$68.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$78.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$78.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$78.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$78.00
|
| Rate for Payer: Managed Health Services Medicaid |
$82.51
|
| Rate for Payer: Managed Health Services Medicaid |
$82.51
|
| Rate for Payer: Managed Health Services Medicaid |
$82.51
|
| Rate for Payer: Managed Health Services Medicaid |
$82.51
|
| Rate for Payer: MDWise Medicaid |
$82.51
|
| Rate for Payer: MDWise Medicaid |
$82.51
|
| Rate for Payer: MDWise Medicaid |
$82.51
|
| Rate for Payer: MDWise Medicaid |
$82.51
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$40.89
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$40.89
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$40.89
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$40.89
|
| Rate for Payer: PHCS All Commercial |
$49.15
|
| Rate for Payer: PHCS All Commercial |
$49.15
|
| Rate for Payer: PHCS All Commercial |
$49.15
|
| Rate for Payer: PHCS All Commercial |
$49.15
|
| Rate for Payer: PHP All Commercial |
$82.82
|
| Rate for Payer: PHP All Commercial |
$82.82
|
| Rate for Payer: PHP All Commercial |
$82.82
|
| Rate for Payer: PHP All Commercial |
$82.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$49.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$49.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$49.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$49.15
|
| Rate for Payer: Sagamore Health Network All Products |
$49.15
|
| Rate for Payer: Sagamore Health Network All Products |
$49.15
|
| Rate for Payer: Sagamore Health Network All Products |
$49.15
|
| Rate for Payer: Sagamore Health Network All Products |
$49.15
|
| Rate for Payer: Signature Care EPO |
$103.73
|
| Rate for Payer: Signature Care EPO |
$103.73
|
| Rate for Payer: Signature Care EPO |
$103.73
|
| Rate for Payer: Signature Care EPO |
$103.73
|
| Rate for Payer: Signature Care PPO |
$103.73
|
| Rate for Payer: Signature Care PPO |
$103.73
|
| Rate for Payer: Signature Care PPO |
$103.73
|
| Rate for Payer: Signature Care PPO |
$103.73
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,300.00
|
| Rate for Payer: United Healthcare Commercial |
$64.46
|
| Rate for Payer: United Healthcare Commercial |
$64.46
|
| Rate for Payer: United Healthcare Commercial |
$64.46
|
| Rate for Payer: United Healthcare Commercial |
$64.46
|
| Rate for Payer: United Healthcare Medicare |
$81.63
|
| Rate for Payer: United Healthcare Medicare |
$81.63
|
| Rate for Payer: United Healthcare Medicare |
$81.63
|
| Rate for Payer: United Healthcare Medicare |
$81.63
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$120.62
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
z20610
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$6,300.00 |
| Rate for Payer: Aetna Commercial |
$42.35
|
| Rate for Payer: Aetna Commercial |
$42.35
|
| Rate for Payer: Aetna Commercial |
$42.35
|
| Rate for Payer: Aetna Commercial |
$42.35
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$89.11
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$29.83
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$29.83
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$29.83
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$29.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$59.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$59.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$59.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$59.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.59
|
| Rate for Payer: Cash Price |
$140.93
|
| Rate for Payer: Cash Price |
$72.37
|
| Rate for Payer: Cash Price |
$144.74
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Centivo All Commercial |
$65.64
|
| Rate for Payer: Centivo All Commercial |
$65.64
|
| Rate for Payer: Centivo All Commercial |
$65.64
|
| Rate for Payer: Centivo All Commercial |
$65.64
|
| Rate for Payer: Cigna All Commercial |
$42.35
|
| Rate for Payer: Cigna All Commercial |
$42.35
|
| Rate for Payer: Cigna All Commercial |
$42.35
|
| Rate for Payer: Cigna All Commercial |
$42.35
|
| Rate for Payer: CORVEL All Commercial |
$42.35
|
| Rate for Payer: CORVEL All Commercial |
$42.35
|
| Rate for Payer: CORVEL All Commercial |
$42.35
|
| Rate for Payer: CORVEL All Commercial |
$42.35
|
| Rate for Payer: Coventry All Commercial |
$50.82
|
| Rate for Payer: Coventry All Commercial |
$50.82
|
| Rate for Payer: Coventry All Commercial |
$50.82
|
| Rate for Payer: Coventry All Commercial |
$50.82
|
| Rate for Payer: Encore All Commercial |
$42.35
|
| Rate for Payer: Encore All Commercial |
$42.35
|
| Rate for Payer: Encore All Commercial |
$42.35
|
| Rate for Payer: Encore All Commercial |
$42.35
|
| Rate for Payer: Frontpath All Commercial |
$58.70
|
| Rate for Payer: Frontpath All Commercial |
$58.70
|
| Rate for Payer: Frontpath All Commercial |
$58.70
|
| Rate for Payer: Frontpath All Commercial |
$58.70
|
| Rate for Payer: Humana ChoiceCare |
$53.20
|
| Rate for Payer: Humana ChoiceCare |
$53.20
|
| Rate for Payer: Humana ChoiceCare |
$53.20
|
| Rate for Payer: Humana ChoiceCare |
$53.20
|
| Rate for Payer: Humana Medicare |
$42.35
|
| Rate for Payer: Humana Medicare |
$42.35
|
| Rate for Payer: Humana Medicare |
$42.35
|
| Rate for Payer: Humana Medicare |
$42.35
|
| Rate for Payer: Lucent All Commercial |
$59.29
|
| Rate for Payer: Lucent All Commercial |
$59.29
|
| Rate for Payer: Lucent All Commercial |
$59.29
|
| Rate for Payer: Lucent All Commercial |
$59.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Managed Health Services Medicaid |
$59.33
|
| Rate for Payer: Managed Health Services Medicaid |
$59.33
|
| Rate for Payer: Managed Health Services Medicaid |
$59.33
|
| Rate for Payer: Managed Health Services Medicaid |
$59.33
|
| Rate for Payer: MDWise Medicaid |
$59.33
|
| Rate for Payer: MDWise Medicaid |
$59.33
|
| Rate for Payer: MDWise Medicaid |
$59.33
|
| Rate for Payer: MDWise Medicaid |
$59.33
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$29.83
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$29.83
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$29.83
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$29.83
|
| Rate for Payer: PHCS All Commercial |
$42.35
|
| Rate for Payer: PHCS All Commercial |
$42.35
|
| Rate for Payer: PHCS All Commercial |
$42.35
|
| Rate for Payer: PHCS All Commercial |
$42.35
|
| Rate for Payer: PHP All Commercial |
$65.53
|
| Rate for Payer: PHP All Commercial |
$65.53
|
| Rate for Payer: PHP All Commercial |
$65.53
|
| Rate for Payer: PHP All Commercial |
$65.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.35
|
| Rate for Payer: Sagamore Health Network All Products |
$42.35
|
| Rate for Payer: Sagamore Health Network All Products |
$42.35
|
| Rate for Payer: Sagamore Health Network All Products |
$42.35
|
| Rate for Payer: Sagamore Health Network All Products |
$42.35
|
| Rate for Payer: Signature Care EPO |
$97.50
|
| Rate for Payer: Signature Care EPO |
$97.50
|
| Rate for Payer: Signature Care EPO |
$97.50
|
| Rate for Payer: Signature Care EPO |
$97.50
|
| Rate for Payer: Signature Care PPO |
$97.50
|
| Rate for Payer: Signature Care PPO |
$97.50
|
| Rate for Payer: Signature Care PPO |
$97.50
|
| Rate for Payer: Signature Care PPO |
$97.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,300.00
|
| Rate for Payer: United Healthcare Commercial |
$55.96
|
| Rate for Payer: United Healthcare Commercial |
$55.96
|
| Rate for Payer: United Healthcare Commercial |
$55.96
|
| Rate for Payer: United Healthcare Commercial |
$55.96
|
| Rate for Payer: United Healthcare Medicare |
$58.72
|
| Rate for Payer: United Healthcare Medicare |
$58.72
|
| Rate for Payer: United Healthcare Medicare |
$58.72
|
| Rate for Payer: United Healthcare Medicare |
$58.72
|
|
