|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$184.88
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
z20611
|
| Min. Negotiated Rate |
$48.04 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Aetna Commercial |
$55.89
|
| Rate for Payer: Aetna Commercial |
$55.89
|
| Rate for Payer: Aetna Commercial |
$55.89
|
| Rate for Payer: Aetna Commercial |
$55.89
|
| Rate for Payer: Aetna Medicare |
$55.89
|
| Rate for Payer: Aetna Medicare |
$55.89
|
| Rate for Payer: Aetna Medicare |
$55.89
|
| Rate for Payer: Aetna Medicare |
$55.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$99.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$48.04
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$48.04
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$48.04
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$48.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$90.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$90.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$90.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$90.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$61.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$61.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$61.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$61.48
|
| Rate for Payer: Cash Price |
$218.02
|
| Rate for Payer: Cash Price |
$110.93
|
| Rate for Payer: Cash Price |
$221.86
|
| Rate for Payer: Cash Price |
$109.01
|
| Rate for Payer: Centivo All Commercial |
$86.63
|
| Rate for Payer: Centivo All Commercial |
$86.63
|
| Rate for Payer: Centivo All Commercial |
$86.63
|
| Rate for Payer: Centivo All Commercial |
$86.63
|
| Rate for Payer: Cigna All Commercial |
$55.89
|
| Rate for Payer: Cigna All Commercial |
$55.89
|
| Rate for Payer: Cigna All Commercial |
$55.89
|
| Rate for Payer: Cigna All Commercial |
$55.89
|
| Rate for Payer: CORVEL All Commercial |
$55.89
|
| Rate for Payer: CORVEL All Commercial |
$55.89
|
| Rate for Payer: CORVEL All Commercial |
$55.89
|
| Rate for Payer: CORVEL All Commercial |
$55.89
|
| Rate for Payer: Coventry All Commercial |
$67.07
|
| Rate for Payer: Coventry All Commercial |
$67.07
|
| Rate for Payer: Coventry All Commercial |
$67.07
|
| Rate for Payer: Coventry All Commercial |
$67.07
|
| Rate for Payer: Encore All Commercial |
$55.89
|
| Rate for Payer: Encore All Commercial |
$55.89
|
| Rate for Payer: Encore All Commercial |
$55.89
|
| Rate for Payer: Encore All Commercial |
$55.89
|
| Rate for Payer: Frontpath All Commercial |
$76.91
|
| Rate for Payer: Frontpath All Commercial |
$76.91
|
| Rate for Payer: Frontpath All Commercial |
$76.91
|
| Rate for Payer: Frontpath All Commercial |
$76.91
|
| Rate for Payer: Humana ChoiceCare |
$68.97
|
| Rate for Payer: Humana ChoiceCare |
$68.97
|
| Rate for Payer: Humana ChoiceCare |
$68.97
|
| Rate for Payer: Humana ChoiceCare |
$68.97
|
| Rate for Payer: Humana Medicare |
$55.89
|
| Rate for Payer: Humana Medicare |
$55.89
|
| Rate for Payer: Humana Medicare |
$55.89
|
| Rate for Payer: Humana Medicare |
$55.89
|
| Rate for Payer: Lucent All Commercial |
$78.25
|
| Rate for Payer: Lucent All Commercial |
$78.25
|
| Rate for Payer: Lucent All Commercial |
$78.25
|
| Rate for Payer: Lucent All Commercial |
$78.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.00
|
| Rate for Payer: Managed Health Services Medicaid |
$90.93
|
| Rate for Payer: Managed Health Services Medicaid |
$90.93
|
| Rate for Payer: Managed Health Services Medicaid |
$90.93
|
| Rate for Payer: Managed Health Services Medicaid |
$90.93
|
| Rate for Payer: MDWise Medicaid |
$90.93
|
| Rate for Payer: MDWise Medicaid |
$90.93
|
| Rate for Payer: MDWise Medicaid |
$90.93
|
| Rate for Payer: MDWise Medicaid |
$90.93
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$48.04
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$48.04
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$48.04
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$48.04
|
| Rate for Payer: PHCS All Commercial |
$55.89
|
| Rate for Payer: PHCS All Commercial |
$55.89
|
| Rate for Payer: PHCS All Commercial |
$55.89
|
| Rate for Payer: PHCS All Commercial |
$55.89
|
| Rate for Payer: PHP All Commercial |
$94.65
|
| Rate for Payer: PHP All Commercial |
$94.65
|
| Rate for Payer: PHP All Commercial |
$94.65
|
| Rate for Payer: PHP All Commercial |
$94.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.89
|
| Rate for Payer: Sagamore Health Network All Products |
$55.89
|
| Rate for Payer: Sagamore Health Network All Products |
$55.89
|
| Rate for Payer: Sagamore Health Network All Products |
$55.89
|
| Rate for Payer: Sagamore Health Network All Products |
$55.89
|
| Rate for Payer: Signature Care EPO |
$79.54
|
| Rate for Payer: Signature Care EPO |
$79.54
|
| Rate for Payer: Signature Care EPO |
$79.54
|
| Rate for Payer: Signature Care EPO |
$79.54
|
| Rate for Payer: Signature Care PPO |
$79.54
|
| Rate for Payer: Signature Care PPO |
$79.54
|
| Rate for Payer: Signature Care PPO |
$79.54
|
| Rate for Payer: Signature Care PPO |
$79.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,400.00
|
| Rate for Payer: United Healthcare Commercial |
$75.29
|
| Rate for Payer: United Healthcare Commercial |
$75.29
|
| Rate for Payer: United Healthcare Commercial |
$75.29
|
| Rate for Payer: United Healthcare Commercial |
$75.29
|
| Rate for Payer: United Healthcare Medicare |
$90.84
|
| Rate for Payer: United Healthcare Medicare |
$90.84
|
| Rate for Payer: United Healthcare Medicare |
$90.84
|
| Rate for Payer: United Healthcare Medicare |
$90.84
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$193.52
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
z20600
|
| Min. Negotiated Rate |
$25.63 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Commercial |
$33.63
|
| Rate for Payer: Aetna Commercial |
$33.63
|
| Rate for Payer: Aetna Commercial |
$33.63
|
| Rate for Payer: Aetna Commercial |
$33.63
|
| Rate for Payer: Aetna Medicare |
$33.63
|
| Rate for Payer: Aetna Medicare |
$33.63
|
| Rate for Payer: Aetna Medicare |
$33.63
|
| Rate for Payer: Aetna Medicare |
$33.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$69.63
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.63
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.63
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.63
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$49.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$49.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$49.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$49.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$38.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$38.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$38.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$38.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.99
|
| Rate for Payer: Cash Price |
$120.29
|
| Rate for Payer: Cash Price |
$116.11
|
| Rate for Payer: Cash Price |
$58.06
|
| Rate for Payer: Cash Price |
$60.14
|
| Rate for Payer: Centivo All Commercial |
$52.13
|
| Rate for Payer: Centivo All Commercial |
$52.13
|
| Rate for Payer: Centivo All Commercial |
$52.13
|
| Rate for Payer: Centivo All Commercial |
$52.13
|
| Rate for Payer: Cigna All Commercial |
$33.63
|
| Rate for Payer: Cigna All Commercial |
$33.63
|
| Rate for Payer: Cigna All Commercial |
$33.63
|
| Rate for Payer: Cigna All Commercial |
$33.63
|
| Rate for Payer: CORVEL All Commercial |
$33.63
|
| Rate for Payer: CORVEL All Commercial |
$33.63
|
| Rate for Payer: CORVEL All Commercial |
$33.63
|
| Rate for Payer: CORVEL All Commercial |
$33.63
|
| Rate for Payer: Coventry All Commercial |
$40.36
|
| Rate for Payer: Coventry All Commercial |
$40.36
|
| Rate for Payer: Coventry All Commercial |
$40.36
|
| Rate for Payer: Coventry All Commercial |
$40.36
|
| Rate for Payer: Encore All Commercial |
$33.63
|
| Rate for Payer: Encore All Commercial |
$33.63
|
| Rate for Payer: Encore All Commercial |
$33.63
|
| Rate for Payer: Encore All Commercial |
$33.63
|
| Rate for Payer: Frontpath All Commercial |
$46.45
|
| Rate for Payer: Frontpath All Commercial |
$46.45
|
| Rate for Payer: Frontpath All Commercial |
$46.45
|
| Rate for Payer: Frontpath All Commercial |
$46.45
|
| Rate for Payer: Humana ChoiceCare |
$44.18
|
| Rate for Payer: Humana ChoiceCare |
$44.18
|
| Rate for Payer: Humana ChoiceCare |
$44.18
|
| Rate for Payer: Humana ChoiceCare |
$44.18
|
| Rate for Payer: Humana Medicare |
$33.63
|
| Rate for Payer: Humana Medicare |
$33.63
|
| Rate for Payer: Humana Medicare |
$33.63
|
| Rate for Payer: Humana Medicare |
$33.63
|
| Rate for Payer: Lucent All Commercial |
$47.08
|
| Rate for Payer: Lucent All Commercial |
$47.08
|
| Rate for Payer: Lucent All Commercial |
$47.08
|
| Rate for Payer: Lucent All Commercial |
$47.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$53.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$53.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$53.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$53.00
|
| Rate for Payer: Managed Health Services Medicaid |
$49.31
|
| Rate for Payer: Managed Health Services Medicaid |
$49.31
|
| Rate for Payer: Managed Health Services Medicaid |
$49.31
|
| Rate for Payer: Managed Health Services Medicaid |
$49.31
|
| Rate for Payer: MDWise Medicaid |
$49.31
|
| Rate for Payer: MDWise Medicaid |
$49.31
|
| Rate for Payer: MDWise Medicaid |
$49.31
|
| Rate for Payer: MDWise Medicaid |
$49.31
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$25.63
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$25.63
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$25.63
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$25.63
|
| Rate for Payer: PHCS All Commercial |
$33.63
|
| Rate for Payer: PHCS All Commercial |
$33.63
|
| Rate for Payer: PHCS All Commercial |
$33.63
|
| Rate for Payer: PHCS All Commercial |
$33.63
|
| Rate for Payer: PHP All Commercial |
$56.40
|
| Rate for Payer: PHP All Commercial |
$56.40
|
| Rate for Payer: PHP All Commercial |
$56.40
|
| Rate for Payer: PHP All Commercial |
$56.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$33.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$33.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$33.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$33.63
|
| Rate for Payer: Sagamore Health Network All Products |
$33.63
|
| Rate for Payer: Sagamore Health Network All Products |
$33.63
|
| Rate for Payer: Sagamore Health Network All Products |
$33.63
|
| Rate for Payer: Sagamore Health Network All Products |
$33.63
|
| Rate for Payer: Signature Care EPO |
$74.80
|
| Rate for Payer: Signature Care EPO |
$74.80
|
| Rate for Payer: Signature Care EPO |
$74.80
|
| Rate for Payer: Signature Care EPO |
$74.80
|
| Rate for Payer: Signature Care PPO |
$74.80
|
| Rate for Payer: Signature Care PPO |
$74.80
|
| Rate for Payer: Signature Care PPO |
$74.80
|
| Rate for Payer: Signature Care PPO |
$74.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,000.00
|
| Rate for Payer: United Healthcare Commercial |
$45.16
|
| Rate for Payer: United Healthcare Commercial |
$45.16
|
| Rate for Payer: United Healthcare Commercial |
$45.16
|
| Rate for Payer: United Healthcare Commercial |
$45.16
|
| Rate for Payer: United Healthcare Medicare |
$48.38
|
| Rate for Payer: United Healthcare Medicare |
$48.38
|
| Rate for Payer: United Healthcare Medicare |
$48.38
|
| Rate for Payer: United Healthcare Medicare |
$48.38
|
|
|
PR ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
Both
|
$154.56
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
z20604
|
| Min. Negotiated Rate |
$36.16 |
| Max. Negotiated Rate |
$6,500.00 |
| Rate for Payer: Aetna Commercial |
$43.62
|
| Rate for Payer: Aetna Commercial |
$43.62
|
| Rate for Payer: Aetna Commercial |
$43.62
|
| Rate for Payer: Aetna Commercial |
$43.62
|
| Rate for Payer: Aetna Medicare |
$43.62
|
| Rate for Payer: Aetna Medicare |
$43.62
|
| Rate for Payer: Aetna Medicare |
$43.62
|
| Rate for Payer: Aetna Medicare |
$43.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$78.58
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$36.16
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$36.16
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$36.16
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$36.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$76.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$76.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$76.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$76.02
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.98
|
| Rate for Payer: Cash Price |
$180.65
|
| Rate for Payer: Cash Price |
$92.74
|
| Rate for Payer: Cash Price |
$185.47
|
| Rate for Payer: Cash Price |
$90.32
|
| Rate for Payer: Centivo All Commercial |
$67.61
|
| Rate for Payer: Centivo All Commercial |
$67.61
|
| Rate for Payer: Centivo All Commercial |
$67.61
|
| Rate for Payer: Centivo All Commercial |
$67.61
|
| Rate for Payer: Cigna All Commercial |
$43.62
|
| Rate for Payer: Cigna All Commercial |
$43.62
|
| Rate for Payer: Cigna All Commercial |
$43.62
|
| Rate for Payer: Cigna All Commercial |
$43.62
|
| Rate for Payer: CORVEL All Commercial |
$43.62
|
| Rate for Payer: CORVEL All Commercial |
$43.62
|
| Rate for Payer: CORVEL All Commercial |
$43.62
|
| Rate for Payer: CORVEL All Commercial |
$43.62
|
| Rate for Payer: Coventry All Commercial |
$52.34
|
| Rate for Payer: Coventry All Commercial |
$52.34
|
| Rate for Payer: Coventry All Commercial |
$52.34
|
| Rate for Payer: Coventry All Commercial |
$52.34
|
| Rate for Payer: Encore All Commercial |
$43.62
|
| Rate for Payer: Encore All Commercial |
$43.62
|
| Rate for Payer: Encore All Commercial |
$43.62
|
| Rate for Payer: Encore All Commercial |
$43.62
|
| Rate for Payer: Frontpath All Commercial |
$59.75
|
| Rate for Payer: Frontpath All Commercial |
$59.75
|
| Rate for Payer: Frontpath All Commercial |
$59.75
|
| Rate for Payer: Frontpath All Commercial |
$59.75
|
| Rate for Payer: Humana ChoiceCare |
$51.71
|
| Rate for Payer: Humana ChoiceCare |
$51.71
|
| Rate for Payer: Humana ChoiceCare |
$51.71
|
| Rate for Payer: Humana ChoiceCare |
$51.71
|
| Rate for Payer: Humana Medicare |
$43.62
|
| Rate for Payer: Humana Medicare |
$43.62
|
| Rate for Payer: Humana Medicare |
$43.62
|
| Rate for Payer: Humana Medicare |
$43.62
|
| Rate for Payer: Lucent All Commercial |
$61.07
|
| Rate for Payer: Lucent All Commercial |
$61.07
|
| Rate for Payer: Lucent All Commercial |
$61.07
|
| Rate for Payer: Lucent All Commercial |
$61.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$69.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$69.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$69.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$69.00
|
| Rate for Payer: Managed Health Services Medicaid |
$76.02
|
| Rate for Payer: Managed Health Services Medicaid |
$76.02
|
| Rate for Payer: Managed Health Services Medicaid |
$76.02
|
| Rate for Payer: Managed Health Services Medicaid |
$76.02
|
| Rate for Payer: MDWise Medicaid |
$76.02
|
| Rate for Payer: MDWise Medicaid |
$76.02
|
| Rate for Payer: MDWise Medicaid |
$76.02
|
| Rate for Payer: MDWise Medicaid |
$76.02
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$36.16
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$36.16
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$36.16
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$36.16
|
| Rate for Payer: PHCS All Commercial |
$43.62
|
| Rate for Payer: PHCS All Commercial |
$43.62
|
| Rate for Payer: PHCS All Commercial |
$43.62
|
| Rate for Payer: PHCS All Commercial |
$43.62
|
| Rate for Payer: PHP All Commercial |
$73.32
|
| Rate for Payer: PHP All Commercial |
$73.32
|
| Rate for Payer: PHP All Commercial |
$73.32
|
| Rate for Payer: PHP All Commercial |
$73.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.62
|
| Rate for Payer: Sagamore Health Network All Products |
$43.62
|
| Rate for Payer: Sagamore Health Network All Products |
$43.62
|
| Rate for Payer: Sagamore Health Network All Products |
$43.62
|
| Rate for Payer: Sagamore Health Network All Products |
$43.62
|
| Rate for Payer: Signature Care EPO |
$102.54
|
| Rate for Payer: Signature Care EPO |
$102.54
|
| Rate for Payer: Signature Care EPO |
$102.54
|
| Rate for Payer: Signature Care EPO |
$102.54
|
| Rate for Payer: Signature Care PPO |
$102.54
|
| Rate for Payer: Signature Care PPO |
$102.54
|
| Rate for Payer: Signature Care PPO |
$102.54
|
| Rate for Payer: Signature Care PPO |
$102.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,500.00
|
| Rate for Payer: United Healthcare Commercial |
$56.49
|
| Rate for Payer: United Healthcare Commercial |
$56.49
|
| Rate for Payer: United Healthcare Commercial |
$56.49
|
| Rate for Payer: United Healthcare Commercial |
$56.49
|
| Rate for Payer: United Healthcare Medicare |
$75.27
|
| Rate for Payer: United Healthcare Medicare |
$75.27
|
| Rate for Payer: United Healthcare Medicare |
$75.27
|
| Rate for Payer: United Healthcare Medicare |
$75.27
|
|
|
PR ARTHRODESIS,ANKLE,OPEN
|
Professional
|
Both
|
$1,869.92
|
|
|
Service Code
|
CPT 27870
|
| Hospital Charge Code |
z27870
|
| Min. Negotiated Rate |
$917.91 |
| Max. Negotiated Rate |
$141,200.00 |
| Rate for Payer: Aetna Commercial |
$946.28
|
| Rate for Payer: Aetna Commercial |
$946.28
|
| Rate for Payer: Aetna Medicare |
$946.28
|
| Rate for Payer: Aetna Medicare |
$946.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,352.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,352.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,352.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,352.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,352.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,352.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,352.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,352.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$919.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$919.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,088.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,088.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,040.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,040.91
|
| Rate for Payer: Cash Price |
$1,121.95
|
| Rate for Payer: Cash Price |
$1,101.49
|
| Rate for Payer: Centivo All Commercial |
$1,466.73
|
| Rate for Payer: Centivo All Commercial |
$1,466.73
|
| Rate for Payer: Cigna All Commercial |
$946.28
|
| Rate for Payer: Cigna All Commercial |
$946.28
|
| Rate for Payer: CORVEL All Commercial |
$946.28
|
| Rate for Payer: CORVEL All Commercial |
$946.28
|
| Rate for Payer: Coventry All Commercial |
$1,135.54
|
| Rate for Payer: Coventry All Commercial |
$1,135.54
|
| Rate for Payer: Encore All Commercial |
$946.28
|
| Rate for Payer: Encore All Commercial |
$946.28
|
| Rate for Payer: Frontpath All Commercial |
$1,313.78
|
| Rate for Payer: Frontpath All Commercial |
$1,313.78
|
| Rate for Payer: Humana ChoiceCare |
$1,068.63
|
| Rate for Payer: Humana ChoiceCare |
$1,068.63
|
| Rate for Payer: Humana Medicare |
$946.28
|
| Rate for Payer: Humana Medicare |
$946.28
|
| Rate for Payer: Lucent All Commercial |
$1,324.79
|
| Rate for Payer: Lucent All Commercial |
$1,324.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,506.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,506.00
|
| Rate for Payer: Managed Health Services Medicaid |
$919.70
|
| Rate for Payer: Managed Health Services Medicaid |
$919.70
|
| Rate for Payer: MDWise Medicaid |
$919.70
|
| Rate for Payer: MDWise Medicaid |
$919.70
|
| Rate for Payer: PHCS All Commercial |
$946.28
|
| Rate for Payer: PHCS All Commercial |
$946.28
|
| Rate for Payer: PHP All Commercial |
$1,597.16
|
| Rate for Payer: PHP All Commercial |
$1,597.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$946.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$946.28
|
| Rate for Payer: Sagamore Health Network All Products |
$946.28
|
| Rate for Payer: Sagamore Health Network All Products |
$946.28
|
| Rate for Payer: Signature Care EPO |
$1,431.40
|
| Rate for Payer: Signature Care EPO |
$1,431.40
|
| Rate for Payer: Signature Care PPO |
$1,431.40
|
| Rate for Payer: Signature Care PPO |
$1,431.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$141,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$141,200.00
|
| Rate for Payer: United Healthcare Commercial |
$1,150.75
|
| Rate for Payer: United Healthcare Commercial |
$1,150.75
|
| Rate for Payer: United Healthcare Medicare |
$917.91
|
| Rate for Payer: United Healthcare Medicare |
$917.91
|
|
|
PR ARTHROPLASTY PATELLA WITH IMPLANT
|
Professional
|
Both
|
$1,556.88
|
|
|
Service Code
|
CPT 27438
|
| Hospital Charge Code |
z27438
|
| Min. Negotiated Rate |
$762.50 |
| Max. Negotiated Rate |
$117,200.00 |
| Rate for Payer: Aetna Commercial |
$783.19
|
| Rate for Payer: Aetna Commercial |
$783.19
|
| Rate for Payer: Aetna Medicare |
$783.19
|
| Rate for Payer: Aetna Medicare |
$783.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,135.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,135.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,135.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,135.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,135.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,135.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,135.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,135.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$765.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$765.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$900.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$900.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$861.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$861.51
|
| Rate for Payer: Cash Price |
$934.13
|
| Rate for Payer: Cash Price |
$915.00
|
| Rate for Payer: Centivo All Commercial |
$1,213.94
|
| Rate for Payer: Centivo All Commercial |
$1,213.94
|
| Rate for Payer: Cigna All Commercial |
$783.19
|
| Rate for Payer: Cigna All Commercial |
$783.19
|
| Rate for Payer: CORVEL All Commercial |
$783.19
|
| Rate for Payer: CORVEL All Commercial |
$783.19
|
| Rate for Payer: Coventry All Commercial |
$939.83
|
| Rate for Payer: Coventry All Commercial |
$939.83
|
| Rate for Payer: Encore All Commercial |
$783.19
|
| Rate for Payer: Encore All Commercial |
$783.19
|
| Rate for Payer: Frontpath All Commercial |
$1,092.03
|
| Rate for Payer: Frontpath All Commercial |
$1,092.03
|
| Rate for Payer: Humana ChoiceCare |
$865.11
|
| Rate for Payer: Humana ChoiceCare |
$865.11
|
| Rate for Payer: Humana Medicare |
$783.19
|
| Rate for Payer: Humana Medicare |
$783.19
|
| Rate for Payer: Lucent All Commercial |
$1,096.47
|
| Rate for Payer: Lucent All Commercial |
$1,096.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,251.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,251.00
|
| Rate for Payer: Managed Health Services Medicaid |
$765.73
|
| Rate for Payer: Managed Health Services Medicaid |
$765.73
|
| Rate for Payer: MDWise Medicaid |
$765.73
|
| Rate for Payer: MDWise Medicaid |
$765.73
|
| Rate for Payer: PHCS All Commercial |
$783.19
|
| Rate for Payer: PHCS All Commercial |
$783.19
|
| Rate for Payer: PHP All Commercial |
$1,326.75
|
| Rate for Payer: PHP All Commercial |
$1,326.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$783.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$783.19
|
| Rate for Payer: Sagamore Health Network All Products |
$783.19
|
| Rate for Payer: Sagamore Health Network All Products |
$783.19
|
| Rate for Payer: Signature Care EPO |
$1,152.60
|
| Rate for Payer: Signature Care EPO |
$1,152.60
|
| Rate for Payer: Signature Care PPO |
$1,152.60
|
| Rate for Payer: Signature Care PPO |
$1,152.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117,200.00
|
| Rate for Payer: United Healthcare Commercial |
$913.41
|
| Rate for Payer: United Healthcare Commercial |
$913.41
|
| Rate for Payer: United Healthcare Medicare |
$762.50
|
| Rate for Payer: United Healthcare Medicare |
$762.50
|
|
|
PR ARTHROSCOPY SHOULDER SURGICAL BICEPS TENODESIS
|
Professional
|
Both
|
$1,693.88
|
|
|
Service Code
|
CPT 29828
|
| Hospital Charge Code |
z29828
|
| Min. Negotiated Rate |
$830.35 |
| Max. Negotiated Rate |
$127,700.00 |
| Rate for Payer: Aetna Commercial |
$854.03
|
| Rate for Payer: Aetna Commercial |
$854.03
|
| Rate for Payer: Aetna Medicare |
$854.03
|
| Rate for Payer: Aetna Medicare |
$854.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,251.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,251.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,251.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,251.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,251.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,251.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,251.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,251.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$833.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$833.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$982.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$982.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$939.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$939.43
|
| Rate for Payer: Cash Price |
$1,016.33
|
| Rate for Payer: Cash Price |
$996.42
|
| Rate for Payer: Centivo All Commercial |
$1,323.75
|
| Rate for Payer: Centivo All Commercial |
$1,323.75
|
| Rate for Payer: Cigna All Commercial |
$854.03
|
| Rate for Payer: Cigna All Commercial |
$854.03
|
| Rate for Payer: CORVEL All Commercial |
$854.03
|
| Rate for Payer: CORVEL All Commercial |
$854.03
|
| Rate for Payer: Coventry All Commercial |
$1,024.84
|
| Rate for Payer: Coventry All Commercial |
$1,024.84
|
| Rate for Payer: Encore All Commercial |
$854.03
|
| Rate for Payer: Encore All Commercial |
$854.03
|
| Rate for Payer: Frontpath All Commercial |
$1,190.80
|
| Rate for Payer: Frontpath All Commercial |
$1,190.80
|
| Rate for Payer: Humana ChoiceCare |
$878.64
|
| Rate for Payer: Humana ChoiceCare |
$878.64
|
| Rate for Payer: Humana Medicare |
$854.03
|
| Rate for Payer: Humana Medicare |
$854.03
|
| Rate for Payer: Lucent All Commercial |
$1,195.64
|
| Rate for Payer: Lucent All Commercial |
$1,195.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,362.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,362.00
|
| Rate for Payer: Managed Health Services Medicaid |
$833.12
|
| Rate for Payer: Managed Health Services Medicaid |
$833.12
|
| Rate for Payer: MDWise Medicaid |
$833.12
|
| Rate for Payer: MDWise Medicaid |
$833.12
|
| Rate for Payer: PHCS All Commercial |
$854.03
|
| Rate for Payer: PHCS All Commercial |
$854.03
|
| Rate for Payer: PHP All Commercial |
$1,444.81
|
| Rate for Payer: PHP All Commercial |
$1,444.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$854.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$854.03
|
| Rate for Payer: Sagamore Health Network All Products |
$854.03
|
| Rate for Payer: Sagamore Health Network All Products |
$854.03
|
| Rate for Payer: Signature Care EPO |
$1,192.88
|
| Rate for Payer: Signature Care EPO |
$1,192.88
|
| Rate for Payer: Signature Care PPO |
$1,192.88
|
| Rate for Payer: Signature Care PPO |
$1,192.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$127,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$127,700.00
|
| Rate for Payer: United Healthcare Commercial |
$994.81
|
| Rate for Payer: United Healthcare Commercial |
$994.81
|
| Rate for Payer: United Healthcare Medicare |
$830.35
|
| Rate for Payer: United Healthcare Medicare |
$830.35
|
|
|
PR ARTHROTOMY/EXPLORE/TREAT KNEE JOINT
|
Professional
|
Both
|
$892.26
|
|
|
Service Code
|
CPT 27331
|
| Hospital Charge Code |
z27331
|
| Min. Negotiated Rate |
$435.93 |
| Max. Negotiated Rate |
$690.54 |
| Rate for Payer: Aetna Commercial |
$445.51
|
| Rate for Payer: Aetna Commercial |
$445.51
|
| Rate for Payer: Aetna Medicare |
$445.51
|
| Rate for Payer: Aetna Medicare |
$445.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$438.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$438.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$512.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$512.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$490.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$490.06
|
| Rate for Payer: Cash Price |
$523.12
|
| Rate for Payer: Cash Price |
$535.36
|
| Rate for Payer: Centivo All Commercial |
$690.54
|
| Rate for Payer: Centivo All Commercial |
$690.54
|
| Rate for Payer: Cigna All Commercial |
$445.51
|
| Rate for Payer: Cigna All Commercial |
$445.51
|
| Rate for Payer: CORVEL All Commercial |
$445.51
|
| Rate for Payer: CORVEL All Commercial |
$445.51
|
| Rate for Payer: Coventry All Commercial |
$534.61
|
| Rate for Payer: Coventry All Commercial |
$534.61
|
| Rate for Payer: Encore All Commercial |
$445.51
|
| Rate for Payer: Encore All Commercial |
$445.51
|
| Rate for Payer: Frontpath All Commercial |
$617.49
|
| Rate for Payer: Frontpath All Commercial |
$617.49
|
| Rate for Payer: Humana ChoiceCare |
$494.82
|
| Rate for Payer: Humana ChoiceCare |
$494.82
|
| Rate for Payer: Humana Medicare |
$445.51
|
| Rate for Payer: Humana Medicare |
$445.51
|
| Rate for Payer: Lucent All Commercial |
$623.71
|
| Rate for Payer: Lucent All Commercial |
$623.71
|
| Rate for Payer: Managed Health Services Medicaid |
$438.85
|
| Rate for Payer: Managed Health Services Medicaid |
$438.85
|
| Rate for Payer: MDWise Medicaid |
$438.85
|
| Rate for Payer: MDWise Medicaid |
$438.85
|
| Rate for Payer: PHCS All Commercial |
$445.51
|
| Rate for Payer: PHCS All Commercial |
$445.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$445.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$445.51
|
| Rate for Payer: Sagamore Health Network All Products |
$445.51
|
| Rate for Payer: Sagamore Health Network All Products |
$445.51
|
| Rate for Payer: United Healthcare Commercial |
$504.30
|
| Rate for Payer: United Healthcare Commercial |
$504.30
|
| Rate for Payer: United Healthcare Medicare |
$435.93
|
| Rate for Payer: United Healthcare Medicare |
$435.93
|
|
|
PR ASPIRAT/INJECTION GANGLION CYST(S)
|
Professional
|
Both
|
$121.04
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
z20612
|
| Min. Negotiated Rate |
$31.48 |
| Max. Negotiated Rate |
$5,700.00 |
| Rate for Payer: Aetna Commercial |
$38.60
|
| Rate for Payer: Aetna Commercial |
$38.60
|
| Rate for Payer: Aetna Medicare |
$38.60
|
| Rate for Payer: Aetna Medicare |
$38.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$64.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$64.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$64.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$64.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$64.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$64.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$64.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$64.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$31.48
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$31.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$59.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$59.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$44.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$44.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$42.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$42.46
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Centivo All Commercial |
$59.83
|
| Rate for Payer: Centivo All Commercial |
$59.83
|
| Rate for Payer: Cigna All Commercial |
$38.60
|
| Rate for Payer: Cigna All Commercial |
$38.60
|
| Rate for Payer: CORVEL All Commercial |
$38.60
|
| Rate for Payer: CORVEL All Commercial |
$38.60
|
| Rate for Payer: Coventry All Commercial |
$46.32
|
| Rate for Payer: Coventry All Commercial |
$46.32
|
| Rate for Payer: Encore All Commercial |
$38.60
|
| Rate for Payer: Encore All Commercial |
$38.60
|
| Rate for Payer: Frontpath All Commercial |
$53.25
|
| Rate for Payer: Frontpath All Commercial |
$53.25
|
| Rate for Payer: Humana ChoiceCare |
$46.70
|
| Rate for Payer: Humana ChoiceCare |
$46.70
|
| Rate for Payer: Humana Medicare |
$38.60
|
| Rate for Payer: Humana Medicare |
$38.60
|
| Rate for Payer: Lucent All Commercial |
$54.04
|
| Rate for Payer: Lucent All Commercial |
$54.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$61.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$61.00
|
| Rate for Payer: Managed Health Services Medicaid |
$59.53
|
| Rate for Payer: Managed Health Services Medicaid |
$59.53
|
| Rate for Payer: MDWise Medicaid |
$59.53
|
| Rate for Payer: MDWise Medicaid |
$59.53
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$31.48
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$31.48
|
| Rate for Payer: PHCS All Commercial |
$38.60
|
| Rate for Payer: PHCS All Commercial |
$38.60
|
| Rate for Payer: PHP All Commercial |
$65.01
|
| Rate for Payer: PHP All Commercial |
$65.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.60
|
| Rate for Payer: Sagamore Health Network All Products |
$38.60
|
| Rate for Payer: Sagamore Health Network All Products |
$38.60
|
| Rate for Payer: Signature Care EPO |
$80.75
|
| Rate for Payer: Signature Care EPO |
$80.75
|
| Rate for Payer: Signature Care PPO |
$80.75
|
| Rate for Payer: Signature Care PPO |
$80.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,700.00
|
| Rate for Payer: United Healthcare Commercial |
$48.33
|
| Rate for Payer: United Healthcare Commercial |
$48.33
|
| Rate for Payer: United Healthcare Medicare |
$58.45
|
| Rate for Payer: United Healthcare Medicare |
$58.45
|
|
|
PR ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$427.12
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
z51102
|
| Min. Negotiated Rate |
$96.02 |
| Max. Negotiated Rate |
$232.86 |
| Rate for Payer: Aetna Commercial |
$136.10
|
| Rate for Payer: Aetna Medicare |
$136.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$96.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$218.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$156.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$149.71
|
| Rate for Payer: Cash Price |
$256.27
|
| Rate for Payer: Centivo All Commercial |
$210.96
|
| Rate for Payer: Cigna All Commercial |
$136.10
|
| Rate for Payer: CORVEL All Commercial |
$136.10
|
| Rate for Payer: Coventry All Commercial |
$163.32
|
| Rate for Payer: Encore All Commercial |
$136.10
|
| Rate for Payer: Frontpath All Commercial |
$185.85
|
| Rate for Payer: Humana ChoiceCare |
$232.86
|
| Rate for Payer: Humana Medicare |
$136.10
|
| Rate for Payer: Lucent All Commercial |
$190.54
|
| Rate for Payer: Managed Health Services Medicaid |
$218.62
|
| Rate for Payer: MDWise Medicaid |
$218.62
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$96.02
|
| Rate for Payer: PHCS All Commercial |
$136.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$136.10
|
| Rate for Payer: Sagamore Health Network All Products |
$136.10
|
| Rate for Payer: United Healthcare Commercial |
$186.40
|
| Rate for Payer: United Healthcare Medicare |
$220.47
|
|
|
PR ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT
|
Professional
|
Both
|
$515.10
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
z99483
|
| Min. Negotiated Rate |
$147.33 |
| Max. Negotiated Rate |
$289.73 |
| Rate for Payer: Aetna Commercial |
$186.92
|
| Rate for Payer: Aetna Commercial |
$186.92
|
| Rate for Payer: Aetna Medicare |
$186.92
|
| Rate for Payer: Aetna Medicare |
$186.92
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$147.33
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$147.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$214.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$214.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$205.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$205.61
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$309.06
|
| Rate for Payer: Centivo All Commercial |
$289.73
|
| Rate for Payer: Centivo All Commercial |
$289.73
|
| Rate for Payer: Cigna All Commercial |
$186.92
|
| Rate for Payer: Cigna All Commercial |
$186.92
|
| Rate for Payer: CORVEL All Commercial |
$186.92
|
| Rate for Payer: CORVEL All Commercial |
$186.92
|
| Rate for Payer: Coventry All Commercial |
$224.30
|
| Rate for Payer: Coventry All Commercial |
$224.30
|
| Rate for Payer: Encore All Commercial |
$186.92
|
| Rate for Payer: Encore All Commercial |
$186.92
|
| Rate for Payer: Frontpath All Commercial |
$200.82
|
| Rate for Payer: Frontpath All Commercial |
$200.82
|
| Rate for Payer: Humana ChoiceCare |
$253.43
|
| Rate for Payer: Humana ChoiceCare |
$253.43
|
| Rate for Payer: Humana Medicare |
$186.92
|
| Rate for Payer: Humana Medicare |
$186.92
|
| Rate for Payer: Lucent All Commercial |
$261.69
|
| Rate for Payer: Lucent All Commercial |
$261.69
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$147.33
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$147.33
|
| Rate for Payer: PHCS All Commercial |
$186.92
|
| Rate for Payer: PHCS All Commercial |
$186.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$186.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$186.92
|
| Rate for Payer: Sagamore Health Network All Products |
$186.92
|
| Rate for Payer: Sagamore Health Network All Products |
$186.92
|
| Rate for Payer: United Healthcare Commercial |
$181.05
|
| Rate for Payer: United Healthcare Commercial |
$181.05
|
| Rate for Payer: United Healthcare Medicare |
$250.00
|
| Rate for Payer: United Healthcare Medicare |
$250.00
|
|
|
PR ATTENDANCE AT DELIVERY W INITIAL STABILIZATION
|
Professional
|
Both
|
$136.86
|
|
|
Service Code
|
CPT 99464
|
| Hospital Charge Code |
z99464
|
| Min. Negotiated Rate |
$67.31 |
| Max. Negotiated Rate |
$25,500.00 |
| Rate for Payer: Aetna Commercial |
$70.96
|
| Rate for Payer: Aetna Commercial |
$70.96
|
| Rate for Payer: Aetna Medicare |
$70.96
|
| Rate for Payer: Aetna Medicare |
$70.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$126.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$126.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$126.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$126.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$126.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$126.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$126.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$126.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$67.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$67.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$81.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$81.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$78.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$78.06
|
| Rate for Payer: Cash Price |
$82.12
|
| Rate for Payer: Cash Price |
$81.28
|
| Rate for Payer: Centivo All Commercial |
$109.99
|
| Rate for Payer: Centivo All Commercial |
$109.99
|
| Rate for Payer: Cigna All Commercial |
$70.96
|
| Rate for Payer: Cigna All Commercial |
$70.96
|
| Rate for Payer: CORVEL All Commercial |
$70.96
|
| Rate for Payer: CORVEL All Commercial |
$70.96
|
| Rate for Payer: Coventry All Commercial |
$85.15
|
| Rate for Payer: Coventry All Commercial |
$85.15
|
| Rate for Payer: Encore All Commercial |
$70.96
|
| Rate for Payer: Encore All Commercial |
$70.96
|
| Rate for Payer: Frontpath All Commercial |
$76.33
|
| Rate for Payer: Frontpath All Commercial |
$76.33
|
| Rate for Payer: Humana ChoiceCare |
$104.33
|
| Rate for Payer: Humana ChoiceCare |
$104.33
|
| Rate for Payer: Humana Medicare |
$70.96
|
| Rate for Payer: Humana Medicare |
$70.96
|
| Rate for Payer: Lucent All Commercial |
$99.34
|
| Rate for Payer: Lucent All Commercial |
$99.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$255.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$255.00
|
| Rate for Payer: Managed Health Services Medicaid |
$67.31
|
| Rate for Payer: Managed Health Services Medicaid |
$67.31
|
| Rate for Payer: MDWise Medicaid |
$67.31
|
| Rate for Payer: MDWise Medicaid |
$67.31
|
| Rate for Payer: PHCS All Commercial |
$70.96
|
| Rate for Payer: PHCS All Commercial |
$70.96
|
| Rate for Payer: PHP All Commercial |
$69.76
|
| Rate for Payer: PHP All Commercial |
$69.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$70.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$70.96
|
| Rate for Payer: Sagamore Health Network All Products |
$70.96
|
| Rate for Payer: Sagamore Health Network All Products |
$70.96
|
| Rate for Payer: Signature Care EPO |
$74.68
|
| Rate for Payer: Signature Care EPO |
$74.68
|
| Rate for Payer: Signature Care PPO |
$74.68
|
| Rate for Payer: Signature Care PPO |
$74.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,500.00
|
| Rate for Payer: United Healthcare Commercial |
$72.07
|
| Rate for Payer: United Healthcare Commercial |
$72.07
|
| Rate for Payer: United Healthcare Medicare |
$67.73
|
| Rate for Payer: United Healthcare Medicare |
$67.73
|
|
|
PR AUDIOMETRY, AIR & BONE
|
Professional
|
Both
|
$84.42
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
z92553
|
| Min. Negotiated Rate |
$25.70 |
| Max. Negotiated Rate |
$4,800.00 |
| Rate for Payer: Aetna Commercial |
$37.22
|
| Rate for Payer: Aetna Commercial |
$37.22
|
| Rate for Payer: Aetna Medicare |
$37.22
|
| Rate for Payer: Aetna Medicare |
$37.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$42.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$42.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$40.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$40.94
|
| Rate for Payer: Cash Price |
$50.65
|
| Rate for Payer: Cash Price |
$46.81
|
| Rate for Payer: Centivo All Commercial |
$57.69
|
| Rate for Payer: Centivo All Commercial |
$57.69
|
| Rate for Payer: Cigna All Commercial |
$37.22
|
| Rate for Payer: Cigna All Commercial |
$37.22
|
| Rate for Payer: CORVEL All Commercial |
$37.22
|
| Rate for Payer: CORVEL All Commercial |
$37.22
|
| Rate for Payer: Coventry All Commercial |
$44.66
|
| Rate for Payer: Coventry All Commercial |
$44.66
|
| Rate for Payer: Encore All Commercial |
$37.22
|
| Rate for Payer: Encore All Commercial |
$37.22
|
| Rate for Payer: Frontpath All Commercial |
$41.78
|
| Rate for Payer: Frontpath All Commercial |
$41.78
|
| Rate for Payer: Humana ChoiceCare |
$27.67
|
| Rate for Payer: Humana ChoiceCare |
$27.67
|
| Rate for Payer: Humana Medicare |
$37.22
|
| Rate for Payer: Humana Medicare |
$37.22
|
| Rate for Payer: Lucent All Commercial |
$52.11
|
| Rate for Payer: Lucent All Commercial |
$52.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$52.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$52.00
|
| Rate for Payer: Managed Health Services Medicaid |
$41.52
|
| Rate for Payer: Managed Health Services Medicaid |
$41.52
|
| Rate for Payer: MDWise Medicaid |
$41.52
|
| Rate for Payer: MDWise Medicaid |
$41.52
|
| Rate for Payer: PHCS All Commercial |
$37.22
|
| Rate for Payer: PHCS All Commercial |
$37.22
|
| Rate for Payer: PHP All Commercial |
$56.56
|
| Rate for Payer: PHP All Commercial |
$56.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$37.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$37.22
|
| Rate for Payer: Sagamore Health Network All Products |
$37.22
|
| Rate for Payer: Sagamore Health Network All Products |
$37.22
|
| Rate for Payer: Signature Care EPO |
$31.64
|
| Rate for Payer: Signature Care EPO |
$31.64
|
| Rate for Payer: Signature Care PPO |
$31.64
|
| Rate for Payer: Signature Care PPO |
$31.64
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,800.00
|
| Rate for Payer: United Healthcare Commercial |
$31.84
|
| Rate for Payer: United Healthcare Commercial |
$31.84
|
| Rate for Payer: United Healthcare Medicare |
$39.01
|
| Rate for Payer: United Healthcare Medicare |
$39.01
|
|
|
PR AUDITORY FUNCTION, + 15 MIN
|
Professional
|
Both
|
$41.42
|
|
|
Service Code
|
CPT 92621
|
| Hospital Charge Code |
z92621
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$2,100.00 |
| Rate for Payer: Aetna Commercial |
$18.19
|
| Rate for Payer: Aetna Commercial |
$18.19
|
| Rate for Payer: Aetna Medicare |
$18.19
|
| Rate for Payer: Aetna Medicare |
$18.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$11.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$11.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$9.19
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$9.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$20.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$20.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$20.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$20.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$20.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$20.01
|
| Rate for Payer: Cash Price |
$24.55
|
| Rate for Payer: Cash Price |
$24.85
|
| Rate for Payer: Centivo All Commercial |
$28.19
|
| Rate for Payer: Centivo All Commercial |
$28.19
|
| Rate for Payer: Cigna All Commercial |
$18.19
|
| Rate for Payer: Cigna All Commercial |
$18.19
|
| Rate for Payer: CORVEL All Commercial |
$18.19
|
| Rate for Payer: CORVEL All Commercial |
$18.19
|
| Rate for Payer: Coventry All Commercial |
$21.83
|
| Rate for Payer: Coventry All Commercial |
$21.83
|
| Rate for Payer: Encore All Commercial |
$18.19
|
| Rate for Payer: Encore All Commercial |
$18.19
|
| Rate for Payer: Frontpath All Commercial |
$20.34
|
| Rate for Payer: Frontpath All Commercial |
$20.34
|
| Rate for Payer: Humana ChoiceCare |
$11.21
|
| Rate for Payer: Humana ChoiceCare |
$11.21
|
| Rate for Payer: Humana Medicare |
$18.19
|
| Rate for Payer: Humana Medicare |
$18.19
|
| Rate for Payer: Lucent All Commercial |
$25.47
|
| Rate for Payer: Lucent All Commercial |
$25.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$23.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$23.00
|
| Rate for Payer: Managed Health Services Medicaid |
$20.37
|
| Rate for Payer: Managed Health Services Medicaid |
$20.37
|
| Rate for Payer: MDWise Medicaid |
$20.37
|
| Rate for Payer: MDWise Medicaid |
$20.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$9.19
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$9.19
|
| Rate for Payer: PHCS All Commercial |
$18.19
|
| Rate for Payer: PHCS All Commercial |
$18.19
|
| Rate for Payer: PHP All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$18.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$18.19
|
| Rate for Payer: Sagamore Health Network All Products |
$18.19
|
| Rate for Payer: Sagamore Health Network All Products |
$18.19
|
| Rate for Payer: Signature Care EPO |
$18.39
|
| Rate for Payer: Signature Care EPO |
$18.39
|
| Rate for Payer: Signature Care PPO |
$18.39
|
| Rate for Payer: Signature Care PPO |
$18.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,100.00
|
| Rate for Payer: United Healthcare Commercial |
$20.19
|
| Rate for Payer: United Healthcare Commercial |
$20.19
|
| Rate for Payer: United Healthcare Medicare |
$20.46
|
| Rate for Payer: United Healthcare Medicare |
$20.46
|
|
|
PR AUDITORY FUNCTION, 60 MIN
|
Professional
|
Both
|
$168.38
|
|
|
Service Code
|
CPT 92620
|
| Hospital Charge Code |
z92620
|
| Min. Negotiated Rate |
$35.83 |
| Max. Negotiated Rate |
$9,100.00 |
| Rate for Payer: Aetna Commercial |
$77.49
|
| Rate for Payer: Aetna Commercial |
$77.49
|
| Rate for Payer: Aetna Medicare |
$77.49
|
| Rate for Payer: Aetna Medicare |
$77.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$42.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$42.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$42.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$42.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$42.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$42.84
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$35.83
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$35.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$82.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$82.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$89.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$89.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$85.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$85.24
|
| Rate for Payer: Cash Price |
$99.67
|
| Rate for Payer: Cash Price |
$101.03
|
| Rate for Payer: Centivo All Commercial |
$120.11
|
| Rate for Payer: Centivo All Commercial |
$120.11
|
| Rate for Payer: Cigna All Commercial |
$77.49
|
| Rate for Payer: Cigna All Commercial |
$77.49
|
| Rate for Payer: CORVEL All Commercial |
$77.49
|
| Rate for Payer: CORVEL All Commercial |
$77.49
|
| Rate for Payer: Coventry All Commercial |
$92.99
|
| Rate for Payer: Coventry All Commercial |
$92.99
|
| Rate for Payer: Encore All Commercial |
$77.49
|
| Rate for Payer: Encore All Commercial |
$77.49
|
| Rate for Payer: Frontpath All Commercial |
$87.54
|
| Rate for Payer: Frontpath All Commercial |
$87.54
|
| Rate for Payer: Humana ChoiceCare |
$46.95
|
| Rate for Payer: Humana ChoiceCare |
$46.95
|
| Rate for Payer: Humana Medicare |
$77.49
|
| Rate for Payer: Humana Medicare |
$77.49
|
| Rate for Payer: Lucent All Commercial |
$108.49
|
| Rate for Payer: Lucent All Commercial |
$108.49
|
| 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 |
$82.82
|
| Rate for Payer: Managed Health Services Medicaid |
$82.82
|
| Rate for Payer: MDWise Medicaid |
$82.82
|
| Rate for Payer: MDWise Medicaid |
$82.82
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$35.83
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$35.83
|
| Rate for Payer: PHCS All Commercial |
$77.49
|
| Rate for Payer: PHCS All Commercial |
$77.49
|
| Rate for Payer: PHP All Commercial |
$107.77
|
| Rate for Payer: PHP All Commercial |
$107.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$77.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$77.49
|
| Rate for Payer: Sagamore Health Network All Products |
$77.49
|
| Rate for Payer: Sagamore Health Network All Products |
$77.49
|
| Rate for Payer: Signature Care EPO |
$77.32
|
| Rate for Payer: Signature Care EPO |
$77.32
|
| Rate for Payer: Signature Care PPO |
$77.32
|
| Rate for Payer: Signature Care PPO |
$77.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,100.00
|
| Rate for Payer: United Healthcare Commercial |
$86.91
|
| Rate for Payer: United Healthcare Commercial |
$86.91
|
| Rate for Payer: United Healthcare Medicare |
$83.06
|
| Rate for Payer: United Healthcare Medicare |
$83.06
|
|
|
PR BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT
|
Professional
|
Both
|
$8.14
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
z96127
|
| Min. Negotiated Rate |
$4.07 |
| Max. Negotiated Rate |
$6.53 |
| Rate for Payer: Aetna Commercial |
$4.21
|
| Rate for Payer: Aetna Commercial |
$4.21
|
| Rate for Payer: Aetna Medicare |
$4.21
|
| Rate for Payer: Aetna Medicare |
$4.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$4.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$4.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4.63
|
| Rate for Payer: Cash Price |
$4.88
|
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Centivo All Commercial |
$6.53
|
| Rate for Payer: Centivo All Commercial |
$6.53
|
| Rate for Payer: Cigna All Commercial |
$4.21
|
| Rate for Payer: Cigna All Commercial |
$4.21
|
| Rate for Payer: CORVEL All Commercial |
$4.21
|
| Rate for Payer: CORVEL All Commercial |
$4.21
|
| Rate for Payer: Coventry All Commercial |
$5.05
|
| Rate for Payer: Coventry All Commercial |
$5.05
|
| Rate for Payer: Encore All Commercial |
$4.21
|
| Rate for Payer: Encore All Commercial |
$4.21
|
| Rate for Payer: Frontpath All Commercial |
$4.94
|
| Rate for Payer: Frontpath All Commercial |
$4.94
|
| Rate for Payer: Humana ChoiceCare |
$4.87
|
| Rate for Payer: Humana ChoiceCare |
$4.87
|
| Rate for Payer: Humana Medicare |
$4.21
|
| Rate for Payer: Humana Medicare |
$4.21
|
| Rate for Payer: Lucent All Commercial |
$5.89
|
| Rate for Payer: Lucent All Commercial |
$5.89
|
| Rate for Payer: Managed Health Services Medicaid |
$4.08
|
| Rate for Payer: Managed Health Services Medicaid |
$4.08
|
| Rate for Payer: MDWise Medicaid |
$4.08
|
| Rate for Payer: MDWise Medicaid |
$4.08
|
| Rate for Payer: PHCS All Commercial |
$4.21
|
| Rate for Payer: PHCS All Commercial |
$4.21
|
| Rate for Payer: PHP All Commercial |
$4.44
|
| Rate for Payer: PHP All Commercial |
$4.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4.21
|
| Rate for Payer: Sagamore Health Network All Products |
$4.21
|
| Rate for Payer: Sagamore Health Network All Products |
$4.21
|
| Rate for Payer: Signature Care EPO |
$4.11
|
| Rate for Payer: Signature Care EPO |
$4.11
|
| Rate for Payer: Signature Care PPO |
$4.11
|
| Rate for Payer: Signature Care PPO |
$4.11
|
| Rate for Payer: United Healthcare Commercial |
$6.06
|
| Rate for Payer: United Healthcare Commercial |
$6.06
|
| Rate for Payer: United Healthcare Medicare |
$4.07
|
| Rate for Payer: United Healthcare Medicare |
$4.07
|
|
|
PR BEKESY AUDIOMETRY, DIAGNOSIS
|
Professional
|
Both
|
$157.14
|
|
|
Service Code
|
CPT 92561
|
| Hospital Charge Code |
z92561
|
| Min. Negotiated Rate |
$27.80 |
| Max. Negotiated Rate |
$133.57 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$27.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$27.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$27.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$27.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$27.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$27.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$27.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$27.80
|
| Rate for Payer: Cash Price |
$188.57
|
| Rate for Payer: Cash Price |
$188.57
|
| Rate for Payer: Cash Price |
$94.28
|
| Rate for Payer: Cash Price |
$94.28
|
| Rate for Payer: Frontpath All Commercial |
$40.44
|
| Rate for Payer: Frontpath All Commercial |
$40.44
|
| Rate for Payer: Humana ChoiceCare |
$30.08
|
| Rate for Payer: Humana ChoiceCare |
$30.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$133.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$267.14
|
|
|
PR BILE DUCT ENDOSCOPY,INTRAOPERATIVE
|
Professional
|
Both
|
$292.44
|
|
|
Service Code
|
CPT 47550
|
| Hospital Charge Code |
z47550
|
| Min. Negotiated Rate |
$143.83 |
| Max. Negotiated Rate |
$234.75 |
| Rate for Payer: Aetna Commercial |
$151.45
|
| Rate for Payer: Aetna Medicare |
$151.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$143.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$174.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$166.59
|
| Rate for Payer: Cash Price |
$175.46
|
| Rate for Payer: Centivo All Commercial |
$234.75
|
| Rate for Payer: Cigna All Commercial |
$151.45
|
| Rate for Payer: CORVEL All Commercial |
$151.45
|
| Rate for Payer: Coventry All Commercial |
$181.74
|
| Rate for Payer: Encore All Commercial |
$151.45
|
| Rate for Payer: Frontpath All Commercial |
$218.20
|
| Rate for Payer: Humana ChoiceCare |
$186.83
|
| Rate for Payer: Humana Medicare |
$151.45
|
| Rate for Payer: Lucent All Commercial |
$212.03
|
| Rate for Payer: Managed Health Services Medicaid |
$143.83
|
| Rate for Payer: MDWise Medicaid |
$143.83
|
| Rate for Payer: PHCS All Commercial |
$151.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.45
|
| Rate for Payer: Sagamore Health Network All Products |
$151.45
|
| Rate for Payer: United Healthcare Commercial |
$184.20
|
| Rate for Payer: United Healthcare Medicare |
$144.88
|
|
|
PR BIOPSY BONE OPEN SUPERFICIAL
|
Professional
|
Both
|
$261.40
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
z20240
|
| Min. Negotiated Rate |
$128.19 |
| Max. Negotiated Rate |
$250.65 |
| Rate for Payer: Aetna Commercial |
$133.62
|
| Rate for Payer: Aetna Commercial |
$133.62
|
| Rate for Payer: Aetna Medicare |
$133.62
|
| Rate for Payer: Aetna Medicare |
$133.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$128.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$128.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$153.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$153.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$146.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$146.98
|
| Rate for Payer: Cash Price |
$153.83
|
| Rate for Payer: Cash Price |
$156.84
|
| Rate for Payer: Centivo All Commercial |
$207.11
|
| Rate for Payer: Centivo All Commercial |
$207.11
|
| Rate for Payer: Cigna All Commercial |
$133.62
|
| Rate for Payer: Cigna All Commercial |
$133.62
|
| Rate for Payer: CORVEL All Commercial |
$133.62
|
| Rate for Payer: CORVEL All Commercial |
$133.62
|
| Rate for Payer: Coventry All Commercial |
$160.34
|
| Rate for Payer: Coventry All Commercial |
$160.34
|
| Rate for Payer: Encore All Commercial |
$133.62
|
| Rate for Payer: Encore All Commercial |
$133.62
|
| Rate for Payer: Frontpath All Commercial |
$183.20
|
| Rate for Payer: Frontpath All Commercial |
$183.20
|
| Rate for Payer: Humana ChoiceCare |
$250.65
|
| Rate for Payer: Humana ChoiceCare |
$250.65
|
| Rate for Payer: Humana Medicare |
$133.62
|
| Rate for Payer: Humana Medicare |
$133.62
|
| Rate for Payer: Lucent All Commercial |
$187.07
|
| Rate for Payer: Lucent All Commercial |
$187.07
|
| Rate for Payer: Managed Health Services Medicaid |
$128.57
|
| Rate for Payer: Managed Health Services Medicaid |
$128.57
|
| Rate for Payer: MDWise Medicaid |
$128.57
|
| Rate for Payer: MDWise Medicaid |
$128.57
|
| Rate for Payer: PHCS All Commercial |
$133.62
|
| Rate for Payer: PHCS All Commercial |
$133.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$133.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$133.62
|
| Rate for Payer: Sagamore Health Network All Products |
$133.62
|
| Rate for Payer: Sagamore Health Network All Products |
$133.62
|
| Rate for Payer: United Healthcare Commercial |
$249.04
|
| Rate for Payer: United Healthcare Commercial |
$249.04
|
| Rate for Payer: United Healthcare Medicare |
$128.19
|
| Rate for Payer: United Healthcare Medicare |
$128.19
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$431.88
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
z20220
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$215.94 |
| Rate for Payer: Aetna Commercial |
$82.71
|
| Rate for Payer: Aetna Commercial |
$82.71
|
| Rate for Payer: Aetna Medicare |
$82.71
|
| Rate for Payer: Aetna Medicare |
$82.71
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$43.95
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$43.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$211.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$211.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$95.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$95.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$90.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$90.98
|
| Rate for Payer: Cash Price |
$257.58
|
| Rate for Payer: Cash Price |
$259.13
|
| Rate for Payer: Centivo All Commercial |
$128.20
|
| Rate for Payer: Centivo All Commercial |
$128.20
|
| Rate for Payer: Cigna All Commercial |
$82.71
|
| Rate for Payer: Cigna All Commercial |
$82.71
|
| Rate for Payer: CORVEL All Commercial |
$82.71
|
| Rate for Payer: CORVEL All Commercial |
$82.71
|
| Rate for Payer: Coventry All Commercial |
$99.25
|
| Rate for Payer: Coventry All Commercial |
$99.25
|
| Rate for Payer: Encore All Commercial |
$82.71
|
| Rate for Payer: Encore All Commercial |
$82.71
|
| Rate for Payer: Frontpath All Commercial |
$111.93
|
| Rate for Payer: Frontpath All Commercial |
$111.93
|
| Rate for Payer: Humana ChoiceCare |
$88.22
|
| Rate for Payer: Humana ChoiceCare |
$88.22
|
| Rate for Payer: Humana Medicare |
$82.71
|
| Rate for Payer: Humana Medicare |
$82.71
|
| Rate for Payer: Lucent All Commercial |
$115.79
|
| Rate for Payer: Lucent All Commercial |
$115.79
|
| Rate for Payer: Managed Health Services Medicaid |
$211.14
|
| Rate for Payer: Managed Health Services Medicaid |
$211.14
|
| Rate for Payer: MDWise Medicaid |
$211.14
|
| Rate for Payer: MDWise Medicaid |
$211.14
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$43.95
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$43.95
|
| Rate for Payer: PHCS All Commercial |
$82.71
|
| Rate for Payer: PHCS All Commercial |
$82.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$82.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$82.71
|
| Rate for Payer: Sagamore Health Network All Products |
$82.71
|
| Rate for Payer: Sagamore Health Network All Products |
$82.71
|
| Rate for Payer: United Healthcare Commercial |
$89.63
|
| Rate for Payer: United Healthcare Commercial |
$89.63
|
| Rate for Payer: United Healthcare Medicare |
$215.94
|
| Rate for Payer: United Healthcare Medicare |
$215.94
|
|
|
PR BIOPSY CERVIX, 1 OR MORE, OR EXCISION OF LESION
|
Professional
|
Both
|
$284.62
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
z57500
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$9,100.00 |
| Rate for Payer: Aetna Commercial |
$69.97
|
| Rate for Payer: Aetna Commercial |
$69.97
|
| Rate for Payer: Aetna Medicare |
$69.97
|
| Rate for Payer: Aetna Medicare |
$69.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$178.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$178.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$178.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$178.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$178.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$178.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$178.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$178.17
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$43.67
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$43.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$139.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$139.98
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$80.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$80.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.97
|
| Rate for Payer: Cash Price |
$169.01
|
| Rate for Payer: Cash Price |
$170.77
|
| Rate for Payer: Centivo All Commercial |
$108.45
|
| Rate for Payer: Centivo All Commercial |
$108.45
|
| Rate for Payer: Cigna All Commercial |
$69.97
|
| Rate for Payer: Cigna All Commercial |
$69.97
|
| Rate for Payer: CORVEL All Commercial |
$69.97
|
| Rate for Payer: CORVEL All Commercial |
$69.97
|
| Rate for Payer: Coventry All Commercial |
$83.96
|
| Rate for Payer: Coventry All Commercial |
$83.96
|
| Rate for Payer: Encore All Commercial |
$69.97
|
| Rate for Payer: Encore All Commercial |
$69.97
|
| Rate for Payer: Frontpath All Commercial |
$97.10
|
| Rate for Payer: Frontpath All Commercial |
$97.10
|
| Rate for Payer: Humana ChoiceCare |
$70.63
|
| Rate for Payer: Humana ChoiceCare |
$70.63
|
| Rate for Payer: Humana Medicare |
$69.97
|
| Rate for Payer: Humana Medicare |
$69.97
|
| Rate for Payer: Lucent All Commercial |
$97.96
|
| Rate for Payer: Lucent All Commercial |
$97.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$98.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$98.00
|
| Rate for Payer: Managed Health Services Medicaid |
$139.98
|
| Rate for Payer: Managed Health Services Medicaid |
$139.98
|
| Rate for Payer: MDWise Medicaid |
$139.98
|
| Rate for Payer: MDWise Medicaid |
$139.98
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$43.67
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$43.67
|
| Rate for Payer: PHCS All Commercial |
$69.97
|
| Rate for Payer: PHCS All Commercial |
$69.97
|
| Rate for Payer: PHP All Commercial |
$89.70
|
| Rate for Payer: PHP All Commercial |
$89.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$69.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$69.97
|
| Rate for Payer: Sagamore Health Network All Products |
$69.97
|
| Rate for Payer: Sagamore Health Network All Products |
$69.97
|
| Rate for Payer: Signature Care EPO |
$172.55
|
| Rate for Payer: Signature Care EPO |
$172.55
|
| Rate for Payer: Signature Care PPO |
$172.55
|
| Rate for Payer: Signature Care PPO |
$172.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,100.00
|
| Rate for Payer: United Healthcare Commercial |
$84.24
|
| Rate for Payer: United Healthcare Commercial |
$84.24
|
| Rate for Payer: United Healthcare Medicare |
$140.84
|
| Rate for Payer: United Healthcare Medicare |
$140.84
|
|
|
PR BIOPSY/EXCISION, LYMPH NODE(S)
|
Professional
|
Both
|
$616.52
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
z38500
|
| Min. Negotiated Rate |
$131.68 |
| Max. Negotiated Rate |
$35,200.00 |
| Rate for Payer: Aetna Commercial |
$236.74
|
| Rate for Payer: Aetna Commercial |
$236.74
|
| Rate for Payer: Aetna Medicare |
$236.74
|
| Rate for Payer: Aetna Medicare |
$236.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$270.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$270.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$270.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$270.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$270.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$270.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$270.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$270.02
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$131.68
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$131.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$303.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$303.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$272.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$272.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$260.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$260.41
|
| Rate for Payer: Cash Price |
$369.91
|
| Rate for Payer: Cash Price |
$364.46
|
| Rate for Payer: Centivo All Commercial |
$366.95
|
| Rate for Payer: Centivo All Commercial |
$366.95
|
| Rate for Payer: Cigna All Commercial |
$236.74
|
| Rate for Payer: Cigna All Commercial |
$236.74
|
| Rate for Payer: CORVEL All Commercial |
$236.74
|
| Rate for Payer: CORVEL All Commercial |
$236.74
|
| Rate for Payer: Coventry All Commercial |
$284.09
|
| Rate for Payer: Coventry All Commercial |
$284.09
|
| Rate for Payer: Encore All Commercial |
$236.74
|
| Rate for Payer: Encore All Commercial |
$236.74
|
| Rate for Payer: Frontpath All Commercial |
$334.66
|
| Rate for Payer: Frontpath All Commercial |
$334.66
|
| Rate for Payer: Humana ChoiceCare |
$289.17
|
| Rate for Payer: Humana ChoiceCare |
$289.17
|
| Rate for Payer: Humana Medicare |
$236.74
|
| Rate for Payer: Humana Medicare |
$236.74
|
| Rate for Payer: Lucent All Commercial |
$331.44
|
| Rate for Payer: Lucent All Commercial |
$331.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$375.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$375.00
|
| Rate for Payer: Managed Health Services Medicaid |
$303.23
|
| Rate for Payer: Managed Health Services Medicaid |
$303.23
|
| Rate for Payer: MDWise Medicaid |
$303.23
|
| Rate for Payer: MDWise Medicaid |
$303.23
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$131.68
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$131.68
|
| Rate for Payer: PHCS All Commercial |
$236.74
|
| Rate for Payer: PHCS All Commercial |
$236.74
|
| Rate for Payer: PHP All Commercial |
$320.22
|
| Rate for Payer: PHP All Commercial |
$320.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$236.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$236.74
|
| Rate for Payer: Sagamore Health Network All Products |
$236.74
|
| Rate for Payer: Sagamore Health Network All Products |
$236.74
|
| Rate for Payer: Signature Care EPO |
$391.00
|
| Rate for Payer: Signature Care EPO |
$391.00
|
| Rate for Payer: Signature Care PPO |
$391.00
|
| Rate for Payer: Signature Care PPO |
$391.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,200.00
|
| Rate for Payer: United Healthcare Commercial |
$268.83
|
| Rate for Payer: United Healthcare Commercial |
$268.83
|
| Rate for Payer: United Healthcare Medicare |
$303.72
|
| Rate for Payer: United Healthcare Medicare |
$303.72
|
|
|
PR BIOPSY, NAIL UNIT (SEP PROC)
|
Professional
|
Both
|
$228.86
|
|
|
Service Code
|
CPT 11755
|
| Hospital Charge Code |
z11755
|
| Min. Negotiated Rate |
$50.44 |
| Max. Negotiated Rate |
$112.77 |
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: Aetna Medicare |
$57.95
|
| Rate for Payer: Aetna Medicare |
$57.95
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$50.44
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$50.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$112.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$112.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$66.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$66.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$63.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$63.74
|
| Rate for Payer: Cash Price |
$135.32
|
| Rate for Payer: Cash Price |
$137.32
|
| Rate for Payer: Centivo All Commercial |
$89.82
|
| Rate for Payer: Centivo All Commercial |
$89.82
|
| Rate for Payer: Cigna All Commercial |
$57.95
|
| Rate for Payer: Cigna All Commercial |
$57.95
|
| Rate for Payer: CORVEL All Commercial |
$57.95
|
| Rate for Payer: CORVEL All Commercial |
$57.95
|
| Rate for Payer: Coventry All Commercial |
$69.54
|
| Rate for Payer: Coventry All Commercial |
$69.54
|
| Rate for Payer: Encore All Commercial |
$57.95
|
| Rate for Payer: Encore All Commercial |
$57.95
|
| Rate for Payer: Frontpath All Commercial |
$78.40
|
| Rate for Payer: Frontpath All Commercial |
$78.40
|
| Rate for Payer: Humana ChoiceCare |
$78.40
|
| Rate for Payer: Humana ChoiceCare |
$78.40
|
| Rate for Payer: Humana Medicare |
$57.95
|
| Rate for Payer: Humana Medicare |
$57.95
|
| Rate for Payer: Lucent All Commercial |
$81.13
|
| Rate for Payer: Lucent All Commercial |
$81.13
|
| Rate for Payer: Managed Health Services Medicaid |
$112.56
|
| Rate for Payer: Managed Health Services Medicaid |
$112.56
|
| Rate for Payer: MDWise Medicaid |
$112.56
|
| Rate for Payer: MDWise Medicaid |
$112.56
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$50.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$50.44
|
| Rate for Payer: PHCS All Commercial |
$57.95
|
| Rate for Payer: PHCS All Commercial |
$57.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$57.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$57.95
|
| Rate for Payer: Sagamore Health Network All Products |
$57.95
|
| Rate for Payer: Sagamore Health Network All Products |
$57.95
|
| Rate for Payer: United Healthcare Commercial |
$94.29
|
| Rate for Payer: United Healthcare Commercial |
$94.29
|
| Rate for Payer: United Healthcare Medicare |
$112.77
|
| Rate for Payer: United Healthcare Medicare |
$112.77
|
|
|
PR BIOPSY OF BREAST, INCISIONAL
|
Professional
|
Both
|
$600.24
|
|
|
Service Code
|
CPT 19101
|
| Hospital Charge Code |
z19101
|
| Min. Negotiated Rate |
$115.59 |
| Max. Negotiated Rate |
$24,700.00 |
| Rate for Payer: Aetna Commercial |
$207.64
|
| Rate for Payer: Aetna Commercial |
$207.64
|
| Rate for Payer: Aetna Medicare |
$207.64
|
| Rate for Payer: Aetna Medicare |
$207.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$403.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$403.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$403.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$403.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$403.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$403.79
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$403.79
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$403.79
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$115.59
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$115.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$295.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$295.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$238.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$238.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.40
|
| Rate for Payer: Cash Price |
$356.98
|
| Rate for Payer: Cash Price |
$360.14
|
| Rate for Payer: Centivo All Commercial |
$321.84
|
| Rate for Payer: Centivo All Commercial |
$321.84
|
| Rate for Payer: Cigna All Commercial |
$207.64
|
| Rate for Payer: Cigna All Commercial |
$207.64
|
| Rate for Payer: CORVEL All Commercial |
$207.64
|
| Rate for Payer: CORVEL All Commercial |
$207.64
|
| Rate for Payer: Coventry All Commercial |
$249.17
|
| Rate for Payer: Coventry All Commercial |
$249.17
|
| Rate for Payer: Encore All Commercial |
$207.64
|
| Rate for Payer: Encore All Commercial |
$207.64
|
| Rate for Payer: Frontpath All Commercial |
$293.29
|
| Rate for Payer: Frontpath All Commercial |
$293.29
|
| Rate for Payer: Humana ChoiceCare |
$192.88
|
| Rate for Payer: Humana ChoiceCare |
$192.88
|
| Rate for Payer: Humana Medicare |
$207.64
|
| Rate for Payer: Humana Medicare |
$207.64
|
| Rate for Payer: Lucent All Commercial |
$290.70
|
| Rate for Payer: Lucent All Commercial |
$290.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$267.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$267.00
|
| Rate for Payer: Managed Health Services Medicaid |
$295.22
|
| Rate for Payer: Managed Health Services Medicaid |
$295.22
|
| Rate for Payer: MDWise Medicaid |
$295.22
|
| Rate for Payer: MDWise Medicaid |
$295.22
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$115.59
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$115.59
|
| Rate for Payer: PHCS All Commercial |
$207.64
|
| Rate for Payer: PHCS All Commercial |
$207.64
|
| Rate for Payer: PHP All Commercial |
$280.70
|
| Rate for Payer: PHP All Commercial |
$280.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$207.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$207.64
|
| Rate for Payer: Sagamore Health Network All Products |
$207.64
|
| Rate for Payer: Sagamore Health Network All Products |
$207.64
|
| Rate for Payer: Signature Care EPO |
$318.75
|
| Rate for Payer: Signature Care EPO |
$318.75
|
| Rate for Payer: Signature Care PPO |
$318.75
|
| Rate for Payer: Signature Care PPO |
$318.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$24,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$24,700.00
|
| Rate for Payer: United Healthcare Commercial |
$230.95
|
| Rate for Payer: United Healthcare Commercial |
$230.95
|
| Rate for Payer: United Healthcare Medicare |
$297.48
|
| Rate for Payer: United Healthcare Medicare |
$297.48
|
|
|
PR BIOPSY OF EXT AUDITORY CANAL
|
Professional
|
Both
|
$267.94
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
z69105
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$8,900.00 |
| Rate for Payer: Aetna Commercial |
$58.59
|
| Rate for Payer: Aetna Commercial |
$58.59
|
| Rate for Payer: Aetna Medicare |
$58.59
|
| Rate for Payer: Aetna Medicare |
$58.59
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$145.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$145.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$145.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$145.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$145.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$145.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$145.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$145.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$31.84
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$31.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$131.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$131.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$67.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$67.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$64.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$64.45
|
| Rate for Payer: Cash Price |
$159.59
|
| Rate for Payer: Cash Price |
$160.76
|
| Rate for Payer: Centivo All Commercial |
$90.81
|
| Rate for Payer: Centivo All Commercial |
$90.81
|
| Rate for Payer: Cigna All Commercial |
$58.59
|
| Rate for Payer: Cigna All Commercial |
$58.59
|
| Rate for Payer: CORVEL All Commercial |
$58.59
|
| Rate for Payer: CORVEL All Commercial |
$58.59
|
| Rate for Payer: Coventry All Commercial |
$70.31
|
| Rate for Payer: Coventry All Commercial |
$70.31
|
| Rate for Payer: Encore All Commercial |
$58.59
|
| Rate for Payer: Encore All Commercial |
$58.59
|
| Rate for Payer: Frontpath All Commercial |
$79.79
|
| Rate for Payer: Frontpath All Commercial |
$79.79
|
| Rate for Payer: Humana ChoiceCare |
$66.21
|
| Rate for Payer: Humana ChoiceCare |
$66.21
|
| Rate for Payer: Humana Medicare |
$58.59
|
| Rate for Payer: Humana Medicare |
$58.59
|
| Rate for Payer: Lucent All Commercial |
$82.03
|
| Rate for Payer: Lucent All Commercial |
$82.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.00
|
| Rate for Payer: Managed Health Services Medicaid |
$131.78
|
| Rate for Payer: Managed Health Services Medicaid |
$131.78
|
| Rate for Payer: MDWise Medicaid |
$131.78
|
| Rate for Payer: MDWise Medicaid |
$131.78
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$31.84
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$31.84
|
| Rate for Payer: PHCS All Commercial |
$58.59
|
| Rate for Payer: PHCS All Commercial |
$58.59
|
| Rate for Payer: PHP All Commercial |
$75.39
|
| Rate for Payer: PHP All Commercial |
$75.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.59
|
| Rate for Payer: Sagamore Health Network All Products |
$58.59
|
| Rate for Payer: Sagamore Health Network All Products |
$58.59
|
| Rate for Payer: Signature Care EPO |
$147.90
|
| Rate for Payer: Signature Care EPO |
$147.90
|
| Rate for Payer: Signature Care PPO |
$147.90
|
| Rate for Payer: Signature Care PPO |
$147.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,900.00
|
| Rate for Payer: United Healthcare Commercial |
$70.43
|
| Rate for Payer: United Healthcare Commercial |
$70.43
|
| Rate for Payer: United Healthcare Medicare |
$132.99
|
| Rate for Payer: United Healthcare Medicare |
$132.99
|
|
|
PR BIOPSY OF EXTERNAL EAR
|
Professional
|
Both
|
$177.76
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
z69100
|
| Min. Negotiated Rate |
$23.53 |
| Max. Negotiated Rate |
$6,600.00 |
| Rate for Payer: Aetna Commercial |
$43.81
|
| Rate for Payer: Aetna Commercial |
$43.81
|
| Rate for Payer: Aetna Medicare |
$43.81
|
| Rate for Payer: Aetna Medicare |
$43.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$117.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$117.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$117.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$117.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$117.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$117.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$117.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$117.32
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$23.53
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$23.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$87.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$87.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.19
|
| Rate for Payer: Cash Price |
$105.94
|
| Rate for Payer: Cash Price |
$106.66
|
| Rate for Payer: Centivo All Commercial |
$67.91
|
| Rate for Payer: Centivo All Commercial |
$67.91
|
| Rate for Payer: Cigna All Commercial |
$43.81
|
| Rate for Payer: Cigna All Commercial |
$43.81
|
| Rate for Payer: CORVEL All Commercial |
$43.81
|
| Rate for Payer: CORVEL All Commercial |
$43.81
|
| Rate for Payer: Coventry All Commercial |
$52.57
|
| Rate for Payer: Coventry All Commercial |
$52.57
|
| Rate for Payer: Encore All Commercial |
$43.81
|
| Rate for Payer: Encore All Commercial |
$43.81
|
| Rate for Payer: Frontpath All Commercial |
$59.76
|
| Rate for Payer: Frontpath All Commercial |
$59.76
|
| Rate for Payer: Humana ChoiceCare |
$49.35
|
| Rate for Payer: Humana ChoiceCare |
$49.35
|
| Rate for Payer: Humana Medicare |
$43.81
|
| Rate for Payer: Humana Medicare |
$43.81
|
| Rate for Payer: Lucent All Commercial |
$61.33
|
| Rate for Payer: Lucent All Commercial |
$61.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$70.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$70.00
|
| Rate for Payer: Managed Health Services Medicaid |
$87.43
|
| Rate for Payer: Managed Health Services Medicaid |
$87.43
|
| Rate for Payer: MDWise Medicaid |
$87.43
|
| Rate for Payer: MDWise Medicaid |
$87.43
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$23.53
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$23.53
|
| Rate for Payer: PHCS All Commercial |
$43.81
|
| Rate for Payer: PHCS All Commercial |
$43.81
|
| Rate for Payer: PHP All Commercial |
$55.65
|
| Rate for Payer: PHP All Commercial |
$55.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.81
|
| Rate for Payer: Sagamore Health Network All Products |
$43.81
|
| Rate for Payer: Sagamore Health Network All Products |
$43.81
|
| 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 |
$6,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,600.00
|
| Rate for Payer: United Healthcare Commercial |
$54.30
|
| Rate for Payer: United Healthcare Commercial |
$54.30
|
| Rate for Payer: United Healthcare Medicare |
$88.28
|
| Rate for Payer: United Healthcare Medicare |
$88.28
|
|
