|
PR CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK
|
Professional
|
Both
|
$276.64
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
z54150
|
| Min. Negotiated Rate |
$50.96 |
| Max. Negotiated Rate |
$11,700.00 |
| Rate for Payer: Aetna Commercial |
$91.27
|
| Rate for Payer: Aetna Commercial |
$91.27
|
| Rate for Payer: Aetna Medicare |
$91.27
|
| Rate for Payer: Aetna Medicare |
$91.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$268.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$268.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$268.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$268.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$268.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$268.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$268.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$268.82
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$50.96
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$50.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$136.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$136.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$104.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$104.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$100.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$100.40
|
| Rate for Payer: Cash Price |
$162.85
|
| Rate for Payer: Cash Price |
$165.98
|
| Rate for Payer: Centivo All Commercial |
$141.47
|
| Rate for Payer: Centivo All Commercial |
$141.47
|
| Rate for Payer: Cigna All Commercial |
$91.27
|
| Rate for Payer: Cigna All Commercial |
$91.27
|
| Rate for Payer: CORVEL All Commercial |
$91.27
|
| Rate for Payer: CORVEL All Commercial |
$91.27
|
| Rate for Payer: Coventry All Commercial |
$109.52
|
| Rate for Payer: Coventry All Commercial |
$109.52
|
| Rate for Payer: Encore All Commercial |
$91.27
|
| Rate for Payer: Encore All Commercial |
$91.27
|
| Rate for Payer: Frontpath All Commercial |
$126.13
|
| Rate for Payer: Frontpath All Commercial |
$126.13
|
| Rate for Payer: Humana ChoiceCare |
$120.90
|
| Rate for Payer: Humana ChoiceCare |
$120.90
|
| Rate for Payer: Humana Medicare |
$91.27
|
| Rate for Payer: Humana Medicare |
$91.27
|
| Rate for Payer: Lucent All Commercial |
$127.78
|
| Rate for Payer: Lucent All Commercial |
$127.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$126.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$126.00
|
| Rate for Payer: Managed Health Services Medicaid |
$136.07
|
| Rate for Payer: Managed Health Services Medicaid |
$136.07
|
| Rate for Payer: MDWise Medicaid |
$136.07
|
| Rate for Payer: MDWise Medicaid |
$136.07
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$50.96
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$50.96
|
| Rate for Payer: PHCS All Commercial |
$91.27
|
| Rate for Payer: PHCS All Commercial |
$91.27
|
| Rate for Payer: PHP All Commercial |
$115.93
|
| Rate for Payer: PHP All Commercial |
$115.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$91.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$91.27
|
| Rate for Payer: Sagamore Health Network All Products |
$91.27
|
| Rate for Payer: Sagamore Health Network All Products |
$91.27
|
| Rate for Payer: Signature Care EPO |
$128.35
|
| Rate for Payer: Signature Care EPO |
$128.35
|
| Rate for Payer: Signature Care PPO |
$128.35
|
| Rate for Payer: Signature Care PPO |
$128.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,700.00
|
| Rate for Payer: United Healthcare Commercial |
$121.03
|
| Rate for Payer: United Healthcare Commercial |
$121.03
|
| Rate for Payer: United Healthcare Medicare |
$135.71
|
| Rate for Payer: United Healthcare Medicare |
$135.71
|
|
|
PR CLOSED RX ACETABULAR FX
|
Professional
|
Both
|
$781.08
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
z27220
|
| Min. Negotiated Rate |
$303.03 |
| Max. Negotiated Rate |
$57,900.00 |
| Rate for Payer: Aetna Commercial |
$386.04
|
| Rate for Payer: Aetna Commercial |
$386.04
|
| Rate for Payer: Aetna Medicare |
$386.04
|
| Rate for Payer: Aetna Medicare |
$386.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$585.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$585.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$585.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$585.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$585.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$585.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$585.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$585.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$303.03
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$303.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$384.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$384.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$443.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$443.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$424.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$424.64
|
| Rate for Payer: Cash Price |
$458.86
|
| Rate for Payer: Cash Price |
$468.65
|
| Rate for Payer: Centivo All Commercial |
$598.36
|
| Rate for Payer: Centivo All Commercial |
$598.36
|
| Rate for Payer: Cigna All Commercial |
$386.04
|
| Rate for Payer: Cigna All Commercial |
$386.04
|
| Rate for Payer: CORVEL All Commercial |
$386.04
|
| Rate for Payer: CORVEL All Commercial |
$386.04
|
| Rate for Payer: Coventry All Commercial |
$463.25
|
| Rate for Payer: Coventry All Commercial |
$463.25
|
| Rate for Payer: Encore All Commercial |
$386.04
|
| Rate for Payer: Encore All Commercial |
$386.04
|
| Rate for Payer: Frontpath All Commercial |
$536.60
|
| Rate for Payer: Frontpath All Commercial |
$536.60
|
| Rate for Payer: Humana ChoiceCare |
$513.22
|
| Rate for Payer: Humana ChoiceCare |
$513.22
|
| Rate for Payer: Humana Medicare |
$386.04
|
| Rate for Payer: Humana Medicare |
$386.04
|
| Rate for Payer: Lucent All Commercial |
$540.46
|
| Rate for Payer: Lucent All Commercial |
$540.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$618.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$618.00
|
| Rate for Payer: Managed Health Services Medicaid |
$384.17
|
| Rate for Payer: Managed Health Services Medicaid |
$384.17
|
| Rate for Payer: MDWise Medicaid |
$384.17
|
| Rate for Payer: MDWise Medicaid |
$384.17
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$303.03
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$303.03
|
| Rate for Payer: PHCS All Commercial |
$386.04
|
| Rate for Payer: PHCS All Commercial |
$386.04
|
| Rate for Payer: PHP All Commercial |
$655.39
|
| Rate for Payer: PHP All Commercial |
$655.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$386.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$386.04
|
| Rate for Payer: Sagamore Health Network All Products |
$386.04
|
| Rate for Payer: Sagamore Health Network All Products |
$386.04
|
| Rate for Payer: Signature Care EPO |
$666.33
|
| Rate for Payer: Signature Care EPO |
$666.33
|
| Rate for Payer: Signature Care PPO |
$666.33
|
| Rate for Payer: Signature Care PPO |
$666.33
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$57,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$57,900.00
|
| Rate for Payer: United Healthcare Commercial |
$554.51
|
| Rate for Payer: United Healthcare Commercial |
$554.51
|
| Rate for Payer: United Healthcare Medicare |
$382.38
|
| Rate for Payer: United Healthcare Medicare |
$382.38
|
|
|
PR CLOSED RX A-C JT DISLOC
|
Professional
|
Both
|
$458.34
|
|
|
Service Code
|
CPT 23540
|
| Hospital Charge Code |
z23540
|
| Min. Negotiated Rate |
$122.51 |
| Max. Negotiated Rate |
$33,900.00 |
| Rate for Payer: Aetna Commercial |
$221.60
|
| Rate for Payer: Aetna Commercial |
$221.60
|
| Rate for Payer: Aetna Medicare |
$221.60
|
| Rate for Payer: Aetna Medicare |
$221.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$344.58
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$122.51
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$122.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$225.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$225.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$254.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$254.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$243.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$243.76
|
| Rate for Payer: Cash Price |
$267.47
|
| Rate for Payer: Cash Price |
$275.00
|
| Rate for Payer: Centivo All Commercial |
$343.48
|
| Rate for Payer: Centivo All Commercial |
$343.48
|
| Rate for Payer: Cigna All Commercial |
$221.60
|
| Rate for Payer: Cigna All Commercial |
$221.60
|
| Rate for Payer: CORVEL All Commercial |
$221.60
|
| Rate for Payer: CORVEL All Commercial |
$221.60
|
| Rate for Payer: Coventry All Commercial |
$265.92
|
| Rate for Payer: Coventry All Commercial |
$265.92
|
| Rate for Payer: Encore All Commercial |
$221.60
|
| Rate for Payer: Encore All Commercial |
$221.60
|
| Rate for Payer: Frontpath All Commercial |
$303.88
|
| Rate for Payer: Frontpath All Commercial |
$303.88
|
| Rate for Payer: Humana ChoiceCare |
$196.62
|
| Rate for Payer: Humana ChoiceCare |
$196.62
|
| Rate for Payer: Humana Medicare |
$221.60
|
| Rate for Payer: Humana Medicare |
$221.60
|
| Rate for Payer: Lucent All Commercial |
$310.24
|
| Rate for Payer: Lucent All Commercial |
$310.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$361.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$361.00
|
| Rate for Payer: Managed Health Services Medicaid |
$225.43
|
| Rate for Payer: Managed Health Services Medicaid |
$225.43
|
| Rate for Payer: MDWise Medicaid |
$225.43
|
| Rate for Payer: MDWise Medicaid |
$225.43
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$122.51
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$122.51
|
| Rate for Payer: PHCS All Commercial |
$221.60
|
| Rate for Payer: PHCS All Commercial |
$221.60
|
| Rate for Payer: PHP All Commercial |
$383.63
|
| Rate for Payer: PHP All Commercial |
$383.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$221.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$221.60
|
| Rate for Payer: Sagamore Health Network All Products |
$221.60
|
| Rate for Payer: Sagamore Health Network All Products |
$221.60
|
| Rate for Payer: Signature Care EPO |
$362.59
|
| Rate for Payer: Signature Care EPO |
$362.59
|
| Rate for Payer: Signature Care PPO |
$362.59
|
| Rate for Payer: Signature Care PPO |
$362.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$33,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$33,900.00
|
| Rate for Payer: United Healthcare Commercial |
$218.23
|
| Rate for Payer: United Healthcare Commercial |
$218.23
|
| Rate for Payer: United Healthcare Medicare |
$222.89
|
| Rate for Payer: United Healthcare Medicare |
$222.89
|
|
|
PR CLOSED RX BIG TOE FRACTURE
|
Professional
|
Both
|
$271.50
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
z28490
|
| Min. Negotiated Rate |
$63.85 |
| Max. Negotiated Rate |
$17,700.00 |
| Rate for Payer: Aetna Commercial |
$116.42
|
| Rate for Payer: Aetna Commercial |
$116.42
|
| Rate for Payer: Aetna Medicare |
$116.42
|
| Rate for Payer: Aetna Medicare |
$116.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$129.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$129.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$129.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$129.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$129.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$129.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$129.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$129.00
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$63.85
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$63.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$133.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$133.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$133.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$133.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.06
|
| Rate for Payer: Cash Price |
$156.96
|
| Rate for Payer: Cash Price |
$162.90
|
| Rate for Payer: Centivo All Commercial |
$180.45
|
| Rate for Payer: Centivo All Commercial |
$180.45
|
| Rate for Payer: Cigna All Commercial |
$116.42
|
| Rate for Payer: Cigna All Commercial |
$116.42
|
| Rate for Payer: CORVEL All Commercial |
$116.42
|
| Rate for Payer: CORVEL All Commercial |
$116.42
|
| Rate for Payer: Coventry All Commercial |
$139.70
|
| Rate for Payer: Coventry All Commercial |
$139.70
|
| Rate for Payer: Encore All Commercial |
$116.42
|
| Rate for Payer: Encore All Commercial |
$116.42
|
| Rate for Payer: Frontpath All Commercial |
$157.52
|
| Rate for Payer: Frontpath All Commercial |
$157.52
|
| Rate for Payer: Humana ChoiceCare |
$115.12
|
| Rate for Payer: Humana ChoiceCare |
$115.12
|
| Rate for Payer: Humana Medicare |
$116.42
|
| Rate for Payer: Humana Medicare |
$116.42
|
| Rate for Payer: Lucent All Commercial |
$162.99
|
| Rate for Payer: Lucent All Commercial |
$162.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Managed Health Services Medicaid |
$133.54
|
| Rate for Payer: Managed Health Services Medicaid |
$133.54
|
| Rate for Payer: MDWise Medicaid |
$133.54
|
| Rate for Payer: MDWise Medicaid |
$133.54
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$63.85
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$63.85
|
| Rate for Payer: PHCS All Commercial |
$116.42
|
| Rate for Payer: PHCS All Commercial |
$116.42
|
| Rate for Payer: PHP All Commercial |
$200.87
|
| Rate for Payer: PHP All Commercial |
$200.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.42
|
| Rate for Payer: Sagamore Health Network All Products |
$116.42
|
| Rate for Payer: Sagamore Health Network All Products |
$116.42
|
| Rate for Payer: Signature Care EPO |
$186.15
|
| Rate for Payer: Signature Care EPO |
$186.15
|
| Rate for Payer: Signature Care PPO |
$186.15
|
| Rate for Payer: Signature Care PPO |
$186.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,700.00
|
| Rate for Payer: United Healthcare Commercial |
$122.15
|
| Rate for Payer: United Healthcare Commercial |
$122.15
|
| Rate for Payer: United Healthcare Medicare |
$130.80
|
| Rate for Payer: United Healthcare Medicare |
$130.80
|
|
|
PR CLOSED RX CARPAL FX
|
Professional
|
Both
|
$587.52
|
|
|
Service Code
|
CPT 25630
|
| Hospital Charge Code |
z25630
|
| Min. Negotiated Rate |
$149.26 |
| Max. Negotiated Rate |
$40,700.00 |
| Rate for Payer: Aetna Commercial |
$268.20
|
| Rate for Payer: Aetna Commercial |
$268.20
|
| Rate for Payer: Aetna Medicare |
$268.20
|
| Rate for Payer: Aetna Medicare |
$268.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$401.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$401.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$401.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$401.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$401.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$401.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$401.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$401.51
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$149.26
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$149.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$288.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$288.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$308.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$308.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$295.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$295.02
|
| Rate for Payer: Cash Price |
$341.84
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Centivo All Commercial |
$415.71
|
| Rate for Payer: Centivo All Commercial |
$415.71
|
| Rate for Payer: Cigna All Commercial |
$268.20
|
| Rate for Payer: Cigna All Commercial |
$268.20
|
| Rate for Payer: CORVEL All Commercial |
$268.20
|
| Rate for Payer: CORVEL All Commercial |
$268.20
|
| Rate for Payer: Coventry All Commercial |
$321.84
|
| Rate for Payer: Coventry All Commercial |
$321.84
|
| Rate for Payer: Encore All Commercial |
$268.20
|
| Rate for Payer: Encore All Commercial |
$268.20
|
| Rate for Payer: Frontpath All Commercial |
$367.68
|
| Rate for Payer: Frontpath All Commercial |
$367.68
|
| Rate for Payer: Humana ChoiceCare |
$250.99
|
| Rate for Payer: Humana ChoiceCare |
$250.99
|
| Rate for Payer: Humana Medicare |
$268.20
|
| Rate for Payer: Humana Medicare |
$268.20
|
| Rate for Payer: Lucent All Commercial |
$375.48
|
| Rate for Payer: Lucent All Commercial |
$375.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$434.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$434.00
|
| Rate for Payer: Managed Health Services Medicaid |
$288.96
|
| Rate for Payer: Managed Health Services Medicaid |
$288.96
|
| Rate for Payer: MDWise Medicaid |
$288.96
|
| Rate for Payer: MDWise Medicaid |
$288.96
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$149.26
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$149.26
|
| Rate for Payer: PHCS All Commercial |
$268.20
|
| Rate for Payer: PHCS All Commercial |
$268.20
|
| Rate for Payer: PHP All Commercial |
$461.09
|
| Rate for Payer: PHP All Commercial |
$461.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$268.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$268.20
|
| Rate for Payer: Sagamore Health Network All Products |
$268.20
|
| Rate for Payer: Sagamore Health Network All Products |
$268.20
|
| Rate for Payer: Signature Care EPO |
$424.15
|
| Rate for Payer: Signature Care EPO |
$424.15
|
| Rate for Payer: Signature Care PPO |
$424.15
|
| Rate for Payer: Signature Care PPO |
$424.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$40,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$40,700.00
|
| Rate for Payer: United Healthcare Commercial |
$275.89
|
| Rate for Payer: United Healthcare Commercial |
$275.89
|
| Rate for Payer: United Healthcare Medicare |
$284.87
|
| Rate for Payer: United Healthcare Medicare |
$284.87
|
|
|
PR CLOSED RX, CARPOMETACAR DISLOC,NON-THUMB
|
Professional
|
Both
|
$671.46
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
z26670
|
| Min. Negotiated Rate |
$162.82 |
| Max. Negotiated Rate |
$44,400.00 |
| Rate for Payer: Aetna Commercial |
$294.74
|
| Rate for Payer: Aetna Commercial |
$294.74
|
| Rate for Payer: Aetna Medicare |
$294.74
|
| Rate for Payer: Aetna Medicare |
$294.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$394.00
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.82
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$330.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$330.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$338.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$338.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$324.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$324.21
|
| Rate for Payer: Cash Price |
$388.36
|
| Rate for Payer: Cash Price |
$402.88
|
| Rate for Payer: Centivo All Commercial |
$456.85
|
| Rate for Payer: Centivo All Commercial |
$456.85
|
| Rate for Payer: Cigna All Commercial |
$294.74
|
| Rate for Payer: Cigna All Commercial |
$294.74
|
| Rate for Payer: CORVEL All Commercial |
$294.74
|
| Rate for Payer: CORVEL All Commercial |
$294.74
|
| Rate for Payer: Coventry All Commercial |
$353.69
|
| Rate for Payer: Coventry All Commercial |
$353.69
|
| Rate for Payer: Encore All Commercial |
$294.74
|
| Rate for Payer: Encore All Commercial |
$294.74
|
| Rate for Payer: Frontpath All Commercial |
$407.77
|
| Rate for Payer: Frontpath All Commercial |
$407.77
|
| Rate for Payer: Humana ChoiceCare |
$284.77
|
| Rate for Payer: Humana ChoiceCare |
$284.77
|
| Rate for Payer: Humana Medicare |
$294.74
|
| Rate for Payer: Humana Medicare |
$294.74
|
| Rate for Payer: Lucent All Commercial |
$412.64
|
| Rate for Payer: Lucent All Commercial |
$412.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$474.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$474.00
|
| Rate for Payer: Managed Health Services Medicaid |
$330.25
|
| Rate for Payer: Managed Health Services Medicaid |
$330.25
|
| Rate for Payer: MDWise Medicaid |
$330.25
|
| Rate for Payer: MDWise Medicaid |
$330.25
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$162.82
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$162.82
|
| Rate for Payer: PHCS All Commercial |
$294.74
|
| Rate for Payer: PHCS All Commercial |
$294.74
|
| Rate for Payer: PHP All Commercial |
$502.85
|
| Rate for Payer: PHP All Commercial |
$502.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$294.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$294.74
|
| Rate for Payer: Sagamore Health Network All Products |
$294.74
|
| Rate for Payer: Sagamore Health Network All Products |
$294.74
|
| Rate for Payer: Signature Care EPO |
$487.05
|
| Rate for Payer: Signature Care EPO |
$487.05
|
| Rate for Payer: Signature Care PPO |
$487.05
|
| Rate for Payer: Signature Care PPO |
$487.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,400.00
|
| Rate for Payer: United Healthcare Commercial |
$302.06
|
| Rate for Payer: United Healthcare Commercial |
$302.06
|
| Rate for Payer: United Healthcare Medicare |
$323.63
|
| Rate for Payer: United Healthcare Medicare |
$323.63
|
|
|
PR CLOSED RX CLAVICLE FRACTURE
|
Professional
|
Both
|
$429.58
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
z23500
|
| Min. Negotiated Rate |
$108.18 |
| Max. Negotiated Rate |
$32,700.00 |
| Rate for Payer: Aetna Commercial |
$214.05
|
| Rate for Payer: Aetna Commercial |
$214.05
|
| Rate for Payer: Aetna Medicare |
$214.05
|
| Rate for Payer: Aetna Medicare |
$214.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$307.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$307.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$307.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$307.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$307.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$307.48
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$108.18
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$108.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$211.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$211.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$246.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$246.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$235.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$235.46
|
| Rate for Payer: Cash Price |
$249.58
|
| Rate for Payer: Cash Price |
$257.75
|
| Rate for Payer: Centivo All Commercial |
$331.78
|
| Rate for Payer: Centivo All Commercial |
$331.78
|
| Rate for Payer: Cigna All Commercial |
$214.05
|
| Rate for Payer: Cigna All Commercial |
$214.05
|
| Rate for Payer: CORVEL All Commercial |
$214.05
|
| Rate for Payer: CORVEL All Commercial |
$214.05
|
| Rate for Payer: Coventry All Commercial |
$256.86
|
| Rate for Payer: Coventry All Commercial |
$256.86
|
| Rate for Payer: Encore All Commercial |
$214.05
|
| Rate for Payer: Encore All Commercial |
$214.05
|
| Rate for Payer: Frontpath All Commercial |
$292.60
|
| Rate for Payer: Frontpath All Commercial |
$292.60
|
| Rate for Payer: Humana ChoiceCare |
$196.59
|
| Rate for Payer: Humana ChoiceCare |
$196.59
|
| Rate for Payer: Humana Medicare |
$214.05
|
| Rate for Payer: Humana Medicare |
$214.05
|
| Rate for Payer: Lucent All Commercial |
$299.67
|
| Rate for Payer: Lucent All Commercial |
$299.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$348.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$348.00
|
| Rate for Payer: Managed Health Services Medicaid |
$211.28
|
| Rate for Payer: Managed Health Services Medicaid |
$211.28
|
| Rate for Payer: MDWise Medicaid |
$211.28
|
| Rate for Payer: MDWise Medicaid |
$211.28
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$108.18
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$108.18
|
| Rate for Payer: PHCS All Commercial |
$214.05
|
| Rate for Payer: PHCS All Commercial |
$214.05
|
| Rate for Payer: PHP All Commercial |
$369.74
|
| Rate for Payer: PHP All Commercial |
$369.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$214.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$214.05
|
| Rate for Payer: Sagamore Health Network All Products |
$214.05
|
| Rate for Payer: Sagamore Health Network All Products |
$214.05
|
| Rate for Payer: Signature Care EPO |
$324.70
|
| Rate for Payer: Signature Care EPO |
$324.70
|
| Rate for Payer: Signature Care PPO |
$324.70
|
| Rate for Payer: Signature Care PPO |
$324.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,700.00
|
| Rate for Payer: United Healthcare Commercial |
$214.21
|
| Rate for Payer: United Healthcare Commercial |
$214.21
|
| Rate for Payer: United Healthcare Medicare |
$207.98
|
| Rate for Payer: United Healthcare Medicare |
$207.98
|
|
|
PR CLOSED RX CLAVICLE FX,MANIPULATN
|
Professional
|
Both
|
$687.42
|
|
|
Service Code
|
CPT 23505
|
| Hospital Charge Code |
z23505
|
| Min. Negotiated Rate |
$184.37 |
| Max. Negotiated Rate |
$47,400.00 |
| Rate for Payer: Aetna Commercial |
$314.99
|
| Rate for Payer: Aetna Commercial |
$314.99
|
| Rate for Payer: Aetna Medicare |
$314.99
|
| Rate for Payer: Aetna Medicare |
$314.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$369.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$369.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$369.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$369.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$369.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$369.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$369.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$369.60
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$184.37
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$184.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$338.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$338.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$362.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$362.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$346.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$346.49
|
| Rate for Payer: Cash Price |
$399.19
|
| Rate for Payer: Cash Price |
$412.45
|
| Rate for Payer: Centivo All Commercial |
$488.23
|
| Rate for Payer: Centivo All Commercial |
$488.23
|
| Rate for Payer: Cigna All Commercial |
$314.99
|
| Rate for Payer: Cigna All Commercial |
$314.99
|
| Rate for Payer: CORVEL All Commercial |
$314.99
|
| Rate for Payer: CORVEL All Commercial |
$314.99
|
| Rate for Payer: Coventry All Commercial |
$377.99
|
| Rate for Payer: Coventry All Commercial |
$377.99
|
| Rate for Payer: Encore All Commercial |
$314.99
|
| Rate for Payer: Encore All Commercial |
$314.99
|
| Rate for Payer: Frontpath All Commercial |
$434.46
|
| Rate for Payer: Frontpath All Commercial |
$434.46
|
| Rate for Payer: Humana ChoiceCare |
$324.55
|
| Rate for Payer: Humana ChoiceCare |
$324.55
|
| Rate for Payer: Humana Medicare |
$314.99
|
| Rate for Payer: Humana Medicare |
$314.99
|
| Rate for Payer: Lucent All Commercial |
$440.99
|
| Rate for Payer: Lucent All Commercial |
$440.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$506.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$506.00
|
| Rate for Payer: Managed Health Services Medicaid |
$338.10
|
| Rate for Payer: Managed Health Services Medicaid |
$338.10
|
| Rate for Payer: MDWise Medicaid |
$338.10
|
| Rate for Payer: MDWise Medicaid |
$338.10
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$184.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$184.37
|
| Rate for Payer: PHCS All Commercial |
$314.99
|
| Rate for Payer: PHCS All Commercial |
$314.99
|
| Rate for Payer: PHP All Commercial |
$537.43
|
| Rate for Payer: PHP All Commercial |
$537.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$314.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$314.99
|
| Rate for Payer: Sagamore Health Network All Products |
$314.99
|
| Rate for Payer: Sagamore Health Network All Products |
$314.99
|
| Rate for Payer: Signature Care EPO |
$515.10
|
| Rate for Payer: Signature Care EPO |
$515.10
|
| Rate for Payer: Signature Care PPO |
$515.10
|
| Rate for Payer: Signature Care PPO |
$515.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,400.00
|
| Rate for Payer: United Healthcare Commercial |
$338.21
|
| Rate for Payer: United Healthcare Commercial |
$338.21
|
| Rate for Payer: United Healthcare Medicare |
$332.66
|
| Rate for Payer: United Healthcare Medicare |
$332.66
|
|
|
PR CLOSED RX CONDYLAR FX
|
Professional
|
Both
|
$945.58
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
z27501
|
| Min. Negotiated Rate |
$350.94 |
| Max. Negotiated Rate |
$70,000.00 |
| Rate for Payer: Aetna Commercial |
$465.90
|
| Rate for Payer: Aetna Commercial |
$465.90
|
| Rate for Payer: Aetna Medicare |
$465.90
|
| Rate for Payer: Aetna Medicare |
$465.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$778.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$778.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$778.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$778.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$778.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$778.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$778.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$778.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$350.94
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$350.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$465.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$465.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$535.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$535.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$512.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$512.49
|
| Rate for Payer: Cash Price |
$555.78
|
| Rate for Payer: Cash Price |
$567.35
|
| Rate for Payer: Centivo All Commercial |
$722.14
|
| Rate for Payer: Centivo All Commercial |
$722.14
|
| Rate for Payer: Cigna All Commercial |
$465.90
|
| Rate for Payer: Cigna All Commercial |
$465.90
|
| Rate for Payer: CORVEL All Commercial |
$465.90
|
| Rate for Payer: CORVEL All Commercial |
$465.90
|
| Rate for Payer: Coventry All Commercial |
$559.08
|
| Rate for Payer: Coventry All Commercial |
$559.08
|
| Rate for Payer: Encore All Commercial |
$465.90
|
| Rate for Payer: Encore All Commercial |
$465.90
|
| Rate for Payer: Frontpath All Commercial |
$647.18
|
| Rate for Payer: Frontpath All Commercial |
$647.18
|
| Rate for Payer: Humana ChoiceCare |
$491.21
|
| Rate for Payer: Humana ChoiceCare |
$491.21
|
| Rate for Payer: Humana Medicare |
$465.90
|
| Rate for Payer: Humana Medicare |
$465.90
|
| Rate for Payer: Lucent All Commercial |
$652.26
|
| Rate for Payer: Lucent All Commercial |
$652.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$747.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$747.00
|
| Rate for Payer: Managed Health Services Medicaid |
$465.07
|
| Rate for Payer: Managed Health Services Medicaid |
$465.07
|
| Rate for Payer: MDWise Medicaid |
$465.07
|
| Rate for Payer: MDWise Medicaid |
$465.07
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$350.94
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$350.94
|
| Rate for Payer: PHCS All Commercial |
$465.90
|
| Rate for Payer: PHCS All Commercial |
$465.90
|
| Rate for Payer: PHP All Commercial |
$792.25
|
| Rate for Payer: PHP All Commercial |
$792.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$465.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$465.90
|
| Rate for Payer: Sagamore Health Network All Products |
$465.90
|
| Rate for Payer: Sagamore Health Network All Products |
$465.90
|
| Rate for Payer: Signature Care EPO |
$775.20
|
| Rate for Payer: Signature Care EPO |
$775.20
|
| Rate for Payer: Signature Care PPO |
$775.20
|
| Rate for Payer: Signature Care PPO |
$775.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,000.00
|
| Rate for Payer: United Healthcare Commercial |
$525.95
|
| Rate for Payer: United Healthcare Commercial |
$525.95
|
| Rate for Payer: United Healthcare Medicare |
$463.15
|
| Rate for Payer: United Healthcare Medicare |
$463.15
|
|
|
PR CLOSED RX DIST FEM EPIPHYSIS
|
Professional
|
Both
|
$980.78
|
|
|
Service Code
|
CPT 27516
|
| Hospital Charge Code |
z27516
|
| Min. Negotiated Rate |
$299.07 |
| Max. Negotiated Rate |
$68,500.00 |
| Rate for Payer: Aetna Commercial |
$454.12
|
| Rate for Payer: Aetna Commercial |
$454.12
|
| Rate for Payer: Aetna Medicare |
$454.12
|
| Rate for Payer: Aetna Medicare |
$454.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$617.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$617.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$617.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$617.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$617.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$617.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$617.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$617.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$299.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$299.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$482.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$482.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$522.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$522.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$499.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$499.53
|
| Rate for Payer: Cash Price |
$571.96
|
| Rate for Payer: Cash Price |
$588.47
|
| Rate for Payer: Centivo All Commercial |
$703.89
|
| Rate for Payer: Centivo All Commercial |
$703.89
|
| Rate for Payer: Cigna All Commercial |
$454.12
|
| Rate for Payer: Cigna All Commercial |
$454.12
|
| Rate for Payer: CORVEL All Commercial |
$454.12
|
| Rate for Payer: CORVEL All Commercial |
$454.12
|
| Rate for Payer: Coventry All Commercial |
$544.94
|
| Rate for Payer: Coventry All Commercial |
$544.94
|
| Rate for Payer: Encore All Commercial |
$454.12
|
| Rate for Payer: Encore All Commercial |
$454.12
|
| Rate for Payer: Frontpath All Commercial |
$627.72
|
| Rate for Payer: Frontpath All Commercial |
$627.72
|
| Rate for Payer: Humana ChoiceCare |
$468.16
|
| Rate for Payer: Humana ChoiceCare |
$468.16
|
| Rate for Payer: Humana Medicare |
$454.12
|
| Rate for Payer: Humana Medicare |
$454.12
|
| Rate for Payer: Lucent All Commercial |
$635.77
|
| Rate for Payer: Lucent All Commercial |
$635.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$731.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$731.00
|
| Rate for Payer: Managed Health Services Medicaid |
$482.39
|
| Rate for Payer: Managed Health Services Medicaid |
$482.39
|
| Rate for Payer: MDWise Medicaid |
$482.39
|
| Rate for Payer: MDWise Medicaid |
$482.39
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$299.07
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$299.07
|
| Rate for Payer: PHCS All Commercial |
$454.12
|
| Rate for Payer: PHCS All Commercial |
$454.12
|
| Rate for Payer: PHP All Commercial |
$775.36
|
| Rate for Payer: PHP All Commercial |
$775.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$454.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$454.12
|
| Rate for Payer: Sagamore Health Network All Products |
$454.12
|
| Rate for Payer: Sagamore Health Network All Products |
$454.12
|
| Rate for Payer: Signature Care EPO |
$724.20
|
| Rate for Payer: Signature Care EPO |
$724.20
|
| Rate for Payer: Signature Care PPO |
$724.20
|
| Rate for Payer: Signature Care PPO |
$724.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$68,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$68,500.00
|
| Rate for Payer: United Healthcare Commercial |
$481.96
|
| Rate for Payer: United Healthcare Commercial |
$481.96
|
| Rate for Payer: United Healthcare Medicare |
$476.63
|
| Rate for Payer: United Healthcare Medicare |
$476.63
|
|
|
PR CLOSED RX DIST FIBULA FX
|
Professional
|
Both
|
$601.52
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
z27786
|
| Min. Negotiated Rate |
$150.19 |
| Max. Negotiated Rate |
$41,100.00 |
| Rate for Payer: Aetna Commercial |
$272.36
|
| Rate for Payer: Aetna Commercial |
$272.36
|
| Rate for Payer: Aetna Medicare |
$272.36
|
| Rate for Payer: Aetna Medicare |
$272.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$425.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$425.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$425.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$425.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$425.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$425.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$425.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$425.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$150.19
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$150.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$295.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$295.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.60
|
| Rate for Payer: Cash Price |
$350.09
|
| Rate for Payer: Cash Price |
$360.91
|
| Rate for Payer: Centivo All Commercial |
$422.16
|
| Rate for Payer: Centivo All Commercial |
$422.16
|
| Rate for Payer: Cigna All Commercial |
$272.36
|
| Rate for Payer: Cigna All Commercial |
$272.36
|
| Rate for Payer: CORVEL All Commercial |
$272.36
|
| Rate for Payer: CORVEL All Commercial |
$272.36
|
| Rate for Payer: Coventry All Commercial |
$326.83
|
| Rate for Payer: Coventry All Commercial |
$326.83
|
| Rate for Payer: Encore All Commercial |
$272.36
|
| Rate for Payer: Encore All Commercial |
$272.36
|
| Rate for Payer: Frontpath All Commercial |
$372.90
|
| Rate for Payer: Frontpath All Commercial |
$372.90
|
| Rate for Payer: Humana ChoiceCare |
$264.86
|
| Rate for Payer: Humana ChoiceCare |
$264.86
|
| Rate for Payer: Humana Medicare |
$272.36
|
| Rate for Payer: Humana Medicare |
$272.36
|
| Rate for Payer: Lucent All Commercial |
$381.30
|
| Rate for Payer: Lucent All Commercial |
$381.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$438.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$438.00
|
| Rate for Payer: Managed Health Services Medicaid |
$295.85
|
| Rate for Payer: Managed Health Services Medicaid |
$295.85
|
| Rate for Payer: MDWise Medicaid |
$295.85
|
| Rate for Payer: MDWise Medicaid |
$295.85
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$150.19
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$150.19
|
| Rate for Payer: PHCS All Commercial |
$272.36
|
| Rate for Payer: PHCS All Commercial |
$272.36
|
| Rate for Payer: PHP All Commercial |
$464.66
|
| Rate for Payer: PHP All Commercial |
$464.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.36
|
| Rate for Payer: Sagamore Health Network All Products |
$272.36
|
| Rate for Payer: Sagamore Health Network All Products |
$272.36
|
| Rate for Payer: Signature Care EPO |
$449.65
|
| Rate for Payer: Signature Care EPO |
$449.65
|
| Rate for Payer: Signature Care PPO |
$449.65
|
| Rate for Payer: Signature Care PPO |
$449.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,100.00
|
| Rate for Payer: United Healthcare Commercial |
$284.74
|
| Rate for Payer: United Healthcare Commercial |
$284.74
|
| Rate for Payer: United Healthcare Medicare |
$291.74
|
| Rate for Payer: United Healthcare Medicare |
$291.74
|
|
|
PR CLOSED RX DIST RAD/ULNA FX
|
Professional
|
Both
|
$651.84
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
z25600
|
| Min. Negotiated Rate |
$171.56 |
| Max. Negotiated Rate |
$46,300.00 |
| Rate for Payer: Aetna Commercial |
$305.01
|
| Rate for Payer: Aetna Commercial |
$305.01
|
| Rate for Payer: Aetna Medicare |
$305.01
|
| Rate for Payer: Aetna Medicare |
$305.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$381.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$381.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$381.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$381.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$381.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$381.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$381.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$381.69
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$171.56
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$171.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$320.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$320.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$350.76
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$350.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$335.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$335.51
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cash Price |
$391.10
|
| Rate for Payer: Centivo All Commercial |
$472.77
|
| Rate for Payer: Centivo All Commercial |
$472.77
|
| Rate for Payer: Cigna All Commercial |
$305.01
|
| Rate for Payer: Cigna All Commercial |
$305.01
|
| Rate for Payer: CORVEL All Commercial |
$305.01
|
| Rate for Payer: CORVEL All Commercial |
$305.01
|
| Rate for Payer: Coventry All Commercial |
$366.01
|
| Rate for Payer: Coventry All Commercial |
$366.01
|
| Rate for Payer: Encore All Commercial |
$305.01
|
| Rate for Payer: Encore All Commercial |
$305.01
|
| Rate for Payer: Frontpath All Commercial |
$415.83
|
| Rate for Payer: Frontpath All Commercial |
$415.83
|
| Rate for Payer: Humana ChoiceCare |
$240.69
|
| Rate for Payer: Humana ChoiceCare |
$240.69
|
| Rate for Payer: Humana Medicare |
$305.01
|
| Rate for Payer: Humana Medicare |
$305.01
|
| Rate for Payer: Lucent All Commercial |
$427.01
|
| Rate for Payer: Lucent All Commercial |
$427.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$494.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$494.00
|
| Rate for Payer: Managed Health Services Medicaid |
$320.60
|
| Rate for Payer: Managed Health Services Medicaid |
$320.60
|
| Rate for Payer: MDWise Medicaid |
$320.60
|
| Rate for Payer: MDWise Medicaid |
$320.60
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$171.56
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$171.56
|
| Rate for Payer: PHCS All Commercial |
$305.01
|
| Rate for Payer: PHCS All Commercial |
$305.01
|
| Rate for Payer: PHP All Commercial |
$524.22
|
| Rate for Payer: PHP All Commercial |
$524.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$305.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$305.01
|
| Rate for Payer: Sagamore Health Network All Products |
$305.01
|
| Rate for Payer: Sagamore Health Network All Products |
$305.01
|
| Rate for Payer: Signature Care EPO |
$402.90
|
| Rate for Payer: Signature Care EPO |
$402.90
|
| Rate for Payer: Signature Care PPO |
$402.90
|
| Rate for Payer: Signature Care PPO |
$402.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,300.00
|
| Rate for Payer: United Healthcare Commercial |
$262.15
|
| Rate for Payer: United Healthcare Commercial |
$262.15
|
| Rate for Payer: United Healthcare Medicare |
$315.13
|
| Rate for Payer: United Healthcare Medicare |
$315.13
|
|
|
PR CLOSED RX DIST RAD/ULNA FX,MANIPUL
|
Professional
|
Both
|
$997.66
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
z25605
|
| Min. Negotiated Rate |
$275.93 |
| Max. Negotiated Rate |
$72,400.00 |
| Rate for Payer: Aetna Commercial |
$480.28
|
| Rate for Payer: Aetna Commercial |
$480.28
|
| Rate for Payer: Aetna Medicare |
$480.28
|
| Rate for Payer: Aetna Medicare |
$480.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$623.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$623.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$623.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$623.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$623.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$623.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$623.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$623.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$275.93
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$275.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$503.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$503.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$552.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$552.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$528.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$528.31
|
| Rate for Payer: Cash Price |
$614.76
|
| Rate for Payer: Cash Price |
$598.60
|
| Rate for Payer: Centivo All Commercial |
$744.43
|
| Rate for Payer: Centivo All Commercial |
$744.43
|
| Rate for Payer: Cigna All Commercial |
$480.28
|
| Rate for Payer: Cigna All Commercial |
$480.28
|
| Rate for Payer: CORVEL All Commercial |
$480.28
|
| Rate for Payer: CORVEL All Commercial |
$480.28
|
| Rate for Payer: Coventry All Commercial |
$576.34
|
| Rate for Payer: Coventry All Commercial |
$576.34
|
| Rate for Payer: Encore All Commercial |
$480.28
|
| Rate for Payer: Encore All Commercial |
$480.28
|
| Rate for Payer: Frontpath All Commercial |
$664.88
|
| Rate for Payer: Frontpath All Commercial |
$664.88
|
| Rate for Payer: Humana ChoiceCare |
$519.07
|
| Rate for Payer: Humana ChoiceCare |
$519.07
|
| Rate for Payer: Humana Medicare |
$480.28
|
| Rate for Payer: Humana Medicare |
$480.28
|
| Rate for Payer: Lucent All Commercial |
$672.39
|
| Rate for Payer: Lucent All Commercial |
$672.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$773.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$773.00
|
| Rate for Payer: Managed Health Services Medicaid |
$503.94
|
| Rate for Payer: Managed Health Services Medicaid |
$503.94
|
| Rate for Payer: MDWise Medicaid |
$503.94
|
| Rate for Payer: MDWise Medicaid |
$503.94
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$275.93
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$275.93
|
| Rate for Payer: PHCS All Commercial |
$480.28
|
| Rate for Payer: PHCS All Commercial |
$480.28
|
| Rate for Payer: PHP All Commercial |
$819.75
|
| Rate for Payer: PHP All Commercial |
$819.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$480.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$480.28
|
| Rate for Payer: Sagamore Health Network All Products |
$480.28
|
| Rate for Payer: Sagamore Health Network All Products |
$480.28
|
| Rate for Payer: Signature Care EPO |
$793.05
|
| Rate for Payer: Signature Care EPO |
$793.05
|
| Rate for Payer: Signature Care PPO |
$793.05
|
| Rate for Payer: Signature Care PPO |
$793.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$72,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$72,400.00
|
| Rate for Payer: United Healthcare Commercial |
$600.91
|
| Rate for Payer: United Healthcare Commercial |
$600.91
|
| Rate for Payer: United Healthcare Medicare |
$498.83
|
| Rate for Payer: United Healthcare Medicare |
$498.83
|
|
|
PR CLOSED RX ELBOW DISLOCATION
|
Professional
|
Both
|
$719.30
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
z24600
|
| Min. Negotiated Rate |
$176.49 |
| Max. Negotiated Rate |
$48,700.00 |
| Rate for Payer: Aetna Commercial |
$319.26
|
| Rate for Payer: Aetna Commercial |
$319.26
|
| Rate for Payer: Aetna Medicare |
$319.26
|
| Rate for Payer: Aetna Medicare |
$319.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$461.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$461.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$461.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$461.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$461.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$461.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$461.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$461.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$176.49
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$176.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$353.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$353.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$367.15
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$367.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$351.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$351.19
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$431.58
|
| Rate for Payer: Centivo All Commercial |
$494.85
|
| Rate for Payer: Centivo All Commercial |
$494.85
|
| Rate for Payer: Cigna All Commercial |
$319.26
|
| Rate for Payer: Cigna All Commercial |
$319.26
|
| Rate for Payer: CORVEL All Commercial |
$319.26
|
| Rate for Payer: CORVEL All Commercial |
$319.26
|
| Rate for Payer: Coventry All Commercial |
$383.11
|
| Rate for Payer: Coventry All Commercial |
$383.11
|
| Rate for Payer: Encore All Commercial |
$319.26
|
| Rate for Payer: Encore All Commercial |
$319.26
|
| Rate for Payer: Frontpath All Commercial |
$443.39
|
| Rate for Payer: Frontpath All Commercial |
$443.39
|
| Rate for Payer: Humana ChoiceCare |
$332.59
|
| Rate for Payer: Humana ChoiceCare |
$332.59
|
| Rate for Payer: Humana Medicare |
$319.26
|
| Rate for Payer: Humana Medicare |
$319.26
|
| Rate for Payer: Lucent All Commercial |
$446.96
|
| Rate for Payer: Lucent All Commercial |
$446.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$519.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$519.00
|
| Rate for Payer: Managed Health Services Medicaid |
$353.78
|
| Rate for Payer: Managed Health Services Medicaid |
$353.78
|
| Rate for Payer: MDWise Medicaid |
$353.78
|
| Rate for Payer: MDWise Medicaid |
$353.78
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$176.49
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$176.49
|
| Rate for Payer: PHCS All Commercial |
$319.26
|
| Rate for Payer: PHCS All Commercial |
$319.26
|
| Rate for Payer: PHP All Commercial |
$550.84
|
| Rate for Payer: PHP All Commercial |
$550.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.26
|
| Rate for Payer: Sagamore Health Network All Products |
$319.26
|
| Rate for Payer: Sagamore Health Network All Products |
$319.26
|
| Rate for Payer: Signature Care EPO |
$559.30
|
| Rate for Payer: Signature Care EPO |
$559.30
|
| Rate for Payer: Signature Care PPO |
$559.30
|
| Rate for Payer: Signature Care PPO |
$559.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$48,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$48,700.00
|
| Rate for Payer: United Healthcare Commercial |
$340.96
|
| Rate for Payer: United Healthcare Commercial |
$340.96
|
| Rate for Payer: United Healthcare Medicare |
$350.00
|
| Rate for Payer: United Healthcare Medicare |
$350.00
|
|
|
PR CLOSED RX ELBOW DISLOCATN,ANESTHESIA
|
Professional
|
Both
|
$900.32
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
z24605
|
| Min. Negotiated Rate |
$438.97 |
| Max. Negotiated Rate |
$67,500.00 |
| Rate for Payer: Aetna Commercial |
$448.97
|
| Rate for Payer: Aetna Commercial |
$448.97
|
| Rate for Payer: Aetna Medicare |
$448.97
|
| Rate for Payer: Aetna Medicare |
$448.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$441.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$441.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$441.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$441.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$441.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$441.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$441.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$441.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$442.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$442.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$516.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$516.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$493.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$493.87
|
| Rate for Payer: Cash Price |
$540.19
|
| Rate for Payer: Cash Price |
$526.76
|
| Rate for Payer: Centivo All Commercial |
$695.90
|
| Rate for Payer: Centivo All Commercial |
$695.90
|
| Rate for Payer: Cigna All Commercial |
$448.97
|
| Rate for Payer: Cigna All Commercial |
$448.97
|
| Rate for Payer: CORVEL All Commercial |
$448.97
|
| Rate for Payer: CORVEL All Commercial |
$448.97
|
| Rate for Payer: Coventry All Commercial |
$538.76
|
| Rate for Payer: Coventry All Commercial |
$538.76
|
| Rate for Payer: Encore All Commercial |
$448.97
|
| Rate for Payer: Encore All Commercial |
$448.97
|
| Rate for Payer: Frontpath All Commercial |
$619.79
|
| Rate for Payer: Frontpath All Commercial |
$619.79
|
| Rate for Payer: Humana ChoiceCare |
$465.93
|
| Rate for Payer: Humana ChoiceCare |
$465.93
|
| Rate for Payer: Humana Medicare |
$448.97
|
| Rate for Payer: Humana Medicare |
$448.97
|
| Rate for Payer: Lucent All Commercial |
$628.56
|
| Rate for Payer: Lucent All Commercial |
$628.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$720.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$720.00
|
| Rate for Payer: Managed Health Services Medicaid |
$442.81
|
| Rate for Payer: Managed Health Services Medicaid |
$442.81
|
| Rate for Payer: MDWise Medicaid |
$442.81
|
| Rate for Payer: MDWise Medicaid |
$442.81
|
| Rate for Payer: PHCS All Commercial |
$448.97
|
| Rate for Payer: PHCS All Commercial |
$448.97
|
| Rate for Payer: PHP All Commercial |
$763.81
|
| Rate for Payer: PHP All Commercial |
$763.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$448.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$448.97
|
| Rate for Payer: Sagamore Health Network All Products |
$448.97
|
| Rate for Payer: Sagamore Health Network All Products |
$448.97
|
| Rate for Payer: Signature Care EPO |
$618.80
|
| Rate for Payer: Signature Care EPO |
$618.80
|
| Rate for Payer: Signature Care PPO |
$618.80
|
| Rate for Payer: Signature Care PPO |
$618.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,500.00
|
| Rate for Payer: United Healthcare Commercial |
$482.65
|
| Rate for Payer: United Healthcare Commercial |
$482.65
|
| Rate for Payer: United Healthcare Medicare |
$438.97
|
| Rate for Payer: United Healthcare Medicare |
$438.97
|
|
|
PR CLOSED RX FEMUR,DISTAL
|
Professional
|
Both
|
$990.22
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
z27508
|
| Min. Negotiated Rate |
$295.86 |
| Max. Negotiated Rate |
$70,300.00 |
| Rate for Payer: Aetna Commercial |
$467.64
|
| Rate for Payer: Aetna Commercial |
$467.64
|
| Rate for Payer: Aetna Medicare |
$467.64
|
| Rate for Payer: Aetna Medicare |
$467.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$612.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$612.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$612.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$612.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$612.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$612.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$295.86
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$295.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$487.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$487.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$537.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$537.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$514.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$514.40
|
| Rate for Payer: Cash Price |
$578.87
|
| Rate for Payer: Cash Price |
$594.13
|
| Rate for Payer: Centivo All Commercial |
$724.84
|
| Rate for Payer: Centivo All Commercial |
$724.84
|
| Rate for Payer: Cigna All Commercial |
$467.64
|
| Rate for Payer: Cigna All Commercial |
$467.64
|
| Rate for Payer: CORVEL All Commercial |
$467.64
|
| Rate for Payer: CORVEL All Commercial |
$467.64
|
| Rate for Payer: Coventry All Commercial |
$561.17
|
| Rate for Payer: Coventry All Commercial |
$561.17
|
| Rate for Payer: Encore All Commercial |
$467.64
|
| Rate for Payer: Encore All Commercial |
$467.64
|
| Rate for Payer: Frontpath All Commercial |
$647.69
|
| Rate for Payer: Frontpath All Commercial |
$647.69
|
| Rate for Payer: Humana ChoiceCare |
$490.10
|
| Rate for Payer: Humana ChoiceCare |
$490.10
|
| Rate for Payer: Humana Medicare |
$467.64
|
| Rate for Payer: Humana Medicare |
$467.64
|
| Rate for Payer: Lucent All Commercial |
$654.70
|
| Rate for Payer: Lucent All Commercial |
$654.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$750.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$750.00
|
| Rate for Payer: Managed Health Services Medicaid |
$487.03
|
| Rate for Payer: Managed Health Services Medicaid |
$487.03
|
| Rate for Payer: MDWise Medicaid |
$487.03
|
| Rate for Payer: MDWise Medicaid |
$487.03
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$295.86
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$295.86
|
| Rate for Payer: PHCS All Commercial |
$467.64
|
| Rate for Payer: PHCS All Commercial |
$467.64
|
| Rate for Payer: PHP All Commercial |
$795.34
|
| Rate for Payer: PHP All Commercial |
$795.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$467.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$467.64
|
| Rate for Payer: Sagamore Health Network All Products |
$467.64
|
| Rate for Payer: Sagamore Health Network All Products |
$467.64
|
| Rate for Payer: Signature Care EPO |
$736.95
|
| Rate for Payer: Signature Care EPO |
$736.95
|
| Rate for Payer: Signature Care PPO |
$736.95
|
| Rate for Payer: Signature Care PPO |
$736.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,300.00
|
| Rate for Payer: United Healthcare Commercial |
$516.34
|
| Rate for Payer: United Healthcare Commercial |
$516.34
|
| Rate for Payer: United Healthcare Medicare |
$482.39
|
| Rate for Payer: United Healthcare Medicare |
$482.39
|
|
|
PR CLOSED RX FEMUR SHAFT FX
|
Professional
|
Both
|
$981.60
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
z27500
|
| Min. Negotiated Rate |
$325.86 |
| Max. Negotiated Rate |
$67,800.00 |
| Rate for Payer: Aetna Commercial |
$449.62
|
| Rate for Payer: Aetna Commercial |
$449.62
|
| Rate for Payer: Aetna Medicare |
$449.62
|
| Rate for Payer: Aetna Medicare |
$449.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$760.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$760.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$760.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$760.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$760.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$760.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$760.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$760.20
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$325.86
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$325.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$482.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$482.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$517.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$517.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$494.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$494.58
|
| Rate for Payer: Cash Price |
$576.19
|
| Rate for Payer: Cash Price |
$588.96
|
| Rate for Payer: Centivo All Commercial |
$696.91
|
| Rate for Payer: Centivo All Commercial |
$696.91
|
| Rate for Payer: Cigna All Commercial |
$449.62
|
| Rate for Payer: Cigna All Commercial |
$449.62
|
| Rate for Payer: CORVEL All Commercial |
$449.62
|
| Rate for Payer: CORVEL All Commercial |
$449.62
|
| Rate for Payer: Coventry All Commercial |
$539.54
|
| Rate for Payer: Coventry All Commercial |
$539.54
|
| Rate for Payer: Encore All Commercial |
$449.62
|
| Rate for Payer: Encore All Commercial |
$449.62
|
| Rate for Payer: Frontpath All Commercial |
$624.42
|
| Rate for Payer: Frontpath All Commercial |
$624.42
|
| Rate for Payer: Humana ChoiceCare |
$475.20
|
| Rate for Payer: Humana ChoiceCare |
$475.20
|
| Rate for Payer: Humana Medicare |
$449.62
|
| Rate for Payer: Humana Medicare |
$449.62
|
| Rate for Payer: Lucent All Commercial |
$629.47
|
| Rate for Payer: Lucent All Commercial |
$629.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$723.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$723.00
|
| Rate for Payer: Managed Health Services Medicaid |
$482.79
|
| Rate for Payer: Managed Health Services Medicaid |
$482.79
|
| Rate for Payer: MDWise Medicaid |
$482.79
|
| Rate for Payer: MDWise Medicaid |
$482.79
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$325.86
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$325.86
|
| Rate for Payer: PHCS All Commercial |
$449.62
|
| Rate for Payer: PHCS All Commercial |
$449.62
|
| Rate for Payer: PHP All Commercial |
$766.83
|
| Rate for Payer: PHP All Commercial |
$766.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$449.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$449.62
|
| Rate for Payer: Sagamore Health Network All Products |
$449.62
|
| Rate for Payer: Sagamore Health Network All Products |
$449.62
|
| Rate for Payer: Signature Care EPO |
$744.60
|
| Rate for Payer: Signature Care EPO |
$744.60
|
| Rate for Payer: Signature Care PPO |
$744.60
|
| Rate for Payer: Signature Care PPO |
$744.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,800.00
|
| Rate for Payer: United Healthcare Commercial |
$505.75
|
| Rate for Payer: United Healthcare Commercial |
$505.75
|
| Rate for Payer: United Healthcare Medicare |
$480.16
|
| Rate for Payer: United Healthcare Medicare |
$480.16
|
|
|
PR CLOSED RX GR TROCHANTERIC FX
|
Professional
|
Both
|
$735.32
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
z27246
|
| Min. Negotiated Rate |
$253.80 |
| Max. Negotiated Rate |
$54,600.00 |
| Rate for Payer: Aetna Commercial |
$362.01
|
| Rate for Payer: Aetna Commercial |
$362.01
|
| Rate for Payer: Aetna Medicare |
$362.01
|
| Rate for Payer: Aetna Medicare |
$362.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$489.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$489.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$489.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$489.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$489.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$489.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$489.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$489.20
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$253.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$253.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$361.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$361.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$416.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$416.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$398.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$398.21
|
| Rate for Payer: Cash Price |
$430.54
|
| Rate for Payer: Cash Price |
$441.19
|
| Rate for Payer: Centivo All Commercial |
$561.12
|
| Rate for Payer: Centivo All Commercial |
$561.12
|
| Rate for Payer: Cigna All Commercial |
$362.01
|
| Rate for Payer: Cigna All Commercial |
$362.01
|
| Rate for Payer: CORVEL All Commercial |
$362.01
|
| Rate for Payer: CORVEL All Commercial |
$362.01
|
| Rate for Payer: Coventry All Commercial |
$434.41
|
| Rate for Payer: Coventry All Commercial |
$434.41
|
| Rate for Payer: Encore All Commercial |
$362.01
|
| Rate for Payer: Encore All Commercial |
$362.01
|
| Rate for Payer: Frontpath All Commercial |
$501.70
|
| Rate for Payer: Frontpath All Commercial |
$501.70
|
| Rate for Payer: Humana ChoiceCare |
$395.84
|
| Rate for Payer: Humana ChoiceCare |
$395.84
|
| Rate for Payer: Humana Medicare |
$362.01
|
| Rate for Payer: Humana Medicare |
$362.01
|
| Rate for Payer: Lucent All Commercial |
$506.81
|
| Rate for Payer: Lucent All Commercial |
$506.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$582.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$582.00
|
| Rate for Payer: Managed Health Services Medicaid |
$361.66
|
| Rate for Payer: Managed Health Services Medicaid |
$361.66
|
| Rate for Payer: MDWise Medicaid |
$361.66
|
| Rate for Payer: MDWise Medicaid |
$361.66
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$253.80
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$253.80
|
| Rate for Payer: PHCS All Commercial |
$362.01
|
| Rate for Payer: PHCS All Commercial |
$362.01
|
| Rate for Payer: PHP All Commercial |
$617.47
|
| Rate for Payer: PHP All Commercial |
$617.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$362.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$362.01
|
| Rate for Payer: Sagamore Health Network All Products |
$362.01
|
| Rate for Payer: Sagamore Health Network All Products |
$362.01
|
| Rate for Payer: Signature Care EPO |
$597.55
|
| Rate for Payer: Signature Care EPO |
$597.55
|
| Rate for Payer: Signature Care PPO |
$597.55
|
| Rate for Payer: Signature Care PPO |
$597.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$54,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$54,600.00
|
| Rate for Payer: United Healthcare Commercial |
$406.95
|
| Rate for Payer: United Healthcare Commercial |
$406.95
|
| Rate for Payer: United Healthcare Medicare |
$358.78
|
| Rate for Payer: United Healthcare Medicare |
$358.78
|
|
|
PR CLOSED RX GR TUBEROSITY HUM FX
|
Professional
|
Both
|
$521.06
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
z23620
|
| Min. Negotiated Rate |
$161.07 |
| Max. Negotiated Rate |
$37,200.00 |
| Rate for Payer: Aetna Commercial |
$245.33
|
| Rate for Payer: Aetna Commercial |
$245.33
|
| Rate for Payer: Aetna Medicare |
$245.33
|
| Rate for Payer: Aetna Medicare |
$245.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$406.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$406.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$406.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$406.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$406.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$406.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$406.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$406.08
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$161.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$161.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$256.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$256.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$282.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$282.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$269.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$269.86
|
| Rate for Payer: Cash Price |
$302.87
|
| Rate for Payer: Cash Price |
$312.64
|
| Rate for Payer: Centivo All Commercial |
$380.26
|
| Rate for Payer: Centivo All Commercial |
$380.26
|
| Rate for Payer: Cigna All Commercial |
$245.33
|
| Rate for Payer: Cigna All Commercial |
$245.33
|
| Rate for Payer: CORVEL All Commercial |
$245.33
|
| Rate for Payer: CORVEL All Commercial |
$245.33
|
| Rate for Payer: Coventry All Commercial |
$294.40
|
| Rate for Payer: Coventry All Commercial |
$294.40
|
| Rate for Payer: Encore All Commercial |
$245.33
|
| Rate for Payer: Encore All Commercial |
$245.33
|
| Rate for Payer: Frontpath All Commercial |
$336.15
|
| Rate for Payer: Frontpath All Commercial |
$336.15
|
| Rate for Payer: Humana ChoiceCare |
$230.66
|
| Rate for Payer: Humana ChoiceCare |
$230.66
|
| Rate for Payer: Humana Medicare |
$245.33
|
| Rate for Payer: Humana Medicare |
$245.33
|
| Rate for Payer: Lucent All Commercial |
$343.46
|
| Rate for Payer: Lucent All Commercial |
$343.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$397.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$397.00
|
| Rate for Payer: Managed Health Services Medicaid |
$256.28
|
| Rate for Payer: Managed Health Services Medicaid |
$256.28
|
| Rate for Payer: MDWise Medicaid |
$256.28
|
| Rate for Payer: MDWise Medicaid |
$256.28
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$161.07
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$161.07
|
| Rate for Payer: PHCS All Commercial |
$245.33
|
| Rate for Payer: PHCS All Commercial |
$245.33
|
| Rate for Payer: PHP All Commercial |
$420.81
|
| Rate for Payer: PHP All Commercial |
$420.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$245.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$245.33
|
| Rate for Payer: Sagamore Health Network All Products |
$245.33
|
| Rate for Payer: Sagamore Health Network All Products |
$245.33
|
| Rate for Payer: Signature Care EPO |
$428.40
|
| Rate for Payer: Signature Care EPO |
$428.40
|
| Rate for Payer: Signature Care PPO |
$428.40
|
| Rate for Payer: Signature Care PPO |
$428.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$37,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$37,200.00
|
| Rate for Payer: United Healthcare Commercial |
$250.41
|
| Rate for Payer: United Healthcare Commercial |
$250.41
|
| Rate for Payer: United Healthcare Medicare |
$252.39
|
| Rate for Payer: United Healthcare Medicare |
$252.39
|
|
|
PR CLOSED RX HEEL FX
|
Professional
|
Both
|
$474.16
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
z28400
|
| Min. Negotiated Rate |
$141.59 |
| Max. Negotiated Rate |
$32,700.00 |
| Rate for Payer: Aetna Commercial |
$215.77
|
| Rate for Payer: Aetna Commercial |
$215.77
|
| Rate for Payer: Aetna Medicare |
$215.77
|
| Rate for Payer: Aetna Medicare |
$215.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$255.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$255.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$255.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$255.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$255.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$255.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$255.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$255.42
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$141.59
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$141.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$233.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$233.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$248.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$248.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$237.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$237.35
|
| Rate for Payer: Cash Price |
$274.80
|
| Rate for Payer: Cash Price |
$284.50
|
| Rate for Payer: Centivo All Commercial |
$334.44
|
| Rate for Payer: Centivo All Commercial |
$334.44
|
| Rate for Payer: Cigna All Commercial |
$215.77
|
| Rate for Payer: Cigna All Commercial |
$215.77
|
| Rate for Payer: CORVEL All Commercial |
$215.77
|
| Rate for Payer: CORVEL All Commercial |
$215.77
|
| Rate for Payer: Coventry All Commercial |
$258.92
|
| Rate for Payer: Coventry All Commercial |
$258.92
|
| Rate for Payer: Encore All Commercial |
$215.77
|
| Rate for Payer: Encore All Commercial |
$215.77
|
| Rate for Payer: Frontpath All Commercial |
$293.41
|
| Rate for Payer: Frontpath All Commercial |
$293.41
|
| Rate for Payer: Humana ChoiceCare |
$222.00
|
| Rate for Payer: Humana ChoiceCare |
$222.00
|
| Rate for Payer: Humana Medicare |
$215.77
|
| Rate for Payer: Humana Medicare |
$215.77
|
| Rate for Payer: Lucent All Commercial |
$302.08
|
| Rate for Payer: Lucent All Commercial |
$302.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.00
|
| Rate for Payer: Managed Health Services Medicaid |
$233.21
|
| Rate for Payer: Managed Health Services Medicaid |
$233.21
|
| Rate for Payer: MDWise Medicaid |
$233.21
|
| Rate for Payer: MDWise Medicaid |
$233.21
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$141.59
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$141.59
|
| Rate for Payer: PHCS All Commercial |
$215.77
|
| Rate for Payer: PHCS All Commercial |
$215.77
|
| Rate for Payer: PHP All Commercial |
$370.16
|
| Rate for Payer: PHP All Commercial |
$370.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$215.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$215.77
|
| Rate for Payer: Sagamore Health Network All Products |
$215.77
|
| Rate for Payer: Sagamore Health Network All Products |
$215.77
|
| Rate for Payer: Signature Care EPO |
$363.80
|
| Rate for Payer: Signature Care EPO |
$363.80
|
| Rate for Payer: Signature Care PPO |
$363.80
|
| Rate for Payer: Signature Care PPO |
$363.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,700.00
|
| Rate for Payer: United Healthcare Commercial |
$230.39
|
| Rate for Payer: United Healthcare Commercial |
$230.39
|
| Rate for Payer: United Healthcare Medicare |
$229.00
|
| Rate for Payer: United Healthcare Medicare |
$229.00
|
|
|
PR CLOSED RX HUMERAL SUPRACONDYLAR FX
|
Professional
|
Both
|
$734.22
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
z24530
|
| Min. Negotiated Rate |
$182.72 |
| Max. Negotiated Rate |
$50,100.00 |
| Rate for Payer: Aetna Commercial |
$330.68
|
| Rate for Payer: Aetna Commercial |
$330.68
|
| Rate for Payer: Aetna Medicare |
$330.68
|
| Rate for Payer: Aetna Medicare |
$330.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$480.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$480.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$480.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$480.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$480.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$480.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$480.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$480.28
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$182.72
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$182.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$361.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$361.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$380.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$380.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$363.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$363.75
|
| Rate for Payer: Cash Price |
$427.04
|
| Rate for Payer: Cash Price |
$440.53
|
| Rate for Payer: Centivo All Commercial |
$512.55
|
| Rate for Payer: Centivo All Commercial |
$512.55
|
| Rate for Payer: Cigna All Commercial |
$330.68
|
| Rate for Payer: Cigna All Commercial |
$330.68
|
| Rate for Payer: CORVEL All Commercial |
$330.68
|
| Rate for Payer: CORVEL All Commercial |
$330.68
|
| Rate for Payer: Coventry All Commercial |
$396.82
|
| Rate for Payer: Coventry All Commercial |
$396.82
|
| Rate for Payer: Encore All Commercial |
$330.68
|
| Rate for Payer: Encore All Commercial |
$330.68
|
| Rate for Payer: Frontpath All Commercial |
$454.13
|
| Rate for Payer: Frontpath All Commercial |
$454.13
|
| Rate for Payer: Humana ChoiceCare |
$323.41
|
| Rate for Payer: Humana ChoiceCare |
$323.41
|
| Rate for Payer: Humana Medicare |
$330.68
|
| Rate for Payer: Humana Medicare |
$330.68
|
| Rate for Payer: Lucent All Commercial |
$462.95
|
| Rate for Payer: Lucent All Commercial |
$462.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$535.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$535.00
|
| Rate for Payer: Managed Health Services Medicaid |
$361.12
|
| Rate for Payer: Managed Health Services Medicaid |
$361.12
|
| Rate for Payer: MDWise Medicaid |
$361.12
|
| Rate for Payer: MDWise Medicaid |
$361.12
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$182.72
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$182.72
|
| Rate for Payer: PHCS All Commercial |
$330.68
|
| Rate for Payer: PHCS All Commercial |
$330.68
|
| Rate for Payer: PHP All Commercial |
$567.34
|
| Rate for Payer: PHP All Commercial |
$567.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$330.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$330.68
|
| Rate for Payer: Sagamore Health Network All Products |
$330.68
|
| Rate for Payer: Sagamore Health Network All Products |
$330.68
|
| Rate for Payer: Signature Care EPO |
$506.60
|
| Rate for Payer: Signature Care EPO |
$506.60
|
| Rate for Payer: Signature Care PPO |
$506.60
|
| Rate for Payer: Signature Care PPO |
$506.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,100.00
|
| Rate for Payer: United Healthcare Commercial |
$343.13
|
| Rate for Payer: United Healthcare Commercial |
$343.13
|
| Rate for Payer: United Healthcare Medicare |
$355.87
|
| Rate for Payer: United Healthcare Medicare |
$355.87
|
|
|
PR CLOSED RX HUMER EPICONDYLR FX
|
Professional
|
Both
|
$638.52
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
z24560
|
| Min. Negotiated Rate |
$153.65 |
| Max. Negotiated Rate |
$42,200.00 |
| Rate for Payer: Aetna Commercial |
$277.85
|
| Rate for Payer: Aetna Commercial |
$277.85
|
| Rate for Payer: Aetna Medicare |
$277.85
|
| Rate for Payer: Aetna Medicare |
$277.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$421.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$421.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$421.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$421.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$421.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$421.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$421.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$421.33
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$153.65
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$153.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$314.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$314.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$319.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$319.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$305.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$305.63
|
| Rate for Payer: Cash Price |
$372.02
|
| Rate for Payer: Cash Price |
$383.11
|
| Rate for Payer: Centivo All Commercial |
$430.67
|
| Rate for Payer: Centivo All Commercial |
$430.67
|
| Rate for Payer: Cigna All Commercial |
$277.85
|
| Rate for Payer: Cigna All Commercial |
$277.85
|
| Rate for Payer: CORVEL All Commercial |
$277.85
|
| Rate for Payer: CORVEL All Commercial |
$277.85
|
| Rate for Payer: Coventry All Commercial |
$333.42
|
| Rate for Payer: Coventry All Commercial |
$333.42
|
| Rate for Payer: Encore All Commercial |
$277.85
|
| Rate for Payer: Encore All Commercial |
$277.85
|
| Rate for Payer: Frontpath All Commercial |
$381.29
|
| Rate for Payer: Frontpath All Commercial |
$381.29
|
| Rate for Payer: Humana ChoiceCare |
$257.20
|
| Rate for Payer: Humana ChoiceCare |
$257.20
|
| Rate for Payer: Humana Medicare |
$277.85
|
| Rate for Payer: Humana Medicare |
$277.85
|
| Rate for Payer: Lucent All Commercial |
$388.99
|
| Rate for Payer: Lucent All Commercial |
$388.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$450.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$450.00
|
| Rate for Payer: Managed Health Services Medicaid |
$314.05
|
| Rate for Payer: Managed Health Services Medicaid |
$314.05
|
| Rate for Payer: MDWise Medicaid |
$314.05
|
| Rate for Payer: MDWise Medicaid |
$314.05
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$153.65
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$153.65
|
| Rate for Payer: PHCS All Commercial |
$277.85
|
| Rate for Payer: PHCS All Commercial |
$277.85
|
| Rate for Payer: PHP All Commercial |
$477.60
|
| Rate for Payer: PHP All Commercial |
$477.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$277.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$277.85
|
| Rate for Payer: Sagamore Health Network All Products |
$277.85
|
| Rate for Payer: Sagamore Health Network All Products |
$277.85
|
| Rate for Payer: Signature Care EPO |
$445.40
|
| Rate for Payer: Signature Care EPO |
$445.40
|
| Rate for Payer: Signature Care PPO |
$445.40
|
| Rate for Payer: Signature Care PPO |
$445.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,200.00
|
| Rate for Payer: United Healthcare Commercial |
$280.33
|
| Rate for Payer: United Healthcare Commercial |
$280.33
|
| Rate for Payer: United Healthcare Medicare |
$310.02
|
| Rate for Payer: United Healthcare Medicare |
$310.02
|
|
|
PR CLOSED RX HUM SUPRACONDYLR FX,MANIPU
|
Professional
|
Both
|
$1,177.90
|
|
|
Service Code
|
CPT 24535
|
| Hospital Charge Code |
z24535
|
| Min. Negotiated Rate |
$294.67 |
| Max. Negotiated Rate |
$80,600.00 |
| Rate for Payer: Aetna Commercial |
$533.49
|
| Rate for Payer: Aetna Commercial |
$533.49
|
| Rate for Payer: Aetna Medicare |
$533.49
|
| Rate for Payer: Aetna Medicare |
$533.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$715.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$715.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$715.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$715.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$715.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$715.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$715.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$715.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$294.67
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$294.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$579.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$579.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$613.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$613.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$586.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$586.84
|
| Rate for Payer: Cash Price |
$685.22
|
| Rate for Payer: Cash Price |
$706.74
|
| Rate for Payer: Centivo All Commercial |
$826.91
|
| Rate for Payer: Centivo All Commercial |
$826.91
|
| Rate for Payer: Cigna All Commercial |
$533.49
|
| Rate for Payer: Cigna All Commercial |
$533.49
|
| Rate for Payer: CORVEL All Commercial |
$533.49
|
| Rate for Payer: CORVEL All Commercial |
$533.49
|
| Rate for Payer: Coventry All Commercial |
$640.19
|
| Rate for Payer: Coventry All Commercial |
$640.19
|
| Rate for Payer: Encore All Commercial |
$533.49
|
| Rate for Payer: Encore All Commercial |
$533.49
|
| Rate for Payer: Frontpath All Commercial |
$738.96
|
| Rate for Payer: Frontpath All Commercial |
$738.96
|
| Rate for Payer: Humana ChoiceCare |
$584.59
|
| Rate for Payer: Humana ChoiceCare |
$584.59
|
| Rate for Payer: Humana Medicare |
$533.49
|
| Rate for Payer: Humana Medicare |
$533.49
|
| Rate for Payer: Lucent All Commercial |
$746.89
|
| Rate for Payer: Lucent All Commercial |
$746.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$859.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$859.00
|
| Rate for Payer: Managed Health Services Medicaid |
$579.33
|
| Rate for Payer: Managed Health Services Medicaid |
$579.33
|
| Rate for Payer: MDWise Medicaid |
$579.33
|
| Rate for Payer: MDWise Medicaid |
$579.33
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$294.67
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$294.67
|
| Rate for Payer: PHCS All Commercial |
$533.49
|
| Rate for Payer: PHCS All Commercial |
$533.49
|
| Rate for Payer: PHP All Commercial |
$911.83
|
| Rate for Payer: PHP All Commercial |
$911.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$533.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$533.49
|
| Rate for Payer: Sagamore Health Network All Products |
$533.49
|
| Rate for Payer: Sagamore Health Network All Products |
$533.49
|
| Rate for Payer: Signature Care EPO |
$878.90
|
| Rate for Payer: Signature Care EPO |
$878.90
|
| Rate for Payer: Signature Care PPO |
$878.90
|
| Rate for Payer: Signature Care PPO |
$878.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$80,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$80,600.00
|
| Rate for Payer: United Healthcare Commercial |
$598.93
|
| Rate for Payer: United Healthcare Commercial |
$598.93
|
| Rate for Payer: United Healthcare Medicare |
$571.02
|
| Rate for Payer: United Healthcare Medicare |
$571.02
|
|
|
PR CLOSED RX INTER/SUBTROCH FEMUR FX
|
Professional
|
Both
|
$878.52
|
|
|
Service Code
|
CPT 27238
|
| Hospital Charge Code |
z27238
|
| Min. Negotiated Rate |
$428.17 |
| Max. Negotiated Rate |
$65,800.00 |
| Rate for Payer: Aetna Commercial |
$437.70
|
| Rate for Payer: Aetna Commercial |
$437.70
|
| Rate for Payer: Aetna Medicare |
$437.70
|
| Rate for Payer: Aetna Medicare |
$437.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$537.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$537.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$537.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$537.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$537.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$537.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$537.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$537.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$432.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$432.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$503.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$503.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$481.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$481.47
|
| Rate for Payer: Cash Price |
$527.11
|
| Rate for Payer: Cash Price |
$513.80
|
| Rate for Payer: Centivo All Commercial |
$678.43
|
| Rate for Payer: Centivo All Commercial |
$678.43
|
| Rate for Payer: Cigna All Commercial |
$437.70
|
| Rate for Payer: Cigna All Commercial |
$437.70
|
| Rate for Payer: CORVEL All Commercial |
$437.70
|
| Rate for Payer: CORVEL All Commercial |
$437.70
|
| Rate for Payer: Coventry All Commercial |
$525.24
|
| Rate for Payer: Coventry All Commercial |
$525.24
|
| Rate for Payer: Encore All Commercial |
$437.70
|
| Rate for Payer: Encore All Commercial |
$437.70
|
| Rate for Payer: Frontpath All Commercial |
$606.24
|
| Rate for Payer: Frontpath All Commercial |
$606.24
|
| Rate for Payer: Humana ChoiceCare |
$461.20
|
| Rate for Payer: Humana ChoiceCare |
$461.20
|
| Rate for Payer: Humana Medicare |
$437.70
|
| Rate for Payer: Humana Medicare |
$437.70
|
| Rate for Payer: Lucent All Commercial |
$612.78
|
| Rate for Payer: Lucent All Commercial |
$612.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$702.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$702.00
|
| Rate for Payer: Managed Health Services Medicaid |
$432.09
|
| Rate for Payer: Managed Health Services Medicaid |
$432.09
|
| Rate for Payer: MDWise Medicaid |
$432.09
|
| Rate for Payer: MDWise Medicaid |
$432.09
|
| Rate for Payer: PHCS All Commercial |
$437.70
|
| Rate for Payer: PHCS All Commercial |
$437.70
|
| Rate for Payer: PHP All Commercial |
$745.01
|
| Rate for Payer: PHP All Commercial |
$745.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$437.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$437.70
|
| Rate for Payer: Sagamore Health Network All Products |
$437.70
|
| Rate for Payer: Sagamore Health Network All Products |
$437.70
|
| Rate for Payer: Signature Care EPO |
$617.10
|
| Rate for Payer: Signature Care EPO |
$617.10
|
| Rate for Payer: Signature Care PPO |
$617.10
|
| Rate for Payer: Signature Care PPO |
$617.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$65,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$65,800.00
|
| Rate for Payer: United Healthcare Commercial |
$479.85
|
| Rate for Payer: United Healthcare Commercial |
$479.85
|
| Rate for Payer: United Healthcare Medicare |
$428.17
|
| Rate for Payer: United Healthcare Medicare |
$428.17
|
|
|
PR CLOSED RX INTER/SUBTROCH FX,MANIP
|
Professional
|
Both
|
$1,759.00
|
|
|
Service Code
|
CPT 27240
|
| Hospital Charge Code |
z27240
|
| Min. Negotiated Rate |
$865.14 |
| Max. Negotiated Rate |
$133,100.00 |
| Rate for Payer: Aetna Commercial |
$892.84
|
| Rate for Payer: Aetna Commercial |
$892.84
|
| Rate for Payer: Aetna Medicare |
$892.84
|
| Rate for Payer: Aetna Medicare |
$892.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,111.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,111.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,111.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,111.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,111.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,111.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,111.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,111.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$865.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$865.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,026.77
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,026.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$982.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$982.12
|
| Rate for Payer: Cash Price |
$1,055.40
|
| Rate for Payer: Cash Price |
$1,039.21
|
| Rate for Payer: Centivo All Commercial |
$1,383.90
|
| Rate for Payer: Centivo All Commercial |
$1,383.90
|
| Rate for Payer: Cigna All Commercial |
$892.84
|
| Rate for Payer: Cigna All Commercial |
$892.84
|
| Rate for Payer: CORVEL All Commercial |
$892.84
|
| Rate for Payer: CORVEL All Commercial |
$892.84
|
| Rate for Payer: Coventry All Commercial |
$1,071.41
|
| Rate for Payer: Coventry All Commercial |
$1,071.41
|
| Rate for Payer: Encore All Commercial |
$892.84
|
| Rate for Payer: Encore All Commercial |
$892.84
|
| Rate for Payer: Frontpath All Commercial |
$1,247.71
|
| Rate for Payer: Frontpath All Commercial |
$1,247.71
|
| Rate for Payer: Humana ChoiceCare |
$961.72
|
| Rate for Payer: Humana ChoiceCare |
$961.72
|
| Rate for Payer: Humana Medicare |
$892.84
|
| Rate for Payer: Humana Medicare |
$892.84
|
| Rate for Payer: Lucent All Commercial |
$1,249.98
|
| Rate for Payer: Lucent All Commercial |
$1,249.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,420.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,420.00
|
| Rate for Payer: Managed Health Services Medicaid |
$865.14
|
| Rate for Payer: Managed Health Services Medicaid |
$865.14
|
| Rate for Payer: MDWise Medicaid |
$865.14
|
| Rate for Payer: MDWise Medicaid |
$865.14
|
| Rate for Payer: PHCS All Commercial |
$892.84
|
| Rate for Payer: PHCS All Commercial |
$892.84
|
| Rate for Payer: PHP All Commercial |
$1,506.85
|
| Rate for Payer: PHP All Commercial |
$1,506.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$892.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$892.84
|
| Rate for Payer: Sagamore Health Network All Products |
$892.84
|
| Rate for Payer: Sagamore Health Network All Products |
$892.84
|
| Rate for Payer: Signature Care EPO |
$1,280.95
|
| Rate for Payer: Signature Care EPO |
$1,280.95
|
| Rate for Payer: Signature Care PPO |
$1,280.95
|
| Rate for Payer: Signature Care PPO |
$1,280.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$133,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$133,100.00
|
| Rate for Payer: United Healthcare Commercial |
$1,039.88
|
| Rate for Payer: United Healthcare Commercial |
$1,039.88
|
| Rate for Payer: United Healthcare Medicare |
$866.01
|
| Rate for Payer: United Healthcare Medicare |
$866.01
|
|
