|
PR CLOSED RX IP JT DISLOCATION
|
Professional
|
Both
|
$555.66
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
z26770
|
| Min. Negotiated Rate |
$135.31 |
| Max. Negotiated Rate |
$37,500.00 |
| Rate for Payer: Aetna Commercial |
$245.28
|
| Rate for Payer: Aetna Commercial |
$245.28
|
| Rate for Payer: Aetna Medicare |
$245.28
|
| Rate for Payer: Aetna Medicare |
$245.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$269.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$269.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$269.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$269.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$269.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$269.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$269.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$269.20
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$135.31
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$135.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$273.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$273.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$282.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$282.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$269.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$269.81
|
| Rate for Payer: Cash Price |
$321.32
|
| Rate for Payer: Cash Price |
$333.40
|
| Rate for Payer: Centivo All Commercial |
$380.18
|
| Rate for Payer: Centivo All Commercial |
$380.18
|
| Rate for Payer: Cigna All Commercial |
$245.28
|
| Rate for Payer: Cigna All Commercial |
$245.28
|
| Rate for Payer: CORVEL All Commercial |
$245.28
|
| Rate for Payer: CORVEL All Commercial |
$245.28
|
| Rate for Payer: Coventry All Commercial |
$294.34
|
| Rate for Payer: Coventry All Commercial |
$294.34
|
| Rate for Payer: Encore All Commercial |
$245.28
|
| Rate for Payer: Encore All Commercial |
$245.28
|
| Rate for Payer: Frontpath All Commercial |
$338.49
|
| Rate for Payer: Frontpath All Commercial |
$338.49
|
| Rate for Payer: Humana ChoiceCare |
$232.70
|
| Rate for Payer: Humana ChoiceCare |
$232.70
|
| Rate for Payer: Humana Medicare |
$245.28
|
| Rate for Payer: Humana Medicare |
$245.28
|
| Rate for Payer: Lucent All Commercial |
$343.39
|
| Rate for Payer: Lucent All Commercial |
$343.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$400.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$400.00
|
| Rate for Payer: Managed Health Services Medicaid |
$273.30
|
| Rate for Payer: Managed Health Services Medicaid |
$273.30
|
| Rate for Payer: MDWise Medicaid |
$273.30
|
| Rate for Payer: MDWise Medicaid |
$273.30
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$135.31
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$135.31
|
| Rate for Payer: PHCS All Commercial |
$245.28
|
| Rate for Payer: PHCS All Commercial |
$245.28
|
| Rate for Payer: PHP All Commercial |
$423.99
|
| Rate for Payer: PHP All Commercial |
$423.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$245.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$245.28
|
| Rate for Payer: Sagamore Health Network All Products |
$245.28
|
| Rate for Payer: Sagamore Health Network All Products |
$245.28
|
| Rate for Payer: Signature Care EPO |
$419.90
|
| Rate for Payer: Signature Care EPO |
$419.90
|
| Rate for Payer: Signature Care PPO |
$419.90
|
| Rate for Payer: Signature Care PPO |
$419.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$37,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$37,500.00
|
| Rate for Payer: United Healthcare Commercial |
$247.93
|
| Rate for Payer: United Healthcare Commercial |
$247.93
|
| Rate for Payer: United Healthcare Medicare |
$267.77
|
| Rate for Payer: United Healthcare Medicare |
$267.77
|
|
|
PR CLOSED RX KNEECAP DISLOCATN
|
Professional
|
Both
|
$713.20
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
z27560
|
| Min. Negotiated Rate |
$175.11 |
| Max. Negotiated Rate |
$48,700.00 |
| Rate for Payer: Aetna Commercial |
$317.11
|
| Rate for Payer: Aetna Commercial |
$317.11
|
| Rate for Payer: Aetna Medicare |
$317.11
|
| Rate for Payer: Aetna Medicare |
$317.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$409.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$409.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$409.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$409.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$409.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$409.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$409.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$409.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$175.11
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$175.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$350.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$350.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$364.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$364.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$348.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$348.82
|
| Rate for Payer: Cash Price |
$416.05
|
| Rate for Payer: Cash Price |
$427.92
|
| Rate for Payer: Centivo All Commercial |
$491.52
|
| Rate for Payer: Centivo All Commercial |
$491.52
|
| Rate for Payer: Cigna All Commercial |
$317.11
|
| Rate for Payer: Cigna All Commercial |
$317.11
|
| Rate for Payer: CORVEL All Commercial |
$317.11
|
| Rate for Payer: CORVEL All Commercial |
$317.11
|
| Rate for Payer: Coventry All Commercial |
$380.53
|
| Rate for Payer: Coventry All Commercial |
$380.53
|
| Rate for Payer: Encore All Commercial |
$317.11
|
| Rate for Payer: Encore All Commercial |
$317.11
|
| Rate for Payer: Frontpath All Commercial |
$437.72
|
| Rate for Payer: Frontpath All Commercial |
$437.72
|
| Rate for Payer: Humana ChoiceCare |
$300.13
|
| Rate for Payer: Humana ChoiceCare |
$300.13
|
| Rate for Payer: Humana Medicare |
$317.11
|
| Rate for Payer: Humana Medicare |
$317.11
|
| Rate for Payer: Lucent All Commercial |
$443.95
|
| Rate for Payer: Lucent All Commercial |
$443.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$520.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$520.00
|
| Rate for Payer: Managed Health Services Medicaid |
$350.78
|
| Rate for Payer: Managed Health Services Medicaid |
$350.78
|
| Rate for Payer: MDWise Medicaid |
$350.78
|
| Rate for Payer: MDWise Medicaid |
$350.78
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$175.11
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$175.11
|
| Rate for Payer: PHCS All Commercial |
$317.11
|
| Rate for Payer: PHCS All Commercial |
$317.11
|
| Rate for Payer: PHP All Commercial |
$551.40
|
| Rate for Payer: PHP All Commercial |
$551.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$317.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$317.11
|
| Rate for Payer: Sagamore Health Network All Products |
$317.11
|
| Rate for Payer: Sagamore Health Network All Products |
$317.11
|
| Rate for Payer: Signature Care EPO |
$532.95
|
| Rate for Payer: Signature Care EPO |
$532.95
|
| Rate for Payer: Signature Care PPO |
$532.95
|
| Rate for Payer: Signature Care PPO |
$532.95
|
| 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 |
$340.10
|
| Rate for Payer: United Healthcare Commercial |
$340.10
|
| Rate for Payer: United Healthcare Medicare |
$346.71
|
| Rate for Payer: United Healthcare Medicare |
$346.71
|
|
|
PR CLOSED RX KNEE DISLOCATN
|
Professional
|
Both
|
$966.34
|
|
|
Service Code
|
CPT 27550
|
| Hospital Charge Code |
z27550
|
| Min. Negotiated Rate |
$245.71 |
| Max. Negotiated Rate |
$66,800.00 |
| Rate for Payer: Aetna Commercial |
$444.30
|
| Rate for Payer: Aetna Commercial |
$444.30
|
| Rate for Payer: Aetna Medicare |
$444.30
|
| Rate for Payer: Aetna Medicare |
$444.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$568.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$568.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$568.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$568.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$568.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$568.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$568.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$568.00
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$245.71
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$245.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$475.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$475.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$510.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$510.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$488.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$488.73
|
| Rate for Payer: Cash Price |
$568.68
|
| Rate for Payer: Cash Price |
$579.80
|
| Rate for Payer: Centivo All Commercial |
$688.66
|
| Rate for Payer: Centivo All Commercial |
$688.66
|
| Rate for Payer: Cigna All Commercial |
$444.30
|
| Rate for Payer: Cigna All Commercial |
$444.30
|
| Rate for Payer: CORVEL All Commercial |
$444.30
|
| Rate for Payer: CORVEL All Commercial |
$444.30
|
| Rate for Payer: Coventry All Commercial |
$533.16
|
| Rate for Payer: Coventry All Commercial |
$533.16
|
| Rate for Payer: Encore All Commercial |
$444.30
|
| Rate for Payer: Encore All Commercial |
$444.30
|
| Rate for Payer: Frontpath All Commercial |
$616.76
|
| Rate for Payer: Frontpath All Commercial |
$616.76
|
| Rate for Payer: Humana ChoiceCare |
$460.89
|
| Rate for Payer: Humana ChoiceCare |
$460.89
|
| Rate for Payer: Humana Medicare |
$444.30
|
| Rate for Payer: Humana Medicare |
$444.30
|
| Rate for Payer: Lucent All Commercial |
$622.02
|
| Rate for Payer: Lucent All Commercial |
$622.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.00
|
| Rate for Payer: Managed Health Services Medicaid |
$475.28
|
| Rate for Payer: Managed Health Services Medicaid |
$475.28
|
| Rate for Payer: MDWise Medicaid |
$475.28
|
| Rate for Payer: MDWise Medicaid |
$475.28
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$245.71
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$245.71
|
| Rate for Payer: PHCS All Commercial |
$444.30
|
| Rate for Payer: PHCS All Commercial |
$444.30
|
| Rate for Payer: PHP All Commercial |
$756.46
|
| Rate for Payer: PHP All Commercial |
$756.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.30
|
| Rate for Payer: Sagamore Health Network All Products |
$444.30
|
| Rate for Payer: Sagamore Health Network All Products |
$444.30
|
| Rate for Payer: Signature Care EPO |
$707.20
|
| Rate for Payer: Signature Care EPO |
$707.20
|
| Rate for Payer: Signature Care PPO |
$707.20
|
| Rate for Payer: Signature Care PPO |
$707.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$66,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$66,800.00
|
| Rate for Payer: United Healthcare Commercial |
$478.74
|
| Rate for Payer: United Healthcare Commercial |
$478.74
|
| Rate for Payer: United Healthcare Medicare |
$473.90
|
| Rate for Payer: United Healthcare Medicare |
$473.90
|
|
|
PR CLOSED RX MED MALLEOLUS FX
|
Professional
|
Both
|
$640.30
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
z27760
|
| Min. Negotiated Rate |
$159.88 |
| Max. Negotiated Rate |
$43,800.00 |
| Rate for Payer: Aetna Commercial |
$290.31
|
| Rate for Payer: Aetna Commercial |
$290.31
|
| Rate for Payer: Aetna Medicare |
$290.31
|
| Rate for Payer: Aetna Medicare |
$290.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$443.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$443.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$443.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$443.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$443.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$443.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$443.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$443.69
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$159.88
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$159.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$314.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$314.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$333.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$333.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$319.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$319.34
|
| Rate for Payer: Cash Price |
$370.46
|
| Rate for Payer: Cash Price |
$384.18
|
| Rate for Payer: Centivo All Commercial |
$449.98
|
| Rate for Payer: Centivo All Commercial |
$449.98
|
| Rate for Payer: Cigna All Commercial |
$290.31
|
| Rate for Payer: Cigna All Commercial |
$290.31
|
| Rate for Payer: CORVEL All Commercial |
$290.31
|
| Rate for Payer: CORVEL All Commercial |
$290.31
|
| Rate for Payer: Coventry All Commercial |
$348.37
|
| Rate for Payer: Coventry All Commercial |
$348.37
|
| Rate for Payer: Encore All Commercial |
$290.31
|
| Rate for Payer: Encore All Commercial |
$290.31
|
| Rate for Payer: Frontpath All Commercial |
$396.73
|
| Rate for Payer: Frontpath All Commercial |
$396.73
|
| Rate for Payer: Humana ChoiceCare |
$282.94
|
| Rate for Payer: Humana ChoiceCare |
$282.94
|
| Rate for Payer: Humana Medicare |
$290.31
|
| Rate for Payer: Humana Medicare |
$290.31
|
| Rate for Payer: Lucent All Commercial |
$406.43
|
| Rate for Payer: Lucent All Commercial |
$406.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$467.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$467.00
|
| Rate for Payer: Managed Health Services Medicaid |
$314.93
|
| Rate for Payer: Managed Health Services Medicaid |
$314.93
|
| Rate for Payer: MDWise Medicaid |
$314.93
|
| Rate for Payer: MDWise Medicaid |
$314.93
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$159.88
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$159.88
|
| Rate for Payer: PHCS All Commercial |
$290.31
|
| Rate for Payer: PHCS All Commercial |
$290.31
|
| Rate for Payer: PHP All Commercial |
$495.78
|
| Rate for Payer: PHP All Commercial |
$495.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$290.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$290.31
|
| Rate for Payer: Sagamore Health Network All Products |
$290.31
|
| Rate for Payer: Sagamore Health Network All Products |
$290.31
|
| Rate for Payer: Signature Care EPO |
$468.35
|
| Rate for Payer: Signature Care EPO |
$468.35
|
| Rate for Payer: Signature Care PPO |
$468.35
|
| Rate for Payer: Signature Care PPO |
$468.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,800.00
|
| Rate for Payer: United Healthcare Commercial |
$302.91
|
| Rate for Payer: United Healthcare Commercial |
$302.91
|
| Rate for Payer: United Healthcare Medicare |
$308.72
|
| Rate for Payer: United Healthcare Medicare |
$308.72
|
|
|
PR CLOSED RX METACARPAL FX
|
Professional
|
Both
|
$580.24
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
z26600
|
| Min. Negotiated Rate |
$149.16 |
| Max. Negotiated Rate |
$41,000.00 |
| Rate for Payer: Aetna Commercial |
$269.95
|
| Rate for Payer: Aetna Commercial |
$269.95
|
| Rate for Payer: Aetna Medicare |
$269.95
|
| Rate for Payer: Aetna Medicare |
$269.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$322.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$322.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$322.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$322.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$322.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$322.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$322.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$322.22
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$149.16
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$149.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$285.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$285.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$310.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$310.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$296.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$296.94
|
| Rate for Payer: Cash Price |
$336.47
|
| Rate for Payer: Cash Price |
$348.14
|
| Rate for Payer: Centivo All Commercial |
$418.42
|
| Rate for Payer: Centivo All Commercial |
$418.42
|
| Rate for Payer: Cigna All Commercial |
$269.95
|
| Rate for Payer: Cigna All Commercial |
$269.95
|
| Rate for Payer: CORVEL All Commercial |
$269.95
|
| Rate for Payer: CORVEL All Commercial |
$269.95
|
| Rate for Payer: Coventry All Commercial |
$323.94
|
| Rate for Payer: Coventry All Commercial |
$323.94
|
| Rate for Payer: Encore All Commercial |
$269.95
|
| Rate for Payer: Encore All Commercial |
$269.95
|
| Rate for Payer: Frontpath All Commercial |
$368.30
|
| Rate for Payer: Frontpath All Commercial |
$368.30
|
| Rate for Payer: Humana ChoiceCare |
$196.50
|
| Rate for Payer: Humana ChoiceCare |
$196.50
|
| Rate for Payer: Humana Medicare |
$269.95
|
| Rate for Payer: Humana Medicare |
$269.95
|
| Rate for Payer: Lucent All Commercial |
$377.93
|
| Rate for Payer: Lucent All Commercial |
$377.93
|
| 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 |
$285.39
|
| Rate for Payer: Managed Health Services Medicaid |
$285.39
|
| Rate for Payer: MDWise Medicaid |
$285.39
|
| Rate for Payer: MDWise Medicaid |
$285.39
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$149.16
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$149.16
|
| Rate for Payer: PHCS All Commercial |
$269.95
|
| Rate for Payer: PHCS All Commercial |
$269.95
|
| Rate for Payer: PHP All Commercial |
$464.29
|
| Rate for Payer: PHP All Commercial |
$464.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$269.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$269.95
|
| Rate for Payer: Sagamore Health Network All Products |
$269.95
|
| Rate for Payer: Sagamore Health Network All Products |
$269.95
|
| Rate for Payer: Signature Care EPO |
$340.00
|
| Rate for Payer: Signature Care EPO |
$340.00
|
| Rate for Payer: Signature Care PPO |
$340.00
|
| Rate for Payer: Signature Care PPO |
$340.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,000.00
|
| Rate for Payer: United Healthcare Commercial |
$255.65
|
| Rate for Payer: United Healthcare Commercial |
$255.65
|
| Rate for Payer: United Healthcare Medicare |
$280.39
|
| Rate for Payer: United Healthcare Medicare |
$280.39
|
|
|
PR CLOSED RX METACARPAL FX,MANIP
|
Professional
|
Both
|
$633.26
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
z26605
|
| Min. Negotiated Rate |
$159.08 |
| Max. Negotiated Rate |
$42,500.00 |
| Rate for Payer: Aetna Commercial |
$281.14
|
| Rate for Payer: Aetna Commercial |
$281.14
|
| Rate for Payer: Aetna Medicare |
$281.14
|
| Rate for Payer: Aetna Medicare |
$281.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$435.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$435.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$435.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$435.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$435.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$435.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$435.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$435.05
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$159.08
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$159.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$311.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$311.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$323.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$323.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$309.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$309.25
|
| Rate for Payer: Cash Price |
$368.59
|
| Rate for Payer: Cash Price |
$379.96
|
| Rate for Payer: Centivo All Commercial |
$435.77
|
| Rate for Payer: Centivo All Commercial |
$435.77
|
| Rate for Payer: Cigna All Commercial |
$281.14
|
| Rate for Payer: Cigna All Commercial |
$281.14
|
| Rate for Payer: CORVEL All Commercial |
$281.14
|
| Rate for Payer: CORVEL All Commercial |
$281.14
|
| Rate for Payer: Coventry All Commercial |
$337.37
|
| Rate for Payer: Coventry All Commercial |
$337.37
|
| Rate for Payer: Encore All Commercial |
$281.14
|
| Rate for Payer: Encore All Commercial |
$281.14
|
| Rate for Payer: Frontpath All Commercial |
$385.59
|
| Rate for Payer: Frontpath All Commercial |
$385.59
|
| Rate for Payer: Humana ChoiceCare |
$278.52
|
| Rate for Payer: Humana ChoiceCare |
$278.52
|
| Rate for Payer: Humana Medicare |
$281.14
|
| Rate for Payer: Humana Medicare |
$281.14
|
| Rate for Payer: Lucent All Commercial |
$393.60
|
| Rate for Payer: Lucent All Commercial |
$393.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$454.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$454.00
|
| Rate for Payer: Managed Health Services Medicaid |
$311.46
|
| Rate for Payer: Managed Health Services Medicaid |
$311.46
|
| Rate for Payer: MDWise Medicaid |
$311.46
|
| Rate for Payer: MDWise Medicaid |
$311.46
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$159.08
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$159.08
|
| Rate for Payer: PHCS All Commercial |
$281.14
|
| Rate for Payer: PHCS All Commercial |
$281.14
|
| Rate for Payer: PHP All Commercial |
$481.53
|
| Rate for Payer: PHP All Commercial |
$481.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$281.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$281.14
|
| Rate for Payer: Sagamore Health Network All Products |
$281.14
|
| Rate for Payer: Sagamore Health Network All Products |
$281.14
|
| Rate for Payer: Signature Care EPO |
$459.00
|
| Rate for Payer: Signature Care EPO |
$459.00
|
| Rate for Payer: Signature Care PPO |
$459.00
|
| Rate for Payer: Signature Care PPO |
$459.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,500.00
|
| Rate for Payer: United Healthcare Commercial |
$291.80
|
| Rate for Payer: United Healthcare Commercial |
$291.80
|
| Rate for Payer: United Healthcare Medicare |
$307.16
|
| Rate for Payer: United Healthcare Medicare |
$307.16
|
|
|
PR CLOSED RX METACARPAL FX,PERCUT
|
Professional
|
Both
|
$908.02
|
|
|
Service Code
|
CPT 26608
|
| Hospital Charge Code |
z26608
|
| Min. Negotiated Rate |
$442.57 |
| Max. Negotiated Rate |
$68,100.00 |
| Rate for Payer: Aetna Commercial |
$452.52
|
| Rate for Payer: Aetna Commercial |
$452.52
|
| Rate for Payer: Aetna Medicare |
$452.52
|
| Rate for Payer: Aetna Medicare |
$452.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$530.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$530.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$530.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$530.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$530.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$530.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$530.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$530.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$446.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$446.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$520.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$520.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$497.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$497.77
|
| Rate for Payer: Cash Price |
$544.81
|
| Rate for Payer: Cash Price |
$531.08
|
| Rate for Payer: Centivo All Commercial |
$701.41
|
| Rate for Payer: Centivo All Commercial |
$701.41
|
| Rate for Payer: Cigna All Commercial |
$452.52
|
| Rate for Payer: Cigna All Commercial |
$452.52
|
| Rate for Payer: CORVEL All Commercial |
$452.52
|
| Rate for Payer: CORVEL All Commercial |
$452.52
|
| Rate for Payer: Coventry All Commercial |
$543.02
|
| Rate for Payer: Coventry All Commercial |
$543.02
|
| Rate for Payer: Encore All Commercial |
$452.52
|
| Rate for Payer: Encore All Commercial |
$452.52
|
| Rate for Payer: Frontpath All Commercial |
$622.56
|
| Rate for Payer: Frontpath All Commercial |
$622.56
|
| Rate for Payer: Humana ChoiceCare |
$498.32
|
| Rate for Payer: Humana ChoiceCare |
$498.32
|
| Rate for Payer: Humana Medicare |
$452.52
|
| Rate for Payer: Humana Medicare |
$452.52
|
| Rate for Payer: Lucent All Commercial |
$633.53
|
| Rate for Payer: Lucent All Commercial |
$633.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$726.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$726.00
|
| Rate for Payer: Managed Health Services Medicaid |
$446.60
|
| Rate for Payer: Managed Health Services Medicaid |
$446.60
|
| Rate for Payer: MDWise Medicaid |
$446.60
|
| Rate for Payer: MDWise Medicaid |
$446.60
|
| Rate for Payer: PHCS All Commercial |
$452.52
|
| Rate for Payer: PHCS All Commercial |
$452.52
|
| Rate for Payer: PHP All Commercial |
$770.08
|
| Rate for Payer: PHP All Commercial |
$770.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$452.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$452.52
|
| Rate for Payer: Sagamore Health Network All Products |
$452.52
|
| Rate for Payer: Sagamore Health Network All Products |
$452.52
|
| Rate for Payer: Signature Care EPO |
$674.05
|
| Rate for Payer: Signature Care EPO |
$674.05
|
| Rate for Payer: Signature Care PPO |
$674.05
|
| Rate for Payer: Signature Care PPO |
$674.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$68,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$68,100.00
|
| Rate for Payer: United Healthcare Commercial |
$498.26
|
| Rate for Payer: United Healthcare Commercial |
$498.26
|
| Rate for Payer: United Healthcare Medicare |
$442.57
|
| Rate for Payer: United Healthcare Medicare |
$442.57
|
|
|
PR CLOSED RX METACARP FX,W/MANIP,W/EXT FIX
|
Professional
|
Both
|
$951.34
|
|
|
Service Code
|
CPT 26607
|
| Hospital Charge Code |
z26607
|
| Min. Negotiated Rate |
$461.46 |
| Max. Negotiated Rate |
$71,800.00 |
| Rate for Payer: Aetna Commercial |
$480.34
|
| Rate for Payer: Aetna Commercial |
$480.34
|
| Rate for Payer: Aetna Medicare |
$480.34
|
| Rate for Payer: Aetna Medicare |
$480.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$530.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$530.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$530.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$530.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$530.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$530.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$530.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$530.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$467.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$467.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$552.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$552.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$528.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$528.37
|
| Rate for Payer: Cash Price |
$570.80
|
| Rate for Payer: Cash Price |
$560.35
|
| Rate for Payer: Centivo All Commercial |
$744.53
|
| Rate for Payer: Centivo All Commercial |
$744.53
|
| Rate for Payer: Cigna All Commercial |
$480.34
|
| Rate for Payer: Cigna All Commercial |
$480.34
|
| Rate for Payer: CORVEL All Commercial |
$480.34
|
| Rate for Payer: CORVEL All Commercial |
$480.34
|
| Rate for Payer: Coventry All Commercial |
$576.41
|
| Rate for Payer: Coventry All Commercial |
$576.41
|
| Rate for Payer: Encore All Commercial |
$480.34
|
| Rate for Payer: Encore All Commercial |
$480.34
|
| Rate for Payer: Frontpath All Commercial |
$660.97
|
| Rate for Payer: Frontpath All Commercial |
$660.97
|
| Rate for Payer: Humana ChoiceCare |
$498.92
|
| Rate for Payer: Humana ChoiceCare |
$498.92
|
| Rate for Payer: Humana Medicare |
$480.34
|
| Rate for Payer: Humana Medicare |
$480.34
|
| Rate for Payer: Lucent All Commercial |
$672.48
|
| Rate for Payer: Lucent All Commercial |
$672.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$766.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$766.00
|
| Rate for Payer: Managed Health Services Medicaid |
$467.90
|
| Rate for Payer: Managed Health Services Medicaid |
$467.90
|
| Rate for Payer: MDWise Medicaid |
$467.90
|
| Rate for Payer: MDWise Medicaid |
$467.90
|
| Rate for Payer: PHCS All Commercial |
$480.34
|
| Rate for Payer: PHCS All Commercial |
$480.34
|
| Rate for Payer: PHP All Commercial |
$812.51
|
| Rate for Payer: PHP All Commercial |
$812.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$480.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$480.34
|
| Rate for Payer: Sagamore Health Network All Products |
$480.34
|
| Rate for Payer: Sagamore Health Network All Products |
$480.34
|
| Rate for Payer: Signature Care EPO |
$673.20
|
| Rate for Payer: Signature Care EPO |
$673.20
|
| Rate for Payer: Signature Care PPO |
$673.20
|
| Rate for Payer: Signature Care PPO |
$673.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71,800.00
|
| Rate for Payer: United Healthcare Commercial |
$461.46
|
| Rate for Payer: United Healthcare Commercial |
$461.46
|
| Rate for Payer: United Healthcare Medicare |
$466.96
|
| Rate for Payer: United Healthcare Medicare |
$466.96
|
|
|
PR CLOSED RX METATARSAL FX
|
Professional
|
Both
|
$417.66
|
|
|
Service Code
|
CPT 28470
|
| Hospital Charge Code |
z28470
|
| Min. Negotiated Rate |
$116.62 |
| Max. Negotiated Rate |
$29,200.00 |
| Rate for Payer: Aetna Commercial |
$193.27
|
| Rate for Payer: Aetna Commercial |
$193.27
|
| Rate for Payer: Aetna Medicare |
$193.27
|
| Rate for Payer: Aetna Medicare |
$193.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$222.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$222.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$222.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$222.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$222.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$222.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$222.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$222.08
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$116.62
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$116.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$205.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$205.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$222.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$222.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$212.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$212.60
|
| Rate for Payer: Cash Price |
$242.12
|
| Rate for Payer: Cash Price |
$250.60
|
| Rate for Payer: Centivo All Commercial |
$299.57
|
| Rate for Payer: Centivo All Commercial |
$299.57
|
| Rate for Payer: Cigna All Commercial |
$193.27
|
| Rate for Payer: Cigna All Commercial |
$193.27
|
| Rate for Payer: CORVEL All Commercial |
$193.27
|
| Rate for Payer: CORVEL All Commercial |
$193.27
|
| Rate for Payer: Coventry All Commercial |
$231.92
|
| Rate for Payer: Coventry All Commercial |
$231.92
|
| Rate for Payer: Encore All Commercial |
$193.27
|
| Rate for Payer: Encore All Commercial |
$193.27
|
| Rate for Payer: Frontpath All Commercial |
$261.68
|
| Rate for Payer: Frontpath All Commercial |
$261.68
|
| Rate for Payer: Humana ChoiceCare |
$189.49
|
| Rate for Payer: Humana ChoiceCare |
$189.49
|
| Rate for Payer: Humana Medicare |
$193.27
|
| Rate for Payer: Humana Medicare |
$193.27
|
| Rate for Payer: Lucent All Commercial |
$270.58
|
| Rate for Payer: Lucent All Commercial |
$270.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.00
|
| Rate for Payer: Managed Health Services Medicaid |
$205.42
|
| Rate for Payer: Managed Health Services Medicaid |
$205.42
|
| Rate for Payer: MDWise Medicaid |
$205.42
|
| Rate for Payer: MDWise Medicaid |
$205.42
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$116.62
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$116.62
|
| Rate for Payer: PHCS All Commercial |
$193.27
|
| Rate for Payer: PHCS All Commercial |
$193.27
|
| Rate for Payer: PHP All Commercial |
$330.11
|
| Rate for Payer: PHP All Commercial |
$330.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$193.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$193.27
|
| Rate for Payer: Sagamore Health Network All Products |
$193.27
|
| Rate for Payer: Sagamore Health Network All Products |
$193.27
|
| Rate for Payer: Signature Care EPO |
$330.65
|
| Rate for Payer: Signature Care EPO |
$330.65
|
| Rate for Payer: Signature Care PPO |
$330.65
|
| Rate for Payer: Signature Care PPO |
$330.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29,200.00
|
| Rate for Payer: United Healthcare Commercial |
$195.90
|
| Rate for Payer: United Healthcare Commercial |
$195.90
|
| Rate for Payer: United Healthcare Medicare |
$201.77
|
| Rate for Payer: United Healthcare Medicare |
$201.77
|
|
|
PR CLOSED RX METATARSAL FX,MANIP
|
Professional
|
Both
|
$498.38
|
|
|
Service Code
|
CPT 28475
|
| Hospital Charge Code |
z28475
|
| Min. Negotiated Rate |
$141.77 |
| Max. Negotiated Rate |
$32,400.00 |
| Rate for Payer: Aetna Commercial |
$213.66
|
| Rate for Payer: Aetna Commercial |
$213.66
|
| Rate for Payer: Aetna Medicare |
$213.66
|
| Rate for Payer: Aetna Medicare |
$213.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$276.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$276.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$276.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$276.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$276.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$276.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$276.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$276.94
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$141.77
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$141.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$245.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$245.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$245.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$245.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$235.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$235.03
|
| Rate for Payer: Cash Price |
$287.57
|
| Rate for Payer: Cash Price |
$299.03
|
| Rate for Payer: Centivo All Commercial |
$331.17
|
| Rate for Payer: Centivo All Commercial |
$331.17
|
| Rate for Payer: Cigna All Commercial |
$213.66
|
| Rate for Payer: Cigna All Commercial |
$213.66
|
| Rate for Payer: CORVEL All Commercial |
$213.66
|
| Rate for Payer: CORVEL All Commercial |
$213.66
|
| Rate for Payer: Coventry All Commercial |
$256.39
|
| Rate for Payer: Coventry All Commercial |
$256.39
|
| Rate for Payer: Encore All Commercial |
$213.66
|
| Rate for Payer: Encore All Commercial |
$213.66
|
| Rate for Payer: Frontpath All Commercial |
$289.34
|
| Rate for Payer: Frontpath All Commercial |
$289.34
|
| Rate for Payer: Humana ChoiceCare |
$265.40
|
| Rate for Payer: Humana ChoiceCare |
$265.40
|
| Rate for Payer: Humana Medicare |
$213.66
|
| Rate for Payer: Humana Medicare |
$213.66
|
| Rate for Payer: Lucent All Commercial |
$299.12
|
| Rate for Payer: Lucent All Commercial |
$299.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$346.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$346.00
|
| Rate for Payer: Managed Health Services Medicaid |
$245.12
|
| Rate for Payer: Managed Health Services Medicaid |
$245.12
|
| Rate for Payer: MDWise Medicaid |
$245.12
|
| Rate for Payer: MDWise Medicaid |
$245.12
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$141.77
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$141.77
|
| Rate for Payer: PHCS All Commercial |
$213.66
|
| Rate for Payer: PHCS All Commercial |
$213.66
|
| Rate for Payer: PHP All Commercial |
$367.18
|
| Rate for Payer: PHP All Commercial |
$367.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$213.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$213.66
|
| Rate for Payer: Sagamore Health Network All Products |
$213.66
|
| Rate for Payer: Sagamore Health Network All Products |
$213.66
|
| Rate for Payer: Signature Care EPO |
$402.05
|
| Rate for Payer: Signature Care EPO |
$402.05
|
| Rate for Payer: Signature Care PPO |
$402.05
|
| Rate for Payer: Signature Care PPO |
$402.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,400.00
|
| Rate for Payer: United Healthcare Commercial |
$256.28
|
| Rate for Payer: United Healthcare Commercial |
$256.28
|
| Rate for Payer: United Healthcare Medicare |
$239.64
|
| Rate for Payer: United Healthcare Medicare |
$239.64
|
|
|
PR CLOSED RX MID HUMERUS FRACTURE
|
Professional
|
Both
|
$672.68
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
z24500
|
| Min. Negotiated Rate |
$173.90 |
| Max. Negotiated Rate |
$47,700.00 |
| Rate for Payer: Aetna Commercial |
$314.73
|
| Rate for Payer: Aetna Commercial |
$314.73
|
| Rate for Payer: Aetna Medicare |
$314.73
|
| Rate for Payer: Aetna Medicare |
$314.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$462.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$462.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$462.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$462.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$462.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$462.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$462.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$462.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$173.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$173.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$342.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$342.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$361.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$361.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$346.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$346.20
|
| Rate for Payer: Cash Price |
$417.70
|
| Rate for Payer: Cash Price |
$403.61
|
| Rate for Payer: Centivo All Commercial |
$487.83
|
| Rate for Payer: Centivo All Commercial |
$487.83
|
| Rate for Payer: Cigna All Commercial |
$314.73
|
| Rate for Payer: Cigna All Commercial |
$314.73
|
| Rate for Payer: CORVEL All Commercial |
$314.73
|
| Rate for Payer: CORVEL All Commercial |
$314.73
|
| Rate for Payer: Coventry All Commercial |
$377.68
|
| Rate for Payer: Coventry All Commercial |
$377.68
|
| Rate for Payer: Encore All Commercial |
$314.73
|
| Rate for Payer: Encore All Commercial |
$314.73
|
| Rate for Payer: Frontpath All Commercial |
$431.60
|
| Rate for Payer: Frontpath All Commercial |
$431.60
|
| Rate for Payer: Humana ChoiceCare |
$295.61
|
| Rate for Payer: Humana ChoiceCare |
$295.61
|
| Rate for Payer: Humana Medicare |
$314.73
|
| Rate for Payer: Humana Medicare |
$314.73
|
| Rate for Payer: Lucent All Commercial |
$440.62
|
| Rate for Payer: Lucent All Commercial |
$440.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$509.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$509.00
|
| Rate for Payer: Managed Health Services Medicaid |
$342.40
|
| Rate for Payer: Managed Health Services Medicaid |
$342.40
|
| Rate for Payer: MDWise Medicaid |
$342.40
|
| Rate for Payer: MDWise Medicaid |
$342.40
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$173.90
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$173.90
|
| Rate for Payer: PHCS All Commercial |
$314.73
|
| Rate for Payer: PHCS All Commercial |
$314.73
|
| Rate for Payer: PHP All Commercial |
$539.64
|
| Rate for Payer: PHP All Commercial |
$539.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$314.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$314.73
|
| Rate for Payer: Sagamore Health Network All Products |
$314.73
|
| Rate for Payer: Sagamore Health Network All Products |
$314.73
|
| Rate for Payer: Signature Care EPO |
$488.75
|
| Rate for Payer: Signature Care EPO |
$488.75
|
| Rate for Payer: Signature Care PPO |
$488.75
|
| Rate for Payer: Signature Care PPO |
$488.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,700.00
|
| Rate for Payer: United Healthcare Commercial |
$318.68
|
| Rate for Payer: United Healthcare Commercial |
$318.68
|
| Rate for Payer: United Healthcare Medicare |
$336.34
|
| Rate for Payer: United Healthcare Medicare |
$336.34
|
|
|
PR CLOSED RX MID HUMERUS FX,MANIPULATN
|
Professional
|
Both
|
$958.82
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
z24505
|
| Min. Negotiated Rate |
$284.52 |
| Max. Negotiated Rate |
$64,100.00 |
| Rate for Payer: Aetna Commercial |
$425.36
|
| Rate for Payer: Aetna Commercial |
$425.36
|
| Rate for Payer: Aetna Medicare |
$425.36
|
| Rate for Payer: Aetna Medicare |
$425.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$616.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$616.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$616.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$616.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$616.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$616.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$616.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$616.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$284.52
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$284.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$471.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$471.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$489.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$489.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$467.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$467.90
|
| Rate for Payer: Cash Price |
$558.37
|
| Rate for Payer: Cash Price |
$575.29
|
| Rate for Payer: Centivo All Commercial |
$659.31
|
| Rate for Payer: Centivo All Commercial |
$659.31
|
| Rate for Payer: Cigna All Commercial |
$425.36
|
| Rate for Payer: Cigna All Commercial |
$425.36
|
| Rate for Payer: CORVEL All Commercial |
$425.36
|
| Rate for Payer: CORVEL All Commercial |
$425.36
|
| Rate for Payer: Coventry All Commercial |
$510.43
|
| Rate for Payer: Coventry All Commercial |
$510.43
|
| Rate for Payer: Encore All Commercial |
$425.36
|
| Rate for Payer: Encore All Commercial |
$425.36
|
| Rate for Payer: Frontpath All Commercial |
$588.25
|
| Rate for Payer: Frontpath All Commercial |
$588.25
|
| Rate for Payer: Humana ChoiceCare |
$456.20
|
| Rate for Payer: Humana ChoiceCare |
$456.20
|
| Rate for Payer: Humana Medicare |
$425.36
|
| Rate for Payer: Humana Medicare |
$425.36
|
| Rate for Payer: Lucent All Commercial |
$595.50
|
| Rate for Payer: Lucent All Commercial |
$595.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$684.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$684.00
|
| Rate for Payer: Managed Health Services Medicaid |
$471.58
|
| Rate for Payer: Managed Health Services Medicaid |
$471.58
|
| Rate for Payer: MDWise Medicaid |
$471.58
|
| Rate for Payer: MDWise Medicaid |
$471.58
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$284.52
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$284.52
|
| Rate for Payer: PHCS All Commercial |
$425.36
|
| Rate for Payer: PHCS All Commercial |
$425.36
|
| Rate for Payer: PHP All Commercial |
$725.78
|
| Rate for Payer: PHP All Commercial |
$725.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$425.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$425.36
|
| Rate for Payer: Sagamore Health Network All Products |
$425.36
|
| Rate for Payer: Sagamore Health Network All Products |
$425.36
|
| Rate for Payer: Signature Care EPO |
$713.15
|
| Rate for Payer: Signature Care EPO |
$713.15
|
| Rate for Payer: Signature Care PPO |
$713.15
|
| Rate for Payer: Signature Care PPO |
$713.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$64,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$64,100.00
|
| Rate for Payer: United Healthcare Commercial |
$469.31
|
| Rate for Payer: United Healthcare Commercial |
$469.31
|
| Rate for Payer: United Healthcare Medicare |
$465.31
|
| Rate for Payer: United Healthcare Medicare |
$465.31
|
|
|
PR CLOSED RX MT-PHAL TOE DISLOCATION
|
Professional
|
Both
|
$291.56
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
z28630
|
| Min. Negotiated Rate |
$56.41 |
| Max. Negotiated Rate |
$160.94 |
| Rate for Payer: Aetna Commercial |
$103.83
|
| Rate for Payer: Aetna Commercial |
$103.83
|
| Rate for Payer: Aetna Medicare |
$103.83
|
| Rate for Payer: Aetna Medicare |
$103.83
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.41
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$143.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$143.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$119.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$119.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$114.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$114.21
|
| Rate for Payer: Cash Price |
$172.81
|
| Rate for Payer: Cash Price |
$174.94
|
| Rate for Payer: Centivo All Commercial |
$160.94
|
| Rate for Payer: Centivo All Commercial |
$160.94
|
| Rate for Payer: Cigna All Commercial |
$103.83
|
| Rate for Payer: Cigna All Commercial |
$103.83
|
| Rate for Payer: CORVEL All Commercial |
$103.83
|
| Rate for Payer: CORVEL All Commercial |
$103.83
|
| Rate for Payer: Coventry All Commercial |
$124.60
|
| Rate for Payer: Coventry All Commercial |
$124.60
|
| Rate for Payer: Encore All Commercial |
$103.83
|
| Rate for Payer: Encore All Commercial |
$103.83
|
| Rate for Payer: Frontpath All Commercial |
$142.79
|
| Rate for Payer: Frontpath All Commercial |
$142.79
|
| Rate for Payer: Humana ChoiceCare |
$117.58
|
| Rate for Payer: Humana ChoiceCare |
$117.58
|
| Rate for Payer: Humana Medicare |
$103.83
|
| Rate for Payer: Humana Medicare |
$103.83
|
| Rate for Payer: Lucent All Commercial |
$145.36
|
| Rate for Payer: Lucent All Commercial |
$145.36
|
| Rate for Payer: Managed Health Services Medicaid |
$143.41
|
| Rate for Payer: Managed Health Services Medicaid |
$143.41
|
| Rate for Payer: MDWise Medicaid |
$143.41
|
| Rate for Payer: MDWise Medicaid |
$143.41
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$56.41
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$56.41
|
| Rate for Payer: PHCS All Commercial |
$103.83
|
| Rate for Payer: PHCS All Commercial |
$103.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$103.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$103.83
|
| Rate for Payer: Sagamore Health Network All Products |
$103.83
|
| Rate for Payer: Sagamore Health Network All Products |
$103.83
|
| Rate for Payer: United Healthcare Commercial |
$121.44
|
| Rate for Payer: United Healthcare Commercial |
$121.44
|
| Rate for Payer: United Healthcare Medicare |
$141.45
|
| Rate for Payer: United Healthcare Medicare |
$141.45
|
|
|
PR CLOSED RX NAVIC/LUNATE FX/DISLOC
|
Professional
|
Both
|
$999.94
|
|
|
Service Code
|
CPT 25680
|
| Hospital Charge Code |
z25680
|
| Min. Negotiated Rate |
$463.81 |
| Max. Negotiated Rate |
$74,900.00 |
| Rate for Payer: Aetna Commercial |
$497.04
|
| Rate for Payer: Aetna Commercial |
$497.04
|
| Rate for Payer: Aetna Medicare |
$497.04
|
| Rate for Payer: Aetna Medicare |
$497.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$501.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$491.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$491.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$571.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$571.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$546.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$546.74
|
| Rate for Payer: Cash Price |
$599.96
|
| Rate for Payer: Cash Price |
$584.26
|
| Rate for Payer: Centivo All Commercial |
$770.41
|
| Rate for Payer: Centivo All Commercial |
$770.41
|
| Rate for Payer: Cigna All Commercial |
$497.04
|
| Rate for Payer: Cigna All Commercial |
$497.04
|
| Rate for Payer: CORVEL All Commercial |
$497.04
|
| Rate for Payer: CORVEL All Commercial |
$497.04
|
| Rate for Payer: Coventry All Commercial |
$596.45
|
| Rate for Payer: Coventry All Commercial |
$596.45
|
| Rate for Payer: Encore All Commercial |
$497.04
|
| Rate for Payer: Encore All Commercial |
$497.04
|
| Rate for Payer: Frontpath All Commercial |
$687.56
|
| Rate for Payer: Frontpath All Commercial |
$687.56
|
| Rate for Payer: Humana ChoiceCare |
$463.81
|
| Rate for Payer: Humana ChoiceCare |
$463.81
|
| Rate for Payer: Humana Medicare |
$497.04
|
| Rate for Payer: Humana Medicare |
$497.04
|
| Rate for Payer: Lucent All Commercial |
$695.86
|
| Rate for Payer: Lucent All Commercial |
$695.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$798.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$798.00
|
| Rate for Payer: Managed Health Services Medicaid |
$491.81
|
| Rate for Payer: Managed Health Services Medicaid |
$491.81
|
| Rate for Payer: MDWise Medicaid |
$491.81
|
| Rate for Payer: MDWise Medicaid |
$491.81
|
| Rate for Payer: PHCS All Commercial |
$497.04
|
| Rate for Payer: PHCS All Commercial |
$497.04
|
| Rate for Payer: PHP All Commercial |
$847.17
|
| Rate for Payer: PHP All Commercial |
$847.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$497.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$497.04
|
| Rate for Payer: Sagamore Health Network All Products |
$497.04
|
| Rate for Payer: Sagamore Health Network All Products |
$497.04
|
| Rate for Payer: Signature Care EPO |
$621.35
|
| Rate for Payer: Signature Care EPO |
$621.35
|
| Rate for Payer: Signature Care PPO |
$621.35
|
| Rate for Payer: Signature Care PPO |
$621.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$74,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$74,900.00
|
| Rate for Payer: United Healthcare Commercial |
$483.48
|
| Rate for Payer: United Healthcare Commercial |
$483.48
|
| Rate for Payer: United Healthcare Medicare |
$486.88
|
| Rate for Payer: United Healthcare Medicare |
$486.88
|
|
|
PR CLOSED RX NAVICULAR FX
|
Professional
|
Both
|
$592.64
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
z25622
|
| Min. Negotiated Rate |
$147.94 |
| Max. Negotiated Rate |
$40,700.00 |
| Rate for Payer: Aetna Commercial |
$267.82
|
| Rate for Payer: Aetna Commercial |
$267.82
|
| Rate for Payer: Aetna Medicare |
$267.82
|
| Rate for Payer: Aetna Medicare |
$267.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$388.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$388.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$388.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$388.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$388.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$388.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$147.94
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$147.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$291.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$291.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$307.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$307.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$294.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$294.60
|
| Rate for Payer: Cash Price |
$344.03
|
| Rate for Payer: Cash Price |
$355.58
|
| Rate for Payer: Centivo All Commercial |
$415.12
|
| Rate for Payer: Centivo All Commercial |
$415.12
|
| Rate for Payer: Cigna All Commercial |
$267.82
|
| Rate for Payer: Cigna All Commercial |
$267.82
|
| Rate for Payer: CORVEL All Commercial |
$267.82
|
| Rate for Payer: CORVEL All Commercial |
$267.82
|
| Rate for Payer: Coventry All Commercial |
$321.38
|
| Rate for Payer: Coventry All Commercial |
$321.38
|
| Rate for Payer: Encore All Commercial |
$267.82
|
| Rate for Payer: Encore All Commercial |
$267.82
|
| Rate for Payer: Frontpath All Commercial |
$366.50
|
| Rate for Payer: Frontpath All Commercial |
$366.50
|
| Rate for Payer: Humana ChoiceCare |
$244.77
|
| Rate for Payer: Humana ChoiceCare |
$244.77
|
| Rate for Payer: Humana Medicare |
$267.82
|
| Rate for Payer: Humana Medicare |
$267.82
|
| Rate for Payer: Lucent All Commercial |
$374.95
|
| Rate for Payer: Lucent All Commercial |
$374.95
|
| 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 |
$291.48
|
| Rate for Payer: Managed Health Services Medicaid |
$291.48
|
| Rate for Payer: MDWise Medicaid |
$291.48
|
| Rate for Payer: MDWise Medicaid |
$291.48
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$147.94
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$147.94
|
| Rate for Payer: PHCS All Commercial |
$267.82
|
| Rate for Payer: PHCS All Commercial |
$267.82
|
| Rate for Payer: PHP All Commercial |
$460.59
|
| Rate for Payer: PHP All Commercial |
$460.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$267.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$267.82
|
| Rate for Payer: Sagamore Health Network All Products |
$267.82
|
| Rate for Payer: Sagamore Health Network All Products |
$267.82
|
| Rate for Payer: Signature Care EPO |
$410.55
|
| Rate for Payer: Signature Care EPO |
$410.55
|
| Rate for Payer: Signature Care PPO |
$410.55
|
| Rate for Payer: Signature Care PPO |
$410.55
|
| 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 |
$267.64
|
| Rate for Payer: United Healthcare Commercial |
$267.64
|
| Rate for Payer: United Healthcare Medicare |
$286.69
|
| Rate for Payer: United Healthcare Medicare |
$286.69
|
|
|
PR CLOSED RX PATELLA FX
|
Professional
|
Both
|
$625.04
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
z27520
|
| Min. Negotiated Rate |
$173.38 |
| Max. Negotiated Rate |
$43,000.00 |
| Rate for Payer: Aetna Commercial |
$283.67
|
| Rate for Payer: Aetna Commercial |
$283.67
|
| Rate for Payer: Aetna Medicare |
$283.67
|
| Rate for Payer: Aetna Medicare |
$283.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$434.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$434.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$434.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$434.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$434.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$434.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$434.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$434.03
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$173.38
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$173.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$307.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$307.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.04
|
| Rate for Payer: Cash Price |
$363.04
|
| Rate for Payer: Cash Price |
$375.02
|
| Rate for Payer: Centivo All Commercial |
$439.69
|
| Rate for Payer: Centivo All Commercial |
$439.69
|
| Rate for Payer: Cigna All Commercial |
$283.67
|
| Rate for Payer: Cigna All Commercial |
$283.67
|
| Rate for Payer: CORVEL All Commercial |
$283.67
|
| Rate for Payer: CORVEL All Commercial |
$283.67
|
| Rate for Payer: Coventry All Commercial |
$340.40
|
| Rate for Payer: Coventry All Commercial |
$340.40
|
| Rate for Payer: Encore All Commercial |
$283.67
|
| Rate for Payer: Encore All Commercial |
$283.67
|
| Rate for Payer: Frontpath All Commercial |
$388.92
|
| Rate for Payer: Frontpath All Commercial |
$388.92
|
| Rate for Payer: Humana ChoiceCare |
$270.27
|
| Rate for Payer: Humana ChoiceCare |
$270.27
|
| Rate for Payer: Humana Medicare |
$283.67
|
| Rate for Payer: Humana Medicare |
$283.67
|
| Rate for Payer: Lucent All Commercial |
$397.14
|
| Rate for Payer: Lucent All Commercial |
$397.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$459.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$459.00
|
| Rate for Payer: Managed Health Services Medicaid |
$307.42
|
| Rate for Payer: Managed Health Services Medicaid |
$307.42
|
| Rate for Payer: MDWise Medicaid |
$307.42
|
| Rate for Payer: MDWise Medicaid |
$307.42
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$173.38
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$173.38
|
| Rate for Payer: PHCS All Commercial |
$283.67
|
| Rate for Payer: PHCS All Commercial |
$283.67
|
| Rate for Payer: PHP All Commercial |
$486.57
|
| Rate for Payer: PHP All Commercial |
$486.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$283.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$283.67
|
| Rate for Payer: Sagamore Health Network All Products |
$283.67
|
| Rate for Payer: Sagamore Health Network All Products |
$283.67
|
| Rate for Payer: Signature Care EPO |
$458.15
|
| Rate for Payer: Signature Care EPO |
$458.15
|
| Rate for Payer: Signature Care PPO |
$458.15
|
| Rate for Payer: Signature Care PPO |
$458.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,000.00
|
| Rate for Payer: United Healthcare Commercial |
$290.05
|
| Rate for Payer: United Healthcare Commercial |
$290.05
|
| Rate for Payer: United Healthcare Medicare |
$302.53
|
| Rate for Payer: United Healthcare Medicare |
$302.53
|
|
|
PR CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Professional
|
Both
|
$786.74
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
z27265
|
| Min. Negotiated Rate |
$381.74 |
| Max. Negotiated Rate |
$58,700.00 |
| Rate for Payer: Aetna Commercial |
$384.49
|
| Rate for Payer: Aetna Commercial |
$384.49
|
| Rate for Payer: Aetna Medicare |
$384.49
|
| Rate for Payer: Aetna Medicare |
$384.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$470.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$386.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$386.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$442.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$442.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$422.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$422.94
|
| Rate for Payer: Cash Price |
$472.04
|
| Rate for Payer: Cash Price |
$458.09
|
| Rate for Payer: Centivo All Commercial |
$595.96
|
| Rate for Payer: Centivo All Commercial |
$595.96
|
| Rate for Payer: Cigna All Commercial |
$384.49
|
| Rate for Payer: Cigna All Commercial |
$384.49
|
| Rate for Payer: CORVEL All Commercial |
$384.49
|
| Rate for Payer: CORVEL All Commercial |
$384.49
|
| Rate for Payer: Coventry All Commercial |
$461.39
|
| Rate for Payer: Coventry All Commercial |
$461.39
|
| Rate for Payer: Encore All Commercial |
$384.49
|
| Rate for Payer: Encore All Commercial |
$384.49
|
| Rate for Payer: Frontpath All Commercial |
$533.61
|
| Rate for Payer: Frontpath All Commercial |
$533.61
|
| Rate for Payer: Humana ChoiceCare |
$421.89
|
| Rate for Payer: Humana ChoiceCare |
$421.89
|
| Rate for Payer: Humana Medicare |
$384.49
|
| Rate for Payer: Humana Medicare |
$384.49
|
| Rate for Payer: Lucent All Commercial |
$538.29
|
| Rate for Payer: Lucent All Commercial |
$538.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$626.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$626.00
|
| Rate for Payer: Managed Health Services Medicaid |
$386.95
|
| Rate for Payer: Managed Health Services Medicaid |
$386.95
|
| Rate for Payer: MDWise Medicaid |
$386.95
|
| Rate for Payer: MDWise Medicaid |
$386.95
|
| Rate for Payer: PHCS All Commercial |
$384.49
|
| Rate for Payer: PHCS All Commercial |
$384.49
|
| Rate for Payer: PHP All Commercial |
$664.22
|
| Rate for Payer: PHP All Commercial |
$664.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$384.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$384.49
|
| Rate for Payer: Sagamore Health Network All Products |
$384.49
|
| Rate for Payer: Sagamore Health Network All Products |
$384.49
|
| Rate for Payer: Signature Care EPO |
$568.65
|
| Rate for Payer: Signature Care EPO |
$568.65
|
| Rate for Payer: Signature Care PPO |
$568.65
|
| Rate for Payer: Signature Care PPO |
$568.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$58,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$58,700.00
|
| Rate for Payer: United Healthcare Commercial |
$416.70
|
| Rate for Payer: United Healthcare Commercial |
$416.70
|
| Rate for Payer: United Healthcare Medicare |
$381.74
|
| Rate for Payer: United Healthcare Medicare |
$381.74
|
|
|
PR CLOSED RX POST HIP FIX DISLOC,ANESTH
|
Professional
|
Both
|
$1,086.14
|
|
|
Service Code
|
CPT 27266
|
| Hospital Charge Code |
z27266
|
| Min. Negotiated Rate |
$532.74 |
| Max. Negotiated Rate |
$81,900.00 |
| Rate for Payer: Aetna Commercial |
$546.79
|
| Rate for Payer: Aetna Commercial |
$546.79
|
| Rate for Payer: Aetna Medicare |
$546.79
|
| Rate for Payer: Aetna Medicare |
$546.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$654.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$654.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$654.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$654.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$654.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$654.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$654.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$654.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$534.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$534.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$628.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$628.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$601.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$601.47
|
| Rate for Payer: Cash Price |
$651.68
|
| Rate for Payer: Cash Price |
$639.29
|
| Rate for Payer: Centivo All Commercial |
$847.52
|
| Rate for Payer: Centivo All Commercial |
$847.52
|
| Rate for Payer: Cigna All Commercial |
$546.79
|
| Rate for Payer: Cigna All Commercial |
$546.79
|
| Rate for Payer: CORVEL All Commercial |
$546.79
|
| Rate for Payer: CORVEL All Commercial |
$546.79
|
| Rate for Payer: Coventry All Commercial |
$656.15
|
| Rate for Payer: Coventry All Commercial |
$656.15
|
| Rate for Payer: Encore All Commercial |
$546.79
|
| Rate for Payer: Encore All Commercial |
$546.79
|
| Rate for Payer: Frontpath All Commercial |
$760.55
|
| Rate for Payer: Frontpath All Commercial |
$760.55
|
| Rate for Payer: Humana ChoiceCare |
$602.68
|
| Rate for Payer: Humana ChoiceCare |
$602.68
|
| Rate for Payer: Humana Medicare |
$546.79
|
| Rate for Payer: Humana Medicare |
$546.79
|
| Rate for Payer: Lucent All Commercial |
$765.51
|
| Rate for Payer: Lucent All Commercial |
$765.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$874.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$874.00
|
| Rate for Payer: Managed Health Services Medicaid |
$534.20
|
| Rate for Payer: Managed Health Services Medicaid |
$534.20
|
| Rate for Payer: MDWise Medicaid |
$534.20
|
| Rate for Payer: MDWise Medicaid |
$534.20
|
| Rate for Payer: PHCS All Commercial |
$546.79
|
| Rate for Payer: PHCS All Commercial |
$546.79
|
| Rate for Payer: PHP All Commercial |
$926.97
|
| Rate for Payer: PHP All Commercial |
$926.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$546.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$546.79
|
| Rate for Payer: Sagamore Health Network All Products |
$546.79
|
| Rate for Payer: Sagamore Health Network All Products |
$546.79
|
| Rate for Payer: Signature Care EPO |
$803.25
|
| Rate for Payer: Signature Care EPO |
$803.25
|
| Rate for Payer: Signature Care PPO |
$803.25
|
| Rate for Payer: Signature Care PPO |
$803.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$81,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$81,900.00
|
| Rate for Payer: United Healthcare Commercial |
$622.33
|
| Rate for Payer: United Healthcare Commercial |
$622.33
|
| Rate for Payer: United Healthcare Medicare |
$532.74
|
| Rate for Payer: United Healthcare Medicare |
$532.74
|
|
|
PR CLOSED RX PROX HUMERUS FRACTURE
|
Professional
|
Both
|
$639.86
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
z23600
|
| Min. Negotiated Rate |
$173.86 |
| Max. Negotiated Rate |
$45,100.00 |
| Rate for Payer: Aetna Commercial |
$297.54
|
| Rate for Payer: Aetna Commercial |
$297.54
|
| Rate for Payer: Aetna Medicare |
$297.54
|
| Rate for Payer: Aetna Medicare |
$297.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$464.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$464.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$464.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$464.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$464.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$464.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$464.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$464.02
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$173.86
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$173.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$314.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$314.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$342.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$342.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$327.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$327.29
|
| Rate for Payer: Cash Price |
$371.74
|
| Rate for Payer: Cash Price |
$383.92
|
| Rate for Payer: Centivo All Commercial |
$461.19
|
| Rate for Payer: Centivo All Commercial |
$461.19
|
| Rate for Payer: Cigna All Commercial |
$297.54
|
| Rate for Payer: Cigna All Commercial |
$297.54
|
| Rate for Payer: CORVEL All Commercial |
$297.54
|
| Rate for Payer: CORVEL All Commercial |
$297.54
|
| Rate for Payer: Coventry All Commercial |
$357.05
|
| Rate for Payer: Coventry All Commercial |
$357.05
|
| Rate for Payer: Encore All Commercial |
$297.54
|
| Rate for Payer: Encore All Commercial |
$297.54
|
| Rate for Payer: Frontpath All Commercial |
$407.24
|
| Rate for Payer: Frontpath All Commercial |
$407.24
|
| Rate for Payer: Humana ChoiceCare |
$277.86
|
| Rate for Payer: Humana ChoiceCare |
$277.86
|
| Rate for Payer: Humana Medicare |
$297.54
|
| Rate for Payer: Humana Medicare |
$297.54
|
| Rate for Payer: Lucent All Commercial |
$416.56
|
| Rate for Payer: Lucent All Commercial |
$416.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$481.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$481.00
|
| Rate for Payer: Managed Health Services Medicaid |
$314.71
|
| Rate for Payer: Managed Health Services Medicaid |
$314.71
|
| Rate for Payer: MDWise Medicaid |
$314.71
|
| Rate for Payer: MDWise Medicaid |
$314.71
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$173.86
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$173.86
|
| Rate for Payer: PHCS All Commercial |
$297.54
|
| Rate for Payer: PHCS All Commercial |
$297.54
|
| Rate for Payer: PHP All Commercial |
$510.72
|
| Rate for Payer: PHP All Commercial |
$510.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$297.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$297.54
|
| Rate for Payer: Sagamore Health Network All Products |
$297.54
|
| Rate for Payer: Sagamore Health Network All Products |
$297.54
|
| Rate for Payer: Signature Care EPO |
$489.60
|
| Rate for Payer: Signature Care EPO |
$489.60
|
| Rate for Payer: Signature Care PPO |
$489.60
|
| Rate for Payer: Signature Care PPO |
$489.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$45,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$45,100.00
|
| Rate for Payer: United Healthcare Commercial |
$298.45
|
| Rate for Payer: United Healthcare Commercial |
$298.45
|
| Rate for Payer: United Healthcare Medicare |
$309.78
|
| Rate for Payer: United Healthcare Medicare |
$309.78
|
|
|
PR CLOSED RX PROX HUMERUS FX,MANIP
|
Professional
|
Both
|
$893.14
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
z23605
|
| Min. Negotiated Rate |
$267.44 |
| Max. Negotiated Rate |
$60,600.00 |
| Rate for Payer: Aetna Commercial |
$401.44
|
| Rate for Payer: Aetna Commercial |
$401.44
|
| Rate for Payer: Aetna Medicare |
$401.44
|
| Rate for Payer: Aetna Medicare |
$401.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$545.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$545.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$545.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$545.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$545.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$545.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$545.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$545.00
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$267.44
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$267.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$439.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$439.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$461.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$461.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$441.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$441.58
|
| Rate for Payer: Cash Price |
$521.20
|
| Rate for Payer: Cash Price |
$535.88
|
| Rate for Payer: Centivo All Commercial |
$622.23
|
| Rate for Payer: Centivo All Commercial |
$622.23
|
| Rate for Payer: Cigna All Commercial |
$401.44
|
| Rate for Payer: Cigna All Commercial |
$401.44
|
| Rate for Payer: CORVEL All Commercial |
$401.44
|
| Rate for Payer: CORVEL All Commercial |
$401.44
|
| Rate for Payer: Coventry All Commercial |
$481.73
|
| Rate for Payer: Coventry All Commercial |
$481.73
|
| Rate for Payer: Encore All Commercial |
$401.44
|
| Rate for Payer: Encore All Commercial |
$401.44
|
| Rate for Payer: Frontpath All Commercial |
$554.68
|
| Rate for Payer: Frontpath All Commercial |
$554.68
|
| Rate for Payer: Humana ChoiceCare |
$430.69
|
| Rate for Payer: Humana ChoiceCare |
$430.69
|
| Rate for Payer: Humana Medicare |
$401.44
|
| Rate for Payer: Humana Medicare |
$401.44
|
| Rate for Payer: Lucent All Commercial |
$562.02
|
| Rate for Payer: Lucent All Commercial |
$562.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$646.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$646.00
|
| Rate for Payer: Managed Health Services Medicaid |
$439.28
|
| Rate for Payer: Managed Health Services Medicaid |
$439.28
|
| Rate for Payer: MDWise Medicaid |
$439.28
|
| Rate for Payer: MDWise Medicaid |
$439.28
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$267.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$267.44
|
| Rate for Payer: PHCS All Commercial |
$401.44
|
| Rate for Payer: PHCS All Commercial |
$401.44
|
| Rate for Payer: PHP All Commercial |
$685.52
|
| Rate for Payer: PHP All Commercial |
$685.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$401.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$401.44
|
| Rate for Payer: Sagamore Health Network All Products |
$401.44
|
| Rate for Payer: Sagamore Health Network All Products |
$401.44
|
| Rate for Payer: Signature Care EPO |
$657.05
|
| Rate for Payer: Signature Care EPO |
$657.05
|
| Rate for Payer: Signature Care PPO |
$657.05
|
| Rate for Payer: Signature Care PPO |
$657.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$60,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$60,600.00
|
| Rate for Payer: United Healthcare Commercial |
$442.40
|
| Rate for Payer: United Healthcare Commercial |
$442.40
|
| Rate for Payer: United Healthcare Medicare |
$434.33
|
| Rate for Payer: United Healthcare Medicare |
$434.33
|
|
|
PR CLOSED RX PROX/NECK FEMUR FX
|
Professional
|
Both
|
$916.32
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
z27230
|
| Min. Negotiated Rate |
$262.44 |
| Max. Negotiated Rate |
$67,300.00 |
| Rate for Payer: Aetna Commercial |
$447.10
|
| Rate for Payer: Aetna Commercial |
$447.10
|
| Rate for Payer: Aetna Medicare |
$447.10
|
| Rate for Payer: Aetna Medicare |
$447.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$522.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$522.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$522.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$522.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$522.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$522.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$522.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$522.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$262.44
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$262.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$450.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$450.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$514.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$514.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$491.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$491.81
|
| Rate for Payer: Cash Price |
$535.88
|
| Rate for Payer: Cash Price |
$549.79
|
| Rate for Payer: Centivo All Commercial |
$693.00
|
| Rate for Payer: Centivo All Commercial |
$693.00
|
| Rate for Payer: Cigna All Commercial |
$447.10
|
| Rate for Payer: Cigna All Commercial |
$447.10
|
| Rate for Payer: CORVEL All Commercial |
$447.10
|
| Rate for Payer: CORVEL All Commercial |
$447.10
|
| Rate for Payer: Coventry All Commercial |
$536.52
|
| Rate for Payer: Coventry All Commercial |
$536.52
|
| Rate for Payer: Encore All Commercial |
$447.10
|
| Rate for Payer: Encore All Commercial |
$447.10
|
| Rate for Payer: Frontpath All Commercial |
$618.89
|
| Rate for Payer: Frontpath All Commercial |
$618.89
|
| Rate for Payer: Humana ChoiceCare |
$459.89
|
| Rate for Payer: Humana ChoiceCare |
$459.89
|
| Rate for Payer: Humana Medicare |
$447.10
|
| Rate for Payer: Humana Medicare |
$447.10
|
| Rate for Payer: Lucent All Commercial |
$625.94
|
| Rate for Payer: Lucent All Commercial |
$625.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$718.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$718.00
|
| Rate for Payer: Managed Health Services Medicaid |
$450.68
|
| Rate for Payer: Managed Health Services Medicaid |
$450.68
|
| Rate for Payer: MDWise Medicaid |
$450.68
|
| Rate for Payer: MDWise Medicaid |
$450.68
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$262.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$262.44
|
| Rate for Payer: PHCS All Commercial |
$447.10
|
| Rate for Payer: PHCS All Commercial |
$447.10
|
| Rate for Payer: PHP All Commercial |
$761.84
|
| Rate for Payer: PHP All Commercial |
$761.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$447.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$447.10
|
| Rate for Payer: Sagamore Health Network All Products |
$447.10
|
| Rate for Payer: Sagamore Health Network All Products |
$447.10
|
| Rate for Payer: Signature Care EPO |
$691.05
|
| Rate for Payer: Signature Care EPO |
$691.05
|
| Rate for Payer: Signature Care PPO |
$691.05
|
| Rate for Payer: Signature Care PPO |
$691.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,300.00
|
| Rate for Payer: United Healthcare Commercial |
$489.53
|
| Rate for Payer: United Healthcare Commercial |
$489.53
|
| Rate for Payer: United Healthcare Medicare |
$446.57
|
| Rate for Payer: United Healthcare Medicare |
$446.57
|
|
|
PR CLOSED RX PROX/SHAFT FIBULA FX
|
Professional
|
Both
|
$593.78
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
z27780
|
| Min. Negotiated Rate |
$148.64 |
| Max. Negotiated Rate |
$40,700.00 |
| Rate for Payer: Aetna Commercial |
$268.90
|
| Rate for Payer: Aetna Commercial |
$268.90
|
| Rate for Payer: Aetna Medicare |
$268.90
|
| Rate for Payer: Aetna Medicare |
$268.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$405.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$405.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$405.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$405.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$405.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$405.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$405.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$405.06
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$148.64
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$148.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$292.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$292.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$309.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$309.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$295.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$295.79
|
| Rate for Payer: Cash Price |
$345.08
|
| Rate for Payer: Cash Price |
$356.27
|
| Rate for Payer: Centivo All Commercial |
$416.80
|
| Rate for Payer: Centivo All Commercial |
$416.80
|
| Rate for Payer: Cigna All Commercial |
$268.90
|
| Rate for Payer: Cigna All Commercial |
$268.90
|
| Rate for Payer: CORVEL All Commercial |
$268.90
|
| Rate for Payer: CORVEL All Commercial |
$268.90
|
| Rate for Payer: Coventry All Commercial |
$322.68
|
| Rate for Payer: Coventry All Commercial |
$322.68
|
| Rate for Payer: Encore All Commercial |
$268.90
|
| Rate for Payer: Encore All Commercial |
$268.90
|
| Rate for Payer: Frontpath All Commercial |
$368.46
|
| Rate for Payer: Frontpath All Commercial |
$368.46
|
| Rate for Payer: Humana ChoiceCare |
$250.86
|
| Rate for Payer: Humana ChoiceCare |
$250.86
|
| Rate for Payer: Humana Medicare |
$268.90
|
| Rate for Payer: Humana Medicare |
$268.90
|
| Rate for Payer: Lucent All Commercial |
$376.46
|
| Rate for Payer: Lucent All Commercial |
$376.46
|
| 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 |
$292.04
|
| Rate for Payer: Managed Health Services Medicaid |
$292.04
|
| Rate for Payer: MDWise Medicaid |
$292.04
|
| Rate for Payer: MDWise Medicaid |
$292.04
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$148.64
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$148.64
|
| Rate for Payer: PHCS All Commercial |
$268.90
|
| Rate for Payer: PHCS All Commercial |
$268.90
|
| Rate for Payer: PHP All Commercial |
$460.54
|
| Rate for Payer: PHP All Commercial |
$460.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$268.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$268.90
|
| Rate for Payer: Sagamore Health Network All Products |
$268.90
|
| Rate for Payer: Sagamore Health Network All Products |
$268.90
|
| 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 |
$40,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$40,700.00
|
| Rate for Payer: United Healthcare Commercial |
$270.28
|
| Rate for Payer: United Healthcare Commercial |
$270.28
|
| Rate for Payer: United Healthcare Medicare |
$287.57
|
| Rate for Payer: United Healthcare Medicare |
$287.57
|
|
|
PR CLOSED RX RADIAL HEAD DISLOC,CHILD
|
Professional
|
Both
|
$197.84
|
|
|
Service Code
|
CPT 24640
|
| Hospital Charge Code |
z24640
|
| Min. Negotiated Rate |
$45.39 |
| Max. Negotiated Rate |
$11,400.00 |
| Rate for Payer: Aetna Commercial |
$77.10
|
| Rate for Payer: Aetna Commercial |
$77.10
|
| Rate for Payer: Aetna Medicare |
$77.10
|
| Rate for Payer: Aetna Medicare |
$77.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$208.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$208.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$208.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$208.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$208.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$208.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$208.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$208.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$45.39
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$45.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$97.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$97.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$88.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$88.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$84.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$84.81
|
| Rate for Payer: Cash Price |
$115.81
|
| Rate for Payer: Cash Price |
$118.70
|
| Rate for Payer: Centivo All Commercial |
$119.50
|
| Rate for Payer: Centivo All Commercial |
$119.50
|
| Rate for Payer: Cigna All Commercial |
$77.10
|
| Rate for Payer: Cigna All Commercial |
$77.10
|
| Rate for Payer: CORVEL All Commercial |
$77.10
|
| Rate for Payer: CORVEL All Commercial |
$77.10
|
| Rate for Payer: Coventry All Commercial |
$92.52
|
| Rate for Payer: Coventry All Commercial |
$92.52
|
| Rate for Payer: Encore All Commercial |
$77.10
|
| Rate for Payer: Encore All Commercial |
$77.10
|
| Rate for Payer: Frontpath All Commercial |
$103.38
|
| Rate for Payer: Frontpath All Commercial |
$103.38
|
| Rate for Payer: Humana ChoiceCare |
$86.32
|
| Rate for Payer: Humana ChoiceCare |
$86.32
|
| Rate for Payer: Humana Medicare |
$77.10
|
| Rate for Payer: Humana Medicare |
$77.10
|
| Rate for Payer: Lucent All Commercial |
$107.94
|
| Rate for Payer: Lucent All Commercial |
$107.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$122.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$122.00
|
| Rate for Payer: Managed Health Services Medicaid |
$97.31
|
| Rate for Payer: Managed Health Services Medicaid |
$97.31
|
| Rate for Payer: MDWise Medicaid |
$97.31
|
| Rate for Payer: MDWise Medicaid |
$97.31
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$45.39
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$45.39
|
| Rate for Payer: PHCS All Commercial |
$77.10
|
| Rate for Payer: PHCS All Commercial |
$77.10
|
| Rate for Payer: PHP All Commercial |
$129.14
|
| Rate for Payer: PHP All Commercial |
$129.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$77.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$77.10
|
| Rate for Payer: Sagamore Health Network All Products |
$77.10
|
| Rate for Payer: Sagamore Health Network All Products |
$77.10
|
| Rate for Payer: Signature Care EPO |
$169.71
|
| Rate for Payer: Signature Care EPO |
$169.71
|
| Rate for Payer: Signature Care PPO |
$169.71
|
| Rate for Payer: Signature Care PPO |
$169.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,400.00
|
| Rate for Payer: United Healthcare Commercial |
$90.94
|
| Rate for Payer: United Healthcare Commercial |
$90.94
|
| Rate for Payer: United Healthcare Medicare |
$96.51
|
| Rate for Payer: United Healthcare Medicare |
$96.51
|
|
|
PR CLOSED RX RADIAL HEAD/NECK FX
|
Professional
|
Both
|
$508.98
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
z24650
|
| Min. Negotiated Rate |
$130.25 |
| Max. Negotiated Rate |
$35,200.00 |
| Rate for Payer: Aetna Commercial |
$231.06
|
| Rate for Payer: Aetna Commercial |
$231.06
|
| Rate for Payer: Aetna Medicare |
$231.06
|
| Rate for Payer: Aetna Medicare |
$231.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$358.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$358.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$358.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$358.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$358.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$358.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$358.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$358.31
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$130.25
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$130.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$250.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$250.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$254.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$254.17
|
| Rate for Payer: Cash Price |
$295.10
|
| Rate for Payer: Cash Price |
$305.39
|
| Rate for Payer: Centivo All Commercial |
$358.14
|
| Rate for Payer: Centivo All Commercial |
$358.14
|
| Rate for Payer: Cigna All Commercial |
$231.06
|
| Rate for Payer: Cigna All Commercial |
$231.06
|
| Rate for Payer: CORVEL All Commercial |
$231.06
|
| Rate for Payer: CORVEL All Commercial |
$231.06
|
| Rate for Payer: Coventry All Commercial |
$277.27
|
| Rate for Payer: Coventry All Commercial |
$277.27
|
| Rate for Payer: Encore All Commercial |
$231.06
|
| Rate for Payer: Encore All Commercial |
$231.06
|
| Rate for Payer: Frontpath All Commercial |
$315.26
|
| Rate for Payer: Frontpath All Commercial |
$315.26
|
| Rate for Payer: Humana ChoiceCare |
$210.14
|
| Rate for Payer: Humana ChoiceCare |
$210.14
|
| Rate for Payer: Humana Medicare |
$231.06
|
| Rate for Payer: Humana Medicare |
$231.06
|
| Rate for Payer: Lucent All Commercial |
$323.48
|
| Rate for Payer: Lucent All Commercial |
$323.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$375.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$375.00
|
| Rate for Payer: Managed Health Services Medicaid |
$250.34
|
| Rate for Payer: Managed Health Services Medicaid |
$250.34
|
| Rate for Payer: MDWise Medicaid |
$250.34
|
| Rate for Payer: MDWise Medicaid |
$250.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$130.25
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$130.25
|
| Rate for Payer: PHCS All Commercial |
$231.06
|
| Rate for Payer: PHCS All Commercial |
$231.06
|
| Rate for Payer: PHP All Commercial |
$398.03
|
| Rate for Payer: PHP All Commercial |
$398.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$231.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$231.06
|
| Rate for Payer: Sagamore Health Network All Products |
$231.06
|
| Rate for Payer: Sagamore Health Network All Products |
$231.06
|
| Rate for Payer: Signature Care EPO |
$378.25
|
| Rate for Payer: Signature Care EPO |
$378.25
|
| Rate for Payer: Signature Care PPO |
$378.25
|
| Rate for Payer: Signature Care PPO |
$378.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,200.00
|
| Rate for Payer: United Healthcare Commercial |
$231.21
|
| Rate for Payer: United Healthcare Commercial |
$231.21
|
| Rate for Payer: United Healthcare Medicare |
$245.92
|
| Rate for Payer: United Healthcare Medicare |
$245.92
|
|
|
PR CLOSED RX RADIAL HEAD/NECK FX,MANIP
|
Professional
|
Both
|
$859.38
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
z24655
|
| Min. Negotiated Rate |
$217.22 |
| Max. Negotiated Rate |
$57,400.00 |
| Rate for Payer: Aetna Commercial |
$379.78
|
| Rate for Payer: Aetna Commercial |
$379.78
|
| Rate for Payer: Aetna Medicare |
$379.78
|
| Rate for Payer: Aetna Medicare |
$379.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$506.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$506.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$506.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$506.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$506.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$506.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$506.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$506.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$217.22
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$217.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$422.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$422.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$436.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$436.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$417.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$417.76
|
| Rate for Payer: Cash Price |
$497.52
|
| Rate for Payer: Cash Price |
$515.63
|
| Rate for Payer: Centivo All Commercial |
$588.66
|
| Rate for Payer: Centivo All Commercial |
$588.66
|
| Rate for Payer: Cigna All Commercial |
$379.78
|
| Rate for Payer: Cigna All Commercial |
$379.78
|
| Rate for Payer: CORVEL All Commercial |
$379.78
|
| Rate for Payer: CORVEL All Commercial |
$379.78
|
| Rate for Payer: Coventry All Commercial |
$455.74
|
| Rate for Payer: Coventry All Commercial |
$455.74
|
| Rate for Payer: Encore All Commercial |
$379.78
|
| Rate for Payer: Encore All Commercial |
$379.78
|
| Rate for Payer: Frontpath All Commercial |
$523.89
|
| Rate for Payer: Frontpath All Commercial |
$523.89
|
| Rate for Payer: Humana ChoiceCare |
$394.84
|
| Rate for Payer: Humana ChoiceCare |
$394.84
|
| Rate for Payer: Humana Medicare |
$379.78
|
| Rate for Payer: Humana Medicare |
$379.78
|
| Rate for Payer: Lucent All Commercial |
$531.69
|
| Rate for Payer: Lucent All Commercial |
$531.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$613.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$613.00
|
| Rate for Payer: Managed Health Services Medicaid |
$422.68
|
| Rate for Payer: Managed Health Services Medicaid |
$422.68
|
| Rate for Payer: MDWise Medicaid |
$422.68
|
| Rate for Payer: MDWise Medicaid |
$422.68
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$217.22
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$217.22
|
| Rate for Payer: PHCS All Commercial |
$379.78
|
| Rate for Payer: PHCS All Commercial |
$379.78
|
| Rate for Payer: PHP All Commercial |
$650.14
|
| Rate for Payer: PHP All Commercial |
$650.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$379.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$379.78
|
| Rate for Payer: Sagamore Health Network All Products |
$379.78
|
| Rate for Payer: Sagamore Health Network All Products |
$379.78
|
| Rate for Payer: Signature Care EPO |
$635.80
|
| Rate for Payer: Signature Care EPO |
$635.80
|
| Rate for Payer: Signature Care PPO |
$635.80
|
| Rate for Payer: Signature Care PPO |
$635.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$57,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$57,400.00
|
| Rate for Payer: United Healthcare Commercial |
$407.53
|
| Rate for Payer: United Healthcare Commercial |
$407.53
|
| Rate for Payer: United Healthcare Medicare |
$414.60
|
| Rate for Payer: United Healthcare Medicare |
$414.60
|
|
