|
PR CLOSED RX WEIGHT BEAR DIST TIBIA
|
Professional
|
Both
|
$604.06
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
z27824
|
| Min. Negotiated Rate |
$197.04 |
| Max. Negotiated Rate |
$43,600.00 |
| Rate for Payer: Aetna Commercial |
$287.25
|
| Rate for Payer: Aetna Commercial |
$287.25
|
| Rate for Payer: Aetna Medicare |
$287.25
|
| Rate for Payer: Aetna Medicare |
$287.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$453.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$453.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$453.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$453.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$453.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$453.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$453.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$453.35
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$197.04
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$197.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$297.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$297.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$330.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$330.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$315.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$315.98
|
| Rate for Payer: Cash Price |
$354.06
|
| Rate for Payer: Cash Price |
$362.44
|
| Rate for Payer: Centivo All Commercial |
$445.24
|
| Rate for Payer: Centivo All Commercial |
$445.24
|
| Rate for Payer: Cigna All Commercial |
$287.25
|
| Rate for Payer: Cigna All Commercial |
$287.25
|
| Rate for Payer: CORVEL All Commercial |
$287.25
|
| Rate for Payer: CORVEL All Commercial |
$287.25
|
| Rate for Payer: Coventry All Commercial |
$344.70
|
| Rate for Payer: Coventry All Commercial |
$344.70
|
| Rate for Payer: Encore All Commercial |
$287.25
|
| Rate for Payer: Encore All Commercial |
$287.25
|
| Rate for Payer: Frontpath All Commercial |
$393.74
|
| Rate for Payer: Frontpath All Commercial |
$393.74
|
| Rate for Payer: Humana ChoiceCare |
$275.95
|
| Rate for Payer: Humana ChoiceCare |
$275.95
|
| Rate for Payer: Humana Medicare |
$287.25
|
| Rate for Payer: Humana Medicare |
$287.25
|
| Rate for Payer: Lucent All Commercial |
$402.15
|
| Rate for Payer: Lucent All Commercial |
$402.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$465.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$465.00
|
| Rate for Payer: Managed Health Services Medicaid |
$297.10
|
| Rate for Payer: Managed Health Services Medicaid |
$297.10
|
| Rate for Payer: MDWise Medicaid |
$297.10
|
| Rate for Payer: MDWise Medicaid |
$297.10
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$197.04
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$197.04
|
| Rate for Payer: PHCS All Commercial |
$287.25
|
| Rate for Payer: PHCS All Commercial |
$287.25
|
| Rate for Payer: PHP All Commercial |
$493.46
|
| Rate for Payer: PHP All Commercial |
$493.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$287.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$287.25
|
| Rate for Payer: Sagamore Health Network All Products |
$287.25
|
| Rate for Payer: Sagamore Health Network All Products |
$287.25
|
| Rate for Payer: Signature Care EPO |
$477.70
|
| Rate for Payer: Signature Care EPO |
$477.70
|
| Rate for Payer: Signature Care PPO |
$477.70
|
| Rate for Payer: Signature Care PPO |
$477.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,600.00
|
| Rate for Payer: United Healthcare Commercial |
$303.34
|
| Rate for Payer: United Healthcare Commercial |
$303.34
|
| Rate for Payer: United Healthcare Medicare |
$295.05
|
| Rate for Payer: United Healthcare Medicare |
$295.05
|
|
|
PR CLOSED RX WEIGHT BEAR DIST TIB,MANIP
|
Professional
|
Both
|
$1,028.78
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
z27825
|
| Min. Negotiated Rate |
$336.64 |
| Max. Negotiated Rate |
$69,500.00 |
| Rate for Payer: Aetna Commercial |
$460.35
|
| Rate for Payer: Aetna Commercial |
$460.35
|
| Rate for Payer: Aetna Medicare |
$460.35
|
| Rate for Payer: Aetna Medicare |
$460.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$713.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$713.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$713.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$713.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$713.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$713.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$713.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$713.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$336.64
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$336.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$506.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$506.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$529.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$529.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$506.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$506.38
|
| Rate for Payer: Cash Price |
$601.81
|
| Rate for Payer: Cash Price |
$617.27
|
| Rate for Payer: Centivo All Commercial |
$713.54
|
| Rate for Payer: Centivo All Commercial |
$713.54
|
| Rate for Payer: Cigna All Commercial |
$460.35
|
| Rate for Payer: Cigna All Commercial |
$460.35
|
| Rate for Payer: CORVEL All Commercial |
$460.35
|
| Rate for Payer: CORVEL All Commercial |
$460.35
|
| Rate for Payer: Coventry All Commercial |
$552.42
|
| Rate for Payer: Coventry All Commercial |
$552.42
|
| Rate for Payer: Encore All Commercial |
$460.35
|
| Rate for Payer: Encore All Commercial |
$460.35
|
| Rate for Payer: Frontpath All Commercial |
$639.98
|
| Rate for Payer: Frontpath All Commercial |
$639.98
|
| Rate for Payer: Humana ChoiceCare |
$502.81
|
| Rate for Payer: Humana ChoiceCare |
$502.81
|
| Rate for Payer: Humana Medicare |
$460.35
|
| Rate for Payer: Humana Medicare |
$460.35
|
| Rate for Payer: Lucent All Commercial |
$644.49
|
| Rate for Payer: Lucent All Commercial |
$644.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$741.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$741.00
|
| Rate for Payer: Managed Health Services Medicaid |
$506.00
|
| Rate for Payer: Managed Health Services Medicaid |
$506.00
|
| Rate for Payer: MDWise Medicaid |
$506.00
|
| Rate for Payer: MDWise Medicaid |
$506.00
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$336.64
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$336.64
|
| Rate for Payer: PHCS All Commercial |
$460.35
|
| Rate for Payer: PHCS All Commercial |
$460.35
|
| Rate for Payer: PHP All Commercial |
$786.16
|
| Rate for Payer: PHP All Commercial |
$786.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$460.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$460.35
|
| Rate for Payer: Sagamore Health Network All Products |
$460.35
|
| Rate for Payer: Sagamore Health Network All Products |
$460.35
|
| Rate for Payer: Signature Care EPO |
$825.35
|
| Rate for Payer: Signature Care EPO |
$825.35
|
| Rate for Payer: Signature Care PPO |
$825.35
|
| Rate for Payer: Signature Care PPO |
$825.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69,500.00
|
| Rate for Payer: United Healthcare Commercial |
$532.85
|
| Rate for Payer: United Healthcare Commercial |
$532.85
|
| Rate for Payer: United Healthcare Medicare |
$501.51
|
| Rate for Payer: United Healthcare Medicare |
$501.51
|
|
|
PR CLOSED TREATMENT PST MALLEOLUS FRACTURE W MANIP
|
Professional
|
Both
|
$847.26
|
|
|
Service Code
|
CPT 27768
|
| Hospital Charge Code |
z27768
|
| Min. Negotiated Rate |
$382.94 |
| Max. Negotiated Rate |
$63,300.00 |
| Rate for Payer: Aetna Commercial |
$419.33
|
| Rate for Payer: Aetna Commercial |
$419.33
|
| Rate for Payer: Aetna Medicare |
$419.33
|
| Rate for Payer: Aetna Medicare |
$419.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$544.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$544.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$544.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$544.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$544.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$544.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$544.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$544.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$416.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$416.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$482.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$482.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$461.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$461.26
|
| Rate for Payer: Cash Price |
$508.36
|
| Rate for Payer: Cash Price |
$494.03
|
| Rate for Payer: Centivo All Commercial |
$649.96
|
| Rate for Payer: Centivo All Commercial |
$649.96
|
| Rate for Payer: Cigna All Commercial |
$419.33
|
| Rate for Payer: Cigna All Commercial |
$419.33
|
| Rate for Payer: CORVEL All Commercial |
$419.33
|
| Rate for Payer: CORVEL All Commercial |
$419.33
|
| Rate for Payer: Coventry All Commercial |
$503.20
|
| Rate for Payer: Coventry All Commercial |
$503.20
|
| Rate for Payer: Encore All Commercial |
$419.33
|
| Rate for Payer: Encore All Commercial |
$419.33
|
| Rate for Payer: Frontpath All Commercial |
$579.06
|
| Rate for Payer: Frontpath All Commercial |
$579.06
|
| Rate for Payer: Humana ChoiceCare |
$382.94
|
| Rate for Payer: Humana ChoiceCare |
$382.94
|
| Rate for Payer: Humana Medicare |
$419.33
|
| Rate for Payer: Humana Medicare |
$419.33
|
| Rate for Payer: Lucent All Commercial |
$587.06
|
| Rate for Payer: Lucent All Commercial |
$587.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$675.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$675.00
|
| Rate for Payer: Managed Health Services Medicaid |
$416.71
|
| Rate for Payer: Managed Health Services Medicaid |
$416.71
|
| Rate for Payer: MDWise Medicaid |
$416.71
|
| Rate for Payer: MDWise Medicaid |
$416.71
|
| Rate for Payer: PHCS All Commercial |
$419.33
|
| Rate for Payer: PHCS All Commercial |
$419.33
|
| Rate for Payer: PHP All Commercial |
$716.35
|
| Rate for Payer: PHP All Commercial |
$716.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$419.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$419.33
|
| Rate for Payer: Sagamore Health Network All Products |
$419.33
|
| Rate for Payer: Sagamore Health Network All Products |
$419.33
|
| Rate for Payer: Signature Care EPO |
$519.89
|
| Rate for Payer: Signature Care EPO |
$519.89
|
| Rate for Payer: Signature Care PPO |
$519.89
|
| Rate for Payer: Signature Care PPO |
$519.89
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$63,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$63,300.00
|
| Rate for Payer: United Healthcare Commercial |
$429.26
|
| Rate for Payer: United Healthcare Commercial |
$429.26
|
| Rate for Payer: United Healthcare Medicare |
$411.69
|
| Rate for Payer: United Healthcare Medicare |
$411.69
|
|
|
PR CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANIP
|
Professional
|
Both
|
$556.48
|
|
|
Service Code
|
CPT 27767
|
| Hospital Charge Code |
z27767
|
| Min. Negotiated Rate |
$150.71 |
| Max. Negotiated Rate |
$41,400.00 |
| Rate for Payer: Aetna Commercial |
$272.89
|
| Rate for Payer: Aetna Commercial |
$272.89
|
| Rate for Payer: Aetna Medicare |
$272.89
|
| Rate for Payer: Aetna Medicare |
$272.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$351.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$351.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$351.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$351.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$351.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$351.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$351.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$351.29
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$150.71
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$150.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$273.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$273.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$300.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$300.18
|
| Rate for Payer: Cash Price |
$325.04
|
| Rate for Payer: Cash Price |
$333.89
|
| Rate for Payer: Centivo All Commercial |
$422.98
|
| Rate for Payer: Centivo All Commercial |
$422.98
|
| Rate for Payer: Cigna All Commercial |
$272.89
|
| Rate for Payer: Cigna All Commercial |
$272.89
|
| Rate for Payer: CORVEL All Commercial |
$272.89
|
| Rate for Payer: CORVEL All Commercial |
$272.89
|
| Rate for Payer: Coventry All Commercial |
$327.47
|
| Rate for Payer: Coventry All Commercial |
$327.47
|
| Rate for Payer: Encore All Commercial |
$272.89
|
| Rate for Payer: Encore All Commercial |
$272.89
|
| Rate for Payer: Frontpath All Commercial |
$372.16
|
| Rate for Payer: Frontpath All Commercial |
$372.16
|
| Rate for Payer: Humana ChoiceCare |
$249.35
|
| Rate for Payer: Humana ChoiceCare |
$249.35
|
| Rate for Payer: Humana Medicare |
$272.89
|
| Rate for Payer: Humana Medicare |
$272.89
|
| Rate for Payer: Lucent All Commercial |
$382.05
|
| Rate for Payer: Lucent All Commercial |
$382.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$442.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$442.00
|
| Rate for Payer: Managed Health Services Medicaid |
$273.70
|
| Rate for Payer: Managed Health Services Medicaid |
$273.70
|
| Rate for Payer: MDWise Medicaid |
$273.70
|
| Rate for Payer: MDWise Medicaid |
$273.70
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$150.71
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$150.71
|
| Rate for Payer: PHCS All Commercial |
$272.89
|
| Rate for Payer: PHCS All Commercial |
$272.89
|
| Rate for Payer: PHP All Commercial |
$469.21
|
| Rate for Payer: PHP All Commercial |
$469.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.89
|
| Rate for Payer: Sagamore Health Network All Products |
$272.89
|
| Rate for Payer: Sagamore Health Network All Products |
$272.89
|
| Rate for Payer: Signature Care EPO |
$336.90
|
| Rate for Payer: Signature Care EPO |
$336.90
|
| Rate for Payer: Signature Care PPO |
$336.90
|
| Rate for Payer: Signature Care PPO |
$336.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,400.00
|
| Rate for Payer: United Healthcare Commercial |
$265.25
|
| Rate for Payer: United Healthcare Commercial |
$265.25
|
| Rate for Payer: United Healthcare Medicare |
$270.87
|
| Rate for Payer: United Healthcare Medicare |
$270.87
|
|
|
PR CLOSED TREAT VERT BODY FRACT
|
Professional
|
Both
|
$580.48
|
|
|
Service Code
|
CPT 22310
|
| Hospital Charge Code |
z22310
|
| Min. Negotiated Rate |
$152.96 |
| Max. Negotiated Rate |
$41,500.00 |
| Rate for Payer: Aetna Commercial |
$275.98
|
| Rate for Payer: Aetna Commercial |
$275.98
|
| Rate for Payer: Aetna Medicare |
$275.98
|
| Rate for Payer: Aetna Medicare |
$275.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$290.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$290.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$290.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$290.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$290.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$290.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$290.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$290.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$152.96
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$152.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$285.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$285.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$317.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$317.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$303.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$303.58
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$348.29
|
| Rate for Payer: Centivo All Commercial |
$427.77
|
| Rate for Payer: Centivo All Commercial |
$427.77
|
| Rate for Payer: Cigna All Commercial |
$275.98
|
| Rate for Payer: Cigna All Commercial |
$275.98
|
| Rate for Payer: CORVEL All Commercial |
$275.98
|
| Rate for Payer: CORVEL All Commercial |
$275.98
|
| Rate for Payer: Coventry All Commercial |
$331.18
|
| Rate for Payer: Coventry All Commercial |
$331.18
|
| Rate for Payer: Encore All Commercial |
$275.98
|
| Rate for Payer: Encore All Commercial |
$275.98
|
| Rate for Payer: Frontpath All Commercial |
$382.71
|
| Rate for Payer: Frontpath All Commercial |
$382.71
|
| Rate for Payer: Humana ChoiceCare |
$216.82
|
| Rate for Payer: Humana ChoiceCare |
$216.82
|
| Rate for Payer: Humana Medicare |
$275.98
|
| Rate for Payer: Humana Medicare |
$275.98
|
| Rate for Payer: Lucent All Commercial |
$386.37
|
| Rate for Payer: Lucent All Commercial |
$386.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$443.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$443.00
|
| Rate for Payer: Managed Health Services Medicaid |
$285.51
|
| Rate for Payer: Managed Health Services Medicaid |
$285.51
|
| Rate for Payer: MDWise Medicaid |
$285.51
|
| Rate for Payer: MDWise Medicaid |
$285.51
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$152.96
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$152.96
|
| Rate for Payer: PHCS All Commercial |
$275.98
|
| Rate for Payer: PHCS All Commercial |
$275.98
|
| Rate for Payer: PHP All Commercial |
$469.98
|
| Rate for Payer: PHP All Commercial |
$469.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$275.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$275.98
|
| Rate for Payer: Sagamore Health Network All Products |
$275.98
|
| Rate for Payer: Sagamore Health Network All Products |
$275.98
|
| Rate for Payer: Signature Care EPO |
$425.00
|
| Rate for Payer: Signature Care EPO |
$425.00
|
| Rate for Payer: Signature Care PPO |
$425.00
|
| Rate for Payer: Signature Care PPO |
$425.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,500.00
|
| Rate for Payer: United Healthcare Commercial |
$284.15
|
| Rate for Payer: United Healthcare Commercial |
$284.15
|
| Rate for Payer: United Healthcare Medicare |
$282.75
|
| Rate for Payer: United Healthcare Medicare |
$282.75
|
|
|
PR CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MANIP
|
Professional
|
Both
|
$901.62
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
z27810
|
| Min. Negotiated Rate |
$274.22 |
| Max. Negotiated Rate |
$60,600.00 |
| Rate for Payer: Aetna Commercial |
$400.18
|
| Rate for Payer: Aetna Commercial |
$400.18
|
| Rate for Payer: Aetna Medicare |
$400.18
|
| Rate for Payer: Aetna Medicare |
$400.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$604.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$604.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$604.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$604.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$604.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$604.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$604.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$604.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$274.22
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$274.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$443.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$443.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.20
|
| Rate for Payer: Cash Price |
$525.59
|
| Rate for Payer: Cash Price |
$540.97
|
| Rate for Payer: Centivo All Commercial |
$620.28
|
| Rate for Payer: Centivo All Commercial |
$620.28
|
| Rate for Payer: Cigna All Commercial |
$400.18
|
| Rate for Payer: Cigna All Commercial |
$400.18
|
| Rate for Payer: CORVEL All Commercial |
$400.18
|
| Rate for Payer: CORVEL All Commercial |
$400.18
|
| Rate for Payer: Coventry All Commercial |
$480.22
|
| Rate for Payer: Coventry All Commercial |
$480.22
|
| Rate for Payer: Encore All Commercial |
$400.18
|
| Rate for Payer: Encore All Commercial |
$400.18
|
| Rate for Payer: Frontpath All Commercial |
$553.97
|
| Rate for Payer: Frontpath All Commercial |
$553.97
|
| Rate for Payer: Humana ChoiceCare |
$443.23
|
| Rate for Payer: Humana ChoiceCare |
$443.23
|
| Rate for Payer: Humana Medicare |
$400.18
|
| Rate for Payer: Humana Medicare |
$400.18
|
| Rate for Payer: Lucent All Commercial |
$560.25
|
| Rate for Payer: Lucent All Commercial |
$560.25
|
| 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 |
$443.45
|
| Rate for Payer: Managed Health Services Medicaid |
$443.45
|
| Rate for Payer: MDWise Medicaid |
$443.45
|
| Rate for Payer: MDWise Medicaid |
$443.45
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$274.22
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$274.22
|
| Rate for Payer: PHCS All Commercial |
$400.18
|
| Rate for Payer: PHCS All Commercial |
$400.18
|
| Rate for Payer: PHP All Commercial |
$685.60
|
| Rate for Payer: PHP All Commercial |
$685.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$400.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$400.18
|
| Rate for Payer: Sagamore Health Network All Products |
$400.18
|
| Rate for Payer: Sagamore Health Network All Products |
$400.18
|
| Rate for Payer: Signature Care EPO |
$692.75
|
| Rate for Payer: Signature Care EPO |
$692.75
|
| Rate for Payer: Signature Care PPO |
$692.75
|
| Rate for Payer: Signature Care PPO |
$692.75
|
| 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 |
$452.75
|
| Rate for Payer: United Healthcare Commercial |
$452.75
|
| Rate for Payer: United Healthcare Medicare |
$437.99
|
| Rate for Payer: United Healthcare Medicare |
$437.99
|
|
|
PR CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANIP
|
Professional
|
Both
|
$644.90
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
z27808
|
| Min. Negotiated Rate |
$159.36 |
| Max. Negotiated Rate |
$43,700.00 |
| Rate for Payer: Aetna Commercial |
$288.76
|
| Rate for Payer: Aetna Commercial |
$288.76
|
| Rate for Payer: Aetna Medicare |
$288.76
|
| Rate for Payer: Aetna Medicare |
$288.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$455.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$455.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$455.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$455.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$455.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$455.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$455.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$455.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$159.36
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$159.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$317.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$317.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$332.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$332.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$317.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$317.64
|
| Rate for Payer: Cash Price |
$373.63
|
| Rate for Payer: Cash Price |
$386.94
|
| Rate for Payer: Centivo All Commercial |
$447.58
|
| Rate for Payer: Centivo All Commercial |
$447.58
|
| Rate for Payer: Cigna All Commercial |
$288.76
|
| Rate for Payer: Cigna All Commercial |
$288.76
|
| Rate for Payer: CORVEL All Commercial |
$288.76
|
| Rate for Payer: CORVEL All Commercial |
$288.76
|
| Rate for Payer: Coventry All Commercial |
$346.51
|
| Rate for Payer: Coventry All Commercial |
$346.51
|
| Rate for Payer: Encore All Commercial |
$288.76
|
| Rate for Payer: Encore All Commercial |
$288.76
|
| Rate for Payer: Frontpath All Commercial |
$394.80
|
| Rate for Payer: Frontpath All Commercial |
$394.80
|
| Rate for Payer: Humana ChoiceCare |
$279.05
|
| Rate for Payer: Humana ChoiceCare |
$279.05
|
| Rate for Payer: Humana Medicare |
$288.76
|
| Rate for Payer: Humana Medicare |
$288.76
|
| Rate for Payer: Lucent All Commercial |
$404.26
|
| Rate for Payer: Lucent All Commercial |
$404.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$466.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$466.00
|
| Rate for Payer: Managed Health Services Medicaid |
$317.18
|
| Rate for Payer: Managed Health Services Medicaid |
$317.18
|
| Rate for Payer: MDWise Medicaid |
$317.18
|
| Rate for Payer: MDWise Medicaid |
$317.18
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$159.36
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$159.36
|
| Rate for Payer: PHCS All Commercial |
$288.76
|
| Rate for Payer: PHCS All Commercial |
$288.76
|
| Rate for Payer: PHP All Commercial |
$494.08
|
| Rate for Payer: PHP All Commercial |
$494.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$288.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$288.76
|
| Rate for Payer: Sagamore Health Network All Products |
$288.76
|
| Rate for Payer: Sagamore Health Network All Products |
$288.76
|
| Rate for Payer: Signature Care EPO |
$481.10
|
| Rate for Payer: Signature Care EPO |
$481.10
|
| Rate for Payer: Signature Care PPO |
$481.10
|
| Rate for Payer: Signature Care PPO |
$481.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,700.00
|
| Rate for Payer: United Healthcare Commercial |
$296.75
|
| Rate for Payer: United Healthcare Commercial |
$296.75
|
| Rate for Payer: United Healthcare Medicare |
$311.36
|
| Rate for Payer: United Healthcare Medicare |
$311.36
|
|
|
PR CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION
|
Professional
|
Both
|
$282.68
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
z21315
|
| Min. Negotiated Rate |
$55.41 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Aetna Commercial |
$55.41
|
| Rate for Payer: Aetna Commercial |
$55.41
|
| Rate for Payer: Aetna Medicare |
$55.41
|
| Rate for Payer: Aetna Medicare |
$55.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$270.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$270.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$270.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$270.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$270.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$270.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$270.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$270.69
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$60.21
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$60.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$139.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$139.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$63.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$63.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$60.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$60.95
|
| Rate for Payer: Cash Price |
$165.25
|
| Rate for Payer: Cash Price |
$169.61
|
| Rate for Payer: Centivo All Commercial |
$85.89
|
| Rate for Payer: Centivo All Commercial |
$85.89
|
| Rate for Payer: Cigna All Commercial |
$55.41
|
| Rate for Payer: Cigna All Commercial |
$55.41
|
| Rate for Payer: CORVEL All Commercial |
$55.41
|
| Rate for Payer: CORVEL All Commercial |
$55.41
|
| Rate for Payer: Coventry All Commercial |
$66.49
|
| Rate for Payer: Coventry All Commercial |
$66.49
|
| Rate for Payer: Encore All Commercial |
$55.41
|
| Rate for Payer: Encore All Commercial |
$55.41
|
| Rate for Payer: Frontpath All Commercial |
$76.36
|
| Rate for Payer: Frontpath All Commercial |
$76.36
|
| Rate for Payer: Humana ChoiceCare |
$143.34
|
| Rate for Payer: Humana ChoiceCare |
$143.34
|
| Rate for Payer: Humana Medicare |
$55.41
|
| Rate for Payer: Humana Medicare |
$55.41
|
| Rate for Payer: Lucent All Commercial |
$77.57
|
| Rate for Payer: Lucent All Commercial |
$77.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$90.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$90.00
|
| Rate for Payer: Managed Health Services Medicaid |
$139.04
|
| Rate for Payer: Managed Health Services Medicaid |
$139.04
|
| Rate for Payer: MDWise Medicaid |
$139.04
|
| Rate for Payer: MDWise Medicaid |
$139.04
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$60.21
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$60.21
|
| Rate for Payer: PHCS All Commercial |
$55.41
|
| Rate for Payer: PHCS All Commercial |
$55.41
|
| Rate for Payer: PHP All Commercial |
$94.98
|
| Rate for Payer: PHP All Commercial |
$94.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.41
|
| Rate for Payer: Sagamore Health Network All Products |
$55.41
|
| Rate for Payer: Sagamore Health Network All Products |
$55.41
|
| Rate for Payer: Signature Care EPO |
$240.86
|
| Rate for Payer: Signature Care EPO |
$240.86
|
| Rate for Payer: Signature Care PPO |
$240.86
|
| Rate for Payer: Signature Care PPO |
$240.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,400.00
|
| Rate for Payer: United Healthcare Commercial |
$158.11
|
| Rate for Payer: United Healthcare Commercial |
$158.11
|
| Rate for Payer: United Healthcare Medicare |
$137.71
|
| Rate for Payer: United Healthcare Medicare |
$137.71
|
|
|
PR CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION
|
Professional
|
Both
|
$401.48
|
|
|
Service Code
|
CPT 21320
|
| Hospital Charge Code |
z21320
|
| Min. Negotiated Rate |
$55.52 |
| Max. Negotiated Rate |
$13,300.00 |
| Rate for Payer: Aetna Commercial |
$89.41
|
| Rate for Payer: Aetna Commercial |
$89.41
|
| Rate for Payer: Aetna Medicare |
$89.41
|
| Rate for Payer: Aetna Medicare |
$89.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$313.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$313.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$313.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$313.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$313.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$313.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$313.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$313.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$55.52
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$55.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$98.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$98.35
|
| Rate for Payer: Cash Price |
$238.73
|
| Rate for Payer: Cash Price |
$240.89
|
| Rate for Payer: Centivo All Commercial |
$138.59
|
| Rate for Payer: Centivo All Commercial |
$138.59
|
| Rate for Payer: Cigna All Commercial |
$89.41
|
| Rate for Payer: Cigna All Commercial |
$89.41
|
| Rate for Payer: CORVEL All Commercial |
$89.41
|
| Rate for Payer: CORVEL All Commercial |
$89.41
|
| Rate for Payer: Coventry All Commercial |
$107.29
|
| Rate for Payer: Coventry All Commercial |
$107.29
|
| Rate for Payer: Encore All Commercial |
$89.41
|
| Rate for Payer: Encore All Commercial |
$89.41
|
| Rate for Payer: Frontpath All Commercial |
$123.59
|
| Rate for Payer: Frontpath All Commercial |
$123.59
|
| Rate for Payer: Humana ChoiceCare |
$148.27
|
| Rate for Payer: Humana ChoiceCare |
$148.27
|
| Rate for Payer: Humana Medicare |
$89.41
|
| Rate for Payer: Humana Medicare |
$89.41
|
| Rate for Payer: Lucent All Commercial |
$125.17
|
| Rate for Payer: Lucent All Commercial |
$125.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$142.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$142.00
|
| Rate for Payer: Managed Health Services Medicaid |
$197.47
|
| Rate for Payer: Managed Health Services Medicaid |
$197.47
|
| Rate for Payer: MDWise Medicaid |
$197.47
|
| Rate for Payer: MDWise Medicaid |
$197.47
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$55.52
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$55.52
|
| Rate for Payer: PHCS All Commercial |
$89.41
|
| Rate for Payer: PHCS All Commercial |
$89.41
|
| Rate for Payer: PHP All Commercial |
$150.68
|
| Rate for Payer: PHP All Commercial |
$150.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$89.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$89.41
|
| Rate for Payer: Sagamore Health Network All Products |
$89.41
|
| Rate for Payer: Sagamore Health Network All Products |
$89.41
|
| 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 |
$13,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,300.00
|
| Rate for Payer: United Healthcare Commercial |
$148.31
|
| Rate for Payer: United Healthcare Commercial |
$148.31
|
| Rate for Payer: United Healthcare Medicare |
$198.94
|
| Rate for Payer: United Healthcare Medicare |
$198.94
|
|
|
PR CLOSED TX ULNAR FRACTURE PROX END W/O MANIPULATE
|
Professional
|
Both
|
$562.66
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
z24670
|
| Min. Negotiated Rate |
$140.02 |
| Max. Negotiated Rate |
$38,300.00 |
| Rate for Payer: Aetna Commercial |
$252.52
|
| Rate for Payer: Aetna Commercial |
$252.52
|
| Rate for Payer: Aetna Medicare |
$252.52
|
| Rate for Payer: Aetna Medicare |
$252.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$375.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$375.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$375.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$375.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$375.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$375.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$375.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$375.08
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$140.02
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$140.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$276.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$276.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$290.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$290.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$277.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$277.77
|
| Rate for Payer: Cash Price |
$326.69
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Centivo All Commercial |
$391.41
|
| Rate for Payer: Centivo All Commercial |
$391.41
|
| Rate for Payer: Cigna All Commercial |
$252.52
|
| Rate for Payer: Cigna All Commercial |
$252.52
|
| Rate for Payer: CORVEL All Commercial |
$252.52
|
| Rate for Payer: CORVEL All Commercial |
$252.52
|
| Rate for Payer: Coventry All Commercial |
$303.02
|
| Rate for Payer: Coventry All Commercial |
$303.02
|
| Rate for Payer: Encore All Commercial |
$252.52
|
| Rate for Payer: Encore All Commercial |
$252.52
|
| Rate for Payer: Frontpath All Commercial |
$346.40
|
| Rate for Payer: Frontpath All Commercial |
$346.40
|
| Rate for Payer: Humana ChoiceCare |
$240.53
|
| Rate for Payer: Humana ChoiceCare |
$240.53
|
| Rate for Payer: Humana Medicare |
$252.52
|
| Rate for Payer: Humana Medicare |
$252.52
|
| Rate for Payer: Lucent All Commercial |
$353.53
|
| Rate for Payer: Lucent All Commercial |
$353.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$408.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$408.00
|
| Rate for Payer: Managed Health Services Medicaid |
$276.73
|
| Rate for Payer: Managed Health Services Medicaid |
$276.73
|
| Rate for Payer: MDWise Medicaid |
$276.73
|
| Rate for Payer: MDWise Medicaid |
$276.73
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$140.02
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$140.02
|
| Rate for Payer: PHCS All Commercial |
$252.52
|
| Rate for Payer: PHCS All Commercial |
$252.52
|
| Rate for Payer: PHP All Commercial |
$433.35
|
| Rate for Payer: PHP All Commercial |
$433.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$252.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$252.52
|
| Rate for Payer: Sagamore Health Network All Products |
$252.52
|
| Rate for Payer: Sagamore Health Network All Products |
$252.52
|
| Rate for Payer: Signature Care EPO |
$396.10
|
| Rate for Payer: Signature Care EPO |
$396.10
|
| Rate for Payer: Signature Care PPO |
$396.10
|
| Rate for Payer: Signature Care PPO |
$396.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$38,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$38,300.00
|
| Rate for Payer: United Healthcare Commercial |
$258.65
|
| Rate for Payer: United Healthcare Commercial |
$258.65
|
| Rate for Payer: United Healthcare Medicare |
$272.24
|
| Rate for Payer: United Healthcare Medicare |
$272.24
|
|
|
PR CLOSE ENTEROSTOMY
|
Professional
|
Both
|
$1,572.96
|
|
|
Service Code
|
CPT 44620
|
| Hospital Charge Code |
z44620
|
| Min. Negotiated Rate |
$773.64 |
| Max. Negotiated Rate |
$111,200.00 |
| Rate for Payer: Aetna Commercial |
$802.91
|
| Rate for Payer: Aetna Commercial |
$802.91
|
| Rate for Payer: Aetna Medicare |
$802.91
|
| Rate for Payer: Aetna Medicare |
$802.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$840.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$840.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$840.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$840.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$840.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$840.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$840.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$840.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$773.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$773.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$923.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$923.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$883.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$883.20
|
| Rate for Payer: Cash Price |
$943.78
|
| Rate for Payer: Cash Price |
$929.56
|
| Rate for Payer: Centivo All Commercial |
$1,244.51
|
| Rate for Payer: Centivo All Commercial |
$1,244.51
|
| Rate for Payer: Cigna All Commercial |
$802.91
|
| Rate for Payer: Cigna All Commercial |
$802.91
|
| Rate for Payer: CORVEL All Commercial |
$802.91
|
| Rate for Payer: CORVEL All Commercial |
$802.91
|
| Rate for Payer: Coventry All Commercial |
$963.49
|
| Rate for Payer: Coventry All Commercial |
$963.49
|
| Rate for Payer: Encore All Commercial |
$802.91
|
| Rate for Payer: Encore All Commercial |
$802.91
|
| Rate for Payer: Frontpath All Commercial |
$1,134.86
|
| Rate for Payer: Frontpath All Commercial |
$1,134.86
|
| Rate for Payer: Humana ChoiceCare |
$801.86
|
| Rate for Payer: Humana ChoiceCare |
$801.86
|
| Rate for Payer: Humana Medicare |
$802.91
|
| Rate for Payer: Humana Medicare |
$802.91
|
| Rate for Payer: Lucent All Commercial |
$1,124.07
|
| Rate for Payer: Lucent All Commercial |
$1,124.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,191.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,191.00
|
| Rate for Payer: Managed Health Services Medicaid |
$773.64
|
| Rate for Payer: Managed Health Services Medicaid |
$773.64
|
| Rate for Payer: MDWise Medicaid |
$773.64
|
| Rate for Payer: MDWise Medicaid |
$773.64
|
| Rate for Payer: PHCS All Commercial |
$802.91
|
| Rate for Payer: PHCS All Commercial |
$802.91
|
| Rate for Payer: PHP All Commercial |
$1,355.60
|
| Rate for Payer: PHP All Commercial |
$1,355.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$802.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$802.91
|
| Rate for Payer: Sagamore Health Network All Products |
$802.91
|
| Rate for Payer: Sagamore Health Network All Products |
$802.91
|
| Rate for Payer: Signature Care EPO |
$1,011.50
|
| Rate for Payer: Signature Care EPO |
$1,011.50
|
| Rate for Payer: Signature Care PPO |
$1,011.50
|
| Rate for Payer: Signature Care PPO |
$1,011.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$111,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$111,200.00
|
| Rate for Payer: United Healthcare Commercial |
$920.73
|
| Rate for Payer: United Healthcare Commercial |
$920.73
|
| Rate for Payer: United Healthcare Medicare |
$774.63
|
| Rate for Payer: United Healthcare Medicare |
$774.63
|
|
|
PR CLOSE ENTEROSTOMY,RESEC+ANAST
|
Professional
|
Both
|
$1,841.00
|
|
|
Service Code
|
CPT 44625
|
| Hospital Charge Code |
z44625
|
| Min. Negotiated Rate |
$905.48 |
| Max. Negotiated Rate |
$130,100.00 |
| Rate for Payer: Aetna Commercial |
$940.05
|
| Rate for Payer: Aetna Commercial |
$940.05
|
| Rate for Payer: Aetna Medicare |
$940.05
|
| Rate for Payer: Aetna Medicare |
$940.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,085.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$905.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$905.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,081.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,081.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,034.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,034.06
|
| Rate for Payer: Cash Price |
$1,104.60
|
| Rate for Payer: Cash Price |
$1,087.55
|
| Rate for Payer: Centivo All Commercial |
$1,457.08
|
| Rate for Payer: Centivo All Commercial |
$1,457.08
|
| Rate for Payer: Cigna All Commercial |
$940.05
|
| Rate for Payer: Cigna All Commercial |
$940.05
|
| Rate for Payer: CORVEL All Commercial |
$940.05
|
| Rate for Payer: CORVEL All Commercial |
$940.05
|
| Rate for Payer: Coventry All Commercial |
$1,128.06
|
| Rate for Payer: Coventry All Commercial |
$1,128.06
|
| Rate for Payer: Encore All Commercial |
$940.05
|
| Rate for Payer: Encore All Commercial |
$940.05
|
| Rate for Payer: Frontpath All Commercial |
$1,325.08
|
| Rate for Payer: Frontpath All Commercial |
$1,325.08
|
| Rate for Payer: Humana ChoiceCare |
$978.15
|
| Rate for Payer: Humana ChoiceCare |
$978.15
|
| Rate for Payer: Humana Medicare |
$940.05
|
| Rate for Payer: Humana Medicare |
$940.05
|
| Rate for Payer: Lucent All Commercial |
$1,316.07
|
| Rate for Payer: Lucent All Commercial |
$1,316.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,393.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,393.00
|
| Rate for Payer: Managed Health Services Medicaid |
$905.48
|
| Rate for Payer: Managed Health Services Medicaid |
$905.48
|
| Rate for Payer: MDWise Medicaid |
$905.48
|
| Rate for Payer: MDWise Medicaid |
$905.48
|
| Rate for Payer: PHCS All Commercial |
$940.05
|
| Rate for Payer: PHCS All Commercial |
$940.05
|
| Rate for Payer: PHP All Commercial |
$1,586.00
|
| Rate for Payer: PHP All Commercial |
$1,586.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$940.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$940.05
|
| Rate for Payer: Sagamore Health Network All Products |
$940.05
|
| Rate for Payer: Sagamore Health Network All Products |
$940.05
|
| Rate for Payer: Signature Care EPO |
$1,234.20
|
| Rate for Payer: Signature Care EPO |
$1,234.20
|
| Rate for Payer: Signature Care PPO |
$1,234.20
|
| Rate for Payer: Signature Care PPO |
$1,234.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$130,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$130,100.00
|
| Rate for Payer: United Healthcare Commercial |
$1,090.95
|
| Rate for Payer: United Healthcare Commercial |
$1,090.95
|
| Rate for Payer: United Healthcare Medicare |
$906.29
|
| Rate for Payer: United Healthcare Medicare |
$906.29
|
|
|
PR CLOSE ENTEROSTOMY,RESEC+COLOREC ANAS
|
Professional
|
Both
|
$2,873.72
|
|
|
Service Code
|
CPT 44626
|
| Hospital Charge Code |
z44626
|
| Min. Negotiated Rate |
$1,413.41 |
| Max. Negotiated Rate |
$203,600.00 |
| Rate for Payer: Aetna Commercial |
$1,476.26
|
| Rate for Payer: Aetna Commercial |
$1,476.26
|
| Rate for Payer: Aetna Medicare |
$1,476.26
|
| Rate for Payer: Aetna Medicare |
$1,476.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,685.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,685.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,685.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,685.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,685.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,685.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,685.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,685.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,413.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,413.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,697.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,697.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,623.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,623.89
|
| Rate for Payer: Cash Price |
$1,724.23
|
| Rate for Payer: Cash Price |
$1,702.16
|
| Rate for Payer: Centivo All Commercial |
$2,288.20
|
| Rate for Payer: Centivo All Commercial |
$2,288.20
|
| Rate for Payer: Cigna All Commercial |
$1,476.26
|
| Rate for Payer: Cigna All Commercial |
$1,476.26
|
| Rate for Payer: CORVEL All Commercial |
$1,476.26
|
| Rate for Payer: CORVEL All Commercial |
$1,476.26
|
| Rate for Payer: Coventry All Commercial |
$1,771.51
|
| Rate for Payer: Coventry All Commercial |
$1,771.51
|
| Rate for Payer: Encore All Commercial |
$1,476.26
|
| Rate for Payer: Encore All Commercial |
$1,476.26
|
| Rate for Payer: Frontpath All Commercial |
$2,103.14
|
| Rate for Payer: Frontpath All Commercial |
$2,103.14
|
| Rate for Payer: Humana ChoiceCare |
$1,617.49
|
| Rate for Payer: Humana ChoiceCare |
$1,617.49
|
| Rate for Payer: Humana Medicare |
$1,476.26
|
| Rate for Payer: Humana Medicare |
$1,476.26
|
| Rate for Payer: Lucent All Commercial |
$2,066.76
|
| Rate for Payer: Lucent All Commercial |
$2,066.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,181.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,181.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,413.41
|
| Rate for Payer: Managed Health Services Medicaid |
$1,413.41
|
| Rate for Payer: MDWise Medicaid |
$1,413.41
|
| Rate for Payer: MDWise Medicaid |
$1,413.41
|
| Rate for Payer: PHCS All Commercial |
$1,476.26
|
| Rate for Payer: PHCS All Commercial |
$1,476.26
|
| Rate for Payer: PHP All Commercial |
$2,482.33
|
| Rate for Payer: PHP All Commercial |
$2,482.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,476.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,476.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,476.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,476.26
|
| Rate for Payer: Signature Care EPO |
$2,045.95
|
| Rate for Payer: Signature Care EPO |
$2,045.95
|
| Rate for Payer: Signature Care PPO |
$2,045.95
|
| Rate for Payer: Signature Care PPO |
$2,045.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$203,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$203,600.00
|
| Rate for Payer: United Healthcare Commercial |
$1,735.69
|
| Rate for Payer: United Healthcare Commercial |
$1,735.69
|
| Rate for Payer: United Healthcare Medicare |
$1,418.47
|
| Rate for Payer: United Healthcare Medicare |
$1,418.47
|
|
|
PR CLOSE RX DIST FINGR FX
|
Professional
|
Both
|
$363.16
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
z26750
|
| Min. Negotiated Rate |
$97.42 |
| Max. Negotiated Rate |
$27,200.00 |
| Rate for Payer: Aetna Commercial |
$177.71
|
| Rate for Payer: Aetna Commercial |
$177.71
|
| Rate for Payer: Aetna Medicare |
$177.71
|
| Rate for Payer: Aetna Medicare |
$177.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$257.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$257.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$257.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$257.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$257.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$257.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$257.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$257.68
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$97.42
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$97.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$178.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$178.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$204.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$204.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$195.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$195.48
|
| Rate for Payer: Cash Price |
$210.29
|
| Rate for Payer: Cash Price |
$217.90
|
| Rate for Payer: Centivo All Commercial |
$275.45
|
| Rate for Payer: Centivo All Commercial |
$275.45
|
| Rate for Payer: Cigna All Commercial |
$177.71
|
| Rate for Payer: Cigna All Commercial |
$177.71
|
| Rate for Payer: CORVEL All Commercial |
$177.71
|
| Rate for Payer: CORVEL All Commercial |
$177.71
|
| Rate for Payer: Coventry All Commercial |
$213.25
|
| Rate for Payer: Coventry All Commercial |
$213.25
|
| Rate for Payer: Encore All Commercial |
$177.71
|
| Rate for Payer: Encore All Commercial |
$177.71
|
| Rate for Payer: Frontpath All Commercial |
$242.71
|
| Rate for Payer: Frontpath All Commercial |
$242.71
|
| Rate for Payer: Humana ChoiceCare |
$158.31
|
| Rate for Payer: Humana ChoiceCare |
$158.31
|
| Rate for Payer: Humana Medicare |
$177.71
|
| Rate for Payer: Humana Medicare |
$177.71
|
| Rate for Payer: Lucent All Commercial |
$248.79
|
| Rate for Payer: Lucent All Commercial |
$248.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$290.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$290.00
|
| Rate for Payer: Managed Health Services Medicaid |
$178.62
|
| Rate for Payer: Managed Health Services Medicaid |
$178.62
|
| Rate for Payer: MDWise Medicaid |
$178.62
|
| Rate for Payer: MDWise Medicaid |
$178.62
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$97.42
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$97.42
|
| Rate for Payer: PHCS All Commercial |
$177.71
|
| Rate for Payer: PHCS All Commercial |
$177.71
|
| Rate for Payer: PHP All Commercial |
$307.54
|
| Rate for Payer: PHP All Commercial |
$307.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$177.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$177.71
|
| Rate for Payer: Sagamore Health Network All Products |
$177.71
|
| Rate for Payer: Sagamore Health Network All Products |
$177.71
|
| Rate for Payer: Signature Care EPO |
$272.85
|
| Rate for Payer: Signature Care EPO |
$272.85
|
| Rate for Payer: Signature Care PPO |
$272.85
|
| Rate for Payer: Signature Care PPO |
$272.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,200.00
|
| Rate for Payer: United Healthcare Commercial |
$174.61
|
| Rate for Payer: United Healthcare Commercial |
$174.61
|
| Rate for Payer: United Healthcare Medicare |
$175.24
|
| Rate for Payer: United Healthcare Medicare |
$175.24
|
|
|
PR CLOSE RX FINGR ARTICULAR FX
|
Professional
|
Both
|
$449.94
|
|
|
Service Code
|
CPT 26740
|
| Hospital Charge Code |
z26740
|
| Min. Negotiated Rate |
$114.72 |
| Max. Negotiated Rate |
$31,600.00 |
| Rate for Payer: Aetna Commercial |
$207.79
|
| Rate for Payer: Aetna Commercial |
$207.79
|
| Rate for Payer: Aetna Medicare |
$207.79
|
| Rate for Payer: Aetna Medicare |
$207.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$294.27
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$114.72
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$114.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$221.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$221.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$238.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$238.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.57
|
| Rate for Payer: Cash Price |
$260.41
|
| Rate for Payer: Cash Price |
$269.96
|
| Rate for Payer: Centivo All Commercial |
$322.07
|
| Rate for Payer: Centivo All Commercial |
$322.07
|
| Rate for Payer: Cigna All Commercial |
$207.79
|
| Rate for Payer: Cigna All Commercial |
$207.79
|
| Rate for Payer: CORVEL All Commercial |
$207.79
|
| Rate for Payer: CORVEL All Commercial |
$207.79
|
| Rate for Payer: Coventry All Commercial |
$249.35
|
| Rate for Payer: Coventry All Commercial |
$249.35
|
| Rate for Payer: Encore All Commercial |
$207.79
|
| Rate for Payer: Encore All Commercial |
$207.79
|
| Rate for Payer: Frontpath All Commercial |
$283.60
|
| Rate for Payer: Frontpath All Commercial |
$283.60
|
| Rate for Payer: Humana ChoiceCare |
$197.79
|
| Rate for Payer: Humana ChoiceCare |
$197.79
|
| Rate for Payer: Humana Medicare |
$207.79
|
| Rate for Payer: Humana Medicare |
$207.79
|
| Rate for Payer: Lucent All Commercial |
$290.91
|
| Rate for Payer: Lucent All Commercial |
$290.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$337.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$337.00
|
| Rate for Payer: Managed Health Services Medicaid |
$221.30
|
| Rate for Payer: Managed Health Services Medicaid |
$221.30
|
| Rate for Payer: MDWise Medicaid |
$221.30
|
| Rate for Payer: MDWise Medicaid |
$221.30
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$114.72
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$114.72
|
| Rate for Payer: PHCS All Commercial |
$207.79
|
| Rate for Payer: PHCS All Commercial |
$207.79
|
| Rate for Payer: PHP All Commercial |
$358.20
|
| Rate for Payer: PHP All Commercial |
$358.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$207.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$207.79
|
| Rate for Payer: Sagamore Health Network All Products |
$207.79
|
| Rate for Payer: Sagamore Health Network All Products |
$207.79
|
| Rate for Payer: Signature Care EPO |
$311.10
|
| Rate for Payer: Signature Care EPO |
$311.10
|
| Rate for Payer: Signature Care PPO |
$311.10
|
| Rate for Payer: Signature Care PPO |
$311.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$31,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$31,600.00
|
| Rate for Payer: United Healthcare Commercial |
$209.41
|
| Rate for Payer: United Healthcare Commercial |
$209.41
|
| Rate for Payer: United Healthcare Medicare |
$217.01
|
| Rate for Payer: United Healthcare Medicare |
$217.01
|
|
|
PR CLOSE RX FINGR ARTICULAR FX,MANIP
|
Professional
|
Both
|
$713.12
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
z26742
|
| Min. Negotiated Rate |
$180.60 |
| Max. Negotiated Rate |
$47,900.00 |
| Rate for Payer: Aetna Commercial |
$317.25
|
| Rate for Payer: Aetna Commercial |
$317.25
|
| Rate for Payer: Aetna Medicare |
$317.25
|
| Rate for Payer: Aetna Medicare |
$317.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$442.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$180.60
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$180.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$350.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$350.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$364.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$364.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$348.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$348.98
|
| Rate for Payer: Cash Price |
$417.12
|
| Rate for Payer: Cash Price |
$427.87
|
| Rate for Payer: Centivo All Commercial |
$491.74
|
| Rate for Payer: Centivo All Commercial |
$491.74
|
| Rate for Payer: Cigna All Commercial |
$317.25
|
| Rate for Payer: Cigna All Commercial |
$317.25
|
| Rate for Payer: CORVEL All Commercial |
$317.25
|
| Rate for Payer: CORVEL All Commercial |
$317.25
|
| Rate for Payer: Coventry All Commercial |
$380.70
|
| Rate for Payer: Coventry All Commercial |
$380.70
|
| Rate for Payer: Encore All Commercial |
$317.25
|
| Rate for Payer: Encore All Commercial |
$317.25
|
| Rate for Payer: Frontpath All Commercial |
$437.06
|
| Rate for Payer: Frontpath All Commercial |
$437.06
|
| Rate for Payer: Humana ChoiceCare |
$332.55
|
| Rate for Payer: Humana ChoiceCare |
$332.55
|
| Rate for Payer: Humana Medicare |
$317.25
|
| Rate for Payer: Humana Medicare |
$317.25
|
| Rate for Payer: Lucent All Commercial |
$444.15
|
| Rate for Payer: Lucent All Commercial |
$444.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$511.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$511.00
|
| Rate for Payer: Managed Health Services Medicaid |
$350.74
|
| Rate for Payer: Managed Health Services Medicaid |
$350.74
|
| Rate for Payer: MDWise Medicaid |
$350.74
|
| Rate for Payer: MDWise Medicaid |
$350.74
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$180.60
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$180.60
|
| Rate for Payer: PHCS All Commercial |
$317.25
|
| Rate for Payer: PHCS All Commercial |
$317.25
|
| Rate for Payer: PHP All Commercial |
$542.47
|
| Rate for Payer: PHP All Commercial |
$542.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$317.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$317.25
|
| Rate for Payer: Sagamore Health Network All Products |
$317.25
|
| Rate for Payer: Sagamore Health Network All Products |
$317.25
|
| Rate for Payer: Signature Care EPO |
$549.95
|
| Rate for Payer: Signature Care EPO |
$549.95
|
| Rate for Payer: Signature Care PPO |
$549.95
|
| Rate for Payer: Signature Care PPO |
$549.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,900.00
|
| Rate for Payer: United Healthcare Commercial |
$343.79
|
| Rate for Payer: United Healthcare Commercial |
$343.79
|
| Rate for Payer: United Healthcare Medicare |
$347.60
|
| Rate for Payer: United Healthcare Medicare |
$347.60
|
|
|
PR CLOSE RX PROX/MID FING SHFT FX
|
Professional
|
Both
|
$388.74
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
z26720
|
| Min. Negotiated Rate |
$97.94 |
| Max. Negotiated Rate |
$27,000.00 |
| Rate for Payer: Aetna Commercial |
$177.26
|
| Rate for Payer: Aetna Commercial |
$177.26
|
| Rate for Payer: Aetna Medicare |
$177.26
|
| Rate for Payer: Aetna Medicare |
$177.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$294.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$294.27
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$97.94
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$97.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$191.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$191.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$203.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$203.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$194.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$194.99
|
| Rate for Payer: Cash Price |
$224.77
|
| Rate for Payer: Cash Price |
$233.24
|
| Rate for Payer: Centivo All Commercial |
$274.75
|
| Rate for Payer: Centivo All Commercial |
$274.75
|
| Rate for Payer: Cigna All Commercial |
$177.26
|
| Rate for Payer: Cigna All Commercial |
$177.26
|
| Rate for Payer: CORVEL All Commercial |
$177.26
|
| Rate for Payer: CORVEL All Commercial |
$177.26
|
| Rate for Payer: Coventry All Commercial |
$212.71
|
| Rate for Payer: Coventry All Commercial |
$212.71
|
| Rate for Payer: Encore All Commercial |
$177.26
|
| Rate for Payer: Encore All Commercial |
$177.26
|
| Rate for Payer: Frontpath All Commercial |
$242.14
|
| Rate for Payer: Frontpath All Commercial |
$242.14
|
| Rate for Payer: Humana ChoiceCare |
$158.53
|
| Rate for Payer: Humana ChoiceCare |
$158.53
|
| Rate for Payer: Humana Medicare |
$177.26
|
| Rate for Payer: Humana Medicare |
$177.26
|
| Rate for Payer: Lucent All Commercial |
$248.16
|
| Rate for Payer: Lucent All Commercial |
$248.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$288.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$288.00
|
| Rate for Payer: Managed Health Services Medicaid |
$191.19
|
| Rate for Payer: Managed Health Services Medicaid |
$191.19
|
| Rate for Payer: MDWise Medicaid |
$191.19
|
| Rate for Payer: MDWise Medicaid |
$191.19
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$97.94
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$97.94
|
| Rate for Payer: PHCS All Commercial |
$177.26
|
| Rate for Payer: PHCS All Commercial |
$177.26
|
| Rate for Payer: PHP All Commercial |
$306.01
|
| Rate for Payer: PHP All Commercial |
$306.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$177.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$177.26
|
| Rate for Payer: Sagamore Health Network All Products |
$177.26
|
| Rate for Payer: Sagamore Health Network All Products |
$177.26
|
| Rate for Payer: Signature Care EPO |
$311.10
|
| Rate for Payer: Signature Care EPO |
$311.10
|
| Rate for Payer: Signature Care PPO |
$311.10
|
| Rate for Payer: Signature Care PPO |
$311.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,000.00
|
| Rate for Payer: United Healthcare Commercial |
$175.41
|
| Rate for Payer: United Healthcare Commercial |
$175.41
|
| Rate for Payer: United Healthcare Medicare |
$187.31
|
| Rate for Payer: United Healthcare Medicare |
$187.31
|
|
|
PR CLOSE RX PROX/MID FING SHFT FX,MANIP
|
Professional
|
Both
|
$655.40
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
z26725
|
| Min. Negotiated Rate |
$158.50 |
| Max. Negotiated Rate |
$43,500.00 |
| Rate for Payer: Aetna Commercial |
$287.25
|
| Rate for Payer: Aetna Commercial |
$287.25
|
| Rate for Payer: Aetna Medicare |
$287.25
|
| Rate for Payer: Aetna Medicare |
$287.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$312.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$312.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$312.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$312.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$312.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$312.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$312.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$312.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$158.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$158.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$322.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$322.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$330.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$330.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$315.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$315.98
|
| Rate for Payer: Cash Price |
$381.64
|
| Rate for Payer: Cash Price |
$393.24
|
| Rate for Payer: Centivo All Commercial |
$445.24
|
| Rate for Payer: Centivo All Commercial |
$445.24
|
| Rate for Payer: Cigna All Commercial |
$287.25
|
| Rate for Payer: Cigna All Commercial |
$287.25
|
| Rate for Payer: CORVEL All Commercial |
$287.25
|
| Rate for Payer: CORVEL All Commercial |
$287.25
|
| Rate for Payer: Coventry All Commercial |
$344.70
|
| Rate for Payer: Coventry All Commercial |
$344.70
|
| Rate for Payer: Encore All Commercial |
$287.25
|
| Rate for Payer: Encore All Commercial |
$287.25
|
| Rate for Payer: Frontpath All Commercial |
$395.32
|
| Rate for Payer: Frontpath All Commercial |
$395.32
|
| Rate for Payer: Humana ChoiceCare |
$294.30
|
| Rate for Payer: Humana ChoiceCare |
$294.30
|
| Rate for Payer: Humana Medicare |
$287.25
|
| Rate for Payer: Humana Medicare |
$287.25
|
| Rate for Payer: Lucent All Commercial |
$402.15
|
| Rate for Payer: Lucent All Commercial |
$402.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$464.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$464.00
|
| Rate for Payer: Managed Health Services Medicaid |
$322.35
|
| Rate for Payer: Managed Health Services Medicaid |
$322.35
|
| Rate for Payer: MDWise Medicaid |
$322.35
|
| Rate for Payer: MDWise Medicaid |
$322.35
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$158.50
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$158.50
|
| Rate for Payer: PHCS All Commercial |
$287.25
|
| Rate for Payer: PHCS All Commercial |
$287.25
|
| Rate for Payer: PHP All Commercial |
$492.06
|
| Rate for Payer: PHP All Commercial |
$492.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$287.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$287.25
|
| Rate for Payer: Sagamore Health Network All Products |
$287.25
|
| Rate for Payer: Sagamore Health Network All Products |
$287.25
|
| 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 |
$43,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,500.00
|
| Rate for Payer: United Healthcare Commercial |
$309.51
|
| Rate for Payer: United Healthcare Commercial |
$309.51
|
| Rate for Payer: United Healthcare Medicare |
$318.03
|
| Rate for Payer: United Healthcare Medicare |
$318.03
|
|
|
PR CLSD TX PELVIC RING FX W/O MANIPULATION
|
Professional
|
Both
|
$246.92
|
|
|
Service Code
|
CPT 27197
|
| Hospital Charge Code |
z27197
|
| Min. Negotiated Rate |
$111.82 |
| Max. Negotiated Rate |
$18,600.00 |
| Rate for Payer: Aetna Commercial |
$124.90
|
| Rate for Payer: Aetna Commercial |
$124.90
|
| Rate for Payer: Aetna Medicare |
$124.90
|
| Rate for Payer: Aetna Medicare |
$124.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$111.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$111.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$111.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$111.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$111.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$111.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$111.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$111.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$121.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$121.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$143.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$143.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$137.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$137.39
|
| Rate for Payer: Cash Price |
$148.15
|
| Rate for Payer: Cash Price |
$145.50
|
| Rate for Payer: Centivo All Commercial |
$193.59
|
| Rate for Payer: Centivo All Commercial |
$193.59
|
| Rate for Payer: Cigna All Commercial |
$124.90
|
| Rate for Payer: Cigna All Commercial |
$124.90
|
| Rate for Payer: CORVEL All Commercial |
$124.90
|
| Rate for Payer: CORVEL All Commercial |
$124.90
|
| Rate for Payer: Coventry All Commercial |
$149.88
|
| Rate for Payer: Coventry All Commercial |
$149.88
|
| Rate for Payer: Encore All Commercial |
$124.90
|
| Rate for Payer: Encore All Commercial |
$124.90
|
| Rate for Payer: Frontpath All Commercial |
$172.39
|
| Rate for Payer: Frontpath All Commercial |
$172.39
|
| Rate for Payer: Humana ChoiceCare |
$128.82
|
| Rate for Payer: Humana ChoiceCare |
$128.82
|
| Rate for Payer: Humana Medicare |
$124.90
|
| Rate for Payer: Humana Medicare |
$124.90
|
| Rate for Payer: Lucent All Commercial |
$174.86
|
| Rate for Payer: Lucent All Commercial |
$174.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$199.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$199.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.44
|
| Rate for Payer: Managed Health Services Medicaid |
$121.44
|
| Rate for Payer: MDWise Medicaid |
$121.44
|
| Rate for Payer: MDWise Medicaid |
$121.44
|
| Rate for Payer: PHCS All Commercial |
$124.90
|
| Rate for Payer: PHCS All Commercial |
$124.90
|
| Rate for Payer: PHP All Commercial |
$210.98
|
| Rate for Payer: PHP All Commercial |
$210.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$124.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$124.90
|
| Rate for Payer: Sagamore Health Network All Products |
$124.90
|
| Rate for Payer: Sagamore Health Network All Products |
$124.90
|
| Rate for Payer: Signature Care EPO |
$158.73
|
| Rate for Payer: Signature Care EPO |
$158.73
|
| Rate for Payer: Signature Care PPO |
$158.73
|
| Rate for Payer: Signature Care PPO |
$158.73
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,600.00
|
| Rate for Payer: United Healthcare Commercial |
$141.28
|
| Rate for Payer: United Healthcare Commercial |
$141.28
|
| Rate for Payer: United Healthcare Medicare |
$121.25
|
| Rate for Payer: United Healthcare Medicare |
$121.25
|
|
|
PR CMBND ANTERPOST COLPORRAPHY W/CYSTO
|
Professional
|
Both
|
$1,446.90
|
|
|
Service Code
|
CPT 57260
|
| Hospital Charge Code |
z57260
|
| Min. Negotiated Rate |
$579.43 |
| Max. Negotiated Rate |
$94,900.00 |
| Rate for Payer: Aetna Commercial |
$736.81
|
| Rate for Payer: Aetna Commercial |
$736.81
|
| Rate for Payer: Aetna Medicare |
$736.81
|
| Rate for Payer: Aetna Medicare |
$736.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$688.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$688.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$688.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$688.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$688.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$688.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$688.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$688.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$711.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$711.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$847.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$847.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$810.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$810.49
|
| Rate for Payer: Cash Price |
$868.14
|
| Rate for Payer: Cash Price |
$854.90
|
| Rate for Payer: Centivo All Commercial |
$1,142.06
|
| Rate for Payer: Centivo All Commercial |
$1,142.06
|
| Rate for Payer: Cigna All Commercial |
$736.81
|
| Rate for Payer: Cigna All Commercial |
$736.81
|
| Rate for Payer: CORVEL All Commercial |
$736.81
|
| Rate for Payer: CORVEL All Commercial |
$736.81
|
| Rate for Payer: Coventry All Commercial |
$884.17
|
| Rate for Payer: Coventry All Commercial |
$884.17
|
| Rate for Payer: Encore All Commercial |
$736.81
|
| Rate for Payer: Encore All Commercial |
$736.81
|
| Rate for Payer: Frontpath All Commercial |
$1,021.31
|
| Rate for Payer: Frontpath All Commercial |
$1,021.31
|
| Rate for Payer: Humana ChoiceCare |
$579.43
|
| Rate for Payer: Humana ChoiceCare |
$579.43
|
| Rate for Payer: Humana Medicare |
$736.81
|
| Rate for Payer: Humana Medicare |
$736.81
|
| Rate for Payer: Lucent All Commercial |
$1,031.53
|
| Rate for Payer: Lucent All Commercial |
$1,031.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,022.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,022.00
|
| Rate for Payer: Managed Health Services Medicaid |
$711.64
|
| Rate for Payer: Managed Health Services Medicaid |
$711.64
|
| Rate for Payer: MDWise Medicaid |
$711.64
|
| Rate for Payer: MDWise Medicaid |
$711.64
|
| Rate for Payer: PHCS All Commercial |
$736.81
|
| Rate for Payer: PHCS All Commercial |
$736.81
|
| Rate for Payer: PHP All Commercial |
$940.40
|
| Rate for Payer: PHP All Commercial |
$940.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$736.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$736.81
|
| Rate for Payer: Sagamore Health Network All Products |
$736.81
|
| Rate for Payer: Sagamore Health Network All Products |
$736.81
|
| Rate for Payer: Signature Care EPO |
$696.15
|
| Rate for Payer: Signature Care EPO |
$696.15
|
| Rate for Payer: Signature Care PPO |
$696.15
|
| Rate for Payer: Signature Care PPO |
$696.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94,900.00
|
| Rate for Payer: United Healthcare Commercial |
$914.05
|
| Rate for Payer: United Healthcare Commercial |
$914.05
|
| Rate for Payer: United Healthcare Medicare |
$712.42
|
| Rate for Payer: United Healthcare Medicare |
$712.42
|
|
|
PR CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR
|
Professional
|
Both
|
$1,617.28
|
|
|
Service Code
|
CPT 57265
|
| Hospital Charge Code |
z57265
|
| Min. Negotiated Rate |
$770.49 |
| Max. Negotiated Rate |
$106,200.00 |
| Rate for Payer: Aetna Commercial |
$824.47
|
| Rate for Payer: Aetna Commercial |
$824.47
|
| Rate for Payer: Aetna Medicare |
$824.47
|
| Rate for Payer: Aetna Medicare |
$824.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$914.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$914.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$914.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$914.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$914.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$914.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$914.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$914.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$795.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$795.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$948.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$948.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$906.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$906.92
|
| Rate for Payer: Cash Price |
$970.37
|
| Rate for Payer: Cash Price |
$956.22
|
| Rate for Payer: Centivo All Commercial |
$1,277.93
|
| Rate for Payer: Centivo All Commercial |
$1,277.93
|
| Rate for Payer: Cigna All Commercial |
$824.47
|
| Rate for Payer: Cigna All Commercial |
$824.47
|
| Rate for Payer: CORVEL All Commercial |
$824.47
|
| Rate for Payer: CORVEL All Commercial |
$824.47
|
| Rate for Payer: Coventry All Commercial |
$989.36
|
| Rate for Payer: Coventry All Commercial |
$989.36
|
| Rate for Payer: Encore All Commercial |
$824.47
|
| Rate for Payer: Encore All Commercial |
$824.47
|
| Rate for Payer: Frontpath All Commercial |
$1,144.46
|
| Rate for Payer: Frontpath All Commercial |
$1,144.46
|
| Rate for Payer: Humana ChoiceCare |
$770.49
|
| Rate for Payer: Humana ChoiceCare |
$770.49
|
| Rate for Payer: Humana Medicare |
$824.47
|
| Rate for Payer: Humana Medicare |
$824.47
|
| Rate for Payer: Lucent All Commercial |
$1,154.26
|
| Rate for Payer: Lucent All Commercial |
$1,154.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,143.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,143.00
|
| Rate for Payer: Managed Health Services Medicaid |
$795.44
|
| Rate for Payer: Managed Health Services Medicaid |
$795.44
|
| Rate for Payer: MDWise Medicaid |
$795.44
|
| Rate for Payer: MDWise Medicaid |
$795.44
|
| Rate for Payer: PHCS All Commercial |
$824.47
|
| Rate for Payer: PHCS All Commercial |
$824.47
|
| Rate for Payer: PHP All Commercial |
$1,051.84
|
| Rate for Payer: PHP All Commercial |
$1,051.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$824.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$824.47
|
| Rate for Payer: Sagamore Health Network All Products |
$824.47
|
| Rate for Payer: Sagamore Health Network All Products |
$824.47
|
| Rate for Payer: Signature Care EPO |
$924.80
|
| Rate for Payer: Signature Care EPO |
$924.80
|
| Rate for Payer: Signature Care PPO |
$924.80
|
| Rate for Payer: Signature Care PPO |
$924.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$106,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$106,200.00
|
| Rate for Payer: United Healthcare Commercial |
$1,020.51
|
| Rate for Payer: United Healthcare Commercial |
$1,020.51
|
| Rate for Payer: United Healthcare Medicare |
$796.85
|
| Rate for Payer: United Healthcare Medicare |
$796.85
|
|
|
PR COCM BY RHC/FQHC 60 MIN MO
|
Professional
|
Both
|
$283.66
|
|
|
Service Code
|
CPT G0512
|
| Hospital Charge Code |
zG0512
|
| Min. Negotiated Rate |
$75.74 |
| Max. Negotiated Rate |
$138.51 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$134.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$134.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$134.30
|
| Rate for Payer: Cash Price |
$170.20
|
| Rate for Payer: Humana ChoiceCare |
$117.16
|
| Rate for Payer: PHP All Commercial |
$138.51
|
| Rate for Payer: United Healthcare Commercial |
$75.74
|
|
|
PR COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D
|
Professional
|
Both
|
$102.20
|
|
|
Service Code
|
CPT 99091
|
| Hospital Charge Code |
z99091
|
| Min. Negotiated Rate |
$50.27 |
| Max. Negotiated Rate |
$82.49 |
| Rate for Payer: Aetna Commercial |
$53.22
|
| Rate for Payer: Aetna Commercial |
$53.22
|
| Rate for Payer: Aetna Medicare |
$53.22
|
| Rate for Payer: Aetna Medicare |
$53.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$50.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$50.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$58.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$58.54
|
| Rate for Payer: Cash Price |
$61.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Centivo All Commercial |
$82.49
|
| Rate for Payer: Centivo All Commercial |
$82.49
|
| Rate for Payer: Cigna All Commercial |
$53.22
|
| Rate for Payer: Cigna All Commercial |
$53.22
|
| Rate for Payer: CORVEL All Commercial |
$53.22
|
| Rate for Payer: CORVEL All Commercial |
$53.22
|
| Rate for Payer: Coventry All Commercial |
$63.86
|
| Rate for Payer: Coventry All Commercial |
$63.86
|
| Rate for Payer: Encore All Commercial |
$53.22
|
| Rate for Payer: Encore All Commercial |
$53.22
|
| Rate for Payer: Frontpath All Commercial |
$57.60
|
| Rate for Payer: Frontpath All Commercial |
$57.60
|
| Rate for Payer: Humana ChoiceCare |
$55.97
|
| Rate for Payer: Humana ChoiceCare |
$55.97
|
| Rate for Payer: Humana Medicare |
$53.22
|
| Rate for Payer: Humana Medicare |
$53.22
|
| Rate for Payer: Lucent All Commercial |
$74.51
|
| Rate for Payer: Lucent All Commercial |
$74.51
|
| Rate for Payer: Managed Health Services Medicaid |
$50.27
|
| Rate for Payer: Managed Health Services Medicaid |
$50.27
|
| Rate for Payer: MDWise Medicaid |
$50.27
|
| Rate for Payer: MDWise Medicaid |
$50.27
|
| Rate for Payer: PHCS All Commercial |
$53.22
|
| Rate for Payer: PHCS All Commercial |
$53.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$53.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$53.22
|
| Rate for Payer: Sagamore Health Network All Products |
$53.22
|
| Rate for Payer: Sagamore Health Network All Products |
$53.22
|
| Rate for Payer: United Healthcare Commercial |
$65.99
|
| Rate for Payer: United Healthcare Commercial |
$65.99
|
| Rate for Payer: United Healthcare Medicare |
$50.27
|
| Rate for Payer: United Healthcare Medicare |
$50.27
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
CPT G0121
|
| Hospital Charge Code |
zG0121
|
| Min. Negotiated Rate |
$145.44 |
| Max. Negotiated Rate |
$472.36 |
| Rate for Payer: Aetna Commercial |
$173.61
|
| Rate for Payer: Aetna Medicare |
$173.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$417.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$417.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$417.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$417.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$310.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$199.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$190.97
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Centivo All Commercial |
$269.10
|
| Rate for Payer: Cigna All Commercial |
$173.61
|
| Rate for Payer: CORVEL All Commercial |
$173.61
|
| Rate for Payer: Coventry All Commercial |
$208.33
|
| Rate for Payer: Encore All Commercial |
$173.61
|
| Rate for Payer: Humana ChoiceCare |
$145.44
|
| Rate for Payer: Humana Medicare |
$173.61
|
| Rate for Payer: Lucent All Commercial |
$243.05
|
| Rate for Payer: Managed Health Services Medicaid |
$310.11
|
| Rate for Payer: MDWise Medicaid |
$310.11
|
| Rate for Payer: PHCS All Commercial |
$173.61
|
| Rate for Payer: PHP All Commercial |
$146.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$173.61
|
| Rate for Payer: Sagamore Health Network All Products |
$173.61
|
| Rate for Payer: Signature Care EPO |
$472.36
|
| Rate for Payer: Signature Care PPO |
$472.36
|
| Rate for Payer: United Healthcare Commercial |
$248.13
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Professional
|
Both
|
$630.20
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
z45378
|
| Min. Negotiated Rate |
$93.44 |
| Max. Negotiated Rate |
$23,900.00 |
| Rate for Payer: Aetna Commercial |
$173.45
|
| Rate for Payer: Aetna Commercial |
$173.45
|
| Rate for Payer: Aetna Medicare |
$173.45
|
| Rate for Payer: Aetna Medicare |
$173.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$519.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$519.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$519.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$519.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$519.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$519.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$519.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$519.26
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.44
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$309.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$309.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$199.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$199.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$190.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$190.79
|
| Rate for Payer: Cash Price |
$372.53
|
| Rate for Payer: Cash Price |
$378.12
|
| Rate for Payer: Centivo All Commercial |
$268.85
|
| Rate for Payer: Centivo All Commercial |
$268.85
|
| Rate for Payer: Cigna All Commercial |
$173.45
|
| Rate for Payer: Cigna All Commercial |
$173.45
|
| Rate for Payer: CORVEL All Commercial |
$173.45
|
| Rate for Payer: CORVEL All Commercial |
$173.45
|
| Rate for Payer: Coventry All Commercial |
$208.14
|
| Rate for Payer: Coventry All Commercial |
$208.14
|
| Rate for Payer: Encore All Commercial |
$173.45
|
| Rate for Payer: Encore All Commercial |
$173.45
|
| Rate for Payer: Frontpath All Commercial |
$237.82
|
| Rate for Payer: Frontpath All Commercial |
$237.82
|
| Rate for Payer: Humana ChoiceCare |
$233.74
|
| Rate for Payer: Humana ChoiceCare |
$233.74
|
| Rate for Payer: Humana Medicare |
$173.45
|
| Rate for Payer: Humana Medicare |
$173.45
|
| Rate for Payer: Lucent All Commercial |
$242.83
|
| Rate for Payer: Lucent All Commercial |
$242.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$256.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$256.00
|
| Rate for Payer: Managed Health Services Medicaid |
$309.95
|
| Rate for Payer: Managed Health Services Medicaid |
$309.95
|
| Rate for Payer: MDWise Medicaid |
$309.95
|
| Rate for Payer: MDWise Medicaid |
$309.95
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.44
|
| Rate for Payer: PHCS All Commercial |
$173.45
|
| Rate for Payer: PHCS All Commercial |
$173.45
|
| Rate for Payer: PHP All Commercial |
$291.86
|
| Rate for Payer: PHP All Commercial |
$291.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$173.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$173.45
|
| Rate for Payer: Sagamore Health Network All Products |
$173.45
|
| Rate for Payer: Sagamore Health Network All Products |
$173.45
|
| Rate for Payer: Signature Care EPO |
$535.50
|
| Rate for Payer: Signature Care EPO |
$535.50
|
| Rate for Payer: Signature Care PPO |
$535.50
|
| Rate for Payer: Signature Care PPO |
$535.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$23,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$23,900.00
|
| Rate for Payer: United Healthcare Commercial |
$248.13
|
| Rate for Payer: United Healthcare Commercial |
$248.13
|
| Rate for Payer: United Healthcare Medicare |
$310.44
|
| Rate for Payer: United Healthcare Medicare |
$310.44
|
|
