|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$611.34
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
z45390
|
| Min. Negotiated Rate |
$300.69 |
| Max. Negotiated Rate |
$485.75 |
| Rate for Payer: Aetna Commercial |
$313.39
|
| Rate for Payer: Aetna Medicare |
$313.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$300.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$360.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$344.73
|
| Rate for Payer: Cash Price |
$366.80
|
| Rate for Payer: Centivo All Commercial |
$485.75
|
| Rate for Payer: Cigna All Commercial |
$313.39
|
| Rate for Payer: CORVEL All Commercial |
$313.39
|
| Rate for Payer: Coventry All Commercial |
$376.07
|
| Rate for Payer: Encore All Commercial |
$313.39
|
| Rate for Payer: Frontpath All Commercial |
$427.84
|
| Rate for Payer: Humana ChoiceCare |
$400.23
|
| Rate for Payer: Humana Medicare |
$313.39
|
| Rate for Payer: Lucent All Commercial |
$438.75
|
| Rate for Payer: Managed Health Services Medicaid |
$300.69
|
| Rate for Payer: MDWise Medicaid |
$300.69
|
| Rate for Payer: PHCS All Commercial |
$313.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$313.39
|
| Rate for Payer: Sagamore Health Network All Products |
$313.39
|
| Rate for Payer: United Healthcare Commercial |
$419.90
|
| Rate for Payer: United Healthcare Medicare |
$300.89
|
|
|
PR COLONOSCOPY STOMA CONTROL BLEEDING
|
Professional
|
Both
|
$1,177.72
|
|
|
Service Code
|
CPT 44391
|
| Hospital Charge Code |
z44391
|
| Min. Negotiated Rate |
$216.09 |
| Max. Negotiated Rate |
$585.15 |
| Rate for Payer: Aetna Commercial |
$216.96
|
| Rate for Payer: Aetna Commercial |
$216.96
|
| Rate for Payer: Aetna Medicare |
$216.96
|
| Rate for Payer: Aetna Medicare |
$216.96
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$216.09
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$216.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$579.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$579.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$249.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$249.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$238.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$238.66
|
| Rate for Payer: Cash Price |
$702.18
|
| Rate for Payer: Cash Price |
$706.63
|
| Rate for Payer: Centivo All Commercial |
$336.29
|
| Rate for Payer: Centivo All Commercial |
$336.29
|
| Rate for Payer: Cigna All Commercial |
$216.96
|
| Rate for Payer: Cigna All Commercial |
$216.96
|
| Rate for Payer: CORVEL All Commercial |
$216.96
|
| Rate for Payer: CORVEL All Commercial |
$216.96
|
| Rate for Payer: Coventry All Commercial |
$260.35
|
| Rate for Payer: Coventry All Commercial |
$260.35
|
| Rate for Payer: Encore All Commercial |
$216.96
|
| Rate for Payer: Encore All Commercial |
$216.96
|
| Rate for Payer: Frontpath All Commercial |
$297.45
|
| Rate for Payer: Frontpath All Commercial |
$297.45
|
| Rate for Payer: Humana ChoiceCare |
$271.70
|
| Rate for Payer: Humana ChoiceCare |
$271.70
|
| Rate for Payer: Humana Medicare |
$216.96
|
| Rate for Payer: Humana Medicare |
$216.96
|
| Rate for Payer: Lucent All Commercial |
$303.74
|
| Rate for Payer: Lucent All Commercial |
$303.74
|
| Rate for Payer: Managed Health Services Medicaid |
$579.25
|
| Rate for Payer: Managed Health Services Medicaid |
$579.25
|
| Rate for Payer: MDWise Medicaid |
$579.25
|
| Rate for Payer: MDWise Medicaid |
$579.25
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$216.09
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$216.09
|
| Rate for Payer: PHCS All Commercial |
$216.96
|
| Rate for Payer: PHCS All Commercial |
$216.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$216.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$216.96
|
| Rate for Payer: Sagamore Health Network All Products |
$216.96
|
| Rate for Payer: Sagamore Health Network All Products |
$216.96
|
| Rate for Payer: United Healthcare Commercial |
$289.58
|
| Rate for Payer: United Healthcare Commercial |
$289.58
|
| Rate for Payer: United Healthcare Medicare |
$585.15
|
| Rate for Payer: United Healthcare Medicare |
$585.15
|
|
|
PR COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX
|
Professional
|
Both
|
$584.10
|
|
|
Service Code
|
CPT 44388
|
| Hospital Charge Code |
z44388
|
| Min. Negotiated Rate |
$79.25 |
| Max. Negotiated Rate |
$20,200.00 |
| Rate for Payer: Aetna Commercial |
$146.04
|
| Rate for Payer: Aetna Commercial |
$146.04
|
| Rate for Payer: Aetna Medicare |
$146.04
|
| Rate for Payer: Aetna Medicare |
$146.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$347.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$347.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$347.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$347.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$347.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$347.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$347.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$347.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$79.25
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$79.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$287.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$287.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$167.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$167.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$160.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$160.64
|
| Rate for Payer: Cash Price |
$345.50
|
| Rate for Payer: Cash Price |
$350.46
|
| Rate for Payer: Centivo All Commercial |
$226.36
|
| Rate for Payer: Centivo All Commercial |
$226.36
|
| Rate for Payer: Cigna All Commercial |
$146.04
|
| Rate for Payer: Cigna All Commercial |
$146.04
|
| Rate for Payer: CORVEL All Commercial |
$146.04
|
| Rate for Payer: CORVEL All Commercial |
$146.04
|
| Rate for Payer: Coventry All Commercial |
$175.25
|
| Rate for Payer: Coventry All Commercial |
$175.25
|
| Rate for Payer: Encore All Commercial |
$146.04
|
| Rate for Payer: Encore All Commercial |
$146.04
|
| Rate for Payer: Frontpath All Commercial |
$202.02
|
| Rate for Payer: Frontpath All Commercial |
$202.02
|
| Rate for Payer: Humana ChoiceCare |
$180.33
|
| Rate for Payer: Humana ChoiceCare |
$180.33
|
| Rate for Payer: Humana Medicare |
$146.04
|
| Rate for Payer: Humana Medicare |
$146.04
|
| Rate for Payer: Lucent All Commercial |
$204.46
|
| Rate for Payer: Lucent All Commercial |
$204.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$216.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$216.00
|
| Rate for Payer: Managed Health Services Medicaid |
$287.28
|
| Rate for Payer: Managed Health Services Medicaid |
$287.28
|
| Rate for Payer: MDWise Medicaid |
$287.28
|
| Rate for Payer: MDWise Medicaid |
$287.28
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$79.25
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$79.25
|
| Rate for Payer: PHCS All Commercial |
$146.04
|
| Rate for Payer: PHCS All Commercial |
$146.04
|
| Rate for Payer: PHP All Commercial |
$246.12
|
| Rate for Payer: PHP All Commercial |
$246.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$146.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$146.04
|
| Rate for Payer: Sagamore Health Network All Products |
$146.04
|
| Rate for Payer: Sagamore Health Network All Products |
$146.04
|
| Rate for Payer: Signature Care EPO |
$437.75
|
| Rate for Payer: Signature Care EPO |
$437.75
|
| Rate for Payer: Signature Care PPO |
$437.75
|
| Rate for Payer: Signature Care PPO |
$437.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,200.00
|
| Rate for Payer: United Healthcare Commercial |
$189.61
|
| Rate for Payer: United Healthcare Commercial |
$189.61
|
| Rate for Payer: United Healthcare Medicare |
$287.92
|
| Rate for Payer: United Healthcare Medicare |
$287.92
|
|
|
PR COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$760.88
|
|
|
Service Code
|
CPT 44389
|
| Hospital Charge Code |
z44389
|
| Min. Negotiated Rate |
$158.44 |
| Max. Negotiated Rate |
$376.44 |
| Rate for Payer: Aetna Commercial |
$161.24
|
| Rate for Payer: Aetna Commercial |
$161.24
|
| Rate for Payer: Aetna Medicare |
$161.24
|
| Rate for Payer: Aetna Medicare |
$161.24
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$158.44
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$158.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$374.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$374.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$185.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$185.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$177.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$177.36
|
| Rate for Payer: Cash Price |
$451.73
|
| Rate for Payer: Cash Price |
$456.53
|
| Rate for Payer: Centivo All Commercial |
$249.92
|
| Rate for Payer: Centivo All Commercial |
$249.92
|
| Rate for Payer: Cigna All Commercial |
$161.24
|
| Rate for Payer: Cigna All Commercial |
$161.24
|
| Rate for Payer: CORVEL All Commercial |
$161.24
|
| Rate for Payer: CORVEL All Commercial |
$161.24
|
| Rate for Payer: Coventry All Commercial |
$193.49
|
| Rate for Payer: Coventry All Commercial |
$193.49
|
| Rate for Payer: Encore All Commercial |
$161.24
|
| Rate for Payer: Encore All Commercial |
$161.24
|
| Rate for Payer: Frontpath All Commercial |
$221.60
|
| Rate for Payer: Frontpath All Commercial |
$221.60
|
| Rate for Payer: Humana ChoiceCare |
$199.53
|
| Rate for Payer: Humana ChoiceCare |
$199.53
|
| Rate for Payer: Humana Medicare |
$161.24
|
| Rate for Payer: Humana Medicare |
$161.24
|
| Rate for Payer: Lucent All Commercial |
$225.74
|
| Rate for Payer: Lucent All Commercial |
$225.74
|
| Rate for Payer: Managed Health Services Medicaid |
$374.23
|
| Rate for Payer: Managed Health Services Medicaid |
$374.23
|
| Rate for Payer: MDWise Medicaid |
$374.23
|
| Rate for Payer: MDWise Medicaid |
$374.23
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$158.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$158.44
|
| Rate for Payer: PHCS All Commercial |
$161.24
|
| Rate for Payer: PHCS All Commercial |
$161.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$161.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$161.24
|
| Rate for Payer: Sagamore Health Network All Products |
$161.24
|
| Rate for Payer: Sagamore Health Network All Products |
$161.24
|
| Rate for Payer: United Healthcare Commercial |
$211.73
|
| Rate for Payer: United Healthcare Commercial |
$211.73
|
| Rate for Payer: United Healthcare Medicare |
$376.44
|
| Rate for Payer: United Healthcare Medicare |
$376.44
|
|
|
PR COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE
|
Professional
|
Both
|
$811.16
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
z44394
|
| Min. Negotiated Rate |
$212.00 |
| Max. Negotiated Rate |
$29,200.00 |
| Rate for Payer: Aetna Commercial |
$212.00
|
| Rate for Payer: Aetna Commercial |
$212.00
|
| Rate for Payer: Aetna Medicare |
$212.00
|
| Rate for Payer: Aetna Medicare |
$212.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$500.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$500.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$500.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$500.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$500.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$500.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$500.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$500.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$220.66
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$220.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$398.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$398.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$243.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$243.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$233.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$233.20
|
| Rate for Payer: Cash Price |
$480.88
|
| Rate for Payer: Cash Price |
$486.70
|
| Rate for Payer: Centivo All Commercial |
$328.60
|
| Rate for Payer: Centivo All Commercial |
$328.60
|
| Rate for Payer: Cigna All Commercial |
$212.00
|
| Rate for Payer: Cigna All Commercial |
$212.00
|
| Rate for Payer: CORVEL All Commercial |
$212.00
|
| Rate for Payer: CORVEL All Commercial |
$212.00
|
| Rate for Payer: Coventry All Commercial |
$254.40
|
| Rate for Payer: Coventry All Commercial |
$254.40
|
| Rate for Payer: Encore All Commercial |
$212.00
|
| Rate for Payer: Encore All Commercial |
$212.00
|
| Rate for Payer: Frontpath All Commercial |
$292.08
|
| Rate for Payer: Frontpath All Commercial |
$292.08
|
| Rate for Payer: Humana ChoiceCare |
$278.71
|
| Rate for Payer: Humana ChoiceCare |
$278.71
|
| Rate for Payer: Humana Medicare |
$212.00
|
| Rate for Payer: Humana Medicare |
$212.00
|
| Rate for Payer: Lucent All Commercial |
$296.80
|
| Rate for Payer: Lucent All Commercial |
$296.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$313.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$313.00
|
| Rate for Payer: Managed Health Services Medicaid |
$398.96
|
| Rate for Payer: Managed Health Services Medicaid |
$398.96
|
| Rate for Payer: MDWise Medicaid |
$398.96
|
| Rate for Payer: MDWise Medicaid |
$398.96
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$220.66
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$220.66
|
| Rate for Payer: PHCS All Commercial |
$212.00
|
| Rate for Payer: PHCS All Commercial |
$212.00
|
| Rate for Payer: PHP All Commercial |
$356.05
|
| Rate for Payer: PHP All Commercial |
$356.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$212.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$212.00
|
| Rate for Payer: Sagamore Health Network All Products |
$212.00
|
| Rate for Payer: Sagamore Health Network All Products |
$212.00
|
| Rate for Payer: Signature Care EPO |
$668.95
|
| Rate for Payer: Signature Care EPO |
$668.95
|
| Rate for Payer: Signature Care PPO |
$668.95
|
| Rate for Payer: Signature Care PPO |
$668.95
|
| 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 |
$294.79
|
| Rate for Payer: United Healthcare Commercial |
$294.79
|
| Rate for Payer: United Healthcare Medicare |
$400.73
|
| Rate for Payer: United Healthcare Medicare |
$400.73
|
|
|
PR COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION
|
Professional
|
Both
|
$777.46
|
|
|
Service Code
|
CPT 44404
|
| Hospital Charge Code |
z44404
|
| Min. Negotiated Rate |
$161.40 |
| Max. Negotiated Rate |
$385.18 |
| Rate for Payer: Aetna Commercial |
$161.40
|
| Rate for Payer: Aetna Commercial |
$161.40
|
| Rate for Payer: Aetna Medicare |
$161.40
|
| Rate for Payer: Aetna Medicare |
$161.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$382.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$382.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$185.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$185.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$177.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$177.54
|
| Rate for Payer: Cash Price |
$462.22
|
| Rate for Payer: Cash Price |
$466.48
|
| Rate for Payer: Centivo All Commercial |
$250.17
|
| Rate for Payer: Centivo All Commercial |
$250.17
|
| Rate for Payer: Cigna All Commercial |
$161.40
|
| Rate for Payer: Cigna All Commercial |
$161.40
|
| Rate for Payer: CORVEL All Commercial |
$161.40
|
| Rate for Payer: CORVEL All Commercial |
$161.40
|
| Rate for Payer: Coventry All Commercial |
$193.68
|
| Rate for Payer: Coventry All Commercial |
$193.68
|
| Rate for Payer: Encore All Commercial |
$161.40
|
| Rate for Payer: Encore All Commercial |
$161.40
|
| Rate for Payer: Frontpath All Commercial |
$222.09
|
| Rate for Payer: Frontpath All Commercial |
$222.09
|
| Rate for Payer: Humana ChoiceCare |
$209.95
|
| Rate for Payer: Humana ChoiceCare |
$209.95
|
| Rate for Payer: Humana Medicare |
$161.40
|
| Rate for Payer: Humana Medicare |
$161.40
|
| Rate for Payer: Lucent All Commercial |
$225.96
|
| Rate for Payer: Lucent All Commercial |
$225.96
|
| Rate for Payer: Managed Health Services Medicaid |
$382.39
|
| Rate for Payer: Managed Health Services Medicaid |
$382.39
|
| Rate for Payer: MDWise Medicaid |
$382.39
|
| Rate for Payer: MDWise Medicaid |
$382.39
|
| Rate for Payer: PHCS All Commercial |
$161.40
|
| Rate for Payer: PHCS All Commercial |
$161.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$161.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$161.40
|
| Rate for Payer: Sagamore Health Network All Products |
$161.40
|
| Rate for Payer: Sagamore Health Network All Products |
$161.40
|
| Rate for Payer: United Healthcare Commercial |
$220.25
|
| Rate for Payer: United Healthcare Commercial |
$220.25
|
| Rate for Payer: United Healthcare Medicare |
$385.18
|
| Rate for Payer: United Healthcare Medicare |
$385.18
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$803.04
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
z45380
|
| Min. Negotiated Rate |
$188.66 |
| Max. Negotiated Rate |
$26,000.00 |
| Rate for Payer: Aetna Commercial |
$188.66
|
| Rate for Payer: Aetna Commercial |
$188.66
|
| Rate for Payer: Aetna Medicare |
$188.66
|
| Rate for Payer: Aetna Medicare |
$188.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$623.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$623.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$623.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$623.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$623.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$623.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$623.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$623.48
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$202.79
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$202.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$394.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$394.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$216.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$216.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$207.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$207.53
|
| Rate for Payer: Cash Price |
$476.26
|
| Rate for Payer: Cash Price |
$481.82
|
| Rate for Payer: Centivo All Commercial |
$292.42
|
| Rate for Payer: Centivo All Commercial |
$292.42
|
| Rate for Payer: Cigna All Commercial |
$188.66
|
| Rate for Payer: Cigna All Commercial |
$188.66
|
| Rate for Payer: CORVEL All Commercial |
$188.66
|
| Rate for Payer: CORVEL All Commercial |
$188.66
|
| Rate for Payer: Coventry All Commercial |
$226.39
|
| Rate for Payer: Coventry All Commercial |
$226.39
|
| Rate for Payer: Encore All Commercial |
$188.66
|
| Rate for Payer: Encore All Commercial |
$188.66
|
| Rate for Payer: Frontpath All Commercial |
$257.97
|
| Rate for Payer: Frontpath All Commercial |
$257.97
|
| Rate for Payer: Humana ChoiceCare |
$279.39
|
| Rate for Payer: Humana ChoiceCare |
$279.39
|
| Rate for Payer: Humana Medicare |
$188.66
|
| Rate for Payer: Humana Medicare |
$188.66
|
| Rate for Payer: Lucent All Commercial |
$264.12
|
| Rate for Payer: Lucent All Commercial |
$264.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$279.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$279.00
|
| Rate for Payer: Managed Health Services Medicaid |
$394.97
|
| Rate for Payer: Managed Health Services Medicaid |
$394.97
|
| Rate for Payer: MDWise Medicaid |
$394.97
|
| Rate for Payer: MDWise Medicaid |
$394.97
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$202.79
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$202.79
|
| Rate for Payer: PHCS All Commercial |
$188.66
|
| Rate for Payer: PHCS All Commercial |
$188.66
|
| Rate for Payer: PHP All Commercial |
$317.68
|
| Rate for Payer: PHP All Commercial |
$317.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$188.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$188.66
|
| Rate for Payer: Sagamore Health Network All Products |
$188.66
|
| Rate for Payer: Sagamore Health Network All Products |
$188.66
|
| Rate for Payer: Signature Care EPO |
$632.40
|
| Rate for Payer: Signature Care EPO |
$632.40
|
| Rate for Payer: Signature Care PPO |
$632.40
|
| Rate for Payer: Signature Care PPO |
$632.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,000.00
|
| Rate for Payer: United Healthcare Commercial |
$298.98
|
| Rate for Payer: United Healthcare Commercial |
$298.98
|
| Rate for Payer: United Healthcare Medicare |
$396.88
|
| Rate for Payer: United Healthcare Medicare |
$396.88
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$909.50
|
|
|
Service Code
|
CPT G0105
|
| Hospital Charge Code |
zG0105
|
| Min. Negotiated Rate |
$145.31 |
| Max. Negotiated Rate |
$472.36 |
| Rate for Payer: Aetna Commercial |
$173.45
|
| Rate for Payer: Aetna Medicare |
$173.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$413.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$413.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$413.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$413.20
|
| 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 Medicare |
$190.79
|
| Rate for Payer: Cash Price |
$545.70
|
| Rate for Payer: Centivo All Commercial |
$268.85
|
| Rate for Payer: Cigna All Commercial |
$173.45
|
| Rate for Payer: CORVEL All Commercial |
$173.45
|
| Rate for Payer: Coventry All Commercial |
$208.14
|
| Rate for Payer: Encore All Commercial |
$173.45
|
| Rate for Payer: Humana ChoiceCare |
$145.31
|
| Rate for Payer: Humana Medicare |
$173.45
|
| Rate for Payer: Lucent All Commercial |
$242.83
|
| Rate for Payer: Managed Health Services Medicaid |
$309.95
|
| Rate for Payer: MDWise Medicaid |
$309.95
|
| Rate for Payer: PHCS All Commercial |
$173.45
|
| Rate for Payer: PHP All Commercial |
$146.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$173.45
|
| Rate for Payer: Sagamore Health Network All Products |
$173.45
|
| 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 COLPORRHAPHY, SUTURE VAGINAL INJURY, NON-OB
|
Professional
|
Both
|
$620.76
|
|
|
Service Code
|
CPT 57200
|
| Hospital Charge Code |
z57200
|
| Min. Negotiated Rate |
$299.65 |
| Max. Negotiated Rate |
$40,400.00 |
| Rate for Payer: Aetna Commercial |
$314.21
|
| Rate for Payer: Aetna Commercial |
$314.21
|
| Rate for Payer: Aetna Medicare |
$314.21
|
| Rate for Payer: Aetna Medicare |
$314.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$356.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$356.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$356.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$356.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$356.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$356.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$356.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$356.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$305.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$305.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$361.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$361.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$345.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$345.63
|
| Rate for Payer: Cash Price |
$372.46
|
| Rate for Payer: Cash Price |
$363.85
|
| Rate for Payer: Centivo All Commercial |
$487.03
|
| Rate for Payer: Centivo All Commercial |
$487.03
|
| Rate for Payer: Cigna All Commercial |
$314.21
|
| Rate for Payer: Cigna All Commercial |
$314.21
|
| Rate for Payer: CORVEL All Commercial |
$314.21
|
| Rate for Payer: CORVEL All Commercial |
$314.21
|
| Rate for Payer: Coventry All Commercial |
$377.05
|
| Rate for Payer: Coventry All Commercial |
$377.05
|
| Rate for Payer: Encore All Commercial |
$314.21
|
| Rate for Payer: Encore All Commercial |
$314.21
|
| Rate for Payer: Frontpath All Commercial |
$431.92
|
| Rate for Payer: Frontpath All Commercial |
$431.92
|
| Rate for Payer: Humana ChoiceCare |
$299.65
|
| Rate for Payer: Humana ChoiceCare |
$299.65
|
| Rate for Payer: Humana Medicare |
$314.21
|
| Rate for Payer: Humana Medicare |
$314.21
|
| Rate for Payer: Lucent All Commercial |
$439.89
|
| Rate for Payer: Lucent All Commercial |
$439.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$435.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$435.00
|
| Rate for Payer: Managed Health Services Medicaid |
$305.32
|
| Rate for Payer: Managed Health Services Medicaid |
$305.32
|
| Rate for Payer: MDWise Medicaid |
$305.32
|
| Rate for Payer: MDWise Medicaid |
$305.32
|
| Rate for Payer: PHCS All Commercial |
$314.21
|
| Rate for Payer: PHCS All Commercial |
$314.21
|
| Rate for Payer: PHP All Commercial |
$400.23
|
| Rate for Payer: PHP All Commercial |
$400.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$314.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$314.21
|
| Rate for Payer: Sagamore Health Network All Products |
$314.21
|
| Rate for Payer: Sagamore Health Network All Products |
$314.21
|
| Rate for Payer: Signature Care EPO |
$337.45
|
| Rate for Payer: Signature Care EPO |
$337.45
|
| Rate for Payer: Signature Care PPO |
$337.45
|
| Rate for Payer: Signature Care PPO |
$337.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$40,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$40,400.00
|
| Rate for Payer: United Healthcare Commercial |
$331.41
|
| Rate for Payer: United Healthcare Commercial |
$331.41
|
| Rate for Payer: United Healthcare Medicare |
$303.21
|
| Rate for Payer: United Healthcare Medicare |
$303.21
|
|
|
PR COLPOSC,CERVIX W/ADJ VAG,W/BX & CURRETAG
|
Professional
|
Both
|
$313.80
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
z57454
|
| Min. Negotiated Rate |
$103.03 |
| Max. Negotiated Rate |
$16,100.00 |
| Rate for Payer: Aetna Commercial |
$125.22
|
| Rate for Payer: Aetna Commercial |
$125.22
|
| Rate for Payer: Aetna Medicare |
$125.22
|
| Rate for Payer: Aetna Medicare |
$125.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$208.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$208.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$208.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$208.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$208.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$208.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$208.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$208.03
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$103.03
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$103.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$154.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$154.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$144.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$144.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$137.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$137.74
|
| Rate for Payer: Cash Price |
$185.42
|
| Rate for Payer: Cash Price |
$188.28
|
| Rate for Payer: Centivo All Commercial |
$194.09
|
| Rate for Payer: Centivo All Commercial |
$194.09
|
| Rate for Payer: Cigna All Commercial |
$125.22
|
| Rate for Payer: Cigna All Commercial |
$125.22
|
| Rate for Payer: CORVEL All Commercial |
$125.22
|
| Rate for Payer: CORVEL All Commercial |
$125.22
|
| Rate for Payer: Coventry All Commercial |
$150.26
|
| Rate for Payer: Coventry All Commercial |
$150.26
|
| Rate for Payer: Encore All Commercial |
$125.22
|
| Rate for Payer: Encore All Commercial |
$125.22
|
| Rate for Payer: Frontpath All Commercial |
$174.54
|
| Rate for Payer: Frontpath All Commercial |
$174.54
|
| Rate for Payer: Humana ChoiceCare |
$154.92
|
| Rate for Payer: Humana ChoiceCare |
$154.92
|
| Rate for Payer: Humana Medicare |
$125.22
|
| Rate for Payer: Humana Medicare |
$125.22
|
| Rate for Payer: Lucent All Commercial |
$175.31
|
| Rate for Payer: Lucent All Commercial |
$175.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$173.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$173.00
|
| Rate for Payer: Managed Health Services Medicaid |
$154.34
|
| Rate for Payer: Managed Health Services Medicaid |
$154.34
|
| Rate for Payer: MDWise Medicaid |
$154.34
|
| Rate for Payer: MDWise Medicaid |
$154.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$103.03
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$103.03
|
| Rate for Payer: PHCS All Commercial |
$125.22
|
| Rate for Payer: PHCS All Commercial |
$125.22
|
| Rate for Payer: PHP All Commercial |
$159.44
|
| Rate for Payer: PHP All Commercial |
$159.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$125.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$125.22
|
| Rate for Payer: Sagamore Health Network All Products |
$125.22
|
| Rate for Payer: Sagamore Health Network All Products |
$125.22
|
| Rate for Payer: Signature Care EPO |
$199.75
|
| Rate for Payer: Signature Care EPO |
$199.75
|
| Rate for Payer: Signature Care PPO |
$199.75
|
| Rate for Payer: Signature Care PPO |
$199.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$16,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$16,100.00
|
| Rate for Payer: United Healthcare Commercial |
$155.24
|
| Rate for Payer: United Healthcare Commercial |
$155.24
|
| Rate for Payer: United Healthcare Medicare |
$154.52
|
| Rate for Payer: United Healthcare Medicare |
$154.52
|
|
|
PR COLPOSCOPY,CERVIX W/ADJ VAGINA
|
Professional
|
Both
|
$235.90
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
z57452
|
| Min. Negotiated Rate |
$71.30 |
| Max. Negotiated Rate |
$11,000.00 |
| Rate for Payer: Aetna Commercial |
$84.74
|
| Rate for Payer: Aetna Commercial |
$84.74
|
| Rate for Payer: Aetna Medicare |
$84.74
|
| Rate for Payer: Aetna Medicare |
$84.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$144.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$144.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$144.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$144.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$144.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$144.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$144.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$144.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$71.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$71.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$116.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$116.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$97.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$97.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$93.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$93.21
|
| Rate for Payer: Cash Price |
$139.03
|
| Rate for Payer: Cash Price |
$141.54
|
| Rate for Payer: Centivo All Commercial |
$131.35
|
| Rate for Payer: Centivo All Commercial |
$131.35
|
| Rate for Payer: Cigna All Commercial |
$84.74
|
| Rate for Payer: Cigna All Commercial |
$84.74
|
| Rate for Payer: CORVEL All Commercial |
$84.74
|
| Rate for Payer: CORVEL All Commercial |
$84.74
|
| Rate for Payer: Coventry All Commercial |
$101.69
|
| Rate for Payer: Coventry All Commercial |
$101.69
|
| Rate for Payer: Encore All Commercial |
$84.74
|
| Rate for Payer: Encore All Commercial |
$84.74
|
| Rate for Payer: Frontpath All Commercial |
$117.49
|
| Rate for Payer: Frontpath All Commercial |
$117.49
|
| Rate for Payer: Humana ChoiceCare |
$100.53
|
| Rate for Payer: Humana ChoiceCare |
$100.53
|
| Rate for Payer: Humana Medicare |
$84.74
|
| Rate for Payer: Humana Medicare |
$84.74
|
| Rate for Payer: Lucent All Commercial |
$118.64
|
| Rate for Payer: Lucent All Commercial |
$118.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$118.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$118.00
|
| Rate for Payer: Managed Health Services Medicaid |
$116.03
|
| Rate for Payer: Managed Health Services Medicaid |
$116.03
|
| Rate for Payer: MDWise Medicaid |
$116.03
|
| Rate for Payer: MDWise Medicaid |
$116.03
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$71.30
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$71.30
|
| Rate for Payer: PHCS All Commercial |
$84.74
|
| Rate for Payer: PHCS All Commercial |
$84.74
|
| Rate for Payer: PHP All Commercial |
$108.81
|
| Rate for Payer: PHP All Commercial |
$108.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$84.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$84.74
|
| Rate for Payer: Sagamore Health Network All Products |
$84.74
|
| Rate for Payer: Sagamore Health Network All Products |
$84.74
|
| Rate for Payer: Signature Care EPO |
$141.10
|
| Rate for Payer: Signature Care EPO |
$141.10
|
| Rate for Payer: Signature Care PPO |
$141.10
|
| Rate for Payer: Signature Care PPO |
$141.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,000.00
|
| Rate for Payer: United Healthcare Commercial |
$103.94
|
| Rate for Payer: United Healthcare Commercial |
$103.94
|
| Rate for Payer: United Healthcare Medicare |
$115.86
|
| Rate for Payer: United Healthcare Medicare |
$115.86
|
|
|
PR COLPOSCOPY,CERVIX W/ADJ VAGINA, CURETTAG
|
Professional
|
Both
|
$283.56
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
z57456
|
| Min. Negotiated Rate |
$70.79 |
| Max. Negotiated Rate |
$12,200.00 |
| Rate for Payer: Aetna Commercial |
$94.85
|
| Rate for Payer: Aetna Commercial |
$94.85
|
| Rate for Payer: Aetna Medicare |
$94.85
|
| Rate for Payer: Aetna Medicare |
$94.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$182.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$182.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$182.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$182.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$182.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$182.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$182.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$182.09
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$70.79
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$70.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$139.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$139.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$109.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$109.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$104.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$104.33
|
| Rate for Payer: Cash Price |
$166.87
|
| Rate for Payer: Cash Price |
$170.14
|
| Rate for Payer: Centivo All Commercial |
$147.02
|
| Rate for Payer: Centivo All Commercial |
$147.02
|
| Rate for Payer: Cigna All Commercial |
$94.85
|
| Rate for Payer: Cigna All Commercial |
$94.85
|
| Rate for Payer: CORVEL All Commercial |
$94.85
|
| Rate for Payer: CORVEL All Commercial |
$94.85
|
| Rate for Payer: Coventry All Commercial |
$113.82
|
| Rate for Payer: Coventry All Commercial |
$113.82
|
| Rate for Payer: Encore All Commercial |
$94.85
|
| Rate for Payer: Encore All Commercial |
$94.85
|
| Rate for Payer: Frontpath All Commercial |
$132.00
|
| Rate for Payer: Frontpath All Commercial |
$132.00
|
| Rate for Payer: Humana ChoiceCare |
$119.22
|
| Rate for Payer: Humana ChoiceCare |
$119.22
|
| Rate for Payer: Humana Medicare |
$94.85
|
| Rate for Payer: Humana Medicare |
$94.85
|
| Rate for Payer: Lucent All Commercial |
$132.79
|
| Rate for Payer: Lucent All Commercial |
$132.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$132.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$132.00
|
| Rate for Payer: Managed Health Services Medicaid |
$139.47
|
| Rate for Payer: Managed Health Services Medicaid |
$139.47
|
| Rate for Payer: MDWise Medicaid |
$139.47
|
| Rate for Payer: MDWise Medicaid |
$139.47
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$70.79
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$70.79
|
| Rate for Payer: PHCS All Commercial |
$94.85
|
| Rate for Payer: PHCS All Commercial |
$94.85
|
| Rate for Payer: PHP All Commercial |
$121.14
|
| Rate for Payer: PHP All Commercial |
$121.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$94.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$94.85
|
| Rate for Payer: Sagamore Health Network All Products |
$94.85
|
| Rate for Payer: Sagamore Health Network All Products |
$94.85
|
| Rate for Payer: Signature Care EPO |
$171.70
|
| Rate for Payer: Signature Care EPO |
$171.70
|
| Rate for Payer: Signature Care PPO |
$171.70
|
| Rate for Payer: Signature Care PPO |
$171.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,200.00
|
| Rate for Payer: United Healthcare Commercial |
$118.31
|
| Rate for Payer: United Healthcare Commercial |
$118.31
|
| Rate for Payer: United Healthcare Medicare |
$139.06
|
| Rate for Payer: United Healthcare Medicare |
$139.06
|
|
|
PR COLPOSCOPY,CERVIX W/ADJ VAGINA,W/BX
|
Professional
|
Both
|
$300.90
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
z57455
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$13,100.00 |
| Rate for Payer: Aetna Commercial |
$102.05
|
| Rate for Payer: Aetna Commercial |
$102.05
|
| Rate for Payer: Aetna Medicare |
$102.05
|
| Rate for Payer: Aetna Medicare |
$102.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$193.35
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$75.83
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$75.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$147.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$147.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$117.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$117.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$112.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$112.25
|
| Rate for Payer: Cash Price |
$176.95
|
| Rate for Payer: Cash Price |
$180.54
|
| Rate for Payer: Centivo All Commercial |
$158.18
|
| Rate for Payer: Centivo All Commercial |
$158.18
|
| Rate for Payer: Cigna All Commercial |
$102.05
|
| Rate for Payer: Cigna All Commercial |
$102.05
|
| Rate for Payer: CORVEL All Commercial |
$102.05
|
| Rate for Payer: CORVEL All Commercial |
$102.05
|
| Rate for Payer: Coventry All Commercial |
$122.46
|
| Rate for Payer: Coventry All Commercial |
$122.46
|
| Rate for Payer: Encore All Commercial |
$102.05
|
| Rate for Payer: Encore All Commercial |
$102.05
|
| Rate for Payer: Frontpath All Commercial |
$142.25
|
| Rate for Payer: Frontpath All Commercial |
$142.25
|
| Rate for Payer: Humana ChoiceCare |
$127.82
|
| Rate for Payer: Humana ChoiceCare |
$127.82
|
| Rate for Payer: Humana Medicare |
$102.05
|
| Rate for Payer: Humana Medicare |
$102.05
|
| Rate for Payer: Lucent All Commercial |
$142.87
|
| Rate for Payer: Lucent All Commercial |
$142.87
|
| 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 |
$147.99
|
| Rate for Payer: Managed Health Services Medicaid |
$147.99
|
| Rate for Payer: MDWise Medicaid |
$147.99
|
| Rate for Payer: MDWise Medicaid |
$147.99
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$75.83
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$75.83
|
| Rate for Payer: PHCS All Commercial |
$102.05
|
| Rate for Payer: PHCS All Commercial |
$102.05
|
| Rate for Payer: PHP All Commercial |
$130.24
|
| Rate for Payer: PHP All Commercial |
$130.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.05
|
| Rate for Payer: Sagamore Health Network All Products |
$102.05
|
| Rate for Payer: Sagamore Health Network All Products |
$102.05
|
| Rate for Payer: Signature Care EPO |
$181.90
|
| Rate for Payer: Signature Care EPO |
$181.90
|
| Rate for Payer: Signature Care PPO |
$181.90
|
| Rate for Payer: Signature Care PPO |
$181.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,100.00
|
| Rate for Payer: United Healthcare Commercial |
$126.83
|
| Rate for Payer: United Healthcare Commercial |
$126.83
|
| Rate for Payer: United Healthcare Medicare |
$147.46
|
| Rate for Payer: United Healthcare Medicare |
$147.46
|
|
|
PR COLPOSCOPY,CERVIX W/ADJ VAG,W/LOOP BX
|
Professional
|
Both
|
$581.08
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
z57460
|
| Min. Negotiated Rate |
$99.57 |
| Max. Negotiated Rate |
$19,300.00 |
| Rate for Payer: Aetna Commercial |
$148.93
|
| Rate for Payer: Aetna Commercial |
$148.93
|
| Rate for Payer: Aetna Medicare |
$148.93
|
| Rate for Payer: Aetna Medicare |
$148.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$442.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$442.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$442.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$442.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$442.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$442.01
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$99.57
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$99.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$285.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$285.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$163.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$163.82
|
| Rate for Payer: Cash Price |
$346.10
|
| Rate for Payer: Cash Price |
$348.65
|
| Rate for Payer: Centivo All Commercial |
$230.84
|
| Rate for Payer: Centivo All Commercial |
$230.84
|
| Rate for Payer: Cigna All Commercial |
$148.93
|
| Rate for Payer: Cigna All Commercial |
$148.93
|
| Rate for Payer: CORVEL All Commercial |
$148.93
|
| Rate for Payer: CORVEL All Commercial |
$148.93
|
| Rate for Payer: Coventry All Commercial |
$178.72
|
| Rate for Payer: Coventry All Commercial |
$178.72
|
| Rate for Payer: Encore All Commercial |
$148.93
|
| Rate for Payer: Encore All Commercial |
$148.93
|
| Rate for Payer: Frontpath All Commercial |
$206.88
|
| Rate for Payer: Frontpath All Commercial |
$206.88
|
| Rate for Payer: Humana ChoiceCare |
$187.49
|
| Rate for Payer: Humana ChoiceCare |
$187.49
|
| Rate for Payer: Humana Medicare |
$148.93
|
| Rate for Payer: Humana Medicare |
$148.93
|
| Rate for Payer: Lucent All Commercial |
$208.50
|
| Rate for Payer: Lucent All Commercial |
$208.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$208.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$208.00
|
| Rate for Payer: Managed Health Services Medicaid |
$285.80
|
| Rate for Payer: Managed Health Services Medicaid |
$285.80
|
| Rate for Payer: MDWise Medicaid |
$285.80
|
| Rate for Payer: MDWise Medicaid |
$285.80
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$99.57
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$99.57
|
| Rate for Payer: PHCS All Commercial |
$148.93
|
| Rate for Payer: PHCS All Commercial |
$148.93
|
| Rate for Payer: PHP All Commercial |
$191.08
|
| Rate for Payer: PHP All Commercial |
$191.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$148.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$148.93
|
| Rate for Payer: Sagamore Health Network All Products |
$148.93
|
| Rate for Payer: Sagamore Health Network All Products |
$148.93
|
| Rate for Payer: Signature Care EPO |
$423.30
|
| Rate for Payer: Signature Care EPO |
$423.30
|
| Rate for Payer: Signature Care PPO |
$423.30
|
| Rate for Payer: Signature Care PPO |
$423.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,300.00
|
| Rate for Payer: United Healthcare Commercial |
$186.43
|
| Rate for Payer: United Healthcare Commercial |
$186.43
|
| Rate for Payer: United Healthcare Medicare |
$288.42
|
| Rate for Payer: United Healthcare Medicare |
$288.42
|
|
|
PR COLPOSCOPY,CERVIX W/ADJ VAG,W/LOOP CONIZ
|
Professional
|
Both
|
$647.58
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
z57461
|
| Min. Negotiated Rate |
$121.19 |
| Max. Negotiated Rate |
$22,200.00 |
| Rate for Payer: Aetna Commercial |
$172.56
|
| Rate for Payer: Aetna Commercial |
$172.56
|
| Rate for Payer: Aetna Medicare |
$172.56
|
| Rate for Payer: Aetna Medicare |
$172.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$487.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$487.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$487.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$487.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$487.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$487.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$487.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$487.53
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$121.19
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$121.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$318.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$318.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$198.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$198.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$189.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$189.82
|
| Rate for Payer: Cash Price |
$385.90
|
| Rate for Payer: Cash Price |
$388.55
|
| Rate for Payer: Centivo All Commercial |
$267.47
|
| Rate for Payer: Centivo All Commercial |
$267.47
|
| Rate for Payer: Cigna All Commercial |
$172.56
|
| Rate for Payer: Cigna All Commercial |
$172.56
|
| Rate for Payer: CORVEL All Commercial |
$172.56
|
| Rate for Payer: CORVEL All Commercial |
$172.56
|
| Rate for Payer: Coventry All Commercial |
$207.07
|
| Rate for Payer: Coventry All Commercial |
$207.07
|
| Rate for Payer: Encore All Commercial |
$172.56
|
| Rate for Payer: Encore All Commercial |
$172.56
|
| Rate for Payer: Frontpath All Commercial |
$241.02
|
| Rate for Payer: Frontpath All Commercial |
$241.02
|
| Rate for Payer: Humana ChoiceCare |
$219.07
|
| Rate for Payer: Humana ChoiceCare |
$219.07
|
| Rate for Payer: Humana Medicare |
$172.56
|
| Rate for Payer: Humana Medicare |
$172.56
|
| Rate for Payer: Lucent All Commercial |
$241.58
|
| Rate for Payer: Lucent All Commercial |
$241.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$239.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$239.00
|
| Rate for Payer: Managed Health Services Medicaid |
$318.51
|
| Rate for Payer: Managed Health Services Medicaid |
$318.51
|
| Rate for Payer: MDWise Medicaid |
$318.51
|
| Rate for Payer: MDWise Medicaid |
$318.51
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$121.19
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$121.19
|
| Rate for Payer: PHCS All Commercial |
$172.56
|
| Rate for Payer: PHCS All Commercial |
$172.56
|
| Rate for Payer: PHP All Commercial |
$219.74
|
| Rate for Payer: PHP All Commercial |
$219.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$172.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$172.56
|
| Rate for Payer: Sagamore Health Network All Products |
$172.56
|
| Rate for Payer: Sagamore Health Network All Products |
$172.56
|
| Rate for Payer: Signature Care EPO |
$464.95
|
| Rate for Payer: Signature Care EPO |
$464.95
|
| Rate for Payer: Signature Care PPO |
$464.95
|
| Rate for Payer: Signature Care PPO |
$464.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$22,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$22,200.00
|
| Rate for Payer: United Healthcare Commercial |
$215.79
|
| Rate for Payer: United Healthcare Commercial |
$215.79
|
| Rate for Payer: United Healthcare Medicare |
$321.58
|
| Rate for Payer: United Healthcare Medicare |
$321.58
|
|
|
PR COLPOSCOPY,ENTIRE VAGINA
|
Professional
|
Both
|
$247.50
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
z57420
|
| Min. Negotiated Rate |
$63.46 |
| Max. Negotiated Rate |
$10,800.00 |
| Rate for Payer: Aetna Commercial |
$83.69
|
| Rate for Payer: Aetna Commercial |
$83.69
|
| Rate for Payer: Aetna Medicare |
$83.69
|
| Rate for Payer: Aetna Medicare |
$83.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$153.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$153.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$153.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$153.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$153.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$153.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$153.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$153.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$63.46
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$63.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$121.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$121.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$96.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$96.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$92.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$92.06
|
| Rate for Payer: Cash Price |
$145.18
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Centivo All Commercial |
$129.72
|
| Rate for Payer: Centivo All Commercial |
$129.72
|
| Rate for Payer: Cigna All Commercial |
$83.69
|
| Rate for Payer: Cigna All Commercial |
$83.69
|
| Rate for Payer: CORVEL All Commercial |
$83.69
|
| Rate for Payer: CORVEL All Commercial |
$83.69
|
| Rate for Payer: Coventry All Commercial |
$100.43
|
| Rate for Payer: Coventry All Commercial |
$100.43
|
| Rate for Payer: Encore All Commercial |
$83.69
|
| Rate for Payer: Encore All Commercial |
$83.69
|
| Rate for Payer: Frontpath All Commercial |
$116.32
|
| Rate for Payer: Frontpath All Commercial |
$116.32
|
| Rate for Payer: Humana ChoiceCare |
$101.53
|
| Rate for Payer: Humana ChoiceCare |
$101.53
|
| Rate for Payer: Humana Medicare |
$83.69
|
| Rate for Payer: Humana Medicare |
$83.69
|
| Rate for Payer: Lucent All Commercial |
$117.17
|
| Rate for Payer: Lucent All Commercial |
$117.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$117.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$117.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.73
|
| Rate for Payer: Managed Health Services Medicaid |
$121.73
|
| Rate for Payer: MDWise Medicaid |
$121.73
|
| Rate for Payer: MDWise Medicaid |
$121.73
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$63.46
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$63.46
|
| Rate for Payer: PHCS All Commercial |
$83.69
|
| Rate for Payer: PHCS All Commercial |
$83.69
|
| Rate for Payer: PHP All Commercial |
$107.21
|
| Rate for Payer: PHP All Commercial |
$107.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$83.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$83.69
|
| Rate for Payer: Sagamore Health Network All Products |
$83.69
|
| Rate for Payer: Sagamore Health Network All Products |
$83.69
|
| Rate for Payer: Signature Care EPO |
$145.35
|
| Rate for Payer: Signature Care EPO |
$145.35
|
| Rate for Payer: Signature Care PPO |
$145.35
|
| Rate for Payer: Signature Care PPO |
$145.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,800.00
|
| Rate for Payer: United Healthcare Commercial |
$102.51
|
| Rate for Payer: United Healthcare Commercial |
$102.51
|
| Rate for Payer: United Healthcare Medicare |
$120.98
|
| Rate for Payer: United Healthcare Medicare |
$120.98
|
|
|
PR COLPOSCOPY,ENTIRE VAGINA,W/BIOPSY(S)
|
Professional
|
Both
|
$330.60
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
z57421
|
| Min. Negotiated Rate |
$82.78 |
| Max. Negotiated Rate |
$14,700.00 |
| Rate for Payer: Aetna Commercial |
$113.85
|
| Rate for Payer: Aetna Commercial |
$113.85
|
| Rate for Payer: Aetna Medicare |
$113.85
|
| Rate for Payer: Aetna Medicare |
$113.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$211.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$211.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$211.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$211.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$211.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$211.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$211.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$211.46
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$82.78
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$82.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$162.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$162.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$130.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$130.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.23
|
| Rate for Payer: Cash Price |
$194.54
|
| Rate for Payer: Cash Price |
$198.36
|
| Rate for Payer: Centivo All Commercial |
$176.47
|
| Rate for Payer: Centivo All Commercial |
$176.47
|
| Rate for Payer: Cigna All Commercial |
$113.85
|
| Rate for Payer: Cigna All Commercial |
$113.85
|
| Rate for Payer: CORVEL All Commercial |
$113.85
|
| Rate for Payer: CORVEL All Commercial |
$113.85
|
| Rate for Payer: Coventry All Commercial |
$136.62
|
| Rate for Payer: Coventry All Commercial |
$136.62
|
| Rate for Payer: Encore All Commercial |
$113.85
|
| Rate for Payer: Encore All Commercial |
$113.85
|
| Rate for Payer: Frontpath All Commercial |
$158.51
|
| Rate for Payer: Frontpath All Commercial |
$158.51
|
| Rate for Payer: Humana ChoiceCare |
$141.34
|
| Rate for Payer: Humana ChoiceCare |
$141.34
|
| Rate for Payer: Humana Medicare |
$113.85
|
| Rate for Payer: Humana Medicare |
$113.85
|
| Rate for Payer: Lucent All Commercial |
$159.39
|
| Rate for Payer: Lucent All Commercial |
$159.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$158.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$158.00
|
| Rate for Payer: Managed Health Services Medicaid |
$162.60
|
| Rate for Payer: Managed Health Services Medicaid |
$162.60
|
| Rate for Payer: MDWise Medicaid |
$162.60
|
| Rate for Payer: MDWise Medicaid |
$162.60
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$82.78
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$82.78
|
| Rate for Payer: PHCS All Commercial |
$113.85
|
| Rate for Payer: PHCS All Commercial |
$113.85
|
| Rate for Payer: PHP All Commercial |
$145.21
|
| Rate for Payer: PHP All Commercial |
$145.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$113.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$113.85
|
| Rate for Payer: Sagamore Health Network All Products |
$113.85
|
| Rate for Payer: Sagamore Health Network All Products |
$113.85
|
| Rate for Payer: Signature Care EPO |
$198.05
|
| Rate for Payer: Signature Care EPO |
$198.05
|
| Rate for Payer: Signature Care PPO |
$198.05
|
| Rate for Payer: Signature Care PPO |
$198.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,700.00
|
| Rate for Payer: United Healthcare Commercial |
$140.00
|
| Rate for Payer: United Healthcare Commercial |
$140.00
|
| Rate for Payer: United Healthcare Medicare |
$162.12
|
| Rate for Payer: United Healthcare Medicare |
$162.12
|
|
|
PR COLPOSCOPY,VULVA
|
Professional
|
Both
|
$233.44
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
z56820
|
| Min. Negotiated Rate |
$60.45 |
| Max. Negotiated Rate |
$10,200.00 |
| Rate for Payer: Aetna Commercial |
$78.98
|
| Rate for Payer: Aetna Commercial |
$78.98
|
| Rate for Payer: Aetna Medicare |
$78.98
|
| Rate for Payer: Aetna Medicare |
$78.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$146.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$146.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$146.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$146.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$146.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$146.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$146.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$146.36
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$60.45
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$60.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$114.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$114.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$90.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$90.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$86.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$86.88
|
| Rate for Payer: Cash Price |
$137.23
|
| Rate for Payer: Cash Price |
$140.06
|
| Rate for Payer: Centivo All Commercial |
$122.42
|
| Rate for Payer: Centivo All Commercial |
$122.42
|
| Rate for Payer: Cigna All Commercial |
$78.98
|
| Rate for Payer: Cigna All Commercial |
$78.98
|
| Rate for Payer: CORVEL All Commercial |
$78.98
|
| Rate for Payer: CORVEL All Commercial |
$78.98
|
| Rate for Payer: Coventry All Commercial |
$94.78
|
| Rate for Payer: Coventry All Commercial |
$94.78
|
| Rate for Payer: Encore All Commercial |
$78.98
|
| Rate for Payer: Encore All Commercial |
$78.98
|
| Rate for Payer: Frontpath All Commercial |
$110.18
|
| Rate for Payer: Frontpath All Commercial |
$110.18
|
| Rate for Payer: Humana ChoiceCare |
$96.10
|
| Rate for Payer: Humana ChoiceCare |
$96.10
|
| Rate for Payer: Humana Medicare |
$78.98
|
| Rate for Payer: Humana Medicare |
$78.98
|
| Rate for Payer: Lucent All Commercial |
$110.57
|
| Rate for Payer: Lucent All Commercial |
$110.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$110.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$110.00
|
| Rate for Payer: Managed Health Services Medicaid |
$114.82
|
| Rate for Payer: Managed Health Services Medicaid |
$114.82
|
| Rate for Payer: MDWise Medicaid |
$114.82
|
| Rate for Payer: MDWise Medicaid |
$114.82
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$60.45
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$60.45
|
| Rate for Payer: PHCS All Commercial |
$78.98
|
| Rate for Payer: PHCS All Commercial |
$78.98
|
| Rate for Payer: PHP All Commercial |
$101.25
|
| Rate for Payer: PHP All Commercial |
$101.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$78.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$78.98
|
| Rate for Payer: Sagamore Health Network All Products |
$78.98
|
| Rate for Payer: Sagamore Health Network All Products |
$78.98
|
| Rate for Payer: Signature Care EPO |
$138.55
|
| Rate for Payer: Signature Care EPO |
$138.55
|
| Rate for Payer: Signature Care PPO |
$138.55
|
| Rate for Payer: Signature Care PPO |
$138.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,200.00
|
| Rate for Payer: United Healthcare Commercial |
$96.49
|
| Rate for Payer: United Healthcare Commercial |
$96.49
|
| Rate for Payer: United Healthcare Medicare |
$114.36
|
| Rate for Payer: United Healthcare Medicare |
$114.36
|
|
|
PR COLPOSCOPY,VULVA,W/BIOPSY(S)
|
Professional
|
Both
|
$312.28
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
z56821
|
| Min. Negotiated Rate |
$78.34 |
| Max. Negotiated Rate |
$13,700.00 |
| Rate for Payer: Aetna Commercial |
$106.31
|
| Rate for Payer: Aetna Commercial |
$106.31
|
| Rate for Payer: Aetna Medicare |
$106.31
|
| Rate for Payer: Aetna Medicare |
$106.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$198.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$198.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$198.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$198.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$198.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$198.73
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$78.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$78.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$153.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$153.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$122.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$122.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$116.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$116.94
|
| Rate for Payer: Cash Price |
$183.70
|
| Rate for Payer: Cash Price |
$187.37
|
| Rate for Payer: Centivo All Commercial |
$164.78
|
| Rate for Payer: Centivo All Commercial |
$164.78
|
| Rate for Payer: Cigna All Commercial |
$106.31
|
| Rate for Payer: Cigna All Commercial |
$106.31
|
| Rate for Payer: CORVEL All Commercial |
$106.31
|
| Rate for Payer: CORVEL All Commercial |
$106.31
|
| Rate for Payer: Coventry All Commercial |
$127.57
|
| Rate for Payer: Coventry All Commercial |
$127.57
|
| Rate for Payer: Encore All Commercial |
$106.31
|
| Rate for Payer: Encore All Commercial |
$106.31
|
| Rate for Payer: Frontpath All Commercial |
$148.40
|
| Rate for Payer: Frontpath All Commercial |
$148.40
|
| Rate for Payer: Humana ChoiceCare |
$132.29
|
| Rate for Payer: Humana ChoiceCare |
$132.29
|
| Rate for Payer: Humana Medicare |
$106.31
|
| Rate for Payer: Humana Medicare |
$106.31
|
| Rate for Payer: Lucent All Commercial |
$148.83
|
| Rate for Payer: Lucent All Commercial |
$148.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$147.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$147.00
|
| Rate for Payer: Managed Health Services Medicaid |
$153.59
|
| Rate for Payer: Managed Health Services Medicaid |
$153.59
|
| Rate for Payer: MDWise Medicaid |
$153.59
|
| Rate for Payer: MDWise Medicaid |
$153.59
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$78.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$78.34
|
| Rate for Payer: PHCS All Commercial |
$106.31
|
| Rate for Payer: PHCS All Commercial |
$106.31
|
| Rate for Payer: PHP All Commercial |
$135.68
|
| Rate for Payer: PHP All Commercial |
$135.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$106.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$106.31
|
| Rate for Payer: Sagamore Health Network All Products |
$106.31
|
| Rate for Payer: Sagamore Health Network All Products |
$106.31
|
| Rate for Payer: Signature Care EPO |
$186.15
|
| Rate for Payer: Signature Care EPO |
$186.15
|
| Rate for Payer: Signature Care PPO |
$186.15
|
| Rate for Payer: Signature Care PPO |
$186.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,700.00
|
| Rate for Payer: United Healthcare Commercial |
$131.04
|
| Rate for Payer: United Healthcare Commercial |
$131.04
|
| Rate for Payer: United Healthcare Medicare |
$153.08
|
| Rate for Payer: United Healthcare Medicare |
$153.08
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,227.24
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
z45382
|
| Min. Negotiated Rate |
$244.39 |
| Max. Negotiated Rate |
$33,600.00 |
| Rate for Payer: Aetna Commercial |
$244.39
|
| Rate for Payer: Aetna Commercial |
$244.39
|
| Rate for Payer: Aetna Medicare |
$244.39
|
| Rate for Payer: Aetna Medicare |
$244.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$821.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$821.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$821.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$821.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$821.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$821.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$821.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$821.19
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$262.66
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$262.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$603.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$603.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$281.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$281.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$268.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$268.83
|
| Rate for Payer: Cash Price |
$731.22
|
| Rate for Payer: Cash Price |
$736.34
|
| Rate for Payer: Centivo All Commercial |
$378.80
|
| Rate for Payer: Centivo All Commercial |
$378.80
|
| Rate for Payer: Cigna All Commercial |
$244.39
|
| Rate for Payer: Cigna All Commercial |
$244.39
|
| Rate for Payer: CORVEL All Commercial |
$244.39
|
| Rate for Payer: CORVEL All Commercial |
$244.39
|
| Rate for Payer: Coventry All Commercial |
$293.27
|
| Rate for Payer: Coventry All Commercial |
$293.27
|
| Rate for Payer: Encore All Commercial |
$244.39
|
| Rate for Payer: Encore All Commercial |
$244.39
|
| Rate for Payer: Frontpath All Commercial |
$334.39
|
| Rate for Payer: Frontpath All Commercial |
$334.39
|
| Rate for Payer: Humana ChoiceCare |
$355.78
|
| Rate for Payer: Humana ChoiceCare |
$355.78
|
| Rate for Payer: Humana Medicare |
$244.39
|
| Rate for Payer: Humana Medicare |
$244.39
|
| Rate for Payer: Lucent All Commercial |
$342.15
|
| Rate for Payer: Lucent All Commercial |
$342.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$360.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$360.00
|
| Rate for Payer: Managed Health Services Medicaid |
$603.61
|
| Rate for Payer: Managed Health Services Medicaid |
$603.61
|
| Rate for Payer: MDWise Medicaid |
$603.61
|
| Rate for Payer: MDWise Medicaid |
$603.61
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$262.66
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$262.66
|
| Rate for Payer: PHCS All Commercial |
$244.39
|
| Rate for Payer: PHCS All Commercial |
$244.39
|
| Rate for Payer: PHP All Commercial |
$410.17
|
| Rate for Payer: PHP All Commercial |
$410.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$244.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$244.39
|
| Rate for Payer: Sagamore Health Network All Products |
$244.39
|
| Rate for Payer: Sagamore Health Network All Products |
$244.39
|
| Rate for Payer: Signature Care EPO |
$844.90
|
| Rate for Payer: Signature Care EPO |
$844.90
|
| Rate for Payer: Signature Care PPO |
$844.90
|
| Rate for Payer: Signature Care PPO |
$844.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$33,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$33,600.00
|
| Rate for Payer: United Healthcare Commercial |
$382.20
|
| Rate for Payer: United Healthcare Commercial |
$382.20
|
| Rate for Payer: United Healthcare Medicare |
$609.35
|
| Rate for Payer: United Healthcare Medicare |
$609.35
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Professional
|
Both
|
$1,122.76
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
z45386
|
| Min. Negotiated Rate |
$198.90 |
| Max. Negotiated Rate |
$27,500.00 |
| Rate for Payer: Aetna Commercial |
$198.90
|
| Rate for Payer: Aetna Commercial |
$198.90
|
| Rate for Payer: Aetna Medicare |
$198.90
|
| Rate for Payer: Aetna Medicare |
$198.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$714.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$213.87
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$213.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$552.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$552.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$228.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$228.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$218.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$218.79
|
| Rate for Payer: Cash Price |
$669.83
|
| Rate for Payer: Cash Price |
$673.66
|
| Rate for Payer: Centivo All Commercial |
$308.30
|
| Rate for Payer: Centivo All Commercial |
$308.30
|
| Rate for Payer: Cigna All Commercial |
$198.90
|
| Rate for Payer: Cigna All Commercial |
$198.90
|
| Rate for Payer: CORVEL All Commercial |
$198.90
|
| Rate for Payer: CORVEL All Commercial |
$198.90
|
| Rate for Payer: Coventry All Commercial |
$238.68
|
| Rate for Payer: Coventry All Commercial |
$238.68
|
| Rate for Payer: Encore All Commercial |
$198.90
|
| Rate for Payer: Encore All Commercial |
$198.90
|
| Rate for Payer: Frontpath All Commercial |
$272.18
|
| Rate for Payer: Frontpath All Commercial |
$272.18
|
| Rate for Payer: Humana ChoiceCare |
$288.60
|
| Rate for Payer: Humana ChoiceCare |
$288.60
|
| Rate for Payer: Humana Medicare |
$198.90
|
| Rate for Payer: Humana Medicare |
$198.90
|
| Rate for Payer: Lucent All Commercial |
$278.46
|
| Rate for Payer: Lucent All Commercial |
$278.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$294.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$294.00
|
| Rate for Payer: Managed Health Services Medicaid |
$552.22
|
| Rate for Payer: Managed Health Services Medicaid |
$552.22
|
| Rate for Payer: MDWise Medicaid |
$552.22
|
| Rate for Payer: MDWise Medicaid |
$552.22
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$213.87
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$213.87
|
| Rate for Payer: PHCS All Commercial |
$198.90
|
| Rate for Payer: PHCS All Commercial |
$198.90
|
| Rate for Payer: PHP All Commercial |
$334.87
|
| Rate for Payer: PHP All Commercial |
$334.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.90
|
| Rate for Payer: Sagamore Health Network All Products |
$198.90
|
| Rate for Payer: Sagamore Health Network All Products |
$198.90
|
| Rate for Payer: Signature Care EPO |
$986.85
|
| Rate for Payer: Signature Care EPO |
$986.85
|
| Rate for Payer: Signature Care PPO |
$986.85
|
| Rate for Payer: Signature Care PPO |
$986.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,500.00
|
| Rate for Payer: United Healthcare Commercial |
$305.13
|
| Rate for Payer: United Healthcare Commercial |
$305.13
|
| Rate for Payer: United Healthcare Medicare |
$558.19
|
| Rate for Payer: United Healthcare Medicare |
$558.19
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$819.62
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
z45381
|
| Min. Negotiated Rate |
$188.66 |
| Max. Negotiated Rate |
$26,000.00 |
| Rate for Payer: Aetna Commercial |
$188.66
|
| Rate for Payer: Aetna Commercial |
$188.66
|
| Rate for Payer: Aetna Medicare |
$188.66
|
| Rate for Payer: Aetna Medicare |
$188.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$714.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$714.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$202.79
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$202.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$403.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$403.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$216.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$216.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$207.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$207.53
|
| Rate for Payer: Cash Price |
$486.18
|
| Rate for Payer: Cash Price |
$491.77
|
| Rate for Payer: Centivo All Commercial |
$292.42
|
| Rate for Payer: Centivo All Commercial |
$292.42
|
| Rate for Payer: Cigna All Commercial |
$188.66
|
| Rate for Payer: Cigna All Commercial |
$188.66
|
| Rate for Payer: CORVEL All Commercial |
$188.66
|
| Rate for Payer: CORVEL All Commercial |
$188.66
|
| Rate for Payer: Coventry All Commercial |
$226.39
|
| Rate for Payer: Coventry All Commercial |
$226.39
|
| Rate for Payer: Encore All Commercial |
$188.66
|
| Rate for Payer: Encore All Commercial |
$188.66
|
| Rate for Payer: Frontpath All Commercial |
$257.97
|
| Rate for Payer: Frontpath All Commercial |
$257.97
|
| Rate for Payer: Humana ChoiceCare |
$263.82
|
| Rate for Payer: Humana ChoiceCare |
$263.82
|
| Rate for Payer: Humana Medicare |
$188.66
|
| Rate for Payer: Humana Medicare |
$188.66
|
| Rate for Payer: Lucent All Commercial |
$264.12
|
| Rate for Payer: Lucent All Commercial |
$264.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$279.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$279.00
|
| Rate for Payer: Managed Health Services Medicaid |
$403.12
|
| Rate for Payer: Managed Health Services Medicaid |
$403.12
|
| Rate for Payer: MDWise Medicaid |
$403.12
|
| Rate for Payer: MDWise Medicaid |
$403.12
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$202.79
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$202.79
|
| Rate for Payer: PHCS All Commercial |
$188.66
|
| Rate for Payer: PHCS All Commercial |
$188.66
|
| Rate for Payer: PHP All Commercial |
$317.40
|
| Rate for Payer: PHP All Commercial |
$317.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$188.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$188.66
|
| Rate for Payer: Sagamore Health Network All Products |
$188.66
|
| Rate for Payer: Sagamore Health Network All Products |
$188.66
|
| Rate for Payer: Signature Care EPO |
$674.90
|
| Rate for Payer: Signature Care EPO |
$674.90
|
| Rate for Payer: Signature Care PPO |
$674.90
|
| Rate for Payer: Signature Care PPO |
$674.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,000.00
|
| Rate for Payer: United Healthcare Commercial |
$283.09
|
| Rate for Payer: United Healthcare Commercial |
$283.09
|
| Rate for Payer: United Healthcare Medicare |
$405.15
|
| Rate for Payer: United Healthcare Medicare |
$405.15
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Professional
|
Both
|
$900.50
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
z45384
|
| Min. Negotiated Rate |
$213.73 |
| Max. Negotiated Rate |
$29,400.00 |
| Rate for Payer: Aetna Commercial |
$213.73
|
| Rate for Payer: Aetna Commercial |
$213.73
|
| Rate for Payer: Aetna Medicare |
$213.73
|
| Rate for Payer: Aetna Medicare |
$213.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$613.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$613.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$613.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$613.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$613.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$613.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$613.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$613.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$231.86
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$231.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$442.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$442.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$245.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$245.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$235.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$235.10
|
| Rate for Payer: Cash Price |
$535.09
|
| Rate for Payer: Cash Price |
$540.30
|
| Rate for Payer: Centivo All Commercial |
$331.28
|
| Rate for Payer: Centivo All Commercial |
$331.28
|
| Rate for Payer: Cigna All Commercial |
$213.73
|
| Rate for Payer: Cigna All Commercial |
$213.73
|
| Rate for Payer: CORVEL All Commercial |
$213.73
|
| Rate for Payer: CORVEL All Commercial |
$213.73
|
| Rate for Payer: Coventry All Commercial |
$256.48
|
| Rate for Payer: Coventry All Commercial |
$256.48
|
| Rate for Payer: Encore All Commercial |
$213.73
|
| Rate for Payer: Encore All Commercial |
$213.73
|
| Rate for Payer: Frontpath All Commercial |
$296.01
|
| Rate for Payer: Frontpath All Commercial |
$296.01
|
| Rate for Payer: Humana ChoiceCare |
$295.48
|
| Rate for Payer: Humana ChoiceCare |
$295.48
|
| Rate for Payer: Humana Medicare |
$213.73
|
| Rate for Payer: Humana Medicare |
$213.73
|
| Rate for Payer: Lucent All Commercial |
$299.22
|
| Rate for Payer: Lucent All Commercial |
$299.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$315.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$315.00
|
| Rate for Payer: Managed Health Services Medicaid |
$442.90
|
| Rate for Payer: Managed Health Services Medicaid |
$442.90
|
| Rate for Payer: MDWise Medicaid |
$442.90
|
| Rate for Payer: MDWise Medicaid |
$442.90
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$231.86
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$231.86
|
| Rate for Payer: PHCS All Commercial |
$213.73
|
| Rate for Payer: PHCS All Commercial |
$213.73
|
| Rate for Payer: PHP All Commercial |
$358.68
|
| Rate for Payer: PHP All Commercial |
$358.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$213.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$213.73
|
| Rate for Payer: Sagamore Health Network All Products |
$213.73
|
| Rate for Payer: Sagamore Health Network All Products |
$213.73
|
| Rate for Payer: Signature Care EPO |
$628.15
|
| Rate for Payer: Signature Care EPO |
$628.15
|
| Rate for Payer: Signature Care PPO |
$628.15
|
| Rate for Payer: Signature Care PPO |
$628.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29,400.00
|
| Rate for Payer: United Healthcare Commercial |
$310.69
|
| Rate for Payer: United Healthcare Commercial |
$310.69
|
| Rate for Payer: United Healthcare Medicare |
$445.91
|
| Rate for Payer: United Healthcare Medicare |
$445.91
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Professional
|
Both
|
$842.24
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
z45385
|
| Min. Negotiated Rate |
$239.72 |
| Max. Negotiated Rate |
$33,000.00 |
| Rate for Payer: Aetna Commercial |
$239.72
|
| Rate for Payer: Aetna Commercial |
$239.72
|
| Rate for Payer: Aetna Medicare |
$239.72
|
| Rate for Payer: Aetna Medicare |
$239.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$704.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$704.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$704.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$704.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$704.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$704.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$704.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$704.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$257.82
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$257.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$414.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$414.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$275.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$275.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$263.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$263.69
|
| Rate for Payer: Cash Price |
$498.52
|
| Rate for Payer: Cash Price |
$505.34
|
| Rate for Payer: Centivo All Commercial |
$371.57
|
| Rate for Payer: Centivo All Commercial |
$371.57
|
| Rate for Payer: Cigna All Commercial |
$239.72
|
| Rate for Payer: Cigna All Commercial |
$239.72
|
| Rate for Payer: CORVEL All Commercial |
$239.72
|
| Rate for Payer: CORVEL All Commercial |
$239.72
|
| Rate for Payer: Coventry All Commercial |
$287.66
|
| Rate for Payer: Coventry All Commercial |
$287.66
|
| Rate for Payer: Encore All Commercial |
$239.72
|
| Rate for Payer: Encore All Commercial |
$239.72
|
| Rate for Payer: Frontpath All Commercial |
$328.29
|
| Rate for Payer: Frontpath All Commercial |
$328.29
|
| Rate for Payer: Humana ChoiceCare |
$332.57
|
| Rate for Payer: Humana ChoiceCare |
$332.57
|
| Rate for Payer: Humana Medicare |
$239.72
|
| Rate for Payer: Humana Medicare |
$239.72
|
| Rate for Payer: Lucent All Commercial |
$335.61
|
| Rate for Payer: Lucent All Commercial |
$335.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$353.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$353.00
|
| Rate for Payer: Managed Health Services Medicaid |
$414.24
|
| Rate for Payer: Managed Health Services Medicaid |
$414.24
|
| Rate for Payer: MDWise Medicaid |
$414.24
|
| Rate for Payer: MDWise Medicaid |
$414.24
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$257.82
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$257.82
|
| Rate for Payer: PHCS All Commercial |
$239.72
|
| Rate for Payer: PHCS All Commercial |
$239.72
|
| Rate for Payer: PHP All Commercial |
$402.33
|
| Rate for Payer: PHP All Commercial |
$402.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$239.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$239.72
|
| Rate for Payer: Sagamore Health Network All Products |
$239.72
|
| Rate for Payer: Sagamore Health Network All Products |
$239.72
|
| Rate for Payer: Signature Care EPO |
$716.55
|
| Rate for Payer: Signature Care EPO |
$716.55
|
| Rate for Payer: Signature Care PPO |
$716.55
|
| Rate for Payer: Signature Care PPO |
$716.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$33,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$33,000.00
|
| Rate for Payer: United Healthcare Commercial |
$354.99
|
| Rate for Payer: United Healthcare Commercial |
$354.99
|
| Rate for Payer: United Healthcare Medicare |
$415.43
|
| Rate for Payer: United Healthcare Medicare |
$415.43
|
|
|
PR COMM SVCS BY RHC/FQHC 5 MIN
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
CPT G0071
|
| Hospital Charge Code |
zG0071
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$23.79 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$13.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$13.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$13.03
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Humana ChoiceCare |
$19.01
|
| Rate for Payer: PHP All Commercial |
$23.79
|
| Rate for Payer: United Healthcare Commercial |
$11.69
|
|
