|
PR DEBRIDE ASSOC OPEN FX/DISLOC SKIN/SUBQ
|
Professional
|
Both
|
$825.20
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
z11010
|
| Min. Negotiated Rate |
$140.68 |
| Max. Negotiated Rate |
$30,700.00 |
| Rate for Payer: Aetna Commercial |
$256.27
|
| Rate for Payer: Aetna Commercial |
$256.27
|
| Rate for Payer: Aetna Medicare |
$256.27
|
| Rate for Payer: Aetna Medicare |
$256.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$470.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$470.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$470.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$470.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$470.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$470.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$470.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$470.62
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$140.68
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$140.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$405.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$405.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$294.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$294.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$281.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$281.90
|
| Rate for Payer: Cash Price |
$493.52
|
| Rate for Payer: Cash Price |
$495.12
|
| Rate for Payer: Centivo All Commercial |
$397.22
|
| Rate for Payer: Centivo All Commercial |
$397.22
|
| Rate for Payer: Cigna All Commercial |
$256.27
|
| Rate for Payer: Cigna All Commercial |
$256.27
|
| Rate for Payer: CORVEL All Commercial |
$256.27
|
| Rate for Payer: CORVEL All Commercial |
$256.27
|
| Rate for Payer: Coventry All Commercial |
$307.52
|
| Rate for Payer: Coventry All Commercial |
$307.52
|
| Rate for Payer: Encore All Commercial |
$256.27
|
| Rate for Payer: Encore All Commercial |
$256.27
|
| Rate for Payer: Frontpath All Commercial |
$356.52
|
| Rate for Payer: Frontpath All Commercial |
$356.52
|
| Rate for Payer: Humana ChoiceCare |
$260.00
|
| Rate for Payer: Humana ChoiceCare |
$260.00
|
| Rate for Payer: Humana Medicare |
$256.27
|
| Rate for Payer: Humana Medicare |
$256.27
|
| Rate for Payer: Lucent All Commercial |
$358.78
|
| Rate for Payer: Lucent All Commercial |
$358.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$333.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$333.00
|
| Rate for Payer: Managed Health Services Medicaid |
$405.87
|
| Rate for Payer: Managed Health Services Medicaid |
$405.87
|
| Rate for Payer: MDWise Medicaid |
$405.87
|
| Rate for Payer: MDWise Medicaid |
$405.87
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$140.68
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$140.68
|
| Rate for Payer: PHCS All Commercial |
$256.27
|
| Rate for Payer: PHCS All Commercial |
$256.27
|
| Rate for Payer: PHP All Commercial |
$349.35
|
| Rate for Payer: PHP All Commercial |
$349.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$256.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$256.27
|
| Rate for Payer: Sagamore Health Network All Products |
$256.27
|
| Rate for Payer: Sagamore Health Network All Products |
$256.27
|
| Rate for Payer: Signature Care EPO |
$446.25
|
| Rate for Payer: Signature Care EPO |
$446.25
|
| Rate for Payer: Signature Care PPO |
$446.25
|
| Rate for Payer: Signature Care PPO |
$446.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$30,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$30,700.00
|
| Rate for Payer: United Healthcare Commercial |
$309.78
|
| Rate for Payer: United Healthcare Commercial |
$309.78
|
| Rate for Payer: United Healthcare Medicare |
$411.27
|
| Rate for Payer: United Healthcare Medicare |
$411.27
|
|
|
PR DEBRIDE ASSOC OPEN FX/DISLO SKIN/MUS/BONE
|
Professional
|
Both
|
$1,196.10
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
z11012
|
| Min. Negotiated Rate |
$211.79 |
| Max. Negotiated Rate |
$45,900.00 |
| Rate for Payer: Aetna Commercial |
$384.97
|
| Rate for Payer: Aetna Commercial |
$384.97
|
| Rate for Payer: Aetna Medicare |
$384.97
|
| Rate for Payer: Aetna Medicare |
$384.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$717.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$717.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$717.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$717.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$717.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$717.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$717.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$717.17
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$211.79
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$211.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$588.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$588.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$442.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$442.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$423.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$423.47
|
| Rate for Payer: Cash Price |
$708.17
|
| Rate for Payer: Cash Price |
$717.66
|
| Rate for Payer: Centivo All Commercial |
$596.70
|
| Rate for Payer: Centivo All Commercial |
$596.70
|
| Rate for Payer: Cigna All Commercial |
$384.97
|
| Rate for Payer: Cigna All Commercial |
$384.97
|
| Rate for Payer: CORVEL All Commercial |
$384.97
|
| Rate for Payer: CORVEL All Commercial |
$384.97
|
| Rate for Payer: Coventry All Commercial |
$461.96
|
| Rate for Payer: Coventry All Commercial |
$461.96
|
| Rate for Payer: Encore All Commercial |
$384.97
|
| Rate for Payer: Encore All Commercial |
$384.97
|
| Rate for Payer: Frontpath All Commercial |
$540.46
|
| Rate for Payer: Frontpath All Commercial |
$540.46
|
| Rate for Payer: Humana ChoiceCare |
$411.71
|
| Rate for Payer: Humana ChoiceCare |
$411.71
|
| Rate for Payer: Humana Medicare |
$384.97
|
| Rate for Payer: Humana Medicare |
$384.97
|
| Rate for Payer: Lucent All Commercial |
$538.96
|
| Rate for Payer: Lucent All Commercial |
$538.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$497.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$497.00
|
| Rate for Payer: Managed Health Services Medicaid |
$588.29
|
| Rate for Payer: Managed Health Services Medicaid |
$588.29
|
| Rate for Payer: MDWise Medicaid |
$588.29
|
| Rate for Payer: MDWise Medicaid |
$588.29
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$211.79
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$211.79
|
| Rate for Payer: PHCS All Commercial |
$384.97
|
| Rate for Payer: PHCS All Commercial |
$384.97
|
| Rate for Payer: PHP All Commercial |
$522.61
|
| Rate for Payer: PHP All Commercial |
$522.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$384.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$384.97
|
| Rate for Payer: Sagamore Health Network All Products |
$384.97
|
| Rate for Payer: Sagamore Health Network All Products |
$384.97
|
| Rate for Payer: Signature Care EPO |
$772.65
|
| Rate for Payer: Signature Care EPO |
$772.65
|
| Rate for Payer: Signature Care PPO |
$772.65
|
| Rate for Payer: Signature Care PPO |
$772.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$45,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$45,900.00
|
| Rate for Payer: United Healthcare Commercial |
$483.41
|
| Rate for Payer: United Healthcare Commercial |
$483.41
|
| Rate for Payer: United Healthcare Medicare |
$590.14
|
| Rate for Payer: United Healthcare Medicare |
$590.14
|
|
|
PR DEBRIDE MASTOID CAVITY,COMPLEX
|
Professional
|
Both
|
$402.24
|
|
|
Service Code
|
CPT 69222
|
| Hospital Charge Code |
z69222
|
| Min. Negotiated Rate |
$70.08 |
| Max. Negotiated Rate |
$19,200.00 |
| Rate for Payer: Aetna Commercial |
$128.00
|
| Rate for Payer: Aetna Commercial |
$128.00
|
| Rate for Payer: Aetna Medicare |
$128.00
|
| Rate for Payer: Aetna Medicare |
$128.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$182.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$182.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$182.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$182.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$182.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$182.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$182.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$182.93
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$70.08
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$70.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$147.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$147.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$140.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$140.80
|
| Rate for Payer: Cash Price |
$238.03
|
| Rate for Payer: Cash Price |
$241.34
|
| Rate for Payer: Centivo All Commercial |
$198.40
|
| Rate for Payer: Centivo All Commercial |
$198.40
|
| Rate for Payer: Cigna All Commercial |
$128.00
|
| Rate for Payer: Cigna All Commercial |
$128.00
|
| Rate for Payer: CORVEL All Commercial |
$128.00
|
| Rate for Payer: CORVEL All Commercial |
$128.00
|
| Rate for Payer: Coventry All Commercial |
$153.60
|
| Rate for Payer: Coventry All Commercial |
$153.60
|
| Rate for Payer: Encore All Commercial |
$128.00
|
| Rate for Payer: Encore All Commercial |
$128.00
|
| Rate for Payer: Frontpath All Commercial |
$173.73
|
| Rate for Payer: Frontpath All Commercial |
$173.73
|
| Rate for Payer: Humana ChoiceCare |
$139.60
|
| Rate for Payer: Humana ChoiceCare |
$139.60
|
| Rate for Payer: Humana Medicare |
$128.00
|
| Rate for Payer: Humana Medicare |
$128.00
|
| Rate for Payer: Lucent All Commercial |
$179.20
|
| Rate for Payer: Lucent All Commercial |
$179.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$205.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$205.00
|
| Rate for Payer: Managed Health Services Medicaid |
$197.84
|
| Rate for Payer: Managed Health Services Medicaid |
$197.84
|
| Rate for Payer: MDWise Medicaid |
$197.84
|
| Rate for Payer: MDWise Medicaid |
$197.84
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$70.08
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$70.08
|
| Rate for Payer: PHCS All Commercial |
$128.00
|
| Rate for Payer: PHCS All Commercial |
$128.00
|
| Rate for Payer: PHP All Commercial |
$162.72
|
| Rate for Payer: PHP All Commercial |
$162.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$128.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$128.00
|
| Rate for Payer: Sagamore Health Network All Products |
$128.00
|
| Rate for Payer: Sagamore Health Network All Products |
$128.00
|
| Rate for Payer: Signature Care EPO |
$243.10
|
| Rate for Payer: Signature Care EPO |
$243.10
|
| Rate for Payer: Signature Care PPO |
$243.10
|
| Rate for Payer: Signature Care PPO |
$243.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,200.00
|
| Rate for Payer: United Healthcare Commercial |
$147.55
|
| Rate for Payer: United Healthcare Commercial |
$147.55
|
| Rate for Payer: United Healthcare Medicare |
$198.36
|
| Rate for Payer: United Healthcare Medicare |
$198.36
|
|
|
PR DEBRIDE MASTOID CAVITY,SIMPLE
|
Professional
|
Both
|
$145.68
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
z69220
|
| Min. Negotiated Rate |
$26.08 |
| Max. Negotiated Rate |
$7,200.00 |
| Rate for Payer: Aetna Commercial |
$47.62
|
| Rate for Payer: Aetna Commercial |
$47.62
|
| Rate for Payer: Aetna Medicare |
$47.62
|
| Rate for Payer: Aetna Medicare |
$47.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$144.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$144.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$144.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$144.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$144.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$144.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$144.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$144.85
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$26.08
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$26.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$71.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$71.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.76
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$52.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$52.38
|
| Rate for Payer: Cash Price |
$85.79
|
| Rate for Payer: Cash Price |
$87.41
|
| Rate for Payer: Centivo All Commercial |
$73.81
|
| Rate for Payer: Centivo All Commercial |
$73.81
|
| Rate for Payer: Cigna All Commercial |
$47.62
|
| Rate for Payer: Cigna All Commercial |
$47.62
|
| Rate for Payer: CORVEL All Commercial |
$47.62
|
| Rate for Payer: CORVEL All Commercial |
$47.62
|
| Rate for Payer: Coventry All Commercial |
$57.14
|
| Rate for Payer: Coventry All Commercial |
$57.14
|
| Rate for Payer: Encore All Commercial |
$47.62
|
| Rate for Payer: Encore All Commercial |
$47.62
|
| Rate for Payer: Frontpath All Commercial |
$65.35
|
| Rate for Payer: Frontpath All Commercial |
$65.35
|
| Rate for Payer: Humana ChoiceCare |
$63.85
|
| Rate for Payer: Humana ChoiceCare |
$63.85
|
| Rate for Payer: Humana Medicare |
$47.62
|
| Rate for Payer: Humana Medicare |
$47.62
|
| Rate for Payer: Lucent All Commercial |
$66.67
|
| Rate for Payer: Lucent All Commercial |
$66.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.00
|
| Rate for Payer: Managed Health Services Medicaid |
$71.65
|
| Rate for Payer: Managed Health Services Medicaid |
$71.65
|
| Rate for Payer: MDWise Medicaid |
$71.65
|
| Rate for Payer: MDWise Medicaid |
$71.65
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$26.08
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$26.08
|
| Rate for Payer: PHCS All Commercial |
$47.62
|
| Rate for Payer: PHCS All Commercial |
$47.62
|
| Rate for Payer: PHP All Commercial |
$60.83
|
| Rate for Payer: PHP All Commercial |
$60.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$47.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$47.62
|
| Rate for Payer: Sagamore Health Network All Products |
$47.62
|
| Rate for Payer: Sagamore Health Network All Products |
$47.62
|
| Rate for Payer: Signature Care EPO |
$123.32
|
| Rate for Payer: Signature Care EPO |
$123.32
|
| Rate for Payer: Signature Care PPO |
$123.32
|
| Rate for Payer: Signature Care PPO |
$123.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,200.00
|
| Rate for Payer: United Healthcare Commercial |
$68.28
|
| Rate for Payer: United Healthcare Commercial |
$68.28
|
| Rate for Payer: United Healthcare Medicare |
$71.49
|
| Rate for Payer: United Healthcare Medicare |
$71.49
|
|
|
PR DEBRIDEMENT BONE 1ST 20 SQ CM/<
|
Professional
|
Both
|
$576.02
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
z11044
|
| Min. Negotiated Rate |
$116.20 |
| Max. Negotiated Rate |
$25,000.00 |
| Rate for Payer: Aetna Commercial |
$209.96
|
| Rate for Payer: Aetna Commercial |
$209.96
|
| Rate for Payer: Aetna Medicare |
$209.96
|
| Rate for Payer: Aetna Medicare |
$209.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$377.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$377.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$377.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$377.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$377.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$377.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$377.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$377.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$116.20
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$116.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$283.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$283.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$241.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$241.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$230.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$230.96
|
| Rate for Payer: Cash Price |
$337.91
|
| Rate for Payer: Cash Price |
$345.61
|
| Rate for Payer: Centivo All Commercial |
$325.44
|
| Rate for Payer: Centivo All Commercial |
$325.44
|
| Rate for Payer: Cigna All Commercial |
$209.96
|
| Rate for Payer: Cigna All Commercial |
$209.96
|
| Rate for Payer: CORVEL All Commercial |
$209.96
|
| Rate for Payer: CORVEL All Commercial |
$209.96
|
| Rate for Payer: Coventry All Commercial |
$251.95
|
| Rate for Payer: Coventry All Commercial |
$251.95
|
| Rate for Payer: Encore All Commercial |
$209.96
|
| Rate for Payer: Encore All Commercial |
$209.96
|
| Rate for Payer: Frontpath All Commercial |
$292.44
|
| Rate for Payer: Frontpath All Commercial |
$292.44
|
| Rate for Payer: Humana ChoiceCare |
$252.17
|
| Rate for Payer: Humana ChoiceCare |
$252.17
|
| Rate for Payer: Humana Medicare |
$209.96
|
| Rate for Payer: Humana Medicare |
$209.96
|
| Rate for Payer: Lucent All Commercial |
$293.94
|
| Rate for Payer: Lucent All Commercial |
$293.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$271.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$271.00
|
| Rate for Payer: Managed Health Services Medicaid |
$283.31
|
| Rate for Payer: Managed Health Services Medicaid |
$283.31
|
| Rate for Payer: MDWise Medicaid |
$283.31
|
| Rate for Payer: MDWise Medicaid |
$283.31
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$116.20
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$116.20
|
| Rate for Payer: PHCS All Commercial |
$209.96
|
| Rate for Payer: PHCS All Commercial |
$209.96
|
| Rate for Payer: PHP All Commercial |
$285.02
|
| Rate for Payer: PHP All Commercial |
$285.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$209.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$209.96
|
| Rate for Payer: Sagamore Health Network All Products |
$209.96
|
| Rate for Payer: Sagamore Health Network All Products |
$209.96
|
| Rate for Payer: Signature Care EPO |
$310.25
|
| Rate for Payer: Signature Care EPO |
$310.25
|
| Rate for Payer: Signature Care PPO |
$310.25
|
| Rate for Payer: Signature Care PPO |
$310.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,000.00
|
| Rate for Payer: United Healthcare Commercial |
$347.96
|
| Rate for Payer: United Healthcare Commercial |
$347.96
|
| Rate for Payer: United Healthcare Medicare |
$281.59
|
| Rate for Payer: United Healthcare Medicare |
$281.59
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Professional
|
Both
|
$431.44
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
z11043
|
| Min. Negotiated Rate |
$78.04 |
| Max. Negotiated Rate |
$17,100.00 |
| Rate for Payer: Aetna Commercial |
$143.64
|
| Rate for Payer: Aetna Commercial |
$143.64
|
| Rate for Payer: Aetna Medicare |
$143.64
|
| Rate for Payer: Aetna Medicare |
$143.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$276.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$276.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$276.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$276.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$276.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$276.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$276.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$276.54
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$78.04
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$78.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$212.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$212.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$165.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$165.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$158.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$158.00
|
| Rate for Payer: Cash Price |
$253.08
|
| Rate for Payer: Cash Price |
$258.86
|
| Rate for Payer: Centivo All Commercial |
$222.64
|
| Rate for Payer: Centivo All Commercial |
$222.64
|
| Rate for Payer: Cigna All Commercial |
$143.64
|
| Rate for Payer: Cigna All Commercial |
$143.64
|
| Rate for Payer: CORVEL All Commercial |
$143.64
|
| Rate for Payer: CORVEL All Commercial |
$143.64
|
| Rate for Payer: Coventry All Commercial |
$172.37
|
| Rate for Payer: Coventry All Commercial |
$172.37
|
| Rate for Payer: Encore All Commercial |
$143.64
|
| Rate for Payer: Encore All Commercial |
$143.64
|
| Rate for Payer: Frontpath All Commercial |
$199.15
|
| Rate for Payer: Frontpath All Commercial |
$199.15
|
| Rate for Payer: Humana ChoiceCare |
$184.75
|
| Rate for Payer: Humana ChoiceCare |
$184.75
|
| Rate for Payer: Humana Medicare |
$143.64
|
| Rate for Payer: Humana Medicare |
$143.64
|
| Rate for Payer: Lucent All Commercial |
$201.10
|
| Rate for Payer: Lucent All Commercial |
$201.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$186.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$186.00
|
| Rate for Payer: Managed Health Services Medicaid |
$212.20
|
| Rate for Payer: Managed Health Services Medicaid |
$212.20
|
| Rate for Payer: MDWise Medicaid |
$212.20
|
| Rate for Payer: MDWise Medicaid |
$212.20
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$78.04
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$78.04
|
| Rate for Payer: PHCS All Commercial |
$143.64
|
| Rate for Payer: PHCS All Commercial |
$143.64
|
| Rate for Payer: PHP All Commercial |
$194.90
|
| Rate for Payer: PHP All Commercial |
$194.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$143.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$143.64
|
| Rate for Payer: Sagamore Health Network All Products |
$143.64
|
| Rate for Payer: Sagamore Health Network All Products |
$143.64
|
| Rate for Payer: Signature Care EPO |
$237.15
|
| Rate for Payer: Signature Care EPO |
$237.15
|
| Rate for Payer: Signature Care PPO |
$237.15
|
| Rate for Payer: Signature Care PPO |
$237.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,100.00
|
| Rate for Payer: United Healthcare Commercial |
$252.89
|
| Rate for Payer: United Healthcare Commercial |
$252.89
|
| Rate for Payer: United Healthcare Medicare |
$210.90
|
| Rate for Payer: United Healthcare Medicare |
$210.90
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Professional
|
Both
|
$134.24
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
z11046
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$6,000.00 |
| Rate for Payer: Aetna Commercial |
$51.32
|
| Rate for Payer: Aetna Commercial |
$51.32
|
| Rate for Payer: Aetna Medicare |
$51.32
|
| Rate for Payer: Aetna Medicare |
$51.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$58.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$58.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$58.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$58.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$58.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$58.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$58.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$58.32
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$28.21
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$28.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$66.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$66.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.02
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.45
|
| Rate for Payer: Cash Price |
$78.78
|
| Rate for Payer: Cash Price |
$80.54
|
| Rate for Payer: Centivo All Commercial |
$79.55
|
| Rate for Payer: Centivo All Commercial |
$79.55
|
| Rate for Payer: Cigna All Commercial |
$51.32
|
| Rate for Payer: Cigna All Commercial |
$51.32
|
| Rate for Payer: CORVEL All Commercial |
$51.32
|
| Rate for Payer: CORVEL All Commercial |
$51.32
|
| Rate for Payer: Coventry All Commercial |
$61.58
|
| Rate for Payer: Coventry All Commercial |
$61.58
|
| Rate for Payer: Encore All Commercial |
$51.32
|
| Rate for Payer: Encore All Commercial |
$51.32
|
| Rate for Payer: Frontpath All Commercial |
$72.60
|
| Rate for Payer: Frontpath All Commercial |
$72.60
|
| Rate for Payer: Humana ChoiceCare |
$36.00
|
| Rate for Payer: Humana ChoiceCare |
$36.00
|
| Rate for Payer: Humana Medicare |
$51.32
|
| Rate for Payer: Humana Medicare |
$51.32
|
| Rate for Payer: Lucent All Commercial |
$71.85
|
| Rate for Payer: Lucent All Commercial |
$71.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$65.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$65.00
|
| Rate for Payer: Managed Health Services Medicaid |
$66.03
|
| Rate for Payer: Managed Health Services Medicaid |
$66.03
|
| Rate for Payer: MDWise Medicaid |
$66.03
|
| Rate for Payer: MDWise Medicaid |
$66.03
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$28.21
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$28.21
|
| Rate for Payer: PHCS All Commercial |
$51.32
|
| Rate for Payer: PHCS All Commercial |
$51.32
|
| Rate for Payer: PHP All Commercial |
$68.72
|
| Rate for Payer: PHP All Commercial |
$68.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.32
|
| Rate for Payer: Sagamore Health Network All Products |
$51.32
|
| Rate for Payer: Sagamore Health Network All Products |
$51.32
|
| Rate for Payer: Signature Care EPO |
$58.85
|
| Rate for Payer: Signature Care EPO |
$58.85
|
| Rate for Payer: Signature Care PPO |
$58.85
|
| Rate for Payer: Signature Care PPO |
$58.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,000.00
|
| Rate for Payer: United Healthcare Commercial |
$47.21
|
| Rate for Payer: United Healthcare Commercial |
$47.21
|
| Rate for Payer: United Healthcare Medicare |
$65.65
|
| Rate for Payer: United Healthcare Medicare |
$65.65
|
|
|
PR DEBRIDEMENT OF NAIL(S), 1-5
|
Professional
|
Both
|
$61.56
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
z11720
|
| Min. Negotiated Rate |
$7.44 |
| Max. Negotiated Rate |
$30.28 |
| Rate for Payer: Aetna Commercial |
$13.90
|
| Rate for Payer: Aetna Commercial |
$13.90
|
| Rate for Payer: Aetna Medicare |
$13.90
|
| Rate for Payer: Aetna Medicare |
$13.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$7.44
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$7.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$30.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$30.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$15.98
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$15.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$15.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$15.29
|
| Rate for Payer: Cash Price |
$35.86
|
| Rate for Payer: Cash Price |
$36.94
|
| Rate for Payer: Centivo All Commercial |
$21.55
|
| Rate for Payer: Centivo All Commercial |
$21.55
|
| Rate for Payer: Cigna All Commercial |
$13.90
|
| Rate for Payer: Cigna All Commercial |
$13.90
|
| Rate for Payer: CORVEL All Commercial |
$13.90
|
| Rate for Payer: CORVEL All Commercial |
$13.90
|
| Rate for Payer: Coventry All Commercial |
$16.68
|
| Rate for Payer: Coventry All Commercial |
$16.68
|
| Rate for Payer: Encore All Commercial |
$13.90
|
| Rate for Payer: Encore All Commercial |
$13.90
|
| Rate for Payer: Frontpath All Commercial |
$19.24
|
| Rate for Payer: Frontpath All Commercial |
$19.24
|
| Rate for Payer: Humana ChoiceCare |
$16.91
|
| Rate for Payer: Humana ChoiceCare |
$16.91
|
| Rate for Payer: Humana Medicare |
$13.90
|
| Rate for Payer: Humana Medicare |
$13.90
|
| Rate for Payer: Lucent All Commercial |
$19.46
|
| Rate for Payer: Lucent All Commercial |
$19.46
|
| Rate for Payer: Managed Health Services Medicaid |
$30.28
|
| Rate for Payer: Managed Health Services Medicaid |
$30.28
|
| Rate for Payer: MDWise Medicaid |
$30.28
|
| Rate for Payer: MDWise Medicaid |
$30.28
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$7.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$7.44
|
| Rate for Payer: PHCS All Commercial |
$13.90
|
| Rate for Payer: PHCS All Commercial |
$13.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.90
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: United Healthcare Commercial |
$19.24
|
| Rate for Payer: United Healthcare Commercial |
$19.24
|
| Rate for Payer: United Healthcare Medicare |
$29.88
|
| Rate for Payer: United Healthcare Medicare |
$29.88
|
|
|
PR DEBRIDEMENT OF NAILS, 6 OR MORE
|
Professional
|
Both
|
$83.90
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
z11721
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$41.26 |
| Rate for Payer: Aetna Commercial |
$23.07
|
| Rate for Payer: Aetna Commercial |
$23.07
|
| Rate for Payer: Aetna Medicare |
$23.07
|
| Rate for Payer: Aetna Medicare |
$23.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$14.91
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$14.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$26.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$26.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$25.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$25.38
|
| Rate for Payer: Cash Price |
$48.92
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Centivo All Commercial |
$35.76
|
| Rate for Payer: Centivo All Commercial |
$35.76
|
| Rate for Payer: Cigna All Commercial |
$23.07
|
| Rate for Payer: Cigna All Commercial |
$23.07
|
| Rate for Payer: CORVEL All Commercial |
$23.07
|
| Rate for Payer: CORVEL All Commercial |
$23.07
|
| Rate for Payer: Coventry All Commercial |
$27.68
|
| Rate for Payer: Coventry All Commercial |
$27.68
|
| Rate for Payer: Encore All Commercial |
$23.07
|
| Rate for Payer: Encore All Commercial |
$23.07
|
| Rate for Payer: Frontpath All Commercial |
$31.19
|
| Rate for Payer: Frontpath All Commercial |
$31.19
|
| Rate for Payer: Humana ChoiceCare |
$28.83
|
| Rate for Payer: Humana ChoiceCare |
$28.83
|
| Rate for Payer: Humana Medicare |
$23.07
|
| Rate for Payer: Humana Medicare |
$23.07
|
| Rate for Payer: Lucent All Commercial |
$32.30
|
| Rate for Payer: Lucent All Commercial |
$32.30
|
| Rate for Payer: Managed Health Services Medicaid |
$41.26
|
| Rate for Payer: Managed Health Services Medicaid |
$41.26
|
| Rate for Payer: MDWise Medicaid |
$41.26
|
| Rate for Payer: MDWise Medicaid |
$41.26
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$14.91
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$14.91
|
| Rate for Payer: PHCS All Commercial |
$23.07
|
| Rate for Payer: PHCS All Commercial |
$23.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23.07
|
| Rate for Payer: Sagamore Health Network All Products |
$23.07
|
| Rate for Payer: Sagamore Health Network All Products |
$23.07
|
| Rate for Payer: United Healthcare Commercial |
$32.86
|
| Rate for Payer: United Healthcare Commercial |
$32.86
|
| Rate for Payer: United Healthcare Medicare |
$40.77
|
| Rate for Payer: United Healthcare Medicare |
$40.77
|
|
|
PR DEBRIDEMENT OPEN WOUND FIRST 20 SQ CM/<
|
Professional
|
Both
|
$184.12
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
z97597
|
| Min. Negotiated Rate |
$11.39 |
| Max. Negotiated Rate |
$4,100.00 |
| Rate for Payer: Aetna Commercial |
$34.63
|
| Rate for Payer: Aetna Commercial |
$34.63
|
| Rate for Payer: Aetna Medicare |
$34.63
|
| Rate for Payer: Aetna Medicare |
$34.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$94.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$94.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$94.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$94.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$94.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$94.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$94.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$94.25
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$11.39
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$11.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$92.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$92.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.09
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$110.47
|
| Rate for Payer: Centivo All Commercial |
$53.68
|
| Rate for Payer: Centivo All Commercial |
$53.68
|
| Rate for Payer: Cigna All Commercial |
$34.63
|
| Rate for Payer: Cigna All Commercial |
$34.63
|
| Rate for Payer: CORVEL All Commercial |
$34.63
|
| Rate for Payer: CORVEL All Commercial |
$34.63
|
| Rate for Payer: Coventry All Commercial |
$41.56
|
| Rate for Payer: Coventry All Commercial |
$41.56
|
| Rate for Payer: Encore All Commercial |
$34.63
|
| Rate for Payer: Encore All Commercial |
$34.63
|
| Rate for Payer: Frontpath All Commercial |
$39.88
|
| Rate for Payer: Frontpath All Commercial |
$39.88
|
| Rate for Payer: Humana ChoiceCare |
$47.06
|
| Rate for Payer: Humana ChoiceCare |
$47.06
|
| Rate for Payer: Humana Medicare |
$34.63
|
| Rate for Payer: Humana Medicare |
$34.63
|
| Rate for Payer: Lucent All Commercial |
$48.48
|
| Rate for Payer: Lucent All Commercial |
$48.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$44.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$44.00
|
| Rate for Payer: Managed Health Services Medicaid |
$92.58
|
| Rate for Payer: Managed Health Services Medicaid |
$92.58
|
| Rate for Payer: MDWise Medicaid |
$92.58
|
| Rate for Payer: MDWise Medicaid |
$92.58
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$11.39
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$11.39
|
| Rate for Payer: PHCS All Commercial |
$34.63
|
| Rate for Payer: PHCS All Commercial |
$34.63
|
| Rate for Payer: PHP All Commercial |
$33.02
|
| Rate for Payer: PHP All Commercial |
$33.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.63
|
| Rate for Payer: Sagamore Health Network All Products |
$34.63
|
| Rate for Payer: Sagamore Health Network All Products |
$34.63
|
| Rate for Payer: Signature Care EPO |
$81.58
|
| Rate for Payer: Signature Care EPO |
$81.58
|
| Rate for Payer: Signature Care PPO |
$81.58
|
| Rate for Payer: Signature Care PPO |
$81.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,100.00
|
| Rate for Payer: United Healthcare Commercial |
$30.61
|
| Rate for Payer: United Healthcare Commercial |
$30.61
|
| Rate for Payer: United Healthcare Medicare |
$92.06
|
| Rate for Payer: United Healthcare Medicare |
$92.06
|
|
|
PR DEBRIDEMENT OPN WND EA ADDL 20 SQ CM/PRT THEREOF
|
Professional
|
Both
|
$83.72
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
z97598
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$60.31 |
| Rate for Payer: Aetna Commercial |
$23.72
|
| Rate for Payer: Aetna Commercial |
$23.72
|
| Rate for Payer: Aetna Medicare |
$23.72
|
| Rate for Payer: Aetna Medicare |
$23.72
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$11.72
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$11.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.09
|
| Rate for Payer: Cash Price |
$49.15
|
| Rate for Payer: Cash Price |
$50.23
|
| Rate for Payer: Centivo All Commercial |
$36.77
|
| Rate for Payer: Centivo All Commercial |
$36.77
|
| Rate for Payer: Cigna All Commercial |
$23.72
|
| Rate for Payer: Cigna All Commercial |
$23.72
|
| Rate for Payer: CORVEL All Commercial |
$23.72
|
| Rate for Payer: CORVEL All Commercial |
$23.72
|
| Rate for Payer: Coventry All Commercial |
$28.46
|
| Rate for Payer: Coventry All Commercial |
$28.46
|
| Rate for Payer: Encore All Commercial |
$23.72
|
| Rate for Payer: Encore All Commercial |
$23.72
|
| Rate for Payer: Frontpath All Commercial |
$27.85
|
| Rate for Payer: Frontpath All Commercial |
$27.85
|
| Rate for Payer: Humana ChoiceCare |
$60.31
|
| Rate for Payer: Humana ChoiceCare |
$60.31
|
| Rate for Payer: Humana Medicare |
$23.72
|
| Rate for Payer: Humana Medicare |
$23.72
|
| Rate for Payer: Lucent All Commercial |
$33.21
|
| Rate for Payer: Lucent All Commercial |
$33.21
|
| Rate for Payer: Managed Health Services Medicaid |
$41.18
|
| Rate for Payer: Managed Health Services Medicaid |
$41.18
|
| Rate for Payer: MDWise Medicaid |
$41.18
|
| Rate for Payer: MDWise Medicaid |
$41.18
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$11.72
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$11.72
|
| Rate for Payer: PHCS All Commercial |
$23.72
|
| Rate for Payer: PHCS All Commercial |
$23.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23.72
|
| Rate for Payer: Sagamore Health Network All Products |
$23.72
|
| Rate for Payer: Sagamore Health Network All Products |
$23.72
|
| Rate for Payer: United Healthcare Commercial |
$40.86
|
| Rate for Payer: United Healthcare Commercial |
$40.86
|
| Rate for Payer: United Healthcare Medicare |
$40.96
|
| Rate for Payer: United Healthcare Medicare |
$40.96
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Professional
|
Both
|
$240.86
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
z11042
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$6,700.00 |
| Rate for Payer: Aetna Commercial |
$56.51
|
| Rate for Payer: Aetna Commercial |
$56.51
|
| Rate for Payer: Aetna Medicare |
$56.51
|
| Rate for Payer: Aetna Medicare |
$56.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$132.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$132.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$132.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$132.44
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$132.44
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$132.44
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$132.44
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$132.44
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$30.46
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$30.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$118.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$118.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.16
|
| Rate for Payer: Cash Price |
$141.00
|
| Rate for Payer: Cash Price |
$144.52
|
| Rate for Payer: Centivo All Commercial |
$87.59
|
| Rate for Payer: Centivo All Commercial |
$87.59
|
| Rate for Payer: Cigna All Commercial |
$56.51
|
| Rate for Payer: Cigna All Commercial |
$56.51
|
| Rate for Payer: CORVEL All Commercial |
$56.51
|
| Rate for Payer: CORVEL All Commercial |
$56.51
|
| Rate for Payer: Coventry All Commercial |
$67.81
|
| Rate for Payer: Coventry All Commercial |
$67.81
|
| Rate for Payer: Encore All Commercial |
$56.51
|
| Rate for Payer: Encore All Commercial |
$56.51
|
| Rate for Payer: Frontpath All Commercial |
$77.22
|
| Rate for Payer: Frontpath All Commercial |
$77.22
|
| Rate for Payer: Humana ChoiceCare |
$59.70
|
| Rate for Payer: Humana ChoiceCare |
$59.70
|
| Rate for Payer: Humana Medicare |
$56.51
|
| Rate for Payer: Humana Medicare |
$56.51
|
| Rate for Payer: Lucent All Commercial |
$79.11
|
| Rate for Payer: Lucent All Commercial |
$79.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$73.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$73.00
|
| Rate for Payer: Managed Health Services Medicaid |
$118.46
|
| Rate for Payer: Managed Health Services Medicaid |
$118.46
|
| Rate for Payer: MDWise Medicaid |
$118.46
|
| Rate for Payer: MDWise Medicaid |
$118.46
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$30.46
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$30.46
|
| Rate for Payer: PHCS All Commercial |
$56.51
|
| Rate for Payer: PHCS All Commercial |
$56.51
|
| Rate for Payer: PHP All Commercial |
$76.37
|
| Rate for Payer: PHP All Commercial |
$76.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$56.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$56.51
|
| Rate for Payer: Sagamore Health Network All Products |
$56.51
|
| Rate for Payer: Sagamore Health Network All Products |
$56.51
|
| Rate for Payer: Signature Care EPO |
$103.89
|
| Rate for Payer: Signature Care EPO |
$103.89
|
| Rate for Payer: Signature Care PPO |
$103.89
|
| Rate for Payer: Signature Care PPO |
$103.89
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,700.00
|
| Rate for Payer: United Healthcare Commercial |
$51.99
|
| Rate for Payer: United Healthcare Commercial |
$51.99
|
| Rate for Payer: United Healthcare Medicare |
$117.50
|
| Rate for Payer: United Healthcare Medicare |
$117.50
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM
|
Professional
|
Both
|
$73.92
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
z11045
|
| Min. Negotiated Rate |
$13.33 |
| Max. Negotiated Rate |
$2,800.00 |
| Rate for Payer: Aetna Commercial |
$24.36
|
| Rate for Payer: Aetna Commercial |
$24.36
|
| Rate for Payer: Aetna Medicare |
$24.36
|
| Rate for Payer: Aetna Medicare |
$24.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$38.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$38.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$38.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$38.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$38.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$38.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$38.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$38.38
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$13.33
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$13.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$28.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$28.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.80
|
| Rate for Payer: Cash Price |
$43.39
|
| Rate for Payer: Cash Price |
$44.35
|
| Rate for Payer: Centivo All Commercial |
$37.76
|
| Rate for Payer: Centivo All Commercial |
$37.76
|
| Rate for Payer: Cigna All Commercial |
$24.36
|
| Rate for Payer: Cigna All Commercial |
$24.36
|
| Rate for Payer: CORVEL All Commercial |
$24.36
|
| Rate for Payer: CORVEL All Commercial |
$24.36
|
| Rate for Payer: Coventry All Commercial |
$29.23
|
| Rate for Payer: Coventry All Commercial |
$29.23
|
| Rate for Payer: Encore All Commercial |
$24.36
|
| Rate for Payer: Encore All Commercial |
$24.36
|
| Rate for Payer: Frontpath All Commercial |
$34.32
|
| Rate for Payer: Frontpath All Commercial |
$34.32
|
| Rate for Payer: Humana ChoiceCare |
$16.87
|
| Rate for Payer: Humana ChoiceCare |
$16.87
|
| Rate for Payer: Humana Medicare |
$24.36
|
| Rate for Payer: Humana Medicare |
$24.36
|
| Rate for Payer: Lucent All Commercial |
$34.10
|
| Rate for Payer: Lucent All Commercial |
$34.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31.00
|
| Rate for Payer: Managed Health Services Medicaid |
$36.36
|
| Rate for Payer: Managed Health Services Medicaid |
$36.36
|
| Rate for Payer: MDWise Medicaid |
$36.36
|
| Rate for Payer: MDWise Medicaid |
$36.36
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$13.33
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$13.33
|
| Rate for Payer: PHCS All Commercial |
$24.36
|
| Rate for Payer: PHCS All Commercial |
$24.36
|
| Rate for Payer: PHP All Commercial |
$32.07
|
| Rate for Payer: PHP All Commercial |
$32.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.36
|
| Rate for Payer: Sagamore Health Network All Products |
$24.36
|
| Rate for Payer: Sagamore Health Network All Products |
$24.36
|
| Rate for Payer: Signature Care EPO |
$33.30
|
| Rate for Payer: Signature Care EPO |
$33.30
|
| Rate for Payer: Signature Care PPO |
$33.30
|
| Rate for Payer: Signature Care PPO |
$33.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,800.00
|
| Rate for Payer: United Healthcare Commercial |
$22.15
|
| Rate for Payer: United Healthcare Commercial |
$22.15
|
| Rate for Payer: United Healthcare Medicare |
$36.16
|
| Rate for Payer: United Healthcare Medicare |
$36.16
|
|
|
PR DEEP DISSEC FOOT INFEC,1 BURSA
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
CPT 28002
|
| Hospital Charge Code |
z28002
|
| Min. Negotiated Rate |
$131.81 |
| Max. Negotiated Rate |
$426.88 |
| Rate for Payer: Aetna Commercial |
$135.16
|
| Rate for Payer: Aetna Medicare |
$135.16
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$131.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$225.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$155.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$148.68
|
| Rate for Payer: Cash Price |
$275.40
|
| Rate for Payer: Centivo All Commercial |
$209.50
|
| Rate for Payer: Cigna All Commercial |
$135.16
|
| Rate for Payer: CORVEL All Commercial |
$135.16
|
| Rate for Payer: Coventry All Commercial |
$162.19
|
| Rate for Payer: Encore All Commercial |
$135.16
|
| Rate for Payer: Frontpath All Commercial |
$183.99
|
| Rate for Payer: Humana ChoiceCare |
$362.38
|
| Rate for Payer: Humana Medicare |
$135.16
|
| Rate for Payer: Lucent All Commercial |
$189.22
|
| Rate for Payer: Managed Health Services Medicaid |
$225.75
|
| Rate for Payer: MDWise Medicaid |
$225.75
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$131.81
|
| Rate for Payer: PHCS All Commercial |
$135.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.16
|
| Rate for Payer: Sagamore Health Network All Products |
$135.16
|
| Rate for Payer: United Healthcare Commercial |
$426.88
|
| Rate for Payer: United Healthcare Medicare |
$225.98
|
|
|
PR DEEP INCIS FOOT BONE INFECTN
|
Professional
|
Both
|
$1,080.16
|
|
|
Service Code
|
CPT 28005
|
| Hospital Charge Code |
z28005
|
| Min. Negotiated Rate |
$527.40 |
| Max. Negotiated Rate |
$844.05 |
| Rate for Payer: Aetna Commercial |
$544.55
|
| Rate for Payer: Aetna Commercial |
$544.55
|
| Rate for Payer: Aetna Medicare |
$544.55
|
| Rate for Payer: Aetna Medicare |
$544.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$531.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$531.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$626.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$626.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$599.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$599.00
|
| Rate for Payer: Cash Price |
$632.88
|
| Rate for Payer: Cash Price |
$648.10
|
| Rate for Payer: Centivo All Commercial |
$844.05
|
| Rate for Payer: Centivo All Commercial |
$844.05
|
| Rate for Payer: Cigna All Commercial |
$544.55
|
| Rate for Payer: Cigna All Commercial |
$544.55
|
| Rate for Payer: CORVEL All Commercial |
$544.55
|
| Rate for Payer: CORVEL All Commercial |
$544.55
|
| Rate for Payer: Coventry All Commercial |
$653.46
|
| Rate for Payer: Coventry All Commercial |
$653.46
|
| Rate for Payer: Encore All Commercial |
$544.55
|
| Rate for Payer: Encore All Commercial |
$544.55
|
| Rate for Payer: Frontpath All Commercial |
$737.19
|
| Rate for Payer: Frontpath All Commercial |
$737.19
|
| Rate for Payer: Humana ChoiceCare |
$640.29
|
| Rate for Payer: Humana ChoiceCare |
$640.29
|
| Rate for Payer: Humana Medicare |
$544.55
|
| Rate for Payer: Humana Medicare |
$544.55
|
| Rate for Payer: Lucent All Commercial |
$762.37
|
| Rate for Payer: Lucent All Commercial |
$762.37
|
| Rate for Payer: Managed Health Services Medicaid |
$531.27
|
| Rate for Payer: Managed Health Services Medicaid |
$531.27
|
| Rate for Payer: MDWise Medicaid |
$531.27
|
| Rate for Payer: MDWise Medicaid |
$531.27
|
| Rate for Payer: PHCS All Commercial |
$544.55
|
| Rate for Payer: PHCS All Commercial |
$544.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$544.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$544.55
|
| Rate for Payer: Sagamore Health Network All Products |
$544.55
|
| Rate for Payer: Sagamore Health Network All Products |
$544.55
|
| Rate for Payer: United Healthcare Commercial |
$685.26
|
| Rate for Payer: United Healthcare Commercial |
$685.26
|
| Rate for Payer: United Healthcare Medicare |
$527.40
|
| Rate for Payer: United Healthcare Medicare |
$527.40
|
|
|
PR DEEP INCIS SHLDR BONE CORTEX
|
Professional
|
Both
|
$1,332.64
|
|
|
Service Code
|
CPT 23040
|
| Hospital Charge Code |
z23040
|
| Min. Negotiated Rate |
$653.07 |
| Max. Negotiated Rate |
$100,400.00 |
| Rate for Payer: Aetna Commercial |
$671.38
|
| Rate for Payer: Aetna Commercial |
$671.38
|
| Rate for Payer: Aetna Medicare |
$671.38
|
| Rate for Payer: Aetna Medicare |
$671.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$957.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$957.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$957.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$957.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$957.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$957.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$957.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$957.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$655.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$655.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$772.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$772.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$738.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$738.52
|
| Rate for Payer: Cash Price |
$799.58
|
| Rate for Payer: Cash Price |
$783.68
|
| Rate for Payer: Centivo All Commercial |
$1,040.64
|
| Rate for Payer: Centivo All Commercial |
$1,040.64
|
| Rate for Payer: Cigna All Commercial |
$671.38
|
| Rate for Payer: Cigna All Commercial |
$671.38
|
| Rate for Payer: CORVEL All Commercial |
$671.38
|
| Rate for Payer: CORVEL All Commercial |
$671.38
|
| Rate for Payer: Coventry All Commercial |
$805.66
|
| Rate for Payer: Coventry All Commercial |
$805.66
|
| Rate for Payer: Encore All Commercial |
$671.38
|
| Rate for Payer: Encore All Commercial |
$671.38
|
| Rate for Payer: Frontpath All Commercial |
$934.51
|
| Rate for Payer: Frontpath All Commercial |
$934.51
|
| Rate for Payer: Humana ChoiceCare |
$743.36
|
| Rate for Payer: Humana ChoiceCare |
$743.36
|
| Rate for Payer: Humana Medicare |
$671.38
|
| Rate for Payer: Humana Medicare |
$671.38
|
| Rate for Payer: Lucent All Commercial |
$939.93
|
| Rate for Payer: Lucent All Commercial |
$939.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,071.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,071.00
|
| Rate for Payer: Managed Health Services Medicaid |
$655.45
|
| Rate for Payer: Managed Health Services Medicaid |
$655.45
|
| Rate for Payer: MDWise Medicaid |
$655.45
|
| Rate for Payer: MDWise Medicaid |
$655.45
|
| Rate for Payer: PHCS All Commercial |
$671.38
|
| Rate for Payer: PHCS All Commercial |
$671.38
|
| Rate for Payer: PHP All Commercial |
$1,136.35
|
| Rate for Payer: PHP All Commercial |
$1,136.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$671.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$671.38
|
| Rate for Payer: Sagamore Health Network All Products |
$671.38
|
| Rate for Payer: Sagamore Health Network All Products |
$671.38
|
| Rate for Payer: Signature Care EPO |
$995.35
|
| Rate for Payer: Signature Care EPO |
$995.35
|
| Rate for Payer: Signature Care PPO |
$995.35
|
| Rate for Payer: Signature Care PPO |
$995.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$100,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$100,400.00
|
| Rate for Payer: United Healthcare Commercial |
$774.51
|
| Rate for Payer: United Healthcare Commercial |
$774.51
|
| Rate for Payer: United Healthcare Medicare |
$653.07
|
| Rate for Payer: United Healthcare Medicare |
$653.07
|
|
|
PR DELIVER PLACENTA
|
Professional
|
Both
|
$161.06
|
|
|
Service Code
|
CPT 59414
|
| Hospital Charge Code |
z59414
|
| Min. Negotiated Rate |
$79.22 |
| Max. Negotiated Rate |
$10,600.00 |
| Rate for Payer: Aetna Commercial |
$81.80
|
| Rate for Payer: Aetna Commercial |
$81.80
|
| Rate for Payer: Aetna Medicare |
$81.80
|
| Rate for Payer: Aetna Medicare |
$81.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$125.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$125.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$125.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$125.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$125.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$125.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$125.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$125.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$79.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$79.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$94.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$94.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.98
|
| Rate for Payer: Cash Price |
$96.64
|
| Rate for Payer: Cash Price |
$95.50
|
| Rate for Payer: Centivo All Commercial |
$126.79
|
| Rate for Payer: Centivo All Commercial |
$126.79
|
| Rate for Payer: Cigna All Commercial |
$81.80
|
| Rate for Payer: Cigna All Commercial |
$81.80
|
| Rate for Payer: CORVEL All Commercial |
$81.80
|
| Rate for Payer: CORVEL All Commercial |
$81.80
|
| Rate for Payer: Coventry All Commercial |
$98.16
|
| Rate for Payer: Coventry All Commercial |
$98.16
|
| Rate for Payer: Encore All Commercial |
$81.80
|
| Rate for Payer: Encore All Commercial |
$81.80
|
| Rate for Payer: Frontpath All Commercial |
$117.31
|
| Rate for Payer: Frontpath All Commercial |
$117.31
|
| Rate for Payer: Humana ChoiceCare |
$89.27
|
| Rate for Payer: Humana ChoiceCare |
$89.27
|
| Rate for Payer: Humana Medicare |
$81.80
|
| Rate for Payer: Humana Medicare |
$81.80
|
| Rate for Payer: Lucent All Commercial |
$114.52
|
| Rate for Payer: Lucent All Commercial |
$114.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$114.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$114.00
|
| Rate for Payer: Managed Health Services Medicaid |
$79.22
|
| Rate for Payer: Managed Health Services Medicaid |
$79.22
|
| Rate for Payer: MDWise Medicaid |
$79.22
|
| Rate for Payer: MDWise Medicaid |
$79.22
|
| Rate for Payer: PHCS All Commercial |
$81.80
|
| Rate for Payer: PHCS All Commercial |
$81.80
|
| Rate for Payer: PHP All Commercial |
$105.05
|
| Rate for Payer: PHP All Commercial |
$105.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.80
|
| Rate for Payer: Sagamore Health Network All Products |
$81.80
|
| Rate for Payer: Sagamore Health Network All Products |
$81.80
|
| Rate for Payer: Signature Care EPO |
$113.90
|
| Rate for Payer: Signature Care EPO |
$113.90
|
| Rate for Payer: Signature Care PPO |
$113.90
|
| Rate for Payer: Signature Care PPO |
$113.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,600.00
|
| Rate for Payer: United Healthcare Commercial |
$103.95
|
| Rate for Payer: United Healthcare Commercial |
$103.95
|
| Rate for Payer: United Healthcare Medicare |
$79.58
|
| Rate for Payer: United Healthcare Medicare |
$79.58
|
|
|
PR DEMO &/OR EVAL,PT USE,AEROSOL DEVICE
|
Professional
|
Both
|
$32.56
|
|
|
Service Code
|
CPT 94664
|
| Hospital Charge Code |
z94664
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$1,900.00 |
| Rate for Payer: Aetna Commercial |
$15.42
|
| Rate for Payer: Aetna Commercial |
$15.42
|
| Rate for Payer: Aetna Medicare |
$15.42
|
| Rate for Payer: Aetna Medicare |
$15.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$23.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$23.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$23.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$23.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$23.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$23.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$23.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$23.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.96
|
| Rate for Payer: Cash Price |
$18.26
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Centivo All Commercial |
$23.90
|
| Rate for Payer: Centivo All Commercial |
$23.90
|
| Rate for Payer: Cigna All Commercial |
$15.42
|
| Rate for Payer: Cigna All Commercial |
$15.42
|
| Rate for Payer: CORVEL All Commercial |
$15.42
|
| Rate for Payer: CORVEL All Commercial |
$15.42
|
| Rate for Payer: Coventry All Commercial |
$18.50
|
| Rate for Payer: Coventry All Commercial |
$18.50
|
| Rate for Payer: Encore All Commercial |
$15.42
|
| Rate for Payer: Encore All Commercial |
$15.42
|
| Rate for Payer: Frontpath All Commercial |
$17.45
|
| Rate for Payer: Frontpath All Commercial |
$17.45
|
| Rate for Payer: Humana ChoiceCare |
$15.76
|
| Rate for Payer: Humana ChoiceCare |
$15.76
|
| Rate for Payer: Humana Medicare |
$15.42
|
| Rate for Payer: Humana Medicare |
$15.42
|
| Rate for Payer: Lucent All Commercial |
$21.59
|
| Rate for Payer: Lucent All Commercial |
$21.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$20.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$20.00
|
| Rate for Payer: PHCS All Commercial |
$15.42
|
| Rate for Payer: PHCS All Commercial |
$15.42
|
| Rate for Payer: PHP All Commercial |
$20.54
|
| Rate for Payer: PHP All Commercial |
$20.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$15.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$15.42
|
| Rate for Payer: Sagamore Health Network All Products |
$15.42
|
| Rate for Payer: Sagamore Health Network All Products |
$15.42
|
| Rate for Payer: Signature Care EPO |
$17.00
|
| Rate for Payer: Signature Care EPO |
$17.00
|
| Rate for Payer: Signature Care PPO |
$17.00
|
| Rate for Payer: Signature Care PPO |
$17.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,900.00
|
| Rate for Payer: United Healthcare Commercial |
$16.39
|
| Rate for Payer: United Healthcare Commercial |
$16.39
|
| Rate for Payer: United Healthcare Medicare |
$15.22
|
| Rate for Payer: United Healthcare Medicare |
$15.22
|
|
|
PR DESTR PENIS LESN,EXTENSIVE
|
Professional
|
Both
|
$417.76
|
|
|
Service Code
|
CPT 54065
|
| Hospital Charge Code |
z54065
|
| Min. Negotiated Rate |
$102.86 |
| Max. Negotiated Rate |
$20,900.00 |
| Rate for Payer: Aetna Commercial |
$160.20
|
| Rate for Payer: Aetna Commercial |
$160.20
|
| Rate for Payer: Aetna Medicare |
$160.20
|
| Rate for Payer: Aetna Medicare |
$160.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$254.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$254.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$254.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$254.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$254.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$254.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$254.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$254.04
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$102.86
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$102.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$205.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$205.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$184.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$184.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$176.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$176.22
|
| Rate for Payer: Cash Price |
$244.21
|
| Rate for Payer: Cash Price |
$250.66
|
| Rate for Payer: Centivo All Commercial |
$248.31
|
| Rate for Payer: Centivo All Commercial |
$248.31
|
| Rate for Payer: Cigna All Commercial |
$160.20
|
| Rate for Payer: Cigna All Commercial |
$160.20
|
| Rate for Payer: CORVEL All Commercial |
$160.20
|
| Rate for Payer: CORVEL All Commercial |
$160.20
|
| Rate for Payer: Coventry All Commercial |
$192.24
|
| Rate for Payer: Coventry All Commercial |
$192.24
|
| Rate for Payer: Encore All Commercial |
$160.20
|
| Rate for Payer: Encore All Commercial |
$160.20
|
| Rate for Payer: Frontpath All Commercial |
$216.66
|
| Rate for Payer: Frontpath All Commercial |
$216.66
|
| Rate for Payer: Humana ChoiceCare |
$172.70
|
| Rate for Payer: Humana ChoiceCare |
$172.70
|
| Rate for Payer: Humana Medicare |
$160.20
|
| Rate for Payer: Humana Medicare |
$160.20
|
| Rate for Payer: Lucent All Commercial |
$224.28
|
| Rate for Payer: Lucent All Commercial |
$224.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$225.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$225.00
|
| Rate for Payer: Managed Health Services Medicaid |
$205.47
|
| Rate for Payer: Managed Health Services Medicaid |
$205.47
|
| Rate for Payer: MDWise Medicaid |
$205.47
|
| Rate for Payer: MDWise Medicaid |
$205.47
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$102.86
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$102.86
|
| Rate for Payer: PHCS All Commercial |
$160.20
|
| Rate for Payer: PHCS All Commercial |
$160.20
|
| Rate for Payer: PHP All Commercial |
$207.40
|
| Rate for Payer: PHP All Commercial |
$207.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$160.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$160.20
|
| Rate for Payer: Sagamore Health Network All Products |
$160.20
|
| Rate for Payer: Sagamore Health Network All Products |
$160.20
|
| 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 |
$20,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,900.00
|
| Rate for Payer: United Healthcare Commercial |
$189.25
|
| Rate for Payer: United Healthcare Commercial |
$189.25
|
| Rate for Payer: United Healthcare Medicare |
$203.51
|
| Rate for Payer: United Healthcare Medicare |
$203.51
|
|
|
PR DESTR PENIS LESN,SIMPL,ELEC-DESSIC
|
Professional
|
Both
|
$250.62
|
|
|
Service Code
|
CPT 54055
|
| Hospital Charge Code |
z54055
|
| Min. Negotiated Rate |
$58.30 |
| Max. Negotiated Rate |
$11,600.00 |
| Rate for Payer: Aetna Commercial |
$88.17
|
| Rate for Payer: Aetna Commercial |
$88.17
|
| Rate for Payer: Aetna Medicare |
$88.17
|
| Rate for Payer: Aetna Medicare |
$88.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$140.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$140.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$140.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$140.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$140.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$140.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$140.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$140.48
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$58.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$58.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$126.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$126.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$101.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$101.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$96.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$96.99
|
| Rate for Payer: Cash Price |
$154.86
|
| Rate for Payer: Cash Price |
$150.37
|
| Rate for Payer: Centivo All Commercial |
$136.66
|
| Rate for Payer: Centivo All Commercial |
$136.66
|
| Rate for Payer: Cigna All Commercial |
$88.17
|
| Rate for Payer: Cigna All Commercial |
$88.17
|
| Rate for Payer: CORVEL All Commercial |
$88.17
|
| Rate for Payer: CORVEL All Commercial |
$88.17
|
| Rate for Payer: Coventry All Commercial |
$105.80
|
| Rate for Payer: Coventry All Commercial |
$105.80
|
| Rate for Payer: Encore All Commercial |
$88.17
|
| Rate for Payer: Encore All Commercial |
$88.17
|
| Rate for Payer: Frontpath All Commercial |
$118.82
|
| Rate for Payer: Frontpath All Commercial |
$118.82
|
| Rate for Payer: Humana ChoiceCare |
$95.20
|
| Rate for Payer: Humana ChoiceCare |
$95.20
|
| Rate for Payer: Humana Medicare |
$88.17
|
| Rate for Payer: Humana Medicare |
$88.17
|
| Rate for Payer: Lucent All Commercial |
$123.44
|
| Rate for Payer: Lucent All Commercial |
$123.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.00
|
| Rate for Payer: Managed Health Services Medicaid |
$126.94
|
| Rate for Payer: Managed Health Services Medicaid |
$126.94
|
| Rate for Payer: MDWise Medicaid |
$126.94
|
| Rate for Payer: MDWise Medicaid |
$126.94
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$58.30
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$58.30
|
| Rate for Payer: PHCS All Commercial |
$88.17
|
| Rate for Payer: PHCS All Commercial |
$88.17
|
| Rate for Payer: PHP All Commercial |
$115.32
|
| Rate for Payer: PHP All Commercial |
$115.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$88.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$88.17
|
| Rate for Payer: Sagamore Health Network All Products |
$88.17
|
| Rate for Payer: Sagamore Health Network All Products |
$88.17
|
| Rate for Payer: Signature Care EPO |
$124.95
|
| Rate for Payer: Signature Care EPO |
$124.95
|
| Rate for Payer: Signature Care PPO |
$124.95
|
| Rate for Payer: Signature Care PPO |
$124.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,600.00
|
| Rate for Payer: United Healthcare Commercial |
$105.21
|
| Rate for Payer: United Healthcare Commercial |
$105.21
|
| Rate for Payer: United Healthcare Medicare |
$125.31
|
| Rate for Payer: United Healthcare Medicare |
$125.31
|
|
|
PR DESTRUC BENIGN/PREMAL,15+ LESIONS
|
Professional
|
Both
|
$312.12
|
|
|
Service Code
|
CPT 17004
|
| Hospital Charge Code |
z17004
|
| Min. Negotiated Rate |
$88.51 |
| Max. Negotiated Rate |
$162.14 |
| Rate for Payer: Aetna Commercial |
$91.39
|
| Rate for Payer: Aetna Commercial |
$91.39
|
| Rate for Payer: Aetna Medicare |
$91.39
|
| Rate for Payer: Aetna Medicare |
$91.39
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$88.51
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$88.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$153.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$153.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$105.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$105.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$100.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$100.53
|
| Rate for Payer: Cash Price |
$185.14
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Centivo All Commercial |
$141.65
|
| Rate for Payer: Centivo All Commercial |
$141.65
|
| Rate for Payer: Cigna All Commercial |
$91.39
|
| Rate for Payer: Cigna All Commercial |
$91.39
|
| Rate for Payer: CORVEL All Commercial |
$91.39
|
| Rate for Payer: CORVEL All Commercial |
$91.39
|
| Rate for Payer: Coventry All Commercial |
$109.67
|
| Rate for Payer: Coventry All Commercial |
$109.67
|
| Rate for Payer: Encore All Commercial |
$91.39
|
| Rate for Payer: Encore All Commercial |
$91.39
|
| Rate for Payer: Frontpath All Commercial |
$122.99
|
| Rate for Payer: Frontpath All Commercial |
$122.99
|
| Rate for Payer: Humana ChoiceCare |
$162.14
|
| Rate for Payer: Humana ChoiceCare |
$162.14
|
| Rate for Payer: Humana Medicare |
$91.39
|
| Rate for Payer: Humana Medicare |
$91.39
|
| Rate for Payer: Lucent All Commercial |
$127.95
|
| Rate for Payer: Lucent All Commercial |
$127.95
|
| Rate for Payer: Managed Health Services Medicaid |
$153.51
|
| Rate for Payer: Managed Health Services Medicaid |
$153.51
|
| Rate for Payer: MDWise Medicaid |
$153.51
|
| Rate for Payer: MDWise Medicaid |
$153.51
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$88.51
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$88.51
|
| Rate for Payer: PHCS All Commercial |
$91.39
|
| Rate for Payer: PHCS All Commercial |
$91.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$91.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$91.39
|
| Rate for Payer: Sagamore Health Network All Products |
$91.39
|
| Rate for Payer: Sagamore Health Network All Products |
$91.39
|
| Rate for Payer: United Healthcare Commercial |
$145.86
|
| Rate for Payer: United Healthcare Commercial |
$145.86
|
| Rate for Payer: United Healthcare Medicare |
$154.28
|
| Rate for Payer: United Healthcare Medicare |
$154.28
|
|
|
PR DESTRUC BENIGN/PREMAL,2-14 LESIONS
|
Professional
|
Both
|
$12.48
|
|
|
Service Code
|
CPT 17003
|
| Hospital Charge Code |
z17003
|
| Min. Negotiated Rate |
$2.01 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: Aetna Commercial |
$2.01
|
| Rate for Payer: Aetna Commercial |
$2.01
|
| Rate for Payer: Aetna Medicare |
$2.01
|
| Rate for Payer: Aetna Medicare |
$2.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$11.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$11.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.69
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$2.08
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$2.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$6.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$6.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2.21
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.49
|
| Rate for Payer: Centivo All Commercial |
$3.12
|
| Rate for Payer: Centivo All Commercial |
$3.12
|
| Rate for Payer: Cigna All Commercial |
$2.01
|
| Rate for Payer: Cigna All Commercial |
$2.01
|
| Rate for Payer: CORVEL All Commercial |
$2.01
|
| Rate for Payer: CORVEL All Commercial |
$2.01
|
| Rate for Payer: Coventry All Commercial |
$2.41
|
| Rate for Payer: Coventry All Commercial |
$2.41
|
| Rate for Payer: Encore All Commercial |
$2.01
|
| Rate for Payer: Encore All Commercial |
$2.01
|
| Rate for Payer: Frontpath All Commercial |
$2.63
|
| Rate for Payer: Frontpath All Commercial |
$2.63
|
| Rate for Payer: Humana ChoiceCare |
$8.25
|
| Rate for Payer: Humana ChoiceCare |
$8.25
|
| Rate for Payer: Humana Medicare |
$2.01
|
| Rate for Payer: Humana Medicare |
$2.01
|
| Rate for Payer: Lucent All Commercial |
$2.81
|
| Rate for Payer: Lucent All Commercial |
$2.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3.00
|
| Rate for Payer: Managed Health Services Medicaid |
$6.14
|
| Rate for Payer: Managed Health Services Medicaid |
$6.14
|
| Rate for Payer: MDWise Medicaid |
$6.14
|
| Rate for Payer: MDWise Medicaid |
$6.14
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$2.08
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$2.08
|
| Rate for Payer: PHCS All Commercial |
$2.01
|
| Rate for Payer: PHCS All Commercial |
$2.01
|
| Rate for Payer: PHP All Commercial |
$2.69
|
| Rate for Payer: PHP All Commercial |
$2.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2.01
|
| Rate for Payer: Sagamore Health Network All Products |
$2.01
|
| Rate for Payer: Sagamore Health Network All Products |
$2.01
|
| Rate for Payer: Signature Care EPO |
$8.96
|
| Rate for Payer: Signature Care EPO |
$8.96
|
| Rate for Payer: Signature Care PPO |
$8.96
|
| Rate for Payer: Signature Care PPO |
$8.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$200.00
|
| Rate for Payer: United Healthcare Commercial |
$5.09
|
| Rate for Payer: United Healthcare Commercial |
$5.09
|
| Rate for Payer: United Healthcare Medicare |
$6.14
|
| Rate for Payer: United Healthcare Medicare |
$6.14
|
|
|
PR DESTRUC BENIGN/PREMAL,FIRST LESION
|
Professional
|
Both
|
$126.64
|
|
|
Service Code
|
CPT 17000
|
| Hospital Charge Code |
z17000
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$6,200.00 |
| Rate for Payer: Aetna Commercial |
$51.20
|
| Rate for Payer: Aetna Commercial |
$51.20
|
| Rate for Payer: Aetna Medicare |
$51.20
|
| Rate for Payer: Aetna Medicare |
$51.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$76.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$76.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$27.86
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$27.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$62.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$62.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.32
|
| Rate for Payer: Cash Price |
$73.76
|
| Rate for Payer: Cash Price |
$75.98
|
| Rate for Payer: Centivo All Commercial |
$79.36
|
| Rate for Payer: Centivo All Commercial |
$79.36
|
| Rate for Payer: Cigna All Commercial |
$51.20
|
| Rate for Payer: Cigna All Commercial |
$51.20
|
| Rate for Payer: CORVEL All Commercial |
$51.20
|
| Rate for Payer: CORVEL All Commercial |
$51.20
|
| Rate for Payer: Coventry All Commercial |
$61.44
|
| Rate for Payer: Coventry All Commercial |
$61.44
|
| Rate for Payer: Encore All Commercial |
$51.20
|
| Rate for Payer: Encore All Commercial |
$51.20
|
| Rate for Payer: Frontpath All Commercial |
$69.08
|
| Rate for Payer: Frontpath All Commercial |
$69.08
|
| Rate for Payer: Humana ChoiceCare |
$41.78
|
| Rate for Payer: Humana ChoiceCare |
$41.78
|
| Rate for Payer: Humana Medicare |
$51.20
|
| Rate for Payer: Humana Medicare |
$51.20
|
| Rate for Payer: Lucent All Commercial |
$71.68
|
| Rate for Payer: Lucent All Commercial |
$71.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Managed Health Services Medicaid |
$62.29
|
| Rate for Payer: Managed Health Services Medicaid |
$62.29
|
| Rate for Payer: MDWise Medicaid |
$62.29
|
| Rate for Payer: MDWise Medicaid |
$62.29
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$27.86
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$27.86
|
| Rate for Payer: PHCS All Commercial |
$51.20
|
| Rate for Payer: PHCS All Commercial |
$51.20
|
| Rate for Payer: PHP All Commercial |
$70.03
|
| Rate for Payer: PHP All Commercial |
$70.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.20
|
| Rate for Payer: Sagamore Health Network All Products |
$51.20
|
| Rate for Payer: Sagamore Health Network All Products |
$51.20
|
| Rate for Payer: Signature Care EPO |
$53.58
|
| Rate for Payer: Signature Care EPO |
$53.58
|
| Rate for Payer: Signature Care PPO |
$53.58
|
| Rate for Payer: Signature Care PPO |
$53.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,200.00
|
| Rate for Payer: United Healthcare Commercial |
$57.74
|
| Rate for Payer: United Healthcare Commercial |
$57.74
|
| Rate for Payer: United Healthcare Medicare |
$61.47
|
| Rate for Payer: United Healthcare Medicare |
$61.47
|
|
|
PR DESTRUC MOUTH LESION/SCAR
|
Professional
|
Both
|
$481.06
|
|
|
Service Code
|
CPT 40820
|
| Hospital Charge Code |
z40820
|
| Min. Negotiated Rate |
$87.10 |
| Max. Negotiated Rate |
$21,800.00 |
| Rate for Payer: Aetna Commercial |
$158.56
|
| Rate for Payer: Aetna Commercial |
$158.56
|
| Rate for Payer: Aetna Medicare |
$158.56
|
| Rate for Payer: Aetna Medicare |
$158.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$237.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$237.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$237.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$237.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$237.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$237.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$237.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$237.65
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$87.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$87.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$236.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$236.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$182.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$182.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$174.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$174.42
|
| Rate for Payer: Cash Price |
$283.86
|
| Rate for Payer: Cash Price |
$288.64
|
| Rate for Payer: Centivo All Commercial |
$245.77
|
| Rate for Payer: Centivo All Commercial |
$245.77
|
| Rate for Payer: Cigna All Commercial |
$158.56
|
| Rate for Payer: Cigna All Commercial |
$158.56
|
| Rate for Payer: CORVEL All Commercial |
$158.56
|
| Rate for Payer: CORVEL All Commercial |
$158.56
|
| Rate for Payer: Coventry All Commercial |
$190.27
|
| Rate for Payer: Coventry All Commercial |
$190.27
|
| Rate for Payer: Encore All Commercial |
$158.56
|
| Rate for Payer: Encore All Commercial |
$158.56
|
| Rate for Payer: Frontpath All Commercial |
$211.59
|
| Rate for Payer: Frontpath All Commercial |
$211.59
|
| Rate for Payer: Humana ChoiceCare |
$160.94
|
| Rate for Payer: Humana ChoiceCare |
$160.94
|
| Rate for Payer: Humana Medicare |
$158.56
|
| Rate for Payer: Humana Medicare |
$158.56
|
| Rate for Payer: Lucent All Commercial |
$221.98
|
| Rate for Payer: Lucent All Commercial |
$221.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$234.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$234.00
|
| Rate for Payer: Managed Health Services Medicaid |
$236.60
|
| Rate for Payer: Managed Health Services Medicaid |
$236.60
|
| Rate for Payer: MDWise Medicaid |
$236.60
|
| Rate for Payer: MDWise Medicaid |
$236.60
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$87.10
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$87.10
|
| Rate for Payer: PHCS All Commercial |
$158.56
|
| Rate for Payer: PHCS All Commercial |
$158.56
|
| Rate for Payer: PHP All Commercial |
$265.85
|
| Rate for Payer: PHP All Commercial |
$265.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$158.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$158.56
|
| Rate for Payer: Sagamore Health Network All Products |
$158.56
|
| Rate for Payer: Sagamore Health Network All Products |
$158.56
|
| Rate for Payer: Signature Care EPO |
$218.11
|
| Rate for Payer: Signature Care EPO |
$218.11
|
| Rate for Payer: Signature Care PPO |
$218.11
|
| Rate for Payer: Signature Care PPO |
$218.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21,800.00
|
| Rate for Payer: United Healthcare Commercial |
$179.53
|
| Rate for Payer: United Healthcare Commercial |
$179.53
|
| Rate for Payer: United Healthcare Medicare |
$236.55
|
| Rate for Payer: United Healthcare Medicare |
$236.55
|
|
|
PR DESTRUCT INTERNAL HEMORRHOID, THERMAL
|
Professional
|
Both
|
$401.88
|
|
|
Service Code
|
CPT 46930
|
| Hospital Charge Code |
z46930
|
| Min. Negotiated Rate |
$141.75 |
| Max. Negotiated Rate |
$19,800.00 |
| Rate for Payer: Aetna Commercial |
$143.97
|
| Rate for Payer: Aetna Commercial |
$143.97
|
| Rate for Payer: Aetna Medicare |
$143.97
|
| Rate for Payer: Aetna Medicare |
$143.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$311.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$311.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$311.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$311.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$311.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$311.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$311.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$311.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$141.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$141.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$165.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$165.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$158.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$158.37
|
| Rate for Payer: Cash Price |
$236.81
|
| Rate for Payer: Cash Price |
$241.13
|
| Rate for Payer: Centivo All Commercial |
$223.15
|
| Rate for Payer: Centivo All Commercial |
$223.15
|
| Rate for Payer: Cigna All Commercial |
$143.97
|
| Rate for Payer: Cigna All Commercial |
$143.97
|
| Rate for Payer: CORVEL All Commercial |
$143.97
|
| Rate for Payer: CORVEL All Commercial |
$143.97
|
| Rate for Payer: Coventry All Commercial |
$172.76
|
| Rate for Payer: Coventry All Commercial |
$172.76
|
| Rate for Payer: Encore All Commercial |
$143.97
|
| Rate for Payer: Encore All Commercial |
$143.97
|
| Rate for Payer: Frontpath All Commercial |
$194.97
|
| Rate for Payer: Frontpath All Commercial |
$194.97
|
| Rate for Payer: Humana ChoiceCare |
$154.32
|
| Rate for Payer: Humana ChoiceCare |
$154.32
|
| Rate for Payer: Humana Medicare |
$143.97
|
| Rate for Payer: Humana Medicare |
$143.97
|
| Rate for Payer: Lucent All Commercial |
$201.56
|
| Rate for Payer: Lucent All Commercial |
$201.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$213.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$213.00
|
| Rate for Payer: Managed Health Services Medicaid |
$197.66
|
| Rate for Payer: Managed Health Services Medicaid |
$197.66
|
| Rate for Payer: MDWise Medicaid |
$197.66
|
| Rate for Payer: MDWise Medicaid |
$197.66
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$141.75
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$141.75
|
| Rate for Payer: PHCS All Commercial |
$143.97
|
| Rate for Payer: PHCS All Commercial |
$143.97
|
| Rate for Payer: PHP All Commercial |
$242.03
|
| Rate for Payer: PHP All Commercial |
$242.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$143.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$143.97
|
| Rate for Payer: Sagamore Health Network All Products |
$143.97
|
| Rate for Payer: Sagamore Health Network All Products |
$143.97
|
| Rate for Payer: Signature Care EPO |
$266.19
|
| Rate for Payer: Signature Care EPO |
$266.19
|
| Rate for Payer: Signature Care PPO |
$266.19
|
| Rate for Payer: Signature Care PPO |
$266.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,800.00
|
| Rate for Payer: United Healthcare Commercial |
$161.15
|
| Rate for Payer: United Healthcare Commercial |
$161.15
|
| Rate for Payer: United Healthcare Medicare |
$197.34
|
| Rate for Payer: United Healthcare Medicare |
$197.34
|
|
