|
HC W PLATE 5DG MTP SM R
|
Facility
IP
|
$4,896.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,672.00 |
| Max. Negotiated Rate |
$4,553.28 |
| Rate for Payer: Aetna Commercial |
$4,230.14
|
| Rate for Payer: Cash Price |
$3,035.52
|
| Rate for Payer: Cigna All Commercial |
$4,225.25
|
| Rate for Payer: CORVEL All Commercial |
$4,553.28
|
| Rate for Payer: Coventry All Commercial |
$4,308.48
|
| Rate for Payer: Encore All Commercial |
$4,506.77
|
| Rate for Payer: Frontpath All Commercial |
$4,504.32
|
| Rate for Payer: Humana ChoiceCare |
$4,228.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,406.40
|
| Rate for Payer: PHCS All Commercial |
$3,672.00
|
| Rate for Payer: PHP All Commercial |
$3,713.13
|
| Rate for Payer: Sagamore Health Network All Products |
$3,779.71
|
| Rate for Payer: Signature Care EPO |
$4,063.68
|
| Rate for Payer: Signature Care PPO |
$4,308.48
|
| Rate for Payer: United Healthcare Commercial |
$3,858.05
|
|
|
HC W PLATE 5-H ST TUB
|
Facility
IP
|
$1,990.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,492.50 |
| Max. Negotiated Rate |
$1,850.70 |
| Rate for Payer: Aetna Commercial |
$1,719.36
|
| Rate for Payer: Cash Price |
$1,233.80
|
| Rate for Payer: Cigna All Commercial |
$1,717.37
|
| Rate for Payer: CORVEL All Commercial |
$1,850.70
|
| Rate for Payer: Coventry All Commercial |
$1,751.20
|
| Rate for Payer: Encore All Commercial |
$1,831.80
|
| Rate for Payer: Frontpath All Commercial |
$1,830.80
|
| Rate for Payer: Humana ChoiceCare |
$1,718.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,791.00
|
| Rate for Payer: PHCS All Commercial |
$1,492.50
|
| Rate for Payer: PHP All Commercial |
$1,509.22
|
| Rate for Payer: Sagamore Health Network All Products |
$1,536.28
|
| Rate for Payer: Signature Care EPO |
$1,651.70
|
| Rate for Payer: Signature Care PPO |
$1,751.20
|
| Rate for Payer: United Healthcare Commercial |
$1,568.12
|
|
|
HC W PLATE 5-H ST TUB
|
Facility
OP
|
$1,990.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,850.70 |
| Rate for Payer: Aetna Commercial |
$1,679.56
|
| Rate for Payer: Aetna Medicare |
$656.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$656.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,142.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,243.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$755.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$722.37
|
| Rate for Payer: Cash Price |
$1,233.80
|
| Rate for Payer: Cash Price |
$1,233.80
|
| Rate for Payer: Centivo All Commercial |
$1,014.90
|
| Rate for Payer: Cigna All Commercial |
$1,717.37
|
| Rate for Payer: CORVEL All Commercial |
$1,850.70
|
| Rate for Payer: Coventry All Commercial |
$1,751.20
|
| Rate for Payer: Encore All Commercial |
$1,831.80
|
| Rate for Payer: Frontpath All Commercial |
$1,830.80
|
| Rate for Payer: Humana ChoiceCare |
$1,718.76
|
| Rate for Payer: Humana Medicare |
$1,014.90
|
| Rate for Payer: Lucent All Commercial |
$1,014.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,791.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,492.50
|
| Rate for Payer: PHP All Commercial |
$1,509.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$776.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,536.28
|
| Rate for Payer: Signature Care EPO |
$1,651.70
|
| Rate for Payer: Signature Care PPO |
$1,751.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,691.50
|
| Rate for Payer: United Healthcare Commercial |
$1,568.12
|
| Rate for Payer: United Healthcare Medicare |
$656.70
|
|
|
HC W PLATE 5-H UTIL
|
Facility
IP
|
$5,770.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,328.10 |
| Max. Negotiated Rate |
$5,366.84 |
| Rate for Payer: Aetna Commercial |
$4,985.97
|
| Rate for Payer: Cash Price |
$3,577.90
|
| Rate for Payer: Cigna All Commercial |
$4,980.20
|
| Rate for Payer: CORVEL All Commercial |
$5,366.84
|
| Rate for Payer: Coventry All Commercial |
$5,078.30
|
| Rate for Payer: Encore All Commercial |
$5,312.02
|
| Rate for Payer: Frontpath All Commercial |
$5,309.14
|
| Rate for Payer: Humana ChoiceCare |
$4,984.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,193.72
|
| Rate for Payer: PHCS All Commercial |
$4,328.10
|
| Rate for Payer: PHP All Commercial |
$4,376.57
|
| Rate for Payer: Sagamore Health Network All Products |
$4,455.06
|
| Rate for Payer: Signature Care EPO |
$4,789.76
|
| Rate for Payer: Signature Care PPO |
$5,078.30
|
| Rate for Payer: United Healthcare Commercial |
$4,547.39
|
|
|
HC W PLATE 5-H UTIL
|
Facility
OP
|
$5,770.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,366.84 |
| Rate for Payer: Aetna Commercial |
$4,870.56
|
| Rate for Payer: Aetna Medicare |
$1,904.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,904.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,314.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,607.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,190.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,094.80
|
| Rate for Payer: Cash Price |
$3,577.90
|
| Rate for Payer: Cash Price |
$3,577.90
|
| Rate for Payer: Centivo All Commercial |
$2,943.11
|
| Rate for Payer: Cigna All Commercial |
$4,980.20
|
| Rate for Payer: CORVEL All Commercial |
$5,366.84
|
| Rate for Payer: Coventry All Commercial |
$5,078.30
|
| Rate for Payer: Encore All Commercial |
$5,312.02
|
| Rate for Payer: Frontpath All Commercial |
$5,309.14
|
| Rate for Payer: Humana ChoiceCare |
$4,984.24
|
| Rate for Payer: Humana Medicare |
$2,943.11
|
| Rate for Payer: Lucent All Commercial |
$2,943.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,193.72
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,328.10
|
| Rate for Payer: PHP All Commercial |
$4,376.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,250.61
|
| Rate for Payer: Sagamore Health Network All Products |
$4,455.06
|
| Rate for Payer: Signature Care EPO |
$4,789.76
|
| Rate for Payer: Signature Care PPO |
$5,078.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,905.18
|
| Rate for Payer: United Healthcare Commercial |
$4,547.39
|
| Rate for Payer: United Healthcare Medicare |
$1,904.36
|
|
|
HC W PLATE 6.5 COTTON WEDGE
|
Facility
OP
|
$5,338.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,965.08 |
| Rate for Payer: Aetna Commercial |
$4,505.95
|
| Rate for Payer: Aetna Medicare |
$1,761.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,761.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,066.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,337.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,026.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,937.98
|
| Rate for Payer: Cash Price |
$3,310.06
|
| Rate for Payer: Cash Price |
$3,310.06
|
| Rate for Payer: Centivo All Commercial |
$2,722.79
|
| Rate for Payer: Cigna All Commercial |
$4,607.38
|
| Rate for Payer: CORVEL All Commercial |
$4,965.08
|
| Rate for Payer: Coventry All Commercial |
$4,698.14
|
| Rate for Payer: Encore All Commercial |
$4,914.37
|
| Rate for Payer: Frontpath All Commercial |
$4,911.70
|
| Rate for Payer: Humana ChoiceCare |
$4,611.12
|
| Rate for Payer: Humana Medicare |
$2,722.79
|
| Rate for Payer: Lucent All Commercial |
$2,722.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,804.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,004.10
|
| Rate for Payer: PHP All Commercial |
$4,048.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,082.13
|
| Rate for Payer: Sagamore Health Network All Products |
$4,121.55
|
| Rate for Payer: Signature Care EPO |
$4,431.20
|
| Rate for Payer: Signature Care PPO |
$4,698.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,537.98
|
| Rate for Payer: United Healthcare Commercial |
$4,206.97
|
| Rate for Payer: United Healthcare Medicare |
$1,761.80
|
|
|
HC W PLATE 6.5 COTTON WEDGE
|
Facility
IP
|
$5,338.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,004.10 |
| Max. Negotiated Rate |
$4,965.08 |
| Rate for Payer: Aetna Commercial |
$4,612.72
|
| Rate for Payer: Cash Price |
$3,310.06
|
| Rate for Payer: Cigna All Commercial |
$4,607.38
|
| Rate for Payer: CORVEL All Commercial |
$4,965.08
|
| Rate for Payer: Coventry All Commercial |
$4,698.14
|
| Rate for Payer: Encore All Commercial |
$4,914.37
|
| Rate for Payer: Frontpath All Commercial |
$4,911.70
|
| Rate for Payer: Humana ChoiceCare |
$4,611.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,804.92
|
| Rate for Payer: PHCS All Commercial |
$4,004.10
|
| Rate for Payer: PHP All Commercial |
$4,048.95
|
| Rate for Payer: Sagamore Health Network All Products |
$4,121.55
|
| Rate for Payer: Signature Care EPO |
$4,431.20
|
| Rate for Payer: Signature Care PPO |
$4,698.14
|
| Rate for Payer: United Healthcare Commercial |
$4,206.97
|
|
|
HC W PLATE 6 EVANS OPN WEDGE
|
Facility
IP
|
$5,695.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,271.40 |
| Max. Negotiated Rate |
$5,296.54 |
| Rate for Payer: Aetna Commercial |
$4,920.65
|
| Rate for Payer: Cash Price |
$3,531.02
|
| Rate for Payer: Cigna All Commercial |
$4,914.96
|
| Rate for Payer: CORVEL All Commercial |
$5,296.54
|
| Rate for Payer: Coventry All Commercial |
$5,011.78
|
| Rate for Payer: Encore All Commercial |
$5,242.43
|
| Rate for Payer: Frontpath All Commercial |
$5,239.58
|
| Rate for Payer: Humana ChoiceCare |
$4,918.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,125.68
|
| Rate for Payer: PHCS All Commercial |
$4,271.40
|
| Rate for Payer: PHP All Commercial |
$4,319.24
|
| Rate for Payer: Sagamore Health Network All Products |
$4,396.69
|
| Rate for Payer: Signature Care EPO |
$4,727.02
|
| Rate for Payer: Signature Care PPO |
$5,011.78
|
| Rate for Payer: United Healthcare Commercial |
$4,487.82
|
|
|
HC W PLATE 6 EVANS OPN WEDGE
|
Facility
OP
|
$5,695.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,296.54 |
| Rate for Payer: Aetna Commercial |
$4,806.75
|
| Rate for Payer: Aetna Medicare |
$1,879.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,879.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,270.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,560.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,161.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,067.36
|
| Rate for Payer: Cash Price |
$3,531.02
|
| Rate for Payer: Cash Price |
$3,531.02
|
| Rate for Payer: Centivo All Commercial |
$2,904.55
|
| Rate for Payer: Cigna All Commercial |
$4,914.96
|
| Rate for Payer: CORVEL All Commercial |
$5,296.54
|
| Rate for Payer: Coventry All Commercial |
$5,011.78
|
| Rate for Payer: Encore All Commercial |
$5,242.43
|
| Rate for Payer: Frontpath All Commercial |
$5,239.58
|
| Rate for Payer: Humana ChoiceCare |
$4,918.94
|
| Rate for Payer: Humana Medicare |
$2,904.55
|
| Rate for Payer: Lucent All Commercial |
$2,904.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,125.68
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,271.40
|
| Rate for Payer: PHP All Commercial |
$4,319.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,221.13
|
| Rate for Payer: Sagamore Health Network All Products |
$4,396.69
|
| Rate for Payer: Signature Care EPO |
$4,727.02
|
| Rate for Payer: Signature Care PPO |
$5,011.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,840.92
|
| Rate for Payer: United Healthcare Commercial |
$4,487.82
|
| Rate for Payer: United Healthcare Medicare |
$1,879.42
|
|
|
HC W PLATE 6-H ST MET
|
Facility
OP
|
$2,005.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,864.84 |
| Rate for Payer: Aetna Commercial |
$1,692.39
|
| Rate for Payer: Aetna Medicare |
$661.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$661.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,151.59
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,253.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$760.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$727.89
|
| Rate for Payer: Cash Price |
$1,243.22
|
| Rate for Payer: Cash Price |
$1,243.22
|
| Rate for Payer: Centivo All Commercial |
$1,022.65
|
| Rate for Payer: Cigna All Commercial |
$1,730.49
|
| Rate for Payer: CORVEL All Commercial |
$1,864.84
|
| Rate for Payer: Coventry All Commercial |
$1,764.58
|
| Rate for Payer: Encore All Commercial |
$1,845.79
|
| Rate for Payer: Frontpath All Commercial |
$1,844.78
|
| Rate for Payer: Humana ChoiceCare |
$1,731.89
|
| Rate for Payer: Humana Medicare |
$1,022.65
|
| Rate for Payer: Lucent All Commercial |
$1,022.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,804.68
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,503.90
|
| Rate for Payer: PHP All Commercial |
$1,520.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$782.03
|
| Rate for Payer: Sagamore Health Network All Products |
$1,548.01
|
| Rate for Payer: Signature Care EPO |
$1,664.32
|
| Rate for Payer: Signature Care PPO |
$1,764.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,704.42
|
| Rate for Payer: United Healthcare Commercial |
$1,580.10
|
| Rate for Payer: United Healthcare Medicare |
$661.72
|
|
|
HC W PLATE 6-H ST MET
|
Facility
IP
|
$2,005.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,503.90 |
| Max. Negotiated Rate |
$1,864.84 |
| Rate for Payer: Aetna Commercial |
$1,732.49
|
| Rate for Payer: Cash Price |
$1,243.22
|
| Rate for Payer: Cigna All Commercial |
$1,730.49
|
| Rate for Payer: CORVEL All Commercial |
$1,864.84
|
| Rate for Payer: Coventry All Commercial |
$1,764.58
|
| Rate for Payer: Encore All Commercial |
$1,845.79
|
| Rate for Payer: Frontpath All Commercial |
$1,844.78
|
| Rate for Payer: Humana ChoiceCare |
$1,731.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,804.68
|
| Rate for Payer: PHCS All Commercial |
$1,503.90
|
| Rate for Payer: PHP All Commercial |
$1,520.74
|
| Rate for Payer: Sagamore Health Network All Products |
$1,548.01
|
| Rate for Payer: Signature Care EPO |
$1,664.32
|
| Rate for Payer: Signature Care PPO |
$1,764.58
|
| Rate for Payer: United Healthcare Commercial |
$1,580.10
|
|
|
HC W PLATE 6-H ST TUB
|
Facility
OP
|
$2,315.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,152.95 |
| Rate for Payer: Aetna Commercial |
$1,953.86
|
| Rate for Payer: Aetna Medicare |
$763.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$763.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,329.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,447.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$878.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$840.34
|
| Rate for Payer: Cash Price |
$1,435.30
|
| Rate for Payer: Cash Price |
$1,435.30
|
| Rate for Payer: Centivo All Commercial |
$1,180.65
|
| Rate for Payer: Cigna All Commercial |
$1,997.84
|
| Rate for Payer: CORVEL All Commercial |
$2,152.95
|
| Rate for Payer: Coventry All Commercial |
$2,037.20
|
| Rate for Payer: Encore All Commercial |
$2,130.96
|
| Rate for Payer: Frontpath All Commercial |
$2,129.80
|
| Rate for Payer: Humana ChoiceCare |
$1,999.47
|
| Rate for Payer: Humana Medicare |
$1,180.65
|
| Rate for Payer: Lucent All Commercial |
$1,180.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,083.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,736.25
|
| Rate for Payer: PHP All Commercial |
$1,755.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$902.85
|
| Rate for Payer: Sagamore Health Network All Products |
$1,787.18
|
| Rate for Payer: Signature Care EPO |
$1,921.45
|
| Rate for Payer: Signature Care PPO |
$2,037.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,967.75
|
| Rate for Payer: United Healthcare Commercial |
$1,824.22
|
| Rate for Payer: United Healthcare Medicare |
$763.95
|
|
|
HC W PLATE 6-H ST TUB
|
Facility
IP
|
$2,315.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,736.25 |
| Max. Negotiated Rate |
$2,152.95 |
| Rate for Payer: Aetna Commercial |
$2,000.16
|
| Rate for Payer: Cash Price |
$1,435.30
|
| Rate for Payer: Cigna All Commercial |
$1,997.84
|
| Rate for Payer: CORVEL All Commercial |
$2,152.95
|
| Rate for Payer: Coventry All Commercial |
$2,037.20
|
| Rate for Payer: Encore All Commercial |
$2,130.96
|
| Rate for Payer: Frontpath All Commercial |
$2,129.80
|
| Rate for Payer: Humana ChoiceCare |
$1,999.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,083.50
|
| Rate for Payer: PHCS All Commercial |
$1,736.25
|
| Rate for Payer: PHP All Commercial |
$1,755.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,787.18
|
| Rate for Payer: Signature Care EPO |
$1,921.45
|
| Rate for Payer: Signature Care PPO |
$2,037.20
|
| Rate for Payer: United Healthcare Commercial |
$1,824.22
|
|
|
HC W PLATE 6-H ST TUB
|
Facility
IP
|
$2,155.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,616.25 |
| Max. Negotiated Rate |
$2,004.15 |
| Rate for Payer: Aetna Commercial |
$1,861.92
|
| Rate for Payer: Cash Price |
$1,336.10
|
| Rate for Payer: Cigna All Commercial |
$1,859.76
|
| Rate for Payer: CORVEL All Commercial |
$2,004.15
|
| Rate for Payer: Coventry All Commercial |
$1,896.40
|
| Rate for Payer: Encore All Commercial |
$1,983.68
|
| Rate for Payer: Frontpath All Commercial |
$1,982.60
|
| Rate for Payer: Humana ChoiceCare |
$1,861.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,939.50
|
| Rate for Payer: PHCS All Commercial |
$1,616.25
|
| Rate for Payer: PHP All Commercial |
$1,634.35
|
| Rate for Payer: Sagamore Health Network All Products |
$1,663.66
|
| Rate for Payer: Signature Care EPO |
$1,788.65
|
| Rate for Payer: Signature Care PPO |
$1,896.40
|
| Rate for Payer: United Healthcare Commercial |
$1,698.14
|
|
|
HC W PLATE 6-H ST TUB
|
Facility
OP
|
$2,155.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,004.15 |
| Rate for Payer: Aetna Commercial |
$1,818.82
|
| Rate for Payer: Aetna Medicare |
$711.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$711.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,237.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,347.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$817.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$782.26
|
| Rate for Payer: Cash Price |
$1,336.10
|
| Rate for Payer: Cash Price |
$1,336.10
|
| Rate for Payer: Centivo All Commercial |
$1,099.05
|
| Rate for Payer: Cigna All Commercial |
$1,859.76
|
| Rate for Payer: CORVEL All Commercial |
$2,004.15
|
| Rate for Payer: Coventry All Commercial |
$1,896.40
|
| Rate for Payer: Encore All Commercial |
$1,983.68
|
| Rate for Payer: Frontpath All Commercial |
$1,982.60
|
| Rate for Payer: Humana ChoiceCare |
$1,861.27
|
| Rate for Payer: Humana Medicare |
$1,099.05
|
| Rate for Payer: Lucent All Commercial |
$1,099.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,939.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,616.25
|
| Rate for Payer: PHP All Commercial |
$1,634.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$840.45
|
| Rate for Payer: Sagamore Health Network All Products |
$1,663.66
|
| Rate for Payer: Signature Care EPO |
$1,788.65
|
| Rate for Payer: Signature Care PPO |
$1,896.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,831.75
|
| Rate for Payer: United Healthcare Commercial |
$1,698.14
|
| Rate for Payer: United Healthcare Medicare |
$711.15
|
|
|
HC W PLATE 6-H T MET
|
Facility
OP
|
$2,347.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,182.90 |
| Rate for Payer: Aetna Commercial |
$1,981.04
|
| Rate for Payer: Aetna Medicare |
$774.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$774.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,348.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,467.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$890.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$852.03
|
| Rate for Payer: Cash Price |
$1,455.26
|
| Rate for Payer: Cash Price |
$1,455.26
|
| Rate for Payer: Centivo All Commercial |
$1,197.07
|
| Rate for Payer: Cigna All Commercial |
$2,025.63
|
| Rate for Payer: CORVEL All Commercial |
$2,182.90
|
| Rate for Payer: Coventry All Commercial |
$2,065.54
|
| Rate for Payer: Encore All Commercial |
$2,160.60
|
| Rate for Payer: Frontpath All Commercial |
$2,159.42
|
| Rate for Payer: Humana ChoiceCare |
$2,027.28
|
| Rate for Payer: Humana Medicare |
$1,197.07
|
| Rate for Payer: Lucent All Commercial |
$1,197.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,112.48
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,760.40
|
| Rate for Payer: PHP All Commercial |
$1,780.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$915.41
|
| Rate for Payer: Sagamore Health Network All Products |
$1,812.04
|
| Rate for Payer: Signature Care EPO |
$1,948.18
|
| Rate for Payer: Signature Care PPO |
$2,065.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,995.12
|
| Rate for Payer: United Healthcare Commercial |
$1,849.59
|
| Rate for Payer: United Healthcare Medicare |
$774.58
|
|
|
HC W PLATE 6-H T MET
|
Facility
IP
|
$2,347.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,760.40 |
| Max. Negotiated Rate |
$2,182.90 |
| Rate for Payer: Aetna Commercial |
$2,027.98
|
| Rate for Payer: Cash Price |
$1,455.26
|
| Rate for Payer: Cigna All Commercial |
$2,025.63
|
| Rate for Payer: CORVEL All Commercial |
$2,182.90
|
| Rate for Payer: Coventry All Commercial |
$2,065.54
|
| Rate for Payer: Encore All Commercial |
$2,160.60
|
| Rate for Payer: Frontpath All Commercial |
$2,159.42
|
| Rate for Payer: Humana ChoiceCare |
$2,027.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,112.48
|
| Rate for Payer: PHCS All Commercial |
$1,760.40
|
| Rate for Payer: PHP All Commercial |
$1,780.12
|
| Rate for Payer: Sagamore Health Network All Products |
$1,812.04
|
| Rate for Payer: Signature Care EPO |
$1,948.18
|
| Rate for Payer: Signature Care PPO |
$2,065.54
|
| Rate for Payer: United Healthcare Commercial |
$1,849.59
|
|
|
HC W PLATE 6-H UNIV
|
Facility
IP
|
$2,862.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,146.50 |
| Max. Negotiated Rate |
$2,661.66 |
| Rate for Payer: Aetna Commercial |
$2,472.77
|
| Rate for Payer: Cash Price |
$1,774.44
|
| Rate for Payer: Cigna All Commercial |
$2,469.91
|
| Rate for Payer: CORVEL All Commercial |
$2,661.66
|
| Rate for Payer: Coventry All Commercial |
$2,518.56
|
| Rate for Payer: Encore All Commercial |
$2,634.47
|
| Rate for Payer: Frontpath All Commercial |
$2,633.04
|
| Rate for Payer: Humana ChoiceCare |
$2,471.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,575.80
|
| Rate for Payer: PHCS All Commercial |
$2,146.50
|
| Rate for Payer: PHP All Commercial |
$2,170.54
|
| Rate for Payer: Sagamore Health Network All Products |
$2,209.46
|
| Rate for Payer: Signature Care EPO |
$2,375.46
|
| Rate for Payer: Signature Care PPO |
$2,518.56
|
| Rate for Payer: United Healthcare Commercial |
$2,255.26
|
|
|
HC W PLATE 6-H UNIV
|
Facility
OP
|
$2,862.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,661.66 |
| Rate for Payer: Aetna Commercial |
$2,415.53
|
| Rate for Payer: Aetna Medicare |
$944.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$944.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,643.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,789.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,086.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,038.91
|
| Rate for Payer: Cash Price |
$1,774.44
|
| Rate for Payer: Cash Price |
$1,774.44
|
| Rate for Payer: Centivo All Commercial |
$1,459.62
|
| Rate for Payer: Cigna All Commercial |
$2,469.91
|
| Rate for Payer: CORVEL All Commercial |
$2,661.66
|
| Rate for Payer: Coventry All Commercial |
$2,518.56
|
| Rate for Payer: Encore All Commercial |
$2,634.47
|
| Rate for Payer: Frontpath All Commercial |
$2,633.04
|
| Rate for Payer: Humana ChoiceCare |
$2,471.91
|
| Rate for Payer: Humana Medicare |
$1,459.62
|
| Rate for Payer: Lucent All Commercial |
$1,459.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,575.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,146.50
|
| Rate for Payer: PHP All Commercial |
$2,170.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,116.18
|
| Rate for Payer: Sagamore Health Network All Products |
$2,209.46
|
| Rate for Payer: Signature Care EPO |
$2,375.46
|
| Rate for Payer: Signature Care PPO |
$2,518.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,432.70
|
| Rate for Payer: United Healthcare Commercial |
$2,255.26
|
| Rate for Payer: United Healthcare Medicare |
$944.46
|
|
|
HC W PLATE 77MM LT FIB L
|
Facility
IP
|
$5,292.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,969.00 |
| Max. Negotiated Rate |
$4,921.56 |
| Rate for Payer: Aetna Commercial |
$4,572.29
|
| Rate for Payer: Cash Price |
$3,281.04
|
| Rate for Payer: Cigna All Commercial |
$4,567.00
|
| Rate for Payer: CORVEL All Commercial |
$4,921.56
|
| Rate for Payer: Coventry All Commercial |
$4,656.96
|
| Rate for Payer: Encore All Commercial |
$4,871.29
|
| Rate for Payer: Frontpath All Commercial |
$4,868.64
|
| Rate for Payer: Humana ChoiceCare |
$4,570.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,762.80
|
| Rate for Payer: PHCS All Commercial |
$3,969.00
|
| Rate for Payer: PHP All Commercial |
$4,013.45
|
| Rate for Payer: Sagamore Health Network All Products |
$4,085.42
|
| Rate for Payer: Signature Care EPO |
$4,392.36
|
| Rate for Payer: Signature Care PPO |
$4,656.96
|
| Rate for Payer: United Healthcare Commercial |
$4,170.10
|
|
|
HC W PLATE 77MM LT FIB L
|
Facility
OP
|
$5,292.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,921.56 |
| Rate for Payer: Aetna Commercial |
$4,466.45
|
| Rate for Payer: Aetna Medicare |
$1,746.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,746.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,039.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,308.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,008.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,921.00
|
| Rate for Payer: Cash Price |
$3,281.04
|
| Rate for Payer: Cash Price |
$3,281.04
|
| Rate for Payer: Centivo All Commercial |
$2,698.92
|
| Rate for Payer: Cigna All Commercial |
$4,567.00
|
| Rate for Payer: CORVEL All Commercial |
$4,921.56
|
| Rate for Payer: Coventry All Commercial |
$4,656.96
|
| Rate for Payer: Encore All Commercial |
$4,871.29
|
| Rate for Payer: Frontpath All Commercial |
$4,868.64
|
| Rate for Payer: Humana ChoiceCare |
$4,570.70
|
| Rate for Payer: Humana Medicare |
$2,698.92
|
| Rate for Payer: Lucent All Commercial |
$2,698.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,762.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,969.00
|
| Rate for Payer: PHP All Commercial |
$4,013.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,063.88
|
| Rate for Payer: Sagamore Health Network All Products |
$4,085.42
|
| Rate for Payer: Signature Care EPO |
$4,392.36
|
| Rate for Payer: Signature Care PPO |
$4,656.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,498.20
|
| Rate for Payer: United Healthcare Commercial |
$4,170.10
|
| Rate for Payer: United Healthcare Medicare |
$1,746.36
|
|
|
HC W PLATE 77MM LT FIB R
|
Facility
IP
|
$5,292.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,969.00 |
| Max. Negotiated Rate |
$4,921.56 |
| Rate for Payer: Aetna Commercial |
$4,572.29
|
| Rate for Payer: Cash Price |
$3,281.04
|
| Rate for Payer: Cigna All Commercial |
$4,567.00
|
| Rate for Payer: CORVEL All Commercial |
$4,921.56
|
| Rate for Payer: Coventry All Commercial |
$4,656.96
|
| Rate for Payer: Encore All Commercial |
$4,871.29
|
| Rate for Payer: Frontpath All Commercial |
$4,868.64
|
| Rate for Payer: Humana ChoiceCare |
$4,570.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,762.80
|
| Rate for Payer: PHCS All Commercial |
$3,969.00
|
| Rate for Payer: PHP All Commercial |
$4,013.45
|
| Rate for Payer: Sagamore Health Network All Products |
$4,085.42
|
| Rate for Payer: Signature Care EPO |
$4,392.36
|
| Rate for Payer: Signature Care PPO |
$4,656.96
|
| Rate for Payer: United Healthcare Commercial |
$4,170.10
|
|
|
HC W PLATE 77MM LT FIB R
|
Facility
OP
|
$5,292.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,921.56 |
| Rate for Payer: Aetna Commercial |
$4,466.45
|
| Rate for Payer: Aetna Medicare |
$1,746.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,746.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,039.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,308.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,008.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,921.00
|
| Rate for Payer: Cash Price |
$3,281.04
|
| Rate for Payer: Cash Price |
$3,281.04
|
| Rate for Payer: Centivo All Commercial |
$2,698.92
|
| Rate for Payer: Cigna All Commercial |
$4,567.00
|
| Rate for Payer: CORVEL All Commercial |
$4,921.56
|
| Rate for Payer: Coventry All Commercial |
$4,656.96
|
| Rate for Payer: Encore All Commercial |
$4,871.29
|
| Rate for Payer: Frontpath All Commercial |
$4,868.64
|
| Rate for Payer: Humana ChoiceCare |
$4,570.70
|
| Rate for Payer: Humana Medicare |
$2,698.92
|
| Rate for Payer: Lucent All Commercial |
$2,698.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,762.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,969.00
|
| Rate for Payer: PHP All Commercial |
$4,013.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,063.88
|
| Rate for Payer: Sagamore Health Network All Products |
$4,085.42
|
| Rate for Payer: Signature Care EPO |
$4,392.36
|
| Rate for Payer: Signature Care PPO |
$4,656.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,498.20
|
| Rate for Payer: United Healthcare Commercial |
$4,170.10
|
| Rate for Payer: United Healthcare Medicare |
$1,746.36
|
|
|
HC W PLATE 77MM OFFSET LAT FIB L
|
Facility
OP
|
$5,529.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,142.53 |
| Rate for Payer: Aetna Commercial |
$4,666.98
|
| Rate for Payer: Aetna Medicare |
$1,824.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,824.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,175.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,456.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,098.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,007.24
|
| Rate for Payer: Cash Price |
$3,428.35
|
| Rate for Payer: Cash Price |
$3,428.35
|
| Rate for Payer: Centivo All Commercial |
$2,820.10
|
| Rate for Payer: Cigna All Commercial |
$4,772.04
|
| Rate for Payer: CORVEL All Commercial |
$5,142.53
|
| Rate for Payer: Coventry All Commercial |
$4,866.05
|
| Rate for Payer: Encore All Commercial |
$5,090.00
|
| Rate for Payer: Frontpath All Commercial |
$5,087.23
|
| Rate for Payer: Humana ChoiceCare |
$4,775.92
|
| Rate for Payer: Humana Medicare |
$2,820.10
|
| Rate for Payer: Lucent All Commercial |
$2,820.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,976.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,147.20
|
| Rate for Payer: PHP All Commercial |
$4,193.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,156.54
|
| Rate for Payer: Sagamore Health Network All Products |
$4,268.85
|
| Rate for Payer: Signature Care EPO |
$4,589.57
|
| Rate for Payer: Signature Care PPO |
$4,866.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,700.16
|
| Rate for Payer: United Healthcare Commercial |
$4,357.32
|
| Rate for Payer: United Healthcare Medicare |
$1,824.77
|
|
|
HC W PLATE 77MM OFFSET LAT FIB L
|
Facility
IP
|
$5,529.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,147.20 |
| Max. Negotiated Rate |
$5,142.53 |
| Rate for Payer: Aetna Commercial |
$4,777.57
|
| Rate for Payer: Cash Price |
$3,428.35
|
| Rate for Payer: Cigna All Commercial |
$4,772.04
|
| Rate for Payer: CORVEL All Commercial |
$5,142.53
|
| Rate for Payer: Coventry All Commercial |
$4,866.05
|
| Rate for Payer: Encore All Commercial |
$5,090.00
|
| Rate for Payer: Frontpath All Commercial |
$5,087.23
|
| Rate for Payer: Humana ChoiceCare |
$4,775.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,976.64
|
| Rate for Payer: PHCS All Commercial |
$4,147.20
|
| Rate for Payer: PHP All Commercial |
$4,193.65
|
| Rate for Payer: Sagamore Health Network All Products |
$4,268.85
|
| Rate for Payer: Signature Care EPO |
$4,589.57
|
| Rate for Payer: Signature Care PPO |
$4,866.05
|
| Rate for Payer: United Healthcare Commercial |
$4,357.32
|
|
