|
PR DOPPLER ECHO HEART,LIMITED,F/U
|
Professional
|
Both
|
$23.20
|
|
|
Service Code
|
CPT 93321
|
| Hospital Charge Code |
z93321
|
| Min. Negotiated Rate |
$13.82 |
| Max. Negotiated Rate |
$3,500.00 |
| Rate for Payer: Aetna Commercial |
$24.04
|
| Rate for Payer: Aetna Commercial |
$24.04
|
| Rate for Payer: Aetna Commercial |
$24.04
|
| Rate for Payer: Aetna Medicare |
$24.04
|
| Rate for Payer: Aetna Medicare |
$24.04
|
| Rate for Payer: Aetna Medicare |
$24.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$66.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$66.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$22.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$22.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$22.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.44
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cash Price |
$13.96
|
| Rate for Payer: Cash Price |
$7.94
|
| Rate for Payer: Centivo All Commercial |
$37.26
|
| Rate for Payer: Centivo All Commercial |
$37.26
|
| Rate for Payer: Centivo All Commercial |
$37.26
|
| Rate for Payer: Cigna All Commercial |
$24.04
|
| Rate for Payer: Cigna All Commercial |
$24.04
|
| Rate for Payer: Cigna All Commercial |
$24.04
|
| Rate for Payer: CORVEL All Commercial |
$24.04
|
| Rate for Payer: CORVEL All Commercial |
$24.04
|
| Rate for Payer: CORVEL All Commercial |
$24.04
|
| Rate for Payer: Coventry All Commercial |
$28.85
|
| Rate for Payer: Coventry All Commercial |
$28.85
|
| Rate for Payer: Coventry All Commercial |
$28.85
|
| Rate for Payer: Encore All Commercial |
$24.04
|
| Rate for Payer: Encore All Commercial |
$24.04
|
| Rate for Payer: Encore All Commercial |
$24.04
|
| Rate for Payer: Frontpath All Commercial |
$26.98
|
| Rate for Payer: Frontpath All Commercial |
$26.98
|
| Rate for Payer: Frontpath All Commercial |
$26.98
|
| Rate for Payer: Humana ChoiceCare |
$64.34
|
| Rate for Payer: Humana ChoiceCare |
$64.34
|
| Rate for Payer: Humana ChoiceCare |
$64.34
|
| Rate for Payer: Humana Medicare |
$24.04
|
| Rate for Payer: Humana Medicare |
$24.04
|
| Rate for Payer: Humana Medicare |
$24.04
|
| Rate for Payer: Lucent All Commercial |
$33.66
|
| Rate for Payer: Lucent All Commercial |
$33.66
|
| Rate for Payer: Lucent All Commercial |
$33.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38.00
|
| Rate for Payer: Managed Health Services Medicaid |
$22.88
|
| Rate for Payer: Managed Health Services Medicaid |
$22.88
|
| Rate for Payer: Managed Health Services Medicaid |
$22.88
|
| Rate for Payer: MDWise Medicaid |
$22.88
|
| Rate for Payer: MDWise Medicaid |
$22.88
|
| Rate for Payer: MDWise Medicaid |
$22.88
|
| Rate for Payer: PHCS All Commercial |
$24.04
|
| Rate for Payer: PHCS All Commercial |
$24.04
|
| Rate for Payer: PHCS All Commercial |
$24.04
|
| Rate for Payer: PHP All Commercial |
$33.64
|
| Rate for Payer: PHP All Commercial |
$33.64
|
| Rate for Payer: PHP All Commercial |
$33.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.04
|
| Rate for Payer: Sagamore Health Network All Products |
$24.04
|
| Rate for Payer: Sagamore Health Network All Products |
$24.04
|
| Rate for Payer: Sagamore Health Network All Products |
$24.04
|
| Rate for Payer: Signature Care EPO |
$13.82
|
| Rate for Payer: Signature Care EPO |
$13.82
|
| Rate for Payer: Signature Care EPO |
$13.82
|
| Rate for Payer: Signature Care PPO |
$13.82
|
| Rate for Payer: Signature Care PPO |
$13.82
|
| Rate for Payer: Signature Care PPO |
$13.82
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,500.00
|
| Rate for Payer: United Healthcare Commercial |
$39.40
|
| Rate for Payer: United Healthcare Commercial |
$39.40
|
| Rate for Payer: United Healthcare Commercial |
$39.40
|
|
|
PR DRAIN ABD ABSCESS OPEN
|
Professional
|
Both
|
$2,888.66
|
|
|
Service Code
|
CPT 49020
|
| Hospital Charge Code |
z49020
|
| Min. Negotiated Rate |
$1,165.00 |
| Max. Negotiated Rate |
$203,900.00 |
| Rate for Payer: Aetna Commercial |
$1,477.12
|
| Rate for Payer: Aetna Commercial |
$1,477.12
|
| Rate for Payer: Aetna Medicare |
$1,477.12
|
| Rate for Payer: Aetna Medicare |
$1,477.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,165.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,165.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,165.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,165.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,165.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,165.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,165.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,165.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,420.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,420.76
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,698.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,698.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,624.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,624.83
|
| Rate for Payer: Cash Price |
$1,733.20
|
| Rate for Payer: Cash Price |
$1,704.67
|
| Rate for Payer: Centivo All Commercial |
$2,289.54
|
| Rate for Payer: Centivo All Commercial |
$2,289.54
|
| Rate for Payer: Cigna All Commercial |
$1,477.12
|
| Rate for Payer: Cigna All Commercial |
$1,477.12
|
| Rate for Payer: CORVEL All Commercial |
$1,477.12
|
| Rate for Payer: CORVEL All Commercial |
$1,477.12
|
| Rate for Payer: Coventry All Commercial |
$1,772.54
|
| Rate for Payer: Coventry All Commercial |
$1,772.54
|
| Rate for Payer: Encore All Commercial |
$1,477.12
|
| Rate for Payer: Encore All Commercial |
$1,477.12
|
| Rate for Payer: Frontpath All Commercial |
$2,103.67
|
| Rate for Payer: Frontpath All Commercial |
$2,103.67
|
| Rate for Payer: Humana ChoiceCare |
$1,510.53
|
| Rate for Payer: Humana ChoiceCare |
$1,510.53
|
| Rate for Payer: Humana Medicare |
$1,477.12
|
| Rate for Payer: Humana Medicare |
$1,477.12
|
| Rate for Payer: Lucent All Commercial |
$2,067.97
|
| Rate for Payer: Lucent All Commercial |
$2,067.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,184.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,184.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,420.76
|
| Rate for Payer: Managed Health Services Medicaid |
$1,420.76
|
| Rate for Payer: MDWise Medicaid |
$1,420.76
|
| Rate for Payer: MDWise Medicaid |
$1,420.76
|
| Rate for Payer: PHCS All Commercial |
$1,477.12
|
| Rate for Payer: PHCS All Commercial |
$1,477.12
|
| Rate for Payer: PHP All Commercial |
$2,485.98
|
| Rate for Payer: PHP All Commercial |
$2,485.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,477.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,477.12
|
| Rate for Payer: Sagamore Health Network All Products |
$1,477.12
|
| Rate for Payer: Sagamore Health Network All Products |
$1,477.12
|
| Rate for Payer: Signature Care EPO |
$1,883.60
|
| Rate for Payer: Signature Care EPO |
$1,883.60
|
| Rate for Payer: Signature Care PPO |
$1,883.60
|
| Rate for Payer: Signature Care PPO |
$1,883.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$203,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$203,900.00
|
| Rate for Payer: United Healthcare Commercial |
$1,696.15
|
| Rate for Payer: United Healthcare Commercial |
$1,696.15
|
| Rate for Payer: United Healthcare Medicare |
$1,420.56
|
| Rate for Payer: United Healthcare Medicare |
$1,420.56
|
|
|
PR DRAIN ABSCESS/HEMATOMA,NASAL
|
Professional
|
Both
|
$491.72
|
|
|
Service Code
|
CPT 30000
|
| Hospital Charge Code |
z30000
|
| Min. Negotiated Rate |
$63.89 |
| Max. Negotiated Rate |
$17,100.00 |
| Rate for Payer: Aetna Commercial |
$112.84
|
| Rate for Payer: Aetna Commercial |
$112.84
|
| Rate for Payer: Aetna Medicare |
$112.84
|
| Rate for Payer: Aetna Medicare |
$112.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$136.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$136.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$136.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$136.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$136.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$136.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$136.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$136.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$63.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$63.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$241.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$241.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$129.77
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$129.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$124.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$124.12
|
| Rate for Payer: Cash Price |
$295.03
|
| Rate for Payer: Cash Price |
$294.89
|
| Rate for Payer: Centivo All Commercial |
$174.90
|
| Rate for Payer: Centivo All Commercial |
$174.90
|
| Rate for Payer: Cigna All Commercial |
$112.84
|
| Rate for Payer: Cigna All Commercial |
$112.84
|
| Rate for Payer: CORVEL All Commercial |
$112.84
|
| Rate for Payer: CORVEL All Commercial |
$112.84
|
| Rate for Payer: Coventry All Commercial |
$135.41
|
| Rate for Payer: Coventry All Commercial |
$135.41
|
| Rate for Payer: Encore All Commercial |
$112.84
|
| Rate for Payer: Encore All Commercial |
$112.84
|
| Rate for Payer: Frontpath All Commercial |
$153.72
|
| Rate for Payer: Frontpath All Commercial |
$153.72
|
| Rate for Payer: Humana ChoiceCare |
$126.24
|
| Rate for Payer: Humana ChoiceCare |
$126.24
|
| Rate for Payer: Humana Medicare |
$112.84
|
| Rate for Payer: Humana Medicare |
$112.84
|
| Rate for Payer: Lucent All Commercial |
$157.98
|
| Rate for Payer: Lucent All Commercial |
$157.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$182.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$182.00
|
| Rate for Payer: Managed Health Services Medicaid |
$241.85
|
| Rate for Payer: Managed Health Services Medicaid |
$241.85
|
| Rate for Payer: MDWise Medicaid |
$241.85
|
| Rate for Payer: MDWise Medicaid |
$241.85
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$63.89
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$63.89
|
| Rate for Payer: PHCS All Commercial |
$112.84
|
| Rate for Payer: PHCS All Commercial |
$112.84
|
| Rate for Payer: PHP All Commercial |
$155.56
|
| Rate for Payer: PHP All Commercial |
$155.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$112.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$112.84
|
| Rate for Payer: Sagamore Health Network All Products |
$112.84
|
| Rate for Payer: Sagamore Health Network All Products |
$112.84
|
| Rate for Payer: Signature Care EPO |
$286.45
|
| Rate for Payer: Signature Care EPO |
$286.45
|
| Rate for Payer: Signature Care PPO |
$286.45
|
| Rate for Payer: Signature Care PPO |
$286.45
|
| 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 |
$125.73
|
| Rate for Payer: United Healthcare Commercial |
$125.73
|
| Rate for Payer: United Healthcare Medicare |
$245.74
|
| Rate for Payer: United Healthcare Medicare |
$245.74
|
|
|
PR DRAIN ABSCESS/HEMATOMA,NASAL SEPTUM
|
Professional
|
Both
|
$500.94
|
|
|
Service Code
|
CPT 30020
|
| Hospital Charge Code |
z30020
|
| Min. Negotiated Rate |
$65.46 |
| Max. Negotiated Rate |
$17,200.00 |
| Rate for Payer: Aetna Commercial |
$113.93
|
| Rate for Payer: Aetna Commercial |
$113.93
|
| Rate for Payer: Aetna Medicare |
$113.93
|
| Rate for Payer: Aetna Medicare |
$113.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$140.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$140.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$140.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$140.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$140.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$140.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$140.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$140.20
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$65.46
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$65.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$246.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$246.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.02
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.32
|
| Rate for Payer: Cash Price |
$298.14
|
| Rate for Payer: Cash Price |
$300.56
|
| Rate for Payer: Centivo All Commercial |
$176.59
|
| Rate for Payer: Centivo All Commercial |
$176.59
|
| Rate for Payer: Cigna All Commercial |
$113.93
|
| Rate for Payer: Cigna All Commercial |
$113.93
|
| Rate for Payer: CORVEL All Commercial |
$113.93
|
| Rate for Payer: CORVEL All Commercial |
$113.93
|
| Rate for Payer: Coventry All Commercial |
$136.72
|
| Rate for Payer: Coventry All Commercial |
$136.72
|
| Rate for Payer: Encore All Commercial |
$113.93
|
| Rate for Payer: Encore All Commercial |
$113.93
|
| Rate for Payer: Frontpath All Commercial |
$155.45
|
| Rate for Payer: Frontpath All Commercial |
$155.45
|
| Rate for Payer: Humana ChoiceCare |
$129.58
|
| Rate for Payer: Humana ChoiceCare |
$129.58
|
| Rate for Payer: Humana Medicare |
$113.93
|
| Rate for Payer: Humana Medicare |
$113.93
|
| Rate for Payer: Lucent All Commercial |
$159.50
|
| Rate for Payer: Lucent All Commercial |
$159.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$184.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$184.00
|
| Rate for Payer: Managed Health Services Medicaid |
$246.38
|
| Rate for Payer: Managed Health Services Medicaid |
$246.38
|
| Rate for Payer: MDWise Medicaid |
$246.38
|
| Rate for Payer: MDWise Medicaid |
$246.38
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$65.46
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$65.46
|
| Rate for Payer: PHCS All Commercial |
$113.93
|
| Rate for Payer: PHCS All Commercial |
$113.93
|
| Rate for Payer: PHP All Commercial |
$156.83
|
| Rate for Payer: PHP All Commercial |
$156.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$113.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$113.93
|
| Rate for Payer: Sagamore Health Network All Products |
$113.93
|
| Rate for Payer: Sagamore Health Network All Products |
$113.93
|
| Rate for Payer: Signature Care EPO |
$244.80
|
| Rate for Payer: Signature Care EPO |
$244.80
|
| Rate for Payer: Signature Care PPO |
$244.80
|
| Rate for Payer: Signature Care PPO |
$244.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,200.00
|
| Rate for Payer: United Healthcare Commercial |
$126.55
|
| Rate for Payer: United Healthcare Commercial |
$126.55
|
| Rate for Payer: United Healthcare Medicare |
$248.45
|
| Rate for Payer: United Healthcare Medicare |
$248.45
|
|
|
PR DRAINAGE OF GUM LESION
|
Professional
|
Both
|
$537.90
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
z41800
|
| Min. Negotiated Rate |
$78.56 |
| Max. Negotiated Rate |
$20,000.00 |
| Rate for Payer: Aetna Commercial |
$142.79
|
| Rate for Payer: Aetna Commercial |
$142.79
|
| Rate for Payer: Aetna Medicare |
$142.79
|
| Rate for Payer: Aetna Medicare |
$142.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$185.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$185.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$185.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$185.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$185.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$185.29
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$78.56
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$78.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$264.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$264.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$164.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$164.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$157.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$157.07
|
| Rate for Payer: Cash Price |
$318.37
|
| Rate for Payer: Cash Price |
$322.74
|
| Rate for Payer: Centivo All Commercial |
$221.32
|
| Rate for Payer: Centivo All Commercial |
$221.32
|
| Rate for Payer: Cigna All Commercial |
$142.79
|
| Rate for Payer: Cigna All Commercial |
$142.79
|
| Rate for Payer: CORVEL All Commercial |
$142.79
|
| Rate for Payer: CORVEL All Commercial |
$142.79
|
| Rate for Payer: Coventry All Commercial |
$171.35
|
| Rate for Payer: Coventry All Commercial |
$171.35
|
| Rate for Payer: Encore All Commercial |
$142.79
|
| Rate for Payer: Encore All Commercial |
$142.79
|
| Rate for Payer: Frontpath All Commercial |
$193.08
|
| Rate for Payer: Frontpath All Commercial |
$193.08
|
| Rate for Payer: Humana ChoiceCare |
$108.05
|
| Rate for Payer: Humana ChoiceCare |
$108.05
|
| Rate for Payer: Humana Medicare |
$142.79
|
| Rate for Payer: Humana Medicare |
$142.79
|
| Rate for Payer: Lucent All Commercial |
$199.91
|
| Rate for Payer: Lucent All Commercial |
$199.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$215.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$215.00
|
| Rate for Payer: Managed Health Services Medicaid |
$264.56
|
| Rate for Payer: Managed Health Services Medicaid |
$264.56
|
| Rate for Payer: MDWise Medicaid |
$264.56
|
| Rate for Payer: MDWise Medicaid |
$264.56
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$78.56
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$78.56
|
| Rate for Payer: PHCS All Commercial |
$142.79
|
| Rate for Payer: PHCS All Commercial |
$142.79
|
| Rate for Payer: PHP All Commercial |
$244.50
|
| Rate for Payer: PHP All Commercial |
$244.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$142.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$142.79
|
| Rate for Payer: Sagamore Health Network All Products |
$142.79
|
| Rate for Payer: Sagamore Health Network All Products |
$142.79
|
| Rate for Payer: Signature Care EPO |
$233.35
|
| Rate for Payer: Signature Care EPO |
$233.35
|
| Rate for Payer: Signature Care PPO |
$233.35
|
| Rate for Payer: Signature Care PPO |
$233.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,000.00
|
| Rate for Payer: United Healthcare Commercial |
$136.01
|
| Rate for Payer: United Healthcare Commercial |
$136.01
|
| Rate for Payer: United Healthcare Medicare |
$265.31
|
| Rate for Payer: United Healthcare Medicare |
$265.31
|
|
|
PR DRAINAGE OF HIP JOINT
|
Professional
|
Both
|
$1,726.82
|
|
|
Service Code
|
CPT 27030
|
| Hospital Charge Code |
z27030
|
| Min. Negotiated Rate |
$847.44 |
| Max. Negotiated Rate |
$1,474.54 |
| Rate for Payer: Aetna Commercial |
$871.87
|
| Rate for Payer: Aetna Commercial |
$871.87
|
| Rate for Payer: Aetna Medicare |
$871.87
|
| Rate for Payer: Aetna Medicare |
$871.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$849.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$849.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,002.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,002.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$959.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$959.06
|
| Rate for Payer: Cash Price |
$1,036.09
|
| Rate for Payer: Cash Price |
$1,016.93
|
| Rate for Payer: Centivo All Commercial |
$1,351.40
|
| Rate for Payer: Centivo All Commercial |
$1,351.40
|
| Rate for Payer: Cigna All Commercial |
$871.87
|
| Rate for Payer: Cigna All Commercial |
$871.87
|
| Rate for Payer: CORVEL All Commercial |
$871.87
|
| Rate for Payer: CORVEL All Commercial |
$871.87
|
| Rate for Payer: Coventry All Commercial |
$1,046.24
|
| Rate for Payer: Coventry All Commercial |
$1,046.24
|
| Rate for Payer: Encore All Commercial |
$871.87
|
| Rate for Payer: Encore All Commercial |
$871.87
|
| Rate for Payer: Frontpath All Commercial |
$1,219.32
|
| Rate for Payer: Frontpath All Commercial |
$1,219.32
|
| Rate for Payer: Humana ChoiceCare |
$992.62
|
| Rate for Payer: Humana ChoiceCare |
$992.62
|
| Rate for Payer: Humana Medicare |
$871.87
|
| Rate for Payer: Humana Medicare |
$871.87
|
| Rate for Payer: Lucent All Commercial |
$1,220.62
|
| Rate for Payer: Lucent All Commercial |
$1,220.62
|
| Rate for Payer: Managed Health Services Medicaid |
$849.32
|
| Rate for Payer: Managed Health Services Medicaid |
$849.32
|
| Rate for Payer: MDWise Medicaid |
$849.32
|
| Rate for Payer: MDWise Medicaid |
$849.32
|
| Rate for Payer: PHCS All Commercial |
$871.87
|
| Rate for Payer: PHCS All Commercial |
$871.87
|
| Rate for Payer: PHP All Commercial |
$1,474.54
|
| Rate for Payer: PHP All Commercial |
$1,474.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$871.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$871.87
|
| Rate for Payer: Sagamore Health Network All Products |
$871.87
|
| Rate for Payer: Sagamore Health Network All Products |
$871.87
|
| Rate for Payer: Signature Care EPO |
$1,330.25
|
| Rate for Payer: Signature Care EPO |
$1,330.25
|
| Rate for Payer: Signature Care PPO |
$1,330.25
|
| Rate for Payer: Signature Care PPO |
$1,330.25
|
| Rate for Payer: United Healthcare Commercial |
$1,031.79
|
| Rate for Payer: United Healthcare Commercial |
$1,031.79
|
| Rate for Payer: United Healthcare Medicare |
$847.44
|
| Rate for Payer: United Healthcare Medicare |
$847.44
|
|
|
PR DRAINAGE OF HYDROCELE,TUNICA
|
Professional
|
Both
|
$224.40
|
|
|
Service Code
|
CPT 55000
|
| Hospital Charge Code |
z55000
|
| Min. Negotiated Rate |
$53.12 |
| Max. Negotiated Rate |
$10,200.00 |
| Rate for Payer: Aetna Commercial |
$79.02
|
| Rate for Payer: Aetna Commercial |
$79.02
|
| Rate for Payer: Aetna Medicare |
$79.02
|
| Rate for Payer: Aetna Medicare |
$79.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$176.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$176.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$176.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$176.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$176.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$176.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$176.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$176.71
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$53.12
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$53.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$110.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$110.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$90.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$90.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$86.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$86.92
|
| Rate for Payer: Cash Price |
$131.69
|
| Rate for Payer: Cash Price |
$134.64
|
| Rate for Payer: Centivo All Commercial |
$122.48
|
| Rate for Payer: Centivo All Commercial |
$122.48
|
| Rate for Payer: Cigna All Commercial |
$79.02
|
| Rate for Payer: Cigna All Commercial |
$79.02
|
| Rate for Payer: CORVEL All Commercial |
$79.02
|
| Rate for Payer: CORVEL All Commercial |
$79.02
|
| Rate for Payer: Coventry All Commercial |
$94.82
|
| Rate for Payer: Coventry All Commercial |
$94.82
|
| Rate for Payer: Encore All Commercial |
$79.02
|
| Rate for Payer: Encore All Commercial |
$79.02
|
| Rate for Payer: Frontpath All Commercial |
$108.60
|
| Rate for Payer: Frontpath All Commercial |
$108.60
|
| Rate for Payer: Humana ChoiceCare |
$99.40
|
| Rate for Payer: Humana ChoiceCare |
$99.40
|
| Rate for Payer: Humana Medicare |
$79.02
|
| Rate for Payer: Humana Medicare |
$79.02
|
| Rate for Payer: Lucent All Commercial |
$110.63
|
| Rate for Payer: Lucent All Commercial |
$110.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$110.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$110.00
|
| Rate for Payer: Managed Health Services Medicaid |
$110.36
|
| Rate for Payer: Managed Health Services Medicaid |
$110.36
|
| Rate for Payer: MDWise Medicaid |
$110.36
|
| Rate for Payer: MDWise Medicaid |
$110.36
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$53.12
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$53.12
|
| Rate for Payer: PHCS All Commercial |
$79.02
|
| Rate for Payer: PHCS All Commercial |
$79.02
|
| Rate for Payer: PHP All Commercial |
$101.12
|
| Rate for Payer: PHP All Commercial |
$101.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$79.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$79.02
|
| Rate for Payer: Sagamore Health Network All Products |
$79.02
|
| Rate for Payer: Sagamore Health Network All Products |
$79.02
|
| Rate for Payer: Signature Care EPO |
$156.40
|
| Rate for Payer: Signature Care EPO |
$156.40
|
| Rate for Payer: Signature Care PPO |
$156.40
|
| Rate for Payer: Signature Care PPO |
$156.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,200.00
|
| Rate for Payer: United Healthcare Commercial |
$103.86
|
| Rate for Payer: United Healthcare Commercial |
$103.86
|
| Rate for Payer: United Healthcare Medicare |
$109.74
|
| Rate for Payer: United Healthcare Medicare |
$109.74
|
|
|
PR DRAIN BLOOD FROM UNDER NAIL
|
Professional
|
Both
|
$107.86
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
z11740
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$3,600.00 |
| Rate for Payer: Aetna Commercial |
$29.33
|
| Rate for Payer: Aetna Commercial |
$29.33
|
| Rate for Payer: Aetna Medicare |
$29.33
|
| Rate for Payer: Aetna Medicare |
$29.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$45.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$45.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$45.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$45.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$45.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$45.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$45.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$45.26
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$15.92
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$15.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$53.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$53.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$33.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$33.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.26
|
| Rate for Payer: Cash Price |
$62.41
|
| Rate for Payer: Cash Price |
$64.72
|
| Rate for Payer: Centivo All Commercial |
$45.46
|
| Rate for Payer: Centivo All Commercial |
$45.46
|
| Rate for Payer: Cigna All Commercial |
$29.33
|
| Rate for Payer: Cigna All Commercial |
$29.33
|
| Rate for Payer: CORVEL All Commercial |
$29.33
|
| Rate for Payer: CORVEL All Commercial |
$29.33
|
| Rate for Payer: Coventry All Commercial |
$35.20
|
| Rate for Payer: Coventry All Commercial |
$35.20
|
| Rate for Payer: Encore All Commercial |
$29.33
|
| Rate for Payer: Encore All Commercial |
$29.33
|
| Rate for Payer: Frontpath All Commercial |
$39.56
|
| Rate for Payer: Frontpath All Commercial |
$39.56
|
| Rate for Payer: Humana ChoiceCare |
$26.70
|
| Rate for Payer: Humana ChoiceCare |
$26.70
|
| Rate for Payer: Humana Medicare |
$29.33
|
| Rate for Payer: Humana Medicare |
$29.33
|
| Rate for Payer: Lucent All Commercial |
$41.06
|
| Rate for Payer: Lucent All Commercial |
$41.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$39.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$39.00
|
| Rate for Payer: Managed Health Services Medicaid |
$53.05
|
| Rate for Payer: Managed Health Services Medicaid |
$53.05
|
| Rate for Payer: MDWise Medicaid |
$53.05
|
| Rate for Payer: MDWise Medicaid |
$53.05
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$15.92
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$15.92
|
| Rate for Payer: PHCS All Commercial |
$29.33
|
| Rate for Payer: PHCS All Commercial |
$29.33
|
| Rate for Payer: PHP All Commercial |
$40.77
|
| Rate for Payer: PHP All Commercial |
$40.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.33
|
| Rate for Payer: Sagamore Health Network All Products |
$29.33
|
| Rate for Payer: Sagamore Health Network All Products |
$29.33
|
| Rate for Payer: Signature Care EPO |
$49.30
|
| Rate for Payer: Signature Care EPO |
$49.30
|
| Rate for Payer: Signature Care PPO |
$49.30
|
| Rate for Payer: Signature Care PPO |
$49.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,600.00
|
| Rate for Payer: United Healthcare Commercial |
$34.31
|
| Rate for Payer: United Healthcare Commercial |
$34.31
|
| Rate for Payer: United Healthcare Medicare |
$52.01
|
| Rate for Payer: United Healthcare Medicare |
$52.01
|
|
|
PR DRAIN EXT AUD CANAL ABSCESS
|
Professional
|
Both
|
$431.84
|
|
|
Service Code
|
CPT 69020
|
| Hospital Charge Code |
z69020
|
| Min. Negotiated Rate |
$73.89 |
| Max. Negotiated Rate |
$20,300.00 |
| Rate for Payer: Aetna Commercial |
$134.97
|
| Rate for Payer: Aetna Commercial |
$134.97
|
| Rate for Payer: Aetna Medicare |
$134.97
|
| Rate for Payer: Aetna Medicare |
$134.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$249.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$249.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$249.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$249.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$249.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$249.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$249.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$249.54
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$73.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$73.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$212.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$212.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$155.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$155.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$148.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$148.47
|
| Rate for Payer: Cash Price |
$258.20
|
| Rate for Payer: Cash Price |
$259.10
|
| Rate for Payer: Centivo All Commercial |
$209.20
|
| Rate for Payer: Centivo All Commercial |
$209.20
|
| Rate for Payer: Cigna All Commercial |
$134.97
|
| Rate for Payer: Cigna All Commercial |
$134.97
|
| Rate for Payer: CORVEL All Commercial |
$134.97
|
| Rate for Payer: CORVEL All Commercial |
$134.97
|
| Rate for Payer: Coventry All Commercial |
$161.96
|
| Rate for Payer: Coventry All Commercial |
$161.96
|
| Rate for Payer: Encore All Commercial |
$134.97
|
| Rate for Payer: Encore All Commercial |
$134.97
|
| Rate for Payer: Frontpath All Commercial |
$183.17
|
| Rate for Payer: Frontpath All Commercial |
$183.17
|
| Rate for Payer: Humana ChoiceCare |
$142.96
|
| Rate for Payer: Humana ChoiceCare |
$142.96
|
| Rate for Payer: Humana Medicare |
$134.97
|
| Rate for Payer: Humana Medicare |
$134.97
|
| Rate for Payer: Lucent All Commercial |
$188.96
|
| Rate for Payer: Lucent All Commercial |
$188.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$217.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$217.00
|
| Rate for Payer: Managed Health Services Medicaid |
$212.39
|
| Rate for Payer: Managed Health Services Medicaid |
$212.39
|
| Rate for Payer: MDWise Medicaid |
$212.39
|
| Rate for Payer: MDWise Medicaid |
$212.39
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$73.89
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$73.89
|
| Rate for Payer: PHCS All Commercial |
$134.97
|
| Rate for Payer: PHCS All Commercial |
$134.97
|
| Rate for Payer: PHP All Commercial |
$172.05
|
| Rate for Payer: PHP All Commercial |
$172.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$134.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$134.97
|
| Rate for Payer: Sagamore Health Network All Products |
$134.97
|
| Rate for Payer: Sagamore Health Network All Products |
$134.97
|
| Rate for Payer: Signature Care EPO |
$253.30
|
| Rate for Payer: Signature Care EPO |
$253.30
|
| Rate for Payer: Signature Care PPO |
$253.30
|
| Rate for Payer: Signature Care PPO |
$253.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,300.00
|
| Rate for Payer: United Healthcare Commercial |
$151.99
|
| Rate for Payer: United Healthcare Commercial |
$151.99
|
| Rate for Payer: United Healthcare Medicare |
$215.17
|
| Rate for Payer: United Healthcare Medicare |
$215.17
|
|
|
PR DRAIN EXT EAR ABSC/BLOOD,COMPLIC
|
Professional
|
Both
|
$408.58
|
|
|
Service Code
|
CPT 69005
|
| Hospital Charge Code |
z69005
|
| Min. Negotiated Rate |
$82.02 |
| Max. Negotiated Rate |
$22,600.00 |
| Rate for Payer: Aetna Commercial |
$150.29
|
| Rate for Payer: Aetna Commercial |
$150.29
|
| Rate for Payer: Aetna Medicare |
$150.29
|
| Rate for Payer: Aetna Medicare |
$150.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$186.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$186.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$186.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$186.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$186.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$186.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$186.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$186.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$82.02
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$82.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$200.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$200.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$172.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$172.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$165.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$165.32
|
| Rate for Payer: Cash Price |
$241.33
|
| Rate for Payer: Cash Price |
$245.15
|
| Rate for Payer: Centivo All Commercial |
$232.95
|
| Rate for Payer: Centivo All Commercial |
$232.95
|
| Rate for Payer: Cigna All Commercial |
$150.29
|
| Rate for Payer: Cigna All Commercial |
$150.29
|
| Rate for Payer: CORVEL All Commercial |
$150.29
|
| Rate for Payer: CORVEL All Commercial |
$150.29
|
| Rate for Payer: Coventry All Commercial |
$180.35
|
| Rate for Payer: Coventry All Commercial |
$180.35
|
| Rate for Payer: Encore All Commercial |
$150.29
|
| Rate for Payer: Encore All Commercial |
$150.29
|
| Rate for Payer: Frontpath All Commercial |
$205.75
|
| Rate for Payer: Frontpath All Commercial |
$205.75
|
| Rate for Payer: Humana ChoiceCare |
$161.57
|
| Rate for Payer: Humana ChoiceCare |
$161.57
|
| Rate for Payer: Humana Medicare |
$150.29
|
| Rate for Payer: Humana Medicare |
$150.29
|
| Rate for Payer: Lucent All Commercial |
$210.41
|
| Rate for Payer: Lucent All Commercial |
$210.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$241.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$241.00
|
| Rate for Payer: Managed Health Services Medicaid |
$200.96
|
| Rate for Payer: Managed Health Services Medicaid |
$200.96
|
| Rate for Payer: MDWise Medicaid |
$200.96
|
| Rate for Payer: MDWise Medicaid |
$200.96
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$82.02
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$82.02
|
| Rate for Payer: PHCS All Commercial |
$150.29
|
| Rate for Payer: PHCS All Commercial |
$150.29
|
| Rate for Payer: PHP All Commercial |
$190.97
|
| Rate for Payer: PHP All Commercial |
$190.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$150.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$150.29
|
| Rate for Payer: Sagamore Health Network All Products |
$150.29
|
| Rate for Payer: Sagamore Health Network All Products |
$150.29
|
| Rate for Payer: Signature Care EPO |
$242.25
|
| Rate for Payer: Signature Care EPO |
$242.25
|
| Rate for Payer: Signature Care PPO |
$242.25
|
| Rate for Payer: Signature Care PPO |
$242.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$22,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$22,600.00
|
| Rate for Payer: United Healthcare Commercial |
$170.98
|
| Rate for Payer: United Healthcare Commercial |
$170.98
|
| Rate for Payer: United Healthcare Medicare |
$201.11
|
| Rate for Payer: United Healthcare Medicare |
$201.11
|
|
|
PR DRAIN EXT EAR ABSC/BLOOD,SIMPLE
|
Professional
|
Both
|
$346.06
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
z69000
|
| Min. Negotiated Rate |
$63.50 |
| Max. Negotiated Rate |
$17,600.00 |
| Rate for Payer: Aetna Commercial |
$116.03
|
| Rate for Payer: Aetna Commercial |
$116.03
|
| Rate for Payer: Aetna Medicare |
$116.03
|
| Rate for Payer: Aetna Medicare |
$116.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$203.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$203.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$203.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$203.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$203.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$203.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$203.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$203.96
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$63.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$63.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$170.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$170.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$133.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$133.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$127.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$127.63
|
| Rate for Payer: Cash Price |
$204.97
|
| Rate for Payer: Cash Price |
$207.64
|
| Rate for Payer: Centivo All Commercial |
$179.85
|
| Rate for Payer: Centivo All Commercial |
$179.85
|
| Rate for Payer: Cigna All Commercial |
$116.03
|
| Rate for Payer: Cigna All Commercial |
$116.03
|
| Rate for Payer: CORVEL All Commercial |
$116.03
|
| Rate for Payer: CORVEL All Commercial |
$116.03
|
| Rate for Payer: Coventry All Commercial |
$139.24
|
| Rate for Payer: Coventry All Commercial |
$139.24
|
| Rate for Payer: Encore All Commercial |
$116.03
|
| Rate for Payer: Encore All Commercial |
$116.03
|
| Rate for Payer: Frontpath All Commercial |
$158.48
|
| Rate for Payer: Frontpath All Commercial |
$158.48
|
| Rate for Payer: Humana ChoiceCare |
$114.72
|
| Rate for Payer: Humana ChoiceCare |
$114.72
|
| Rate for Payer: Humana Medicare |
$116.03
|
| Rate for Payer: Humana Medicare |
$116.03
|
| Rate for Payer: Lucent All Commercial |
$162.44
|
| Rate for Payer: Lucent All Commercial |
$162.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$187.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$187.00
|
| Rate for Payer: Managed Health Services Medicaid |
$170.21
|
| Rate for Payer: Managed Health Services Medicaid |
$170.21
|
| Rate for Payer: MDWise Medicaid |
$170.21
|
| Rate for Payer: MDWise Medicaid |
$170.21
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$63.50
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$63.50
|
| Rate for Payer: PHCS All Commercial |
$116.03
|
| Rate for Payer: PHCS All Commercial |
$116.03
|
| Rate for Payer: PHP All Commercial |
$148.44
|
| Rate for Payer: PHP All Commercial |
$148.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.03
|
| Rate for Payer: Sagamore Health Network All Products |
$116.03
|
| Rate for Payer: Sagamore Health Network All Products |
$116.03
|
| Rate for Payer: Signature Care EPO |
$208.25
|
| Rate for Payer: Signature Care EPO |
$208.25
|
| Rate for Payer: Signature Care PPO |
$208.25
|
| Rate for Payer: Signature Care PPO |
$208.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,600.00
|
| Rate for Payer: United Healthcare Commercial |
$125.39
|
| Rate for Payer: United Healthcare Commercial |
$125.39
|
| Rate for Payer: United Healthcare Medicare |
$170.81
|
| Rate for Payer: United Healthcare Medicare |
$170.81
|
|
|
PR DRAIN FINGER ABSCESS,COMPLICATED
|
Professional
|
Both
|
$880.22
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
z26011
|
| Min. Negotiated Rate |
$95.34 |
| Max. Negotiated Rate |
$26,000.00 |
| Rate for Payer: Aetna Commercial |
$173.34
|
| Rate for Payer: Aetna Commercial |
$173.34
|
| Rate for Payer: Aetna Medicare |
$173.34
|
| Rate for Payer: Aetna Medicare |
$173.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$439.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$439.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$439.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$439.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$439.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$439.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$439.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$439.63
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$95.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$95.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$432.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$432.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$199.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$199.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$190.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$190.67
|
| Rate for Payer: Cash Price |
$527.58
|
| Rate for Payer: Cash Price |
$528.13
|
| Rate for Payer: Centivo All Commercial |
$268.68
|
| Rate for Payer: Centivo All Commercial |
$268.68
|
| Rate for Payer: Cigna All Commercial |
$173.34
|
| Rate for Payer: Cigna All Commercial |
$173.34
|
| Rate for Payer: CORVEL All Commercial |
$173.34
|
| Rate for Payer: CORVEL All Commercial |
$173.34
|
| Rate for Payer: Coventry All Commercial |
$208.01
|
| Rate for Payer: Coventry All Commercial |
$208.01
|
| Rate for Payer: Encore All Commercial |
$173.34
|
| Rate for Payer: Encore All Commercial |
$173.34
|
| Rate for Payer: Frontpath All Commercial |
$238.34
|
| Rate for Payer: Frontpath All Commercial |
$238.34
|
| Rate for Payer: Humana ChoiceCare |
$194.05
|
| Rate for Payer: Humana ChoiceCare |
$194.05
|
| Rate for Payer: Humana Medicare |
$173.34
|
| Rate for Payer: Humana Medicare |
$173.34
|
| Rate for Payer: Lucent All Commercial |
$242.68
|
| Rate for Payer: Lucent All Commercial |
$242.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$278.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$278.00
|
| Rate for Payer: Managed Health Services Medicaid |
$432.48
|
| Rate for Payer: Managed Health Services Medicaid |
$432.48
|
| Rate for Payer: MDWise Medicaid |
$432.48
|
| Rate for Payer: MDWise Medicaid |
$432.48
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$95.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$95.34
|
| Rate for Payer: PHCS All Commercial |
$173.34
|
| Rate for Payer: PHCS All Commercial |
$173.34
|
| Rate for Payer: PHP All Commercial |
$294.66
|
| Rate for Payer: PHP All Commercial |
$294.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$173.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$173.34
|
| Rate for Payer: Sagamore Health Network All Products |
$173.34
|
| Rate for Payer: Sagamore Health Network All Products |
$173.34
|
| Rate for Payer: Signature Care EPO |
$621.35
|
| Rate for Payer: Signature Care EPO |
$621.35
|
| Rate for Payer: Signature Care PPO |
$621.35
|
| Rate for Payer: Signature Care PPO |
$621.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,000.00
|
| Rate for Payer: United Healthcare Commercial |
$194.63
|
| Rate for Payer: United Healthcare Commercial |
$194.63
|
| Rate for Payer: United Healthcare Medicare |
$440.11
|
| Rate for Payer: United Healthcare Medicare |
$440.11
|
|
|
PR DRAIN FINGER ABSCESS,SIMPLE
|
Professional
|
Both
|
$636.32
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
z26010
|
| Min. Negotiated Rate |
$72.33 |
| Max. Negotiated Rate |
$19,800.00 |
| Rate for Payer: Aetna Commercial |
$131.63
|
| Rate for Payer: Aetna Commercial |
$131.63
|
| Rate for Payer: Aetna Medicare |
$131.63
|
| Rate for Payer: Aetna Medicare |
$131.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$298.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$298.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$298.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$298.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$298.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$298.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$298.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$298.38
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$72.33
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$72.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$312.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$312.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$151.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$151.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$144.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$144.79
|
| Rate for Payer: Cash Price |
$381.79
|
| Rate for Payer: Cash Price |
$377.90
|
| Rate for Payer: Centivo All Commercial |
$204.03
|
| Rate for Payer: Centivo All Commercial |
$204.03
|
| Rate for Payer: Cigna All Commercial |
$131.63
|
| Rate for Payer: Cigna All Commercial |
$131.63
|
| Rate for Payer: CORVEL All Commercial |
$131.63
|
| Rate for Payer: CORVEL All Commercial |
$131.63
|
| Rate for Payer: Coventry All Commercial |
$157.96
|
| Rate for Payer: Coventry All Commercial |
$157.96
|
| Rate for Payer: Encore All Commercial |
$131.63
|
| Rate for Payer: Encore All Commercial |
$131.63
|
| Rate for Payer: Frontpath All Commercial |
$180.12
|
| Rate for Payer: Frontpath All Commercial |
$180.12
|
| Rate for Payer: Humana ChoiceCare |
$135.13
|
| Rate for Payer: Humana ChoiceCare |
$135.13
|
| Rate for Payer: Humana Medicare |
$131.63
|
| Rate for Payer: Humana Medicare |
$131.63
|
| Rate for Payer: Lucent All Commercial |
$184.28
|
| Rate for Payer: Lucent All Commercial |
$184.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$211.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$211.00
|
| Rate for Payer: Managed Health Services Medicaid |
$312.97
|
| Rate for Payer: Managed Health Services Medicaid |
$312.97
|
| Rate for Payer: MDWise Medicaid |
$312.97
|
| Rate for Payer: MDWise Medicaid |
$312.97
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$72.33
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$72.33
|
| Rate for Payer: PHCS All Commercial |
$131.63
|
| Rate for Payer: PHCS All Commercial |
$131.63
|
| Rate for Payer: PHP All Commercial |
$224.09
|
| Rate for Payer: PHP All Commercial |
$224.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$131.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$131.63
|
| Rate for Payer: Sagamore Health Network All Products |
$131.63
|
| Rate for Payer: Sagamore Health Network All Products |
$131.63
|
| Rate for Payer: Signature Care EPO |
$397.80
|
| Rate for Payer: Signature Care EPO |
$397.80
|
| Rate for Payer: Signature Care PPO |
$397.80
|
| Rate for Payer: Signature Care PPO |
$397.80
|
| 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 |
$139.34
|
| Rate for Payer: United Healthcare Commercial |
$139.34
|
| Rate for Payer: United Healthcare Medicare |
$314.92
|
| Rate for Payer: United Healthcare Medicare |
$314.92
|
|
|
PR DRAIN HAND TENDON SHEATH
|
Professional
|
Both
|
$1,041.52
|
|
|
Service Code
|
CPT 26020
|
| Hospital Charge Code |
z26020
|
| Min. Negotiated Rate |
$429.74 |
| Max. Negotiated Rate |
$78,300.00 |
| Rate for Payer: Aetna Commercial |
$520.81
|
| Rate for Payer: Aetna Commercial |
$520.81
|
| Rate for Payer: Aetna Medicare |
$520.81
|
| Rate for Payer: Aetna Medicare |
$520.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$565.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$565.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$565.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$565.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$565.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$565.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$565.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$565.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$512.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$512.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$598.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$598.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$572.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$572.89
|
| Rate for Payer: Cash Price |
$624.91
|
| Rate for Payer: Cash Price |
$611.00
|
| Rate for Payer: Centivo All Commercial |
$807.26
|
| Rate for Payer: Centivo All Commercial |
$807.26
|
| Rate for Payer: Cigna All Commercial |
$520.81
|
| Rate for Payer: Cigna All Commercial |
$520.81
|
| Rate for Payer: CORVEL All Commercial |
$520.81
|
| Rate for Payer: CORVEL All Commercial |
$520.81
|
| Rate for Payer: Coventry All Commercial |
$624.97
|
| Rate for Payer: Coventry All Commercial |
$624.97
|
| Rate for Payer: Encore All Commercial |
$520.81
|
| Rate for Payer: Encore All Commercial |
$520.81
|
| Rate for Payer: Frontpath All Commercial |
$718.77
|
| Rate for Payer: Frontpath All Commercial |
$718.77
|
| Rate for Payer: Humana ChoiceCare |
$429.74
|
| Rate for Payer: Humana ChoiceCare |
$429.74
|
| Rate for Payer: Humana Medicare |
$520.81
|
| Rate for Payer: Humana Medicare |
$520.81
|
| Rate for Payer: Lucent All Commercial |
$729.13
|
| Rate for Payer: Lucent All Commercial |
$729.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$835.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$835.00
|
| Rate for Payer: Managed Health Services Medicaid |
$512.26
|
| Rate for Payer: Managed Health Services Medicaid |
$512.26
|
| Rate for Payer: MDWise Medicaid |
$512.26
|
| Rate for Payer: MDWise Medicaid |
$512.26
|
| Rate for Payer: PHCS All Commercial |
$520.81
|
| Rate for Payer: PHCS All Commercial |
$520.81
|
| Rate for Payer: PHP All Commercial |
$885.95
|
| Rate for Payer: PHP All Commercial |
$885.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$520.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$520.81
|
| Rate for Payer: Sagamore Health Network All Products |
$520.81
|
| Rate for Payer: Sagamore Health Network All Products |
$520.81
|
| Rate for Payer: Signature Care EPO |
$588.20
|
| Rate for Payer: Signature Care EPO |
$588.20
|
| Rate for Payer: Signature Care PPO |
$588.20
|
| Rate for Payer: Signature Care PPO |
$588.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$78,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$78,300.00
|
| Rate for Payer: United Healthcare Commercial |
$448.64
|
| Rate for Payer: United Healthcare Commercial |
$448.64
|
| Rate for Payer: United Healthcare Medicare |
$509.17
|
| Rate for Payer: United Healthcare Medicare |
$509.17
|
|
|
PR DRAIN MOUTH ABSC/CYST/HEMATOMA,SIMPL
|
Professional
|
Both
|
$375.80
|
|
|
Service Code
|
CPT 40800
|
| Hospital Charge Code |
z40800
|
| Min. Negotiated Rate |
$85.75 |
| Max. Negotiated Rate |
$15,600.00 |
| Rate for Payer: Aetna Commercial |
$111.46
|
| Rate for Payer: Aetna Commercial |
$111.46
|
| Rate for Payer: Aetna Medicare |
$111.46
|
| Rate for Payer: Aetna Medicare |
$111.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$164.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$164.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$164.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$164.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$164.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$164.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$164.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$164.92
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$85.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$85.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$184.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$184.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$128.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$128.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$122.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$122.61
|
| Rate for Payer: Cash Price |
$222.01
|
| Rate for Payer: Cash Price |
$225.48
|
| Rate for Payer: Centivo All Commercial |
$172.76
|
| Rate for Payer: Centivo All Commercial |
$172.76
|
| Rate for Payer: Cigna All Commercial |
$111.46
|
| Rate for Payer: Cigna All Commercial |
$111.46
|
| Rate for Payer: CORVEL All Commercial |
$111.46
|
| Rate for Payer: CORVEL All Commercial |
$111.46
|
| Rate for Payer: Coventry All Commercial |
$133.75
|
| Rate for Payer: Coventry All Commercial |
$133.75
|
| Rate for Payer: Encore All Commercial |
$111.46
|
| Rate for Payer: Encore All Commercial |
$111.46
|
| Rate for Payer: Frontpath All Commercial |
$149.55
|
| Rate for Payer: Frontpath All Commercial |
$149.55
|
| Rate for Payer: Humana ChoiceCare |
$128.80
|
| Rate for Payer: Humana ChoiceCare |
$128.80
|
| Rate for Payer: Humana Medicare |
$111.46
|
| Rate for Payer: Humana Medicare |
$111.46
|
| Rate for Payer: Lucent All Commercial |
$156.04
|
| Rate for Payer: Lucent All Commercial |
$156.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$167.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$167.00
|
| Rate for Payer: Managed Health Services Medicaid |
$184.84
|
| Rate for Payer: Managed Health Services Medicaid |
$184.84
|
| Rate for Payer: MDWise Medicaid |
$184.84
|
| Rate for Payer: MDWise Medicaid |
$184.84
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$85.75
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$85.75
|
| Rate for Payer: PHCS All Commercial |
$111.46
|
| Rate for Payer: PHCS All Commercial |
$111.46
|
| Rate for Payer: PHP All Commercial |
$189.89
|
| Rate for Payer: PHP All Commercial |
$189.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$111.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$111.46
|
| Rate for Payer: Sagamore Health Network All Products |
$111.46
|
| Rate for Payer: Sagamore Health Network All Products |
$111.46
|
| 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 |
$15,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,600.00
|
| Rate for Payer: United Healthcare Commercial |
$134.14
|
| Rate for Payer: United Healthcare Commercial |
$134.14
|
| Rate for Payer: United Healthcare Medicare |
$185.01
|
| Rate for Payer: United Healthcare Medicare |
$185.01
|
|
|
PR DRAIN OVARIAN ABSCESS,ABD APPRCH
|
Professional
|
Both
|
$1,327.76
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
z58822
|
| Min. Negotiated Rate |
$653.05 |
| Max. Negotiated Rate |
$87,100.00 |
| Rate for Payer: Aetna Commercial |
$676.31
|
| Rate for Payer: Aetna Commercial |
$676.31
|
| Rate for Payer: Aetna Medicare |
$676.31
|
| Rate for Payer: Aetna Medicare |
$676.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$807.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$807.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$807.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$807.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$807.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$807.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$807.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$807.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$653.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$653.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$777.76
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$777.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$743.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$743.94
|
| Rate for Payer: Cash Price |
$796.66
|
| Rate for Payer: Cash Price |
$784.84
|
| Rate for Payer: Centivo All Commercial |
$1,048.28
|
| Rate for Payer: Centivo All Commercial |
$1,048.28
|
| Rate for Payer: Cigna All Commercial |
$676.31
|
| Rate for Payer: Cigna All Commercial |
$676.31
|
| Rate for Payer: CORVEL All Commercial |
$676.31
|
| Rate for Payer: CORVEL All Commercial |
$676.31
|
| Rate for Payer: Coventry All Commercial |
$811.57
|
| Rate for Payer: Coventry All Commercial |
$811.57
|
| Rate for Payer: Encore All Commercial |
$676.31
|
| Rate for Payer: Encore All Commercial |
$676.31
|
| Rate for Payer: Frontpath All Commercial |
$938.55
|
| Rate for Payer: Frontpath All Commercial |
$938.55
|
| Rate for Payer: Humana ChoiceCare |
$680.80
|
| Rate for Payer: Humana ChoiceCare |
$680.80
|
| Rate for Payer: Humana Medicare |
$676.31
|
| Rate for Payer: Humana Medicare |
$676.31
|
| Rate for Payer: Lucent All Commercial |
$946.83
|
| Rate for Payer: Lucent All Commercial |
$946.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$939.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$939.00
|
| Rate for Payer: Managed Health Services Medicaid |
$653.05
|
| Rate for Payer: Managed Health Services Medicaid |
$653.05
|
| Rate for Payer: MDWise Medicaid |
$653.05
|
| Rate for Payer: MDWise Medicaid |
$653.05
|
| Rate for Payer: PHCS All Commercial |
$676.31
|
| Rate for Payer: PHCS All Commercial |
$676.31
|
| Rate for Payer: PHP All Commercial |
$863.32
|
| Rate for Payer: PHP All Commercial |
$863.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$676.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$676.31
|
| Rate for Payer: Sagamore Health Network All Products |
$676.31
|
| Rate for Payer: Sagamore Health Network All Products |
$676.31
|
| Rate for Payer: Signature Care EPO |
$765.00
|
| Rate for Payer: Signature Care EPO |
$765.00
|
| Rate for Payer: Signature Care PPO |
$765.00
|
| Rate for Payer: Signature Care PPO |
$765.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,100.00
|
| Rate for Payer: United Healthcare Commercial |
$792.68
|
| Rate for Payer: United Healthcare Commercial |
$792.68
|
| Rate for Payer: United Healthcare Medicare |
$654.03
|
| Rate for Payer: United Healthcare Medicare |
$654.03
|
|
|
PR DRAIN OVARIAN CYST(S),ABD APPRCH
|
Professional
|
Both
|
$798.08
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
z58805
|
| Min. Negotiated Rate |
$392.44 |
| Max. Negotiated Rate |
$52,300.00 |
| Rate for Payer: Aetna Commercial |
$405.22
|
| Rate for Payer: Aetna Commercial |
$405.22
|
| Rate for Payer: Aetna Medicare |
$405.22
|
| Rate for Payer: Aetna Medicare |
$405.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$492.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$492.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$492.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$492.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$492.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$492.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$492.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$492.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$392.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$392.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$466.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$466.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$445.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$445.74
|
| Rate for Payer: Cash Price |
$478.85
|
| Rate for Payer: Cash Price |
$470.93
|
| Rate for Payer: Centivo All Commercial |
$628.09
|
| Rate for Payer: Centivo All Commercial |
$628.09
|
| Rate for Payer: Cigna All Commercial |
$405.22
|
| Rate for Payer: Cigna All Commercial |
$405.22
|
| Rate for Payer: CORVEL All Commercial |
$405.22
|
| Rate for Payer: CORVEL All Commercial |
$405.22
|
| Rate for Payer: Coventry All Commercial |
$486.26
|
| Rate for Payer: Coventry All Commercial |
$486.26
|
| Rate for Payer: Encore All Commercial |
$405.22
|
| Rate for Payer: Encore All Commercial |
$405.22
|
| Rate for Payer: Frontpath All Commercial |
$559.35
|
| Rate for Payer: Frontpath All Commercial |
$559.35
|
| Rate for Payer: Humana ChoiceCare |
$414.62
|
| Rate for Payer: Humana ChoiceCare |
$414.62
|
| Rate for Payer: Humana Medicare |
$405.22
|
| Rate for Payer: Humana Medicare |
$405.22
|
| Rate for Payer: Lucent All Commercial |
$567.31
|
| Rate for Payer: Lucent All Commercial |
$567.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$563.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$563.00
|
| Rate for Payer: Managed Health Services Medicaid |
$392.53
|
| Rate for Payer: Managed Health Services Medicaid |
$392.53
|
| Rate for Payer: MDWise Medicaid |
$392.53
|
| Rate for Payer: MDWise Medicaid |
$392.53
|
| Rate for Payer: PHCS All Commercial |
$405.22
|
| Rate for Payer: PHCS All Commercial |
$405.22
|
| Rate for Payer: PHP All Commercial |
$518.02
|
| Rate for Payer: PHP All Commercial |
$518.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$405.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$405.22
|
| Rate for Payer: Sagamore Health Network All Products |
$405.22
|
| Rate for Payer: Sagamore Health Network All Products |
$405.22
|
| Rate for Payer: Signature Care EPO |
$468.35
|
| Rate for Payer: Signature Care EPO |
$468.35
|
| Rate for Payer: Signature Care PPO |
$468.35
|
| Rate for Payer: Signature Care PPO |
$468.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$52,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$52,300.00
|
| Rate for Payer: United Healthcare Commercial |
$453.45
|
| Rate for Payer: United Healthcare Commercial |
$453.45
|
| Rate for Payer: United Healthcare Medicare |
$392.44
|
| Rate for Payer: United Healthcare Medicare |
$392.44
|
|
|
PR DRESS/DEBRID LARGE BURN NO ANESTH
|
Professional
|
Both
|
$363.20
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
z16030
|
| Min. Negotiated Rate |
$66.97 |
| Max. Negotiated Rate |
$14,500.00 |
| Rate for Payer: Aetna Commercial |
$121.86
|
| Rate for Payer: Aetna Commercial |
$121.86
|
| Rate for Payer: Aetna Medicare |
$121.86
|
| Rate for Payer: Aetna Medicare |
$121.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$205.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$205.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.21
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$205.21
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$205.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$205.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$205.21
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$66.97
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$66.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$178.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$178.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$140.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$140.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$134.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$134.05
|
| Rate for Payer: Cash Price |
$213.30
|
| Rate for Payer: Cash Price |
$217.92
|
| Rate for Payer: Centivo All Commercial |
$188.88
|
| Rate for Payer: Centivo All Commercial |
$188.88
|
| Rate for Payer: Cigna All Commercial |
$121.86
|
| Rate for Payer: Cigna All Commercial |
$121.86
|
| Rate for Payer: CORVEL All Commercial |
$121.86
|
| Rate for Payer: CORVEL All Commercial |
$121.86
|
| Rate for Payer: Coventry All Commercial |
$146.23
|
| Rate for Payer: Coventry All Commercial |
$146.23
|
| Rate for Payer: Encore All Commercial |
$121.86
|
| Rate for Payer: Encore All Commercial |
$121.86
|
| Rate for Payer: Frontpath All Commercial |
$170.27
|
| Rate for Payer: Frontpath All Commercial |
$170.27
|
| Rate for Payer: Humana ChoiceCare |
$121.25
|
| Rate for Payer: Humana ChoiceCare |
$121.25
|
| Rate for Payer: Humana Medicare |
$121.86
|
| Rate for Payer: Humana Medicare |
$121.86
|
| Rate for Payer: Lucent All Commercial |
$170.60
|
| Rate for Payer: Lucent All Commercial |
$170.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$157.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$157.00
|
| Rate for Payer: Managed Health Services Medicaid |
$178.63
|
| Rate for Payer: Managed Health Services Medicaid |
$178.63
|
| Rate for Payer: MDWise Medicaid |
$178.63
|
| Rate for Payer: MDWise Medicaid |
$178.63
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$66.97
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$66.97
|
| Rate for Payer: PHCS All Commercial |
$121.86
|
| Rate for Payer: PHCS All Commercial |
$121.86
|
| Rate for Payer: PHP All Commercial |
$165.36
|
| Rate for Payer: PHP All Commercial |
$165.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$121.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$121.86
|
| Rate for Payer: Sagamore Health Network All Products |
$121.86
|
| Rate for Payer: Sagamore Health Network All Products |
$121.86
|
| Rate for Payer: Signature Care EPO |
$175.95
|
| Rate for Payer: Signature Care EPO |
$175.95
|
| Rate for Payer: Signature Care PPO |
$175.95
|
| Rate for Payer: Signature Care PPO |
$175.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,500.00
|
| Rate for Payer: United Healthcare Commercial |
$143.30
|
| Rate for Payer: United Healthcare Commercial |
$143.30
|
| Rate for Payer: United Healthcare Medicare |
$177.75
|
| Rate for Payer: United Healthcare Medicare |
$177.75
|
|
|
PR DRESS/DEBRID MED BURN NO ANESTH
|
Professional
|
Both
|
$291.54
|
|
|
Service Code
|
CPT 16025
|
| Hospital Charge Code |
z16025
|
| Min. Negotiated Rate |
$65.93 |
| Max. Negotiated Rate |
$12,300.00 |
| Rate for Payer: Aetna Commercial |
$103.80
|
| Rate for Payer: Aetna Commercial |
$103.80
|
| Rate for Payer: Aetna Medicare |
$103.80
|
| Rate for Payer: Aetna Medicare |
$103.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$149.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$149.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$149.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$149.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$149.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$149.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$149.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$149.76
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$65.93
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$65.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$143.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$143.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$119.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$119.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$114.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$114.18
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cash Price |
$174.92
|
| Rate for Payer: Centivo All Commercial |
$160.89
|
| Rate for Payer: Centivo All Commercial |
$160.89
|
| Rate for Payer: Cigna All Commercial |
$103.80
|
| Rate for Payer: Cigna All Commercial |
$103.80
|
| Rate for Payer: CORVEL All Commercial |
$103.80
|
| Rate for Payer: CORVEL All Commercial |
$103.80
|
| Rate for Payer: Coventry All Commercial |
$124.56
|
| Rate for Payer: Coventry All Commercial |
$124.56
|
| Rate for Payer: Encore All Commercial |
$103.80
|
| Rate for Payer: Encore All Commercial |
$103.80
|
| Rate for Payer: Frontpath All Commercial |
$143.33
|
| Rate for Payer: Frontpath All Commercial |
$143.33
|
| Rate for Payer: Humana ChoiceCare |
$106.21
|
| Rate for Payer: Humana ChoiceCare |
$106.21
|
| Rate for Payer: Humana Medicare |
$103.80
|
| Rate for Payer: Humana Medicare |
$103.80
|
| Rate for Payer: Lucent All Commercial |
$145.32
|
| Rate for Payer: Lucent All Commercial |
$145.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$133.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$133.00
|
| Rate for Payer: Managed Health Services Medicaid |
$143.40
|
| Rate for Payer: Managed Health Services Medicaid |
$143.40
|
| Rate for Payer: MDWise Medicaid |
$143.40
|
| Rate for Payer: MDWise Medicaid |
$143.40
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$65.93
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$65.93
|
| Rate for Payer: PHCS All Commercial |
$103.80
|
| Rate for Payer: PHCS All Commercial |
$103.80
|
| Rate for Payer: PHP All Commercial |
$140.02
|
| Rate for Payer: PHP All Commercial |
$140.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$103.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$103.80
|
| Rate for Payer: Sagamore Health Network All Products |
$103.80
|
| Rate for Payer: Sagamore Health Network All Products |
$103.80
|
| Rate for Payer: Signature Care EPO |
$150.45
|
| Rate for Payer: Signature Care EPO |
$150.45
|
| Rate for Payer: Signature Care PPO |
$150.45
|
| Rate for Payer: Signature Care PPO |
$150.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,300.00
|
| Rate for Payer: United Healthcare Commercial |
$126.20
|
| Rate for Payer: United Healthcare Commercial |
$126.20
|
| Rate for Payer: United Healthcare Medicare |
$142.18
|
| Rate for Payer: United Healthcare Medicare |
$142.18
|
|
|
PR DRESS/DEBRID SMALL BURN NO ANES
|
Professional
|
Both
|
$159.18
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
z16020
|
| Min. Negotiated Rate |
$32.83 |
| Max. Negotiated Rate |
$6,200.00 |
| Rate for Payer: Aetna Commercial |
$50.63
|
| Rate for Payer: Aetna Commercial |
$50.63
|
| Rate for Payer: Aetna Medicare |
$50.63
|
| Rate for Payer: Aetna Medicare |
$50.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$99.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$99.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$99.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$99.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$99.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$99.41
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$32.83
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$32.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$78.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$78.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.69
|
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Cash Price |
$95.51
|
| Rate for Payer: Centivo All Commercial |
$78.48
|
| Rate for Payer: Centivo All Commercial |
$78.48
|
| Rate for Payer: Cigna All Commercial |
$50.63
|
| Rate for Payer: Cigna All Commercial |
$50.63
|
| Rate for Payer: CORVEL All Commercial |
$50.63
|
| Rate for Payer: CORVEL All Commercial |
$50.63
|
| Rate for Payer: Coventry All Commercial |
$60.76
|
| Rate for Payer: Coventry All Commercial |
$60.76
|
| Rate for Payer: Encore All Commercial |
$50.63
|
| Rate for Payer: Encore All Commercial |
$50.63
|
| Rate for Payer: Frontpath All Commercial |
$69.39
|
| Rate for Payer: Frontpath All Commercial |
$69.39
|
| Rate for Payer: Humana ChoiceCare |
$51.55
|
| Rate for Payer: Humana ChoiceCare |
$51.55
|
| Rate for Payer: Humana Medicare |
$50.63
|
| Rate for Payer: Humana Medicare |
$50.63
|
| Rate for Payer: Lucent All Commercial |
$70.88
|
| Rate for Payer: Lucent All Commercial |
$70.88
|
| 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 |
$78.29
|
| Rate for Payer: Managed Health Services Medicaid |
$78.29
|
| Rate for Payer: MDWise Medicaid |
$78.29
|
| Rate for Payer: MDWise Medicaid |
$78.29
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$32.83
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$32.83
|
| Rate for Payer: PHCS All Commercial |
$50.63
|
| Rate for Payer: PHCS All Commercial |
$50.63
|
| Rate for Payer: PHP All Commercial |
$70.08
|
| Rate for Payer: PHP All Commercial |
$70.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.63
|
| Rate for Payer: Sagamore Health Network All Products |
$50.63
|
| Rate for Payer: Sagamore Health Network All Products |
$50.63
|
| Rate for Payer: Signature Care EPO |
$85.85
|
| Rate for Payer: Signature Care EPO |
$85.85
|
| Rate for Payer: Signature Care PPO |
$85.85
|
| Rate for Payer: Signature Care PPO |
$85.85
|
| 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 |
$61.40
|
| Rate for Payer: United Healthcare Commercial |
$61.40
|
| Rate for Payer: United Healthcare Medicare |
$77.46
|
| Rate for Payer: United Healthcare Medicare |
$77.46
|
|
|
PR DRESSING CHANGE,NOT FOR BURN
|
Professional
|
Both
|
$82.68
|
|
|
Service Code
|
CPT 15852
|
| Hospital Charge Code |
z15852
|
| Min. Negotiated Rate |
$40.35 |
| Max. Negotiated Rate |
$73.78 |
| Rate for Payer: Aetna Commercial |
$43.40
|
| Rate for Payer: Aetna Commercial |
$43.40
|
| Rate for Payer: Aetna Medicare |
$43.40
|
| Rate for Payer: Aetna Medicare |
$43.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$40.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$40.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.91
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.74
|
| Rate for Payer: Cash Price |
$49.61
|
| Rate for Payer: Cash Price |
$49.22
|
| Rate for Payer: Centivo All Commercial |
$67.27
|
| Rate for Payer: Centivo All Commercial |
$67.27
|
| Rate for Payer: Cigna All Commercial |
$43.40
|
| Rate for Payer: Cigna All Commercial |
$43.40
|
| Rate for Payer: CORVEL All Commercial |
$43.40
|
| Rate for Payer: CORVEL All Commercial |
$43.40
|
| Rate for Payer: Coventry All Commercial |
$52.08
|
| Rate for Payer: Coventry All Commercial |
$52.08
|
| Rate for Payer: Encore All Commercial |
$43.40
|
| Rate for Payer: Encore All Commercial |
$43.40
|
| Rate for Payer: Frontpath All Commercial |
$61.44
|
| Rate for Payer: Frontpath All Commercial |
$61.44
|
| Rate for Payer: Humana ChoiceCare |
$45.41
|
| Rate for Payer: Humana ChoiceCare |
$45.41
|
| Rate for Payer: Humana Medicare |
$43.40
|
| Rate for Payer: Humana Medicare |
$43.40
|
| Rate for Payer: Lucent All Commercial |
$60.76
|
| Rate for Payer: Lucent All Commercial |
$60.76
|
| Rate for Payer: Managed Health Services Medicaid |
$40.35
|
| Rate for Payer: Managed Health Services Medicaid |
$40.35
|
| Rate for Payer: MDWise Medicaid |
$40.35
|
| Rate for Payer: MDWise Medicaid |
$40.35
|
| Rate for Payer: PHCS All Commercial |
$43.40
|
| Rate for Payer: PHCS All Commercial |
$43.40
|
| Rate for Payer: PHP All Commercial |
$57.88
|
| Rate for Payer: PHP All Commercial |
$57.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.40
|
| Rate for Payer: Sagamore Health Network All Products |
$43.40
|
| Rate for Payer: Sagamore Health Network All Products |
$43.40
|
| Rate for Payer: Signature Care EPO |
$73.78
|
| Rate for Payer: Signature Care EPO |
$73.78
|
| Rate for Payer: Signature Care PPO |
$73.78
|
| Rate for Payer: Signature Care PPO |
$73.78
|
| Rate for Payer: United Healthcare Commercial |
$53.20
|
| Rate for Payer: United Healthcare Commercial |
$53.20
|
| Rate for Payer: United Healthcare Medicare |
$41.34
|
| Rate for Payer: United Healthcare Medicare |
$41.34
|
|
|
PR EAR AND THROAT EXAMINATION
|
Professional
|
Both
|
$179.88
|
|
|
Service Code
|
CPT 92502
|
| Hospital Charge Code |
z92502
|
| Min. Negotiated Rate |
$87.63 |
| Max. Negotiated Rate |
$10,800.00 |
| Rate for Payer: Aetna Commercial |
$90.30
|
| Rate for Payer: Aetna Commercial |
$90.30
|
| Rate for Payer: Aetna Medicare |
$90.30
|
| Rate for Payer: Aetna Medicare |
$90.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$98.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$98.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$98.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$98.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$98.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$98.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$98.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$98.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$88.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$88.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$103.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$103.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$99.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$99.33
|
| Rate for Payer: Cash Price |
$107.93
|
| Rate for Payer: Cash Price |
$105.16
|
| Rate for Payer: Centivo All Commercial |
$139.97
|
| Rate for Payer: Centivo All Commercial |
$139.97
|
| Rate for Payer: Cigna All Commercial |
$90.30
|
| Rate for Payer: Cigna All Commercial |
$90.30
|
| Rate for Payer: CORVEL All Commercial |
$90.30
|
| Rate for Payer: CORVEL All Commercial |
$90.30
|
| Rate for Payer: Coventry All Commercial |
$108.36
|
| Rate for Payer: Coventry All Commercial |
$108.36
|
| Rate for Payer: Encore All Commercial |
$90.30
|
| Rate for Payer: Encore All Commercial |
$90.30
|
| Rate for Payer: Frontpath All Commercial |
$102.31
|
| Rate for Payer: Frontpath All Commercial |
$102.31
|
| Rate for Payer: Humana ChoiceCare |
$112.51
|
| Rate for Payer: Humana ChoiceCare |
$112.51
|
| Rate for Payer: Humana Medicare |
$90.30
|
| Rate for Payer: Humana Medicare |
$90.30
|
| Rate for Payer: Lucent All Commercial |
$126.42
|
| Rate for Payer: Lucent All Commercial |
$126.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$117.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$117.00
|
| Rate for Payer: Managed Health Services Medicaid |
$88.47
|
| Rate for Payer: Managed Health Services Medicaid |
$88.47
|
| Rate for Payer: MDWise Medicaid |
$88.47
|
| Rate for Payer: MDWise Medicaid |
$88.47
|
| Rate for Payer: PHCS All Commercial |
$90.30
|
| Rate for Payer: PHCS All Commercial |
$90.30
|
| Rate for Payer: PHP All Commercial |
$127.07
|
| Rate for Payer: PHP All Commercial |
$127.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$90.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$90.30
|
| Rate for Payer: Sagamore Health Network All Products |
$90.30
|
| Rate for Payer: Sagamore Health Network All Products |
$90.30
|
| 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 |
$10,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,800.00
|
| Rate for Payer: United Healthcare Commercial |
$109.58
|
| Rate for Payer: United Healthcare Commercial |
$109.58
|
| Rate for Payer: United Healthcare Medicare |
$87.63
|
| Rate for Payer: United Healthcare Medicare |
$87.63
|
|
|
PR EAR MICROSCOPY EXAMINATION
|
Professional
|
Both
|
$54.04
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
z92504
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Aetna Commercial |
$8.88
|
| Rate for Payer: Aetna Commercial |
$8.88
|
| Rate for Payer: Aetna Medicare |
$8.88
|
| Rate for Payer: Aetna Medicare |
$8.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$24.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$24.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$24.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$24.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$24.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$24.72
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$4.09
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$4.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$10.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$10.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$9.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$9.77
|
| Rate for Payer: Cash Price |
$31.91
|
| Rate for Payer: Cash Price |
$32.42
|
| Rate for Payer: Centivo All Commercial |
$13.76
|
| Rate for Payer: Centivo All Commercial |
$13.76
|
| Rate for Payer: Cigna All Commercial |
$8.88
|
| Rate for Payer: Cigna All Commercial |
$8.88
|
| Rate for Payer: CORVEL All Commercial |
$8.88
|
| Rate for Payer: CORVEL All Commercial |
$8.88
|
| Rate for Payer: Coventry All Commercial |
$10.66
|
| Rate for Payer: Coventry All Commercial |
$10.66
|
| Rate for Payer: Encore All Commercial |
$8.88
|
| Rate for Payer: Encore All Commercial |
$8.88
|
| Rate for Payer: Frontpath All Commercial |
$10.05
|
| Rate for Payer: Frontpath All Commercial |
$10.05
|
| Rate for Payer: Humana ChoiceCare |
$11.79
|
| Rate for Payer: Humana ChoiceCare |
$11.79
|
| Rate for Payer: Humana Medicare |
$8.88
|
| Rate for Payer: Humana Medicare |
$8.88
|
| Rate for Payer: Lucent All Commercial |
$12.43
|
| Rate for Payer: Lucent All Commercial |
$12.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12.00
|
| Rate for Payer: Managed Health Services Medicaid |
$26.58
|
| Rate for Payer: Managed Health Services Medicaid |
$26.58
|
| Rate for Payer: MDWise Medicaid |
$26.58
|
| Rate for Payer: MDWise Medicaid |
$26.58
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$4.09
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$4.09
|
| Rate for Payer: PHCS All Commercial |
$8.88
|
| Rate for Payer: PHCS All Commercial |
$8.88
|
| Rate for Payer: PHP All Commercial |
$12.79
|
| Rate for Payer: PHP All Commercial |
$12.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$8.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$8.88
|
| Rate for Payer: Sagamore Health Network All Products |
$8.88
|
| Rate for Payer: Sagamore Health Network All Products |
$8.88
|
| Rate for Payer: Signature Care EPO |
$28.05
|
| Rate for Payer: Signature Care EPO |
$28.05
|
| Rate for Payer: Signature Care PPO |
$28.05
|
| Rate for Payer: Signature Care PPO |
$28.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.00
|
| Rate for Payer: United Healthcare Commercial |
$11.29
|
| Rate for Payer: United Healthcare Commercial |
$11.29
|
| Rate for Payer: United Healthcare Medicare |
$26.59
|
| Rate for Payer: United Healthcare Medicare |
$26.59
|
|
|
PR EAR MOLD/INSERT
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
CPT V5264
|
| Hospital Charge Code |
zV5264
|
| Min. Negotiated Rate |
$25.46 |
| Max. Negotiated Rate |
$125.00 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$45.91
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Managed Health Services Medicaid |
$45.91
|
| Rate for Payer: MDWise Medicaid |
$45.91
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$25.46
|
| Rate for Payer: Signature Care EPO |
$125.00
|
| Rate for Payer: Signature Care PPO |
$125.00
|
|
|
PR ECG/SIGNAL-AVERAGED
|
Professional
|
Both
|
$59.02
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
z93278
|
| Min. Negotiated Rate |
$27.04 |
| Max. Negotiated Rate |
$4,100.00 |
| Rate for Payer: Aetna Commercial |
$27.04
|
| Rate for Payer: Aetna Commercial |
$27.04
|
| Rate for Payer: Aetna Medicare |
$27.04
|
| Rate for Payer: Aetna Medicare |
$27.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$77.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$77.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$77.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$77.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$77.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$77.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$77.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$77.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.74
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cash Price |
$35.41
|
| Rate for Payer: Centivo All Commercial |
$41.91
|
| Rate for Payer: Centivo All Commercial |
$41.91
|
| Rate for Payer: Cigna All Commercial |
$27.04
|
| Rate for Payer: Cigna All Commercial |
$27.04
|
| Rate for Payer: CORVEL All Commercial |
$27.04
|
| Rate for Payer: CORVEL All Commercial |
$27.04
|
| Rate for Payer: Coventry All Commercial |
$32.45
|
| Rate for Payer: Coventry All Commercial |
$32.45
|
| Rate for Payer: Encore All Commercial |
$27.04
|
| Rate for Payer: Encore All Commercial |
$27.04
|
| Rate for Payer: Frontpath All Commercial |
$30.50
|
| Rate for Payer: Frontpath All Commercial |
$30.50
|
| Rate for Payer: Humana ChoiceCare |
$73.90
|
| Rate for Payer: Humana ChoiceCare |
$73.90
|
| Rate for Payer: Humana Medicare |
$27.04
|
| Rate for Payer: Humana Medicare |
$27.04
|
| Rate for Payer: Lucent All Commercial |
$37.86
|
| Rate for Payer: Lucent All Commercial |
$37.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$43.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$43.00
|
| Rate for Payer: Managed Health Services Medicaid |
$29.03
|
| Rate for Payer: Managed Health Services Medicaid |
$29.03
|
| Rate for Payer: MDWise Medicaid |
$29.03
|
| Rate for Payer: MDWise Medicaid |
$29.03
|
| Rate for Payer: PHCS All Commercial |
$27.04
|
| Rate for Payer: PHCS All Commercial |
$27.04
|
| Rate for Payer: PHP All Commercial |
$38.73
|
| Rate for Payer: PHP All Commercial |
$38.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.04
|
| Rate for Payer: Sagamore Health Network All Products |
$27.04
|
| Rate for Payer: Sagamore Health Network All Products |
$27.04
|
| Rate for Payer: Signature Care EPO |
$45.97
|
| Rate for Payer: Signature Care EPO |
$45.97
|
| Rate for Payer: Signature Care PPO |
$45.97
|
| Rate for Payer: Signature Care PPO |
$45.97
|
| 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 |
$45.96
|
| Rate for Payer: United Healthcare Commercial |
$45.96
|
|
