|
HC W PLATE FRAC TAB LRG
|
Facility
IP
|
$5,104.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,828.60 |
| Max. Negotiated Rate |
$4,747.46 |
| Rate for Payer: Aetna Commercial |
$4,410.55
|
| Rate for Payer: Cash Price |
$3,164.98
|
| Rate for Payer: Cigna All Commercial |
$4,405.44
|
| Rate for Payer: CORVEL All Commercial |
$4,747.46
|
| Rate for Payer: Coventry All Commercial |
$4,492.22
|
| Rate for Payer: Encore All Commercial |
$4,698.97
|
| Rate for Payer: Frontpath All Commercial |
$4,696.42
|
| Rate for Payer: Humana ChoiceCare |
$4,409.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,594.32
|
| Rate for Payer: PHCS All Commercial |
$3,828.60
|
| Rate for Payer: PHP All Commercial |
$3,871.48
|
| Rate for Payer: Sagamore Health Network All Products |
$3,940.91
|
| Rate for Payer: Signature Care EPO |
$4,236.98
|
| Rate for Payer: Signature Care PPO |
$4,492.22
|
| Rate for Payer: United Healthcare Commercial |
$4,022.58
|
|
|
HC W PLATE FRAC TAB LRG
|
Facility
OP
|
$5,104.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,747.46 |
| Rate for Payer: Aetna Commercial |
$4,308.45
|
| Rate for Payer: Aetna Medicare |
$1,684.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,684.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,931.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,191.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,937.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,853.04
|
| Rate for Payer: Cash Price |
$3,164.98
|
| Rate for Payer: Cash Price |
$3,164.98
|
| Rate for Payer: Centivo All Commercial |
$2,603.45
|
| Rate for Payer: Cigna All Commercial |
$4,405.44
|
| Rate for Payer: CORVEL All Commercial |
$4,747.46
|
| Rate for Payer: Coventry All Commercial |
$4,492.22
|
| Rate for Payer: Encore All Commercial |
$4,698.97
|
| Rate for Payer: Frontpath All Commercial |
$4,696.42
|
| Rate for Payer: Humana ChoiceCare |
$4,409.02
|
| Rate for Payer: Humana Medicare |
$2,603.45
|
| Rate for Payer: Lucent All Commercial |
$2,603.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,594.32
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,828.60
|
| Rate for Payer: PHP All Commercial |
$3,871.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,990.87
|
| Rate for Payer: Sagamore Health Network All Products |
$3,940.91
|
| Rate for Payer: Signature Care EPO |
$4,236.98
|
| Rate for Payer: Signature Care PPO |
$4,492.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,339.08
|
| Rate for Payer: United Healthcare Commercial |
$4,022.58
|
| Rate for Payer: United Healthcare Medicare |
$1,684.58
|
|
|
HC W PLATE FRAC TAB MED
|
Facility
IP
|
$5,104.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,828.60 |
| Max. Negotiated Rate |
$4,747.46 |
| Rate for Payer: Aetna Commercial |
$4,410.55
|
| Rate for Payer: Cash Price |
$3,164.98
|
| Rate for Payer: Cigna All Commercial |
$4,405.44
|
| Rate for Payer: CORVEL All Commercial |
$4,747.46
|
| Rate for Payer: Coventry All Commercial |
$4,492.22
|
| Rate for Payer: Encore All Commercial |
$4,698.97
|
| Rate for Payer: Frontpath All Commercial |
$4,696.42
|
| Rate for Payer: Humana ChoiceCare |
$4,409.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,594.32
|
| Rate for Payer: PHCS All Commercial |
$3,828.60
|
| Rate for Payer: PHP All Commercial |
$3,871.48
|
| Rate for Payer: Sagamore Health Network All Products |
$3,940.91
|
| Rate for Payer: Signature Care EPO |
$4,236.98
|
| Rate for Payer: Signature Care PPO |
$4,492.22
|
| Rate for Payer: United Healthcare Commercial |
$4,022.58
|
|
|
HC W PLATE FRAC TAB MED
|
Facility
OP
|
$5,104.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,747.46 |
| Rate for Payer: Aetna Commercial |
$4,308.45
|
| Rate for Payer: Aetna Medicare |
$1,684.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,684.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,931.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,191.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,937.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,853.04
|
| Rate for Payer: Cash Price |
$3,164.98
|
| Rate for Payer: Cash Price |
$3,164.98
|
| Rate for Payer: Centivo All Commercial |
$2,603.45
|
| Rate for Payer: Cigna All Commercial |
$4,405.44
|
| Rate for Payer: CORVEL All Commercial |
$4,747.46
|
| Rate for Payer: Coventry All Commercial |
$4,492.22
|
| Rate for Payer: Encore All Commercial |
$4,698.97
|
| Rate for Payer: Frontpath All Commercial |
$4,696.42
|
| Rate for Payer: Humana ChoiceCare |
$4,409.02
|
| Rate for Payer: Humana Medicare |
$2,603.45
|
| Rate for Payer: Lucent All Commercial |
$2,603.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,594.32
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,828.60
|
| Rate for Payer: PHP All Commercial |
$3,871.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,990.87
|
| Rate for Payer: Sagamore Health Network All Products |
$3,940.91
|
| Rate for Payer: Signature Care EPO |
$4,236.98
|
| Rate for Payer: Signature Care PPO |
$4,492.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,339.08
|
| Rate for Payer: United Healthcare Commercial |
$4,022.58
|
| Rate for Payer: United Healthcare Medicare |
$1,684.58
|
|
|
HC W PLATE FRAC TAB XSM
|
Facility
OP
|
$5,104.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,747.46 |
| Rate for Payer: Aetna Commercial |
$4,308.45
|
| Rate for Payer: Aetna Medicare |
$1,684.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,684.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,931.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,191.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,937.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,853.04
|
| Rate for Payer: Cash Price |
$3,164.98
|
| Rate for Payer: Cash Price |
$3,164.98
|
| Rate for Payer: Centivo All Commercial |
$2,603.45
|
| Rate for Payer: Cigna All Commercial |
$4,405.44
|
| Rate for Payer: CORVEL All Commercial |
$4,747.46
|
| Rate for Payer: Coventry All Commercial |
$4,492.22
|
| Rate for Payer: Encore All Commercial |
$4,698.97
|
| Rate for Payer: Frontpath All Commercial |
$4,696.42
|
| Rate for Payer: Humana ChoiceCare |
$4,409.02
|
| Rate for Payer: Humana Medicare |
$2,603.45
|
| Rate for Payer: Lucent All Commercial |
$2,603.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,594.32
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,828.60
|
| Rate for Payer: PHP All Commercial |
$3,871.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,990.87
|
| Rate for Payer: Sagamore Health Network All Products |
$3,940.91
|
| Rate for Payer: Signature Care EPO |
$4,236.98
|
| Rate for Payer: Signature Care PPO |
$4,492.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,339.08
|
| Rate for Payer: United Healthcare Commercial |
$4,022.58
|
| Rate for Payer: United Healthcare Medicare |
$1,684.58
|
|
|
HC W PLATE FRAC TAB XSM
|
Facility
IP
|
$5,104.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,828.60 |
| Max. Negotiated Rate |
$4,747.46 |
| Rate for Payer: Aetna Commercial |
$4,410.55
|
| Rate for Payer: Cash Price |
$3,164.98
|
| Rate for Payer: Cigna All Commercial |
$4,405.44
|
| Rate for Payer: CORVEL All Commercial |
$4,747.46
|
| Rate for Payer: Coventry All Commercial |
$4,492.22
|
| Rate for Payer: Encore All Commercial |
$4,698.97
|
| Rate for Payer: Frontpath All Commercial |
$4,696.42
|
| Rate for Payer: Humana ChoiceCare |
$4,409.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,594.32
|
| Rate for Payer: PHCS All Commercial |
$3,828.60
|
| Rate for Payer: PHP All Commercial |
$3,871.48
|
| Rate for Payer: Sagamore Health Network All Products |
$3,940.91
|
| Rate for Payer: Signature Care EPO |
$4,236.98
|
| Rate for Payer: Signature Care PPO |
$4,492.22
|
| Rate for Payer: United Healthcare Commercial |
$4,022.58
|
|
|
HC W PLATE FUSION ANT
|
Facility
OP
|
$9,075.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,440.31 |
| Rate for Payer: Aetna Commercial |
$7,659.81
|
| Rate for Payer: Aetna Medicare |
$2,994.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,994.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,212.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,673.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,444.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,294.44
|
| Rate for Payer: Cash Price |
$5,626.87
|
| Rate for Payer: Cash Price |
$5,626.87
|
| Rate for Payer: Centivo All Commercial |
$4,628.56
|
| Rate for Payer: Cigna All Commercial |
$7,832.24
|
| Rate for Payer: CORVEL All Commercial |
$8,440.31
|
| Rate for Payer: Coventry All Commercial |
$7,986.53
|
| Rate for Payer: Encore All Commercial |
$8,354.09
|
| Rate for Payer: Frontpath All Commercial |
$8,349.55
|
| Rate for Payer: Humana ChoiceCare |
$7,838.60
|
| Rate for Payer: Humana Medicare |
$4,628.56
|
| Rate for Payer: Lucent All Commercial |
$4,628.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,168.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,806.70
|
| Rate for Payer: PHP All Commercial |
$6,882.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,539.48
|
| Rate for Payer: Sagamore Health Network All Products |
$7,006.36
|
| Rate for Payer: Signature Care EPO |
$7,532.75
|
| Rate for Payer: Signature Care PPO |
$7,986.53
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,714.26
|
| Rate for Payer: United Healthcare Commercial |
$7,151.57
|
| Rate for Payer: United Healthcare Medicare |
$2,994.95
|
|
|
HC W PLATE FUSION ANT
|
Facility
IP
|
$9,075.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,806.70 |
| Max. Negotiated Rate |
$8,440.31 |
| Rate for Payer: Aetna Commercial |
$7,841.32
|
| Rate for Payer: Cash Price |
$5,626.87
|
| Rate for Payer: Cigna All Commercial |
$7,832.24
|
| Rate for Payer: CORVEL All Commercial |
$8,440.31
|
| Rate for Payer: Coventry All Commercial |
$7,986.53
|
| Rate for Payer: Encore All Commercial |
$8,354.09
|
| Rate for Payer: Frontpath All Commercial |
$8,349.55
|
| Rate for Payer: Humana ChoiceCare |
$7,838.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,168.04
|
| Rate for Payer: PHCS All Commercial |
$6,806.70
|
| Rate for Payer: PHP All Commercial |
$6,882.94
|
| Rate for Payer: Sagamore Health Network All Products |
$7,006.36
|
| Rate for Payer: Signature Care EPO |
$7,532.75
|
| Rate for Payer: Signature Care PPO |
$7,986.53
|
| Rate for Payer: United Healthcare Commercial |
$7,151.57
|
|
|
HC W PLATE GRAVITY PLANTAR SET
|
Facility
IP
|
$3,783.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,837.70 |
| Max. Negotiated Rate |
$3,518.75 |
| Rate for Payer: Aetna Commercial |
$3,269.03
|
| Rate for Payer: Cash Price |
$2,345.83
|
| Rate for Payer: Cigna All Commercial |
$3,265.25
|
| Rate for Payer: CORVEL All Commercial |
$3,518.75
|
| Rate for Payer: Coventry All Commercial |
$3,329.57
|
| Rate for Payer: Encore All Commercial |
$3,482.80
|
| Rate for Payer: Frontpath All Commercial |
$3,480.91
|
| Rate for Payer: Humana ChoiceCare |
$3,267.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,405.24
|
| Rate for Payer: PHCS All Commercial |
$2,837.70
|
| Rate for Payer: PHP All Commercial |
$2,869.48
|
| Rate for Payer: Sagamore Health Network All Products |
$2,920.94
|
| Rate for Payer: Signature Care EPO |
$3,140.39
|
| Rate for Payer: Signature Care PPO |
$3,329.57
|
| Rate for Payer: United Healthcare Commercial |
$2,981.48
|
|
|
HC W PLATE GRAVITY PLANTAR SET
|
Facility
OP
|
$3,783.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,518.75 |
| Rate for Payer: Aetna Commercial |
$3,193.36
|
| Rate for Payer: Aetna Medicare |
$1,248.59
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,248.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,172.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,365.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,435.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,373.45
|
| Rate for Payer: Cash Price |
$2,345.83
|
| Rate for Payer: Cash Price |
$2,345.83
|
| Rate for Payer: Centivo All Commercial |
$1,929.64
|
| Rate for Payer: Cigna All Commercial |
$3,265.25
|
| Rate for Payer: CORVEL All Commercial |
$3,518.75
|
| Rate for Payer: Coventry All Commercial |
$3,329.57
|
| Rate for Payer: Encore All Commercial |
$3,482.80
|
| Rate for Payer: Frontpath All Commercial |
$3,480.91
|
| Rate for Payer: Humana ChoiceCare |
$3,267.90
|
| Rate for Payer: Humana Medicare |
$1,929.64
|
| Rate for Payer: Lucent All Commercial |
$1,929.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,405.24
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,837.70
|
| Rate for Payer: PHP All Commercial |
$2,869.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,475.60
|
| Rate for Payer: Sagamore Health Network All Products |
$2,920.94
|
| Rate for Payer: Signature Care EPO |
$3,140.39
|
| Rate for Payer: Signature Care PPO |
$3,329.57
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,216.06
|
| Rate for Payer: United Healthcare Commercial |
$2,981.48
|
| Rate for Payer: United Healthcare Medicare |
$1,248.59
|
|
|
HC W PLATE HOOK LONG LRG
|
Facility
IP
|
$5,007.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,755.70 |
| Max. Negotiated Rate |
$4,657.07 |
| Rate for Payer: Aetna Commercial |
$4,326.57
|
| Rate for Payer: Cash Price |
$3,104.71
|
| Rate for Payer: Cigna All Commercial |
$4,321.56
|
| Rate for Payer: CORVEL All Commercial |
$4,657.07
|
| Rate for Payer: Coventry All Commercial |
$4,406.69
|
| Rate for Payer: Encore All Commercial |
$4,609.50
|
| Rate for Payer: Frontpath All Commercial |
$4,606.99
|
| Rate for Payer: Humana ChoiceCare |
$4,325.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,506.84
|
| Rate for Payer: PHCS All Commercial |
$3,755.70
|
| Rate for Payer: PHP All Commercial |
$3,797.76
|
| Rate for Payer: Sagamore Health Network All Products |
$3,865.87
|
| Rate for Payer: Signature Care EPO |
$4,156.31
|
| Rate for Payer: Signature Care PPO |
$4,406.69
|
| Rate for Payer: United Healthcare Commercial |
$3,945.99
|
|
|
HC W PLATE HOOK LONG LRG
|
Facility
OP
|
$5,007.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,657.07 |
| Rate for Payer: Aetna Commercial |
$4,226.41
|
| Rate for Payer: Aetna Medicare |
$1,652.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,652.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,875.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,130.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,900.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,817.76
|
| Rate for Payer: Cash Price |
$3,104.71
|
| Rate for Payer: Cash Price |
$3,104.71
|
| Rate for Payer: Centivo All Commercial |
$2,553.88
|
| Rate for Payer: Cigna All Commercial |
$4,321.56
|
| Rate for Payer: CORVEL All Commercial |
$4,657.07
|
| Rate for Payer: Coventry All Commercial |
$4,406.69
|
| Rate for Payer: Encore All Commercial |
$4,609.50
|
| Rate for Payer: Frontpath All Commercial |
$4,606.99
|
| Rate for Payer: Humana ChoiceCare |
$4,325.06
|
| Rate for Payer: Humana Medicare |
$2,553.88
|
| Rate for Payer: Lucent All Commercial |
$2,553.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,506.84
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,755.70
|
| Rate for Payer: PHP All Commercial |
$3,797.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,952.96
|
| Rate for Payer: Sagamore Health Network All Products |
$3,865.87
|
| Rate for Payer: Signature Care EPO |
$4,156.31
|
| Rate for Payer: Signature Care PPO |
$4,406.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,256.46
|
| Rate for Payer: United Healthcare Commercial |
$3,945.99
|
| Rate for Payer: United Healthcare Medicare |
$1,652.51
|
|
|
HC W PLATE HOOK LONG SM
|
Facility
IP
|
$5,007.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,755.70 |
| Max. Negotiated Rate |
$4,657.07 |
| Rate for Payer: Aetna Commercial |
$4,326.57
|
| Rate for Payer: Cash Price |
$3,104.71
|
| Rate for Payer: Cigna All Commercial |
$4,321.56
|
| Rate for Payer: CORVEL All Commercial |
$4,657.07
|
| Rate for Payer: Coventry All Commercial |
$4,406.69
|
| Rate for Payer: Encore All Commercial |
$4,609.50
|
| Rate for Payer: Frontpath All Commercial |
$4,606.99
|
| Rate for Payer: Humana ChoiceCare |
$4,325.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,506.84
|
| Rate for Payer: PHCS All Commercial |
$3,755.70
|
| Rate for Payer: PHP All Commercial |
$3,797.76
|
| Rate for Payer: Sagamore Health Network All Products |
$3,865.87
|
| Rate for Payer: Signature Care EPO |
$4,156.31
|
| Rate for Payer: Signature Care PPO |
$4,406.69
|
| Rate for Payer: United Healthcare Commercial |
$3,945.99
|
|
|
HC W PLATE HOOK LONG SM
|
Facility
OP
|
$5,007.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,657.07 |
| Rate for Payer: Aetna Commercial |
$4,226.41
|
| Rate for Payer: Aetna Medicare |
$1,652.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,652.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,875.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,130.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,900.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,817.76
|
| Rate for Payer: Cash Price |
$3,104.71
|
| Rate for Payer: Cash Price |
$3,104.71
|
| Rate for Payer: Centivo All Commercial |
$2,553.88
|
| Rate for Payer: Cigna All Commercial |
$4,321.56
|
| Rate for Payer: CORVEL All Commercial |
$4,657.07
|
| Rate for Payer: Coventry All Commercial |
$4,406.69
|
| Rate for Payer: Encore All Commercial |
$4,609.50
|
| Rate for Payer: Frontpath All Commercial |
$4,606.99
|
| Rate for Payer: Humana ChoiceCare |
$4,325.06
|
| Rate for Payer: Humana Medicare |
$2,553.88
|
| Rate for Payer: Lucent All Commercial |
$2,553.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,506.84
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,755.70
|
| Rate for Payer: PHP All Commercial |
$3,797.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,952.96
|
| Rate for Payer: Sagamore Health Network All Products |
$3,865.87
|
| Rate for Payer: Signature Care EPO |
$4,156.31
|
| Rate for Payer: Signature Care PPO |
$4,406.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,256.46
|
| Rate for Payer: United Healthcare Commercial |
$3,945.99
|
| Rate for Payer: United Healthcare Medicare |
$1,652.51
|
|
|
HC W PLATE HOOK SHRT LRG
|
Facility
IP
|
$4,532.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,399.30 |
| Max. Negotiated Rate |
$4,215.13 |
| Rate for Payer: Aetna Commercial |
$3,915.99
|
| Rate for Payer: Cash Price |
$2,810.09
|
| Rate for Payer: Cigna All Commercial |
$3,911.46
|
| Rate for Payer: CORVEL All Commercial |
$4,215.13
|
| Rate for Payer: Coventry All Commercial |
$3,988.51
|
| Rate for Payer: Encore All Commercial |
$4,172.07
|
| Rate for Payer: Frontpath All Commercial |
$4,169.81
|
| Rate for Payer: Humana ChoiceCare |
$3,914.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,079.16
|
| Rate for Payer: PHCS All Commercial |
$3,399.30
|
| Rate for Payer: PHP All Commercial |
$3,437.37
|
| Rate for Payer: Sagamore Health Network All Products |
$3,499.01
|
| Rate for Payer: Signature Care EPO |
$3,761.89
|
| Rate for Payer: Signature Care PPO |
$3,988.51
|
| Rate for Payer: United Healthcare Commercial |
$3,571.53
|
|
|
HC W PLATE HOOK SHRT LRG
|
Facility
OP
|
$4,532.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,215.13 |
| Rate for Payer: Aetna Commercial |
$3,825.35
|
| Rate for Payer: Aetna Medicare |
$1,495.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,495.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,602.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,833.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,720.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,645.26
|
| Rate for Payer: Cash Price |
$2,810.09
|
| Rate for Payer: Cash Price |
$2,810.09
|
| Rate for Payer: Centivo All Commercial |
$2,311.52
|
| Rate for Payer: Cigna All Commercial |
$3,911.46
|
| Rate for Payer: CORVEL All Commercial |
$4,215.13
|
| Rate for Payer: Coventry All Commercial |
$3,988.51
|
| Rate for Payer: Encore All Commercial |
$4,172.07
|
| Rate for Payer: Frontpath All Commercial |
$4,169.81
|
| Rate for Payer: Humana ChoiceCare |
$3,914.63
|
| Rate for Payer: Humana Medicare |
$2,311.52
|
| Rate for Payer: Lucent All Commercial |
$2,311.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,079.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,399.30
|
| Rate for Payer: PHP All Commercial |
$3,437.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,767.64
|
| Rate for Payer: Sagamore Health Network All Products |
$3,499.01
|
| Rate for Payer: Signature Care EPO |
$3,761.89
|
| Rate for Payer: Signature Care PPO |
$3,988.51
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,852.54
|
| Rate for Payer: United Healthcare Commercial |
$3,571.53
|
| Rate for Payer: United Healthcare Medicare |
$1,495.69
|
|
|
HC W PLATE HOOK SHRT SM
|
Facility
IP
|
$4,532.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,399.30 |
| Max. Negotiated Rate |
$4,215.13 |
| Rate for Payer: Aetna Commercial |
$3,915.99
|
| Rate for Payer: Cash Price |
$2,810.09
|
| Rate for Payer: Cigna All Commercial |
$3,911.46
|
| Rate for Payer: CORVEL All Commercial |
$4,215.13
|
| Rate for Payer: Coventry All Commercial |
$3,988.51
|
| Rate for Payer: Encore All Commercial |
$4,172.07
|
| Rate for Payer: Frontpath All Commercial |
$4,169.81
|
| Rate for Payer: Humana ChoiceCare |
$3,914.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,079.16
|
| Rate for Payer: PHCS All Commercial |
$3,399.30
|
| Rate for Payer: PHP All Commercial |
$3,437.37
|
| Rate for Payer: Sagamore Health Network All Products |
$3,499.01
|
| Rate for Payer: Signature Care EPO |
$3,761.89
|
| Rate for Payer: Signature Care PPO |
$3,988.51
|
| Rate for Payer: United Healthcare Commercial |
$3,571.53
|
|
|
HC W PLATE HOOK SHRT SM
|
Facility
OP
|
$4,532.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,215.13 |
| Rate for Payer: Aetna Commercial |
$3,825.35
|
| Rate for Payer: Aetna Medicare |
$1,495.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,495.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,602.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,833.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,720.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,645.26
|
| Rate for Payer: Cash Price |
$2,810.09
|
| Rate for Payer: Cash Price |
$2,810.09
|
| Rate for Payer: Centivo All Commercial |
$2,311.52
|
| Rate for Payer: Cigna All Commercial |
$3,911.46
|
| Rate for Payer: CORVEL All Commercial |
$4,215.13
|
| Rate for Payer: Coventry All Commercial |
$3,988.51
|
| Rate for Payer: Encore All Commercial |
$4,172.07
|
| Rate for Payer: Frontpath All Commercial |
$4,169.81
|
| Rate for Payer: Humana ChoiceCare |
$3,914.63
|
| Rate for Payer: Humana Medicare |
$2,311.52
|
| Rate for Payer: Lucent All Commercial |
$2,311.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,079.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,399.30
|
| Rate for Payer: PHP All Commercial |
$3,437.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,767.64
|
| Rate for Payer: Sagamore Health Network All Products |
$3,499.01
|
| Rate for Payer: Signature Care EPO |
$3,761.89
|
| Rate for Payer: Signature Care PPO |
$3,988.51
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,852.54
|
| Rate for Payer: United Healthcare Commercial |
$3,571.53
|
| Rate for Payer: United Healthcare Medicare |
$1,495.69
|
|
|
HC W PLATE LAPIDUS STD LT
|
Facility
OP
|
$7,120.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607098
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,622.34 |
| Rate for Payer: Aetna Commercial |
$6,009.96
|
| Rate for Payer: Aetna Medicare |
$2,349.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,349.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,089.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,451.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,702.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,584.85
|
| Rate for Payer: Cash Price |
$4,414.90
|
| Rate for Payer: Cash Price |
$4,414.90
|
| Rate for Payer: Centivo All Commercial |
$3,631.61
|
| Rate for Payer: Cigna All Commercial |
$6,145.25
|
| Rate for Payer: CORVEL All Commercial |
$6,622.34
|
| Rate for Payer: Coventry All Commercial |
$6,266.30
|
| Rate for Payer: Encore All Commercial |
$6,554.70
|
| Rate for Payer: Frontpath All Commercial |
$6,551.14
|
| Rate for Payer: Humana ChoiceCare |
$6,150.23
|
| Rate for Payer: Humana Medicare |
$3,631.61
|
| Rate for Payer: Lucent All Commercial |
$3,631.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,408.72
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,340.60
|
| Rate for Payer: PHP All Commercial |
$5,400.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,777.11
|
| Rate for Payer: Sagamore Health Network All Products |
$5,497.26
|
| Rate for Payer: Signature Care EPO |
$5,910.26
|
| Rate for Payer: Signature Care PPO |
$6,266.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,052.68
|
| Rate for Payer: United Healthcare Commercial |
$5,611.19
|
| Rate for Payer: United Healthcare Medicare |
$2,349.86
|
|
|
HC W PLATE LAPIDUS STD LT
|
Facility
IP
|
$7,120.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607098
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,340.60 |
| Max. Negotiated Rate |
$6,622.34 |
| Rate for Payer: Aetna Commercial |
$6,152.37
|
| Rate for Payer: Cash Price |
$4,414.90
|
| Rate for Payer: Cigna All Commercial |
$6,145.25
|
| Rate for Payer: CORVEL All Commercial |
$6,622.34
|
| Rate for Payer: Coventry All Commercial |
$6,266.30
|
| Rate for Payer: Encore All Commercial |
$6,554.70
|
| Rate for Payer: Frontpath All Commercial |
$6,551.14
|
| Rate for Payer: Humana ChoiceCare |
$6,150.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,408.72
|
| Rate for Payer: PHCS All Commercial |
$5,340.60
|
| Rate for Payer: PHP All Commercial |
$5,400.41
|
| Rate for Payer: Sagamore Health Network All Products |
$5,497.26
|
| Rate for Payer: Signature Care EPO |
$5,910.26
|
| Rate for Payer: Signature Care PPO |
$6,266.30
|
| Rate for Payer: United Healthcare Commercial |
$5,611.19
|
|
|
HC W PLATE LAPIDUS STD R
|
Facility
OP
|
$7,120.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,622.34 |
| Rate for Payer: Aetna Commercial |
$6,009.96
|
| Rate for Payer: Aetna Medicare |
$2,349.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,349.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,089.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,451.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,702.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,584.85
|
| Rate for Payer: Cash Price |
$4,414.90
|
| Rate for Payer: Cash Price |
$4,414.90
|
| Rate for Payer: Centivo All Commercial |
$3,631.61
|
| Rate for Payer: Cigna All Commercial |
$6,145.25
|
| Rate for Payer: CORVEL All Commercial |
$6,622.34
|
| Rate for Payer: Coventry All Commercial |
$6,266.30
|
| Rate for Payer: Encore All Commercial |
$6,554.70
|
| Rate for Payer: Frontpath All Commercial |
$6,551.14
|
| Rate for Payer: Humana ChoiceCare |
$6,150.23
|
| Rate for Payer: Humana Medicare |
$3,631.61
|
| Rate for Payer: Lucent All Commercial |
$3,631.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,408.72
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,340.60
|
| Rate for Payer: PHP All Commercial |
$5,400.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,777.11
|
| Rate for Payer: Sagamore Health Network All Products |
$5,497.26
|
| Rate for Payer: Signature Care EPO |
$5,910.26
|
| Rate for Payer: Signature Care PPO |
$6,266.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,052.68
|
| Rate for Payer: United Healthcare Commercial |
$5,611.19
|
| Rate for Payer: United Healthcare Medicare |
$2,349.86
|
|
|
HC W PLATE LAPIDUS STD R
|
Facility
IP
|
$7,120.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,340.60 |
| Max. Negotiated Rate |
$6,622.34 |
| Rate for Payer: Aetna Commercial |
$6,152.37
|
| Rate for Payer: Cash Price |
$4,414.90
|
| Rate for Payer: Cigna All Commercial |
$6,145.25
|
| Rate for Payer: CORVEL All Commercial |
$6,622.34
|
| Rate for Payer: Coventry All Commercial |
$6,266.30
|
| Rate for Payer: Encore All Commercial |
$6,554.70
|
| Rate for Payer: Frontpath All Commercial |
$6,551.14
|
| Rate for Payer: Humana ChoiceCare |
$6,150.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,408.72
|
| Rate for Payer: PHCS All Commercial |
$5,340.60
|
| Rate for Payer: PHP All Commercial |
$5,400.41
|
| Rate for Payer: Sagamore Health Network All Products |
$5,497.26
|
| Rate for Payer: Signature Care EPO |
$5,910.26
|
| Rate for Payer: Signature Care PPO |
$6,266.30
|
| Rate for Payer: United Healthcare Commercial |
$5,611.19
|
|
|
HC W PLATE L MET
|
Facility
OP
|
$2,347.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605099
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,182.90 |
| Rate for Payer: Aetna Commercial |
$1,981.04
|
| Rate for Payer: Aetna Medicare |
$774.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$774.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,348.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,467.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$890.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$852.03
|
| Rate for Payer: Cash Price |
$1,455.26
|
| Rate for Payer: Cash Price |
$1,455.26
|
| Rate for Payer: Centivo All Commercial |
$1,197.07
|
| Rate for Payer: Cigna All Commercial |
$2,025.63
|
| Rate for Payer: CORVEL All Commercial |
$2,182.90
|
| Rate for Payer: Coventry All Commercial |
$2,065.54
|
| Rate for Payer: Encore All Commercial |
$2,160.60
|
| Rate for Payer: Frontpath All Commercial |
$2,159.42
|
| Rate for Payer: Humana ChoiceCare |
$2,027.28
|
| Rate for Payer: Humana Medicare |
$1,197.07
|
| Rate for Payer: Lucent All Commercial |
$1,197.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,112.48
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,760.40
|
| Rate for Payer: PHP All Commercial |
$1,780.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$915.41
|
| Rate for Payer: Sagamore Health Network All Products |
$1,812.04
|
| Rate for Payer: Signature Care EPO |
$1,948.18
|
| Rate for Payer: Signature Care PPO |
$2,065.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,995.12
|
| Rate for Payer: United Healthcare Commercial |
$1,849.59
|
| Rate for Payer: United Healthcare Medicare |
$774.58
|
|
|
HC W PLATE L MET
|
Facility
IP
|
$2,347.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605099
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,760.40 |
| Max. Negotiated Rate |
$2,182.90 |
| Rate for Payer: Aetna Commercial |
$2,027.98
|
| Rate for Payer: Cash Price |
$1,455.26
|
| Rate for Payer: Cigna All Commercial |
$2,025.63
|
| Rate for Payer: CORVEL All Commercial |
$2,182.90
|
| Rate for Payer: Coventry All Commercial |
$2,065.54
|
| Rate for Payer: Encore All Commercial |
$2,160.60
|
| Rate for Payer: Frontpath All Commercial |
$2,159.42
|
| Rate for Payer: Humana ChoiceCare |
$2,027.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,112.48
|
| Rate for Payer: PHCS All Commercial |
$1,760.40
|
| Rate for Payer: PHP All Commercial |
$1,780.12
|
| Rate for Payer: Sagamore Health Network All Products |
$1,812.04
|
| Rate for Payer: Signature Care EPO |
$1,948.18
|
| Rate for Payer: Signature Care PPO |
$2,065.54
|
| Rate for Payer: United Healthcare Commercial |
$1,849.59
|
|
|
HC W PLATE LT FIB LRG L
|
Facility
IP
|
$5,450.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604986
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,087.80 |
| Max. Negotiated Rate |
$5,068.87 |
| Rate for Payer: Aetna Commercial |
$4,709.15
|
| Rate for Payer: Cash Price |
$3,379.25
|
| Rate for Payer: Cigna All Commercial |
$4,703.70
|
| Rate for Payer: CORVEL All Commercial |
$5,068.87
|
| Rate for Payer: Coventry All Commercial |
$4,796.35
|
| Rate for Payer: Encore All Commercial |
$5,017.09
|
| Rate for Payer: Frontpath All Commercial |
$5,014.37
|
| Rate for Payer: Humana ChoiceCare |
$4,707.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,905.36
|
| Rate for Payer: PHCS All Commercial |
$4,087.80
|
| Rate for Payer: PHP All Commercial |
$4,133.58
|
| Rate for Payer: Sagamore Health Network All Products |
$4,207.71
|
| Rate for Payer: Signature Care EPO |
$4,523.83
|
| Rate for Payer: Signature Care PPO |
$4,796.35
|
| Rate for Payer: United Healthcare Commercial |
$4,294.92
|
|
