|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Professional
|
Both
|
$360.18
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
z43246
|
| Min. Negotiated Rate |
$179.95 |
| Max. Negotiated Rate |
$25,800.00 |
| Rate for Payer: Aetna Commercial |
$187.32
|
| Rate for Payer: Aetna Commercial |
$187.32
|
| Rate for Payer: Aetna Medicare |
$187.32
|
| Rate for Payer: Aetna Medicare |
$187.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$373.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$373.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$373.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$373.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$373.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$373.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$373.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$373.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$179.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$179.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$215.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$215.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$206.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$206.05
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cash Price |
$226.83
|
| Rate for Payer: Centivo All Commercial |
$290.35
|
| Rate for Payer: Centivo All Commercial |
$290.35
|
| Rate for Payer: Cigna All Commercial |
$187.32
|
| Rate for Payer: Cigna All Commercial |
$187.32
|
| Rate for Payer: CORVEL All Commercial |
$187.32
|
| Rate for Payer: CORVEL All Commercial |
$187.32
|
| Rate for Payer: Coventry All Commercial |
$224.78
|
| Rate for Payer: Coventry All Commercial |
$224.78
|
| Rate for Payer: Encore All Commercial |
$187.32
|
| Rate for Payer: Encore All Commercial |
$187.32
|
| Rate for Payer: Frontpath All Commercial |
$259.27
|
| Rate for Payer: Frontpath All Commercial |
$259.27
|
| Rate for Payer: Humana ChoiceCare |
$272.15
|
| Rate for Payer: Humana ChoiceCare |
$272.15
|
| Rate for Payer: Humana Medicare |
$187.32
|
| Rate for Payer: Humana Medicare |
$187.32
|
| Rate for Payer: Lucent All Commercial |
$262.25
|
| Rate for Payer: Lucent All Commercial |
$262.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$277.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$277.00
|
| Rate for Payer: Managed Health Services Medicaid |
$179.95
|
| Rate for Payer: Managed Health Services Medicaid |
$179.95
|
| Rate for Payer: MDWise Medicaid |
$179.95
|
| Rate for Payer: MDWise Medicaid |
$179.95
|
| Rate for Payer: PHCS All Commercial |
$187.32
|
| Rate for Payer: PHCS All Commercial |
$187.32
|
| Rate for Payer: PHP All Commercial |
$315.15
|
| Rate for Payer: PHP All Commercial |
$315.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$187.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$187.32
|
| Rate for Payer: Sagamore Health Network All Products |
$187.32
|
| Rate for Payer: Sagamore Health Network All Products |
$187.32
|
| Rate for Payer: Signature Care EPO |
$318.44
|
| Rate for Payer: Signature Care EPO |
$318.44
|
| Rate for Payer: Signature Care PPO |
$318.44
|
| Rate for Payer: Signature Care PPO |
$318.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,800.00
|
| Rate for Payer: United Healthcare Commercial |
$289.20
|
| Rate for Payer: United Healthcare Commercial |
$289.20
|
| Rate for Payer: United Healthcare Medicare |
$180.09
|
| Rate for Payer: United Healthcare Medicare |
$180.09
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$913.64
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
z43251
|
| Min. Negotiated Rate |
$184.45 |
| Max. Negotiated Rate |
$25,400.00 |
| Rate for Payer: Aetna Commercial |
$184.45
|
| Rate for Payer: Aetna Commercial |
$184.45
|
| Rate for Payer: Aetna Medicare |
$184.45
|
| Rate for Payer: Aetna Medicare |
$184.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$318.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$318.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$318.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$318.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$187.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$187.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$449.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$449.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$202.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$202.90
|
| Rate for Payer: Cash Price |
$562.36
|
| Rate for Payer: Cash Price |
$566.46
|
| Rate for Payer: Centivo All Commercial |
$285.90
|
| Rate for Payer: Centivo All Commercial |
$285.90
|
| Rate for Payer: Cigna All Commercial |
$184.45
|
| Rate for Payer: Cigna All Commercial |
$184.45
|
| Rate for Payer: CORVEL All Commercial |
$184.45
|
| Rate for Payer: CORVEL All Commercial |
$184.45
|
| Rate for Payer: Coventry All Commercial |
$221.34
|
| Rate for Payer: Coventry All Commercial |
$221.34
|
| Rate for Payer: Encore All Commercial |
$184.45
|
| Rate for Payer: Encore All Commercial |
$184.45
|
| Rate for Payer: Frontpath All Commercial |
$252.19
|
| Rate for Payer: Frontpath All Commercial |
$252.19
|
| Rate for Payer: Humana ChoiceCare |
$233.95
|
| Rate for Payer: Humana ChoiceCare |
$233.95
|
| Rate for Payer: Humana Medicare |
$184.45
|
| Rate for Payer: Humana Medicare |
$184.45
|
| Rate for Payer: Lucent All Commercial |
$258.23
|
| Rate for Payer: Lucent All Commercial |
$258.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$273.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$273.00
|
| Rate for Payer: Managed Health Services Medicaid |
$449.37
|
| Rate for Payer: Managed Health Services Medicaid |
$449.37
|
| Rate for Payer: MDWise Medicaid |
$449.37
|
| Rate for Payer: MDWise Medicaid |
$449.37
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$187.34
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$187.34
|
| Rate for Payer: PHCS All Commercial |
$184.45
|
| Rate for Payer: PHCS All Commercial |
$184.45
|
| Rate for Payer: PHP All Commercial |
$310.34
|
| Rate for Payer: PHP All Commercial |
$310.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$184.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$184.45
|
| Rate for Payer: Sagamore Health Network All Products |
$184.45
|
| Rate for Payer: Sagamore Health Network All Products |
$184.45
|
| Rate for Payer: Signature Care EPO |
$410.41
|
| Rate for Payer: Signature Care EPO |
$410.41
|
| Rate for Payer: Signature Care PPO |
$410.41
|
| Rate for Payer: Signature Care PPO |
$410.41
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,400.00
|
| Rate for Payer: United Healthcare Commercial |
$251.16
|
| Rate for Payer: United Healthcare Commercial |
$251.16
|
| Rate for Payer: United Healthcare Medicare |
$453.52
|
| Rate for Payer: United Healthcare Medicare |
$453.52
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$696.08
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
z43239
|
| Min. Negotiated Rate |
$130.03 |
| Max. Negotiated Rate |
$18,000.00 |
| Rate for Payer: Aetna Commercial |
$130.03
|
| Rate for Payer: Aetna Commercial |
$130.03
|
| Rate for Payer: Aetna Medicare |
$130.03
|
| Rate for Payer: Aetna Medicare |
$130.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$338.24
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$139.81
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$139.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$342.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$342.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$149.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$149.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$143.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$143.03
|
| Rate for Payer: Cash Price |
$427.04
|
| Rate for Payer: Cash Price |
$431.57
|
| Rate for Payer: Centivo All Commercial |
$201.55
|
| Rate for Payer: Centivo All Commercial |
$201.55
|
| Rate for Payer: Cigna All Commercial |
$130.03
|
| Rate for Payer: Cigna All Commercial |
$130.03
|
| Rate for Payer: CORVEL All Commercial |
$130.03
|
| Rate for Payer: CORVEL All Commercial |
$130.03
|
| Rate for Payer: Coventry All Commercial |
$156.04
|
| Rate for Payer: Coventry All Commercial |
$156.04
|
| Rate for Payer: Encore All Commercial |
$130.03
|
| Rate for Payer: Encore All Commercial |
$130.03
|
| Rate for Payer: Frontpath All Commercial |
$177.49
|
| Rate for Payer: Frontpath All Commercial |
$177.49
|
| Rate for Payer: Humana ChoiceCare |
$183.45
|
| Rate for Payer: Humana ChoiceCare |
$183.45
|
| Rate for Payer: Humana Medicare |
$130.03
|
| Rate for Payer: Humana Medicare |
$130.03
|
| Rate for Payer: Lucent All Commercial |
$182.04
|
| Rate for Payer: Lucent All Commercial |
$182.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$192.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$192.00
|
| Rate for Payer: Managed Health Services Medicaid |
$342.36
|
| Rate for Payer: Managed Health Services Medicaid |
$342.36
|
| Rate for Payer: MDWise Medicaid |
$342.36
|
| Rate for Payer: MDWise Medicaid |
$342.36
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$139.81
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$139.81
|
| Rate for Payer: PHCS All Commercial |
$130.03
|
| Rate for Payer: PHCS All Commercial |
$130.03
|
| Rate for Payer: PHP All Commercial |
$218.98
|
| Rate for Payer: PHP All Commercial |
$218.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$130.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$130.03
|
| Rate for Payer: Sagamore Health Network All Products |
$130.03
|
| Rate for Payer: Sagamore Health Network All Products |
$130.03
|
| Rate for Payer: Signature Care EPO |
$462.40
|
| Rate for Payer: Signature Care EPO |
$462.40
|
| Rate for Payer: Signature Care PPO |
$462.40
|
| Rate for Payer: Signature Care PPO |
$462.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,000.00
|
| Rate for Payer: United Healthcare Commercial |
$197.41
|
| Rate for Payer: United Healthcare Commercial |
$197.41
|
| Rate for Payer: United Healthcare Medicare |
$344.39
|
| Rate for Payer: United Healthcare Medicare |
$344.39
|
|
|
PR EGD TRANSORAL CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,153.18
|
|
|
Service Code
|
CPT 43255
|
| Hospital Charge Code |
z43255
|
| Min. Negotiated Rate |
$189.12 |
| Max. Negotiated Rate |
$26,000.00 |
| Rate for Payer: Aetna Commercial |
$189.12
|
| Rate for Payer: Aetna Commercial |
$189.12
|
| Rate for Payer: Aetna Medicare |
$189.12
|
| Rate for Payer: Aetna Medicare |
$189.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$377.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$377.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$377.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$377.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$377.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$377.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$377.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$377.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$196.25
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$196.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$567.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$567.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$217.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$217.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$208.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$208.03
|
| Rate for Payer: Cash Price |
$711.14
|
| Rate for Payer: Cash Price |
$714.97
|
| Rate for Payer: Centivo All Commercial |
$293.14
|
| Rate for Payer: Centivo All Commercial |
$293.14
|
| Rate for Payer: Cigna All Commercial |
$189.12
|
| Rate for Payer: Cigna All Commercial |
$189.12
|
| Rate for Payer: CORVEL All Commercial |
$189.12
|
| Rate for Payer: CORVEL All Commercial |
$189.12
|
| Rate for Payer: Coventry All Commercial |
$226.94
|
| Rate for Payer: Coventry All Commercial |
$226.94
|
| Rate for Payer: Encore All Commercial |
$189.12
|
| Rate for Payer: Encore All Commercial |
$189.12
|
| Rate for Payer: Frontpath All Commercial |
$258.30
|
| Rate for Payer: Frontpath All Commercial |
$258.30
|
| Rate for Payer: Humana ChoiceCare |
$302.79
|
| Rate for Payer: Humana ChoiceCare |
$302.79
|
| Rate for Payer: Humana Medicare |
$189.12
|
| Rate for Payer: Humana Medicare |
$189.12
|
| Rate for Payer: Lucent All Commercial |
$264.77
|
| Rate for Payer: Lucent All Commercial |
$264.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$279.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$279.00
|
| Rate for Payer: Managed Health Services Medicaid |
$567.18
|
| Rate for Payer: Managed Health Services Medicaid |
$567.18
|
| Rate for Payer: MDWise Medicaid |
$567.18
|
| Rate for Payer: MDWise Medicaid |
$567.18
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$196.25
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$196.25
|
| Rate for Payer: PHCS All Commercial |
$189.12
|
| Rate for Payer: PHCS All Commercial |
$189.12
|
| Rate for Payer: PHP All Commercial |
$317.38
|
| Rate for Payer: PHP All Commercial |
$317.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$189.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$189.12
|
| Rate for Payer: Sagamore Health Network All Products |
$189.12
|
| Rate for Payer: Sagamore Health Network All Products |
$189.12
|
| Rate for Payer: Signature Care EPO |
$521.06
|
| Rate for Payer: Signature Care EPO |
$521.06
|
| Rate for Payer: Signature Care PPO |
$521.06
|
| Rate for Payer: Signature Care PPO |
$521.06
|
| 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 |
$326.88
|
| Rate for Payer: United Healthcare Commercial |
$326.88
|
| Rate for Payer: United Healthcare Medicare |
$573.50
|
| Rate for Payer: United Healthcare Medicare |
$573.50
|
|
|
PR ELBOW ARTHROSCOP,FULL SYNOVECT
|
Professional
|
Both
|
$1,087.60
|
|
|
Service Code
|
CPT 29836
|
| Hospital Charge Code |
z29836
|
| Min. Negotiated Rate |
$533.57 |
| Max. Negotiated Rate |
$82,000.00 |
| Rate for Payer: Aetna Commercial |
$546.85
|
| Rate for Payer: Aetna Commercial |
$546.85
|
| Rate for Payer: Aetna Medicare |
$546.85
|
| Rate for Payer: Aetna Medicare |
$546.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$724.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$724.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$724.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$724.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$724.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$724.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$724.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$724.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$534.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$534.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$628.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$628.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$601.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$601.53
|
| Rate for Payer: Cash Price |
$674.31
|
| Rate for Payer: Cash Price |
$661.63
|
| Rate for Payer: Centivo All Commercial |
$847.62
|
| Rate for Payer: Centivo All Commercial |
$847.62
|
| Rate for Payer: Cigna All Commercial |
$546.85
|
| Rate for Payer: Cigna All Commercial |
$546.85
|
| Rate for Payer: CORVEL All Commercial |
$546.85
|
| Rate for Payer: CORVEL All Commercial |
$546.85
|
| Rate for Payer: Coventry All Commercial |
$656.22
|
| Rate for Payer: Coventry All Commercial |
$656.22
|
| Rate for Payer: Encore All Commercial |
$546.85
|
| Rate for Payer: Encore All Commercial |
$546.85
|
| Rate for Payer: Frontpath All Commercial |
$758.43
|
| Rate for Payer: Frontpath All Commercial |
$758.43
|
| Rate for Payer: Humana ChoiceCare |
$621.77
|
| Rate for Payer: Humana ChoiceCare |
$621.77
|
| Rate for Payer: Humana Medicare |
$546.85
|
| Rate for Payer: Humana Medicare |
$546.85
|
| Rate for Payer: Lucent All Commercial |
$765.59
|
| Rate for Payer: Lucent All Commercial |
$765.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$875.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$875.00
|
| Rate for Payer: Managed Health Services Medicaid |
$534.92
|
| Rate for Payer: Managed Health Services Medicaid |
$534.92
|
| Rate for Payer: MDWise Medicaid |
$534.92
|
| Rate for Payer: MDWise Medicaid |
$534.92
|
| Rate for Payer: PHCS All Commercial |
$546.85
|
| Rate for Payer: PHCS All Commercial |
$546.85
|
| Rate for Payer: PHP All Commercial |
$928.42
|
| Rate for Payer: PHP All Commercial |
$928.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$546.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$546.85
|
| Rate for Payer: Sagamore Health Network All Products |
$546.85
|
| Rate for Payer: Sagamore Health Network All Products |
$546.85
|
| Rate for Payer: Signature Care EPO |
$828.75
|
| Rate for Payer: Signature Care EPO |
$828.75
|
| Rate for Payer: Signature Care PPO |
$828.75
|
| Rate for Payer: Signature Care PPO |
$828.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$82,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$82,000.00
|
| Rate for Payer: United Healthcare Commercial |
$626.00
|
| Rate for Payer: United Healthcare Commercial |
$626.00
|
| Rate for Payer: United Healthcare Medicare |
$533.57
|
| Rate for Payer: United Healthcare Medicare |
$533.57
|
|
|
PR ELECTROCARDIOGRAM, COMPLETE
|
Professional
|
Both
|
$26.70
|
|
|
Service Code
|
CPT 93000
|
| Hospital Charge Code |
z93000
|
| Min. Negotiated Rate |
$13.13 |
| Max. Negotiated Rate |
$2,000.00 |
| Rate for Payer: Aetna Commercial |
$13.37
|
| Rate for Payer: Aetna Commercial |
$13.37
|
| Rate for Payer: Aetna Medicare |
$13.37
|
| Rate for Payer: Aetna Medicare |
$13.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$24.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$24.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$24.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$24.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$24.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$24.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$15.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$15.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$14.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$14.71
|
| Rate for Payer: Cash Price |
$16.55
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Centivo All Commercial |
$20.72
|
| Rate for Payer: Centivo All Commercial |
$20.72
|
| Rate for Payer: Cigna All Commercial |
$13.37
|
| Rate for Payer: Cigna All Commercial |
$13.37
|
| Rate for Payer: CORVEL All Commercial |
$13.37
|
| Rate for Payer: CORVEL All Commercial |
$13.37
|
| Rate for Payer: Coventry All Commercial |
$16.04
|
| Rate for Payer: Coventry All Commercial |
$16.04
|
| Rate for Payer: Encore All Commercial |
$13.37
|
| Rate for Payer: Encore All Commercial |
$13.37
|
| Rate for Payer: Frontpath All Commercial |
$15.30
|
| Rate for Payer: Frontpath All Commercial |
$15.30
|
| Rate for Payer: Humana ChoiceCare |
$33.23
|
| Rate for Payer: Humana ChoiceCare |
$33.23
|
| Rate for Payer: Humana Medicare |
$13.37
|
| Rate for Payer: Humana Medicare |
$13.37
|
| Rate for Payer: Lucent All Commercial |
$18.72
|
| Rate for Payer: Lucent All Commercial |
$18.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$22.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$22.00
|
| Rate for Payer: Managed Health Services Medicaid |
$13.13
|
| Rate for Payer: Managed Health Services Medicaid |
$13.13
|
| Rate for Payer: MDWise Medicaid |
$13.13
|
| Rate for Payer: MDWise Medicaid |
$13.13
|
| Rate for Payer: PHCS All Commercial |
$13.37
|
| Rate for Payer: PHCS All Commercial |
$13.37
|
| Rate for Payer: PHP All Commercial |
$19.35
|
| Rate for Payer: PHP All Commercial |
$19.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.37
|
| Rate for Payer: Sagamore Health Network All Products |
$13.37
|
| Rate for Payer: Sagamore Health Network All Products |
$13.37
|
| Rate for Payer: Signature Care EPO |
$22.73
|
| Rate for Payer: Signature Care EPO |
$22.73
|
| Rate for Payer: Signature Care PPO |
$22.73
|
| Rate for Payer: Signature Care PPO |
$22.73
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,000.00
|
| Rate for Payer: United Healthcare Commercial |
$24.20
|
| Rate for Payer: United Healthcare Commercial |
$24.20
|
| Rate for Payer: United Healthcare Medicare |
$13.16
|
| Rate for Payer: United Healthcare Medicare |
$13.16
|
|
|
PR ELECTROCARDIOGRAM REPORT
|
Professional
|
Both
|
$15.32
|
|
|
Service Code
|
CPT 93010
|
| Hospital Charge Code |
z93010
|
| Min. Negotiated Rate |
$7.54 |
| Max. Negotiated Rate |
$1,200.00 |
| Rate for Payer: Aetna Commercial |
$7.91
|
| Rate for Payer: Aetna Commercial |
$7.91
|
| Rate for Payer: Aetna Medicare |
$7.91
|
| Rate for Payer: Aetna Medicare |
$7.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$8.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$8.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$7.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$7.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$8.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$8.70
|
| Rate for Payer: Cash Price |
$9.50
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Centivo All Commercial |
$12.26
|
| Rate for Payer: Centivo All Commercial |
$12.26
|
| Rate for Payer: Cigna All Commercial |
$7.91
|
| Rate for Payer: Cigna All Commercial |
$7.91
|
| Rate for Payer: CORVEL All Commercial |
$7.91
|
| Rate for Payer: CORVEL All Commercial |
$7.91
|
| Rate for Payer: Coventry All Commercial |
$9.49
|
| Rate for Payer: Coventry All Commercial |
$9.49
|
| Rate for Payer: Encore All Commercial |
$7.91
|
| Rate for Payer: Encore All Commercial |
$7.91
|
| Rate for Payer: Frontpath All Commercial |
$8.98
|
| Rate for Payer: Frontpath All Commercial |
$8.98
|
| Rate for Payer: Humana ChoiceCare |
$11.78
|
| Rate for Payer: Humana ChoiceCare |
$11.78
|
| Rate for Payer: Humana Medicare |
$7.91
|
| Rate for Payer: Humana Medicare |
$7.91
|
| Rate for Payer: Lucent All Commercial |
$11.07
|
| Rate for Payer: Lucent All Commercial |
$11.07
|
| 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 |
$7.54
|
| Rate for Payer: Managed Health Services Medicaid |
$7.54
|
| Rate for Payer: MDWise Medicaid |
$7.54
|
| Rate for Payer: MDWise Medicaid |
$7.54
|
| Rate for Payer: PHCS All Commercial |
$7.91
|
| Rate for Payer: PHCS All Commercial |
$7.91
|
| Rate for Payer: PHP All Commercial |
$11.15
|
| Rate for Payer: PHP All Commercial |
$11.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.91
|
| Rate for Payer: Sagamore Health Network All Products |
$7.91
|
| Rate for Payer: Sagamore Health Network All Products |
$7.91
|
| Rate for Payer: Signature Care EPO |
$13.45
|
| Rate for Payer: Signature Care EPO |
$13.45
|
| Rate for Payer: Signature Care PPO |
$13.45
|
| Rate for Payer: Signature Care PPO |
$13.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,200.00
|
| Rate for Payer: United Healthcare Commercial |
$10.84
|
| Rate for Payer: United Healthcare Commercial |
$10.84
|
| Rate for Payer: United Healthcare Medicare |
$7.58
|
| Rate for Payer: United Healthcare Medicare |
$7.58
|
|
|
PR ELECTROCARDIOGRAM, TRACING
|
Professional
|
Both
|
$11.38
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
z93005
|
| Min. Negotiated Rate |
$5.46 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Commercial |
$5.46
|
| Rate for Payer: Aetna Commercial |
$5.46
|
| Rate for Payer: Aetna Medicare |
$5.46
|
| Rate for Payer: Aetna Medicare |
$5.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6.01
|
| Rate for Payer: Cash Price |
$7.06
|
| Rate for Payer: Cash Price |
$6.92
|
| Rate for Payer: Centivo All Commercial |
$8.46
|
| Rate for Payer: Centivo All Commercial |
$8.46
|
| Rate for Payer: Cigna All Commercial |
$5.46
|
| Rate for Payer: Cigna All Commercial |
$5.46
|
| Rate for Payer: CORVEL All Commercial |
$5.46
|
| Rate for Payer: CORVEL All Commercial |
$5.46
|
| Rate for Payer: Coventry All Commercial |
$6.55
|
| Rate for Payer: Coventry All Commercial |
$6.55
|
| Rate for Payer: Encore All Commercial |
$5.46
|
| Rate for Payer: Encore All Commercial |
$5.46
|
| Rate for Payer: Frontpath All Commercial |
$6.32
|
| Rate for Payer: Frontpath All Commercial |
$6.32
|
| Rate for Payer: Humana ChoiceCare |
$21.45
|
| Rate for Payer: Humana ChoiceCare |
$21.45
|
| Rate for Payer: Humana Medicare |
$5.46
|
| Rate for Payer: Humana Medicare |
$5.46
|
| Rate for Payer: Lucent All Commercial |
$7.64
|
| Rate for Payer: Lucent All Commercial |
$7.64
|
| Rate for Payer: Managed Health Services Medicaid |
$5.59
|
| Rate for Payer: Managed Health Services Medicaid |
$5.59
|
| Rate for Payer: MDWise Medicaid |
$5.59
|
| Rate for Payer: MDWise Medicaid |
$5.59
|
| Rate for Payer: PHCS All Commercial |
$5.46
|
| Rate for Payer: PHCS All Commercial |
$5.46
|
| Rate for Payer: PHP All Commercial |
$8.20
|
| Rate for Payer: PHP All Commercial |
$8.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5.46
|
| Rate for Payer: Sagamore Health Network All Products |
$5.46
|
| Rate for Payer: Sagamore Health Network All Products |
$5.46
|
| Rate for Payer: Signature Care EPO |
$9.28
|
| Rate for Payer: Signature Care EPO |
$9.28
|
| Rate for Payer: Signature Care PPO |
$9.28
|
| Rate for Payer: Signature Care PPO |
$9.28
|
| Rate for Payer: United Healthcare Commercial |
$13.38
|
| Rate for Payer: United Healthcare Commercial |
$13.38
|
| Rate for Payer: United Healthcare Medicare |
$5.58
|
| Rate for Payer: United Healthcare Medicare |
$5.58
|
|
|
PR ELECTROCONVULSIVE THERAPY,1 SEIZ
|
Professional
|
Both
|
$328.04
|
|
|
Service Code
|
CPT 90870
|
| Hospital Charge Code |
z90870
|
| Min. Negotiated Rate |
$53.64 |
| Max. Negotiated Rate |
$12,200.00 |
| Rate for Payer: Aetna Commercial |
$103.85
|
| Rate for Payer: Aetna Commercial |
$103.85
|
| Rate for Payer: Aetna Medicare |
$103.85
|
| Rate for Payer: Aetna Medicare |
$103.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$168.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$168.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$168.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$168.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$168.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$168.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.95
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$53.64
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$53.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$161.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$161.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$119.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$119.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$114.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$114.23
|
| Rate for Payer: Cash Price |
$198.18
|
| Rate for Payer: Cash Price |
$203.38
|
| Rate for Payer: Centivo All Commercial |
$160.97
|
| Rate for Payer: Centivo All Commercial |
$160.97
|
| Rate for Payer: Cigna All Commercial |
$103.85
|
| Rate for Payer: Cigna All Commercial |
$103.85
|
| Rate for Payer: CORVEL All Commercial |
$103.85
|
| Rate for Payer: CORVEL All Commercial |
$103.85
|
| Rate for Payer: Coventry All Commercial |
$124.62
|
| Rate for Payer: Coventry All Commercial |
$124.62
|
| Rate for Payer: Encore All Commercial |
$103.85
|
| Rate for Payer: Encore All Commercial |
$103.85
|
| Rate for Payer: Frontpath All Commercial |
$116.64
|
| Rate for Payer: Frontpath All Commercial |
$116.64
|
| Rate for Payer: Humana ChoiceCare |
$74.66
|
| Rate for Payer: Humana ChoiceCare |
$74.66
|
| Rate for Payer: Humana Medicare |
$103.85
|
| Rate for Payer: Humana Medicare |
$103.85
|
| Rate for Payer: Lucent All Commercial |
$145.39
|
| Rate for Payer: Lucent All Commercial |
$145.39
|
| 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 |
$161.34
|
| Rate for Payer: Managed Health Services Medicaid |
$161.34
|
| Rate for Payer: MDWise Medicaid |
$161.34
|
| Rate for Payer: MDWise Medicaid |
$161.34
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$53.64
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$53.64
|
| Rate for Payer: PHCS All Commercial |
$103.85
|
| Rate for Payer: PHCS All Commercial |
$103.85
|
| Rate for Payer: PHP All Commercial |
$108.54
|
| Rate for Payer: PHP All Commercial |
$108.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$103.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$103.85
|
| Rate for Payer: Sagamore Health Network All Products |
$103.85
|
| Rate for Payer: Sagamore Health Network All Products |
$103.85
|
| Rate for Payer: Signature Care EPO |
$144.84
|
| Rate for Payer: Signature Care EPO |
$144.84
|
| Rate for Payer: Signature Care PPO |
$144.84
|
| Rate for Payer: Signature Care PPO |
$144.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,200.00
|
| Rate for Payer: United Healthcare Commercial |
$104.05
|
| Rate for Payer: United Healthcare Commercial |
$104.05
|
| Rate for Payer: United Healthcare Medicare |
$159.82
|
| Rate for Payer: United Healthcare Medicare |
$159.82
|
|
|
PR ELECTRODESSICATN,ANAL LESN(S)
|
Professional
|
Both
|
$489.82
|
|
|
Service Code
|
CPT 46910
|
| Hospital Charge Code |
z46910
|
| Min. Negotiated Rate |
$104.73 |
| Max. Negotiated Rate |
$17,600.00 |
| Rate for Payer: Aetna Commercial |
$126.53
|
| Rate for Payer: Aetna Commercial |
$126.53
|
| Rate for Payer: Aetna Medicare |
$126.53
|
| Rate for Payer: Aetna Medicare |
$126.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$192.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$192.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$192.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$192.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$192.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$192.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$192.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$192.76
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$104.73
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$104.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$240.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$240.91
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$145.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$145.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$139.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$139.18
|
| Rate for Payer: Cash Price |
$297.39
|
| Rate for Payer: Cash Price |
$303.69
|
| Rate for Payer: Centivo All Commercial |
$196.12
|
| Rate for Payer: Centivo All Commercial |
$196.12
|
| Rate for Payer: Cigna All Commercial |
$126.53
|
| Rate for Payer: Cigna All Commercial |
$126.53
|
| Rate for Payer: CORVEL All Commercial |
$126.53
|
| Rate for Payer: CORVEL All Commercial |
$126.53
|
| Rate for Payer: Coventry All Commercial |
$151.84
|
| Rate for Payer: Coventry All Commercial |
$151.84
|
| Rate for Payer: Encore All Commercial |
$126.53
|
| Rate for Payer: Encore All Commercial |
$126.53
|
| Rate for Payer: Frontpath All Commercial |
$174.29
|
| Rate for Payer: Frontpath All Commercial |
$174.29
|
| Rate for Payer: Humana ChoiceCare |
$131.69
|
| Rate for Payer: Humana ChoiceCare |
$131.69
|
| Rate for Payer: Humana Medicare |
$126.53
|
| Rate for Payer: Humana Medicare |
$126.53
|
| Rate for Payer: Lucent All Commercial |
$177.14
|
| Rate for Payer: Lucent All Commercial |
$177.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$188.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$188.00
|
| Rate for Payer: Managed Health Services Medicaid |
$240.91
|
| Rate for Payer: Managed Health Services Medicaid |
$240.91
|
| Rate for Payer: MDWise Medicaid |
$240.91
|
| Rate for Payer: MDWise Medicaid |
$240.91
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$104.73
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$104.73
|
| Rate for Payer: PHCS All Commercial |
$126.53
|
| Rate for Payer: PHCS All Commercial |
$126.53
|
| Rate for Payer: PHP All Commercial |
$214.15
|
| Rate for Payer: PHP All Commercial |
$214.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$126.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$126.53
|
| Rate for Payer: Sagamore Health Network All Products |
$126.53
|
| Rate for Payer: Sagamore Health Network All Products |
$126.53
|
| Rate for Payer: Signature Care EPO |
$251.60
|
| Rate for Payer: Signature Care EPO |
$251.60
|
| Rate for Payer: Signature Care PPO |
$251.60
|
| Rate for Payer: Signature Care PPO |
$251.60
|
| 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 |
$139.55
|
| Rate for Payer: United Healthcare Commercial |
$139.55
|
| Rate for Payer: United Healthcare Medicare |
$239.83
|
| Rate for Payer: United Healthcare Medicare |
$239.83
|
|
|
PR ELECTRO HEARINGAID TEST, BOTH
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
CPT 92595
|
| Hospital Charge Code |
z92595
|
| Min. Negotiated Rate |
$32.82 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$40.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$40.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$40.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$40.00
|
| Rate for Payer: Cash Price |
$62.00
|
| Rate for Payer: Cash Price |
$62.00
|
| Rate for Payer: Frontpath All Commercial |
$47.23
|
| Rate for Payer: Humana ChoiceCare |
$32.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$85.00
|
| Rate for Payer: Signature Care EPO |
$51.00
|
| Rate for Payer: Signature Care PPO |
$51.00
|
| Rate for Payer: United Healthcare Commercial |
$44.66
|
|
|
PR ELECTRO HEARING AID TEST, ONE
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
CPT 92594
|
| Hospital Charge Code |
z92594
|
| Min. Negotiated Rate |
$20.63 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$30.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$30.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$30.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$30.00
|
| Rate for Payer: Cash Price |
$31.00
|
| Rate for Payer: Cash Price |
$31.00
|
| Rate for Payer: Frontpath All Commercial |
$21.66
|
| Rate for Payer: Humana ChoiceCare |
$22.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.50
|
| Rate for Payer: Signature Care EPO |
$34.00
|
| Rate for Payer: Signature Care PPO |
$34.00
|
| Rate for Payer: United Healthcare Commercial |
$20.63
|
|
|
PR EMERGENCY DEPARTMENT VISIT HIGH MDM
|
Professional
|
Both
|
$327.74
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
z99285
|
| Min. Negotiated Rate |
$161.20 |
| Max. Negotiated Rate |
$288.75 |
| Rate for Payer: Aetna Commercial |
$168.54
|
| Rate for Payer: Aetna Commercial |
$168.54
|
| Rate for Payer: Aetna Medicare |
$168.54
|
| Rate for Payer: Aetna Medicare |
$168.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$237.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$237.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$237.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$237.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$237.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$237.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$237.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$237.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$161.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$161.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$193.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$193.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$185.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$185.39
|
| Rate for Payer: Cash Price |
$201.66
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$201.66
|
| Rate for Payer: Centivo All Commercial |
$261.24
|
| Rate for Payer: Centivo All Commercial |
$261.24
|
| Rate for Payer: Cigna All Commercial |
$168.54
|
| Rate for Payer: Cigna All Commercial |
$168.54
|
| Rate for Payer: CORVEL All Commercial |
$168.54
|
| Rate for Payer: CORVEL All Commercial |
$168.54
|
| Rate for Payer: Coventry All Commercial |
$202.25
|
| Rate for Payer: Coventry All Commercial |
$202.25
|
| Rate for Payer: Encore All Commercial |
$168.54
|
| Rate for Payer: Encore All Commercial |
$168.54
|
| Rate for Payer: Frontpath All Commercial |
$288.75
|
| Rate for Payer: Frontpath All Commercial |
$288.75
|
| Rate for Payer: Humana ChoiceCare |
$192.17
|
| Rate for Payer: Humana ChoiceCare |
$192.17
|
| Rate for Payer: Humana Medicare |
$168.54
|
| Rate for Payer: Humana Medicare |
$168.54
|
| Rate for Payer: Lucent All Commercial |
$235.96
|
| Rate for Payer: Lucent All Commercial |
$235.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$278.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$276.47
|
| Rate for Payer: Managed Health Services Medicaid |
$161.20
|
| Rate for Payer: Managed Health Services Medicaid |
$161.20
|
| Rate for Payer: MDWise Medicaid |
$161.20
|
| Rate for Payer: MDWise Medicaid |
$161.20
|
| Rate for Payer: PHCS All Commercial |
$168.54
|
| Rate for Payer: PHCS All Commercial |
$168.54
|
| Rate for Payer: PHP All Commercial |
$167.51
|
| Rate for Payer: PHP All Commercial |
$167.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$168.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$168.54
|
| Rate for Payer: Sagamore Health Network All Products |
$168.54
|
| Rate for Payer: Sagamore Health Network All Products |
$168.54
|
| Rate for Payer: Signature Care EPO |
$267.75
|
| Rate for Payer: Signature Care EPO |
$267.75
|
| Rate for Payer: Signature Care PPO |
$267.75
|
| Rate for Payer: Signature Care PPO |
$267.75
|
| Rate for Payer: United Healthcare Commercial |
$255.55
|
| Rate for Payer: United Healthcare Commercial |
$255.55
|
| Rate for Payer: United Healthcare Medicare |
$162.63
|
| Rate for Payer: United Healthcare Medicare |
$162.63
|
|
|
PR EMERGENCY DEPARTMENT VISIT LOW MDM
|
Professional
|
Both
|
$132.88
|
|
|
Service Code
|
CPT 99283
|
| Hospital Charge Code |
z99283
|
| Min. Negotiated Rate |
$65.36 |
| Max. Negotiated Rate |
$138.75 |
| Rate for Payer: Aetna Commercial |
$68.54
|
| Rate for Payer: Aetna Commercial |
$68.54
|
| Rate for Payer: Aetna Medicare |
$68.54
|
| Rate for Payer: Aetna Medicare |
$68.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$94.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$94.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$94.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$94.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$94.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$94.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$94.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$94.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$65.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$65.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$75.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$75.39
|
| Rate for Payer: Cash Price |
$82.17
|
| Rate for Payer: Cash Price |
$82.39
|
| Rate for Payer: Cash Price |
$82.39
|
| Rate for Payer: Cash Price |
$82.17
|
| Rate for Payer: Centivo All Commercial |
$106.24
|
| Rate for Payer: Centivo All Commercial |
$106.24
|
| Rate for Payer: Cigna All Commercial |
$68.54
|
| Rate for Payer: Cigna All Commercial |
$68.54
|
| Rate for Payer: CORVEL All Commercial |
$68.54
|
| Rate for Payer: CORVEL All Commercial |
$68.54
|
| Rate for Payer: Coventry All Commercial |
$82.25
|
| Rate for Payer: Coventry All Commercial |
$82.25
|
| Rate for Payer: Encore All Commercial |
$68.54
|
| Rate for Payer: Encore All Commercial |
$68.54
|
| Rate for Payer: Frontpath All Commercial |
$138.75
|
| Rate for Payer: Frontpath All Commercial |
$138.75
|
| Rate for Payer: Humana ChoiceCare |
$78.63
|
| Rate for Payer: Humana ChoiceCare |
$78.63
|
| Rate for Payer: Humana Medicare |
$68.54
|
| Rate for Payer: Humana Medicare |
$68.54
|
| Rate for Payer: Lucent All Commercial |
$95.96
|
| Rate for Payer: Lucent All Commercial |
$95.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$112.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$112.66
|
| Rate for Payer: Managed Health Services Medicaid |
$65.36
|
| Rate for Payer: Managed Health Services Medicaid |
$65.36
|
| Rate for Payer: MDWise Medicaid |
$65.36
|
| Rate for Payer: MDWise Medicaid |
$65.36
|
| Rate for Payer: PHCS All Commercial |
$68.54
|
| Rate for Payer: PHCS All Commercial |
$68.54
|
| Rate for Payer: PHP All Commercial |
$68.25
|
| Rate for Payer: PHP All Commercial |
$68.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.54
|
| Rate for Payer: Sagamore Health Network All Products |
$68.54
|
| Rate for Payer: Sagamore Health Network All Products |
$68.54
|
| Rate for Payer: Signature Care EPO |
$102.00
|
| Rate for Payer: Signature Care EPO |
$102.00
|
| Rate for Payer: Signature Care PPO |
$102.00
|
| Rate for Payer: Signature Care PPO |
$102.00
|
| Rate for Payer: United Healthcare Commercial |
$91.78
|
| Rate for Payer: United Healthcare Commercial |
$91.78
|
| Rate for Payer: United Healthcare Medicare |
$66.27
|
| Rate for Payer: United Healthcare Medicare |
$66.27
|
|
|
PR EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP
|
Professional
|
Both
|
$21.40
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
z99281
|
| Min. Negotiated Rate |
$10.47 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$20.84
|
| Rate for Payer: Aetna Commercial |
$20.84
|
| Rate for Payer: Aetna Medicare |
$20.84
|
| Rate for Payer: Aetna Medicare |
$20.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$33.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$33.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$33.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$33.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$33.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$33.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$33.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$33.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$10.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$10.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$23.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$23.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22.92
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Centivo All Commercial |
$32.30
|
| Rate for Payer: Centivo All Commercial |
$32.30
|
| Rate for Payer: Cigna All Commercial |
$20.84
|
| Rate for Payer: Cigna All Commercial |
$20.84
|
| Rate for Payer: CORVEL All Commercial |
$20.84
|
| Rate for Payer: CORVEL All Commercial |
$20.84
|
| Rate for Payer: Coventry All Commercial |
$25.01
|
| Rate for Payer: Coventry All Commercial |
$25.01
|
| Rate for Payer: Encore All Commercial |
$20.84
|
| Rate for Payer: Encore All Commercial |
$20.84
|
| Rate for Payer: Frontpath All Commercial |
$60.00
|
| Rate for Payer: Frontpath All Commercial |
$60.00
|
| Rate for Payer: Humana ChoiceCare |
$21.19
|
| Rate for Payer: Humana ChoiceCare |
$21.19
|
| Rate for Payer: Humana Medicare |
$20.84
|
| Rate for Payer: Humana Medicare |
$20.84
|
| Rate for Payer: Lucent All Commercial |
$29.18
|
| Rate for Payer: Lucent All Commercial |
$29.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.11
|
| Rate for Payer: Managed Health Services Medicaid |
$10.47
|
| Rate for Payer: Managed Health Services Medicaid |
$10.47
|
| Rate for Payer: MDWise Medicaid |
$10.47
|
| Rate for Payer: MDWise Medicaid |
$10.47
|
| Rate for Payer: PHCS All Commercial |
$20.84
|
| Rate for Payer: PHCS All Commercial |
$20.84
|
| Rate for Payer: PHP All Commercial |
$11.02
|
| Rate for Payer: PHP All Commercial |
$11.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20.84
|
| Rate for Payer: Sagamore Health Network All Products |
$20.84
|
| Rate for Payer: Sagamore Health Network All Products |
$20.84
|
| Rate for Payer: Signature Care EPO |
$26.35
|
| Rate for Payer: Signature Care EPO |
$26.35
|
| Rate for Payer: Signature Care PPO |
$26.35
|
| Rate for Payer: Signature Care PPO |
$26.35
|
| Rate for Payer: United Healthcare Commercial |
$30.44
|
| Rate for Payer: United Healthcare Commercial |
$30.44
|
| Rate for Payer: United Healthcare Medicare |
$10.70
|
| Rate for Payer: United Healthcare Medicare |
$10.70
|
|
|
PR EMERGENCY DEPARTMENT VISIT MODERATE MDM
|
Professional
|
Both
|
$226.16
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
z99284
|
| Min. Negotiated Rate |
$111.23 |
| Max. Negotiated Rate |
$221.25 |
| Rate for Payer: Aetna Commercial |
$116.15
|
| Rate for Payer: Aetna Commercial |
$116.15
|
| Rate for Payer: Aetna Medicare |
$116.15
|
| Rate for Payer: Aetna Medicare |
$116.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$159.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$159.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$159.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$159.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$159.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$159.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$159.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$159.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$111.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$111.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$133.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$133.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$127.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$127.77
|
| Rate for Payer: Cash Price |
$138.87
|
| Rate for Payer: Cash Price |
$140.22
|
| Rate for Payer: Cash Price |
$140.22
|
| Rate for Payer: Cash Price |
$138.87
|
| Rate for Payer: Centivo All Commercial |
$180.03
|
| Rate for Payer: Centivo All Commercial |
$180.03
|
| Rate for Payer: Cigna All Commercial |
$116.15
|
| Rate for Payer: Cigna All Commercial |
$116.15
|
| Rate for Payer: CORVEL All Commercial |
$116.15
|
| Rate for Payer: CORVEL All Commercial |
$116.15
|
| Rate for Payer: Coventry All Commercial |
$139.38
|
| Rate for Payer: Coventry All Commercial |
$139.38
|
| Rate for Payer: Encore All Commercial |
$116.15
|
| Rate for Payer: Encore All Commercial |
$116.15
|
| Rate for Payer: Frontpath All Commercial |
$221.25
|
| Rate for Payer: Frontpath All Commercial |
$221.25
|
| Rate for Payer: Humana ChoiceCare |
$122.83
|
| Rate for Payer: Humana ChoiceCare |
$122.83
|
| Rate for Payer: Humana Medicare |
$116.15
|
| Rate for Payer: Humana Medicare |
$116.15
|
| Rate for Payer: Lucent All Commercial |
$162.61
|
| Rate for Payer: Lucent All Commercial |
$162.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$192.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$190.38
|
| Rate for Payer: Managed Health Services Medicaid |
$111.23
|
| Rate for Payer: Managed Health Services Medicaid |
$111.23
|
| Rate for Payer: MDWise Medicaid |
$111.23
|
| Rate for Payer: MDWise Medicaid |
$111.23
|
| Rate for Payer: PHCS All Commercial |
$116.15
|
| Rate for Payer: PHCS All Commercial |
$116.15
|
| Rate for Payer: PHP All Commercial |
$115.35
|
| Rate for Payer: PHP All Commercial |
$115.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.15
|
| Rate for Payer: Sagamore Health Network All Products |
$116.15
|
| Rate for Payer: Sagamore Health Network All Products |
$116.15
|
| Rate for Payer: Signature Care EPO |
$180.20
|
| Rate for Payer: Signature Care EPO |
$180.20
|
| Rate for Payer: Signature Care PPO |
$180.20
|
| Rate for Payer: Signature Care PPO |
$180.20
|
| Rate for Payer: United Healthcare Commercial |
$171.93
|
| Rate for Payer: United Healthcare Commercial |
$171.93
|
| Rate for Payer: United Healthcare Medicare |
$111.99
|
| Rate for Payer: United Healthcare Medicare |
$111.99
|
|
|
PR EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM
|
Professional
|
Both
|
$78.04
|
|
|
Service Code
|
CPT 99282
|
| Hospital Charge Code |
z99282
|
| Min. Negotiated Rate |
$34.99 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Aetna Commercial |
$40.33
|
| Rate for Payer: Aetna Commercial |
$40.33
|
| Rate for Payer: Aetna Medicare |
$40.33
|
| Rate for Payer: Aetna Medicare |
$40.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$56.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$56.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$56.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$56.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$56.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$56.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$56.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$56.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$38.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$38.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$46.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$46.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$44.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$44.36
|
| Rate for Payer: Cash Price |
$47.91
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$47.91
|
| Rate for Payer: Centivo All Commercial |
$62.51
|
| Rate for Payer: Centivo All Commercial |
$62.51
|
| Rate for Payer: Cigna All Commercial |
$40.33
|
| Rate for Payer: Cigna All Commercial |
$40.33
|
| Rate for Payer: CORVEL All Commercial |
$40.33
|
| Rate for Payer: CORVEL All Commercial |
$40.33
|
| Rate for Payer: Coventry All Commercial |
$48.40
|
| Rate for Payer: Coventry All Commercial |
$48.40
|
| Rate for Payer: Encore All Commercial |
$40.33
|
| Rate for Payer: Encore All Commercial |
$40.33
|
| Rate for Payer: Frontpath All Commercial |
$82.50
|
| Rate for Payer: Frontpath All Commercial |
$82.50
|
| Rate for Payer: Humana ChoiceCare |
$34.99
|
| Rate for Payer: Humana ChoiceCare |
$34.99
|
| Rate for Payer: Humana Medicare |
$40.33
|
| Rate for Payer: Humana Medicare |
$40.33
|
| Rate for Payer: Lucent All Commercial |
$56.46
|
| Rate for Payer: Lucent All Commercial |
$56.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$66.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$65.69
|
| Rate for Payer: Managed Health Services Medicaid |
$38.38
|
| Rate for Payer: Managed Health Services Medicaid |
$38.38
|
| Rate for Payer: MDWise Medicaid |
$38.38
|
| Rate for Payer: MDWise Medicaid |
$38.38
|
| Rate for Payer: PHCS All Commercial |
$40.33
|
| Rate for Payer: PHCS All Commercial |
$40.33
|
| Rate for Payer: PHP All Commercial |
$39.80
|
| Rate for Payer: PHP All Commercial |
$39.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.33
|
| Rate for Payer: Sagamore Health Network All Products |
$40.33
|
| Rate for Payer: Sagamore Health Network All Products |
$40.33
|
| Rate for Payer: Signature Care EPO |
$45.05
|
| Rate for Payer: Signature Care EPO |
$45.05
|
| Rate for Payer: Signature Care PPO |
$45.05
|
| Rate for Payer: Signature Care PPO |
$45.05
|
| Rate for Payer: United Healthcare Commercial |
$59.26
|
| Rate for Payer: United Healthcare Commercial |
$59.26
|
| Rate for Payer: United Healthcare Medicare |
$38.64
|
| Rate for Payer: United Healthcare Medicare |
$38.64
|
|
|
PR ENDOCERVICAL CURETTAGE
|
Professional
|
Both
|
$288.24
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
z57505
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$13,300.00 |
| Rate for Payer: Aetna Commercial |
$102.95
|
| Rate for Payer: Aetna Commercial |
$102.95
|
| Rate for Payer: Aetna Medicare |
$102.95
|
| Rate for Payer: Aetna Medicare |
$102.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$134.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$134.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$134.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$134.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$134.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$134.12
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.58
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$141.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$141.77
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$118.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$118.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$113.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$113.25
|
| Rate for Payer: Cash Price |
$176.10
|
| Rate for Payer: Cash Price |
$178.71
|
| Rate for Payer: Centivo All Commercial |
$159.57
|
| Rate for Payer: Centivo All Commercial |
$159.57
|
| Rate for Payer: Cigna All Commercial |
$102.95
|
| Rate for Payer: Cigna All Commercial |
$102.95
|
| Rate for Payer: CORVEL All Commercial |
$102.95
|
| Rate for Payer: CORVEL All Commercial |
$102.95
|
| Rate for Payer: Coventry All Commercial |
$123.54
|
| Rate for Payer: Coventry All Commercial |
$123.54
|
| Rate for Payer: Encore All Commercial |
$102.95
|
| Rate for Payer: Encore All Commercial |
$102.95
|
| Rate for Payer: Frontpath All Commercial |
$140.60
|
| Rate for Payer: Frontpath All Commercial |
$140.60
|
| Rate for Payer: Humana ChoiceCare |
$97.45
|
| Rate for Payer: Humana ChoiceCare |
$97.45
|
| Rate for Payer: Humana Medicare |
$102.95
|
| Rate for Payer: Humana Medicare |
$102.95
|
| Rate for Payer: Lucent All Commercial |
$144.13
|
| Rate for Payer: Lucent All Commercial |
$144.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$143.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$143.00
|
| Rate for Payer: Managed Health Services Medicaid |
$141.77
|
| Rate for Payer: Managed Health Services Medicaid |
$141.77
|
| Rate for Payer: MDWise Medicaid |
$141.77
|
| Rate for Payer: MDWise Medicaid |
$141.77
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$56.58
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$56.58
|
| Rate for Payer: PHCS All Commercial |
$102.95
|
| Rate for Payer: PHCS All Commercial |
$102.95
|
| Rate for Payer: PHP All Commercial |
$131.80
|
| Rate for Payer: PHP All Commercial |
$131.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.95
|
| Rate for Payer: Sagamore Health Network All Products |
$102.95
|
| Rate for Payer: Sagamore Health Network All Products |
$102.95
|
| Rate for Payer: Signature Care EPO |
$126.65
|
| Rate for Payer: Signature Care EPO |
$126.65
|
| Rate for Payer: Signature Care PPO |
$126.65
|
| Rate for Payer: Signature Care PPO |
$126.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,300.00
|
| Rate for Payer: United Healthcare Commercial |
$100.78
|
| Rate for Payer: United Healthcare Commercial |
$100.78
|
| Rate for Payer: United Healthcare Medicare |
$142.02
|
| Rate for Payer: United Healthcare Medicare |
$142.02
|
|
|
PR ENDOMET BIOPSY DONE W/COLPOSCOPY
|
Professional
|
Both
|
$92.90
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
z58110
|
| Min. Negotiated Rate |
$30.63 |
| Max. Negotiated Rate |
$4,800.00 |
| Rate for Payer: Aetna Commercial |
$37.92
|
| Rate for Payer: Aetna Commercial |
$37.92
|
| Rate for Payer: Aetna Medicare |
$37.92
|
| Rate for Payer: Aetna Medicare |
$37.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$59.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$59.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$59.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$59.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$59.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$59.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$59.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$59.13
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$30.63
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$30.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$45.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$45.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$43.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$43.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$41.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$41.71
|
| Rate for Payer: Cash Price |
$56.31
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Centivo All Commercial |
$58.78
|
| Rate for Payer: Centivo All Commercial |
$58.78
|
| Rate for Payer: Cigna All Commercial |
$37.92
|
| Rate for Payer: Cigna All Commercial |
$37.92
|
| Rate for Payer: CORVEL All Commercial |
$37.92
|
| Rate for Payer: CORVEL All Commercial |
$37.92
|
| Rate for Payer: Coventry All Commercial |
$45.50
|
| Rate for Payer: Coventry All Commercial |
$45.50
|
| Rate for Payer: Encore All Commercial |
$37.92
|
| Rate for Payer: Encore All Commercial |
$37.92
|
| Rate for Payer: Frontpath All Commercial |
$52.87
|
| Rate for Payer: Frontpath All Commercial |
$52.87
|
| Rate for Payer: Humana ChoiceCare |
$48.33
|
| Rate for Payer: Humana ChoiceCare |
$48.33
|
| Rate for Payer: Humana Medicare |
$37.92
|
| Rate for Payer: Humana Medicare |
$37.92
|
| Rate for Payer: Lucent All Commercial |
$53.09
|
| Rate for Payer: Lucent All Commercial |
$53.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$52.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$52.00
|
| Rate for Payer: Managed Health Services Medicaid |
$45.69
|
| Rate for Payer: Managed Health Services Medicaid |
$45.69
|
| Rate for Payer: MDWise Medicaid |
$45.69
|
| Rate for Payer: MDWise Medicaid |
$45.69
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$30.63
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$30.63
|
| Rate for Payer: PHCS All Commercial |
$37.92
|
| Rate for Payer: PHCS All Commercial |
$37.92
|
| Rate for Payer: PHP All Commercial |
$48.02
|
| Rate for Payer: PHP All Commercial |
$48.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$37.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$37.92
|
| Rate for Payer: Sagamore Health Network All Products |
$37.92
|
| Rate for Payer: Sagamore Health Network All Products |
$37.92
|
| Rate for Payer: Signature Care EPO |
$57.80
|
| Rate for Payer: Signature Care EPO |
$57.80
|
| Rate for Payer: Signature Care PPO |
$57.80
|
| Rate for Payer: Signature Care PPO |
$57.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,800.00
|
| Rate for Payer: United Healthcare Commercial |
$47.49
|
| Rate for Payer: United Healthcare Commercial |
$47.49
|
| Rate for Payer: United Healthcare Medicare |
$45.41
|
| Rate for Payer: United Healthcare Medicare |
$45.41
|
|
|
PR ENDOSCOPIC INJECTION/IMPLANT
|
Professional
|
Both
|
$631.88
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
z51715
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$339.14 |
| Rate for Payer: Aetna Commercial |
$186.65
|
| Rate for Payer: Aetna Medicare |
$186.65
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$109.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$337.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$214.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$205.31
|
| Rate for Payer: Cash Price |
$391.77
|
| Rate for Payer: Centivo All Commercial |
$289.31
|
| Rate for Payer: Cigna All Commercial |
$186.65
|
| Rate for Payer: CORVEL All Commercial |
$186.65
|
| Rate for Payer: Coventry All Commercial |
$223.98
|
| Rate for Payer: Encore All Commercial |
$186.65
|
| Rate for Payer: Frontpath All Commercial |
$257.73
|
| Rate for Payer: Humana ChoiceCare |
$194.04
|
| Rate for Payer: Humana Medicare |
$186.65
|
| Rate for Payer: Lucent All Commercial |
$261.31
|
| Rate for Payer: Managed Health Services Medicaid |
$337.34
|
| Rate for Payer: MDWise Medicaid |
$337.34
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$109.27
|
| Rate for Payer: PHCS All Commercial |
$186.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$186.65
|
| Rate for Payer: Sagamore Health Network All Products |
$186.65
|
| Rate for Payer: United Healthcare Commercial |
$247.18
|
| Rate for Payer: United Healthcare Medicare |
$339.14
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$706.82
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
z44378
|
| Min. Negotiated Rate |
$347.65 |
| Max. Negotiated Rate |
$562.79 |
| Rate for Payer: Aetna Commercial |
$363.09
|
| Rate for Payer: Aetna Commercial |
$363.09
|
| Rate for Payer: Aetna Medicare |
$363.09
|
| Rate for Payer: Aetna Medicare |
$363.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$347.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$347.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$417.55
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$417.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$399.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$399.40
|
| Rate for Payer: Cash Price |
$431.46
|
| Rate for Payer: Cash Price |
$438.23
|
| Rate for Payer: Centivo All Commercial |
$562.79
|
| Rate for Payer: Centivo All Commercial |
$562.79
|
| Rate for Payer: Cigna All Commercial |
$363.09
|
| Rate for Payer: Cigna All Commercial |
$363.09
|
| Rate for Payer: CORVEL All Commercial |
$363.09
|
| Rate for Payer: CORVEL All Commercial |
$363.09
|
| Rate for Payer: Coventry All Commercial |
$435.71
|
| Rate for Payer: Coventry All Commercial |
$435.71
|
| Rate for Payer: Encore All Commercial |
$363.09
|
| Rate for Payer: Encore All Commercial |
$363.09
|
| Rate for Payer: Frontpath All Commercial |
$495.83
|
| Rate for Payer: Frontpath All Commercial |
$495.83
|
| Rate for Payer: Humana ChoiceCare |
$444.24
|
| Rate for Payer: Humana ChoiceCare |
$444.24
|
| Rate for Payer: Humana Medicare |
$363.09
|
| Rate for Payer: Humana Medicare |
$363.09
|
| Rate for Payer: Lucent All Commercial |
$508.33
|
| Rate for Payer: Lucent All Commercial |
$508.33
|
| Rate for Payer: Managed Health Services Medicaid |
$347.65
|
| Rate for Payer: Managed Health Services Medicaid |
$347.65
|
| Rate for Payer: MDWise Medicaid |
$347.65
|
| Rate for Payer: MDWise Medicaid |
$347.65
|
| Rate for Payer: PHCS All Commercial |
$363.09
|
| Rate for Payer: PHCS All Commercial |
$363.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.09
|
| Rate for Payer: Sagamore Health Network All Products |
$363.09
|
| Rate for Payer: Sagamore Health Network All Products |
$363.09
|
| Rate for Payer: United Healthcare Commercial |
$476.99
|
| Rate for Payer: United Healthcare Commercial |
$476.99
|
| Rate for Payer: United Healthcare Medicare |
$347.95
|
| Rate for Payer: United Healthcare Medicare |
$347.95
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING
|
Professional
|
Both
|
$441.44
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
z44366
|
| Min. Negotiated Rate |
$217.11 |
| Max. Negotiated Rate |
$350.01 |
| Rate for Payer: Aetna Commercial |
$225.81
|
| Rate for Payer: Aetna Commercial |
$225.81
|
| Rate for Payer: Aetna Medicare |
$225.81
|
| Rate for Payer: Aetna Medicare |
$225.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$217.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$217.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$259.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$259.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$248.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$248.39
|
| Rate for Payer: Cash Price |
$269.48
|
| Rate for Payer: Cash Price |
$273.69
|
| Rate for Payer: Centivo All Commercial |
$350.01
|
| Rate for Payer: Centivo All Commercial |
$350.01
|
| Rate for Payer: Cigna All Commercial |
$225.81
|
| Rate for Payer: Cigna All Commercial |
$225.81
|
| Rate for Payer: CORVEL All Commercial |
$225.81
|
| Rate for Payer: CORVEL All Commercial |
$225.81
|
| Rate for Payer: Coventry All Commercial |
$270.97
|
| Rate for Payer: Coventry All Commercial |
$270.97
|
| Rate for Payer: Encore All Commercial |
$225.81
|
| Rate for Payer: Encore All Commercial |
$225.81
|
| Rate for Payer: Frontpath All Commercial |
$307.61
|
| Rate for Payer: Frontpath All Commercial |
$307.61
|
| Rate for Payer: Humana ChoiceCare |
$277.44
|
| Rate for Payer: Humana ChoiceCare |
$277.44
|
| Rate for Payer: Humana Medicare |
$225.81
|
| Rate for Payer: Humana Medicare |
$225.81
|
| Rate for Payer: Lucent All Commercial |
$316.13
|
| Rate for Payer: Lucent All Commercial |
$316.13
|
| Rate for Payer: Managed Health Services Medicaid |
$217.11
|
| Rate for Payer: Managed Health Services Medicaid |
$217.11
|
| Rate for Payer: MDWise Medicaid |
$217.11
|
| Rate for Payer: MDWise Medicaid |
$217.11
|
| Rate for Payer: PHCS All Commercial |
$225.81
|
| Rate for Payer: PHCS All Commercial |
$225.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$225.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$225.81
|
| Rate for Payer: Sagamore Health Network All Products |
$225.81
|
| Rate for Payer: Sagamore Health Network All Products |
$225.81
|
| Rate for Payer: United Healthcare Commercial |
$300.95
|
| Rate for Payer: United Healthcare Commercial |
$300.95
|
| Rate for Payer: United Healthcare Medicare |
$217.32
|
| Rate for Payer: United Healthcare Medicare |
$217.32
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$352.78
|
|
|
Service Code
|
CPT 44363
|
| Hospital Charge Code |
z44363
|
| Min. Negotiated Rate |
$173.47 |
| Max. Negotiated Rate |
$279.91 |
| Rate for Payer: Aetna Commercial |
$180.59
|
| Rate for Payer: Aetna Commercial |
$180.59
|
| Rate for Payer: Aetna Medicare |
$180.59
|
| Rate for Payer: Aetna Medicare |
$180.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$173.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$173.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$207.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$207.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$198.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$198.65
|
| Rate for Payer: Cash Price |
$215.10
|
| Rate for Payer: Cash Price |
$218.72
|
| Rate for Payer: Centivo All Commercial |
$279.91
|
| Rate for Payer: Centivo All Commercial |
$279.91
|
| Rate for Payer: Cigna All Commercial |
$180.59
|
| Rate for Payer: Cigna All Commercial |
$180.59
|
| Rate for Payer: CORVEL All Commercial |
$180.59
|
| Rate for Payer: CORVEL All Commercial |
$180.59
|
| Rate for Payer: Coventry All Commercial |
$216.71
|
| Rate for Payer: Coventry All Commercial |
$216.71
|
| Rate for Payer: Encore All Commercial |
$180.59
|
| Rate for Payer: Encore All Commercial |
$180.59
|
| Rate for Payer: Frontpath All Commercial |
$246.87
|
| Rate for Payer: Frontpath All Commercial |
$246.87
|
| Rate for Payer: Humana ChoiceCare |
$220.38
|
| Rate for Payer: Humana ChoiceCare |
$220.38
|
| Rate for Payer: Humana Medicare |
$180.59
|
| Rate for Payer: Humana Medicare |
$180.59
|
| Rate for Payer: Lucent All Commercial |
$252.83
|
| Rate for Payer: Lucent All Commercial |
$252.83
|
| Rate for Payer: Managed Health Services Medicaid |
$173.51
|
| Rate for Payer: Managed Health Services Medicaid |
$173.51
|
| Rate for Payer: MDWise Medicaid |
$173.51
|
| Rate for Payer: MDWise Medicaid |
$173.51
|
| Rate for Payer: PHCS All Commercial |
$180.59
|
| Rate for Payer: PHCS All Commercial |
$180.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$180.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$180.59
|
| Rate for Payer: Sagamore Health Network All Products |
$180.59
|
| Rate for Payer: Sagamore Health Network All Products |
$180.59
|
| Rate for Payer: United Healthcare Commercial |
$237.06
|
| Rate for Payer: United Healthcare Commercial |
$237.06
|
| Rate for Payer: United Healthcare Medicare |
$173.47
|
| Rate for Payer: United Healthcare Medicare |
$173.47
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE
|
Professional
|
Both
|
$376.16
|
|
|
Service Code
|
CPT 44364
|
| Hospital Charge Code |
z44364
|
| Min. Negotiated Rate |
$185.01 |
| Max. Negotiated Rate |
$298.34 |
| Rate for Payer: Aetna Commercial |
$192.48
|
| Rate for Payer: Aetna Commercial |
$192.48
|
| Rate for Payer: Aetna Medicare |
$192.48
|
| Rate for Payer: Aetna Medicare |
$192.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$185.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$185.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$221.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$221.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$211.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$211.73
|
| Rate for Payer: Cash Price |
$229.45
|
| Rate for Payer: Cash Price |
$233.22
|
| Rate for Payer: Centivo All Commercial |
$298.34
|
| Rate for Payer: Centivo All Commercial |
$298.34
|
| Rate for Payer: Cigna All Commercial |
$192.48
|
| Rate for Payer: Cigna All Commercial |
$192.48
|
| Rate for Payer: CORVEL All Commercial |
$192.48
|
| Rate for Payer: CORVEL All Commercial |
$192.48
|
| Rate for Payer: Coventry All Commercial |
$230.98
|
| Rate for Payer: Coventry All Commercial |
$230.98
|
| Rate for Payer: Encore All Commercial |
$192.48
|
| Rate for Payer: Encore All Commercial |
$192.48
|
| Rate for Payer: Frontpath All Commercial |
$262.68
|
| Rate for Payer: Frontpath All Commercial |
$262.68
|
| Rate for Payer: Humana ChoiceCare |
$235.79
|
| Rate for Payer: Humana ChoiceCare |
$235.79
|
| Rate for Payer: Humana Medicare |
$192.48
|
| Rate for Payer: Humana Medicare |
$192.48
|
| Rate for Payer: Lucent All Commercial |
$269.47
|
| Rate for Payer: Lucent All Commercial |
$269.47
|
| Rate for Payer: Managed Health Services Medicaid |
$185.01
|
| Rate for Payer: Managed Health Services Medicaid |
$185.01
|
| Rate for Payer: MDWise Medicaid |
$185.01
|
| Rate for Payer: MDWise Medicaid |
$185.01
|
| Rate for Payer: PHCS All Commercial |
$192.48
|
| Rate for Payer: PHCS All Commercial |
$192.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$192.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$192.48
|
| Rate for Payer: Sagamore Health Network All Products |
$192.48
|
| Rate for Payer: Sagamore Health Network All Products |
$192.48
|
| Rate for Payer: United Healthcare Commercial |
$255.33
|
| Rate for Payer: United Healthcare Commercial |
$255.33
|
| Rate for Payer: United Healthcare Medicare |
$185.04
|
| Rate for Payer: United Healthcare Medicare |
$185.04
|
|
|
PR EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
z93640
|
| Min. Negotiated Rate |
$254.27 |
| Max. Negotiated Rate |
$632.50 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$632.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$632.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$632.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$632.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$254.27
|
| Rate for Payer: Cash Price |
$194.06
|
| Rate for Payer: Cash Price |
$194.06
|
| Rate for Payer: Frontpath All Commercial |
$413.67
|
| Rate for Payer: Humana ChoiceCare |
$594.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$266.05
|
| Rate for Payer: Managed Health Services Medicaid |
$254.27
|
| Rate for Payer: MDWise Medicaid |
$254.27
|
| Rate for Payer: Signature Care EPO |
$329.06
|
| Rate for Payer: Signature Care PPO |
$329.06
|
| Rate for Payer: United Healthcare Commercial |
$529.93
|
|
