|
PR EXCIS/CURET BENIGN TUMR CLAV/SCAPULA
|
Professional
|
Both
|
$1,037.42
|
|
|
Service Code
|
CPT 23140
|
| Hospital Charge Code |
z23140
|
| Min. Negotiated Rate |
$506.78 |
| Max. Negotiated Rate |
$77,900.00 |
| Rate for Payer: Aetna Commercial |
$518.90
|
| Rate for Payer: Aetna Commercial |
$518.90
|
| Rate for Payer: Aetna Medicare |
$518.90
|
| Rate for Payer: Aetna Medicare |
$518.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$636.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$636.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$636.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$636.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$636.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$636.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$636.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$636.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$510.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$510.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$596.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$596.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$570.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$570.79
|
| Rate for Payer: Cash Price |
$622.45
|
| Rate for Payer: Cash Price |
$608.14
|
| Rate for Payer: Centivo All Commercial |
$804.29
|
| Rate for Payer: Centivo All Commercial |
$804.29
|
| Rate for Payer: Cigna All Commercial |
$518.90
|
| Rate for Payer: Cigna All Commercial |
$518.90
|
| Rate for Payer: CORVEL All Commercial |
$518.90
|
| Rate for Payer: CORVEL All Commercial |
$518.90
|
| Rate for Payer: Coventry All Commercial |
$622.68
|
| Rate for Payer: Coventry All Commercial |
$622.68
|
| Rate for Payer: Encore All Commercial |
$518.90
|
| Rate for Payer: Encore All Commercial |
$518.90
|
| Rate for Payer: Frontpath All Commercial |
$720.85
|
| Rate for Payer: Frontpath All Commercial |
$720.85
|
| Rate for Payer: Humana ChoiceCare |
$528.19
|
| Rate for Payer: Humana ChoiceCare |
$528.19
|
| Rate for Payer: Humana Medicare |
$518.90
|
| Rate for Payer: Humana Medicare |
$518.90
|
| Rate for Payer: Lucent All Commercial |
$726.46
|
| Rate for Payer: Lucent All Commercial |
$726.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$831.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$831.00
|
| Rate for Payer: Managed Health Services Medicaid |
$510.24
|
| Rate for Payer: Managed Health Services Medicaid |
$510.24
|
| Rate for Payer: MDWise Medicaid |
$510.24
|
| Rate for Payer: MDWise Medicaid |
$510.24
|
| Rate for Payer: PHCS All Commercial |
$518.90
|
| Rate for Payer: PHCS All Commercial |
$518.90
|
| Rate for Payer: PHP All Commercial |
$881.80
|
| Rate for Payer: PHP All Commercial |
$881.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$518.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$518.90
|
| Rate for Payer: Sagamore Health Network All Products |
$518.90
|
| Rate for Payer: Sagamore Health Network All Products |
$518.90
|
| Rate for Payer: Signature Care EPO |
$715.70
|
| Rate for Payer: Signature Care EPO |
$715.70
|
| Rate for Payer: Signature Care PPO |
$715.70
|
| Rate for Payer: Signature Care PPO |
$715.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$77,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$77,900.00
|
| Rate for Payer: United Healthcare Commercial |
$551.71
|
| Rate for Payer: United Healthcare Commercial |
$551.71
|
| Rate for Payer: United Healthcare Medicare |
$506.78
|
| Rate for Payer: United Healthcare Medicare |
$506.78
|
|
|
PR EXCIS/DEST INTRANAS LESION; INT APP
|
Professional
|
Both
|
$1,828.90
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
z30117
|
| Min. Negotiated Rate |
$177.52 |
| Max. Negotiated Rate |
$47,000.00 |
| Rate for Payer: Aetna Commercial |
$312.38
|
| Rate for Payer: Aetna Commercial |
$312.38
|
| Rate for Payer: Aetna Medicare |
$312.38
|
| Rate for Payer: Aetna Medicare |
$312.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$320.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$177.52
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$177.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$899.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$899.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$359.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$359.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$343.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$343.62
|
| Rate for Payer: Cash Price |
$1,065.77
|
| Rate for Payer: Cash Price |
$1,097.34
|
| Rate for Payer: Centivo All Commercial |
$484.19
|
| Rate for Payer: Centivo All Commercial |
$484.19
|
| Rate for Payer: Cigna All Commercial |
$312.38
|
| Rate for Payer: Cigna All Commercial |
$312.38
|
| Rate for Payer: CORVEL All Commercial |
$312.38
|
| Rate for Payer: CORVEL All Commercial |
$312.38
|
| Rate for Payer: Coventry All Commercial |
$374.86
|
| Rate for Payer: Coventry All Commercial |
$374.86
|
| Rate for Payer: Encore All Commercial |
$312.38
|
| Rate for Payer: Encore All Commercial |
$312.38
|
| Rate for Payer: Frontpath All Commercial |
$422.15
|
| Rate for Payer: Frontpath All Commercial |
$422.15
|
| Rate for Payer: Humana ChoiceCare |
$344.29
|
| Rate for Payer: Humana ChoiceCare |
$344.29
|
| Rate for Payer: Humana Medicare |
$312.38
|
| Rate for Payer: Humana Medicare |
$312.38
|
| Rate for Payer: Lucent All Commercial |
$437.33
|
| Rate for Payer: Lucent All Commercial |
$437.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$501.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$501.00
|
| Rate for Payer: Managed Health Services Medicaid |
$899.53
|
| Rate for Payer: Managed Health Services Medicaid |
$899.53
|
| Rate for Payer: MDWise Medicaid |
$899.53
|
| Rate for Payer: MDWise Medicaid |
$899.53
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$177.52
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$177.52
|
| Rate for Payer: PHCS All Commercial |
$312.38
|
| Rate for Payer: PHCS All Commercial |
$312.38
|
| Rate for Payer: PHP All Commercial |
$427.91
|
| Rate for Payer: PHP All Commercial |
$427.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$312.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$312.38
|
| Rate for Payer: Sagamore Health Network All Products |
$312.38
|
| Rate for Payer: Sagamore Health Network All Products |
$312.38
|
| Rate for Payer: Signature Care EPO |
$788.11
|
| Rate for Payer: Signature Care EPO |
$788.11
|
| Rate for Payer: Signature Care PPO |
$788.11
|
| Rate for Payer: Signature Care PPO |
$788.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,000.00
|
| Rate for Payer: United Healthcare Commercial |
$351.19
|
| Rate for Payer: United Healthcare Commercial |
$351.19
|
| Rate for Payer: United Healthcare Medicare |
$888.14
|
| Rate for Payer: United Healthcare Medicare |
$888.14
|
|
|
PR EXCISE BREAST CYST
|
Professional
|
Both
|
$953.52
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
z19120
|
| Min. Negotiated Rate |
$215.08 |
| Max. Negotiated Rate |
$46,000.00 |
| Rate for Payer: Aetna Commercial |
$386.10
|
| Rate for Payer: Aetna Commercial |
$386.10
|
| Rate for Payer: Aetna Medicare |
$386.10
|
| Rate for Payer: Aetna Medicare |
$386.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$586.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$586.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$586.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$586.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$586.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$586.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$586.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$586.43
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$215.08
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$215.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$468.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$468.98
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$444.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$444.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$424.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$424.71
|
| Rate for Payer: Cash Price |
$560.17
|
| Rate for Payer: Cash Price |
$572.11
|
| Rate for Payer: Centivo All Commercial |
$598.46
|
| Rate for Payer: Centivo All Commercial |
$598.46
|
| Rate for Payer: Cigna All Commercial |
$386.10
|
| Rate for Payer: Cigna All Commercial |
$386.10
|
| Rate for Payer: CORVEL All Commercial |
$386.10
|
| Rate for Payer: CORVEL All Commercial |
$386.10
|
| Rate for Payer: Coventry All Commercial |
$463.32
|
| Rate for Payer: Coventry All Commercial |
$463.32
|
| Rate for Payer: Encore All Commercial |
$386.10
|
| Rate for Payer: Encore All Commercial |
$386.10
|
| Rate for Payer: Frontpath All Commercial |
$545.36
|
| Rate for Payer: Frontpath All Commercial |
$545.36
|
| Rate for Payer: Humana ChoiceCare |
$327.80
|
| Rate for Payer: Humana ChoiceCare |
$327.80
|
| Rate for Payer: Humana Medicare |
$386.10
|
| Rate for Payer: Humana Medicare |
$386.10
|
| Rate for Payer: Lucent All Commercial |
$540.54
|
| Rate for Payer: Lucent All Commercial |
$540.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$499.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$499.00
|
| Rate for Payer: Managed Health Services Medicaid |
$468.98
|
| Rate for Payer: Managed Health Services Medicaid |
$468.98
|
| Rate for Payer: MDWise Medicaid |
$468.98
|
| Rate for Payer: MDWise Medicaid |
$468.98
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$215.08
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$215.08
|
| Rate for Payer: PHCS All Commercial |
$386.10
|
| Rate for Payer: PHCS All Commercial |
$386.10
|
| Rate for Payer: PHP All Commercial |
$524.08
|
| Rate for Payer: PHP All Commercial |
$524.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$386.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$386.10
|
| Rate for Payer: Sagamore Health Network All Products |
$386.10
|
| Rate for Payer: Sagamore Health Network All Products |
$386.10
|
| Rate for Payer: Signature Care EPO |
$455.60
|
| Rate for Payer: Signature Care EPO |
$455.60
|
| Rate for Payer: Signature Care PPO |
$455.60
|
| Rate for Payer: Signature Care PPO |
$455.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,000.00
|
| Rate for Payer: United Healthcare Commercial |
$421.65
|
| Rate for Payer: United Healthcare Commercial |
$421.65
|
| Rate for Payer: United Healthcare Medicare |
$466.81
|
| Rate for Payer: United Healthcare Medicare |
$466.81
|
|
|
PR EXCISE BREAST LES W XRAY MARKER
|
Professional
|
Both
|
$1,049.32
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
z19125
|
| Min. Negotiated Rate |
$238.61 |
| Max. Negotiated Rate |
$50,900.00 |
| Rate for Payer: Aetna Commercial |
$427.66
|
| Rate for Payer: Aetna Commercial |
$427.66
|
| Rate for Payer: Aetna Medicare |
$427.66
|
| Rate for Payer: Aetna Medicare |
$427.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$649.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$649.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$649.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$649.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$649.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$649.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$649.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$649.64
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$238.61
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$238.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$516.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$516.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$491.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$491.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$470.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$470.43
|
| Rate for Payer: Cash Price |
$616.55
|
| Rate for Payer: Cash Price |
$629.59
|
| Rate for Payer: Centivo All Commercial |
$662.87
|
| Rate for Payer: Centivo All Commercial |
$662.87
|
| Rate for Payer: Cigna All Commercial |
$427.66
|
| Rate for Payer: Cigna All Commercial |
$427.66
|
| Rate for Payer: CORVEL All Commercial |
$427.66
|
| Rate for Payer: CORVEL All Commercial |
$427.66
|
| Rate for Payer: Coventry All Commercial |
$513.19
|
| Rate for Payer: Coventry All Commercial |
$513.19
|
| Rate for Payer: Encore All Commercial |
$427.66
|
| Rate for Payer: Encore All Commercial |
$427.66
|
| Rate for Payer: Frontpath All Commercial |
$606.11
|
| Rate for Payer: Frontpath All Commercial |
$606.11
|
| Rate for Payer: Humana ChoiceCare |
$355.46
|
| Rate for Payer: Humana ChoiceCare |
$355.46
|
| Rate for Payer: Humana Medicare |
$427.66
|
| Rate for Payer: Humana Medicare |
$427.66
|
| Rate for Payer: Lucent All Commercial |
$598.72
|
| Rate for Payer: Lucent All Commercial |
$598.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$551.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$551.00
|
| Rate for Payer: Managed Health Services Medicaid |
$516.10
|
| Rate for Payer: Managed Health Services Medicaid |
$516.10
|
| Rate for Payer: MDWise Medicaid |
$516.10
|
| Rate for Payer: MDWise Medicaid |
$516.10
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$238.61
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$238.61
|
| Rate for Payer: PHCS All Commercial |
$427.66
|
| Rate for Payer: PHCS All Commercial |
$427.66
|
| Rate for Payer: PHP All Commercial |
$579.32
|
| Rate for Payer: PHP All Commercial |
$579.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$427.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$427.66
|
| Rate for Payer: Sagamore Health Network All Products |
$427.66
|
| Rate for Payer: Sagamore Health Network All Products |
$427.66
|
| Rate for Payer: Signature Care EPO |
$485.35
|
| Rate for Payer: Signature Care EPO |
$485.35
|
| Rate for Payer: Signature Care PPO |
$485.35
|
| Rate for Payer: Signature Care PPO |
$485.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,900.00
|
| Rate for Payer: United Healthcare Commercial |
$468.11
|
| Rate for Payer: United Healthcare Commercial |
$468.11
|
| Rate for Payer: United Healthcare Medicare |
$513.79
|
| Rate for Payer: United Healthcare Medicare |
$513.79
|
|
|
PR EXCISE BREAST LES XRAY MARK ADDNL
|
Professional
|
Both
|
$286.48
|
|
|
Service Code
|
CPT 19126
|
| Hospital Charge Code |
z19126
|
| Min. Negotiated Rate |
$140.90 |
| Max. Negotiated Rate |
$17,400.00 |
| Rate for Payer: Aetna Commercial |
$147.71
|
| Rate for Payer: Aetna Commercial |
$147.71
|
| Rate for Payer: Aetna Medicare |
$147.71
|
| Rate for Payer: Aetna Medicare |
$147.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$214.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$214.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$214.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$214.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$214.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$214.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$214.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$214.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$140.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$140.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$169.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$169.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$162.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$162.48
|
| Rate for Payer: Cash Price |
$171.89
|
| Rate for Payer: Cash Price |
$169.56
|
| Rate for Payer: Centivo All Commercial |
$228.95
|
| Rate for Payer: Centivo All Commercial |
$228.95
|
| Rate for Payer: Cigna All Commercial |
$147.71
|
| Rate for Payer: Cigna All Commercial |
$147.71
|
| Rate for Payer: CORVEL All Commercial |
$147.71
|
| Rate for Payer: CORVEL All Commercial |
$147.71
|
| Rate for Payer: Coventry All Commercial |
$177.25
|
| Rate for Payer: Coventry All Commercial |
$177.25
|
| Rate for Payer: Encore All Commercial |
$147.71
|
| Rate for Payer: Encore All Commercial |
$147.71
|
| Rate for Payer: Frontpath All Commercial |
$213.33
|
| Rate for Payer: Frontpath All Commercial |
$213.33
|
| Rate for Payer: Humana ChoiceCare |
$151.65
|
| Rate for Payer: Humana ChoiceCare |
$151.65
|
| Rate for Payer: Humana Medicare |
$147.71
|
| Rate for Payer: Humana Medicare |
$147.71
|
| Rate for Payer: Lucent All Commercial |
$206.79
|
| Rate for Payer: Lucent All Commercial |
$206.79
|
| 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 |
$140.90
|
| Rate for Payer: Managed Health Services Medicaid |
$140.90
|
| Rate for Payer: MDWise Medicaid |
$140.90
|
| Rate for Payer: MDWise Medicaid |
$140.90
|
| Rate for Payer: PHCS All Commercial |
$147.71
|
| Rate for Payer: PHCS All Commercial |
$147.71
|
| Rate for Payer: PHP All Commercial |
$197.83
|
| Rate for Payer: PHP All Commercial |
$197.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$147.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$147.71
|
| Rate for Payer: Sagamore Health Network All Products |
$147.71
|
| Rate for Payer: Sagamore Health Network All Products |
$147.71
|
| Rate for Payer: Signature Care EPO |
$168.30
|
| Rate for Payer: Signature Care EPO |
$168.30
|
| Rate for Payer: Signature Care PPO |
$168.30
|
| Rate for Payer: Signature Care PPO |
$168.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,400.00
|
| Rate for Payer: United Healthcare Commercial |
$177.54
|
| Rate for Payer: United Healthcare Commercial |
$177.54
|
| Rate for Payer: United Healthcare Medicare |
$141.30
|
| Rate for Payer: United Healthcare Medicare |
$141.30
|
|
|
PR EXCISE CUTANEOUS NEUROMA
|
Professional
|
Both
|
$794.96
|
|
|
Service Code
|
CPT 64774
|
| Hospital Charge Code |
z64774
|
| Min. Negotiated Rate |
$387.78 |
| Max. Negotiated Rate |
$604.98 |
| Rate for Payer: Aetna Commercial |
$390.31
|
| Rate for Payer: Aetna Commercial |
$390.31
|
| Rate for Payer: Aetna Medicare |
$390.31
|
| Rate for Payer: Aetna Medicare |
$390.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$390.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$390.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$448.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$448.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$429.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$429.34
|
| Rate for Payer: Cash Price |
$465.34
|
| Rate for Payer: Cash Price |
$476.98
|
| Rate for Payer: Centivo All Commercial |
$604.98
|
| Rate for Payer: Centivo All Commercial |
$604.98
|
| Rate for Payer: Cigna All Commercial |
$390.31
|
| Rate for Payer: Cigna All Commercial |
$390.31
|
| Rate for Payer: CORVEL All Commercial |
$390.31
|
| Rate for Payer: CORVEL All Commercial |
$390.31
|
| Rate for Payer: Coventry All Commercial |
$468.37
|
| Rate for Payer: Coventry All Commercial |
$468.37
|
| Rate for Payer: Encore All Commercial |
$390.31
|
| Rate for Payer: Encore All Commercial |
$390.31
|
| Rate for Payer: Frontpath All Commercial |
$540.07
|
| Rate for Payer: Frontpath All Commercial |
$540.07
|
| Rate for Payer: Humana ChoiceCare |
$458.50
|
| Rate for Payer: Humana ChoiceCare |
$458.50
|
| Rate for Payer: Humana Medicare |
$390.31
|
| Rate for Payer: Humana Medicare |
$390.31
|
| Rate for Payer: Lucent All Commercial |
$546.43
|
| Rate for Payer: Lucent All Commercial |
$546.43
|
| Rate for Payer: Managed Health Services Medicaid |
$390.99
|
| Rate for Payer: Managed Health Services Medicaid |
$390.99
|
| Rate for Payer: MDWise Medicaid |
$390.99
|
| Rate for Payer: MDWise Medicaid |
$390.99
|
| Rate for Payer: PHCS All Commercial |
$390.31
|
| Rate for Payer: PHCS All Commercial |
$390.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.31
|
| Rate for Payer: Sagamore Health Network All Products |
$390.31
|
| Rate for Payer: Sagamore Health Network All Products |
$390.31
|
| Rate for Payer: United Healthcare Commercial |
$441.68
|
| Rate for Payer: United Healthcare Commercial |
$441.68
|
| Rate for Payer: United Healthcare Medicare |
$387.78
|
| Rate for Payer: United Healthcare Medicare |
$387.78
|
|
|
PR EXCISE DIGITAL NEUROMA
|
Professional
|
Both
|
$757.34
|
|
|
Service Code
|
CPT 64776
|
| Hospital Charge Code |
z64776
|
| Min. Negotiated Rate |
$364.31 |
| Max. Negotiated Rate |
$56,000.00 |
| Rate for Payer: Aetna Commercial |
$369.44
|
| Rate for Payer: Aetna Commercial |
$369.44
|
| Rate for Payer: Aetna Medicare |
$369.44
|
| Rate for Payer: Aetna Medicare |
$369.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$416.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$416.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$416.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$416.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$416.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$416.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$416.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$416.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$372.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$372.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$424.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$424.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$406.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$406.38
|
| Rate for Payer: Cash Price |
$454.40
|
| Rate for Payer: Cash Price |
$437.17
|
| Rate for Payer: Centivo All Commercial |
$572.63
|
| Rate for Payer: Centivo All Commercial |
$572.63
|
| Rate for Payer: Cigna All Commercial |
$369.44
|
| Rate for Payer: Cigna All Commercial |
$369.44
|
| Rate for Payer: CORVEL All Commercial |
$369.44
|
| Rate for Payer: CORVEL All Commercial |
$369.44
|
| Rate for Payer: Coventry All Commercial |
$443.33
|
| Rate for Payer: Coventry All Commercial |
$443.33
|
| Rate for Payer: Encore All Commercial |
$369.44
|
| Rate for Payer: Encore All Commercial |
$369.44
|
| Rate for Payer: Frontpath All Commercial |
$507.92
|
| Rate for Payer: Frontpath All Commercial |
$507.92
|
| Rate for Payer: Humana ChoiceCare |
$449.43
|
| Rate for Payer: Humana ChoiceCare |
$449.43
|
| Rate for Payer: Humana Medicare |
$369.44
|
| Rate for Payer: Humana Medicare |
$369.44
|
| Rate for Payer: Lucent All Commercial |
$517.22
|
| Rate for Payer: Lucent All Commercial |
$517.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$597.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$597.00
|
| Rate for Payer: Managed Health Services Medicaid |
$372.49
|
| Rate for Payer: Managed Health Services Medicaid |
$372.49
|
| Rate for Payer: MDWise Medicaid |
$372.49
|
| Rate for Payer: MDWise Medicaid |
$372.49
|
| Rate for Payer: PHCS All Commercial |
$369.44
|
| Rate for Payer: PHCS All Commercial |
$369.44
|
| Rate for Payer: PHP All Commercial |
$637.54
|
| Rate for Payer: PHP All Commercial |
$637.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$369.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$369.44
|
| Rate for Payer: Sagamore Health Network All Products |
$369.44
|
| Rate for Payer: Sagamore Health Network All Products |
$369.44
|
| Rate for Payer: Signature Care EPO |
$513.40
|
| Rate for Payer: Signature Care EPO |
$513.40
|
| Rate for Payer: Signature Care PPO |
$513.40
|
| Rate for Payer: Signature Care PPO |
$513.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$56,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$56,000.00
|
| Rate for Payer: United Healthcare Commercial |
$424.59
|
| Rate for Payer: United Healthcare Commercial |
$424.59
|
| Rate for Payer: United Healthcare Medicare |
$364.31
|
| Rate for Payer: United Healthcare Medicare |
$364.31
|
|
|
PR EXCISE HAND/FOOT NEUROMA
|
Professional
|
Both
|
$853.86
|
|
|
Service Code
|
CPT 64782
|
| Hospital Charge Code |
z64782
|
| Min. Negotiated Rate |
$417.45 |
| Max. Negotiated Rate |
$665.63 |
| Rate for Payer: Aetna Commercial |
$429.44
|
| Rate for Payer: Aetna Commercial |
$429.44
|
| Rate for Payer: Aetna Medicare |
$429.44
|
| Rate for Payer: Aetna Medicare |
$429.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$419.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$419.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$493.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$493.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$472.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$472.38
|
| Rate for Payer: Cash Price |
$500.94
|
| Rate for Payer: Cash Price |
$512.32
|
| Rate for Payer: Centivo All Commercial |
$665.63
|
| Rate for Payer: Centivo All Commercial |
$665.63
|
| Rate for Payer: Cigna All Commercial |
$429.44
|
| Rate for Payer: Cigna All Commercial |
$429.44
|
| Rate for Payer: CORVEL All Commercial |
$429.44
|
| Rate for Payer: CORVEL All Commercial |
$429.44
|
| Rate for Payer: Coventry All Commercial |
$515.33
|
| Rate for Payer: Coventry All Commercial |
$515.33
|
| Rate for Payer: Encore All Commercial |
$429.44
|
| Rate for Payer: Encore All Commercial |
$429.44
|
| Rate for Payer: Frontpath All Commercial |
$588.76
|
| Rate for Payer: Frontpath All Commercial |
$588.76
|
| Rate for Payer: Humana ChoiceCare |
$512.62
|
| Rate for Payer: Humana ChoiceCare |
$512.62
|
| Rate for Payer: Humana Medicare |
$429.44
|
| Rate for Payer: Humana Medicare |
$429.44
|
| Rate for Payer: Lucent All Commercial |
$601.22
|
| Rate for Payer: Lucent All Commercial |
$601.22
|
| Rate for Payer: Managed Health Services Medicaid |
$419.96
|
| Rate for Payer: Managed Health Services Medicaid |
$419.96
|
| Rate for Payer: MDWise Medicaid |
$419.96
|
| Rate for Payer: MDWise Medicaid |
$419.96
|
| Rate for Payer: PHCS All Commercial |
$429.44
|
| Rate for Payer: PHCS All Commercial |
$429.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$429.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$429.44
|
| Rate for Payer: Sagamore Health Network All Products |
$429.44
|
| Rate for Payer: Sagamore Health Network All Products |
$429.44
|
| Rate for Payer: United Healthcare Commercial |
$500.99
|
| Rate for Payer: United Healthcare Commercial |
$500.99
|
| Rate for Payer: United Healthcare Medicare |
$417.45
|
| Rate for Payer: United Healthcare Medicare |
$417.45
|
|
|
PR EXCISE LIP OR CHEEK FOLD
|
Professional
|
Both
|
$504.48
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
z40819
|
| Min. Negotiated Rate |
$128.08 |
| Max. Negotiated Rate |
$26,200.00 |
| Rate for Payer: Aetna Commercial |
$187.26
|
| Rate for Payer: Aetna Commercial |
$187.26
|
| Rate for Payer: Aetna Medicare |
$187.26
|
| Rate for Payer: Aetna Medicare |
$187.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$250.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$250.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$250.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$250.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$250.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$250.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$250.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$250.24
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$128.08
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$128.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$248.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$248.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$215.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$215.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$205.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$205.99
|
| Rate for Payer: Cash Price |
$296.54
|
| Rate for Payer: Cash Price |
$302.69
|
| Rate for Payer: Centivo All Commercial |
$290.25
|
| Rate for Payer: Centivo All Commercial |
$290.25
|
| Rate for Payer: Cigna All Commercial |
$187.26
|
| Rate for Payer: Cigna All Commercial |
$187.26
|
| Rate for Payer: CORVEL All Commercial |
$187.26
|
| Rate for Payer: CORVEL All Commercial |
$187.26
|
| Rate for Payer: Coventry All Commercial |
$224.71
|
| Rate for Payer: Coventry All Commercial |
$224.71
|
| Rate for Payer: Encore All Commercial |
$187.26
|
| Rate for Payer: Encore All Commercial |
$187.26
|
| Rate for Payer: Frontpath All Commercial |
$251.48
|
| Rate for Payer: Frontpath All Commercial |
$251.48
|
| Rate for Payer: Humana ChoiceCare |
$242.46
|
| Rate for Payer: Humana ChoiceCare |
$242.46
|
| Rate for Payer: Humana Medicare |
$187.26
|
| Rate for Payer: Humana Medicare |
$187.26
|
| Rate for Payer: Lucent All Commercial |
$262.16
|
| Rate for Payer: Lucent All Commercial |
$262.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$281.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$281.00
|
| Rate for Payer: Managed Health Services Medicaid |
$248.12
|
| Rate for Payer: Managed Health Services Medicaid |
$248.12
|
| Rate for Payer: MDWise Medicaid |
$248.12
|
| Rate for Payer: MDWise Medicaid |
$248.12
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$128.08
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$128.08
|
| Rate for Payer: PHCS All Commercial |
$187.26
|
| Rate for Payer: PHCS All Commercial |
$187.26
|
| Rate for Payer: PHP All Commercial |
$319.68
|
| Rate for Payer: PHP All Commercial |
$319.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$187.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$187.26
|
| Rate for Payer: Sagamore Health Network All Products |
$187.26
|
| Rate for Payer: Sagamore Health Network All Products |
$187.26
|
| Rate for Payer: Signature Care EPO |
$374.00
|
| Rate for Payer: Signature Care EPO |
$374.00
|
| Rate for Payer: Signature Care PPO |
$374.00
|
| Rate for Payer: Signature Care PPO |
$374.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,200.00
|
| Rate for Payer: United Healthcare Commercial |
$247.41
|
| Rate for Payer: United Healthcare Commercial |
$247.41
|
| Rate for Payer: United Healthcare Medicare |
$247.12
|
| Rate for Payer: United Healthcare Medicare |
$247.12
|
|
|
PR EXCISE MAJOR PERIPHERAL NEUROMA
|
Professional
|
Both
|
$1,338.28
|
|
|
Service Code
|
CPT 64784
|
| Hospital Charge Code |
z64784
|
| Min. Negotiated Rate |
$657.65 |
| Max. Negotiated Rate |
$101,100.00 |
| Rate for Payer: Aetna Commercial |
$678.62
|
| Rate for Payer: Aetna Commercial |
$678.62
|
| Rate for Payer: Aetna Medicare |
$678.62
|
| Rate for Payer: Aetna Medicare |
$678.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$800.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$800.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$800.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$800.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$800.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$800.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$800.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$800.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$658.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$658.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$780.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$780.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$746.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$746.48
|
| Rate for Payer: Cash Price |
$802.97
|
| Rate for Payer: Cash Price |
$789.18
|
| Rate for Payer: Centivo All Commercial |
$1,051.86
|
| Rate for Payer: Centivo All Commercial |
$1,051.86
|
| Rate for Payer: Cigna All Commercial |
$678.62
|
| Rate for Payer: Cigna All Commercial |
$678.62
|
| Rate for Payer: CORVEL All Commercial |
$678.62
|
| Rate for Payer: CORVEL All Commercial |
$678.62
|
| Rate for Payer: Coventry All Commercial |
$814.34
|
| Rate for Payer: Coventry All Commercial |
$814.34
|
| Rate for Payer: Encore All Commercial |
$678.62
|
| Rate for Payer: Encore All Commercial |
$678.62
|
| Rate for Payer: Frontpath All Commercial |
$944.31
|
| Rate for Payer: Frontpath All Commercial |
$944.31
|
| Rate for Payer: Humana ChoiceCare |
$839.07
|
| Rate for Payer: Humana ChoiceCare |
$839.07
|
| Rate for Payer: Humana Medicare |
$678.62
|
| Rate for Payer: Humana Medicare |
$678.62
|
| Rate for Payer: Lucent All Commercial |
$950.07
|
| Rate for Payer: Lucent All Commercial |
$950.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,079.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,079.00
|
| Rate for Payer: Managed Health Services Medicaid |
$658.22
|
| Rate for Payer: Managed Health Services Medicaid |
$658.22
|
| Rate for Payer: MDWise Medicaid |
$658.22
|
| Rate for Payer: MDWise Medicaid |
$658.22
|
| Rate for Payer: PHCS All Commercial |
$678.62
|
| Rate for Payer: PHCS All Commercial |
$678.62
|
| Rate for Payer: PHP All Commercial |
$1,150.89
|
| Rate for Payer: PHP All Commercial |
$1,150.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$678.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$678.62
|
| Rate for Payer: Sagamore Health Network All Products |
$678.62
|
| Rate for Payer: Sagamore Health Network All Products |
$678.62
|
| Rate for Payer: Signature Care EPO |
$958.80
|
| Rate for Payer: Signature Care EPO |
$958.80
|
| Rate for Payer: Signature Care PPO |
$958.80
|
| Rate for Payer: Signature Care PPO |
$958.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$101,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$101,100.00
|
| Rate for Payer: United Healthcare Commercial |
$779.61
|
| Rate for Payer: United Healthcare Commercial |
$779.61
|
| Rate for Payer: United Healthcare Medicare |
$657.65
|
| Rate for Payer: United Healthcare Medicare |
$657.65
|
|
|
PR EXCIS INTERDIGITAL NEUROMA,EA
|
Professional
|
Both
|
$994.96
|
|
|
Service Code
|
CPT 28080
|
| Hospital Charge Code |
z28080
|
| Min. Negotiated Rate |
$191.55 |
| Max. Negotiated Rate |
$547.88 |
| Rate for Payer: Aetna Commercial |
$353.47
|
| Rate for Payer: Aetna Commercial |
$353.47
|
| Rate for Payer: Aetna Medicare |
$353.47
|
| Rate for Payer: Aetna Medicare |
$353.47
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$191.55
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$191.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$489.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$489.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$406.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$406.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$388.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$388.82
|
| Rate for Payer: Cash Price |
$581.54
|
| Rate for Payer: Cash Price |
$596.98
|
| Rate for Payer: Centivo All Commercial |
$547.88
|
| Rate for Payer: Centivo All Commercial |
$547.88
|
| Rate for Payer: Cigna All Commercial |
$353.47
|
| Rate for Payer: Cigna All Commercial |
$353.47
|
| Rate for Payer: CORVEL All Commercial |
$353.47
|
| Rate for Payer: CORVEL All Commercial |
$353.47
|
| Rate for Payer: Coventry All Commercial |
$424.16
|
| Rate for Payer: Coventry All Commercial |
$424.16
|
| Rate for Payer: Encore All Commercial |
$353.47
|
| Rate for Payer: Encore All Commercial |
$353.47
|
| Rate for Payer: Frontpath All Commercial |
$478.11
|
| Rate for Payer: Frontpath All Commercial |
$478.11
|
| Rate for Payer: Humana ChoiceCare |
$310.76
|
| Rate for Payer: Humana ChoiceCare |
$310.76
|
| Rate for Payer: Humana Medicare |
$353.47
|
| Rate for Payer: Humana Medicare |
$353.47
|
| Rate for Payer: Lucent All Commercial |
$494.86
|
| Rate for Payer: Lucent All Commercial |
$494.86
|
| Rate for Payer: Managed Health Services Medicaid |
$489.37
|
| Rate for Payer: Managed Health Services Medicaid |
$489.37
|
| Rate for Payer: MDWise Medicaid |
$489.37
|
| Rate for Payer: MDWise Medicaid |
$489.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$191.55
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$191.55
|
| Rate for Payer: PHCS All Commercial |
$353.47
|
| Rate for Payer: PHCS All Commercial |
$353.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$353.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$353.47
|
| Rate for Payer: Sagamore Health Network All Products |
$353.47
|
| Rate for Payer: Sagamore Health Network All Products |
$353.47
|
| Rate for Payer: United Healthcare Commercial |
$387.88
|
| Rate for Payer: United Healthcare Commercial |
$387.88
|
| Rate for Payer: United Healthcare Medicare |
$484.62
|
| Rate for Payer: United Healthcare Medicare |
$484.62
|
|
|
PR EXCISION BRANC CLFT CYST,DEEP
|
Professional
|
Both
|
$992.30
|
|
|
Service Code
|
CPT 42815
|
| Hospital Charge Code |
z42815
|
| Min. Negotiated Rate |
$494.58 |
| Max. Negotiated Rate |
$71,200.00 |
| Rate for Payer: Aetna Commercial |
$509.23
|
| Rate for Payer: Aetna Commercial |
$509.23
|
| Rate for Payer: Aetna Medicare |
$509.23
|
| Rate for Payer: Aetna Medicare |
$509.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$709.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$709.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$709.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$709.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$709.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$709.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$709.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$709.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$494.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$494.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$585.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$585.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$560.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$560.15
|
| Rate for Payer: Cash Price |
$595.38
|
| Rate for Payer: Cash Price |
$603.35
|
| Rate for Payer: Centivo All Commercial |
$789.31
|
| Rate for Payer: Centivo All Commercial |
$789.31
|
| Rate for Payer: Cigna All Commercial |
$509.23
|
| Rate for Payer: Cigna All Commercial |
$509.23
|
| Rate for Payer: CORVEL All Commercial |
$509.23
|
| Rate for Payer: CORVEL All Commercial |
$509.23
|
| Rate for Payer: Coventry All Commercial |
$611.08
|
| Rate for Payer: Coventry All Commercial |
$611.08
|
| Rate for Payer: Encore All Commercial |
$509.23
|
| Rate for Payer: Encore All Commercial |
$509.23
|
| Rate for Payer: Frontpath All Commercial |
$696.49
|
| Rate for Payer: Frontpath All Commercial |
$696.49
|
| Rate for Payer: Humana ChoiceCare |
$596.60
|
| Rate for Payer: Humana ChoiceCare |
$596.60
|
| Rate for Payer: Humana Medicare |
$509.23
|
| Rate for Payer: Humana Medicare |
$509.23
|
| Rate for Payer: Lucent All Commercial |
$712.92
|
| Rate for Payer: Lucent All Commercial |
$712.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$763.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$763.00
|
| Rate for Payer: Managed Health Services Medicaid |
$494.58
|
| Rate for Payer: Managed Health Services Medicaid |
$494.58
|
| Rate for Payer: MDWise Medicaid |
$494.58
|
| Rate for Payer: MDWise Medicaid |
$494.58
|
| Rate for Payer: PHCS All Commercial |
$509.23
|
| Rate for Payer: PHCS All Commercial |
$509.23
|
| Rate for Payer: PHP All Commercial |
$868.26
|
| Rate for Payer: PHP All Commercial |
$868.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$509.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$509.23
|
| Rate for Payer: Sagamore Health Network All Products |
$509.23
|
| Rate for Payer: Sagamore Health Network All Products |
$509.23
|
| Rate for Payer: Signature Care EPO |
$705.50
|
| Rate for Payer: Signature Care EPO |
$705.50
|
| Rate for Payer: Signature Care PPO |
$705.50
|
| Rate for Payer: Signature Care PPO |
$705.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71,200.00
|
| Rate for Payer: United Healthcare Commercial |
$605.64
|
| Rate for Payer: United Healthcare Commercial |
$605.64
|
| Rate for Payer: United Healthcare Medicare |
$496.15
|
| Rate for Payer: United Healthcare Medicare |
$496.15
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Professional
|
Both
|
$965.82
|
|
|
Service Code
|
CPT 11451
|
| Hospital Charge Code |
z11451
|
| Min. Negotiated Rate |
$169.40 |
| Max. Negotiated Rate |
$36,800.00 |
| Rate for Payer: Aetna Commercial |
$306.10
|
| Rate for Payer: Aetna Commercial |
$306.10
|
| Rate for Payer: Aetna Medicare |
$306.10
|
| Rate for Payer: Aetna Medicare |
$306.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$454.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$454.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$454.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$454.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$454.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$454.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$454.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$454.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$169.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$169.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$475.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$475.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$352.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$352.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$336.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$336.71
|
| Rate for Payer: Cash Price |
$574.04
|
| Rate for Payer: Cash Price |
$579.49
|
| Rate for Payer: Centivo All Commercial |
$474.45
|
| Rate for Payer: Centivo All Commercial |
$474.45
|
| Rate for Payer: Cigna All Commercial |
$306.10
|
| Rate for Payer: Cigna All Commercial |
$306.10
|
| Rate for Payer: CORVEL All Commercial |
$306.10
|
| Rate for Payer: CORVEL All Commercial |
$306.10
|
| Rate for Payer: Coventry All Commercial |
$367.32
|
| Rate for Payer: Coventry All Commercial |
$367.32
|
| Rate for Payer: Encore All Commercial |
$306.10
|
| Rate for Payer: Encore All Commercial |
$306.10
|
| Rate for Payer: Frontpath All Commercial |
$427.12
|
| Rate for Payer: Frontpath All Commercial |
$427.12
|
| Rate for Payer: Humana ChoiceCare |
$245.63
|
| Rate for Payer: Humana ChoiceCare |
$245.63
|
| Rate for Payer: Humana Medicare |
$306.10
|
| Rate for Payer: Humana Medicare |
$306.10
|
| Rate for Payer: Lucent All Commercial |
$428.54
|
| Rate for Payer: Lucent All Commercial |
$428.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$399.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$399.00
|
| Rate for Payer: Managed Health Services Medicaid |
$475.03
|
| Rate for Payer: Managed Health Services Medicaid |
$475.03
|
| Rate for Payer: MDWise Medicaid |
$475.03
|
| Rate for Payer: MDWise Medicaid |
$475.03
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$169.40
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$169.40
|
| Rate for Payer: PHCS All Commercial |
$306.10
|
| Rate for Payer: PHCS All Commercial |
$306.10
|
| Rate for Payer: PHP All Commercial |
$418.83
|
| Rate for Payer: PHP All Commercial |
$418.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$306.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$306.10
|
| Rate for Payer: Sagamore Health Network All Products |
$306.10
|
| Rate for Payer: Sagamore Health Network All Products |
$306.10
|
| Rate for Payer: Signature Care EPO |
$434.35
|
| Rate for Payer: Signature Care EPO |
$434.35
|
| Rate for Payer: Signature Care PPO |
$434.35
|
| Rate for Payer: Signature Care PPO |
$434.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$36,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$36,800.00
|
| Rate for Payer: United Healthcare Commercial |
$327.55
|
| Rate for Payer: United Healthcare Commercial |
$327.55
|
| Rate for Payer: United Healthcare Medicare |
$478.37
|
| Rate for Payer: United Healthcare Medicare |
$478.37
|
|
|
PR EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR
|
Professional
|
Both
|
$791.94
|
|
|
Service Code
|
CPT 11450
|
| Hospital Charge Code |
z11450
|
| Min. Negotiated Rate |
$134.62 |
| Max. Negotiated Rate |
$28,900.00 |
| Rate for Payer: Aetna Commercial |
$242.17
|
| Rate for Payer: Aetna Commercial |
$242.17
|
| Rate for Payer: Aetna Medicare |
$242.17
|
| Rate for Payer: Aetna Medicare |
$242.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$346.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$346.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$346.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$346.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$346.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$346.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$346.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$346.94
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$134.62
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$134.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$389.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$389.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$278.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$278.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$266.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$266.39
|
| Rate for Payer: Cash Price |
$469.14
|
| Rate for Payer: Cash Price |
$475.16
|
| Rate for Payer: Centivo All Commercial |
$375.36
|
| Rate for Payer: Centivo All Commercial |
$375.36
|
| Rate for Payer: Cigna All Commercial |
$242.17
|
| Rate for Payer: Cigna All Commercial |
$242.17
|
| Rate for Payer: CORVEL All Commercial |
$242.17
|
| Rate for Payer: CORVEL All Commercial |
$242.17
|
| Rate for Payer: Coventry All Commercial |
$290.60
|
| Rate for Payer: Coventry All Commercial |
$290.60
|
| Rate for Payer: Encore All Commercial |
$242.17
|
| Rate for Payer: Encore All Commercial |
$242.17
|
| Rate for Payer: Frontpath All Commercial |
$338.27
|
| Rate for Payer: Frontpath All Commercial |
$338.27
|
| Rate for Payer: Humana ChoiceCare |
$178.78
|
| Rate for Payer: Humana ChoiceCare |
$178.78
|
| Rate for Payer: Humana Medicare |
$242.17
|
| Rate for Payer: Humana Medicare |
$242.17
|
| Rate for Payer: Lucent All Commercial |
$339.04
|
| Rate for Payer: Lucent All Commercial |
$339.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$313.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$313.00
|
| Rate for Payer: Managed Health Services Medicaid |
$389.50
|
| Rate for Payer: Managed Health Services Medicaid |
$389.50
|
| Rate for Payer: MDWise Medicaid |
$389.50
|
| Rate for Payer: MDWise Medicaid |
$389.50
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$134.62
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$134.62
|
| Rate for Payer: PHCS All Commercial |
$242.17
|
| Rate for Payer: PHCS All Commercial |
$242.17
|
| Rate for Payer: PHP All Commercial |
$329.33
|
| Rate for Payer: PHP All Commercial |
$329.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.17
|
| Rate for Payer: Sagamore Health Network All Products |
$242.17
|
| Rate for Payer: Sagamore Health Network All Products |
$242.17
|
| Rate for Payer: Signature Care EPO |
$347.21
|
| Rate for Payer: Signature Care EPO |
$347.21
|
| Rate for Payer: Signature Care PPO |
$347.21
|
| Rate for Payer: Signature Care PPO |
$347.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28,900.00
|
| Rate for Payer: United Healthcare Commercial |
$247.59
|
| Rate for Payer: United Healthcare Commercial |
$247.59
|
| Rate for Payer: United Healthcare Medicare |
$390.95
|
| Rate for Payer: United Healthcare Medicare |
$390.95
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$770.44
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
z11462
|
| Min. Negotiated Rate |
$131.15 |
| Max. Negotiated Rate |
$27,500.00 |
| Rate for Payer: Aetna Commercial |
$230.61
|
| Rate for Payer: Aetna Commercial |
$230.61
|
| Rate for Payer: Aetna Medicare |
$230.61
|
| Rate for Payer: Aetna Medicare |
$230.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$342.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$342.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$342.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$342.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$342.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$342.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$342.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$342.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$131.15
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$131.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$378.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$378.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.67
|
| Rate for Payer: Cash Price |
$454.38
|
| Rate for Payer: Cash Price |
$462.26
|
| Rate for Payer: Centivo All Commercial |
$357.45
|
| Rate for Payer: Centivo All Commercial |
$357.45
|
| Rate for Payer: Cigna All Commercial |
$230.61
|
| Rate for Payer: Cigna All Commercial |
$230.61
|
| Rate for Payer: CORVEL All Commercial |
$230.61
|
| Rate for Payer: CORVEL All Commercial |
$230.61
|
| Rate for Payer: Coventry All Commercial |
$276.73
|
| Rate for Payer: Coventry All Commercial |
$276.73
|
| Rate for Payer: Encore All Commercial |
$230.61
|
| Rate for Payer: Encore All Commercial |
$230.61
|
| Rate for Payer: Frontpath All Commercial |
$320.66
|
| Rate for Payer: Frontpath All Commercial |
$320.66
|
| Rate for Payer: Humana ChoiceCare |
$169.77
|
| Rate for Payer: Humana ChoiceCare |
$169.77
|
| Rate for Payer: Humana Medicare |
$230.61
|
| Rate for Payer: Humana Medicare |
$230.61
|
| Rate for Payer: Lucent All Commercial |
$322.85
|
| Rate for Payer: Lucent All Commercial |
$322.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$298.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$298.00
|
| Rate for Payer: Managed Health Services Medicaid |
$378.93
|
| Rate for Payer: Managed Health Services Medicaid |
$378.93
|
| Rate for Payer: MDWise Medicaid |
$378.93
|
| Rate for Payer: MDWise Medicaid |
$378.93
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$131.15
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$131.15
|
| Rate for Payer: PHCS All Commercial |
$230.61
|
| Rate for Payer: PHCS All Commercial |
$230.61
|
| Rate for Payer: PHP All Commercial |
$312.95
|
| Rate for Payer: PHP All Commercial |
$312.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$230.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$230.61
|
| Rate for Payer: Sagamore Health Network All Products |
$230.61
|
| Rate for Payer: Sagamore Health Network All Products |
$230.61
|
| Rate for Payer: Signature Care EPO |
$337.39
|
| Rate for Payer: Signature Care EPO |
$337.39
|
| Rate for Payer: Signature Care PPO |
$337.39
|
| Rate for Payer: Signature Care PPO |
$337.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,500.00
|
| Rate for Payer: United Healthcare Commercial |
$237.96
|
| Rate for Payer: United Healthcare Commercial |
$237.96
|
| Rate for Payer: United Healthcare Medicare |
$378.65
|
| Rate for Payer: United Healthcare Medicare |
$378.65
|
|
|
PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR
|
Professional
|
Both
|
$838.90
|
|
|
Service Code
|
CPT 11470
|
| Hospital Charge Code |
z11470
|
| Min. Negotiated Rate |
$146.56 |
| Max. Negotiated Rate |
$32,000.00 |
| Rate for Payer: Aetna Commercial |
$265.46
|
| Rate for Payer: Aetna Commercial |
$265.46
|
| Rate for Payer: Aetna Medicare |
$265.46
|
| Rate for Payer: Aetna Medicare |
$265.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$381.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$381.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$381.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$381.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$381.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$381.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$381.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$381.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$146.56
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$146.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$412.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$412.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$305.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$305.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$292.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$292.01
|
| Rate for Payer: Cash Price |
$498.64
|
| Rate for Payer: Cash Price |
$503.34
|
| Rate for Payer: Centivo All Commercial |
$411.46
|
| Rate for Payer: Centivo All Commercial |
$411.46
|
| Rate for Payer: Cigna All Commercial |
$265.46
|
| Rate for Payer: Cigna All Commercial |
$265.46
|
| Rate for Payer: CORVEL All Commercial |
$265.46
|
| Rate for Payer: CORVEL All Commercial |
$265.46
|
| Rate for Payer: Coventry All Commercial |
$318.55
|
| Rate for Payer: Coventry All Commercial |
$318.55
|
| Rate for Payer: Encore All Commercial |
$265.46
|
| Rate for Payer: Encore All Commercial |
$265.46
|
| Rate for Payer: Frontpath All Commercial |
$368.64
|
| Rate for Payer: Frontpath All Commercial |
$368.64
|
| Rate for Payer: Humana ChoiceCare |
$207.72
|
| Rate for Payer: Humana ChoiceCare |
$207.72
|
| Rate for Payer: Humana Medicare |
$265.46
|
| Rate for Payer: Humana Medicare |
$265.46
|
| Rate for Payer: Lucent All Commercial |
$371.64
|
| Rate for Payer: Lucent All Commercial |
$371.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$346.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$346.00
|
| Rate for Payer: Managed Health Services Medicaid |
$412.60
|
| Rate for Payer: Managed Health Services Medicaid |
$412.60
|
| Rate for Payer: MDWise Medicaid |
$412.60
|
| Rate for Payer: MDWise Medicaid |
$412.60
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$146.56
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$146.56
|
| Rate for Payer: PHCS All Commercial |
$265.46
|
| Rate for Payer: PHCS All Commercial |
$265.46
|
| Rate for Payer: PHP All Commercial |
$363.74
|
| Rate for Payer: PHP All Commercial |
$363.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$265.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$265.46
|
| Rate for Payer: Sagamore Health Network All Products |
$265.46
|
| Rate for Payer: Sagamore Health Network All Products |
$265.46
|
| Rate for Payer: Signature Care EPO |
$365.15
|
| Rate for Payer: Signature Care EPO |
$365.15
|
| Rate for Payer: Signature Care PPO |
$365.15
|
| Rate for Payer: Signature Care PPO |
$365.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,000.00
|
| Rate for Payer: United Healthcare Commercial |
$282.18
|
| Rate for Payer: United Healthcare Commercial |
$282.18
|
| Rate for Payer: United Healthcare Medicare |
$415.53
|
| Rate for Payer: United Healthcare Medicare |
$415.53
|
|
|
PR EXCISION NOSE POLYP(S),SIMPLE
|
Professional
|
Both
|
$463.34
|
|
|
Service Code
|
CPT 30110
|
| Hospital Charge Code |
z30110
|
| Min. Negotiated Rate |
$88.46 |
| Max. Negotiated Rate |
$18,700.00 |
| Rate for Payer: Aetna Commercial |
$123.67
|
| Rate for Payer: Aetna Commercial |
$123.67
|
| Rate for Payer: Aetna Medicare |
$123.67
|
| Rate for Payer: Aetna Medicare |
$123.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$241.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$241.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$241.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$241.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$241.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$241.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$241.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$241.95
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$88.46
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$88.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$227.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$227.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$142.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$142.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$136.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$136.04
|
| Rate for Payer: Cash Price |
$274.10
|
| Rate for Payer: Cash Price |
$278.00
|
| Rate for Payer: Centivo All Commercial |
$191.69
|
| Rate for Payer: Centivo All Commercial |
$191.69
|
| Rate for Payer: Cigna All Commercial |
$123.67
|
| Rate for Payer: Cigna All Commercial |
$123.67
|
| Rate for Payer: CORVEL All Commercial |
$123.67
|
| Rate for Payer: CORVEL All Commercial |
$123.67
|
| Rate for Payer: Coventry All Commercial |
$148.40
|
| Rate for Payer: Coventry All Commercial |
$148.40
|
| Rate for Payer: Encore All Commercial |
$123.67
|
| Rate for Payer: Encore All Commercial |
$123.67
|
| Rate for Payer: Frontpath All Commercial |
$168.71
|
| Rate for Payer: Frontpath All Commercial |
$168.71
|
| Rate for Payer: Humana ChoiceCare |
$143.36
|
| Rate for Payer: Humana ChoiceCare |
$143.36
|
| Rate for Payer: Humana Medicare |
$123.67
|
| Rate for Payer: Humana Medicare |
$123.67
|
| Rate for Payer: Lucent All Commercial |
$173.14
|
| Rate for Payer: Lucent All Commercial |
$173.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$199.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$199.00
|
| Rate for Payer: Managed Health Services Medicaid |
$227.89
|
| Rate for Payer: Managed Health Services Medicaid |
$227.89
|
| Rate for Payer: MDWise Medicaid |
$227.89
|
| Rate for Payer: MDWise Medicaid |
$227.89
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$88.46
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$88.46
|
| Rate for Payer: PHCS All Commercial |
$123.67
|
| Rate for Payer: PHCS All Commercial |
$123.67
|
| Rate for Payer: PHP All Commercial |
$170.10
|
| Rate for Payer: PHP All Commercial |
$170.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$123.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$123.67
|
| Rate for Payer: Sagamore Health Network All Products |
$123.67
|
| Rate for Payer: Sagamore Health Network All Products |
$123.67
|
| Rate for Payer: Signature Care EPO |
$256.70
|
| Rate for Payer: Signature Care EPO |
$256.70
|
| Rate for Payer: Signature Care PPO |
$256.70
|
| Rate for Payer: Signature Care PPO |
$256.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,700.00
|
| Rate for Payer: United Healthcare Commercial |
$140.25
|
| Rate for Payer: United Healthcare Commercial |
$140.25
|
| Rate for Payer: United Healthcare Medicare |
$228.42
|
| Rate for Payer: United Healthcare Medicare |
$228.42
|
|
|
PR EXCISION OF MESENTERY LESION
|
Professional
|
Both
|
$1,542.14
|
|
|
Service Code
|
CPT 44820
|
| Hospital Charge Code |
z44820
|
| Min. Negotiated Rate |
$757.91 |
| Max. Negotiated Rate |
$108,800.00 |
| Rate for Payer: Aetna Commercial |
$788.41
|
| Rate for Payer: Aetna Commercial |
$788.41
|
| Rate for Payer: Aetna Medicare |
$788.41
|
| Rate for Payer: Aetna Medicare |
$788.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$804.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$804.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$804.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$804.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$804.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$804.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$804.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$804.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$758.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$758.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$906.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$906.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$867.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$867.25
|
| Rate for Payer: Cash Price |
$925.28
|
| Rate for Payer: Cash Price |
$909.49
|
| Rate for Payer: Centivo All Commercial |
$1,222.04
|
| Rate for Payer: Centivo All Commercial |
$1,222.04
|
| Rate for Payer: Cigna All Commercial |
$788.41
|
| Rate for Payer: Cigna All Commercial |
$788.41
|
| Rate for Payer: CORVEL All Commercial |
$788.41
|
| Rate for Payer: CORVEL All Commercial |
$788.41
|
| Rate for Payer: Coventry All Commercial |
$946.09
|
| Rate for Payer: Coventry All Commercial |
$946.09
|
| Rate for Payer: Encore All Commercial |
$788.41
|
| Rate for Payer: Encore All Commercial |
$788.41
|
| Rate for Payer: Frontpath All Commercial |
$1,128.23
|
| Rate for Payer: Frontpath All Commercial |
$1,128.23
|
| Rate for Payer: Humana ChoiceCare |
$805.03
|
| Rate for Payer: Humana ChoiceCare |
$805.03
|
| Rate for Payer: Humana Medicare |
$788.41
|
| Rate for Payer: Humana Medicare |
$788.41
|
| Rate for Payer: Lucent All Commercial |
$1,103.77
|
| Rate for Payer: Lucent All Commercial |
$1,103.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,166.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,166.00
|
| Rate for Payer: Managed Health Services Medicaid |
$758.49
|
| Rate for Payer: Managed Health Services Medicaid |
$758.49
|
| Rate for Payer: MDWise Medicaid |
$758.49
|
| Rate for Payer: MDWise Medicaid |
$758.49
|
| Rate for Payer: PHCS All Commercial |
$788.41
|
| Rate for Payer: PHCS All Commercial |
$788.41
|
| Rate for Payer: PHP All Commercial |
$1,326.35
|
| Rate for Payer: PHP All Commercial |
$1,326.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$788.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$788.41
|
| Rate for Payer: Sagamore Health Network All Products |
$788.41
|
| Rate for Payer: Sagamore Health Network All Products |
$788.41
|
| Rate for Payer: Signature Care EPO |
$1,013.20
|
| Rate for Payer: Signature Care EPO |
$1,013.20
|
| Rate for Payer: Signature Care PPO |
$1,013.20
|
| Rate for Payer: Signature Care PPO |
$1,013.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$108,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$108,800.00
|
| Rate for Payer: United Healthcare Commercial |
$894.56
|
| Rate for Payer: United Healthcare Commercial |
$894.56
|
| Rate for Payer: United Healthcare Medicare |
$757.91
|
| Rate for Payer: United Healthcare Medicare |
$757.91
|
|
|
PR EXCISION OF NAIL FOLD, TOE
|
Professional
|
Both
|
$310.34
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
z11765
|
| Min. Negotiated Rate |
$46.55 |
| Max. Negotiated Rate |
$10,400.00 |
| Rate for Payer: Aetna Commercial |
$86.50
|
| Rate for Payer: Aetna Commercial |
$86.50
|
| Rate for Payer: Aetna Medicare |
$86.50
|
| Rate for Payer: Aetna Medicare |
$86.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$86.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$86.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$86.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$86.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$86.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$86.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$86.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$86.19
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$46.55
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$46.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$152.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$152.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$99.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$99.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$95.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$95.15
|
| Rate for Payer: Cash Price |
$181.48
|
| Rate for Payer: Cash Price |
$186.20
|
| Rate for Payer: Centivo All Commercial |
$134.07
|
| Rate for Payer: Centivo All Commercial |
$134.07
|
| Rate for Payer: Cigna All Commercial |
$86.50
|
| Rate for Payer: Cigna All Commercial |
$86.50
|
| Rate for Payer: CORVEL All Commercial |
$86.50
|
| Rate for Payer: CORVEL All Commercial |
$86.50
|
| Rate for Payer: Coventry All Commercial |
$103.80
|
| Rate for Payer: Coventry All Commercial |
$103.80
|
| Rate for Payer: Encore All Commercial |
$86.50
|
| Rate for Payer: Encore All Commercial |
$86.50
|
| Rate for Payer: Frontpath All Commercial |
$116.08
|
| Rate for Payer: Frontpath All Commercial |
$116.08
|
| Rate for Payer: Humana ChoiceCare |
$53.57
|
| Rate for Payer: Humana ChoiceCare |
$53.57
|
| Rate for Payer: Humana Medicare |
$86.50
|
| Rate for Payer: Humana Medicare |
$86.50
|
| Rate for Payer: Lucent All Commercial |
$121.10
|
| Rate for Payer: Lucent All Commercial |
$121.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$113.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$113.00
|
| Rate for Payer: Managed Health Services Medicaid |
$152.64
|
| Rate for Payer: Managed Health Services Medicaid |
$152.64
|
| Rate for Payer: MDWise Medicaid |
$152.64
|
| Rate for Payer: MDWise Medicaid |
$152.64
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$46.55
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$46.55
|
| Rate for Payer: PHCS All Commercial |
$86.50
|
| Rate for Payer: PHCS All Commercial |
$86.50
|
| Rate for Payer: PHP All Commercial |
$118.54
|
| Rate for Payer: PHP All Commercial |
$118.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$86.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$86.50
|
| Rate for Payer: Sagamore Health Network All Products |
$86.50
|
| Rate for Payer: Sagamore Health Network All Products |
$86.50
|
| Rate for Payer: Signature Care EPO |
$134.50
|
| Rate for Payer: Signature Care EPO |
$134.50
|
| Rate for Payer: Signature Care PPO |
$134.50
|
| Rate for Payer: Signature Care PPO |
$134.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,400.00
|
| Rate for Payer: United Healthcare Commercial |
$72.25
|
| Rate for Payer: United Healthcare Commercial |
$72.25
|
| Rate for Payer: United Healthcare Medicare |
$151.23
|
| Rate for Payer: United Healthcare Medicare |
$151.23
|
|
|
PR EXCISION THROMBOSED HEMORRHOID, EXTERNAL
|
Professional
|
Both
|
$395.38
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
z46320
|
| Min. Negotiated Rate |
$74.39 |
| Max. Negotiated Rate |
$14,700.00 |
| Rate for Payer: Aetna Commercial |
$106.11
|
| Rate for Payer: Aetna Commercial |
$106.11
|
| Rate for Payer: Aetna Medicare |
$106.11
|
| Rate for Payer: Aetna Medicare |
$106.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$185.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$185.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$185.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$185.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$185.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$185.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$74.39
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$74.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$194.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$194.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$122.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$122.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$116.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$116.72
|
| Rate for Payer: Cash Price |
$233.51
|
| Rate for Payer: Cash Price |
$237.23
|
| Rate for Payer: Centivo All Commercial |
$164.47
|
| Rate for Payer: Centivo All Commercial |
$164.47
|
| Rate for Payer: Cigna All Commercial |
$106.11
|
| Rate for Payer: Cigna All Commercial |
$106.11
|
| Rate for Payer: CORVEL All Commercial |
$106.11
|
| Rate for Payer: CORVEL All Commercial |
$106.11
|
| Rate for Payer: Coventry All Commercial |
$127.33
|
| Rate for Payer: Coventry All Commercial |
$127.33
|
| Rate for Payer: Encore All Commercial |
$106.11
|
| Rate for Payer: Encore All Commercial |
$106.11
|
| Rate for Payer: Frontpath All Commercial |
$146.70
|
| Rate for Payer: Frontpath All Commercial |
$146.70
|
| Rate for Payer: Humana ChoiceCare |
$111.52
|
| Rate for Payer: Humana ChoiceCare |
$111.52
|
| Rate for Payer: Humana Medicare |
$106.11
|
| Rate for Payer: Humana Medicare |
$106.11
|
| Rate for Payer: Lucent All Commercial |
$148.55
|
| Rate for Payer: Lucent All Commercial |
$148.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$158.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$158.00
|
| Rate for Payer: Managed Health Services Medicaid |
$194.46
|
| Rate for Payer: Managed Health Services Medicaid |
$194.46
|
| Rate for Payer: MDWise Medicaid |
$194.46
|
| Rate for Payer: MDWise Medicaid |
$194.46
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$74.39
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$74.39
|
| Rate for Payer: PHCS All Commercial |
$106.11
|
| Rate for Payer: PHCS All Commercial |
$106.11
|
| Rate for Payer: PHP All Commercial |
$179.78
|
| Rate for Payer: PHP All Commercial |
$179.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$106.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$106.11
|
| Rate for Payer: Sagamore Health Network All Products |
$106.11
|
| Rate for Payer: Sagamore Health Network All Products |
$106.11
|
| Rate for Payer: Signature Care EPO |
$208.25
|
| Rate for Payer: Signature Care EPO |
$208.25
|
| Rate for Payer: Signature Care PPO |
$208.25
|
| Rate for Payer: Signature Care PPO |
$208.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,700.00
|
| Rate for Payer: United Healthcare Commercial |
$114.73
|
| Rate for Payer: United Healthcare Commercial |
$114.73
|
| Rate for Payer: United Healthcare Medicare |
$194.59
|
| Rate for Payer: United Healthcare Medicare |
$194.59
|
|
|
PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM
|
Professional
|
Both
|
$628.26
|
|
|
Service Code
|
CPT 21012
|
| Hospital Charge Code |
z21012
|
| Min. Negotiated Rate |
$307.33 |
| Max. Negotiated Rate |
$47,300.00 |
| Rate for Payer: Aetna Commercial |
$315.49
|
| Rate for Payer: Aetna Commercial |
$315.49
|
| Rate for Payer: Aetna Medicare |
$315.49
|
| Rate for Payer: Aetna Medicare |
$315.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$393.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$393.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$393.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$393.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$393.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$393.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$393.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$393.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$309.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$309.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$362.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$362.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$347.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$347.04
|
| Rate for Payer: Cash Price |
$376.96
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Centivo All Commercial |
$489.01
|
| Rate for Payer: Centivo All Commercial |
$489.01
|
| Rate for Payer: Cigna All Commercial |
$315.49
|
| Rate for Payer: Cigna All Commercial |
$315.49
|
| Rate for Payer: CORVEL All Commercial |
$315.49
|
| Rate for Payer: CORVEL All Commercial |
$315.49
|
| Rate for Payer: Coventry All Commercial |
$378.59
|
| Rate for Payer: Coventry All Commercial |
$378.59
|
| Rate for Payer: Encore All Commercial |
$315.49
|
| Rate for Payer: Encore All Commercial |
$315.49
|
| Rate for Payer: Frontpath All Commercial |
$438.36
|
| Rate for Payer: Frontpath All Commercial |
$438.36
|
| Rate for Payer: Humana ChoiceCare |
$352.57
|
| Rate for Payer: Humana ChoiceCare |
$352.57
|
| Rate for Payer: Humana Medicare |
$315.49
|
| Rate for Payer: Humana Medicare |
$315.49
|
| Rate for Payer: Lucent All Commercial |
$441.69
|
| Rate for Payer: Lucent All Commercial |
$441.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.00
|
| Rate for Payer: Managed Health Services Medicaid |
$309.00
|
| Rate for Payer: Managed Health Services Medicaid |
$309.00
|
| Rate for Payer: MDWise Medicaid |
$309.00
|
| Rate for Payer: MDWise Medicaid |
$309.00
|
| Rate for Payer: PHCS All Commercial |
$315.49
|
| Rate for Payer: PHCS All Commercial |
$315.49
|
| Rate for Payer: PHP All Commercial |
$534.75
|
| Rate for Payer: PHP All Commercial |
$534.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$315.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$315.49
|
| Rate for Payer: Sagamore Health Network All Products |
$315.49
|
| Rate for Payer: Sagamore Health Network All Products |
$315.49
|
| Rate for Payer: Signature Care EPO |
$338.30
|
| Rate for Payer: Signature Care EPO |
$338.30
|
| Rate for Payer: Signature Care PPO |
$338.30
|
| Rate for Payer: Signature Care PPO |
$338.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,300.00
|
| Rate for Payer: United Healthcare Commercial |
$385.86
|
| Rate for Payer: United Healthcare Commercial |
$385.86
|
| Rate for Payer: United Healthcare Medicare |
$307.33
|
| Rate for Payer: United Healthcare Medicare |
$307.33
|
|
|
PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM
|
Professional
|
Both
|
$862.10
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
z21931
|
| Min. Negotiated Rate |
$422.15 |
| Max. Negotiated Rate |
$64,900.00 |
| Rate for Payer: Aetna Commercial |
$436.23
|
| Rate for Payer: Aetna Commercial |
$436.23
|
| Rate for Payer: Aetna Medicare |
$436.23
|
| Rate for Payer: Aetna Medicare |
$436.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$550.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$550.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$550.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$550.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$550.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$550.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$550.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$550.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$424.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$424.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$501.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$501.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$479.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$479.85
|
| Rate for Payer: Cash Price |
$517.26
|
| Rate for Payer: Cash Price |
$506.58
|
| Rate for Payer: Centivo All Commercial |
$676.16
|
| Rate for Payer: Centivo All Commercial |
$676.16
|
| Rate for Payer: Cigna All Commercial |
$436.23
|
| Rate for Payer: Cigna All Commercial |
$436.23
|
| Rate for Payer: CORVEL All Commercial |
$436.23
|
| Rate for Payer: CORVEL All Commercial |
$436.23
|
| Rate for Payer: Coventry All Commercial |
$523.48
|
| Rate for Payer: Coventry All Commercial |
$523.48
|
| Rate for Payer: Encore All Commercial |
$436.23
|
| Rate for Payer: Encore All Commercial |
$436.23
|
| Rate for Payer: Frontpath All Commercial |
$615.90
|
| Rate for Payer: Frontpath All Commercial |
$615.90
|
| Rate for Payer: Humana ChoiceCare |
$491.07
|
| Rate for Payer: Humana ChoiceCare |
$491.07
|
| Rate for Payer: Humana Medicare |
$436.23
|
| Rate for Payer: Humana Medicare |
$436.23
|
| Rate for Payer: Lucent All Commercial |
$610.72
|
| Rate for Payer: Lucent All Commercial |
$610.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$692.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$692.00
|
| Rate for Payer: Managed Health Services Medicaid |
$424.01
|
| Rate for Payer: Managed Health Services Medicaid |
$424.01
|
| Rate for Payer: MDWise Medicaid |
$424.01
|
| Rate for Payer: MDWise Medicaid |
$424.01
|
| Rate for Payer: PHCS All Commercial |
$436.23
|
| Rate for Payer: PHCS All Commercial |
$436.23
|
| Rate for Payer: PHP All Commercial |
$734.54
|
| Rate for Payer: PHP All Commercial |
$734.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$436.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$436.23
|
| Rate for Payer: Sagamore Health Network All Products |
$436.23
|
| Rate for Payer: Sagamore Health Network All Products |
$436.23
|
| Rate for Payer: Signature Care EPO |
$470.90
|
| Rate for Payer: Signature Care EPO |
$470.90
|
| Rate for Payer: Signature Care PPO |
$470.90
|
| Rate for Payer: Signature Care PPO |
$470.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$64,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$64,900.00
|
| Rate for Payer: United Healthcare Commercial |
$537.74
|
| Rate for Payer: United Healthcare Commercial |
$537.74
|
| Rate for Payer: United Healthcare Medicare |
$422.15
|
| Rate for Payer: United Healthcare Medicare |
$422.15
|
|
|
PR EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
CPT 28039
|
| Hospital Charge Code |
z28039
|
| Min. Negotiated Rate |
$177.19 |
| Max. Negotiated Rate |
$505.22 |
| Rate for Payer: Aetna Commercial |
$325.95
|
| Rate for Payer: Aetna Commercial |
$325.95
|
| Rate for Payer: Aetna Medicare |
$325.95
|
| Rate for Payer: Aetna Medicare |
$325.95
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$177.19
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$177.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$437.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$437.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$374.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$374.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$358.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$358.55
|
| Rate for Payer: Cash Price |
$527.26
|
| Rate for Payer: Cash Price |
$534.00
|
| Rate for Payer: Centivo All Commercial |
$505.22
|
| Rate for Payer: Centivo All Commercial |
$505.22
|
| Rate for Payer: Cigna All Commercial |
$325.95
|
| Rate for Payer: Cigna All Commercial |
$325.95
|
| Rate for Payer: CORVEL All Commercial |
$325.95
|
| Rate for Payer: CORVEL All Commercial |
$325.95
|
| Rate for Payer: Coventry All Commercial |
$391.14
|
| Rate for Payer: Coventry All Commercial |
$391.14
|
| Rate for Payer: Encore All Commercial |
$325.95
|
| Rate for Payer: Encore All Commercial |
$325.95
|
| Rate for Payer: Frontpath All Commercial |
$448.16
|
| Rate for Payer: Frontpath All Commercial |
$448.16
|
| Rate for Payer: Humana ChoiceCare |
$360.84
|
| Rate for Payer: Humana ChoiceCare |
$360.84
|
| Rate for Payer: Humana Medicare |
$325.95
|
| Rate for Payer: Humana Medicare |
$325.95
|
| Rate for Payer: Lucent All Commercial |
$456.33
|
| Rate for Payer: Lucent All Commercial |
$456.33
|
| Rate for Payer: Managed Health Services Medicaid |
$437.74
|
| Rate for Payer: Managed Health Services Medicaid |
$437.74
|
| Rate for Payer: MDWise Medicaid |
$437.74
|
| Rate for Payer: MDWise Medicaid |
$437.74
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$177.19
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$177.19
|
| Rate for Payer: PHCS All Commercial |
$325.95
|
| Rate for Payer: PHCS All Commercial |
$325.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$325.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$325.95
|
| Rate for Payer: Sagamore Health Network All Products |
$325.95
|
| Rate for Payer: Sagamore Health Network All Products |
$325.95
|
| Rate for Payer: United Healthcare Commercial |
$395.04
|
| Rate for Payer: United Healthcare Commercial |
$395.04
|
| Rate for Payer: United Healthcare Medicare |
$439.38
|
| Rate for Payer: United Healthcare Medicare |
$439.38
|
|
|
PR EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM
|
Professional
|
Both
|
$861.20
|
|
|
Service Code
|
CPT 27043
|
| Hospital Charge Code |
z27043
|
| Min. Negotiated Rate |
$422.15 |
| Max. Negotiated Rate |
$64,900.00 |
| Rate for Payer: Aetna Commercial |
$435.15
|
| Rate for Payer: Aetna Commercial |
$435.15
|
| Rate for Payer: Aetna Medicare |
$435.15
|
| Rate for Payer: Aetna Medicare |
$435.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$549.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$549.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$549.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$549.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$549.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$549.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$549.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$549.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$423.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$423.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$500.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$500.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$478.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$478.67
|
| Rate for Payer: Cash Price |
$516.72
|
| Rate for Payer: Cash Price |
$506.58
|
| Rate for Payer: Centivo All Commercial |
$674.48
|
| Rate for Payer: Centivo All Commercial |
$674.48
|
| Rate for Payer: Cigna All Commercial |
$435.15
|
| Rate for Payer: Cigna All Commercial |
$435.15
|
| Rate for Payer: CORVEL All Commercial |
$435.15
|
| Rate for Payer: CORVEL All Commercial |
$435.15
|
| Rate for Payer: Coventry All Commercial |
$522.18
|
| Rate for Payer: Coventry All Commercial |
$522.18
|
| Rate for Payer: Encore All Commercial |
$435.15
|
| Rate for Payer: Encore All Commercial |
$435.15
|
| Rate for Payer: Frontpath All Commercial |
$614.74
|
| Rate for Payer: Frontpath All Commercial |
$614.74
|
| Rate for Payer: Humana ChoiceCare |
$490.31
|
| Rate for Payer: Humana ChoiceCare |
$490.31
|
| Rate for Payer: Humana Medicare |
$435.15
|
| Rate for Payer: Humana Medicare |
$435.15
|
| Rate for Payer: Lucent All Commercial |
$609.21
|
| Rate for Payer: Lucent All Commercial |
$609.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$692.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$692.00
|
| Rate for Payer: Managed Health Services Medicaid |
$423.57
|
| Rate for Payer: Managed Health Services Medicaid |
$423.57
|
| Rate for Payer: MDWise Medicaid |
$423.57
|
| Rate for Payer: MDWise Medicaid |
$423.57
|
| Rate for Payer: PHCS All Commercial |
$435.15
|
| Rate for Payer: PHCS All Commercial |
$435.15
|
| Rate for Payer: PHP All Commercial |
$734.54
|
| Rate for Payer: PHP All Commercial |
$734.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$435.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$435.15
|
| Rate for Payer: Sagamore Health Network All Products |
$435.15
|
| Rate for Payer: Sagamore Health Network All Products |
$435.15
|
| Rate for Payer: Signature Care EPO |
$470.05
|
| Rate for Payer: Signature Care EPO |
$470.05
|
| Rate for Payer: Signature Care PPO |
$470.05
|
| Rate for Payer: Signature Care PPO |
$470.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$64,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$64,900.00
|
| Rate for Payer: United Healthcare Commercial |
$536.91
|
| Rate for Payer: United Healthcare Commercial |
$536.91
|
| Rate for Payer: United Healthcare Medicare |
$422.15
|
| Rate for Payer: United Healthcare Medicare |
$422.15
|
|
|
PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM
|
Professional
|
Both
|
$923.96
|
|
|
Service Code
|
CPT 27327
|
| Hospital Charge Code |
z27327
|
| Min. Negotiated Rate |
$162.31 |
| Max. Negotiated Rate |
$43,900.00 |
| Rate for Payer: Aetna Commercial |
$292.75
|
| Rate for Payer: Aetna Commercial |
$292.75
|
| Rate for Payer: Aetna Medicare |
$292.75
|
| Rate for Payer: Aetna Medicare |
$292.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$457.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$457.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$457.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$457.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$457.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$457.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$457.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$457.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.31
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$454.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$454.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$336.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$336.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$322.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$322.02
|
| Rate for Payer: Cash Price |
$547.18
|
| Rate for Payer: Cash Price |
$554.38
|
| Rate for Payer: Centivo All Commercial |
$453.76
|
| Rate for Payer: Centivo All Commercial |
$453.76
|
| Rate for Payer: Cigna All Commercial |
$292.75
|
| Rate for Payer: Cigna All Commercial |
$292.75
|
| Rate for Payer: CORVEL All Commercial |
$292.75
|
| Rate for Payer: CORVEL All Commercial |
$292.75
|
| Rate for Payer: Coventry All Commercial |
$351.30
|
| Rate for Payer: Coventry All Commercial |
$351.30
|
| Rate for Payer: Encore All Commercial |
$292.75
|
| Rate for Payer: Encore All Commercial |
$292.75
|
| Rate for Payer: Frontpath All Commercial |
$407.86
|
| Rate for Payer: Frontpath All Commercial |
$407.86
|
| Rate for Payer: Humana ChoiceCare |
$354.44
|
| Rate for Payer: Humana ChoiceCare |
$354.44
|
| Rate for Payer: Humana Medicare |
$292.75
|
| Rate for Payer: Humana Medicare |
$292.75
|
| Rate for Payer: Lucent All Commercial |
$409.85
|
| Rate for Payer: Lucent All Commercial |
$409.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$468.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$468.00
|
| Rate for Payer: Managed Health Services Medicaid |
$454.44
|
| Rate for Payer: Managed Health Services Medicaid |
$454.44
|
| Rate for Payer: MDWise Medicaid |
$454.44
|
| Rate for Payer: MDWise Medicaid |
$454.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$162.31
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$162.31
|
| Rate for Payer: PHCS All Commercial |
$292.75
|
| Rate for Payer: PHCS All Commercial |
$292.75
|
| Rate for Payer: PHP All Commercial |
$496.79
|
| Rate for Payer: PHP All Commercial |
$496.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$292.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$292.75
|
| Rate for Payer: Sagamore Health Network All Products |
$292.75
|
| Rate for Payer: Sagamore Health Network All Products |
$292.75
|
| Rate for Payer: Signature Care EPO |
$561.00
|
| Rate for Payer: Signature Care EPO |
$561.00
|
| Rate for Payer: Signature Care PPO |
$561.00
|
| Rate for Payer: Signature Care PPO |
$561.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,900.00
|
| Rate for Payer: United Healthcare Commercial |
$372.54
|
| Rate for Payer: United Healthcare Commercial |
$372.54
|
| Rate for Payer: United Healthcare Medicare |
$455.98
|
| Rate for Payer: United Healthcare Medicare |
$455.98
|
|
