|
HC W PLATE MD COLUMN FUSION MED
|
Facility
IP
|
$7,218.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,413.50 |
| Max. Negotiated Rate |
$6,712.74 |
| Rate for Payer: Aetna Commercial |
$6,236.35
|
| Rate for Payer: Cash Price |
$4,475.16
|
| Rate for Payer: Cigna All Commercial |
$6,229.13
|
| Rate for Payer: CORVEL All Commercial |
$6,712.74
|
| Rate for Payer: Coventry All Commercial |
$6,351.84
|
| Rate for Payer: Encore All Commercial |
$6,644.17
|
| Rate for Payer: Frontpath All Commercial |
$6,640.56
|
| Rate for Payer: Humana ChoiceCare |
$6,234.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,496.20
|
| Rate for Payer: PHCS All Commercial |
$5,413.50
|
| Rate for Payer: PHP All Commercial |
$5,474.13
|
| Rate for Payer: Sagamore Health Network All Products |
$5,572.30
|
| Rate for Payer: Signature Care EPO |
$5,990.94
|
| Rate for Payer: Signature Care PPO |
$6,351.84
|
| Rate for Payer: United Healthcare Commercial |
$5,687.78
|
|
|
HC W PLATE MD COLUMN FUSION MED
|
Facility
OP
|
$7,218.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,712.74 |
| Rate for Payer: Aetna Commercial |
$6,091.99
|
| Rate for Payer: Aetna Medicare |
$2,381.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,381.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,145.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,511.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,739.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,620.13
|
| Rate for Payer: Cash Price |
$4,475.16
|
| Rate for Payer: Cash Price |
$4,475.16
|
| Rate for Payer: Centivo All Commercial |
$3,681.18
|
| Rate for Payer: Cigna All Commercial |
$6,229.13
|
| Rate for Payer: CORVEL All Commercial |
$6,712.74
|
| Rate for Payer: Coventry All Commercial |
$6,351.84
|
| Rate for Payer: Encore All Commercial |
$6,644.17
|
| Rate for Payer: Frontpath All Commercial |
$6,640.56
|
| Rate for Payer: Humana ChoiceCare |
$6,234.19
|
| Rate for Payer: Humana Medicare |
$3,681.18
|
| Rate for Payer: Lucent All Commercial |
$3,681.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,496.20
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,413.50
|
| Rate for Payer: PHP All Commercial |
$5,474.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,815.02
|
| Rate for Payer: Sagamore Health Network All Products |
$5,572.30
|
| Rate for Payer: Signature Care EPO |
$5,990.94
|
| Rate for Payer: Signature Care PPO |
$6,351.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,135.30
|
| Rate for Payer: United Healthcare Commercial |
$5,687.78
|
| Rate for Payer: United Healthcare Medicare |
$2,381.94
|
|
|
HC W PLATE MD FUSION T L
|
Facility
OP
|
$4,615.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,292.14 |
| Rate for Payer: Aetna Commercial |
$3,895.23
|
| Rate for Payer: Aetna Medicare |
$1,523.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,523.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,650.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,884.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,751.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,675.32
|
| Rate for Payer: Cash Price |
$2,861.42
|
| Rate for Payer: Cash Price |
$2,861.42
|
| Rate for Payer: Centivo All Commercial |
$2,353.75
|
| Rate for Payer: Cigna All Commercial |
$3,982.92
|
| Rate for Payer: CORVEL All Commercial |
$4,292.14
|
| Rate for Payer: Coventry All Commercial |
$4,061.38
|
| Rate for Payer: Encore All Commercial |
$4,248.29
|
| Rate for Payer: Frontpath All Commercial |
$4,245.98
|
| Rate for Payer: Humana ChoiceCare |
$3,986.15
|
| Rate for Payer: Humana Medicare |
$2,353.75
|
| Rate for Payer: Lucent All Commercial |
$2,353.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,153.68
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,461.40
|
| Rate for Payer: PHP All Commercial |
$3,500.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,799.93
|
| Rate for Payer: Sagamore Health Network All Products |
$3,562.93
|
| Rate for Payer: Signature Care EPO |
$3,830.62
|
| Rate for Payer: Signature Care PPO |
$4,061.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,922.92
|
| Rate for Payer: United Healthcare Commercial |
$3,636.78
|
| Rate for Payer: United Healthcare Medicare |
$1,523.02
|
|
|
HC W PLATE MD FUSION T L
|
Facility
IP
|
$4,615.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,461.40 |
| Max. Negotiated Rate |
$4,292.14 |
| Rate for Payer: Aetna Commercial |
$3,987.53
|
| Rate for Payer: Cash Price |
$2,861.42
|
| Rate for Payer: Cigna All Commercial |
$3,982.92
|
| Rate for Payer: CORVEL All Commercial |
$4,292.14
|
| Rate for Payer: Coventry All Commercial |
$4,061.38
|
| Rate for Payer: Encore All Commercial |
$4,248.29
|
| Rate for Payer: Frontpath All Commercial |
$4,245.98
|
| Rate for Payer: Humana ChoiceCare |
$3,986.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,153.68
|
| Rate for Payer: PHCS All Commercial |
$3,461.40
|
| Rate for Payer: PHP All Commercial |
$3,500.17
|
| Rate for Payer: Sagamore Health Network All Products |
$3,562.93
|
| Rate for Payer: Signature Care EPO |
$3,830.62
|
| Rate for Payer: Signature Care PPO |
$4,061.38
|
| Rate for Payer: United Healthcare Commercial |
$3,636.78
|
|
|
HC W PLATE MD FUSION T R
|
Facility
OP
|
$4,615.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,292.14 |
| Rate for Payer: Aetna Commercial |
$3,895.23
|
| Rate for Payer: Aetna Medicare |
$1,523.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,523.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,650.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,884.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,751.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,675.32
|
| Rate for Payer: Cash Price |
$2,861.42
|
| Rate for Payer: Cash Price |
$2,861.42
|
| Rate for Payer: Centivo All Commercial |
$2,353.75
|
| Rate for Payer: Cigna All Commercial |
$3,982.92
|
| Rate for Payer: CORVEL All Commercial |
$4,292.14
|
| Rate for Payer: Coventry All Commercial |
$4,061.38
|
| Rate for Payer: Encore All Commercial |
$4,248.29
|
| Rate for Payer: Frontpath All Commercial |
$4,245.98
|
| Rate for Payer: Humana ChoiceCare |
$3,986.15
|
| Rate for Payer: Humana Medicare |
$2,353.75
|
| Rate for Payer: Lucent All Commercial |
$2,353.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,153.68
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,461.40
|
| Rate for Payer: PHP All Commercial |
$3,500.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,799.93
|
| Rate for Payer: Sagamore Health Network All Products |
$3,562.93
|
| Rate for Payer: Signature Care EPO |
$3,830.62
|
| Rate for Payer: Signature Care PPO |
$4,061.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,922.92
|
| Rate for Payer: United Healthcare Commercial |
$3,636.78
|
| Rate for Payer: United Healthcare Medicare |
$1,523.02
|
|
|
HC W PLATE MD FUSION T R
|
Facility
IP
|
$4,615.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,461.40 |
| Max. Negotiated Rate |
$4,292.14 |
| Rate for Payer: Aetna Commercial |
$3,987.53
|
| Rate for Payer: Cash Price |
$2,861.42
|
| Rate for Payer: Cigna All Commercial |
$3,982.92
|
| Rate for Payer: CORVEL All Commercial |
$4,292.14
|
| Rate for Payer: Coventry All Commercial |
$4,061.38
|
| Rate for Payer: Encore All Commercial |
$4,248.29
|
| Rate for Payer: Frontpath All Commercial |
$4,245.98
|
| Rate for Payer: Humana ChoiceCare |
$3,986.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,153.68
|
| Rate for Payer: PHCS All Commercial |
$3,461.40
|
| Rate for Payer: PHP All Commercial |
$3,500.17
|
| Rate for Payer: Sagamore Health Network All Products |
$3,562.93
|
| Rate for Payer: Signature Care EPO |
$3,830.62
|
| Rate for Payer: Signature Care PPO |
$4,061.38
|
| Rate for Payer: United Healthcare Commercial |
$3,636.78
|
|
|
HC W PLATE MD FUSION U LRG L
|
Facility
IP
|
$6,804.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,103.00 |
| Max. Negotiated Rate |
$6,327.72 |
| Rate for Payer: Aetna Commercial |
$5,878.66
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Cigna All Commercial |
$5,871.85
|
| Rate for Payer: CORVEL All Commercial |
$6,327.72
|
| Rate for Payer: Coventry All Commercial |
$5,987.52
|
| Rate for Payer: Encore All Commercial |
$6,263.08
|
| Rate for Payer: Frontpath All Commercial |
$6,259.68
|
| Rate for Payer: Humana ChoiceCare |
$5,876.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,123.60
|
| Rate for Payer: PHCS All Commercial |
$5,103.00
|
| Rate for Payer: PHP All Commercial |
$5,160.15
|
| Rate for Payer: Sagamore Health Network All Products |
$5,252.69
|
| Rate for Payer: Signature Care EPO |
$5,647.32
|
| Rate for Payer: Signature Care PPO |
$5,987.52
|
| Rate for Payer: United Healthcare Commercial |
$5,361.55
|
|
|
HC W PLATE MD FUSION U LRG L
|
Facility
OP
|
$6,804.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,327.72 |
| Rate for Payer: Aetna Commercial |
$5,742.58
|
| Rate for Payer: Aetna Medicare |
$2,245.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,245.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,907.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,253.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,582.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,469.85
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Centivo All Commercial |
$3,470.04
|
| Rate for Payer: Cigna All Commercial |
$5,871.85
|
| Rate for Payer: CORVEL All Commercial |
$6,327.72
|
| Rate for Payer: Coventry All Commercial |
$5,987.52
|
| Rate for Payer: Encore All Commercial |
$6,263.08
|
| Rate for Payer: Frontpath All Commercial |
$6,259.68
|
| Rate for Payer: Humana ChoiceCare |
$5,876.61
|
| Rate for Payer: Humana Medicare |
$3,470.04
|
| Rate for Payer: Lucent All Commercial |
$3,470.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,123.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,103.00
|
| Rate for Payer: PHP All Commercial |
$5,160.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,653.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,252.69
|
| Rate for Payer: Signature Care EPO |
$5,647.32
|
| Rate for Payer: Signature Care PPO |
$5,987.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,783.40
|
| Rate for Payer: United Healthcare Commercial |
$5,361.55
|
| Rate for Payer: United Healthcare Medicare |
$2,245.32
|
|
|
HC W PLATE MD FUSION U LRG R
|
Facility
IP
|
$6,804.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,103.00 |
| Max. Negotiated Rate |
$6,327.72 |
| Rate for Payer: Aetna Commercial |
$5,878.66
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Cigna All Commercial |
$5,871.85
|
| Rate for Payer: CORVEL All Commercial |
$6,327.72
|
| Rate for Payer: Coventry All Commercial |
$5,987.52
|
| Rate for Payer: Encore All Commercial |
$6,263.08
|
| Rate for Payer: Frontpath All Commercial |
$6,259.68
|
| Rate for Payer: Humana ChoiceCare |
$5,876.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,123.60
|
| Rate for Payer: PHCS All Commercial |
$5,103.00
|
| Rate for Payer: PHP All Commercial |
$5,160.15
|
| Rate for Payer: Sagamore Health Network All Products |
$5,252.69
|
| Rate for Payer: Signature Care EPO |
$5,647.32
|
| Rate for Payer: Signature Care PPO |
$5,987.52
|
| Rate for Payer: United Healthcare Commercial |
$5,361.55
|
|
|
HC W PLATE MD FUSION U LRG R
|
Facility
OP
|
$6,804.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,327.72 |
| Rate for Payer: Aetna Commercial |
$5,742.58
|
| Rate for Payer: Aetna Medicare |
$2,245.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,245.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,907.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,253.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,582.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,469.85
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Centivo All Commercial |
$3,470.04
|
| Rate for Payer: Cigna All Commercial |
$5,871.85
|
| Rate for Payer: CORVEL All Commercial |
$6,327.72
|
| Rate for Payer: Coventry All Commercial |
$5,987.52
|
| Rate for Payer: Encore All Commercial |
$6,263.08
|
| Rate for Payer: Frontpath All Commercial |
$6,259.68
|
| Rate for Payer: Humana ChoiceCare |
$5,876.61
|
| Rate for Payer: Humana Medicare |
$3,470.04
|
| Rate for Payer: Lucent All Commercial |
$3,470.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,123.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,103.00
|
| Rate for Payer: PHP All Commercial |
$5,160.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,653.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,252.69
|
| Rate for Payer: Signature Care EPO |
$5,647.32
|
| Rate for Payer: Signature Care PPO |
$5,987.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,783.40
|
| Rate for Payer: United Healthcare Commercial |
$5,361.55
|
| Rate for Payer: United Healthcare Medicare |
$2,245.32
|
|
|
HC W PLATE MD FUSION U MED L
|
Facility
OP
|
$6,804.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,327.72 |
| Rate for Payer: Aetna Commercial |
$5,742.58
|
| Rate for Payer: Aetna Medicare |
$2,245.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,245.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,907.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,253.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,582.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,469.85
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Centivo All Commercial |
$3,470.04
|
| Rate for Payer: Cigna All Commercial |
$5,871.85
|
| Rate for Payer: CORVEL All Commercial |
$6,327.72
|
| Rate for Payer: Coventry All Commercial |
$5,987.52
|
| Rate for Payer: Encore All Commercial |
$6,263.08
|
| Rate for Payer: Frontpath All Commercial |
$6,259.68
|
| Rate for Payer: Humana ChoiceCare |
$5,876.61
|
| Rate for Payer: Humana Medicare |
$3,470.04
|
| Rate for Payer: Lucent All Commercial |
$3,470.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,123.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,103.00
|
| Rate for Payer: PHP All Commercial |
$5,160.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,653.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,252.69
|
| Rate for Payer: Signature Care EPO |
$5,647.32
|
| Rate for Payer: Signature Care PPO |
$5,987.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,783.40
|
| Rate for Payer: United Healthcare Commercial |
$5,361.55
|
| Rate for Payer: United Healthcare Medicare |
$2,245.32
|
|
|
HC W PLATE MD FUSION U MED L
|
Facility
IP
|
$6,804.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,103.00 |
| Max. Negotiated Rate |
$6,327.72 |
| Rate for Payer: Aetna Commercial |
$5,878.66
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Cigna All Commercial |
$5,871.85
|
| Rate for Payer: CORVEL All Commercial |
$6,327.72
|
| Rate for Payer: Coventry All Commercial |
$5,987.52
|
| Rate for Payer: Encore All Commercial |
$6,263.08
|
| Rate for Payer: Frontpath All Commercial |
$6,259.68
|
| Rate for Payer: Humana ChoiceCare |
$5,876.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,123.60
|
| Rate for Payer: PHCS All Commercial |
$5,103.00
|
| Rate for Payer: PHP All Commercial |
$5,160.15
|
| Rate for Payer: Sagamore Health Network All Products |
$5,252.69
|
| Rate for Payer: Signature Care EPO |
$5,647.32
|
| Rate for Payer: Signature Care PPO |
$5,987.52
|
| Rate for Payer: United Healthcare Commercial |
$5,361.55
|
|
|
HC W PLATE MD FUSION U MED R
|
Facility
IP
|
$6,804.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605089
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,103.00 |
| Max. Negotiated Rate |
$6,327.72 |
| Rate for Payer: Aetna Commercial |
$5,878.66
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Cigna All Commercial |
$5,871.85
|
| Rate for Payer: CORVEL All Commercial |
$6,327.72
|
| Rate for Payer: Coventry All Commercial |
$5,987.52
|
| Rate for Payer: Encore All Commercial |
$6,263.08
|
| Rate for Payer: Frontpath All Commercial |
$6,259.68
|
| Rate for Payer: Humana ChoiceCare |
$5,876.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,123.60
|
| Rate for Payer: PHCS All Commercial |
$5,103.00
|
| Rate for Payer: PHP All Commercial |
$5,160.15
|
| Rate for Payer: Sagamore Health Network All Products |
$5,252.69
|
| Rate for Payer: Signature Care EPO |
$5,647.32
|
| Rate for Payer: Signature Care PPO |
$5,987.52
|
| Rate for Payer: United Healthcare Commercial |
$5,361.55
|
|
|
HC W PLATE MD FUSION U MED R
|
Facility
OP
|
$6,804.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605089
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,327.72 |
| Rate for Payer: Aetna Commercial |
$5,742.58
|
| Rate for Payer: Aetna Medicare |
$2,245.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,245.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,907.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,253.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,582.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,469.85
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Centivo All Commercial |
$3,470.04
|
| Rate for Payer: Cigna All Commercial |
$5,871.85
|
| Rate for Payer: CORVEL All Commercial |
$6,327.72
|
| Rate for Payer: Coventry All Commercial |
$5,987.52
|
| Rate for Payer: Encore All Commercial |
$6,263.08
|
| Rate for Payer: Frontpath All Commercial |
$6,259.68
|
| Rate for Payer: Humana ChoiceCare |
$5,876.61
|
| Rate for Payer: Humana Medicare |
$3,470.04
|
| Rate for Payer: Lucent All Commercial |
$3,470.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,123.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,103.00
|
| Rate for Payer: PHP All Commercial |
$5,160.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,653.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,252.69
|
| Rate for Payer: Signature Care EPO |
$5,647.32
|
| Rate for Payer: Signature Care PPO |
$5,987.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,783.40
|
| Rate for Payer: United Healthcare Commercial |
$5,361.55
|
| Rate for Payer: United Healthcare Medicare |
$2,245.32
|
|
|
HC W PLATE MD FUSION U SM R
|
Facility
IP
|
$6,804.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,103.00 |
| Max. Negotiated Rate |
$6,327.72 |
| Rate for Payer: Aetna Commercial |
$5,878.66
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Cigna All Commercial |
$5,871.85
|
| Rate for Payer: CORVEL All Commercial |
$6,327.72
|
| Rate for Payer: Coventry All Commercial |
$5,987.52
|
| Rate for Payer: Encore All Commercial |
$6,263.08
|
| Rate for Payer: Frontpath All Commercial |
$6,259.68
|
| Rate for Payer: Humana ChoiceCare |
$5,876.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,123.60
|
| Rate for Payer: PHCS All Commercial |
$5,103.00
|
| Rate for Payer: PHP All Commercial |
$5,160.15
|
| Rate for Payer: Sagamore Health Network All Products |
$5,252.69
|
| Rate for Payer: Signature Care EPO |
$5,647.32
|
| Rate for Payer: Signature Care PPO |
$5,987.52
|
| Rate for Payer: United Healthcare Commercial |
$5,361.55
|
|
|
HC W PLATE MD FUSION U SM R
|
Facility
OP
|
$6,804.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,327.72 |
| Rate for Payer: Aetna Commercial |
$5,742.58
|
| Rate for Payer: Aetna Medicare |
$2,245.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,245.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,907.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,253.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,582.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,469.85
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Cash Price |
$4,218.48
|
| Rate for Payer: Centivo All Commercial |
$3,470.04
|
| Rate for Payer: Cigna All Commercial |
$5,871.85
|
| Rate for Payer: CORVEL All Commercial |
$6,327.72
|
| Rate for Payer: Coventry All Commercial |
$5,987.52
|
| Rate for Payer: Encore All Commercial |
$6,263.08
|
| Rate for Payer: Frontpath All Commercial |
$6,259.68
|
| Rate for Payer: Humana ChoiceCare |
$5,876.61
|
| Rate for Payer: Humana Medicare |
$3,470.04
|
| Rate for Payer: Lucent All Commercial |
$3,470.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,123.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,103.00
|
| Rate for Payer: PHP All Commercial |
$5,160.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,653.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,252.69
|
| Rate for Payer: Signature Care EPO |
$5,647.32
|
| Rate for Payer: Signature Care PPO |
$5,987.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,783.40
|
| Rate for Payer: United Healthcare Commercial |
$5,361.55
|
| Rate for Payer: United Healthcare Medicare |
$2,245.32
|
|
|
HC W PLATE MD MALLEOLAR LRG
|
Facility
IP
|
$2,862.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604989
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,146.50 |
| Max. Negotiated Rate |
$2,661.66 |
| Rate for Payer: Aetna Commercial |
$2,472.77
|
| Rate for Payer: Cash Price |
$1,774.44
|
| Rate for Payer: Cigna All Commercial |
$2,469.91
|
| Rate for Payer: CORVEL All Commercial |
$2,661.66
|
| Rate for Payer: Coventry All Commercial |
$2,518.56
|
| Rate for Payer: Encore All Commercial |
$2,634.47
|
| Rate for Payer: Frontpath All Commercial |
$2,633.04
|
| Rate for Payer: Humana ChoiceCare |
$2,471.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,575.80
|
| Rate for Payer: PHCS All Commercial |
$2,146.50
|
| Rate for Payer: PHP All Commercial |
$2,170.54
|
| Rate for Payer: Sagamore Health Network All Products |
$2,209.46
|
| Rate for Payer: Signature Care EPO |
$2,375.46
|
| Rate for Payer: Signature Care PPO |
$2,518.56
|
| Rate for Payer: United Healthcare Commercial |
$2,255.26
|
|
|
HC W PLATE MD MALLEOLAR LRG
|
Facility
OP
|
$2,862.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604989
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,661.66 |
| Rate for Payer: Aetna Commercial |
$2,415.53
|
| Rate for Payer: Aetna Medicare |
$944.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$944.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,643.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,789.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,086.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,038.91
|
| Rate for Payer: Cash Price |
$1,774.44
|
| Rate for Payer: Cash Price |
$1,774.44
|
| Rate for Payer: Centivo All Commercial |
$1,459.62
|
| Rate for Payer: Cigna All Commercial |
$2,469.91
|
| Rate for Payer: CORVEL All Commercial |
$2,661.66
|
| Rate for Payer: Coventry All Commercial |
$2,518.56
|
| Rate for Payer: Encore All Commercial |
$2,634.47
|
| Rate for Payer: Frontpath All Commercial |
$2,633.04
|
| Rate for Payer: Humana ChoiceCare |
$2,471.91
|
| Rate for Payer: Humana Medicare |
$1,459.62
|
| Rate for Payer: Lucent All Commercial |
$1,459.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,575.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,146.50
|
| Rate for Payer: PHP All Commercial |
$2,170.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,116.18
|
| Rate for Payer: Sagamore Health Network All Products |
$2,209.46
|
| Rate for Payer: Signature Care EPO |
$2,375.46
|
| Rate for Payer: Signature Care PPO |
$2,518.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,432.70
|
| Rate for Payer: United Healthcare Commercial |
$2,255.26
|
| Rate for Payer: United Healthcare Medicare |
$944.46
|
|
|
HC W PLATE MD MALLEOLAR SM
|
Facility
IP
|
$2,440.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604988
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,830.60 |
| Max. Negotiated Rate |
$2,269.94 |
| Rate for Payer: Aetna Commercial |
$2,108.85
|
| Rate for Payer: Cash Price |
$1,513.30
|
| Rate for Payer: Cigna All Commercial |
$2,106.41
|
| Rate for Payer: CORVEL All Commercial |
$2,269.94
|
| Rate for Payer: Coventry All Commercial |
$2,147.90
|
| Rate for Payer: Encore All Commercial |
$2,246.76
|
| Rate for Payer: Frontpath All Commercial |
$2,245.54
|
| Rate for Payer: Humana ChoiceCare |
$2,108.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,196.72
|
| Rate for Payer: PHCS All Commercial |
$1,830.60
|
| Rate for Payer: PHP All Commercial |
$1,851.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,884.30
|
| Rate for Payer: Signature Care EPO |
$2,025.86
|
| Rate for Payer: Signature Care PPO |
$2,147.90
|
| Rate for Payer: United Healthcare Commercial |
$1,923.35
|
|
|
HC W PLATE MD MALLEOLAR SM
|
Facility
OP
|
$2,440.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604988
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,269.94 |
| Rate for Payer: Aetna Commercial |
$2,060.04
|
| Rate for Payer: Aetna Medicare |
$805.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$805.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,401.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,525.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$926.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$886.01
|
| Rate for Payer: Cash Price |
$1,513.30
|
| Rate for Payer: Cash Price |
$1,513.30
|
| Rate for Payer: Centivo All Commercial |
$1,244.81
|
| Rate for Payer: Cigna All Commercial |
$2,106.41
|
| Rate for Payer: CORVEL All Commercial |
$2,269.94
|
| Rate for Payer: Coventry All Commercial |
$2,147.90
|
| Rate for Payer: Encore All Commercial |
$2,246.76
|
| Rate for Payer: Frontpath All Commercial |
$2,245.54
|
| Rate for Payer: Humana ChoiceCare |
$2,108.12
|
| Rate for Payer: Humana Medicare |
$1,244.81
|
| Rate for Payer: Lucent All Commercial |
$1,244.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,196.72
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,830.60
|
| Rate for Payer: PHP All Commercial |
$1,851.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$951.91
|
| Rate for Payer: Sagamore Health Network All Products |
$1,884.30
|
| Rate for Payer: Signature Care EPO |
$2,025.86
|
| Rate for Payer: Signature Care PPO |
$2,147.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,074.68
|
| Rate for Payer: United Healthcare Commercial |
$1,923.35
|
| Rate for Payer: United Healthcare Medicare |
$805.46
|
|
|
HC W PLATE MD TIB LRG
|
Facility
IP
|
$5,482.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,112.10 |
| Max. Negotiated Rate |
$5,099.00 |
| Rate for Payer: Aetna Commercial |
$4,737.14
|
| Rate for Payer: Cash Price |
$3,399.34
|
| Rate for Payer: Cigna All Commercial |
$4,731.66
|
| Rate for Payer: CORVEL All Commercial |
$5,099.00
|
| Rate for Payer: Coventry All Commercial |
$4,824.86
|
| Rate for Payer: Encore All Commercial |
$5,046.92
|
| Rate for Payer: Frontpath All Commercial |
$5,044.18
|
| Rate for Payer: Humana ChoiceCare |
$4,735.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,934.52
|
| Rate for Payer: PHCS All Commercial |
$4,112.10
|
| Rate for Payer: PHP All Commercial |
$4,158.16
|
| Rate for Payer: Sagamore Health Network All Products |
$4,232.72
|
| Rate for Payer: Signature Care EPO |
$4,550.72
|
| Rate for Payer: Signature Care PPO |
$4,824.86
|
| Rate for Payer: United Healthcare Commercial |
$4,320.45
|
|
|
HC W PLATE MD TIB LRG
|
Facility
OP
|
$5,482.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,099.00 |
| Rate for Payer: Aetna Commercial |
$4,627.48
|
| Rate for Payer: Aetna Medicare |
$1,809.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,809.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,148.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,427.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,080.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,990.26
|
| Rate for Payer: Cash Price |
$3,399.34
|
| Rate for Payer: Cash Price |
$3,399.34
|
| Rate for Payer: Centivo All Commercial |
$2,796.23
|
| Rate for Payer: Cigna All Commercial |
$4,731.66
|
| Rate for Payer: CORVEL All Commercial |
$5,099.00
|
| Rate for Payer: Coventry All Commercial |
$4,824.86
|
| Rate for Payer: Encore All Commercial |
$5,046.92
|
| Rate for Payer: Frontpath All Commercial |
$5,044.18
|
| Rate for Payer: Humana ChoiceCare |
$4,735.49
|
| Rate for Payer: Humana Medicare |
$2,796.23
|
| Rate for Payer: Lucent All Commercial |
$2,796.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,934.52
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,112.10
|
| Rate for Payer: PHP All Commercial |
$4,158.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,138.29
|
| Rate for Payer: Sagamore Health Network All Products |
$4,232.72
|
| Rate for Payer: Signature Care EPO |
$4,550.72
|
| Rate for Payer: Signature Care PPO |
$4,824.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,660.38
|
| Rate for Payer: United Healthcare Commercial |
$4,320.45
|
| Rate for Payer: United Healthcare Medicare |
$1,809.32
|
|
|
HC W PLATE MD TIB MED L
|
Facility
OP
|
$7,146.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604992
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,645.78 |
| Rate for Payer: Aetna Commercial |
$6,031.22
|
| Rate for Payer: Aetna Medicare |
$2,358.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,358.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,103.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,466.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,711.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,594.00
|
| Rate for Payer: Cash Price |
$4,430.52
|
| Rate for Payer: Cash Price |
$4,430.52
|
| Rate for Payer: Centivo All Commercial |
$3,644.46
|
| Rate for Payer: Cigna All Commercial |
$6,167.00
|
| Rate for Payer: CORVEL All Commercial |
$6,645.78
|
| Rate for Payer: Coventry All Commercial |
$6,288.48
|
| Rate for Payer: Encore All Commercial |
$6,577.89
|
| Rate for Payer: Frontpath All Commercial |
$6,574.32
|
| Rate for Payer: Humana ChoiceCare |
$6,172.00
|
| Rate for Payer: Humana Medicare |
$3,644.46
|
| Rate for Payer: Lucent All Commercial |
$3,644.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,431.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,359.50
|
| Rate for Payer: PHP All Commercial |
$5,419.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,786.94
|
| Rate for Payer: Sagamore Health Network All Products |
$5,516.71
|
| Rate for Payer: Signature Care EPO |
$5,931.18
|
| Rate for Payer: Signature Care PPO |
$6,288.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,074.10
|
| Rate for Payer: United Healthcare Commercial |
$5,631.05
|
| Rate for Payer: United Healthcare Medicare |
$2,358.18
|
|
|
HC W PLATE MD TIB MED L
|
Facility
IP
|
$7,146.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604992
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,359.50 |
| Max. Negotiated Rate |
$6,645.78 |
| Rate for Payer: Aetna Commercial |
$6,174.14
|
| Rate for Payer: Cash Price |
$4,430.52
|
| Rate for Payer: Cigna All Commercial |
$6,167.00
|
| Rate for Payer: CORVEL All Commercial |
$6,645.78
|
| Rate for Payer: Coventry All Commercial |
$6,288.48
|
| Rate for Payer: Encore All Commercial |
$6,577.89
|
| Rate for Payer: Frontpath All Commercial |
$6,574.32
|
| Rate for Payer: Humana ChoiceCare |
$6,172.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,431.40
|
| Rate for Payer: PHCS All Commercial |
$5,359.50
|
| Rate for Payer: PHP All Commercial |
$5,419.53
|
| Rate for Payer: Sagamore Health Network All Products |
$5,516.71
|
| Rate for Payer: Signature Care EPO |
$5,931.18
|
| Rate for Payer: Signature Care PPO |
$6,288.48
|
| Rate for Payer: United Healthcare Commercial |
$5,631.05
|
|
|
HC W PLATE MD TIB MED R
|
Facility
IP
|
$7,146.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604993
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,359.50 |
| Max. Negotiated Rate |
$6,645.78 |
| Rate for Payer: Aetna Commercial |
$6,174.14
|
| Rate for Payer: Cash Price |
$4,430.52
|
| Rate for Payer: Cigna All Commercial |
$6,167.00
|
| Rate for Payer: CORVEL All Commercial |
$6,645.78
|
| Rate for Payer: Coventry All Commercial |
$6,288.48
|
| Rate for Payer: Encore All Commercial |
$6,577.89
|
| Rate for Payer: Frontpath All Commercial |
$6,574.32
|
| Rate for Payer: Humana ChoiceCare |
$6,172.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,431.40
|
| Rate for Payer: PHCS All Commercial |
$5,359.50
|
| Rate for Payer: PHP All Commercial |
$5,419.53
|
| Rate for Payer: Sagamore Health Network All Products |
$5,516.71
|
| Rate for Payer: Signature Care EPO |
$5,931.18
|
| Rate for Payer: Signature Care PPO |
$6,288.48
|
| Rate for Payer: United Healthcare Commercial |
$5,631.05
|
|
