|
PR EXC SKIN BENIG 2.1-3 CM REMAINDR BODY
|
Professional
|
Both
|
$383.42
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
z11423
|
| Min. Negotiated Rate |
$78.90 |
| Max. Negotiated Rate |
$17,500.00 |
| Rate for Payer: Aetna Commercial |
$145.09
|
| Rate for Payer: Aetna Commercial |
$145.09
|
| Rate for Payer: Aetna Medicare |
$145.09
|
| Rate for Payer: Aetna Medicare |
$145.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$207.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$207.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$207.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$207.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$207.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$207.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$207.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$207.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$78.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$78.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$188.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$188.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$166.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$166.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$159.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$159.60
|
| Rate for Payer: Cash Price |
$224.52
|
| Rate for Payer: Cash Price |
$230.05
|
| Rate for Payer: Centivo All Commercial |
$224.89
|
| Rate for Payer: Centivo All Commercial |
$224.89
|
| Rate for Payer: Cigna All Commercial |
$145.09
|
| Rate for Payer: Cigna All Commercial |
$145.09
|
| Rate for Payer: CORVEL All Commercial |
$145.09
|
| Rate for Payer: CORVEL All Commercial |
$145.09
|
| Rate for Payer: Coventry All Commercial |
$174.11
|
| Rate for Payer: Coventry All Commercial |
$174.11
|
| Rate for Payer: Encore All Commercial |
$145.09
|
| Rate for Payer: Encore All Commercial |
$145.09
|
| Rate for Payer: Frontpath All Commercial |
$197.56
|
| Rate for Payer: Frontpath All Commercial |
$197.56
|
| Rate for Payer: Humana ChoiceCare |
$129.26
|
| Rate for Payer: Humana ChoiceCare |
$129.26
|
| Rate for Payer: Humana Medicare |
$145.09
|
| Rate for Payer: Humana Medicare |
$145.09
|
| Rate for Payer: Lucent All Commercial |
$203.13
|
| Rate for Payer: Lucent All Commercial |
$203.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$190.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$190.00
|
| Rate for Payer: Managed Health Services Medicaid |
$188.58
|
| Rate for Payer: Managed Health Services Medicaid |
$188.58
|
| Rate for Payer: MDWise Medicaid |
$188.58
|
| Rate for Payer: MDWise Medicaid |
$188.58
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$78.90
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$78.90
|
| Rate for Payer: PHCS All Commercial |
$145.09
|
| Rate for Payer: PHCS All Commercial |
$145.09
|
| Rate for Payer: PHP All Commercial |
$199.53
|
| Rate for Payer: PHP All Commercial |
$199.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$145.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$145.09
|
| Rate for Payer: Sagamore Health Network All Products |
$145.09
|
| Rate for Payer: Sagamore Health Network All Products |
$145.09
|
| Rate for Payer: Signature Care EPO |
$188.70
|
| Rate for Payer: Signature Care EPO |
$188.70
|
| Rate for Payer: Signature Care PPO |
$188.70
|
| Rate for Payer: Signature Care PPO |
$188.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,500.00
|
| Rate for Payer: United Healthcare Commercial |
$163.96
|
| Rate for Payer: United Healthcare Commercial |
$163.96
|
| Rate for Payer: United Healthcare Medicare |
$187.10
|
| Rate for Payer: United Healthcare Medicare |
$187.10
|
|
|
PR EXC SKIN BENIG 2.1-3 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$368.76
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
z11403
|
| Min. Negotiated Rate |
$75.27 |
| Max. Negotiated Rate |
$16,700.00 |
| Rate for Payer: Aetna Commercial |
$138.09
|
| Rate for Payer: Aetna Commercial |
$138.09
|
| Rate for Payer: Aetna Medicare |
$138.09
|
| Rate for Payer: Aetna Medicare |
$138.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$189.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$189.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$189.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$189.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$189.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$189.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$189.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$189.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$75.27
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$75.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$181.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$181.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$158.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$158.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$151.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$151.90
|
| Rate for Payer: Cash Price |
$216.50
|
| Rate for Payer: Cash Price |
$221.26
|
| Rate for Payer: Centivo All Commercial |
$214.04
|
| Rate for Payer: Centivo All Commercial |
$214.04
|
| Rate for Payer: Cigna All Commercial |
$138.09
|
| Rate for Payer: Cigna All Commercial |
$138.09
|
| Rate for Payer: CORVEL All Commercial |
$138.09
|
| Rate for Payer: CORVEL All Commercial |
$138.09
|
| Rate for Payer: Coventry All Commercial |
$165.71
|
| Rate for Payer: Coventry All Commercial |
$165.71
|
| Rate for Payer: Encore All Commercial |
$138.09
|
| Rate for Payer: Encore All Commercial |
$138.09
|
| Rate for Payer: Frontpath All Commercial |
$187.92
|
| Rate for Payer: Frontpath All Commercial |
$187.92
|
| Rate for Payer: Humana ChoiceCare |
$115.97
|
| Rate for Payer: Humana ChoiceCare |
$115.97
|
| Rate for Payer: Humana Medicare |
$138.09
|
| Rate for Payer: Humana Medicare |
$138.09
|
| Rate for Payer: Lucent All Commercial |
$193.33
|
| Rate for Payer: Lucent All Commercial |
$193.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$181.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$181.00
|
| Rate for Payer: Managed Health Services Medicaid |
$181.37
|
| Rate for Payer: Managed Health Services Medicaid |
$181.37
|
| Rate for Payer: MDWise Medicaid |
$181.37
|
| Rate for Payer: MDWise Medicaid |
$181.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$75.27
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$75.27
|
| Rate for Payer: PHCS All Commercial |
$138.09
|
| Rate for Payer: PHCS All Commercial |
$138.09
|
| Rate for Payer: PHP All Commercial |
$189.77
|
| Rate for Payer: PHP All Commercial |
$189.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.09
|
| Rate for Payer: Sagamore Health Network All Products |
$138.09
|
| Rate for Payer: Sagamore Health Network All Products |
$138.09
|
| Rate for Payer: Signature Care EPO |
$171.70
|
| Rate for Payer: Signature Care EPO |
$171.70
|
| Rate for Payer: Signature Care PPO |
$171.70
|
| Rate for Payer: Signature Care PPO |
$171.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$16,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$16,700.00
|
| Rate for Payer: United Healthcare Commercial |
$149.10
|
| Rate for Payer: United Healthcare Commercial |
$149.10
|
| Rate for Payer: United Healthcare Medicare |
$180.42
|
| Rate for Payer: United Healthcare Medicare |
$180.42
|
|
|
PR EXC SKIN BENIG 3.1- 4 CM FACE,FACIAL
|
Professional
|
Both
|
$527.96
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
z11444
|
| Min. Negotiated Rate |
$114.72 |
| Max. Negotiated Rate |
$25,300.00 |
| Rate for Payer: Aetna Commercial |
$211.06
|
| Rate for Payer: Aetna Commercial |
$211.06
|
| Rate for Payer: Aetna Medicare |
$211.06
|
| Rate for Payer: Aetna Medicare |
$211.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$294.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$294.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$294.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$294.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$294.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$294.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$294.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$294.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$114.72
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$114.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$259.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$259.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$242.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$242.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$232.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$232.17
|
| Rate for Payer: Cash Price |
$310.50
|
| Rate for Payer: Cash Price |
$316.78
|
| Rate for Payer: Centivo All Commercial |
$327.14
|
| Rate for Payer: Centivo All Commercial |
$327.14
|
| Rate for Payer: Cigna All Commercial |
$211.06
|
| Rate for Payer: Cigna All Commercial |
$211.06
|
| Rate for Payer: CORVEL All Commercial |
$211.06
|
| Rate for Payer: CORVEL All Commercial |
$211.06
|
| Rate for Payer: Coventry All Commercial |
$253.27
|
| Rate for Payer: Coventry All Commercial |
$253.27
|
| Rate for Payer: Encore All Commercial |
$211.06
|
| Rate for Payer: Encore All Commercial |
$211.06
|
| Rate for Payer: Frontpath All Commercial |
$288.31
|
| Rate for Payer: Frontpath All Commercial |
$288.31
|
| Rate for Payer: Humana ChoiceCare |
$199.15
|
| Rate for Payer: Humana ChoiceCare |
$199.15
|
| Rate for Payer: Humana Medicare |
$211.06
|
| Rate for Payer: Humana Medicare |
$211.06
|
| Rate for Payer: Lucent All Commercial |
$295.48
|
| Rate for Payer: Lucent All Commercial |
$295.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$274.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$274.00
|
| Rate for Payer: Managed Health Services Medicaid |
$259.68
|
| Rate for Payer: Managed Health Services Medicaid |
$259.68
|
| Rate for Payer: MDWise Medicaid |
$259.68
|
| Rate for Payer: MDWise Medicaid |
$259.68
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$114.72
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$114.72
|
| Rate for Payer: PHCS All Commercial |
$211.06
|
| Rate for Payer: PHCS All Commercial |
$211.06
|
| Rate for Payer: PHP All Commercial |
$287.61
|
| Rate for Payer: PHP All Commercial |
$287.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$211.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$211.06
|
| Rate for Payer: Sagamore Health Network All Products |
$211.06
|
| Rate for Payer: Sagamore Health Network All Products |
$211.06
|
| Rate for Payer: Signature Care EPO |
$273.70
|
| Rate for Payer: Signature Care EPO |
$273.70
|
| Rate for Payer: Signature Care PPO |
$273.70
|
| Rate for Payer: Signature Care PPO |
$273.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,300.00
|
| Rate for Payer: United Healthcare Commercial |
$240.38
|
| Rate for Payer: United Healthcare Commercial |
$240.38
|
| Rate for Payer: United Healthcare Medicare |
$258.75
|
| Rate for Payer: United Healthcare Medicare |
$258.75
|
|
|
PR EXC SKIN BENIG 3.1-4 CM REMAINDR BODY
|
Professional
|
Both
|
$442.84
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
z11424
|
| Min. Negotiated Rate |
$90.34 |
| Max. Negotiated Rate |
$20,000.00 |
| Rate for Payer: Aetna Commercial |
$165.58
|
| Rate for Payer: Aetna Commercial |
$165.58
|
| Rate for Payer: Aetna Medicare |
$165.58
|
| Rate for Payer: Aetna Medicare |
$165.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$235.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$235.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$235.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$235.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$235.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$235.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$235.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$235.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$90.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$90.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$217.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$217.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$190.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$190.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$182.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$182.14
|
| Rate for Payer: Cash Price |
$258.23
|
| Rate for Payer: Cash Price |
$265.70
|
| Rate for Payer: Centivo All Commercial |
$256.65
|
| Rate for Payer: Centivo All Commercial |
$256.65
|
| Rate for Payer: Cigna All Commercial |
$165.58
|
| Rate for Payer: Cigna All Commercial |
$165.58
|
| Rate for Payer: CORVEL All Commercial |
$165.58
|
| Rate for Payer: CORVEL All Commercial |
$165.58
|
| Rate for Payer: Coventry All Commercial |
$198.70
|
| Rate for Payer: Coventry All Commercial |
$198.70
|
| Rate for Payer: Encore All Commercial |
$165.58
|
| Rate for Payer: Encore All Commercial |
$165.58
|
| Rate for Payer: Frontpath All Commercial |
$226.55
|
| Rate for Payer: Frontpath All Commercial |
$226.55
|
| Rate for Payer: Humana ChoiceCare |
$151.16
|
| Rate for Payer: Humana ChoiceCare |
$151.16
|
| Rate for Payer: Humana Medicare |
$165.58
|
| Rate for Payer: Humana Medicare |
$165.58
|
| Rate for Payer: Lucent All Commercial |
$231.81
|
| Rate for Payer: Lucent All Commercial |
$231.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$217.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$217.00
|
| Rate for Payer: Managed Health Services Medicaid |
$217.80
|
| Rate for Payer: Managed Health Services Medicaid |
$217.80
|
| Rate for Payer: MDWise Medicaid |
$217.80
|
| Rate for Payer: MDWise Medicaid |
$217.80
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$90.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$90.34
|
| Rate for Payer: PHCS All Commercial |
$165.58
|
| Rate for Payer: PHCS All Commercial |
$165.58
|
| Rate for Payer: PHP All Commercial |
$227.90
|
| Rate for Payer: PHP All Commercial |
$227.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$165.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$165.58
|
| Rate for Payer: Sagamore Health Network All Products |
$165.58
|
| Rate for Payer: Sagamore Health Network All Products |
$165.58
|
| Rate for Payer: Signature Care EPO |
$215.90
|
| Rate for Payer: Signature Care EPO |
$215.90
|
| Rate for Payer: Signature Care PPO |
$215.90
|
| Rate for Payer: Signature Care PPO |
$215.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,000.00
|
| Rate for Payer: United Healthcare Commercial |
$189.21
|
| Rate for Payer: United Healthcare Commercial |
$189.21
|
| Rate for Payer: United Healthcare Medicare |
$215.19
|
| Rate for Payer: United Healthcare Medicare |
$215.19
|
|
|
PR EXC SKIN BENIG 3.1-4 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$416.34
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
z11404
|
| Min. Negotiated Rate |
$83.40 |
| Max. Negotiated Rate |
$18,300.00 |
| Rate for Payer: Aetna Commercial |
$152.31
|
| Rate for Payer: Aetna Commercial |
$152.31
|
| Rate for Payer: Aetna Medicare |
$152.31
|
| Rate for Payer: Aetna Medicare |
$152.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$213.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$213.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$213.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$213.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$213.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$213.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$213.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$213.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$83.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$83.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$204.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$204.77
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$175.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$175.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$167.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$167.54
|
| Rate for Payer: Cash Price |
$244.99
|
| Rate for Payer: Cash Price |
$249.80
|
| Rate for Payer: Centivo All Commercial |
$236.08
|
| Rate for Payer: Centivo All Commercial |
$236.08
|
| Rate for Payer: Cigna All Commercial |
$152.31
|
| Rate for Payer: Cigna All Commercial |
$152.31
|
| Rate for Payer: CORVEL All Commercial |
$152.31
|
| Rate for Payer: CORVEL All Commercial |
$152.31
|
| Rate for Payer: Coventry All Commercial |
$182.77
|
| Rate for Payer: Coventry All Commercial |
$182.77
|
| Rate for Payer: Encore All Commercial |
$152.31
|
| Rate for Payer: Encore All Commercial |
$152.31
|
| Rate for Payer: Frontpath All Commercial |
$209.00
|
| Rate for Payer: Frontpath All Commercial |
$209.00
|
| Rate for Payer: Humana ChoiceCare |
$129.61
|
| Rate for Payer: Humana ChoiceCare |
$129.61
|
| Rate for Payer: Humana Medicare |
$152.31
|
| Rate for Payer: Humana Medicare |
$152.31
|
| Rate for Payer: Lucent All Commercial |
$213.23
|
| Rate for Payer: Lucent All Commercial |
$213.23
|
| 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 |
$204.77
|
| Rate for Payer: Managed Health Services Medicaid |
$204.77
|
| Rate for Payer: MDWise Medicaid |
$204.77
|
| Rate for Payer: MDWise Medicaid |
$204.77
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$83.40
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$83.40
|
| Rate for Payer: PHCS All Commercial |
$152.31
|
| Rate for Payer: PHCS All Commercial |
$152.31
|
| Rate for Payer: PHP All Commercial |
$208.66
|
| Rate for Payer: PHP All Commercial |
$208.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$152.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$152.31
|
| Rate for Payer: Sagamore Health Network All Products |
$152.31
|
| Rate for Payer: Sagamore Health Network All Products |
$152.31
|
| Rate for Payer: Signature Care EPO |
$196.35
|
| Rate for Payer: Signature Care EPO |
$196.35
|
| Rate for Payer: Signature Care PPO |
$196.35
|
| Rate for Payer: Signature Care PPO |
$196.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,300.00
|
| Rate for Payer: United Healthcare Commercial |
$166.08
|
| Rate for Payer: United Healthcare Commercial |
$166.08
|
| Rate for Payer: United Healthcare Medicare |
$204.16
|
| Rate for Payer: United Healthcare Medicare |
$204.16
|
|
|
PR EXC SKIN BENIG >4 CM FACE,FACIAL
|
Professional
|
Both
|
$715.34
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
z11446
|
| Min. Negotiated Rate |
$162.48 |
| Max. Negotiated Rate |
$35,400.00 |
| Rate for Payer: Aetna Commercial |
$299.13
|
| Rate for Payer: Aetna Commercial |
$299.13
|
| Rate for Payer: Aetna Medicare |
$299.13
|
| Rate for Payer: Aetna Medicare |
$299.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$366.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.48
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$351.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$351.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$344.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$344.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$329.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$329.04
|
| Rate for Payer: Cash Price |
$419.89
|
| Rate for Payer: Cash Price |
$429.20
|
| Rate for Payer: Centivo All Commercial |
$463.65
|
| Rate for Payer: Centivo All Commercial |
$463.65
|
| Rate for Payer: Cigna All Commercial |
$299.13
|
| Rate for Payer: Cigna All Commercial |
$299.13
|
| Rate for Payer: CORVEL All Commercial |
$299.13
|
| Rate for Payer: CORVEL All Commercial |
$299.13
|
| Rate for Payer: Coventry All Commercial |
$358.96
|
| Rate for Payer: Coventry All Commercial |
$358.96
|
| Rate for Payer: Encore All Commercial |
$299.13
|
| Rate for Payer: Encore All Commercial |
$299.13
|
| Rate for Payer: Frontpath All Commercial |
$409.85
|
| Rate for Payer: Frontpath All Commercial |
$409.85
|
| Rate for Payer: Humana ChoiceCare |
$272.34
|
| Rate for Payer: Humana ChoiceCare |
$272.34
|
| Rate for Payer: Humana Medicare |
$299.13
|
| Rate for Payer: Humana Medicare |
$299.13
|
| Rate for Payer: Lucent All Commercial |
$418.78
|
| Rate for Payer: Lucent All Commercial |
$418.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$384.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$384.00
|
| Rate for Payer: Managed Health Services Medicaid |
$351.83
|
| Rate for Payer: Managed Health Services Medicaid |
$351.83
|
| Rate for Payer: MDWise Medicaid |
$351.83
|
| Rate for Payer: MDWise Medicaid |
$351.83
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$162.48
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$162.48
|
| Rate for Payer: PHCS All Commercial |
$299.13
|
| Rate for Payer: PHCS All Commercial |
$299.13
|
| Rate for Payer: PHP All Commercial |
$403.43
|
| Rate for Payer: PHP All Commercial |
$403.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$299.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$299.13
|
| Rate for Payer: Sagamore Health Network All Products |
$299.13
|
| Rate for Payer: Sagamore Health Network All Products |
$299.13
|
| Rate for Payer: Signature Care EPO |
$353.60
|
| Rate for Payer: Signature Care EPO |
$353.60
|
| Rate for Payer: Signature Care PPO |
$353.60
|
| Rate for Payer: Signature Care PPO |
$353.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,400.00
|
| Rate for Payer: United Healthcare Commercial |
$340.81
|
| Rate for Payer: United Healthcare Commercial |
$340.81
|
| Rate for Payer: United Healthcare Medicare |
$349.91
|
| Rate for Payer: United Healthcare Medicare |
$349.91
|
|
|
PR EXC SKIN BENIG >4 CM REMAINDR BODY
|
Professional
|
Both
|
$609.98
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
z11426
|
| Min. Negotiated Rate |
$138.43 |
| Max. Negotiated Rate |
$30,100.00 |
| Rate for Payer: Aetna Commercial |
$253.53
|
| Rate for Payer: Aetna Commercial |
$253.53
|
| Rate for Payer: Aetna Medicare |
$253.53
|
| Rate for Payer: Aetna Medicare |
$253.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$328.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$328.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$328.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$328.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$328.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$328.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$328.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$328.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$138.43
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$138.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$300.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$300.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$291.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$291.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$278.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$278.88
|
| Rate for Payer: Cash Price |
$361.01
|
| Rate for Payer: Cash Price |
$365.99
|
| Rate for Payer: Centivo All Commercial |
$392.97
|
| Rate for Payer: Centivo All Commercial |
$392.97
|
| Rate for Payer: Cigna All Commercial |
$253.53
|
| Rate for Payer: Cigna All Commercial |
$253.53
|
| Rate for Payer: CORVEL All Commercial |
$253.53
|
| Rate for Payer: CORVEL All Commercial |
$253.53
|
| Rate for Payer: Coventry All Commercial |
$304.24
|
| Rate for Payer: Coventry All Commercial |
$304.24
|
| Rate for Payer: Encore All Commercial |
$253.53
|
| Rate for Payer: Encore All Commercial |
$253.53
|
| Rate for Payer: Frontpath All Commercial |
$349.90
|
| Rate for Payer: Frontpath All Commercial |
$349.90
|
| Rate for Payer: Humana ChoiceCare |
$222.59
|
| Rate for Payer: Humana ChoiceCare |
$222.59
|
| Rate for Payer: Humana Medicare |
$253.53
|
| Rate for Payer: Humana Medicare |
$253.53
|
| Rate for Payer: Lucent All Commercial |
$354.94
|
| Rate for Payer: Lucent All Commercial |
$354.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$326.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$326.00
|
| Rate for Payer: Managed Health Services Medicaid |
$300.01
|
| Rate for Payer: Managed Health Services Medicaid |
$300.01
|
| Rate for Payer: MDWise Medicaid |
$300.01
|
| Rate for Payer: MDWise Medicaid |
$300.01
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$138.43
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$138.43
|
| Rate for Payer: PHCS All Commercial |
$253.53
|
| Rate for Payer: PHCS All Commercial |
$253.53
|
| Rate for Payer: PHP All Commercial |
$342.74
|
| Rate for Payer: PHP All Commercial |
$342.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$253.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$253.53
|
| Rate for Payer: Sagamore Health Network All Products |
$253.53
|
| Rate for Payer: Sagamore Health Network All Products |
$253.53
|
| Rate for Payer: Signature Care EPO |
$301.75
|
| Rate for Payer: Signature Care EPO |
$301.75
|
| Rate for Payer: Signature Care PPO |
$301.75
|
| Rate for Payer: Signature Care PPO |
$301.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$30,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$30,100.00
|
| Rate for Payer: United Healthcare Commercial |
$289.63
|
| Rate for Payer: United Healthcare Commercial |
$289.63
|
| Rate for Payer: United Healthcare Medicare |
$300.84
|
| Rate for Payer: United Healthcare Medicare |
$300.84
|
|
|
PR EXC SKIN BENIG >4 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$590.18
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
z11406
|
| Min. Negotiated Rate |
$126.49 |
| Max. Negotiated Rate |
$27,500.00 |
| Rate for Payer: Aetna Commercial |
$230.07
|
| Rate for Payer: Aetna Commercial |
$230.07
|
| Rate for Payer: Aetna Medicare |
$230.07
|
| Rate for Payer: Aetna Medicare |
$230.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$295.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$295.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$295.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$295.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$295.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$295.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$295.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$295.15
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$126.49
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$126.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$290.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$290.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$264.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$264.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.08
|
| Rate for Payer: Cash Price |
$346.70
|
| Rate for Payer: Cash Price |
$354.11
|
| Rate for Payer: Centivo All Commercial |
$356.61
|
| Rate for Payer: Centivo All Commercial |
$356.61
|
| Rate for Payer: Cigna All Commercial |
$230.07
|
| Rate for Payer: Cigna All Commercial |
$230.07
|
| Rate for Payer: CORVEL All Commercial |
$230.07
|
| Rate for Payer: CORVEL All Commercial |
$230.07
|
| Rate for Payer: Coventry All Commercial |
$276.08
|
| Rate for Payer: Coventry All Commercial |
$276.08
|
| Rate for Payer: Encore All Commercial |
$230.07
|
| Rate for Payer: Encore All Commercial |
$230.07
|
| Rate for Payer: Frontpath All Commercial |
$319.32
|
| Rate for Payer: Frontpath All Commercial |
$319.32
|
| Rate for Payer: Humana ChoiceCare |
$166.54
|
| Rate for Payer: Humana ChoiceCare |
$166.54
|
| Rate for Payer: Humana Medicare |
$230.07
|
| Rate for Payer: Humana Medicare |
$230.07
|
| Rate for Payer: Lucent All Commercial |
$322.10
|
| Rate for Payer: Lucent All Commercial |
$322.10
|
| 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 |
$290.28
|
| Rate for Payer: Managed Health Services Medicaid |
$290.28
|
| Rate for Payer: MDWise Medicaid |
$290.28
|
| Rate for Payer: MDWise Medicaid |
$290.28
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$126.49
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$126.49
|
| Rate for Payer: PHCS All Commercial |
$230.07
|
| Rate for Payer: PHCS All Commercial |
$230.07
|
| Rate for Payer: PHP All Commercial |
$313.41
|
| Rate for Payer: PHP All Commercial |
$313.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$230.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$230.07
|
| Rate for Payer: Sagamore Health Network All Products |
$230.07
|
| Rate for Payer: Sagamore Health Network All Products |
$230.07
|
| Rate for Payer: Signature Care EPO |
$253.80
|
| Rate for Payer: Signature Care EPO |
$253.80
|
| Rate for Payer: Signature Care PPO |
$253.80
|
| Rate for Payer: Signature Care PPO |
$253.80
|
| 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 |
$249.10
|
| Rate for Payer: United Healthcare Commercial |
$249.10
|
| Rate for Payer: United Healthcare Medicare |
$288.92
|
| Rate for Payer: United Healthcare Medicare |
$288.92
|
|
|
PR EXC SKIN MALIG <0.5 CM FACE,FACIAL
|
Professional
|
Both
|
$378.84
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
z11640
|
| Min. Negotiated Rate |
$72.29 |
| Max. Negotiated Rate |
$14,200.00 |
| Rate for Payer: Aetna Commercial |
$117.86
|
| Rate for Payer: Aetna Commercial |
$117.86
|
| Rate for Payer: Aetna Medicare |
$117.86
|
| Rate for Payer: Aetna Medicare |
$117.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$189.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$189.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$189.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$189.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$189.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$189.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$189.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$189.71
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$72.29
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$72.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$186.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$186.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$135.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$135.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$129.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$129.65
|
| Rate for Payer: Cash Price |
$222.90
|
| Rate for Payer: Cash Price |
$227.30
|
| Rate for Payer: Centivo All Commercial |
$182.68
|
| Rate for Payer: Centivo All Commercial |
$182.68
|
| Rate for Payer: Cigna All Commercial |
$117.86
|
| Rate for Payer: Cigna All Commercial |
$117.86
|
| Rate for Payer: CORVEL All Commercial |
$117.86
|
| Rate for Payer: CORVEL All Commercial |
$117.86
|
| Rate for Payer: Coventry All Commercial |
$141.43
|
| Rate for Payer: Coventry All Commercial |
$141.43
|
| Rate for Payer: Encore All Commercial |
$117.86
|
| Rate for Payer: Encore All Commercial |
$117.86
|
| Rate for Payer: Frontpath All Commercial |
$160.22
|
| Rate for Payer: Frontpath All Commercial |
$160.22
|
| Rate for Payer: Humana ChoiceCare |
$91.09
|
| Rate for Payer: Humana ChoiceCare |
$91.09
|
| Rate for Payer: Humana Medicare |
$117.86
|
| Rate for Payer: Humana Medicare |
$117.86
|
| Rate for Payer: Lucent All Commercial |
$165.00
|
| Rate for Payer: Lucent All Commercial |
$165.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$154.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$154.00
|
| Rate for Payer: Managed Health Services Medicaid |
$186.33
|
| Rate for Payer: Managed Health Services Medicaid |
$186.33
|
| Rate for Payer: MDWise Medicaid |
$186.33
|
| Rate for Payer: MDWise Medicaid |
$186.33
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$72.29
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$72.29
|
| Rate for Payer: PHCS All Commercial |
$117.86
|
| Rate for Payer: PHCS All Commercial |
$117.86
|
| Rate for Payer: PHP All Commercial |
$161.39
|
| Rate for Payer: PHP All Commercial |
$161.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$117.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$117.86
|
| Rate for Payer: Sagamore Health Network All Products |
$117.86
|
| Rate for Payer: Sagamore Health Network All Products |
$117.86
|
| Rate for Payer: Signature Care EPO |
$162.92
|
| Rate for Payer: Signature Care EPO |
$162.92
|
| Rate for Payer: Signature Care PPO |
$162.92
|
| Rate for Payer: Signature Care PPO |
$162.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,200.00
|
| Rate for Payer: United Healthcare Commercial |
$128.15
|
| Rate for Payer: United Healthcare Commercial |
$128.15
|
| Rate for Payer: United Healthcare Medicare |
$185.75
|
| Rate for Payer: United Healthcare Medicare |
$185.75
|
|
|
PR EXC SKIN MALIG <0.5 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$367.28
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
z11600
|
| Min. Negotiated Rate |
$67.70 |
| Max. Negotiated Rate |
$13,700.00 |
| Rate for Payer: Aetna Commercial |
$113.98
|
| Rate for Payer: Aetna Commercial |
$113.98
|
| Rate for Payer: Aetna Medicare |
$113.98
|
| Rate for Payer: Aetna Medicare |
$113.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$185.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$185.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$185.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$185.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$185.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$185.60
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$67.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$67.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$180.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$180.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.38
|
| Rate for Payer: Cash Price |
$216.64
|
| Rate for Payer: Cash Price |
$220.37
|
| Rate for Payer: Centivo All Commercial |
$176.67
|
| Rate for Payer: Centivo All Commercial |
$176.67
|
| Rate for Payer: Cigna All Commercial |
$113.98
|
| Rate for Payer: Cigna All Commercial |
$113.98
|
| Rate for Payer: CORVEL All Commercial |
$113.98
|
| Rate for Payer: CORVEL All Commercial |
$113.98
|
| Rate for Payer: Coventry All Commercial |
$136.78
|
| Rate for Payer: Coventry All Commercial |
$136.78
|
| Rate for Payer: Encore All Commercial |
$113.98
|
| Rate for Payer: Encore All Commercial |
$113.98
|
| Rate for Payer: Frontpath All Commercial |
$155.13
|
| Rate for Payer: Frontpath All Commercial |
$155.13
|
| Rate for Payer: Humana ChoiceCare |
$84.60
|
| Rate for Payer: Humana ChoiceCare |
$84.60
|
| Rate for Payer: Humana Medicare |
$113.98
|
| Rate for Payer: Humana Medicare |
$113.98
|
| Rate for Payer: Lucent All Commercial |
$159.57
|
| Rate for Payer: Lucent All Commercial |
$159.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$148.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$148.00
|
| Rate for Payer: Managed Health Services Medicaid |
$180.65
|
| Rate for Payer: Managed Health Services Medicaid |
$180.65
|
| Rate for Payer: MDWise Medicaid |
$180.65
|
| Rate for Payer: MDWise Medicaid |
$180.65
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$67.70
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$67.70
|
| Rate for Payer: PHCS All Commercial |
$113.98
|
| Rate for Payer: PHCS All Commercial |
$113.98
|
| Rate for Payer: PHP All Commercial |
$155.76
|
| Rate for Payer: PHP All Commercial |
$155.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$113.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$113.98
|
| Rate for Payer: Sagamore Health Network All Products |
$113.98
|
| Rate for Payer: Sagamore Health Network All Products |
$113.98
|
| Rate for Payer: Signature Care EPO |
$158.95
|
| Rate for Payer: Signature Care EPO |
$158.95
|
| Rate for Payer: Signature Care PPO |
$158.95
|
| Rate for Payer: Signature Care PPO |
$158.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,700.00
|
| Rate for Payer: United Healthcare Commercial |
$119.88
|
| Rate for Payer: United Healthcare Commercial |
$119.88
|
| Rate for Payer: United Healthcare Medicare |
$180.53
|
| Rate for Payer: United Healthcare Medicare |
$180.53
|
|
|
PR EXC SKIN MALIG 0.6-1CM FACE,FACIAL
|
Professional
|
Both
|
$441.68
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
z11641
|
| Min. Negotiated Rate |
$113.16 |
| Max. Negotiated Rate |
$17,400.00 |
| Rate for Payer: Aetna Commercial |
$144.84
|
| Rate for Payer: Aetna Commercial |
$144.84
|
| Rate for Payer: Aetna Medicare |
$144.84
|
| Rate for Payer: Aetna Medicare |
$144.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$246.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$246.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$246.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$246.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$246.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$246.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$246.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$246.26
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$113.16
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$113.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$217.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$217.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$166.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$166.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$159.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$159.32
|
| Rate for Payer: Cash Price |
$260.33
|
| Rate for Payer: Cash Price |
$265.01
|
| Rate for Payer: Centivo All Commercial |
$224.50
|
| Rate for Payer: Centivo All Commercial |
$224.50
|
| Rate for Payer: Cigna All Commercial |
$144.84
|
| Rate for Payer: Cigna All Commercial |
$144.84
|
| Rate for Payer: CORVEL All Commercial |
$144.84
|
| Rate for Payer: CORVEL All Commercial |
$144.84
|
| Rate for Payer: Coventry All Commercial |
$173.81
|
| Rate for Payer: Coventry All Commercial |
$173.81
|
| Rate for Payer: Encore All Commercial |
$144.84
|
| Rate for Payer: Encore All Commercial |
$144.84
|
| Rate for Payer: Frontpath All Commercial |
$196.60
|
| Rate for Payer: Frontpath All Commercial |
$196.60
|
| Rate for Payer: Humana ChoiceCare |
$137.04
|
| Rate for Payer: Humana ChoiceCare |
$137.04
|
| Rate for Payer: Humana Medicare |
$144.84
|
| Rate for Payer: Humana Medicare |
$144.84
|
| Rate for Payer: Lucent All Commercial |
$202.78
|
| Rate for Payer: Lucent All Commercial |
$202.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Managed Health Services Medicaid |
$217.24
|
| Rate for Payer: Managed Health Services Medicaid |
$217.24
|
| Rate for Payer: MDWise Medicaid |
$217.24
|
| Rate for Payer: MDWise Medicaid |
$217.24
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$113.16
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$113.16
|
| Rate for Payer: PHCS All Commercial |
$144.84
|
| Rate for Payer: PHCS All Commercial |
$144.84
|
| Rate for Payer: PHP All Commercial |
$198.30
|
| Rate for Payer: PHP All Commercial |
$198.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$144.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$144.84
|
| Rate for Payer: Sagamore Health Network All Products |
$144.84
|
| Rate for Payer: Sagamore Health Network All Products |
$144.84
|
| Rate for Payer: Signature Care EPO |
$212.50
|
| Rate for Payer: Signature Care EPO |
$212.50
|
| Rate for Payer: Signature Care PPO |
$212.50
|
| Rate for Payer: Signature Care PPO |
$212.50
|
| 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 |
$167.36
|
| Rate for Payer: United Healthcare Commercial |
$167.36
|
| Rate for Payer: United Healthcare Medicare |
$216.94
|
| Rate for Payer: United Healthcare Medicare |
$216.94
|
|
|
PR EXC SKIN MALIG 0.6-1 CM REMAINDR BODY
|
Professional
|
Both
|
$427.38
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
z11621
|
| Min. Negotiated Rate |
$80.03 |
| Max. Negotiated Rate |
$16,700.00 |
| Rate for Payer: Aetna Commercial |
$139.23
|
| Rate for Payer: Aetna Commercial |
$139.23
|
| Rate for Payer: Aetna Medicare |
$139.23
|
| Rate for Payer: Aetna Medicare |
$139.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$211.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$211.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$211.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$211.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$211.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$211.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$211.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$211.14
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$80.03
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$80.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$210.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$210.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$160.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$160.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$153.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$153.15
|
| Rate for Payer: Cash Price |
$252.23
|
| Rate for Payer: Cash Price |
$256.43
|
| Rate for Payer: Centivo All Commercial |
$215.81
|
| Rate for Payer: Centivo All Commercial |
$215.81
|
| Rate for Payer: Cigna All Commercial |
$139.23
|
| Rate for Payer: Cigna All Commercial |
$139.23
|
| Rate for Payer: CORVEL All Commercial |
$139.23
|
| Rate for Payer: CORVEL All Commercial |
$139.23
|
| Rate for Payer: Coventry All Commercial |
$167.08
|
| Rate for Payer: Coventry All Commercial |
$167.08
|
| Rate for Payer: Encore All Commercial |
$139.23
|
| Rate for Payer: Encore All Commercial |
$139.23
|
| Rate for Payer: Frontpath All Commercial |
$189.25
|
| Rate for Payer: Frontpath All Commercial |
$189.25
|
| Rate for Payer: Humana ChoiceCare |
$111.26
|
| Rate for Payer: Humana ChoiceCare |
$111.26
|
| Rate for Payer: Humana Medicare |
$139.23
|
| Rate for Payer: Humana Medicare |
$139.23
|
| Rate for Payer: Lucent All Commercial |
$194.92
|
| Rate for Payer: Lucent All Commercial |
$194.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$181.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$181.00
|
| Rate for Payer: Managed Health Services Medicaid |
$210.21
|
| Rate for Payer: Managed Health Services Medicaid |
$210.21
|
| Rate for Payer: MDWise Medicaid |
$210.21
|
| Rate for Payer: MDWise Medicaid |
$210.21
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$80.03
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$80.03
|
| Rate for Payer: PHCS All Commercial |
$139.23
|
| Rate for Payer: PHCS All Commercial |
$139.23
|
| Rate for Payer: PHP All Commercial |
$190.54
|
| Rate for Payer: PHP All Commercial |
$190.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$139.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$139.23
|
| Rate for Payer: Sagamore Health Network All Products |
$139.23
|
| Rate for Payer: Sagamore Health Network All Products |
$139.23
|
| Rate for Payer: Signature Care EPO |
$183.88
|
| Rate for Payer: Signature Care EPO |
$183.88
|
| Rate for Payer: Signature Care PPO |
$183.88
|
| Rate for Payer: Signature Care PPO |
$183.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$16,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$16,700.00
|
| Rate for Payer: United Healthcare Commercial |
$156.84
|
| Rate for Payer: United Healthcare Commercial |
$156.84
|
| Rate for Payer: United Healthcare Medicare |
$210.19
|
| Rate for Payer: United Healthcare Medicare |
$210.19
|
|
|
PR EXC SKIN MALIG 0.6-1 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$426.40
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
z11601
|
| Min. Negotiated Rate |
$79.51 |
| Max. Negotiated Rate |
$16,600.00 |
| Rate for Payer: Aetna Commercial |
$138.57
|
| Rate for Payer: Aetna Commercial |
$138.57
|
| Rate for Payer: Aetna Medicare |
$138.57
|
| Rate for Payer: Aetna Medicare |
$138.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$212.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$212.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$212.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$212.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$212.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$212.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$212.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$212.51
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$79.51
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$79.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$209.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$209.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$159.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$159.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$152.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$152.43
|
| Rate for Payer: Cash Price |
$250.92
|
| Rate for Payer: Cash Price |
$255.84
|
| Rate for Payer: Centivo All Commercial |
$214.78
|
| Rate for Payer: Centivo All Commercial |
$214.78
|
| Rate for Payer: Cigna All Commercial |
$138.57
|
| Rate for Payer: Cigna All Commercial |
$138.57
|
| Rate for Payer: CORVEL All Commercial |
$138.57
|
| Rate for Payer: CORVEL All Commercial |
$138.57
|
| Rate for Payer: Coventry All Commercial |
$166.28
|
| Rate for Payer: Coventry All Commercial |
$166.28
|
| Rate for Payer: Encore All Commercial |
$138.57
|
| Rate for Payer: Encore All Commercial |
$138.57
|
| Rate for Payer: Frontpath All Commercial |
$188.40
|
| Rate for Payer: Frontpath All Commercial |
$188.40
|
| Rate for Payer: Humana ChoiceCare |
$112.09
|
| Rate for Payer: Humana ChoiceCare |
$112.09
|
| Rate for Payer: Humana Medicare |
$138.57
|
| Rate for Payer: Humana Medicare |
$138.57
|
| Rate for Payer: Lucent All Commercial |
$194.00
|
| Rate for Payer: Lucent All Commercial |
$194.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$180.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$180.00
|
| Rate for Payer: Managed Health Services Medicaid |
$209.72
|
| Rate for Payer: Managed Health Services Medicaid |
$209.72
|
| Rate for Payer: MDWise Medicaid |
$209.72
|
| Rate for Payer: MDWise Medicaid |
$209.72
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$79.51
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$79.51
|
| Rate for Payer: PHCS All Commercial |
$138.57
|
| Rate for Payer: PHCS All Commercial |
$138.57
|
| Rate for Payer: PHP All Commercial |
$189.43
|
| Rate for Payer: PHP All Commercial |
$189.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.57
|
| Rate for Payer: Sagamore Health Network All Products |
$138.57
|
| Rate for Payer: Sagamore Health Network All Products |
$138.57
|
| Rate for Payer: Signature Care EPO |
$183.18
|
| Rate for Payer: Signature Care EPO |
$183.18
|
| Rate for Payer: Signature Care PPO |
$183.18
|
| Rate for Payer: Signature Care PPO |
$183.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$16,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$16,600.00
|
| Rate for Payer: United Healthcare Commercial |
$155.15
|
| Rate for Payer: United Healthcare Commercial |
$155.15
|
| Rate for Payer: United Healthcare Medicare |
$209.10
|
| Rate for Payer: United Healthcare Medicare |
$209.10
|
|
|
PR EXC SKIN MALIG 1.1-2 CM FACE,FACIAL
|
Professional
|
Both
|
$499.68
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
z11642
|
| Min. Negotiated Rate |
$115.61 |
| Max. Negotiated Rate |
$20,400.00 |
| Rate for Payer: Aetna Commercial |
$169.63
|
| Rate for Payer: Aetna Commercial |
$169.63
|
| Rate for Payer: Aetna Medicare |
$169.63
|
| Rate for Payer: Aetna Medicare |
$169.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$285.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$285.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$285.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$285.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$285.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$285.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$285.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$285.02
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$115.61
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$115.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$245.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$245.76
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$195.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$195.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$186.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$186.59
|
| Rate for Payer: Cash Price |
$294.11
|
| Rate for Payer: Cash Price |
$299.81
|
| Rate for Payer: Centivo All Commercial |
$262.93
|
| Rate for Payer: Centivo All Commercial |
$262.93
|
| Rate for Payer: Cigna All Commercial |
$169.63
|
| Rate for Payer: Cigna All Commercial |
$169.63
|
| Rate for Payer: CORVEL All Commercial |
$169.63
|
| Rate for Payer: CORVEL All Commercial |
$169.63
|
| Rate for Payer: Coventry All Commercial |
$203.56
|
| Rate for Payer: Coventry All Commercial |
$203.56
|
| Rate for Payer: Encore All Commercial |
$169.63
|
| Rate for Payer: Encore All Commercial |
$169.63
|
| Rate for Payer: Frontpath All Commercial |
$230.96
|
| Rate for Payer: Frontpath All Commercial |
$230.96
|
| Rate for Payer: Humana ChoiceCare |
$160.01
|
| Rate for Payer: Humana ChoiceCare |
$160.01
|
| Rate for Payer: Humana Medicare |
$169.63
|
| Rate for Payer: Humana Medicare |
$169.63
|
| Rate for Payer: Lucent All Commercial |
$237.48
|
| Rate for Payer: Lucent All Commercial |
$237.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$221.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$221.00
|
| Rate for Payer: Managed Health Services Medicaid |
$245.76
|
| Rate for Payer: Managed Health Services Medicaid |
$245.76
|
| Rate for Payer: MDWise Medicaid |
$245.76
|
| Rate for Payer: MDWise Medicaid |
$245.76
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$115.61
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$115.61
|
| Rate for Payer: PHCS All Commercial |
$169.63
|
| Rate for Payer: PHCS All Commercial |
$169.63
|
| Rate for Payer: PHP All Commercial |
$231.81
|
| Rate for Payer: PHP All Commercial |
$231.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$169.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$169.63
|
| Rate for Payer: Sagamore Health Network All Products |
$169.63
|
| Rate for Payer: Sagamore Health Network All Products |
$169.63
|
| Rate for Payer: Signature Care EPO |
$245.65
|
| Rate for Payer: Signature Care EPO |
$245.65
|
| Rate for Payer: Signature Care PPO |
$245.65
|
| Rate for Payer: Signature Care PPO |
$245.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,400.00
|
| Rate for Payer: United Healthcare Commercial |
$197.56
|
| Rate for Payer: United Healthcare Commercial |
$197.56
|
| Rate for Payer: United Healthcare Medicare |
$245.09
|
| Rate for Payer: United Healthcare Medicare |
$245.09
|
|
|
PR EXC SKIN MALIG 1.1-2 CM REMAINDR BODY
|
Professional
|
Both
|
$472.42
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
z11622
|
| Min. Negotiated Rate |
$93.59 |
| Max. Negotiated Rate |
$19,000.00 |
| Rate for Payer: Aetna Commercial |
$157.82
|
| Rate for Payer: Aetna Commercial |
$157.82
|
| Rate for Payer: Aetna Medicare |
$157.82
|
| Rate for Payer: Aetna Medicare |
$157.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$237.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$237.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$237.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$237.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$237.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$237.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$237.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$237.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.59
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$232.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$232.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$181.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$181.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$173.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$173.60
|
| Rate for Payer: Cash Price |
$277.80
|
| Rate for Payer: Cash Price |
$283.45
|
| Rate for Payer: Centivo All Commercial |
$244.62
|
| Rate for Payer: Centivo All Commercial |
$244.62
|
| Rate for Payer: Cigna All Commercial |
$157.82
|
| Rate for Payer: Cigna All Commercial |
$157.82
|
| Rate for Payer: CORVEL All Commercial |
$157.82
|
| Rate for Payer: CORVEL All Commercial |
$157.82
|
| Rate for Payer: Coventry All Commercial |
$189.38
|
| Rate for Payer: Coventry All Commercial |
$189.38
|
| Rate for Payer: Encore All Commercial |
$157.82
|
| Rate for Payer: Encore All Commercial |
$157.82
|
| Rate for Payer: Frontpath All Commercial |
$214.12
|
| Rate for Payer: Frontpath All Commercial |
$214.12
|
| Rate for Payer: Humana ChoiceCare |
$129.24
|
| Rate for Payer: Humana ChoiceCare |
$129.24
|
| Rate for Payer: Humana Medicare |
$157.82
|
| Rate for Payer: Humana Medicare |
$157.82
|
| Rate for Payer: Lucent All Commercial |
$220.95
|
| Rate for Payer: Lucent All Commercial |
$220.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$206.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$206.00
|
| Rate for Payer: Managed Health Services Medicaid |
$232.36
|
| Rate for Payer: Managed Health Services Medicaid |
$232.36
|
| Rate for Payer: MDWise Medicaid |
$232.36
|
| Rate for Payer: MDWise Medicaid |
$232.36
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.59
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.59
|
| Rate for Payer: PHCS All Commercial |
$157.82
|
| Rate for Payer: PHCS All Commercial |
$157.82
|
| Rate for Payer: PHP All Commercial |
$216.15
|
| Rate for Payer: PHP All Commercial |
$216.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$157.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$157.82
|
| Rate for Payer: Sagamore Health Network All Products |
$157.82
|
| Rate for Payer: Sagamore Health Network All Products |
$157.82
|
| Rate for Payer: Signature Care EPO |
$206.55
|
| Rate for Payer: Signature Care EPO |
$206.55
|
| Rate for Payer: Signature Care PPO |
$206.55
|
| Rate for Payer: Signature Care PPO |
$206.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,000.00
|
| Rate for Payer: United Healthcare Commercial |
$180.95
|
| Rate for Payer: United Healthcare Commercial |
$180.95
|
| Rate for Payer: United Healthcare Medicare |
$231.50
|
| Rate for Payer: United Healthcare Medicare |
$231.50
|
|
|
PR EXC SKIN MALIG 1.1-2 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$456.90
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
z11602
|
| Min. Negotiated Rate |
$85.67 |
| Max. Negotiated Rate |
$18,100.00 |
| Rate for Payer: Aetna Commercial |
$150.79
|
| Rate for Payer: Aetna Commercial |
$150.79
|
| Rate for Payer: Aetna Medicare |
$150.79
|
| Rate for Payer: Aetna Medicare |
$150.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$226.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$226.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$226.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$226.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$226.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$226.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$226.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$226.65
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$85.67
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$85.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$224.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$224.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$173.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$173.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$165.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$165.87
|
| Rate for Payer: Cash Price |
$268.97
|
| Rate for Payer: Cash Price |
$274.14
|
| Rate for Payer: Centivo All Commercial |
$233.72
|
| Rate for Payer: Centivo All Commercial |
$233.72
|
| Rate for Payer: Cigna All Commercial |
$150.79
|
| Rate for Payer: Cigna All Commercial |
$150.79
|
| Rate for Payer: CORVEL All Commercial |
$150.79
|
| Rate for Payer: CORVEL All Commercial |
$150.79
|
| Rate for Payer: Coventry All Commercial |
$180.95
|
| Rate for Payer: Coventry All Commercial |
$180.95
|
| Rate for Payer: Encore All Commercial |
$150.79
|
| Rate for Payer: Encore All Commercial |
$150.79
|
| Rate for Payer: Frontpath All Commercial |
$204.37
|
| Rate for Payer: Frontpath All Commercial |
$204.37
|
| Rate for Payer: Humana ChoiceCare |
$119.15
|
| Rate for Payer: Humana ChoiceCare |
$119.15
|
| Rate for Payer: Humana Medicare |
$150.79
|
| Rate for Payer: Humana Medicare |
$150.79
|
| Rate for Payer: Lucent All Commercial |
$211.11
|
| Rate for Payer: Lucent All Commercial |
$211.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$196.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$196.00
|
| Rate for Payer: Managed Health Services Medicaid |
$224.72
|
| Rate for Payer: Managed Health Services Medicaid |
$224.72
|
| Rate for Payer: MDWise Medicaid |
$224.72
|
| Rate for Payer: MDWise Medicaid |
$224.72
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$85.67
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$85.67
|
| Rate for Payer: PHCS All Commercial |
$150.79
|
| Rate for Payer: PHCS All Commercial |
$150.79
|
| Rate for Payer: PHP All Commercial |
$206.28
|
| Rate for Payer: PHP All Commercial |
$206.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$150.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$150.79
|
| Rate for Payer: Sagamore Health Network All Products |
$150.79
|
| Rate for Payer: Sagamore Health Network All Products |
$150.79
|
| Rate for Payer: Signature Care EPO |
$197.96
|
| Rate for Payer: Signature Care EPO |
$197.96
|
| Rate for Payer: Signature Care PPO |
$197.96
|
| Rate for Payer: Signature Care PPO |
$197.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,100.00
|
| Rate for Payer: United Healthcare Commercial |
$170.79
|
| Rate for Payer: United Healthcare Commercial |
$170.79
|
| Rate for Payer: United Healthcare Medicare |
$224.14
|
| Rate for Payer: United Healthcare Medicare |
$224.14
|
|
|
PR EXC SKIN MALIG 2.1-3 CM FACE,FACIAL
|
Professional
|
Both
|
$586.28
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
z11643
|
| Min. Negotiated Rate |
$133.36 |
| Max. Negotiated Rate |
$25,400.00 |
| Rate for Payer: Aetna Commercial |
$212.17
|
| Rate for Payer: Aetna Commercial |
$212.17
|
| Rate for Payer: Aetna Medicare |
$212.17
|
| Rate for Payer: Aetna Medicare |
$212.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$325.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$325.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$325.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$325.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$325.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$325.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$325.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$325.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$133.36
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$133.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$288.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$288.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$244.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$244.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$233.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$233.39
|
| Rate for Payer: Cash Price |
$345.65
|
| Rate for Payer: Cash Price |
$351.77
|
| Rate for Payer: Centivo All Commercial |
$328.86
|
| Rate for Payer: Centivo All Commercial |
$328.86
|
| Rate for Payer: Cigna All Commercial |
$212.17
|
| Rate for Payer: Cigna All Commercial |
$212.17
|
| Rate for Payer: CORVEL All Commercial |
$212.17
|
| Rate for Payer: CORVEL All Commercial |
$212.17
|
| Rate for Payer: Coventry All Commercial |
$254.60
|
| Rate for Payer: Coventry All Commercial |
$254.60
|
| Rate for Payer: Encore All Commercial |
$212.17
|
| Rate for Payer: Encore All Commercial |
$212.17
|
| Rate for Payer: Frontpath All Commercial |
$289.61
|
| Rate for Payer: Frontpath All Commercial |
$289.61
|
| Rate for Payer: Humana ChoiceCare |
$189.42
|
| Rate for Payer: Humana ChoiceCare |
$189.42
|
| Rate for Payer: Humana Medicare |
$212.17
|
| Rate for Payer: Humana Medicare |
$212.17
|
| Rate for Payer: Lucent All Commercial |
$297.04
|
| Rate for Payer: Lucent All Commercial |
$297.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$275.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$275.00
|
| Rate for Payer: Managed Health Services Medicaid |
$288.36
|
| Rate for Payer: Managed Health Services Medicaid |
$288.36
|
| Rate for Payer: MDWise Medicaid |
$288.36
|
| Rate for Payer: MDWise Medicaid |
$288.36
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$133.36
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$133.36
|
| Rate for Payer: PHCS All Commercial |
$212.17
|
| Rate for Payer: PHCS All Commercial |
$212.17
|
| Rate for Payer: PHP All Commercial |
$289.41
|
| Rate for Payer: PHP All Commercial |
$289.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$212.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$212.17
|
| Rate for Payer: Sagamore Health Network All Products |
$212.17
|
| Rate for Payer: Sagamore Health Network All Products |
$212.17
|
| Rate for Payer: Signature Care EPO |
$283.90
|
| Rate for Payer: Signature Care EPO |
$283.90
|
| Rate for Payer: Signature Care PPO |
$283.90
|
| Rate for Payer: Signature Care PPO |
$283.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,400.00
|
| Rate for Payer: United Healthcare Commercial |
$247.10
|
| Rate for Payer: United Healthcare Commercial |
$247.10
|
| Rate for Payer: United Healthcare Medicare |
$288.04
|
| Rate for Payer: United Healthcare Medicare |
$288.04
|
|
|
PR EXC SKIN MALIG 2.1-3 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$519.74
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
z11603
|
| Min. Negotiated Rate |
$106.14 |
| Max. Negotiated Rate |
$21,700.00 |
| Rate for Payer: Aetna Commercial |
$180.14
|
| Rate for Payer: Aetna Commercial |
$180.14
|
| Rate for Payer: Aetna Medicare |
$180.14
|
| Rate for Payer: Aetna Medicare |
$180.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$250.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$250.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$250.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$250.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$250.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$250.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$250.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$250.36
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$106.14
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$106.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$255.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$255.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$207.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$207.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$198.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$198.15
|
| Rate for Payer: Cash Price |
$306.41
|
| Rate for Payer: Cash Price |
$311.84
|
| Rate for Payer: Centivo All Commercial |
$279.22
|
| Rate for Payer: Centivo All Commercial |
$279.22
|
| Rate for Payer: Cigna All Commercial |
$180.14
|
| Rate for Payer: Cigna All Commercial |
$180.14
|
| Rate for Payer: CORVEL All Commercial |
$180.14
|
| Rate for Payer: CORVEL All Commercial |
$180.14
|
| Rate for Payer: Coventry All Commercial |
$216.17
|
| Rate for Payer: Coventry All Commercial |
$216.17
|
| Rate for Payer: Encore All Commercial |
$180.14
|
| Rate for Payer: Encore All Commercial |
$180.14
|
| Rate for Payer: Frontpath All Commercial |
$244.97
|
| Rate for Payer: Frontpath All Commercial |
$244.97
|
| Rate for Payer: Humana ChoiceCare |
$131.30
|
| Rate for Payer: Humana ChoiceCare |
$131.30
|
| Rate for Payer: Humana Medicare |
$180.14
|
| Rate for Payer: Humana Medicare |
$180.14
|
| Rate for Payer: Lucent All Commercial |
$252.20
|
| Rate for Payer: Lucent All Commercial |
$252.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$235.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$235.00
|
| Rate for Payer: Managed Health Services Medicaid |
$255.63
|
| Rate for Payer: Managed Health Services Medicaid |
$255.63
|
| Rate for Payer: MDWise Medicaid |
$255.63
|
| Rate for Payer: MDWise Medicaid |
$255.63
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$106.14
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$106.14
|
| Rate for Payer: PHCS All Commercial |
$180.14
|
| Rate for Payer: PHCS All Commercial |
$180.14
|
| Rate for Payer: PHP All Commercial |
$246.58
|
| Rate for Payer: PHP All Commercial |
$246.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$180.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$180.14
|
| Rate for Payer: Sagamore Health Network All Products |
$180.14
|
| Rate for Payer: Sagamore Health Network All Products |
$180.14
|
| Rate for Payer: Signature Care EPO |
$226.63
|
| Rate for Payer: Signature Care EPO |
$226.63
|
| Rate for Payer: Signature Care PPO |
$226.63
|
| Rate for Payer: Signature Care PPO |
$226.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21,700.00
|
| Rate for Payer: United Healthcare Commercial |
$203.29
|
| Rate for Payer: United Healthcare Commercial |
$203.29
|
| Rate for Payer: United Healthcare Medicare |
$255.34
|
| Rate for Payer: United Healthcare Medicare |
$255.34
|
|
|
PR EXC SKIN MALIG 3.1-4 CM FACE,FACIAL
|
Professional
|
Both
|
$722.68
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
z11644
|
| Min. Negotiated Rate |
$165.23 |
| Max. Negotiated Rate |
$31,500.00 |
| Rate for Payer: Aetna Commercial |
$263.25
|
| Rate for Payer: Aetna Commercial |
$263.25
|
| Rate for Payer: Aetna Medicare |
$263.25
|
| Rate for Payer: Aetna Medicare |
$263.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$405.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$405.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$405.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$405.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$405.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$405.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$405.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$405.20
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$165.23
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$165.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$355.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$355.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$302.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$302.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$289.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$289.57
|
| Rate for Payer: Cash Price |
$425.64
|
| Rate for Payer: Cash Price |
$433.61
|
| Rate for Payer: Centivo All Commercial |
$408.04
|
| Rate for Payer: Centivo All Commercial |
$408.04
|
| Rate for Payer: Cigna All Commercial |
$263.25
|
| Rate for Payer: Cigna All Commercial |
$263.25
|
| Rate for Payer: CORVEL All Commercial |
$263.25
|
| Rate for Payer: CORVEL All Commercial |
$263.25
|
| Rate for Payer: Coventry All Commercial |
$315.90
|
| Rate for Payer: Coventry All Commercial |
$315.90
|
| Rate for Payer: Encore All Commercial |
$263.25
|
| Rate for Payer: Encore All Commercial |
$263.25
|
| Rate for Payer: Frontpath All Commercial |
$361.14
|
| Rate for Payer: Frontpath All Commercial |
$361.14
|
| Rate for Payer: Humana ChoiceCare |
$242.93
|
| Rate for Payer: Humana ChoiceCare |
$242.93
|
| Rate for Payer: Humana Medicare |
$263.25
|
| Rate for Payer: Humana Medicare |
$263.25
|
| Rate for Payer: Lucent All Commercial |
$368.55
|
| Rate for Payer: Lucent All Commercial |
$368.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$341.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$341.00
|
| Rate for Payer: Managed Health Services Medicaid |
$355.44
|
| Rate for Payer: Managed Health Services Medicaid |
$355.44
|
| Rate for Payer: MDWise Medicaid |
$355.44
|
| Rate for Payer: MDWise Medicaid |
$355.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$165.23
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$165.23
|
| Rate for Payer: PHCS All Commercial |
$263.25
|
| Rate for Payer: PHCS All Commercial |
$263.25
|
| Rate for Payer: PHP All Commercial |
$358.27
|
| Rate for Payer: PHP All Commercial |
$358.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$263.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$263.25
|
| Rate for Payer: Sagamore Health Network All Products |
$263.25
|
| Rate for Payer: Sagamore Health Network All Products |
$263.25
|
| Rate for Payer: Signature Care EPO |
$359.55
|
| Rate for Payer: Signature Care EPO |
$359.55
|
| Rate for Payer: Signature Care PPO |
$359.55
|
| Rate for Payer: Signature Care PPO |
$359.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$31,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$31,500.00
|
| Rate for Payer: United Healthcare Commercial |
$308.11
|
| Rate for Payer: United Healthcare Commercial |
$308.11
|
| Rate for Payer: United Healthcare Medicare |
$354.70
|
| Rate for Payer: United Healthcare Medicare |
$354.70
|
|
|
PR EXC SKIN MALIG 3.1-4 CM REMAINDR BODY
|
Professional
|
Both
|
$627.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
z11624
|
| Min. Negotiated Rate |
$133.88 |
| Max. Negotiated Rate |
$343.74 |
| Rate for Payer: Aetna Commercial |
$221.77
|
| Rate for Payer: Aetna Medicare |
$221.77
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$133.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$308.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$255.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$243.95
|
| Rate for Payer: Cash Price |
$376.20
|
| Rate for Payer: Centivo All Commercial |
$343.74
|
| Rate for Payer: Cigna All Commercial |
$221.77
|
| Rate for Payer: CORVEL All Commercial |
$221.77
|
| Rate for Payer: Coventry All Commercial |
$266.12
|
| Rate for Payer: Encore All Commercial |
$221.77
|
| Rate for Payer: Frontpath All Commercial |
$304.12
|
| Rate for Payer: Humana ChoiceCare |
$181.54
|
| Rate for Payer: Humana Medicare |
$221.77
|
| Rate for Payer: Lucent All Commercial |
$310.48
|
| Rate for Payer: Managed Health Services Medicaid |
$308.23
|
| Rate for Payer: MDWise Medicaid |
$308.23
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$133.88
|
| Rate for Payer: PHCS All Commercial |
$221.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$221.77
|
| Rate for Payer: Sagamore Health Network All Products |
$221.77
|
| Rate for Payer: United Healthcare Commercial |
$253.91
|
| Rate for Payer: United Healthcare Medicare |
$307.80
|
|
|
PR EXC SKIN MALIG >4 CM FACE,FACIAL
|
Professional
|
Both
|
$934.88
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
z11646
|
| Min. Negotiated Rate |
$212.59 |
| Max. Negotiated Rate |
$43,400.00 |
| Rate for Payer: Aetna Commercial |
$364.29
|
| Rate for Payer: Aetna Commercial |
$364.29
|
| Rate for Payer: Aetna Medicare |
$364.29
|
| Rate for Payer: Aetna Medicare |
$364.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$526.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$526.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$526.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$526.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$526.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$526.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$526.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$526.20
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$212.59
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$212.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$459.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$459.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$418.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$418.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$400.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$400.72
|
| Rate for Payer: Cash Price |
$552.32
|
| Rate for Payer: Cash Price |
$560.93
|
| Rate for Payer: Centivo All Commercial |
$564.65
|
| Rate for Payer: Centivo All Commercial |
$564.65
|
| Rate for Payer: Cigna All Commercial |
$364.29
|
| Rate for Payer: Cigna All Commercial |
$364.29
|
| Rate for Payer: CORVEL All Commercial |
$364.29
|
| Rate for Payer: CORVEL All Commercial |
$364.29
|
| Rate for Payer: Coventry All Commercial |
$437.15
|
| Rate for Payer: Coventry All Commercial |
$437.15
|
| Rate for Payer: Encore All Commercial |
$364.29
|
| Rate for Payer: Encore All Commercial |
$364.29
|
| Rate for Payer: Frontpath All Commercial |
$502.94
|
| Rate for Payer: Frontpath All Commercial |
$502.94
|
| Rate for Payer: Humana ChoiceCare |
$354.68
|
| Rate for Payer: Humana ChoiceCare |
$354.68
|
| Rate for Payer: Humana Medicare |
$364.29
|
| Rate for Payer: Humana Medicare |
$364.29
|
| Rate for Payer: Lucent All Commercial |
$510.01
|
| Rate for Payer: Lucent All Commercial |
$510.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$470.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$470.00
|
| Rate for Payer: Managed Health Services Medicaid |
$459.81
|
| Rate for Payer: Managed Health Services Medicaid |
$459.81
|
| Rate for Payer: MDWise Medicaid |
$459.81
|
| Rate for Payer: MDWise Medicaid |
$459.81
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$212.59
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$212.59
|
| Rate for Payer: PHCS All Commercial |
$364.29
|
| Rate for Payer: PHCS All Commercial |
$364.29
|
| Rate for Payer: PHP All Commercial |
$494.27
|
| Rate for Payer: PHP All Commercial |
$494.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$364.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$364.29
|
| Rate for Payer: Sagamore Health Network All Products |
$364.29
|
| Rate for Payer: Sagamore Health Network All Products |
$364.29
|
| Rate for Payer: Signature Care EPO |
$483.65
|
| Rate for Payer: Signature Care EPO |
$483.65
|
| Rate for Payer: Signature Care PPO |
$483.65
|
| Rate for Payer: Signature Care PPO |
$483.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,400.00
|
| Rate for Payer: United Healthcare Commercial |
$433.84
|
| Rate for Payer: United Healthcare Commercial |
$433.84
|
| Rate for Payer: United Healthcare Medicare |
$460.27
|
| Rate for Payer: United Healthcare Medicare |
$460.27
|
|
|
PR EXC SKIN MALIG >4 CM TRUNK,ARM,LEG
|
Professional
|
Both
|
$828.80
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
z11606
|
| Min. Negotiated Rate |
$161.27 |
| Max. Negotiated Rate |
$35,100.00 |
| Rate for Payer: Aetna Commercial |
$295.00
|
| Rate for Payer: Aetna Commercial |
$295.00
|
| Rate for Payer: Aetna Medicare |
$295.00
|
| Rate for Payer: Aetna Medicare |
$295.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$429.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$429.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$429.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$429.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$429.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$429.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$429.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$429.84
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$161.27
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$161.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$407.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$407.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$339.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$339.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$324.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$324.50
|
| Rate for Payer: Cash Price |
$487.67
|
| Rate for Payer: Cash Price |
$497.28
|
| Rate for Payer: Centivo All Commercial |
$457.25
|
| Rate for Payer: Centivo All Commercial |
$457.25
|
| Rate for Payer: Cigna All Commercial |
$295.00
|
| Rate for Payer: Cigna All Commercial |
$295.00
|
| Rate for Payer: CORVEL All Commercial |
$295.00
|
| Rate for Payer: CORVEL All Commercial |
$295.00
|
| Rate for Payer: Coventry All Commercial |
$354.00
|
| Rate for Payer: Coventry All Commercial |
$354.00
|
| Rate for Payer: Encore All Commercial |
$295.00
|
| Rate for Payer: Encore All Commercial |
$295.00
|
| Rate for Payer: Frontpath All Commercial |
$409.31
|
| Rate for Payer: Frontpath All Commercial |
$409.31
|
| Rate for Payer: Humana ChoiceCare |
$195.30
|
| Rate for Payer: Humana ChoiceCare |
$195.30
|
| Rate for Payer: Humana Medicare |
$295.00
|
| Rate for Payer: Humana Medicare |
$295.00
|
| Rate for Payer: Lucent All Commercial |
$413.00
|
| Rate for Payer: Lucent All Commercial |
$413.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.00
|
| Rate for Payer: Managed Health Services Medicaid |
$407.64
|
| Rate for Payer: Managed Health Services Medicaid |
$407.64
|
| Rate for Payer: MDWise Medicaid |
$407.64
|
| Rate for Payer: MDWise Medicaid |
$407.64
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$161.27
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$161.27
|
| Rate for Payer: PHCS All Commercial |
$295.00
|
| Rate for Payer: PHCS All Commercial |
$295.00
|
| Rate for Payer: PHP All Commercial |
$399.86
|
| Rate for Payer: PHP All Commercial |
$399.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$295.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$295.00
|
| Rate for Payer: Sagamore Health Network All Products |
$295.00
|
| Rate for Payer: Sagamore Health Network All Products |
$295.00
|
| Rate for Payer: Signature Care EPO |
$360.99
|
| Rate for Payer: Signature Care EPO |
$360.99
|
| Rate for Payer: Signature Care PPO |
$360.99
|
| Rate for Payer: Signature Care PPO |
$360.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,100.00
|
| Rate for Payer: United Healthcare Commercial |
$331.88
|
| Rate for Payer: United Healthcare Commercial |
$331.88
|
| Rate for Payer: United Healthcare Medicare |
$406.39
|
| Rate for Payer: United Healthcare Medicare |
$406.39
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM
|
Professional
|
Both
|
$1,349.78
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
z21933
|
| Min. Negotiated Rate |
$663.11 |
| Max. Negotiated Rate |
$102,000.00 |
| Rate for Payer: Aetna Commercial |
$685.51
|
| Rate for Payer: Aetna Commercial |
$685.51
|
| Rate for Payer: Aetna Medicare |
$685.51
|
| Rate for Payer: Aetna Medicare |
$685.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$872.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$872.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$872.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$872.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$872.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$872.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$872.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$872.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$663.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$663.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$788.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$788.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$754.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$754.06
|
| Rate for Payer: Cash Price |
$809.87
|
| Rate for Payer: Cash Price |
$795.73
|
| Rate for Payer: Centivo All Commercial |
$1,062.54
|
| Rate for Payer: Centivo All Commercial |
$1,062.54
|
| Rate for Payer: Cigna All Commercial |
$685.51
|
| Rate for Payer: Cigna All Commercial |
$685.51
|
| Rate for Payer: CORVEL All Commercial |
$685.51
|
| Rate for Payer: CORVEL All Commercial |
$685.51
|
| Rate for Payer: Coventry All Commercial |
$822.61
|
| Rate for Payer: Coventry All Commercial |
$822.61
|
| Rate for Payer: Encore All Commercial |
$685.51
|
| Rate for Payer: Encore All Commercial |
$685.51
|
| Rate for Payer: Frontpath All Commercial |
$969.59
|
| Rate for Payer: Frontpath All Commercial |
$969.59
|
| Rate for Payer: Humana ChoiceCare |
$776.98
|
| Rate for Payer: Humana ChoiceCare |
$776.98
|
| Rate for Payer: Humana Medicare |
$685.51
|
| Rate for Payer: Humana Medicare |
$685.51
|
| Rate for Payer: Lucent All Commercial |
$959.71
|
| Rate for Payer: Lucent All Commercial |
$959.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,088.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,088.00
|
| Rate for Payer: Managed Health Services Medicaid |
$663.87
|
| Rate for Payer: Managed Health Services Medicaid |
$663.87
|
| Rate for Payer: MDWise Medicaid |
$663.87
|
| Rate for Payer: MDWise Medicaid |
$663.87
|
| Rate for Payer: PHCS All Commercial |
$685.51
|
| Rate for Payer: PHCS All Commercial |
$685.51
|
| Rate for Payer: PHP All Commercial |
$1,153.82
|
| Rate for Payer: PHP All Commercial |
$1,153.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$685.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$685.51
|
| Rate for Payer: Sagamore Health Network All Products |
$685.51
|
| Rate for Payer: Sagamore Health Network All Products |
$685.51
|
| Rate for Payer: Signature Care EPO |
$745.45
|
| Rate for Payer: Signature Care EPO |
$745.45
|
| Rate for Payer: Signature Care PPO |
$745.45
|
| Rate for Payer: Signature Care PPO |
$745.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$102,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$102,000.00
|
| Rate for Payer: United Healthcare Commercial |
$851.03
|
| Rate for Payer: United Healthcare Commercial |
$851.03
|
| Rate for Payer: United Healthcare Medicare |
$663.11
|
| Rate for Payer: United Healthcare Medicare |
$663.11
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2+CM
|
Professional
|
Both
|
$966.36
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
z21014
|
| Min. Negotiated Rate |
$474.51 |
| Max. Negotiated Rate |
$73,000.00 |
| Rate for Payer: Aetna Commercial |
$486.16
|
| Rate for Payer: Aetna Commercial |
$486.16
|
| Rate for Payer: Aetna Medicare |
$486.16
|
| Rate for Payer: Aetna Medicare |
$486.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$607.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$607.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$607.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$607.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$607.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$607.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$607.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$607.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$475.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$475.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$559.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$559.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$534.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$534.78
|
| Rate for Payer: Cash Price |
$579.82
|
| Rate for Payer: Cash Price |
$569.41
|
| Rate for Payer: Centivo All Commercial |
$753.55
|
| Rate for Payer: Centivo All Commercial |
$753.55
|
| Rate for Payer: Cigna All Commercial |
$486.16
|
| Rate for Payer: Cigna All Commercial |
$486.16
|
| Rate for Payer: CORVEL All Commercial |
$486.16
|
| Rate for Payer: CORVEL All Commercial |
$486.16
|
| Rate for Payer: Coventry All Commercial |
$583.39
|
| Rate for Payer: Coventry All Commercial |
$583.39
|
| Rate for Payer: Encore All Commercial |
$486.16
|
| Rate for Payer: Encore All Commercial |
$486.16
|
| Rate for Payer: Frontpath All Commercial |
$673.74
|
| Rate for Payer: Frontpath All Commercial |
$673.74
|
| Rate for Payer: Humana ChoiceCare |
$544.80
|
| Rate for Payer: Humana ChoiceCare |
$544.80
|
| Rate for Payer: Humana Medicare |
$486.16
|
| Rate for Payer: Humana Medicare |
$486.16
|
| Rate for Payer: Lucent All Commercial |
$680.62
|
| Rate for Payer: Lucent All Commercial |
$680.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$778.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$778.00
|
| Rate for Payer: Managed Health Services Medicaid |
$475.29
|
| Rate for Payer: Managed Health Services Medicaid |
$475.29
|
| Rate for Payer: MDWise Medicaid |
$475.29
|
| Rate for Payer: MDWise Medicaid |
$475.29
|
| Rate for Payer: PHCS All Commercial |
$486.16
|
| Rate for Payer: PHCS All Commercial |
$486.16
|
| Rate for Payer: PHP All Commercial |
$825.64
|
| Rate for Payer: PHP All Commercial |
$825.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$486.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$486.16
|
| Rate for Payer: Sagamore Health Network All Products |
$486.16
|
| Rate for Payer: Sagamore Health Network All Products |
$486.16
|
| Rate for Payer: Signature Care EPO |
$522.75
|
| Rate for Payer: Signature Care EPO |
$522.75
|
| Rate for Payer: Signature Care PPO |
$522.75
|
| Rate for Payer: Signature Care PPO |
$522.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$73,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$73,000.00
|
| Rate for Payer: United Healthcare Commercial |
$596.85
|
| Rate for Payer: United Healthcare Commercial |
$596.85
|
| Rate for Payer: United Healthcare Medicare |
$474.51
|
| Rate for Payer: United Healthcare Medicare |
$474.51
|
|
|
PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM
|
Professional
|
Both
|
$786.18
|
|
|
Service Code
|
CPT 25071
|
| Hospital Charge Code |
z25071
|
| Min. Negotiated Rate |
$383.84 |
| Max. Negotiated Rate |
$59,000.00 |
| Rate for Payer: Aetna Commercial |
$395.01
|
| Rate for Payer: Aetna Commercial |
$395.01
|
| Rate for Payer: Aetna Medicare |
$395.01
|
| Rate for Payer: Aetna Medicare |
$395.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$496.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$496.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$496.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$496.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$496.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$496.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$496.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$496.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$386.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$386.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$454.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$454.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$434.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$434.51
|
| Rate for Payer: Cash Price |
$471.71
|
| Rate for Payer: Cash Price |
$460.61
|
| Rate for Payer: Centivo All Commercial |
$612.27
|
| Rate for Payer: Centivo All Commercial |
$612.27
|
| Rate for Payer: Cigna All Commercial |
$395.01
|
| Rate for Payer: Cigna All Commercial |
$395.01
|
| Rate for Payer: CORVEL All Commercial |
$395.01
|
| Rate for Payer: CORVEL All Commercial |
$395.01
|
| Rate for Payer: Coventry All Commercial |
$474.01
|
| Rate for Payer: Coventry All Commercial |
$474.01
|
| Rate for Payer: Encore All Commercial |
$395.01
|
| Rate for Payer: Encore All Commercial |
$395.01
|
| Rate for Payer: Frontpath All Commercial |
$552.66
|
| Rate for Payer: Frontpath All Commercial |
$552.66
|
| Rate for Payer: Humana ChoiceCare |
$443.53
|
| Rate for Payer: Humana ChoiceCare |
$443.53
|
| Rate for Payer: Humana Medicare |
$395.01
|
| Rate for Payer: Humana Medicare |
$395.01
|
| Rate for Payer: Lucent All Commercial |
$553.01
|
| Rate for Payer: Lucent All Commercial |
$553.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.00
|
| Rate for Payer: Managed Health Services Medicaid |
$386.68
|
| Rate for Payer: Managed Health Services Medicaid |
$386.68
|
| Rate for Payer: MDWise Medicaid |
$386.68
|
| Rate for Payer: MDWise Medicaid |
$386.68
|
| Rate for Payer: PHCS All Commercial |
$395.01
|
| Rate for Payer: PHCS All Commercial |
$395.01
|
| Rate for Payer: PHP All Commercial |
$667.88
|
| Rate for Payer: PHP All Commercial |
$667.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$395.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$395.01
|
| Rate for Payer: Sagamore Health Network All Products |
$395.01
|
| Rate for Payer: Sagamore Health Network All Products |
$395.01
|
| Rate for Payer: Signature Care EPO |
$425.85
|
| Rate for Payer: Signature Care EPO |
$425.85
|
| Rate for Payer: Signature Care PPO |
$425.85
|
| Rate for Payer: Signature Care PPO |
$425.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$59,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$59,000.00
|
| Rate for Payer: United Healthcare Commercial |
$485.84
|
| Rate for Payer: United Healthcare Commercial |
$485.84
|
| Rate for Payer: United Healthcare Medicare |
$383.84
|
| Rate for Payer: United Healthcare Medicare |
$383.84
|
|
