|
HC W PLATE POST FIB SM L
|
Facility
IP
|
$5,450.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604994
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,087.80 |
| Max. Negotiated Rate |
$5,068.87 |
| Rate for Payer: Aetna Commercial |
$4,709.15
|
| Rate for Payer: Cash Price |
$3,379.25
|
| Rate for Payer: Cigna All Commercial |
$4,703.70
|
| Rate for Payer: CORVEL All Commercial |
$5,068.87
|
| Rate for Payer: Coventry All Commercial |
$4,796.35
|
| Rate for Payer: Encore All Commercial |
$5,017.09
|
| Rate for Payer: Frontpath All Commercial |
$5,014.37
|
| Rate for Payer: Humana ChoiceCare |
$4,707.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,905.36
|
| Rate for Payer: PHCS All Commercial |
$4,087.80
|
| Rate for Payer: PHP All Commercial |
$4,133.58
|
| Rate for Payer: Sagamore Health Network All Products |
$4,207.71
|
| Rate for Payer: Signature Care EPO |
$4,523.83
|
| Rate for Payer: Signature Care PPO |
$4,796.35
|
| Rate for Payer: United Healthcare Commercial |
$4,294.92
|
|
|
HC W PLATE POST FIB SM L
|
Facility
OP
|
$5,450.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604994
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,068.87 |
| Rate for Payer: Aetna Commercial |
$4,600.14
|
| Rate for Payer: Aetna Medicare |
$1,798.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,798.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,130.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,407.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,068.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,978.50
|
| Rate for Payer: Cash Price |
$3,379.25
|
| Rate for Payer: Cash Price |
$3,379.25
|
| Rate for Payer: Centivo All Commercial |
$2,779.70
|
| Rate for Payer: Cigna All Commercial |
$4,703.70
|
| Rate for Payer: CORVEL All Commercial |
$5,068.87
|
| Rate for Payer: Coventry All Commercial |
$4,796.35
|
| Rate for Payer: Encore All Commercial |
$5,017.09
|
| Rate for Payer: Frontpath All Commercial |
$5,014.37
|
| Rate for Payer: Humana ChoiceCare |
$4,707.51
|
| Rate for Payer: Humana Medicare |
$2,779.70
|
| Rate for Payer: Lucent All Commercial |
$2,779.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,905.36
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,087.80
|
| Rate for Payer: PHP All Commercial |
$4,133.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,125.66
|
| Rate for Payer: Sagamore Health Network All Products |
$4,207.71
|
| Rate for Payer: Signature Care EPO |
$4,523.83
|
| Rate for Payer: Signature Care PPO |
$4,796.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,632.84
|
| Rate for Payer: United Healthcare Commercial |
$4,294.92
|
| Rate for Payer: United Healthcare Medicare |
$1,798.63
|
|
|
HC W PLATE POST FIB SM R
|
Facility
IP
|
$5,450.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604995
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,087.80 |
| Max. Negotiated Rate |
$5,068.87 |
| Rate for Payer: Aetna Commercial |
$4,709.15
|
| Rate for Payer: Cash Price |
$3,379.25
|
| Rate for Payer: Cigna All Commercial |
$4,703.70
|
| Rate for Payer: CORVEL All Commercial |
$5,068.87
|
| Rate for Payer: Coventry All Commercial |
$4,796.35
|
| Rate for Payer: Encore All Commercial |
$5,017.09
|
| Rate for Payer: Frontpath All Commercial |
$5,014.37
|
| Rate for Payer: Humana ChoiceCare |
$4,707.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,905.36
|
| Rate for Payer: PHCS All Commercial |
$4,087.80
|
| Rate for Payer: PHP All Commercial |
$4,133.58
|
| Rate for Payer: Sagamore Health Network All Products |
$4,207.71
|
| Rate for Payer: Signature Care EPO |
$4,523.83
|
| Rate for Payer: Signature Care PPO |
$4,796.35
|
| Rate for Payer: United Healthcare Commercial |
$4,294.92
|
|
|
HC W PLATE POST FIB SM R
|
Facility
OP
|
$5,450.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604995
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,068.87 |
| Rate for Payer: Aetna Commercial |
$4,600.14
|
| Rate for Payer: Aetna Medicare |
$1,798.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,798.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,130.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,407.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,068.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,978.50
|
| Rate for Payer: Cash Price |
$3,379.25
|
| Rate for Payer: Cash Price |
$3,379.25
|
| Rate for Payer: Centivo All Commercial |
$2,779.70
|
| Rate for Payer: Cigna All Commercial |
$4,703.70
|
| Rate for Payer: CORVEL All Commercial |
$5,068.87
|
| Rate for Payer: Coventry All Commercial |
$4,796.35
|
| Rate for Payer: Encore All Commercial |
$5,017.09
|
| Rate for Payer: Frontpath All Commercial |
$5,014.37
|
| Rate for Payer: Humana ChoiceCare |
$4,707.51
|
| Rate for Payer: Humana Medicare |
$2,779.70
|
| Rate for Payer: Lucent All Commercial |
$2,779.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,905.36
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,087.80
|
| Rate for Payer: PHP All Commercial |
$4,133.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,125.66
|
| Rate for Payer: Sagamore Health Network All Products |
$4,207.71
|
| Rate for Payer: Signature Care EPO |
$4,523.83
|
| Rate for Payer: Signature Care PPO |
$4,796.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,632.84
|
| Rate for Payer: United Healthcare Commercial |
$4,294.92
|
| Rate for Payer: United Healthcare Medicare |
$1,798.63
|
|
|
HC W PLATE POST TIB
|
Facility
OP
|
$2,100.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604998
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,953.00 |
| Rate for Payer: Aetna Commercial |
$1,772.40
|
| Rate for Payer: Aetna Medicare |
$693.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$693.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,206.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,312.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$796.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$762.30
|
| Rate for Payer: Cash Price |
$1,302.00
|
| Rate for Payer: Cash Price |
$1,302.00
|
| Rate for Payer: Centivo All Commercial |
$1,071.00
|
| Rate for Payer: Cigna All Commercial |
$1,812.30
|
| Rate for Payer: CORVEL All Commercial |
$1,953.00
|
| Rate for Payer: Coventry All Commercial |
$1,848.00
|
| Rate for Payer: Encore All Commercial |
$1,933.05
|
| Rate for Payer: Frontpath All Commercial |
$1,932.00
|
| Rate for Payer: Humana ChoiceCare |
$1,813.77
|
| Rate for Payer: Humana Medicare |
$1,071.00
|
| Rate for Payer: Lucent All Commercial |
$1,071.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,890.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,575.00
|
| Rate for Payer: PHP All Commercial |
$1,592.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$819.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,621.20
|
| Rate for Payer: Signature Care EPO |
$1,743.00
|
| Rate for Payer: Signature Care PPO |
$1,848.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,785.00
|
| Rate for Payer: United Healthcare Commercial |
$1,654.80
|
| Rate for Payer: United Healthcare Medicare |
$693.00
|
|
|
HC W PLATE POST TIB
|
Facility
IP
|
$2,100.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604998
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,575.00 |
| Max. Negotiated Rate |
$1,953.00 |
| Rate for Payer: Aetna Commercial |
$1,814.40
|
| Rate for Payer: Cash Price |
$1,302.00
|
| Rate for Payer: Cigna All Commercial |
$1,812.30
|
| Rate for Payer: CORVEL All Commercial |
$1,953.00
|
| Rate for Payer: Coventry All Commercial |
$1,848.00
|
| Rate for Payer: Encore All Commercial |
$1,933.05
|
| Rate for Payer: Frontpath All Commercial |
$1,932.00
|
| Rate for Payer: Humana ChoiceCare |
$1,813.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,890.00
|
| Rate for Payer: PHCS All Commercial |
$1,575.00
|
| Rate for Payer: PHP All Commercial |
$1,592.64
|
| Rate for Payer: Sagamore Health Network All Products |
$1,621.20
|
| Rate for Payer: Signature Care EPO |
$1,743.00
|
| Rate for Payer: Signature Care PPO |
$1,848.00
|
| Rate for Payer: United Healthcare Commercial |
$1,654.80
|
|
|
HC W PLATE POST TIB LRG
|
Facility
OP
|
$4,532.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,215.13 |
| Rate for Payer: Aetna Commercial |
$3,825.35
|
| Rate for Payer: Aetna Medicare |
$1,495.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,495.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,602.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,833.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,720.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,645.26
|
| Rate for Payer: Cash Price |
$2,810.09
|
| Rate for Payer: Cash Price |
$2,810.09
|
| Rate for Payer: Centivo All Commercial |
$2,311.52
|
| Rate for Payer: Cigna All Commercial |
$3,911.46
|
| Rate for Payer: CORVEL All Commercial |
$4,215.13
|
| Rate for Payer: Coventry All Commercial |
$3,988.51
|
| Rate for Payer: Encore All Commercial |
$4,172.07
|
| Rate for Payer: Frontpath All Commercial |
$4,169.81
|
| Rate for Payer: Humana ChoiceCare |
$3,914.63
|
| Rate for Payer: Humana Medicare |
$2,311.52
|
| Rate for Payer: Lucent All Commercial |
$2,311.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,079.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,399.30
|
| Rate for Payer: PHP All Commercial |
$3,437.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,767.64
|
| Rate for Payer: Sagamore Health Network All Products |
$3,499.01
|
| Rate for Payer: Signature Care EPO |
$3,761.89
|
| Rate for Payer: Signature Care PPO |
$3,988.51
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,852.54
|
| Rate for Payer: United Healthcare Commercial |
$3,571.53
|
| Rate for Payer: United Healthcare Medicare |
$1,495.69
|
|
|
HC W PLATE POST TIB LRG
|
Facility
IP
|
$4,532.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,399.30 |
| Max. Negotiated Rate |
$4,215.13 |
| Rate for Payer: Aetna Commercial |
$3,915.99
|
| Rate for Payer: Cash Price |
$2,810.09
|
| Rate for Payer: Cigna All Commercial |
$3,911.46
|
| Rate for Payer: CORVEL All Commercial |
$4,215.13
|
| Rate for Payer: Coventry All Commercial |
$3,988.51
|
| Rate for Payer: Encore All Commercial |
$4,172.07
|
| Rate for Payer: Frontpath All Commercial |
$4,169.81
|
| Rate for Payer: Humana ChoiceCare |
$3,914.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,079.16
|
| Rate for Payer: PHCS All Commercial |
$3,399.30
|
| Rate for Payer: PHP All Commercial |
$3,437.37
|
| Rate for Payer: Sagamore Health Network All Products |
$3,499.01
|
| Rate for Payer: Signature Care EPO |
$3,761.89
|
| Rate for Payer: Signature Care PPO |
$3,988.51
|
| Rate for Payer: United Healthcare Commercial |
$3,571.53
|
|
|
HC W PLATE POST TIB SM
|
Facility
IP
|
$4,053.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,040.20 |
| Max. Negotiated Rate |
$3,769.85 |
| Rate for Payer: Aetna Commercial |
$3,502.31
|
| Rate for Payer: Cash Price |
$2,513.23
|
| Rate for Payer: Cigna All Commercial |
$3,498.26
|
| Rate for Payer: CORVEL All Commercial |
$3,769.85
|
| Rate for Payer: Coventry All Commercial |
$3,567.17
|
| Rate for Payer: Encore All Commercial |
$3,731.34
|
| Rate for Payer: Frontpath All Commercial |
$3,729.31
|
| Rate for Payer: Humana ChoiceCare |
$3,501.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,648.24
|
| Rate for Payer: PHCS All Commercial |
$3,040.20
|
| Rate for Payer: PHP All Commercial |
$3,074.25
|
| Rate for Payer: Sagamore Health Network All Products |
$3,129.38
|
| Rate for Payer: Signature Care EPO |
$3,364.49
|
| Rate for Payer: Signature Care PPO |
$3,567.17
|
| Rate for Payer: United Healthcare Commercial |
$3,194.24
|
|
|
HC W PLATE POST TIB SM
|
Facility
OP
|
$4,053.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,769.85 |
| Rate for Payer: Aetna Commercial |
$3,421.24
|
| Rate for Payer: Aetna Medicare |
$1,337.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,337.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,327.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,533.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,538.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,471.46
|
| Rate for Payer: Cash Price |
$2,513.23
|
| Rate for Payer: Cash Price |
$2,513.23
|
| Rate for Payer: Centivo All Commercial |
$2,067.34
|
| Rate for Payer: Cigna All Commercial |
$3,498.26
|
| Rate for Payer: CORVEL All Commercial |
$3,769.85
|
| Rate for Payer: Coventry All Commercial |
$3,567.17
|
| Rate for Payer: Encore All Commercial |
$3,731.34
|
| Rate for Payer: Frontpath All Commercial |
$3,729.31
|
| Rate for Payer: Humana ChoiceCare |
$3,501.09
|
| Rate for Payer: Humana Medicare |
$2,067.34
|
| Rate for Payer: Lucent All Commercial |
$2,067.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,648.24
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,040.20
|
| Rate for Payer: PHP All Commercial |
$3,074.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,580.90
|
| Rate for Payer: Sagamore Health Network All Products |
$3,129.38
|
| Rate for Payer: Signature Care EPO |
$3,364.49
|
| Rate for Payer: Signature Care PPO |
$3,567.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,445.56
|
| Rate for Payer: United Healthcare Commercial |
$3,194.24
|
| Rate for Payer: United Healthcare Medicare |
$1,337.69
|
|
|
HC W PLATE POST TTC FUSION LRG
|
Facility
IP
|
$8,787.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,590.70 |
| Max. Negotiated Rate |
$8,172.47 |
| Rate for Payer: Aetna Commercial |
$7,592.49
|
| Rate for Payer: Cash Price |
$5,448.31
|
| Rate for Payer: Cigna All Commercial |
$7,583.70
|
| Rate for Payer: CORVEL All Commercial |
$8,172.47
|
| Rate for Payer: Coventry All Commercial |
$7,733.09
|
| Rate for Payer: Encore All Commercial |
$8,088.99
|
| Rate for Payer: Frontpath All Commercial |
$8,084.59
|
| Rate for Payer: Humana ChoiceCare |
$7,589.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,908.84
|
| Rate for Payer: PHCS All Commercial |
$6,590.70
|
| Rate for Payer: PHP All Commercial |
$6,664.52
|
| Rate for Payer: Sagamore Health Network All Products |
$6,784.03
|
| Rate for Payer: Signature Care EPO |
$7,293.71
|
| Rate for Payer: Signature Care PPO |
$7,733.09
|
| Rate for Payer: United Healthcare Commercial |
$6,924.63
|
|
|
HC W PLATE POST TTC FUSION LRG
|
Facility
OP
|
$8,787.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,172.47 |
| Rate for Payer: Aetna Commercial |
$7,416.73
|
| Rate for Payer: Aetna Medicare |
$2,899.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,899.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,046.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,493.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,334.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,189.90
|
| Rate for Payer: Cash Price |
$5,448.31
|
| Rate for Payer: Cash Price |
$5,448.31
|
| Rate for Payer: Centivo All Commercial |
$4,481.68
|
| Rate for Payer: Cigna All Commercial |
$7,583.70
|
| Rate for Payer: CORVEL All Commercial |
$8,172.47
|
| Rate for Payer: Coventry All Commercial |
$7,733.09
|
| Rate for Payer: Encore All Commercial |
$8,088.99
|
| Rate for Payer: Frontpath All Commercial |
$8,084.59
|
| Rate for Payer: Humana ChoiceCare |
$7,589.85
|
| Rate for Payer: Humana Medicare |
$4,481.68
|
| Rate for Payer: Lucent All Commercial |
$4,481.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,908.84
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,590.70
|
| Rate for Payer: PHP All Commercial |
$6,664.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,427.16
|
| Rate for Payer: Sagamore Health Network All Products |
$6,784.03
|
| Rate for Payer: Signature Care EPO |
$7,293.71
|
| Rate for Payer: Signature Care PPO |
$7,733.09
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,469.46
|
| Rate for Payer: United Healthcare Commercial |
$6,924.63
|
| Rate for Payer: United Healthcare Medicare |
$2,899.91
|
|
|
HC W PLATE POST TTC FUSION SM
|
Facility
OP
|
$8,787.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,172.47 |
| Rate for Payer: Aetna Commercial |
$7,416.73
|
| Rate for Payer: Aetna Medicare |
$2,899.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,899.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,046.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,493.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,334.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,189.90
|
| Rate for Payer: Cash Price |
$5,448.31
|
| Rate for Payer: Cash Price |
$5,448.31
|
| Rate for Payer: Centivo All Commercial |
$4,481.68
|
| Rate for Payer: Cigna All Commercial |
$7,583.70
|
| Rate for Payer: CORVEL All Commercial |
$8,172.47
|
| Rate for Payer: Coventry All Commercial |
$7,733.09
|
| Rate for Payer: Encore All Commercial |
$8,088.99
|
| Rate for Payer: Frontpath All Commercial |
$8,084.59
|
| Rate for Payer: Humana ChoiceCare |
$7,589.85
|
| Rate for Payer: Humana Medicare |
$4,481.68
|
| Rate for Payer: Lucent All Commercial |
$4,481.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,908.84
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,590.70
|
| Rate for Payer: PHP All Commercial |
$6,664.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,427.16
|
| Rate for Payer: Sagamore Health Network All Products |
$6,784.03
|
| Rate for Payer: Signature Care EPO |
$7,293.71
|
| Rate for Payer: Signature Care PPO |
$7,733.09
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,469.46
|
| Rate for Payer: United Healthcare Commercial |
$6,924.63
|
| Rate for Payer: United Healthcare Medicare |
$2,899.91
|
|
|
HC W PLATE POST TTC FUSION SM
|
Facility
IP
|
$8,787.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,590.70 |
| Max. Negotiated Rate |
$8,172.47 |
| Rate for Payer: Aetna Commercial |
$7,592.49
|
| Rate for Payer: Cash Price |
$5,448.31
|
| Rate for Payer: Cigna All Commercial |
$7,583.70
|
| Rate for Payer: CORVEL All Commercial |
$8,172.47
|
| Rate for Payer: Coventry All Commercial |
$7,733.09
|
| Rate for Payer: Encore All Commercial |
$8,088.99
|
| Rate for Payer: Frontpath All Commercial |
$8,084.59
|
| Rate for Payer: Humana ChoiceCare |
$7,589.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,908.84
|
| Rate for Payer: PHCS All Commercial |
$6,590.70
|
| Rate for Payer: PHP All Commercial |
$6,664.52
|
| Rate for Payer: Sagamore Health Network All Products |
$6,784.03
|
| Rate for Payer: Signature Care EPO |
$7,293.71
|
| Rate for Payer: Signature Care PPO |
$7,733.09
|
| Rate for Payer: United Healthcare Commercial |
$6,924.63
|
|
|
HC W PLATE POST TT FUSION LRG
|
Facility
IP
|
$8,103.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,077.70 |
| Max. Negotiated Rate |
$7,536.35 |
| Rate for Payer: Aetna Commercial |
$7,001.51
|
| Rate for Payer: Cash Price |
$5,024.23
|
| Rate for Payer: Cigna All Commercial |
$6,993.41
|
| Rate for Payer: CORVEL All Commercial |
$7,536.35
|
| Rate for Payer: Coventry All Commercial |
$7,131.17
|
| Rate for Payer: Encore All Commercial |
$7,459.36
|
| Rate for Payer: Frontpath All Commercial |
$7,455.31
|
| Rate for Payer: Humana ChoiceCare |
$6,999.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,293.24
|
| Rate for Payer: PHCS All Commercial |
$6,077.70
|
| Rate for Payer: PHP All Commercial |
$6,145.77
|
| Rate for Payer: Sagamore Health Network All Products |
$6,255.98
|
| Rate for Payer: Signature Care EPO |
$6,725.99
|
| Rate for Payer: Signature Care PPO |
$7,131.17
|
| Rate for Payer: United Healthcare Commercial |
$6,385.64
|
|
|
HC W PLATE POST TT FUSION LRG
|
Facility
OP
|
$8,103.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,536.35 |
| Rate for Payer: Aetna Commercial |
$6,839.44
|
| Rate for Payer: Aetna Medicare |
$2,674.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,674.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,653.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,065.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,075.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,941.61
|
| Rate for Payer: Cash Price |
$5,024.23
|
| Rate for Payer: Cash Price |
$5,024.23
|
| Rate for Payer: Centivo All Commercial |
$4,132.84
|
| Rate for Payer: Cigna All Commercial |
$6,993.41
|
| Rate for Payer: CORVEL All Commercial |
$7,536.35
|
| Rate for Payer: Coventry All Commercial |
$7,131.17
|
| Rate for Payer: Encore All Commercial |
$7,459.36
|
| Rate for Payer: Frontpath All Commercial |
$7,455.31
|
| Rate for Payer: Humana ChoiceCare |
$6,999.08
|
| Rate for Payer: Humana Medicare |
$4,132.84
|
| Rate for Payer: Lucent All Commercial |
$4,132.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,293.24
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,077.70
|
| Rate for Payer: PHP All Commercial |
$6,145.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,160.40
|
| Rate for Payer: Sagamore Health Network All Products |
$6,255.98
|
| Rate for Payer: Signature Care EPO |
$6,725.99
|
| Rate for Payer: Signature Care PPO |
$7,131.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,888.06
|
| Rate for Payer: United Healthcare Commercial |
$6,385.64
|
| Rate for Payer: United Healthcare Medicare |
$2,674.19
|
|
|
HC W PLATE POST TT FUSION SM
|
Facility
IP
|
$8,103.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,077.70 |
| Max. Negotiated Rate |
$7,536.35 |
| Rate for Payer: Aetna Commercial |
$7,001.51
|
| Rate for Payer: Cash Price |
$5,024.23
|
| Rate for Payer: Cigna All Commercial |
$6,993.41
|
| Rate for Payer: CORVEL All Commercial |
$7,536.35
|
| Rate for Payer: Coventry All Commercial |
$7,131.17
|
| Rate for Payer: Encore All Commercial |
$7,459.36
|
| Rate for Payer: Frontpath All Commercial |
$7,455.31
|
| Rate for Payer: Humana ChoiceCare |
$6,999.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,293.24
|
| Rate for Payer: PHCS All Commercial |
$6,077.70
|
| Rate for Payer: PHP All Commercial |
$6,145.77
|
| Rate for Payer: Sagamore Health Network All Products |
$6,255.98
|
| Rate for Payer: Signature Care EPO |
$6,725.99
|
| Rate for Payer: Signature Care PPO |
$7,131.17
|
| Rate for Payer: United Healthcare Commercial |
$6,385.64
|
|
|
HC W PLATE POST TT FUSION SM
|
Facility
OP
|
$8,103.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,536.35 |
| Rate for Payer: Aetna Commercial |
$6,839.44
|
| Rate for Payer: Aetna Medicare |
$2,674.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,674.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,653.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,065.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,075.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,941.61
|
| Rate for Payer: Cash Price |
$5,024.23
|
| Rate for Payer: Cash Price |
$5,024.23
|
| Rate for Payer: Centivo All Commercial |
$4,132.84
|
| Rate for Payer: Cigna All Commercial |
$6,993.41
|
| Rate for Payer: CORVEL All Commercial |
$7,536.35
|
| Rate for Payer: Coventry All Commercial |
$7,131.17
|
| Rate for Payer: Encore All Commercial |
$7,459.36
|
| Rate for Payer: Frontpath All Commercial |
$7,455.31
|
| Rate for Payer: Humana ChoiceCare |
$6,999.08
|
| Rate for Payer: Humana Medicare |
$4,132.84
|
| Rate for Payer: Lucent All Commercial |
$4,132.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,293.24
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,077.70
|
| Rate for Payer: PHP All Commercial |
$6,145.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,160.40
|
| Rate for Payer: Sagamore Health Network All Products |
$6,255.98
|
| Rate for Payer: Signature Care EPO |
$6,725.99
|
| Rate for Payer: Signature Care PPO |
$7,131.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,888.06
|
| Rate for Payer: United Healthcare Commercial |
$6,385.64
|
| Rate for Payer: United Healthcare Medicare |
$2,674.19
|
|
|
HC W PLATE REVISION LRG L
|
Facility
IP
|
$6,472.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604974
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,854.60 |
| Max. Negotiated Rate |
$6,019.70 |
| Rate for Payer: Aetna Commercial |
$5,592.50
|
| Rate for Payer: Cash Price |
$4,013.14
|
| Rate for Payer: Cigna All Commercial |
$5,586.03
|
| Rate for Payer: CORVEL All Commercial |
$6,019.70
|
| Rate for Payer: Coventry All Commercial |
$5,696.06
|
| Rate for Payer: Encore All Commercial |
$5,958.21
|
| Rate for Payer: Frontpath All Commercial |
$5,954.98
|
| Rate for Payer: Humana ChoiceCare |
$5,590.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,825.52
|
| Rate for Payer: PHCS All Commercial |
$4,854.60
|
| Rate for Payer: PHP All Commercial |
$4,908.97
|
| Rate for Payer: Sagamore Health Network All Products |
$4,997.00
|
| Rate for Payer: Signature Care EPO |
$5,372.42
|
| Rate for Payer: Signature Care PPO |
$5,696.06
|
| Rate for Payer: United Healthcare Commercial |
$5,100.57
|
|
|
HC W PLATE REVISION LRG L
|
Facility
OP
|
$6,472.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604974
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,019.70 |
| Rate for Payer: Aetna Commercial |
$5,463.04
|
| Rate for Payer: Aetna Medicare |
$2,136.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,136.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,717.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,046.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,456.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,349.63
|
| Rate for Payer: Cash Price |
$4,013.14
|
| Rate for Payer: Cash Price |
$4,013.14
|
| Rate for Payer: Centivo All Commercial |
$3,301.13
|
| Rate for Payer: Cigna All Commercial |
$5,586.03
|
| Rate for Payer: CORVEL All Commercial |
$6,019.70
|
| Rate for Payer: Coventry All Commercial |
$5,696.06
|
| Rate for Payer: Encore All Commercial |
$5,958.21
|
| Rate for Payer: Frontpath All Commercial |
$5,954.98
|
| Rate for Payer: Humana ChoiceCare |
$5,590.56
|
| Rate for Payer: Humana Medicare |
$3,301.13
|
| Rate for Payer: Lucent All Commercial |
$3,301.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,825.52
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,854.60
|
| Rate for Payer: PHP All Commercial |
$4,908.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,524.39
|
| Rate for Payer: Sagamore Health Network All Products |
$4,997.00
|
| Rate for Payer: Signature Care EPO |
$5,372.42
|
| Rate for Payer: Signature Care PPO |
$5,696.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,501.88
|
| Rate for Payer: United Healthcare Commercial |
$5,100.57
|
| Rate for Payer: United Healthcare Medicare |
$2,136.02
|
|
|
HC W PLATE REVISION LRG R
|
Facility
OP
|
$6,472.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604975
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,019.70 |
| Rate for Payer: Aetna Commercial |
$5,463.04
|
| Rate for Payer: Aetna Medicare |
$2,136.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,136.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,717.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,046.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,456.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,349.63
|
| Rate for Payer: Cash Price |
$4,013.14
|
| Rate for Payer: Cash Price |
$4,013.14
|
| Rate for Payer: Centivo All Commercial |
$3,301.13
|
| Rate for Payer: Cigna All Commercial |
$5,586.03
|
| Rate for Payer: CORVEL All Commercial |
$6,019.70
|
| Rate for Payer: Coventry All Commercial |
$5,696.06
|
| Rate for Payer: Encore All Commercial |
$5,958.21
|
| Rate for Payer: Frontpath All Commercial |
$5,954.98
|
| Rate for Payer: Humana ChoiceCare |
$5,590.56
|
| Rate for Payer: Humana Medicare |
$3,301.13
|
| Rate for Payer: Lucent All Commercial |
$3,301.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,825.52
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,854.60
|
| Rate for Payer: PHP All Commercial |
$4,908.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,524.39
|
| Rate for Payer: Sagamore Health Network All Products |
$4,997.00
|
| Rate for Payer: Signature Care EPO |
$5,372.42
|
| Rate for Payer: Signature Care PPO |
$5,696.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,501.88
|
| Rate for Payer: United Healthcare Commercial |
$5,100.57
|
| Rate for Payer: United Healthcare Medicare |
$2,136.02
|
|
|
HC W PLATE REVISION LRG R
|
Facility
IP
|
$6,472.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604975
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,854.60 |
| Max. Negotiated Rate |
$6,019.70 |
| Rate for Payer: Aetna Commercial |
$5,592.50
|
| Rate for Payer: Cash Price |
$4,013.14
|
| Rate for Payer: Cigna All Commercial |
$5,586.03
|
| Rate for Payer: CORVEL All Commercial |
$6,019.70
|
| Rate for Payer: Coventry All Commercial |
$5,696.06
|
| Rate for Payer: Encore All Commercial |
$5,958.21
|
| Rate for Payer: Frontpath All Commercial |
$5,954.98
|
| Rate for Payer: Humana ChoiceCare |
$5,590.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,825.52
|
| Rate for Payer: PHCS All Commercial |
$4,854.60
|
| Rate for Payer: PHP All Commercial |
$4,908.97
|
| Rate for Payer: Sagamore Health Network All Products |
$4,997.00
|
| Rate for Payer: Signature Care EPO |
$5,372.42
|
| Rate for Payer: Signature Care PPO |
$5,696.06
|
| Rate for Payer: United Healthcare Commercial |
$5,100.57
|
|
|
HC W PLATE REVISION MTP L
|
Facility
IP
|
$6,472.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604972
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,854.60 |
| Max. Negotiated Rate |
$6,019.70 |
| Rate for Payer: Aetna Commercial |
$5,592.50
|
| Rate for Payer: Cash Price |
$4,013.14
|
| Rate for Payer: Cigna All Commercial |
$5,586.03
|
| Rate for Payer: CORVEL All Commercial |
$6,019.70
|
| Rate for Payer: Coventry All Commercial |
$5,696.06
|
| Rate for Payer: Encore All Commercial |
$5,958.21
|
| Rate for Payer: Frontpath All Commercial |
$5,954.98
|
| Rate for Payer: Humana ChoiceCare |
$5,590.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,825.52
|
| Rate for Payer: PHCS All Commercial |
$4,854.60
|
| Rate for Payer: PHP All Commercial |
$4,908.97
|
| Rate for Payer: Sagamore Health Network All Products |
$4,997.00
|
| Rate for Payer: Signature Care EPO |
$5,372.42
|
| Rate for Payer: Signature Care PPO |
$5,696.06
|
| Rate for Payer: United Healthcare Commercial |
$5,100.57
|
|
|
HC W PLATE REVISION MTP L
|
Facility
OP
|
$6,472.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604972
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,019.70 |
| Rate for Payer: Aetna Commercial |
$5,463.04
|
| Rate for Payer: Aetna Medicare |
$2,136.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,136.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,717.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,046.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,456.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,349.63
|
| Rate for Payer: Cash Price |
$4,013.14
|
| Rate for Payer: Cash Price |
$4,013.14
|
| Rate for Payer: Centivo All Commercial |
$3,301.13
|
| Rate for Payer: Cigna All Commercial |
$5,586.03
|
| Rate for Payer: CORVEL All Commercial |
$6,019.70
|
| Rate for Payer: Coventry All Commercial |
$5,696.06
|
| Rate for Payer: Encore All Commercial |
$5,958.21
|
| Rate for Payer: Frontpath All Commercial |
$5,954.98
|
| Rate for Payer: Humana ChoiceCare |
$5,590.56
|
| Rate for Payer: Humana Medicare |
$3,301.13
|
| Rate for Payer: Lucent All Commercial |
$3,301.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,825.52
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,854.60
|
| Rate for Payer: PHP All Commercial |
$4,908.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,524.39
|
| Rate for Payer: Sagamore Health Network All Products |
$4,997.00
|
| Rate for Payer: Signature Care EPO |
$5,372.42
|
| Rate for Payer: Signature Care PPO |
$5,696.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,501.88
|
| Rate for Payer: United Healthcare Commercial |
$5,100.57
|
| Rate for Payer: United Healthcare Medicare |
$2,136.02
|
|
|
HC W PLATE REVISION MTP R
|
Facility
IP
|
$6,472.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604973
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,854.60 |
| Max. Negotiated Rate |
$6,019.70 |
| Rate for Payer: Aetna Commercial |
$5,592.50
|
| Rate for Payer: Cash Price |
$4,013.14
|
| Rate for Payer: Cigna All Commercial |
$5,586.03
|
| Rate for Payer: CORVEL All Commercial |
$6,019.70
|
| Rate for Payer: Coventry All Commercial |
$5,696.06
|
| Rate for Payer: Encore All Commercial |
$5,958.21
|
| Rate for Payer: Frontpath All Commercial |
$5,954.98
|
| Rate for Payer: Humana ChoiceCare |
$5,590.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,825.52
|
| Rate for Payer: PHCS All Commercial |
$4,854.60
|
| Rate for Payer: PHP All Commercial |
$4,908.97
|
| Rate for Payer: Sagamore Health Network All Products |
$4,997.00
|
| Rate for Payer: Signature Care EPO |
$5,372.42
|
| Rate for Payer: Signature Care PPO |
$5,696.06
|
| Rate for Payer: United Healthcare Commercial |
$5,100.57
|
|
