|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM
|
Professional
|
Both
|
$1,219.24
|
|
|
Service Code
|
CPT 22901
|
| Hospital Charge Code |
z22901
|
| Min. Negotiated Rate |
$597.20 |
| Max. Negotiated Rate |
$91,800.00 |
| Rate for Payer: Aetna Commercial |
$620.05
|
| Rate for Payer: Aetna Commercial |
$620.05
|
| Rate for Payer: Aetna Medicare |
$620.05
|
| Rate for Payer: Aetna Medicare |
$620.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$778.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$778.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$778.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$778.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$778.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$778.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$778.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$778.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$599.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$599.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$713.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$713.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$682.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$682.05
|
| Rate for Payer: Cash Price |
$731.54
|
| Rate for Payer: Cash Price |
$716.64
|
| Rate for Payer: Centivo All Commercial |
$961.08
|
| Rate for Payer: Centivo All Commercial |
$961.08
|
| Rate for Payer: Cigna All Commercial |
$620.05
|
| Rate for Payer: Cigna All Commercial |
$620.05
|
| Rate for Payer: CORVEL All Commercial |
$620.05
|
| Rate for Payer: CORVEL All Commercial |
$620.05
|
| Rate for Payer: Coventry All Commercial |
$744.06
|
| Rate for Payer: Coventry All Commercial |
$744.06
|
| Rate for Payer: Encore All Commercial |
$620.05
|
| Rate for Payer: Encore All Commercial |
$620.05
|
| Rate for Payer: Frontpath All Commercial |
$878.05
|
| Rate for Payer: Frontpath All Commercial |
$878.05
|
| Rate for Payer: Humana ChoiceCare |
$694.18
|
| Rate for Payer: Humana ChoiceCare |
$694.18
|
| Rate for Payer: Humana Medicare |
$620.05
|
| Rate for Payer: Humana Medicare |
$620.05
|
| Rate for Payer: Lucent All Commercial |
$868.07
|
| Rate for Payer: Lucent All Commercial |
$868.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$979.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$979.00
|
| Rate for Payer: Managed Health Services Medicaid |
$599.67
|
| Rate for Payer: Managed Health Services Medicaid |
$599.67
|
| Rate for Payer: MDWise Medicaid |
$599.67
|
| Rate for Payer: MDWise Medicaid |
$599.67
|
| Rate for Payer: PHCS All Commercial |
$620.05
|
| Rate for Payer: PHCS All Commercial |
$620.05
|
| Rate for Payer: PHP All Commercial |
$1,039.14
|
| Rate for Payer: PHP All Commercial |
$1,039.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$620.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$620.05
|
| Rate for Payer: Sagamore Health Network All Products |
$620.05
|
| Rate for Payer: Sagamore Health Network All Products |
$620.05
|
| Rate for Payer: Signature Care EPO |
$665.55
|
| Rate for Payer: Signature Care EPO |
$665.55
|
| Rate for Payer: Signature Care PPO |
$665.55
|
| Rate for Payer: Signature Care PPO |
$665.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$91,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$91,800.00
|
| Rate for Payer: United Healthcare Commercial |
$760.60
|
| Rate for Payer: United Healthcare Commercial |
$760.60
|
| Rate for Payer: United Healthcare Medicare |
$597.20
|
| Rate for Payer: United Healthcare Medicare |
$597.20
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$958.22
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
z25075
|
| Min. Negotiated Rate |
$162.65 |
| Max. Negotiated Rate |
$44,300.00 |
| Rate for Payer: Aetna Commercial |
$294.73
|
| Rate for Payer: Aetna Commercial |
$294.73
|
| Rate for Payer: Aetna Medicare |
$294.73
|
| Rate for Payer: Aetna Medicare |
$294.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$394.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$394.00
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.65
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$471.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$471.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$338.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$338.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$324.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$324.20
|
| Rate for Payer: Cash Price |
$568.46
|
| Rate for Payer: Cash Price |
$574.93
|
| Rate for Payer: Centivo All Commercial |
$456.83
|
| Rate for Payer: Centivo All Commercial |
$456.83
|
| Rate for Payer: Cigna All Commercial |
$294.73
|
| Rate for Payer: Cigna All Commercial |
$294.73
|
| Rate for Payer: CORVEL All Commercial |
$294.73
|
| Rate for Payer: CORVEL All Commercial |
$294.73
|
| Rate for Payer: Coventry All Commercial |
$353.68
|
| Rate for Payer: Coventry All Commercial |
$353.68
|
| Rate for Payer: Encore All Commercial |
$294.73
|
| Rate for Payer: Encore All Commercial |
$294.73
|
| Rate for Payer: Frontpath All Commercial |
$407.95
|
| Rate for Payer: Frontpath All Commercial |
$407.95
|
| Rate for Payer: Humana ChoiceCare |
$407.08
|
| Rate for Payer: Humana ChoiceCare |
$407.08
|
| Rate for Payer: Humana Medicare |
$294.73
|
| Rate for Payer: Humana Medicare |
$294.73
|
| Rate for Payer: Lucent All Commercial |
$412.62
|
| Rate for Payer: Lucent All Commercial |
$412.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$472.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$472.00
|
| Rate for Payer: Managed Health Services Medicaid |
$471.29
|
| Rate for Payer: Managed Health Services Medicaid |
$471.29
|
| Rate for Payer: MDWise Medicaid |
$471.29
|
| Rate for Payer: MDWise Medicaid |
$471.29
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$162.65
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$162.65
|
| Rate for Payer: PHCS All Commercial |
$294.73
|
| Rate for Payer: PHCS All Commercial |
$294.73
|
| Rate for Payer: PHP All Commercial |
$500.94
|
| Rate for Payer: PHP All Commercial |
$500.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$294.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$294.73
|
| Rate for Payer: Sagamore Health Network All Products |
$294.73
|
| Rate for Payer: Sagamore Health Network All Products |
$294.73
|
| Rate for Payer: Signature Care EPO |
$557.60
|
| Rate for Payer: Signature Care EPO |
$557.60
|
| Rate for Payer: Signature Care PPO |
$557.60
|
| Rate for Payer: Signature Care PPO |
$557.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,300.00
|
| Rate for Payer: United Healthcare Commercial |
$349.99
|
| Rate for Payer: United Healthcare Commercial |
$349.99
|
| Rate for Payer: United Healthcare Medicare |
$473.72
|
| Rate for Payer: United Healthcare Medicare |
$473.72
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5+CM
|
Professional
|
Both
|
$1,243.52
|
|
|
Service Code
|
CPT 27634
|
| Hospital Charge Code |
z27634
|
| Min. Negotiated Rate |
$611.61 |
| Max. Negotiated Rate |
$94,200.00 |
| Rate for Payer: Aetna Commercial |
$629.89
|
| Rate for Payer: Aetna Commercial |
$629.89
|
| Rate for Payer: Aetna Medicare |
$629.89
|
| Rate for Payer: Aetna Medicare |
$629.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$788.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$788.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$788.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$788.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$788.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$788.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$788.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$788.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$611.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$611.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$724.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$724.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$692.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$692.88
|
| Rate for Payer: Cash Price |
$746.11
|
| Rate for Payer: Cash Price |
$735.55
|
| Rate for Payer: Centivo All Commercial |
$976.33
|
| Rate for Payer: Centivo All Commercial |
$976.33
|
| Rate for Payer: Cigna All Commercial |
$629.89
|
| Rate for Payer: Cigna All Commercial |
$629.89
|
| Rate for Payer: CORVEL All Commercial |
$629.89
|
| Rate for Payer: CORVEL All Commercial |
$629.89
|
| Rate for Payer: Coventry All Commercial |
$755.87
|
| Rate for Payer: Coventry All Commercial |
$755.87
|
| Rate for Payer: Encore All Commercial |
$629.89
|
| Rate for Payer: Encore All Commercial |
$629.89
|
| Rate for Payer: Frontpath All Commercial |
$880.37
|
| Rate for Payer: Frontpath All Commercial |
$880.37
|
| Rate for Payer: Humana ChoiceCare |
$706.45
|
| Rate for Payer: Humana ChoiceCare |
$706.45
|
| Rate for Payer: Humana Medicare |
$629.89
|
| Rate for Payer: Humana Medicare |
$629.89
|
| Rate for Payer: Lucent All Commercial |
$881.85
|
| Rate for Payer: Lucent All Commercial |
$881.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,005.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,005.00
|
| Rate for Payer: Managed Health Services Medicaid |
$611.61
|
| Rate for Payer: Managed Health Services Medicaid |
$611.61
|
| Rate for Payer: MDWise Medicaid |
$611.61
|
| Rate for Payer: MDWise Medicaid |
$611.61
|
| Rate for Payer: PHCS All Commercial |
$629.89
|
| Rate for Payer: PHCS All Commercial |
$629.89
|
| Rate for Payer: PHP All Commercial |
$1,066.54
|
| Rate for Payer: PHP All Commercial |
$1,066.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$629.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$629.89
|
| Rate for Payer: Sagamore Health Network All Products |
$629.89
|
| Rate for Payer: Sagamore Health Network All Products |
$629.89
|
| Rate for Payer: Signature Care EPO |
$677.45
|
| Rate for Payer: Signature Care EPO |
$677.45
|
| Rate for Payer: Signature Care PPO |
$677.45
|
| Rate for Payer: Signature Care PPO |
$677.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94,200.00
|
| Rate for Payer: United Healthcare Commercial |
$774.19
|
| Rate for Payer: United Healthcare Commercial |
$774.19
|
| Rate for Payer: United Healthcare Medicare |
$612.96
|
| Rate for Payer: United Healthcare Medicare |
$612.96
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBFASCIAL 5+CM
|
Professional
|
Both
|
$1,344.80
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
z21554
|
| Min. Negotiated Rate |
$659.67 |
| Max. Negotiated Rate |
$101,400.00 |
| Rate for Payer: Aetna Commercial |
$680.11
|
| Rate for Payer: Aetna Commercial |
$680.11
|
| Rate for Payer: Aetna Medicare |
$680.11
|
| Rate for Payer: Aetna Medicare |
$680.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$863.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$863.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$863.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$863.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$863.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$863.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$863.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$863.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$661.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$661.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$782.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$782.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$748.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$748.12
|
| Rate for Payer: Cash Price |
$806.88
|
| Rate for Payer: Cash Price |
$791.60
|
| Rate for Payer: Centivo All Commercial |
$1,054.17
|
| Rate for Payer: Centivo All Commercial |
$1,054.17
|
| Rate for Payer: Cigna All Commercial |
$680.11
|
| Rate for Payer: Cigna All Commercial |
$680.11
|
| Rate for Payer: CORVEL All Commercial |
$680.11
|
| Rate for Payer: CORVEL All Commercial |
$680.11
|
| Rate for Payer: Coventry All Commercial |
$816.13
|
| Rate for Payer: Coventry All Commercial |
$816.13
|
| Rate for Payer: Encore All Commercial |
$680.11
|
| Rate for Payer: Encore All Commercial |
$680.11
|
| Rate for Payer: Frontpath All Commercial |
$956.31
|
| Rate for Payer: Frontpath All Commercial |
$956.31
|
| Rate for Payer: Humana ChoiceCare |
$772.00
|
| Rate for Payer: Humana ChoiceCare |
$772.00
|
| Rate for Payer: Humana Medicare |
$680.11
|
| Rate for Payer: Humana Medicare |
$680.11
|
| Rate for Payer: Lucent All Commercial |
$952.15
|
| Rate for Payer: Lucent All Commercial |
$952.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,082.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,082.00
|
| Rate for Payer: Managed Health Services Medicaid |
$661.43
|
| Rate for Payer: Managed Health Services Medicaid |
$661.43
|
| Rate for Payer: MDWise Medicaid |
$661.43
|
| Rate for Payer: MDWise Medicaid |
$661.43
|
| Rate for Payer: PHCS All Commercial |
$680.11
|
| Rate for Payer: PHCS All Commercial |
$680.11
|
| Rate for Payer: PHP All Commercial |
$1,147.83
|
| Rate for Payer: PHP All Commercial |
$1,147.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$680.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$680.11
|
| Rate for Payer: Sagamore Health Network All Products |
$680.11
|
| Rate for Payer: Sagamore Health Network All Products |
$680.11
|
| Rate for Payer: Signature Care EPO |
$740.35
|
| Rate for Payer: Signature Care EPO |
$740.35
|
| Rate for Payer: Signature Care PPO |
$740.35
|
| Rate for Payer: Signature Care PPO |
$740.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$101,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$101,400.00
|
| Rate for Payer: United Healthcare Commercial |
$846.04
|
| Rate for Payer: United Healthcare Commercial |
$846.04
|
| Rate for Payer: United Healthcare Medicare |
$659.67
|
| Rate for Payer: United Healthcare Medicare |
$659.67
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$980.70
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
z21556
|
| Min. Negotiated Rate |
$417.68 |
| Max. Negotiated Rate |
$74,100.00 |
| Rate for Payer: Aetna Commercial |
$496.33
|
| Rate for Payer: Aetna Commercial |
$496.33
|
| Rate for Payer: Aetna Medicare |
$496.33
|
| Rate for Payer: Aetna Medicare |
$496.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$459.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$459.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$459.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$459.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$459.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$459.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$459.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$459.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$482.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$482.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$570.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$570.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$545.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$545.96
|
| Rate for Payer: Cash Price |
$588.42
|
| Rate for Payer: Cash Price |
$578.63
|
| Rate for Payer: Centivo All Commercial |
$769.31
|
| Rate for Payer: Centivo All Commercial |
$769.31
|
| Rate for Payer: Cigna All Commercial |
$496.33
|
| Rate for Payer: Cigna All Commercial |
$496.33
|
| Rate for Payer: CORVEL All Commercial |
$496.33
|
| Rate for Payer: CORVEL All Commercial |
$496.33
|
| Rate for Payer: Coventry All Commercial |
$595.60
|
| Rate for Payer: Coventry All Commercial |
$595.60
|
| Rate for Payer: Encore All Commercial |
$496.33
|
| Rate for Payer: Encore All Commercial |
$496.33
|
| Rate for Payer: Frontpath All Commercial |
$691.00
|
| Rate for Payer: Frontpath All Commercial |
$691.00
|
| Rate for Payer: Humana ChoiceCare |
$417.68
|
| Rate for Payer: Humana ChoiceCare |
$417.68
|
| Rate for Payer: Humana Medicare |
$496.33
|
| Rate for Payer: Humana Medicare |
$496.33
|
| Rate for Payer: Lucent All Commercial |
$694.86
|
| Rate for Payer: Lucent All Commercial |
$694.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$791.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$791.00
|
| Rate for Payer: Managed Health Services Medicaid |
$482.35
|
| Rate for Payer: Managed Health Services Medicaid |
$482.35
|
| Rate for Payer: MDWise Medicaid |
$482.35
|
| Rate for Payer: MDWise Medicaid |
$482.35
|
| Rate for Payer: PHCS All Commercial |
$496.33
|
| Rate for Payer: PHCS All Commercial |
$496.33
|
| Rate for Payer: PHP All Commercial |
$839.02
|
| Rate for Payer: PHP All Commercial |
$839.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$496.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$496.33
|
| Rate for Payer: Sagamore Health Network All Products |
$496.33
|
| Rate for Payer: Sagamore Health Network All Products |
$496.33
|
| Rate for Payer: Signature Care EPO |
$559.30
|
| Rate for Payer: Signature Care EPO |
$559.30
|
| Rate for Payer: Signature Care PPO |
$559.30
|
| Rate for Payer: Signature Care PPO |
$559.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$74,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$74,100.00
|
| Rate for Payer: United Healthcare Commercial |
$444.36
|
| Rate for Payer: United Healthcare Commercial |
$444.36
|
| Rate for Payer: United Healthcare Medicare |
$482.19
|
| Rate for Payer: United Healthcare Medicare |
$482.19
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM
|
Professional
|
Both
|
$822.12
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
z21552
|
| Min. Negotiated Rate |
$402.55 |
| Max. Negotiated Rate |
$61,900.00 |
| Rate for Payer: Aetna Commercial |
$415.35
|
| Rate for Payer: Aetna Commercial |
$415.35
|
| Rate for Payer: Aetna Medicare |
$415.35
|
| Rate for Payer: Aetna Medicare |
$415.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$525.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$525.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$525.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$525.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$525.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$525.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$525.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$525.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$404.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$404.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$477.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$477.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$456.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$456.88
|
| Rate for Payer: Cash Price |
$493.27
|
| Rate for Payer: Cash Price |
$483.06
|
| Rate for Payer: Centivo All Commercial |
$643.79
|
| Rate for Payer: Centivo All Commercial |
$643.79
|
| Rate for Payer: Cigna All Commercial |
$415.35
|
| Rate for Payer: Cigna All Commercial |
$415.35
|
| Rate for Payer: CORVEL All Commercial |
$415.35
|
| Rate for Payer: CORVEL All Commercial |
$415.35
|
| Rate for Payer: Coventry All Commercial |
$498.42
|
| Rate for Payer: Coventry All Commercial |
$498.42
|
| Rate for Payer: Encore All Commercial |
$415.35
|
| Rate for Payer: Encore All Commercial |
$415.35
|
| Rate for Payer: Frontpath All Commercial |
$584.97
|
| Rate for Payer: Frontpath All Commercial |
$584.97
|
| Rate for Payer: Humana ChoiceCare |
$469.56
|
| Rate for Payer: Humana ChoiceCare |
$469.56
|
| Rate for Payer: Humana Medicare |
$415.35
|
| Rate for Payer: Humana Medicare |
$415.35
|
| Rate for Payer: Lucent All Commercial |
$581.49
|
| Rate for Payer: Lucent All Commercial |
$581.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$660.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$660.00
|
| Rate for Payer: Managed Health Services Medicaid |
$404.35
|
| Rate for Payer: Managed Health Services Medicaid |
$404.35
|
| Rate for Payer: MDWise Medicaid |
$404.35
|
| Rate for Payer: MDWise Medicaid |
$404.35
|
| Rate for Payer: PHCS All Commercial |
$415.35
|
| Rate for Payer: PHCS All Commercial |
$415.35
|
| Rate for Payer: PHP All Commercial |
$700.44
|
| Rate for Payer: PHP All Commercial |
$700.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$415.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$415.35
|
| Rate for Payer: Sagamore Health Network All Products |
$415.35
|
| Rate for Payer: Sagamore Health Network All Products |
$415.35
|
| Rate for Payer: Signature Care EPO |
$450.50
|
| Rate for Payer: Signature Care EPO |
$450.50
|
| Rate for Payer: Signature Care PPO |
$450.50
|
| Rate for Payer: Signature Care PPO |
$450.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$61,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$61,900.00
|
| Rate for Payer: United Healthcare Commercial |
$514.15
|
| Rate for Payer: United Healthcare Commercial |
$514.15
|
| Rate for Payer: United Healthcare Medicare |
$402.55
|
| Rate for Payer: United Healthcare Medicare |
$402.55
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$802.34
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
z21555
|
| Min. Negotiated Rate |
$157.81 |
| Max. Negotiated Rate |
$42,800.00 |
| Rate for Payer: Aetna Commercial |
$285.86
|
| Rate for Payer: Aetna Commercial |
$285.86
|
| Rate for Payer: Aetna Medicare |
$285.86
|
| Rate for Payer: Aetna Medicare |
$285.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$450.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$450.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$450.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$450.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$450.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$450.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$450.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$450.64
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$157.81
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$157.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$394.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$394.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$328.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$328.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$314.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$314.45
|
| Rate for Payer: Cash Price |
$473.77
|
| Rate for Payer: Cash Price |
$481.40
|
| Rate for Payer: Centivo All Commercial |
$443.08
|
| Rate for Payer: Centivo All Commercial |
$443.08
|
| Rate for Payer: Cigna All Commercial |
$285.86
|
| Rate for Payer: Cigna All Commercial |
$285.86
|
| Rate for Payer: CORVEL All Commercial |
$285.86
|
| Rate for Payer: CORVEL All Commercial |
$285.86
|
| Rate for Payer: Coventry All Commercial |
$343.03
|
| Rate for Payer: Coventry All Commercial |
$343.03
|
| Rate for Payer: Encore All Commercial |
$285.86
|
| Rate for Payer: Encore All Commercial |
$285.86
|
| Rate for Payer: Frontpath All Commercial |
$396.53
|
| Rate for Payer: Frontpath All Commercial |
$396.53
|
| Rate for Payer: Humana ChoiceCare |
$326.71
|
| Rate for Payer: Humana ChoiceCare |
$326.71
|
| Rate for Payer: Humana Medicare |
$285.86
|
| Rate for Payer: Humana Medicare |
$285.86
|
| Rate for Payer: Lucent All Commercial |
$400.20
|
| Rate for Payer: Lucent All Commercial |
$400.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.00
|
| Rate for Payer: Managed Health Services Medicaid |
$394.62
|
| Rate for Payer: Managed Health Services Medicaid |
$394.62
|
| Rate for Payer: MDWise Medicaid |
$394.62
|
| Rate for Payer: MDWise Medicaid |
$394.62
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$157.81
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$157.81
|
| Rate for Payer: PHCS All Commercial |
$285.86
|
| Rate for Payer: PHCS All Commercial |
$285.86
|
| Rate for Payer: PHP All Commercial |
$484.69
|
| Rate for Payer: PHP All Commercial |
$484.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$285.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$285.86
|
| Rate for Payer: Sagamore Health Network All Products |
$285.86
|
| Rate for Payer: Sagamore Health Network All Products |
$285.86
|
| Rate for Payer: Signature Care EPO |
$536.35
|
| Rate for Payer: Signature Care EPO |
$536.35
|
| Rate for Payer: Signature Care PPO |
$536.35
|
| Rate for Payer: Signature Care PPO |
$536.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,800.00
|
| Rate for Payer: United Healthcare Commercial |
$355.03
|
| Rate for Payer: United Healthcare Commercial |
$355.03
|
| Rate for Payer: United Healthcare Medicare |
$394.81
|
| Rate for Payer: United Healthcare Medicare |
$394.81
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM
|
Professional
|
Both
|
$1,281.72
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
z23073
|
| Min. Negotiated Rate |
$628.20 |
| Max. Negotiated Rate |
$96,600.00 |
| Rate for Payer: Aetna Commercial |
$647.31
|
| Rate for Payer: Aetna Commercial |
$647.31
|
| Rate for Payer: Aetna Medicare |
$647.31
|
| Rate for Payer: Aetna Medicare |
$647.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$810.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$810.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$810.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$810.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$810.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$810.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$810.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$810.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$630.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$630.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$744.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$744.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$712.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$712.04
|
| Rate for Payer: Cash Price |
$769.03
|
| Rate for Payer: Cash Price |
$753.84
|
| Rate for Payer: Centivo All Commercial |
$1,003.33
|
| Rate for Payer: Centivo All Commercial |
$1,003.33
|
| Rate for Payer: Cigna All Commercial |
$647.31
|
| Rate for Payer: Cigna All Commercial |
$647.31
|
| Rate for Payer: CORVEL All Commercial |
$647.31
|
| Rate for Payer: CORVEL All Commercial |
$647.31
|
| Rate for Payer: Coventry All Commercial |
$776.77
|
| Rate for Payer: Coventry All Commercial |
$776.77
|
| Rate for Payer: Encore All Commercial |
$647.31
|
| Rate for Payer: Encore All Commercial |
$647.31
|
| Rate for Payer: Frontpath All Commercial |
$910.34
|
| Rate for Payer: Frontpath All Commercial |
$910.34
|
| Rate for Payer: Humana ChoiceCare |
$722.88
|
| Rate for Payer: Humana ChoiceCare |
$722.88
|
| Rate for Payer: Humana Medicare |
$647.31
|
| Rate for Payer: Humana Medicare |
$647.31
|
| Rate for Payer: Lucent All Commercial |
$906.23
|
| Rate for Payer: Lucent All Commercial |
$906.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,030.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,030.00
|
| Rate for Payer: Managed Health Services Medicaid |
$630.40
|
| Rate for Payer: Managed Health Services Medicaid |
$630.40
|
| Rate for Payer: MDWise Medicaid |
$630.40
|
| Rate for Payer: MDWise Medicaid |
$630.40
|
| Rate for Payer: PHCS All Commercial |
$647.31
|
| Rate for Payer: PHCS All Commercial |
$647.31
|
| Rate for Payer: PHP All Commercial |
$1,093.06
|
| Rate for Payer: PHP All Commercial |
$1,093.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$647.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$647.31
|
| Rate for Payer: Sagamore Health Network All Products |
$647.31
|
| Rate for Payer: Sagamore Health Network All Products |
$647.31
|
| Rate for Payer: Signature Care EPO |
$693.60
|
| Rate for Payer: Signature Care EPO |
$693.60
|
| Rate for Payer: Signature Care PPO |
$693.60
|
| Rate for Payer: Signature Care PPO |
$693.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$96,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$96,600.00
|
| Rate for Payer: United Healthcare Commercial |
$791.46
|
| Rate for Payer: United Healthcare Commercial |
$791.46
|
| Rate for Payer: United Healthcare Medicare |
$628.20
|
| Rate for Payer: United Healthcare Medicare |
$628.20
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM
|
Professional
|
Both
|
$1,388.58
|
|
|
Service Code
|
CPT 27339
|
| Hospital Charge Code |
z27339
|
| Min. Negotiated Rate |
$678.41 |
| Max. Negotiated Rate |
$104,300.00 |
| Rate for Payer: Aetna Commercial |
$701.04
|
| Rate for Payer: Aetna Commercial |
$701.04
|
| Rate for Payer: Aetna Medicare |
$701.04
|
| Rate for Payer: Aetna Medicare |
$701.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$882.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$882.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$882.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$882.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$882.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$882.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$882.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$882.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$682.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$682.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$806.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$806.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$771.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$771.14
|
| Rate for Payer: Cash Price |
$833.15
|
| Rate for Payer: Cash Price |
$814.09
|
| Rate for Payer: Centivo All Commercial |
$1,086.61
|
| Rate for Payer: Centivo All Commercial |
$1,086.61
|
| Rate for Payer: Cigna All Commercial |
$701.04
|
| Rate for Payer: Cigna All Commercial |
$701.04
|
| Rate for Payer: CORVEL All Commercial |
$701.04
|
| Rate for Payer: CORVEL All Commercial |
$701.04
|
| Rate for Payer: Coventry All Commercial |
$841.25
|
| Rate for Payer: Coventry All Commercial |
$841.25
|
| Rate for Payer: Encore All Commercial |
$701.04
|
| Rate for Payer: Encore All Commercial |
$701.04
|
| Rate for Payer: Frontpath All Commercial |
$987.26
|
| Rate for Payer: Frontpath All Commercial |
$987.26
|
| Rate for Payer: Humana ChoiceCare |
$787.45
|
| Rate for Payer: Humana ChoiceCare |
$787.45
|
| Rate for Payer: Humana Medicare |
$701.04
|
| Rate for Payer: Humana Medicare |
$701.04
|
| Rate for Payer: Lucent All Commercial |
$981.46
|
| Rate for Payer: Lucent All Commercial |
$981.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,113.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,113.00
|
| Rate for Payer: Managed Health Services Medicaid |
$682.96
|
| Rate for Payer: Managed Health Services Medicaid |
$682.96
|
| Rate for Payer: MDWise Medicaid |
$682.96
|
| Rate for Payer: MDWise Medicaid |
$682.96
|
| Rate for Payer: PHCS All Commercial |
$701.04
|
| Rate for Payer: PHCS All Commercial |
$701.04
|
| Rate for Payer: PHP All Commercial |
$1,180.43
|
| Rate for Payer: PHP All Commercial |
$1,180.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$701.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$701.04
|
| Rate for Payer: Sagamore Health Network All Products |
$701.04
|
| Rate for Payer: Sagamore Health Network All Products |
$701.04
|
| Rate for Payer: Signature Care EPO |
$755.65
|
| Rate for Payer: Signature Care EPO |
$755.65
|
| Rate for Payer: Signature Care PPO |
$755.65
|
| Rate for Payer: Signature Care PPO |
$755.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$104,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$104,300.00
|
| Rate for Payer: United Healthcare Commercial |
$862.80
|
| Rate for Payer: United Healthcare Commercial |
$862.80
|
| Rate for Payer: United Healthcare Medicare |
$678.41
|
| Rate for Payer: United Healthcare Medicare |
$678.41
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,150.92
|
|
|
Service Code
|
CPT 27328
|
| Hospital Charge Code |
z27328
|
| Min. Negotiated Rate |
$431.98 |
| Max. Negotiated Rate |
$897.23 |
| Rate for Payer: Aetna Commercial |
$578.86
|
| Rate for Payer: Aetna Commercial |
$578.86
|
| Rate for Payer: Aetna Medicare |
$578.86
|
| Rate for Payer: Aetna Medicare |
$578.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$566.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$566.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$665.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$665.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$636.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$636.75
|
| Rate for Payer: Cash Price |
$676.25
|
| Rate for Payer: Cash Price |
$690.55
|
| Rate for Payer: Centivo All Commercial |
$897.23
|
| Rate for Payer: Centivo All Commercial |
$897.23
|
| Rate for Payer: Cigna All Commercial |
$578.86
|
| Rate for Payer: Cigna All Commercial |
$578.86
|
| Rate for Payer: CORVEL All Commercial |
$578.86
|
| Rate for Payer: CORVEL All Commercial |
$578.86
|
| Rate for Payer: Coventry All Commercial |
$694.63
|
| Rate for Payer: Coventry All Commercial |
$694.63
|
| Rate for Payer: Encore All Commercial |
$578.86
|
| Rate for Payer: Encore All Commercial |
$578.86
|
| Rate for Payer: Frontpath All Commercial |
$811.95
|
| Rate for Payer: Frontpath All Commercial |
$811.95
|
| Rate for Payer: Humana ChoiceCare |
$431.98
|
| Rate for Payer: Humana ChoiceCare |
$431.98
|
| Rate for Payer: Humana Medicare |
$578.86
|
| Rate for Payer: Humana Medicare |
$578.86
|
| Rate for Payer: Lucent All Commercial |
$810.40
|
| Rate for Payer: Lucent All Commercial |
$810.40
|
| Rate for Payer: Managed Health Services Medicaid |
$566.07
|
| Rate for Payer: Managed Health Services Medicaid |
$566.07
|
| Rate for Payer: MDWise Medicaid |
$566.07
|
| Rate for Payer: MDWise Medicaid |
$566.07
|
| Rate for Payer: PHCS All Commercial |
$578.86
|
| Rate for Payer: PHCS All Commercial |
$578.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$578.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$578.86
|
| Rate for Payer: Sagamore Health Network All Products |
$578.86
|
| Rate for Payer: Sagamore Health Network All Products |
$578.86
|
| Rate for Payer: United Healthcare Commercial |
$450.29
|
| Rate for Payer: United Healthcare Commercial |
$450.29
|
| Rate for Payer: United Healthcare Medicare |
$563.54
|
| Rate for Payer: United Healthcare Medicare |
$563.54
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM
|
Professional
|
Both
|
$748.30
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
z24071
|
| Min. Negotiated Rate |
$365.76 |
| Max. Negotiated Rate |
$585.09 |
| Rate for Payer: Aetna Commercial |
$377.48
|
| Rate for Payer: Aetna Commercial |
$377.48
|
| Rate for Payer: Aetna Medicare |
$377.48
|
| Rate for Payer: Aetna Medicare |
$377.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$368.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$368.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$434.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$434.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$415.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$415.23
|
| Rate for Payer: Cash Price |
$438.91
|
| Rate for Payer: Cash Price |
$448.98
|
| Rate for Payer: Centivo All Commercial |
$585.09
|
| Rate for Payer: Centivo All Commercial |
$585.09
|
| Rate for Payer: Cigna All Commercial |
$377.48
|
| Rate for Payer: Cigna All Commercial |
$377.48
|
| Rate for Payer: CORVEL All Commercial |
$377.48
|
| Rate for Payer: CORVEL All Commercial |
$377.48
|
| Rate for Payer: Coventry All Commercial |
$452.98
|
| Rate for Payer: Coventry All Commercial |
$452.98
|
| Rate for Payer: Encore All Commercial |
$377.48
|
| Rate for Payer: Encore All Commercial |
$377.48
|
| Rate for Payer: Frontpath All Commercial |
$530.22
|
| Rate for Payer: Frontpath All Commercial |
$530.22
|
| Rate for Payer: Humana ChoiceCare |
$423.23
|
| Rate for Payer: Humana ChoiceCare |
$423.23
|
| Rate for Payer: Humana Medicare |
$377.48
|
| Rate for Payer: Humana Medicare |
$377.48
|
| Rate for Payer: Lucent All Commercial |
$528.47
|
| Rate for Payer: Lucent All Commercial |
$528.47
|
| Rate for Payer: Managed Health Services Medicaid |
$368.04
|
| Rate for Payer: Managed Health Services Medicaid |
$368.04
|
| Rate for Payer: MDWise Medicaid |
$368.04
|
| Rate for Payer: MDWise Medicaid |
$368.04
|
| Rate for Payer: PHCS All Commercial |
$377.48
|
| Rate for Payer: PHCS All Commercial |
$377.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$377.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$377.48
|
| Rate for Payer: Sagamore Health Network All Products |
$377.48
|
| Rate for Payer: Sagamore Health Network All Products |
$377.48
|
| Rate for Payer: United Healthcare Commercial |
$463.69
|
| Rate for Payer: United Healthcare Commercial |
$463.69
|
| Rate for Payer: United Healthcare Medicare |
$365.76
|
| Rate for Payer: United Healthcare Medicare |
$365.76
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$979.18
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
z24075
|
| Min. Negotiated Rate |
$170.09 |
| Max. Negotiated Rate |
$485.15 |
| Rate for Payer: Aetna Commercial |
$307.29
|
| Rate for Payer: Aetna Medicare |
$307.29
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$170.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$481.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.02
|
| Rate for Payer: Cash Price |
$587.51
|
| Rate for Payer: Centivo All Commercial |
$476.30
|
| Rate for Payer: Cigna All Commercial |
$307.29
|
| Rate for Payer: CORVEL All Commercial |
$307.29
|
| Rate for Payer: Coventry All Commercial |
$368.75
|
| Rate for Payer: Encore All Commercial |
$307.29
|
| Rate for Payer: Frontpath All Commercial |
$427.69
|
| Rate for Payer: Humana ChoiceCare |
$316.25
|
| Rate for Payer: Humana Medicare |
$307.29
|
| Rate for Payer: Lucent All Commercial |
$430.21
|
| Rate for Payer: Managed Health Services Medicaid |
$481.60
|
| Rate for Payer: MDWise Medicaid |
$481.60
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$170.09
|
| Rate for Payer: PHCS All Commercial |
$307.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$307.29
|
| Rate for Payer: Sagamore Health Network All Products |
$307.29
|
| Rate for Payer: United Healthcare Commercial |
$331.89
|
| Rate for Payer: United Healthcare Medicare |
$485.15
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM
|
Professional
|
Both
|
$1,275.24
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
z24073
|
| Min. Negotiated Rate |
$625.30 |
| Max. Negotiated Rate |
$96,100.00 |
| Rate for Payer: Aetna Commercial |
$644.47
|
| Rate for Payer: Aetna Commercial |
$644.47
|
| Rate for Payer: Aetna Medicare |
$644.47
|
| Rate for Payer: Aetna Medicare |
$644.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$814.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$814.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$814.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$814.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$814.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$814.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$814.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$814.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$627.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$627.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$741.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$741.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$708.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$708.92
|
| Rate for Payer: Cash Price |
$765.14
|
| Rate for Payer: Cash Price |
$750.36
|
| Rate for Payer: Centivo All Commercial |
$998.93
|
| Rate for Payer: Centivo All Commercial |
$998.93
|
| Rate for Payer: Cigna All Commercial |
$644.47
|
| Rate for Payer: Cigna All Commercial |
$644.47
|
| Rate for Payer: CORVEL All Commercial |
$644.47
|
| Rate for Payer: CORVEL All Commercial |
$644.47
|
| Rate for Payer: Coventry All Commercial |
$773.36
|
| Rate for Payer: Coventry All Commercial |
$773.36
|
| Rate for Payer: Encore All Commercial |
$644.47
|
| Rate for Payer: Encore All Commercial |
$644.47
|
| Rate for Payer: Frontpath All Commercial |
$904.92
|
| Rate for Payer: Frontpath All Commercial |
$904.92
|
| Rate for Payer: Humana ChoiceCare |
$726.96
|
| Rate for Payer: Humana ChoiceCare |
$726.96
|
| Rate for Payer: Humana Medicare |
$644.47
|
| Rate for Payer: Humana Medicare |
$644.47
|
| Rate for Payer: Lucent All Commercial |
$902.26
|
| Rate for Payer: Lucent All Commercial |
$902.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,025.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,025.00
|
| Rate for Payer: Managed Health Services Medicaid |
$627.21
|
| Rate for Payer: Managed Health Services Medicaid |
$627.21
|
| Rate for Payer: MDWise Medicaid |
$627.21
|
| Rate for Payer: MDWise Medicaid |
$627.21
|
| Rate for Payer: PHCS All Commercial |
$644.47
|
| Rate for Payer: PHCS All Commercial |
$644.47
|
| Rate for Payer: PHP All Commercial |
$1,088.03
|
| Rate for Payer: PHP All Commercial |
$1,088.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$644.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$644.47
|
| Rate for Payer: Sagamore Health Network All Products |
$644.47
|
| Rate for Payer: Sagamore Health Network All Products |
$644.47
|
| Rate for Payer: Signature Care EPO |
$697.00
|
| Rate for Payer: Signature Care EPO |
$697.00
|
| Rate for Payer: Signature Care PPO |
$697.00
|
| Rate for Payer: Signature Care PPO |
$697.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$96,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$96,100.00
|
| Rate for Payer: United Healthcare Commercial |
$795.89
|
| Rate for Payer: United Healthcare Commercial |
$795.89
|
| Rate for Payer: United Healthcare Medicare |
$625.30
|
| Rate for Payer: United Healthcare Medicare |
$625.30
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,020.76
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
z26115
|
| Min. Negotiated Rate |
$170.44 |
| Max. Negotiated Rate |
$46,800.00 |
| Rate for Payer: Aetna Commercial |
$309.50
|
| Rate for Payer: Aetna Commercial |
$309.50
|
| Rate for Payer: Aetna Medicare |
$309.50
|
| Rate for Payer: Aetna Medicare |
$309.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$630.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$630.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$630.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$630.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$630.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$630.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$630.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$630.11
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$170.44
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$170.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$502.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$502.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$355.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$355.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$340.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$340.45
|
| Rate for Payer: Cash Price |
$603.48
|
| Rate for Payer: Cash Price |
$612.46
|
| Rate for Payer: Centivo All Commercial |
$479.73
|
| Rate for Payer: Centivo All Commercial |
$479.73
|
| Rate for Payer: Cigna All Commercial |
$309.50
|
| Rate for Payer: Cigna All Commercial |
$309.50
|
| Rate for Payer: CORVEL All Commercial |
$309.50
|
| Rate for Payer: CORVEL All Commercial |
$309.50
|
| Rate for Payer: Coventry All Commercial |
$371.40
|
| Rate for Payer: Coventry All Commercial |
$371.40
|
| Rate for Payer: Encore All Commercial |
$309.50
|
| Rate for Payer: Encore All Commercial |
$309.50
|
| Rate for Payer: Frontpath All Commercial |
$426.02
|
| Rate for Payer: Frontpath All Commercial |
$426.02
|
| Rate for Payer: Humana ChoiceCare |
$368.39
|
| Rate for Payer: Humana ChoiceCare |
$368.39
|
| Rate for Payer: Humana Medicare |
$309.50
|
| Rate for Payer: Humana Medicare |
$309.50
|
| Rate for Payer: Lucent All Commercial |
$433.30
|
| Rate for Payer: Lucent All Commercial |
$433.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$499.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$499.00
|
| Rate for Payer: Managed Health Services Medicaid |
$502.05
|
| Rate for Payer: Managed Health Services Medicaid |
$502.05
|
| Rate for Payer: MDWise Medicaid |
$502.05
|
| Rate for Payer: MDWise Medicaid |
$502.05
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$170.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$170.44
|
| Rate for Payer: PHCS All Commercial |
$309.50
|
| Rate for Payer: PHCS All Commercial |
$309.50
|
| Rate for Payer: PHP All Commercial |
$529.17
|
| Rate for Payer: PHP All Commercial |
$529.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$309.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$309.50
|
| Rate for Payer: Sagamore Health Network All Products |
$309.50
|
| Rate for Payer: Sagamore Health Network All Products |
$309.50
|
| Rate for Payer: Signature Care EPO |
$808.67
|
| Rate for Payer: Signature Care EPO |
$808.67
|
| Rate for Payer: Signature Care PPO |
$808.67
|
| Rate for Payer: Signature Care PPO |
$808.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,800.00
|
| Rate for Payer: United Healthcare Commercial |
$374.35
|
| Rate for Payer: United Healthcare Commercial |
$374.35
|
| Rate for Payer: United Healthcare Medicare |
$502.90
|
| Rate for Payer: United Healthcare Medicare |
$502.90
|
|
|
PR EXPLOR ANKLE JOINT
|
Professional
|
Both
|
$841.84
|
|
|
Service Code
|
CPT 27620
|
| Hospital Charge Code |
z27620
|
| Min. Negotiated Rate |
$407.36 |
| Max. Negotiated Rate |
$62,600.00 |
| Rate for Payer: Aetna Commercial |
$423.26
|
| Rate for Payer: Aetna Commercial |
$423.26
|
| Rate for Payer: Aetna Medicare |
$423.26
|
| Rate for Payer: Aetna Medicare |
$423.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$625.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$625.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$625.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$625.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$625.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$625.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$625.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$625.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$414.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$414.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$486.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$486.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$465.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$465.59
|
| Rate for Payer: Cash Price |
$505.10
|
| Rate for Payer: Cash Price |
$488.83
|
| Rate for Payer: Centivo All Commercial |
$656.05
|
| Rate for Payer: Centivo All Commercial |
$656.05
|
| Rate for Payer: Cigna All Commercial |
$423.26
|
| Rate for Payer: Cigna All Commercial |
$423.26
|
| Rate for Payer: CORVEL All Commercial |
$423.26
|
| Rate for Payer: CORVEL All Commercial |
$423.26
|
| Rate for Payer: Coventry All Commercial |
$507.91
|
| Rate for Payer: Coventry All Commercial |
$507.91
|
| Rate for Payer: Encore All Commercial |
$423.26
|
| Rate for Payer: Encore All Commercial |
$423.26
|
| Rate for Payer: Frontpath All Commercial |
$581.62
|
| Rate for Payer: Frontpath All Commercial |
$581.62
|
| Rate for Payer: Humana ChoiceCare |
$495.86
|
| Rate for Payer: Humana ChoiceCare |
$495.86
|
| Rate for Payer: Humana Medicare |
$423.26
|
| Rate for Payer: Humana Medicare |
$423.26
|
| Rate for Payer: Lucent All Commercial |
$592.56
|
| Rate for Payer: Lucent All Commercial |
$592.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$668.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$668.00
|
| Rate for Payer: Managed Health Services Medicaid |
$414.05
|
| Rate for Payer: Managed Health Services Medicaid |
$414.05
|
| Rate for Payer: MDWise Medicaid |
$414.05
|
| Rate for Payer: MDWise Medicaid |
$414.05
|
| Rate for Payer: PHCS All Commercial |
$423.26
|
| Rate for Payer: PHCS All Commercial |
$423.26
|
| Rate for Payer: PHP All Commercial |
$708.80
|
| Rate for Payer: PHP All Commercial |
$708.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$423.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$423.26
|
| Rate for Payer: Sagamore Health Network All Products |
$423.26
|
| Rate for Payer: Sagamore Health Network All Products |
$423.26
|
| Rate for Payer: Signature Care EPO |
$668.10
|
| Rate for Payer: Signature Care EPO |
$668.10
|
| Rate for Payer: Signature Care PPO |
$668.10
|
| Rate for Payer: Signature Care PPO |
$668.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62,600.00
|
| Rate for Payer: United Healthcare Commercial |
$499.23
|
| Rate for Payer: United Healthcare Commercial |
$499.23
|
| Rate for Payer: United Healthcare Medicare |
$407.36
|
| Rate for Payer: United Healthcare Medicare |
$407.36
|
|
|
PR EXPLOR/DRAIN KNEE,INFECTN
|
Professional
|
Both
|
$1,360.78
|
|
|
Service Code
|
CPT 27310
|
| Hospital Charge Code |
z27310
|
| Min. Negotiated Rate |
$666.21 |
| Max. Negotiated Rate |
$102,400.00 |
| Rate for Payer: Aetna Commercial |
$683.02
|
| Rate for Payer: Aetna Commercial |
$683.02
|
| Rate for Payer: Aetna Medicare |
$683.02
|
| Rate for Payer: Aetna Medicare |
$683.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$934.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$934.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$934.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$934.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$934.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$934.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$934.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$934.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$669.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$669.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$751.32
|
| Rate for Payer: Cash Price |
$816.47
|
| Rate for Payer: Cash Price |
$799.45
|
| Rate for Payer: Centivo All Commercial |
$1,058.68
|
| Rate for Payer: Centivo All Commercial |
$1,058.68
|
| Rate for Payer: Cigna All Commercial |
$683.02
|
| Rate for Payer: Cigna All Commercial |
$683.02
|
| Rate for Payer: CORVEL All Commercial |
$683.02
|
| Rate for Payer: CORVEL All Commercial |
$683.02
|
| Rate for Payer: Coventry All Commercial |
$819.62
|
| Rate for Payer: Coventry All Commercial |
$819.62
|
| Rate for Payer: Encore All Commercial |
$683.02
|
| Rate for Payer: Encore All Commercial |
$683.02
|
| Rate for Payer: Frontpath All Commercial |
$951.08
|
| Rate for Payer: Frontpath All Commercial |
$951.08
|
| Rate for Payer: Humana ChoiceCare |
$735.53
|
| Rate for Payer: Humana ChoiceCare |
$735.53
|
| Rate for Payer: Humana Medicare |
$683.02
|
| Rate for Payer: Humana Medicare |
$683.02
|
| Rate for Payer: Lucent All Commercial |
$956.23
|
| Rate for Payer: Lucent All Commercial |
$956.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.00
|
| Rate for Payer: Managed Health Services Medicaid |
$669.29
|
| Rate for Payer: Managed Health Services Medicaid |
$669.29
|
| Rate for Payer: MDWise Medicaid |
$669.29
|
| Rate for Payer: MDWise Medicaid |
$669.29
|
| Rate for Payer: PHCS All Commercial |
$683.02
|
| Rate for Payer: PHCS All Commercial |
$683.02
|
| Rate for Payer: PHP All Commercial |
$1,159.20
|
| Rate for Payer: PHP All Commercial |
$1,159.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$683.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$683.02
|
| Rate for Payer: Sagamore Health Network All Products |
$683.02
|
| Rate for Payer: Sagamore Health Network All Products |
$683.02
|
| Rate for Payer: Signature Care EPO |
$983.45
|
| Rate for Payer: Signature Care EPO |
$983.45
|
| Rate for Payer: Signature Care PPO |
$983.45
|
| Rate for Payer: Signature Care PPO |
$983.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$102,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$102,400.00
|
| Rate for Payer: United Healthcare Commercial |
$784.40
|
| Rate for Payer: United Healthcare Commercial |
$784.40
|
| Rate for Payer: United Healthcare Medicare |
$666.21
|
| Rate for Payer: United Healthcare Medicare |
$666.21
|
|
|
PR EXPLORE/DRAIN ELBOW FOR INFECT
|
Professional
|
Both
|
$896.56
|
|
|
Service Code
|
CPT 24000
|
| Hospital Charge Code |
z24000
|
| Min. Negotiated Rate |
$437.45 |
| Max. Negotiated Rate |
$67,300.00 |
| Rate for Payer: Aetna Commercial |
$442.91
|
| Rate for Payer: Aetna Commercial |
$442.91
|
| Rate for Payer: Aetna Medicare |
$442.91
|
| Rate for Payer: Aetna Medicare |
$442.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$585.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$440.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$440.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$509.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$509.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$487.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$487.20
|
| Rate for Payer: Cash Price |
$537.94
|
| Rate for Payer: Cash Price |
$524.94
|
| Rate for Payer: Centivo All Commercial |
$686.51
|
| Rate for Payer: Centivo All Commercial |
$686.51
|
| Rate for Payer: Cigna All Commercial |
$442.91
|
| Rate for Payer: Cigna All Commercial |
$442.91
|
| Rate for Payer: CORVEL All Commercial |
$442.91
|
| Rate for Payer: CORVEL All Commercial |
$442.91
|
| Rate for Payer: Coventry All Commercial |
$531.49
|
| Rate for Payer: Coventry All Commercial |
$531.49
|
| Rate for Payer: Encore All Commercial |
$442.91
|
| Rate for Payer: Encore All Commercial |
$442.91
|
| Rate for Payer: Frontpath All Commercial |
$614.03
|
| Rate for Payer: Frontpath All Commercial |
$614.03
|
| Rate for Payer: Humana ChoiceCare |
$486.89
|
| Rate for Payer: Humana ChoiceCare |
$486.89
|
| Rate for Payer: Humana Medicare |
$442.91
|
| Rate for Payer: Humana Medicare |
$442.91
|
| Rate for Payer: Lucent All Commercial |
$620.07
|
| Rate for Payer: Lucent All Commercial |
$620.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$717.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$717.00
|
| Rate for Payer: Managed Health Services Medicaid |
$440.96
|
| Rate for Payer: Managed Health Services Medicaid |
$440.96
|
| Rate for Payer: MDWise Medicaid |
$440.96
|
| Rate for Payer: MDWise Medicaid |
$440.96
|
| Rate for Payer: PHCS All Commercial |
$442.91
|
| Rate for Payer: PHCS All Commercial |
$442.91
|
| Rate for Payer: PHP All Commercial |
$761.17
|
| Rate for Payer: PHP All Commercial |
$761.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$442.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$442.91
|
| Rate for Payer: Sagamore Health Network All Products |
$442.91
|
| Rate for Payer: Sagamore Health Network All Products |
$442.91
|
| Rate for Payer: Signature Care EPO |
$649.40
|
| Rate for Payer: Signature Care EPO |
$649.40
|
| Rate for Payer: Signature Care PPO |
$649.40
|
| Rate for Payer: Signature Care PPO |
$649.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,300.00
|
| Rate for Payer: United Healthcare Commercial |
$504.00
|
| Rate for Payer: United Healthcare Commercial |
$504.00
|
| Rate for Payer: United Healthcare Medicare |
$437.45
|
| Rate for Payer: United Healthcare Medicare |
$437.45
|
|
|
PR EXPLORE/TREAT INTERPHALANGEAL JT,EA
|
Professional
|
Both
|
$752.86
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
z26080
|
| Min. Negotiated Rate |
$366.37 |
| Max. Negotiated Rate |
$56,300.00 |
| Rate for Payer: Aetna Commercial |
$373.77
|
| Rate for Payer: Aetna Commercial |
$373.77
|
| Rate for Payer: Aetna Medicare |
$373.77
|
| Rate for Payer: Aetna Medicare |
$373.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$532.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$532.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$532.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$532.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$532.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$532.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$532.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$532.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$370.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$370.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$429.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$429.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$411.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$411.15
|
| Rate for Payer: Cash Price |
$451.72
|
| Rate for Payer: Cash Price |
$439.64
|
| Rate for Payer: Centivo All Commercial |
$579.34
|
| Rate for Payer: Centivo All Commercial |
$579.34
|
| Rate for Payer: Cigna All Commercial |
$373.77
|
| Rate for Payer: Cigna All Commercial |
$373.77
|
| Rate for Payer: CORVEL All Commercial |
$373.77
|
| Rate for Payer: CORVEL All Commercial |
$373.77
|
| Rate for Payer: Coventry All Commercial |
$448.52
|
| Rate for Payer: Coventry All Commercial |
$448.52
|
| Rate for Payer: Encore All Commercial |
$373.77
|
| Rate for Payer: Encore All Commercial |
$373.77
|
| Rate for Payer: Frontpath All Commercial |
$513.53
|
| Rate for Payer: Frontpath All Commercial |
$513.53
|
| Rate for Payer: Humana ChoiceCare |
$389.47
|
| Rate for Payer: Humana ChoiceCare |
$389.47
|
| Rate for Payer: Humana Medicare |
$373.77
|
| Rate for Payer: Humana Medicare |
$373.77
|
| Rate for Payer: Lucent All Commercial |
$523.28
|
| Rate for Payer: Lucent All Commercial |
$523.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$601.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$601.00
|
| Rate for Payer: Managed Health Services Medicaid |
$370.29
|
| Rate for Payer: Managed Health Services Medicaid |
$370.29
|
| Rate for Payer: MDWise Medicaid |
$370.29
|
| Rate for Payer: MDWise Medicaid |
$370.29
|
| Rate for Payer: PHCS All Commercial |
$373.77
|
| Rate for Payer: PHCS All Commercial |
$373.77
|
| Rate for Payer: PHP All Commercial |
$637.48
|
| Rate for Payer: PHP All Commercial |
$637.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$373.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$373.77
|
| Rate for Payer: Sagamore Health Network All Products |
$373.77
|
| Rate for Payer: Sagamore Health Network All Products |
$373.77
|
| Rate for Payer: Signature Care EPO |
$518.50
|
| Rate for Payer: Signature Care EPO |
$518.50
|
| Rate for Payer: Signature Care PPO |
$518.50
|
| Rate for Payer: Signature Care PPO |
$518.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$56,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$56,300.00
|
| Rate for Payer: United Healthcare Commercial |
$400.63
|
| Rate for Payer: United Healthcare Commercial |
$400.63
|
| Rate for Payer: United Healthcare Medicare |
$366.37
|
| Rate for Payer: United Healthcare Medicare |
$366.37
|
|
|
PR EXPLORE & TREAT METACARPO-PHAL JT
|
Professional
|
Both
|
$639.00
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
z26075
|
| Min. Negotiated Rate |
$311.95 |
| Max. Negotiated Rate |
$47,900.00 |
| Rate for Payer: Aetna Commercial |
$316.80
|
| Rate for Payer: Aetna Commercial |
$316.80
|
| Rate for Payer: Aetna Medicare |
$316.80
|
| Rate for Payer: Aetna Medicare |
$316.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$511.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$511.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$511.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$511.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$511.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$511.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$511.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$511.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$314.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$314.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$364.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$364.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$348.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$348.48
|
| Rate for Payer: Cash Price |
$383.40
|
| Rate for Payer: Cash Price |
$374.34
|
| Rate for Payer: Centivo All Commercial |
$491.04
|
| Rate for Payer: Centivo All Commercial |
$491.04
|
| Rate for Payer: Cigna All Commercial |
$316.80
|
| Rate for Payer: Cigna All Commercial |
$316.80
|
| Rate for Payer: CORVEL All Commercial |
$316.80
|
| Rate for Payer: CORVEL All Commercial |
$316.80
|
| Rate for Payer: Coventry All Commercial |
$380.16
|
| Rate for Payer: Coventry All Commercial |
$380.16
|
| Rate for Payer: Encore All Commercial |
$316.80
|
| Rate for Payer: Encore All Commercial |
$316.80
|
| Rate for Payer: Frontpath All Commercial |
$435.68
|
| Rate for Payer: Frontpath All Commercial |
$435.68
|
| Rate for Payer: Humana ChoiceCare |
$325.03
|
| Rate for Payer: Humana ChoiceCare |
$325.03
|
| Rate for Payer: Humana Medicare |
$316.80
|
| Rate for Payer: Humana Medicare |
$316.80
|
| Rate for Payer: Lucent All Commercial |
$443.52
|
| Rate for Payer: Lucent All Commercial |
$443.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$511.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$511.00
|
| Rate for Payer: Managed Health Services Medicaid |
$314.28
|
| Rate for Payer: Managed Health Services Medicaid |
$314.28
|
| Rate for Payer: MDWise Medicaid |
$314.28
|
| Rate for Payer: MDWise Medicaid |
$314.28
|
| Rate for Payer: PHCS All Commercial |
$316.80
|
| Rate for Payer: PHCS All Commercial |
$316.80
|
| Rate for Payer: PHP All Commercial |
$542.79
|
| Rate for Payer: PHP All Commercial |
$542.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$316.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$316.80
|
| Rate for Payer: Sagamore Health Network All Products |
$316.80
|
| Rate for Payer: Sagamore Health Network All Products |
$316.80
|
| Rate for Payer: Signature Care EPO |
$433.50
|
| Rate for Payer: Signature Care EPO |
$433.50
|
| Rate for Payer: Signature Care PPO |
$433.50
|
| Rate for Payer: Signature Care PPO |
$433.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,900.00
|
| Rate for Payer: United Healthcare Commercial |
$332.66
|
| Rate for Payer: United Healthcare Commercial |
$332.66
|
| Rate for Payer: United Healthcare Medicare |
$311.95
|
| Rate for Payer: United Healthcare Medicare |
$311.95
|
|
|
PR EXPLORE WOUND,EXTREMITY
|
Professional
|
Both
|
$1,038.80
|
|
|
Service Code
|
CPT 20103
|
| Hospital Charge Code |
z20103
|
| Min. Negotiated Rate |
$176.49 |
| Max. Negotiated Rate |
$47,900.00 |
| Rate for Payer: Aetna Commercial |
$321.26
|
| Rate for Payer: Aetna Commercial |
$321.26
|
| Rate for Payer: Aetna Medicare |
$321.26
|
| Rate for Payer: Aetna Medicare |
$321.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$589.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$589.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$589.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$589.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$589.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$589.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$589.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$589.09
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$176.49
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$176.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$510.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$510.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$369.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$369.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$353.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$353.39
|
| Rate for Payer: Cash Price |
$614.51
|
| Rate for Payer: Cash Price |
$623.28
|
| Rate for Payer: Centivo All Commercial |
$497.95
|
| Rate for Payer: Centivo All Commercial |
$497.95
|
| Rate for Payer: Cigna All Commercial |
$321.26
|
| Rate for Payer: Cigna All Commercial |
$321.26
|
| Rate for Payer: CORVEL All Commercial |
$321.26
|
| Rate for Payer: CORVEL All Commercial |
$321.26
|
| Rate for Payer: Coventry All Commercial |
$385.51
|
| Rate for Payer: Coventry All Commercial |
$385.51
|
| Rate for Payer: Encore All Commercial |
$321.26
|
| Rate for Payer: Encore All Commercial |
$321.26
|
| Rate for Payer: Frontpath All Commercial |
$447.92
|
| Rate for Payer: Frontpath All Commercial |
$447.92
|
| Rate for Payer: Humana ChoiceCare |
$379.71
|
| Rate for Payer: Humana ChoiceCare |
$379.71
|
| Rate for Payer: Humana Medicare |
$321.26
|
| Rate for Payer: Humana Medicare |
$321.26
|
| Rate for Payer: Lucent All Commercial |
$449.76
|
| Rate for Payer: Lucent All Commercial |
$449.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$511.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$511.00
|
| Rate for Payer: Managed Health Services Medicaid |
$510.93
|
| Rate for Payer: Managed Health Services Medicaid |
$510.93
|
| Rate for Payer: MDWise Medicaid |
$510.93
|
| Rate for Payer: MDWise Medicaid |
$510.93
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$176.49
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$176.49
|
| Rate for Payer: PHCS All Commercial |
$321.26
|
| Rate for Payer: PHCS All Commercial |
$321.26
|
| Rate for Payer: PHP All Commercial |
$542.54
|
| Rate for Payer: PHP All Commercial |
$542.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$321.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$321.26
|
| Rate for Payer: Sagamore Health Network All Products |
$321.26
|
| Rate for Payer: Sagamore Health Network All Products |
$321.26
|
| Rate for Payer: Signature Care EPO |
$547.40
|
| Rate for Payer: Signature Care EPO |
$547.40
|
| Rate for Payer: Signature Care PPO |
$547.40
|
| Rate for Payer: Signature Care PPO |
$547.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,900.00
|
| Rate for Payer: United Healthcare Commercial |
$384.23
|
| Rate for Payer: United Healthcare Commercial |
$384.23
|
| Rate for Payer: United Healthcare Medicare |
$512.09
|
| Rate for Payer: United Healthcare Medicare |
$512.09
|
|
|
PR EXPLOR METATARSO-PHALANG JT
|
Professional
|
Both
|
$907.28
|
|
|
Service Code
|
CPT 28022
|
| Hospital Charge Code |
z28022
|
| Min. Negotiated Rate |
$166.29 |
| Max. Negotiated Rate |
$46,200.00 |
| Rate for Payer: Aetna Commercial |
$307.68
|
| Rate for Payer: Aetna Commercial |
$307.68
|
| Rate for Payer: Aetna Medicare |
$307.68
|
| Rate for Payer: Aetna Medicare |
$307.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$449.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$166.29
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$166.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$446.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$446.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.45
|
| Rate for Payer: Cash Price |
$531.52
|
| Rate for Payer: Cash Price |
$544.37
|
| Rate for Payer: Centivo All Commercial |
$476.90
|
| Rate for Payer: Centivo All Commercial |
$476.90
|
| Rate for Payer: Cigna All Commercial |
$307.68
|
| Rate for Payer: Cigna All Commercial |
$307.68
|
| Rate for Payer: CORVEL All Commercial |
$307.68
|
| Rate for Payer: CORVEL All Commercial |
$307.68
|
| Rate for Payer: Coventry All Commercial |
$369.22
|
| Rate for Payer: Coventry All Commercial |
$369.22
|
| Rate for Payer: Encore All Commercial |
$307.68
|
| Rate for Payer: Encore All Commercial |
$307.68
|
| Rate for Payer: Frontpath All Commercial |
$418.03
|
| Rate for Payer: Frontpath All Commercial |
$418.03
|
| Rate for Payer: Humana ChoiceCare |
$367.93
|
| Rate for Payer: Humana ChoiceCare |
$367.93
|
| Rate for Payer: Humana Medicare |
$307.68
|
| Rate for Payer: Humana Medicare |
$307.68
|
| Rate for Payer: Lucent All Commercial |
$430.75
|
| Rate for Payer: Lucent All Commercial |
$430.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$493.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$493.00
|
| Rate for Payer: Managed Health Services Medicaid |
$446.24
|
| Rate for Payer: Managed Health Services Medicaid |
$446.24
|
| Rate for Payer: MDWise Medicaid |
$446.24
|
| Rate for Payer: MDWise Medicaid |
$446.24
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$166.29
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$166.29
|
| Rate for Payer: PHCS All Commercial |
$307.68
|
| Rate for Payer: PHCS All Commercial |
$307.68
|
| Rate for Payer: PHP All Commercial |
$523.34
|
| Rate for Payer: PHP All Commercial |
$523.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$307.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$307.68
|
| Rate for Payer: Sagamore Health Network All Products |
$307.68
|
| Rate for Payer: Sagamore Health Network All Products |
$307.68
|
| Rate for Payer: Signature Care EPO |
$617.10
|
| Rate for Payer: Signature Care EPO |
$617.10
|
| Rate for Payer: Signature Care PPO |
$617.10
|
| Rate for Payer: Signature Care PPO |
$617.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,200.00
|
| Rate for Payer: United Healthcare Commercial |
$371.08
|
| Rate for Payer: United Healthcare Commercial |
$371.08
|
| Rate for Payer: United Healthcare Medicare |
$442.93
|
| Rate for Payer: United Healthcare Medicare |
$442.93
|
|
|
PR EXT ECG,PT DEMAND EVENT, SYMPT MEMORY LOOP, RECORD
|
Professional
|
Both
|
$15.06
|
|
|
Service Code
|
CPT 93270
|
| Hospital Charge Code |
z93270
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Aetna Commercial |
$7.64
|
| Rate for Payer: Aetna Commercial |
$7.64
|
| Rate for Payer: Aetna Medicare |
$7.64
|
| Rate for Payer: Aetna Medicare |
$7.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$8.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$8.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$7.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$7.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$8.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$8.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$8.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$8.40
|
| Rate for Payer: Cash Price |
$9.04
|
| Rate for Payer: Cash Price |
$8.87
|
| Rate for Payer: Centivo All Commercial |
$11.84
|
| Rate for Payer: Centivo All Commercial |
$11.84
|
| Rate for Payer: Cigna All Commercial |
$7.64
|
| Rate for Payer: Cigna All Commercial |
$7.64
|
| Rate for Payer: CORVEL All Commercial |
$7.64
|
| Rate for Payer: CORVEL All Commercial |
$7.64
|
| Rate for Payer: Coventry All Commercial |
$9.17
|
| Rate for Payer: Coventry All Commercial |
$9.17
|
| Rate for Payer: Encore All Commercial |
$7.64
|
| Rate for Payer: Encore All Commercial |
$7.64
|
| Rate for Payer: Frontpath All Commercial |
$8.76
|
| Rate for Payer: Frontpath All Commercial |
$8.76
|
| Rate for Payer: Humana ChoiceCare |
$59.66
|
| Rate for Payer: Humana ChoiceCare |
$59.66
|
| Rate for Payer: Humana Medicare |
$7.64
|
| Rate for Payer: Humana Medicare |
$7.64
|
| Rate for Payer: Lucent All Commercial |
$10.70
|
| Rate for Payer: Lucent All Commercial |
$10.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12.00
|
| Rate for Payer: Managed Health Services Medicaid |
$7.40
|
| Rate for Payer: Managed Health Services Medicaid |
$7.40
|
| Rate for Payer: MDWise Medicaid |
$7.40
|
| Rate for Payer: MDWise Medicaid |
$7.40
|
| Rate for Payer: PHCS All Commercial |
$7.64
|
| Rate for Payer: PHCS All Commercial |
$7.64
|
| Rate for Payer: PHP All Commercial |
$10.86
|
| Rate for Payer: PHP All Commercial |
$10.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.64
|
| Rate for Payer: Sagamore Health Network All Products |
$7.64
|
| Rate for Payer: Sagamore Health Network All Products |
$7.64
|
| Rate for Payer: Signature Care EPO |
$12.99
|
| Rate for Payer: Signature Care EPO |
$12.99
|
| Rate for Payer: Signature Care PPO |
$12.99
|
| Rate for Payer: Signature Care PPO |
$12.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.00
|
| Rate for Payer: United Healthcare Commercial |
$23.69
|
| Rate for Payer: United Healthcare Commercial |
$23.69
|
| Rate for Payer: United Healthcare Medicare |
$7.39
|
| Rate for Payer: United Healthcare Medicare |
$7.39
|
|
|
PR EXT ECG RECORD CONTIN 48 HR, RECORD
|
Professional
|
Both
|
$33.46
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
z93225
|
| Min. Negotiated Rate |
$16.42 |
| Max. Negotiated Rate |
$59.66 |
| Rate for Payer: Aetna Commercial |
$17.60
|
| Rate for Payer: Aetna Commercial |
$17.60
|
| Rate for Payer: Aetna Medicare |
$17.60
|
| Rate for Payer: Aetna Medicare |
$17.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$16.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$16.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$20.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$20.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$19.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$19.36
|
| Rate for Payer: Cash Price |
$19.70
|
| Rate for Payer: Cash Price |
$20.08
|
| Rate for Payer: Centivo All Commercial |
$27.28
|
| Rate for Payer: Centivo All Commercial |
$27.28
|
| Rate for Payer: Cigna All Commercial |
$17.60
|
| Rate for Payer: Cigna All Commercial |
$17.60
|
| Rate for Payer: CORVEL All Commercial |
$17.60
|
| Rate for Payer: CORVEL All Commercial |
$17.60
|
| Rate for Payer: Coventry All Commercial |
$21.12
|
| Rate for Payer: Coventry All Commercial |
$21.12
|
| Rate for Payer: Encore All Commercial |
$17.60
|
| Rate for Payer: Encore All Commercial |
$17.60
|
| Rate for Payer: Frontpath All Commercial |
$19.88
|
| Rate for Payer: Frontpath All Commercial |
$19.88
|
| Rate for Payer: Humana ChoiceCare |
$59.66
|
| Rate for Payer: Humana ChoiceCare |
$59.66
|
| Rate for Payer: Humana Medicare |
$17.60
|
| Rate for Payer: Humana Medicare |
$17.60
|
| Rate for Payer: Lucent All Commercial |
$24.64
|
| Rate for Payer: Lucent All Commercial |
$24.64
|
| Rate for Payer: Managed Health Services Medicaid |
$16.46
|
| Rate for Payer: Managed Health Services Medicaid |
$16.46
|
| Rate for Payer: MDWise Medicaid |
$16.46
|
| Rate for Payer: MDWise Medicaid |
$16.46
|
| Rate for Payer: PHCS All Commercial |
$17.60
|
| Rate for Payer: PHCS All Commercial |
$17.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$17.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$17.60
|
| Rate for Payer: Sagamore Health Network All Products |
$17.60
|
| Rate for Payer: Sagamore Health Network All Products |
$17.60
|
| Rate for Payer: United Healthcare Commercial |
$39.83
|
| Rate for Payer: United Healthcare Commercial |
$39.83
|
| Rate for Payer: United Healthcare Medicare |
$16.42
|
| Rate for Payer: United Healthcare Medicare |
$16.42
|
|
|
PR EXTERNAL ECG REC>48HR<7D RECORDING
|
Professional
|
Both
|
$21.80
|
|
|
Service Code
|
CPT 93242
|
| Hospital Charge Code |
z93242
|
| Min. Negotiated Rate |
$10.70 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: Aetna Commercial |
$12.93
|
| Rate for Payer: Aetna Commercial |
$12.93
|
| Rate for Payer: Aetna Medicare |
$12.93
|
| Rate for Payer: Aetna Medicare |
$12.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$13.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$13.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$13.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$13.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$13.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$13.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$10.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$10.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$14.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$14.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$14.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$14.22
|
| Rate for Payer: Cash Price |
$13.08
|
| Rate for Payer: Cash Price |
$12.84
|
| Rate for Payer: Centivo All Commercial |
$20.04
|
| Rate for Payer: Centivo All Commercial |
$20.04
|
| Rate for Payer: Cigna All Commercial |
$12.93
|
| Rate for Payer: Cigna All Commercial |
$12.93
|
| Rate for Payer: CORVEL All Commercial |
$12.93
|
| Rate for Payer: CORVEL All Commercial |
$12.93
|
| Rate for Payer: Coventry All Commercial |
$15.52
|
| Rate for Payer: Coventry All Commercial |
$15.52
|
| Rate for Payer: Encore All Commercial |
$12.93
|
| Rate for Payer: Encore All Commercial |
$12.93
|
| Rate for Payer: Frontpath All Commercial |
$14.66
|
| Rate for Payer: Frontpath All Commercial |
$14.66
|
| Rate for Payer: Humana ChoiceCare |
$18.58
|
| Rate for Payer: Humana ChoiceCare |
$18.58
|
| Rate for Payer: Humana Medicare |
$12.93
|
| Rate for Payer: Humana Medicare |
$12.93
|
| Rate for Payer: Lucent All Commercial |
$18.10
|
| Rate for Payer: Lucent All Commercial |
$18.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.00
|
| Rate for Payer: Managed Health Services Medicaid |
$10.73
|
| Rate for Payer: Managed Health Services Medicaid |
$10.73
|
| Rate for Payer: MDWise Medicaid |
$10.73
|
| Rate for Payer: MDWise Medicaid |
$10.73
|
| Rate for Payer: PHCS All Commercial |
$12.93
|
| Rate for Payer: PHCS All Commercial |
$12.93
|
| Rate for Payer: PHP All Commercial |
$15.73
|
| Rate for Payer: PHP All Commercial |
$15.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$12.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$12.93
|
| Rate for Payer: Sagamore Health Network All Products |
$12.93
|
| Rate for Payer: Sagamore Health Network All Products |
$12.93
|
| Rate for Payer: Signature Care EPO |
$19.98
|
| Rate for Payer: Signature Care EPO |
$19.98
|
| Rate for Payer: Signature Care PPO |
$19.98
|
| Rate for Payer: Signature Care PPO |
$19.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,600.00
|
| Rate for Payer: United Healthcare Commercial |
$18.48
|
| Rate for Payer: United Healthcare Commercial |
$18.48
|
| Rate for Payer: United Healthcare Medicare |
$10.70
|
| Rate for Payer: United Healthcare Medicare |
$10.70
|
|
|
PR EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$43.92
|
|
|
Service Code
|
CPT 93244
|
| Hospital Charge Code |
z93244
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$3,400.00 |
| Rate for Payer: Aetna Commercial |
$23.54
|
| Rate for Payer: Aetna Commercial |
$23.54
|
| Rate for Payer: Aetna Medicare |
$23.54
|
| Rate for Payer: Aetna Medicare |
$23.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$23.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$23.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$23.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$23.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$23.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$23.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$23.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$23.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$25.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$25.89
|
| Rate for Payer: Cash Price |
$26.35
|
| Rate for Payer: Cash Price |
$26.26
|
| Rate for Payer: Centivo All Commercial |
$36.49
|
| Rate for Payer: Centivo All Commercial |
$36.49
|
| Rate for Payer: Cigna All Commercial |
$23.54
|
| Rate for Payer: Cigna All Commercial |
$23.54
|
| Rate for Payer: CORVEL All Commercial |
$23.54
|
| Rate for Payer: CORVEL All Commercial |
$23.54
|
| Rate for Payer: Coventry All Commercial |
$28.25
|
| Rate for Payer: Coventry All Commercial |
$28.25
|
| Rate for Payer: Encore All Commercial |
$23.54
|
| Rate for Payer: Encore All Commercial |
$23.54
|
| Rate for Payer: Frontpath All Commercial |
$26.47
|
| Rate for Payer: Frontpath All Commercial |
$26.47
|
| Rate for Payer: Humana ChoiceCare |
$32.26
|
| Rate for Payer: Humana ChoiceCare |
$32.26
|
| Rate for Payer: Humana Medicare |
$23.54
|
| Rate for Payer: Humana Medicare |
$23.54
|
| Rate for Payer: Lucent All Commercial |
$32.96
|
| Rate for Payer: Lucent All Commercial |
$32.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$36.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$36.00
|
| Rate for Payer: Managed Health Services Medicaid |
$21.52
|
| Rate for Payer: Managed Health Services Medicaid |
$21.52
|
| Rate for Payer: MDWise Medicaid |
$21.52
|
| Rate for Payer: MDWise Medicaid |
$21.52
|
| Rate for Payer: PHCS All Commercial |
$23.54
|
| Rate for Payer: PHCS All Commercial |
$23.54
|
| Rate for Payer: PHP All Commercial |
$32.29
|
| Rate for Payer: PHP All Commercial |
$32.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23.54
|
| Rate for Payer: Sagamore Health Network All Products |
$23.54
|
| Rate for Payer: Sagamore Health Network All Products |
$23.54
|
| Rate for Payer: Signature Care EPO |
$34.71
|
| Rate for Payer: Signature Care EPO |
$34.71
|
| Rate for Payer: Signature Care PPO |
$34.71
|
| Rate for Payer: Signature Care PPO |
$34.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,400.00
|
| Rate for Payer: United Healthcare Commercial |
$31.36
|
| Rate for Payer: United Healthcare Commercial |
$31.36
|
| Rate for Payer: United Healthcare Medicare |
$21.96
|
| Rate for Payer: United Healthcare Medicare |
$21.96
|
|
