|
PR EXTERNAL ECG REC>7D<15D RECORDING
|
Professional
|
Both
|
$21.80
|
|
|
Service Code
|
CPT 93246
|
| Hospital Charge Code |
z93246
|
| 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>7D<15D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$48.44
|
|
|
Service Code
|
CPT 93248
|
| Hospital Charge Code |
z93248
|
| Min. Negotiated Rate |
$23.76 |
| Max. Negotiated Rate |
$3,700.00 |
| Rate for Payer: Aetna Commercial |
$25.90
|
| Rate for Payer: Aetna Commercial |
$25.90
|
| Rate for Payer: Aetna Medicare |
$25.90
|
| Rate for Payer: Aetna Medicare |
$25.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$26.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$26.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$26.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$26.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$26.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$26.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$26.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$26.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$23.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$23.76
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$29.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$29.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$28.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$28.49
|
| Rate for Payer: Cash Price |
$29.06
|
| Rate for Payer: Cash Price |
$28.99
|
| Rate for Payer: Centivo All Commercial |
$40.15
|
| Rate for Payer: Centivo All Commercial |
$40.15
|
| Rate for Payer: Cigna All Commercial |
$25.90
|
| Rate for Payer: Cigna All Commercial |
$25.90
|
| Rate for Payer: CORVEL All Commercial |
$25.90
|
| Rate for Payer: CORVEL All Commercial |
$25.90
|
| Rate for Payer: Coventry All Commercial |
$31.08
|
| Rate for Payer: Coventry All Commercial |
$31.08
|
| Rate for Payer: Encore All Commercial |
$25.90
|
| Rate for Payer: Encore All Commercial |
$25.90
|
| Rate for Payer: Frontpath All Commercial |
$29.07
|
| Rate for Payer: Frontpath All Commercial |
$29.07
|
| Rate for Payer: Humana ChoiceCare |
$35.48
|
| Rate for Payer: Humana ChoiceCare |
$35.48
|
| Rate for Payer: Humana Medicare |
$25.90
|
| Rate for Payer: Humana Medicare |
$25.90
|
| Rate for Payer: Lucent All Commercial |
$36.26
|
| Rate for Payer: Lucent All Commercial |
$36.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$40.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$40.00
|
| Rate for Payer: Managed Health Services Medicaid |
$23.76
|
| Rate for Payer: Managed Health Services Medicaid |
$23.76
|
| Rate for Payer: MDWise Medicaid |
$23.76
|
| Rate for Payer: MDWise Medicaid |
$23.76
|
| Rate for Payer: PHCS All Commercial |
$25.90
|
| Rate for Payer: PHCS All Commercial |
$25.90
|
| Rate for Payer: PHP All Commercial |
$35.60
|
| Rate for Payer: PHP All Commercial |
$35.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25.90
|
| Rate for Payer: Sagamore Health Network All Products |
$25.90
|
| Rate for Payer: Sagamore Health Network All Products |
$25.90
|
| Rate for Payer: Signature Care EPO |
$38.17
|
| Rate for Payer: Signature Care EPO |
$38.17
|
| Rate for Payer: Signature Care PPO |
$38.17
|
| Rate for Payer: Signature Care PPO |
$38.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,700.00
|
| Rate for Payer: United Healthcare Commercial |
$34.44
|
| Rate for Payer: United Healthcare Commercial |
$34.44
|
| Rate for Payer: United Healthcare Medicare |
$24.22
|
| Rate for Payer: United Healthcare Medicare |
$24.22
|
|
|
PR EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM
|
Professional
|
Both
|
$777.76
|
|
|
Service Code
|
CPT 26111
|
| Hospital Charge Code |
z26111
|
| Min. Negotiated Rate |
$379.53 |
| Max. Negotiated Rate |
$58,400.00 |
| Rate for Payer: Aetna Commercial |
$388.05
|
| Rate for Payer: Aetna Commercial |
$388.05
|
| Rate for Payer: Aetna Medicare |
$388.05
|
| Rate for Payer: Aetna Medicare |
$388.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$481.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$481.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$481.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$481.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$481.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$481.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$481.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$481.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$382.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$382.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$446.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$446.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$426.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$426.86
|
| Rate for Payer: Cash Price |
$466.66
|
| Rate for Payer: Cash Price |
$455.44
|
| Rate for Payer: Centivo All Commercial |
$601.48
|
| Rate for Payer: Centivo All Commercial |
$601.48
|
| Rate for Payer: Cigna All Commercial |
$388.05
|
| Rate for Payer: Cigna All Commercial |
$388.05
|
| Rate for Payer: CORVEL All Commercial |
$388.05
|
| Rate for Payer: CORVEL All Commercial |
$388.05
|
| Rate for Payer: Coventry All Commercial |
$465.66
|
| Rate for Payer: Coventry All Commercial |
$465.66
|
| Rate for Payer: Encore All Commercial |
$388.05
|
| Rate for Payer: Encore All Commercial |
$388.05
|
| Rate for Payer: Frontpath All Commercial |
$536.78
|
| Rate for Payer: Frontpath All Commercial |
$536.78
|
| Rate for Payer: Humana ChoiceCare |
$430.51
|
| Rate for Payer: Humana ChoiceCare |
$430.51
|
| Rate for Payer: Humana Medicare |
$388.05
|
| Rate for Payer: Humana Medicare |
$388.05
|
| Rate for Payer: Lucent All Commercial |
$543.27
|
| Rate for Payer: Lucent All Commercial |
$543.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$622.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$622.00
|
| Rate for Payer: Managed Health Services Medicaid |
$382.54
|
| Rate for Payer: Managed Health Services Medicaid |
$382.54
|
| Rate for Payer: MDWise Medicaid |
$382.54
|
| Rate for Payer: MDWise Medicaid |
$382.54
|
| Rate for Payer: PHCS All Commercial |
$388.05
|
| Rate for Payer: PHCS All Commercial |
$388.05
|
| Rate for Payer: PHP All Commercial |
$660.38
|
| Rate for Payer: PHP All Commercial |
$660.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$388.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$388.05
|
| Rate for Payer: Sagamore Health Network All Products |
$388.05
|
| Rate for Payer: Sagamore Health Network All Products |
$388.05
|
| Rate for Payer: Signature Care EPO |
$413.10
|
| Rate for Payer: Signature Care EPO |
$413.10
|
| Rate for Payer: Signature Care PPO |
$413.10
|
| Rate for Payer: Signature Care PPO |
$413.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$58,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$58,400.00
|
| Rate for Payer: United Healthcare Commercial |
$471.41
|
| Rate for Payer: United Healthcare Commercial |
$471.41
|
| Rate for Payer: United Healthcare Medicare |
$379.53
|
| Rate for Payer: United Healthcare Medicare |
$379.53
|
|
|
PR EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM
|
Professional
|
Both
|
$999.90
|
|
|
Service Code
|
CPT 26113
|
| Hospital Charge Code |
z26113
|
| Min. Negotiated Rate |
$499.95 |
| Max. Negotiated Rate |
$76,900.00 |
| Rate for Payer: Aetna Commercial |
$510.61
|
| Rate for Payer: Aetna Commercial |
$510.61
|
| Rate for Payer: Aetna Medicare |
$510.61
|
| Rate for Payer: Aetna Medicare |
$510.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$633.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$633.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$633.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$633.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$633.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$633.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$633.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$633.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$503.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$503.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$587.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$587.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$561.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$561.67
|
| Rate for Payer: Cash Price |
$599.94
|
| Rate for Payer: Cash Price |
$614.24
|
| Rate for Payer: Centivo All Commercial |
$791.45
|
| Rate for Payer: Centivo All Commercial |
$791.45
|
| Rate for Payer: Cigna All Commercial |
$510.61
|
| Rate for Payer: Cigna All Commercial |
$510.61
|
| Rate for Payer: CORVEL All Commercial |
$510.61
|
| Rate for Payer: CORVEL All Commercial |
$510.61
|
| Rate for Payer: Coventry All Commercial |
$612.73
|
| Rate for Payer: Coventry All Commercial |
$612.73
|
| Rate for Payer: Encore All Commercial |
$510.61
|
| Rate for Payer: Encore All Commercial |
$510.61
|
| Rate for Payer: Frontpath All Commercial |
$705.69
|
| Rate for Payer: Frontpath All Commercial |
$705.69
|
| Rate for Payer: Humana ChoiceCare |
$566.65
|
| Rate for Payer: Humana ChoiceCare |
$566.65
|
| Rate for Payer: Humana Medicare |
$510.61
|
| Rate for Payer: Humana Medicare |
$510.61
|
| Rate for Payer: Lucent All Commercial |
$714.85
|
| Rate for Payer: Lucent All Commercial |
$714.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$820.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$820.00
|
| Rate for Payer: Managed Health Services Medicaid |
$503.51
|
| Rate for Payer: Managed Health Services Medicaid |
$503.51
|
| Rate for Payer: MDWise Medicaid |
$503.51
|
| Rate for Payer: MDWise Medicaid |
$503.51
|
| Rate for Payer: PHCS All Commercial |
$510.61
|
| Rate for Payer: PHCS All Commercial |
$510.61
|
| Rate for Payer: PHP All Commercial |
$869.92
|
| Rate for Payer: PHP All Commercial |
$869.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$510.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$510.61
|
| Rate for Payer: Sagamore Health Network All Products |
$510.61
|
| Rate for Payer: Sagamore Health Network All Products |
$510.61
|
| Rate for Payer: Signature Care EPO |
$543.15
|
| Rate for Payer: Signature Care EPO |
$543.15
|
| Rate for Payer: Signature Care PPO |
$543.15
|
| Rate for Payer: Signature Care PPO |
$543.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$76,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$76,900.00
|
| Rate for Payer: United Healthcare Commercial |
$619.85
|
| Rate for Payer: United Healthcare Commercial |
$619.85
|
| Rate for Payer: United Healthcare Medicare |
$499.95
|
| Rate for Payer: United Healthcare Medicare |
$499.95
|
|
|
PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$190.84
|
|
|
Service Code
|
CPT 90846
|
| Hospital Charge Code |
z90846
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$11,200.00 |
| Rate for Payer: Aetna Commercial |
$94.78
|
| Rate for Payer: Aetna Commercial |
$94.78
|
| Rate for Payer: Aetna Medicare |
$94.78
|
| Rate for Payer: Aetna Medicare |
$94.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$83.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$83.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$83.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$83.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$83.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$83.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$83.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$83.76
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$57.66
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$57.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$109.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$109.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$104.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$104.26
|
| Rate for Payer: Cash Price |
$109.19
|
| Rate for Payer: Cash Price |
$114.50
|
| Rate for Payer: Centivo All Commercial |
$146.91
|
| Rate for Payer: Centivo All Commercial |
$146.91
|
| Rate for Payer: Cigna All Commercial |
$94.78
|
| Rate for Payer: Cigna All Commercial |
$94.78
|
| Rate for Payer: CORVEL All Commercial |
$94.78
|
| Rate for Payer: CORVEL All Commercial |
$94.78
|
| Rate for Payer: Coventry All Commercial |
$113.74
|
| Rate for Payer: Coventry All Commercial |
$113.74
|
| Rate for Payer: Encore All Commercial |
$94.78
|
| Rate for Payer: Encore All Commercial |
$94.78
|
| Rate for Payer: Frontpath All Commercial |
$106.58
|
| Rate for Payer: Frontpath All Commercial |
$106.58
|
| Rate for Payer: Humana ChoiceCare |
$74.79
|
| Rate for Payer: Humana ChoiceCare |
$74.79
|
| Rate for Payer: Humana Medicare |
$94.78
|
| Rate for Payer: Humana Medicare |
$94.78
|
| Rate for Payer: Lucent All Commercial |
$132.69
|
| Rate for Payer: Lucent All Commercial |
$132.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$121.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$121.00
|
| Rate for Payer: Managed Health Services Medicaid |
$17.27
|
| Rate for Payer: Managed Health Services Medicaid |
$17.27
|
| Rate for Payer: MDWise Medicaid |
$17.27
|
| Rate for Payer: MDWise Medicaid |
$17.27
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$57.66
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$57.66
|
| Rate for Payer: PHCS All Commercial |
$94.78
|
| Rate for Payer: PHCS All Commercial |
$94.78
|
| Rate for Payer: PHP All Commercial |
$98.85
|
| Rate for Payer: PHP All Commercial |
$98.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$94.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$94.78
|
| Rate for Payer: Sagamore Health Network All Products |
$94.78
|
| Rate for Payer: Sagamore Health Network All Products |
$94.78
|
| Rate for Payer: Signature Care EPO |
$102.85
|
| Rate for Payer: Signature Care EPO |
$102.85
|
| Rate for Payer: Signature Care PPO |
$102.85
|
| Rate for Payer: Signature Care PPO |
$102.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,200.00
|
| Rate for Payer: United Healthcare Commercial |
$103.86
|
| Rate for Payer: United Healthcare Commercial |
$103.86
|
| Rate for Payer: United Healthcare Medicare |
$90.99
|
| Rate for Payer: United Healthcare Medicare |
$90.99
|
|
|
PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$200.02
|
|
|
Service Code
|
CPT 90847
|
| Hospital Charge Code |
z90847
|
| Min. Negotiated Rate |
$67.71 |
| Max. Negotiated Rate |
$11,600.00 |
| Rate for Payer: Aetna Commercial |
$98.55
|
| Rate for Payer: Aetna Commercial |
$98.55
|
| Rate for Payer: Aetna Medicare |
$98.55
|
| Rate for Payer: Aetna Medicare |
$98.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$104.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$104.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$104.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$104.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$104.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$104.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$104.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$104.16
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$67.71
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$67.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$98.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$98.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$113.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$113.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$108.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$108.41
|
| Rate for Payer: Cash Price |
$113.87
|
| Rate for Payer: Cash Price |
$120.01
|
| Rate for Payer: Centivo All Commercial |
$152.75
|
| Rate for Payer: Centivo All Commercial |
$152.75
|
| Rate for Payer: Cigna All Commercial |
$98.55
|
| Rate for Payer: Cigna All Commercial |
$98.55
|
| Rate for Payer: CORVEL All Commercial |
$98.55
|
| Rate for Payer: CORVEL All Commercial |
$98.55
|
| Rate for Payer: Coventry All Commercial |
$118.26
|
| Rate for Payer: Coventry All Commercial |
$118.26
|
| Rate for Payer: Encore All Commercial |
$98.55
|
| Rate for Payer: Encore All Commercial |
$98.55
|
| Rate for Payer: Frontpath All Commercial |
$110.74
|
| Rate for Payer: Frontpath All Commercial |
$110.74
|
| Rate for Payer: Humana ChoiceCare |
$89.64
|
| Rate for Payer: Humana ChoiceCare |
$89.64
|
| Rate for Payer: Humana Medicare |
$98.55
|
| Rate for Payer: Humana Medicare |
$98.55
|
| Rate for Payer: Lucent All Commercial |
$137.97
|
| Rate for Payer: Lucent All Commercial |
$137.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$126.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$126.00
|
| Rate for Payer: Managed Health Services Medicaid |
$98.37
|
| Rate for Payer: Managed Health Services Medicaid |
$98.37
|
| Rate for Payer: MDWise Medicaid |
$98.37
|
| Rate for Payer: MDWise Medicaid |
$98.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$67.71
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$67.71
|
| Rate for Payer: PHCS All Commercial |
$98.55
|
| Rate for Payer: PHCS All Commercial |
$98.55
|
| Rate for Payer: PHP All Commercial |
$103.11
|
| Rate for Payer: PHP All Commercial |
$103.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$98.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$98.55
|
| Rate for Payer: Sagamore Health Network All Products |
$98.55
|
| Rate for Payer: Sagamore Health Network All Products |
$98.55
|
| Rate for Payer: Signature Care EPO |
$125.80
|
| Rate for Payer: Signature Care EPO |
$125.80
|
| Rate for Payer: Signature Care PPO |
$125.80
|
| Rate for Payer: Signature Care PPO |
$125.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,600.00
|
| Rate for Payer: United Healthcare Commercial |
$124.58
|
| Rate for Payer: United Healthcare Commercial |
$124.58
|
| Rate for Payer: United Healthcare Medicare |
$94.89
|
| Rate for Payer: United Healthcare Medicare |
$94.89
|
|
|
PR FASCIOTOMY,ILIOTIBIAL,OPEN
|
Professional
|
Both
|
$903.24
|
|
|
Service Code
|
CPT 27305
|
| Hospital Charge Code |
z27305
|
| Min. Negotiated Rate |
$442.28 |
| Max. Negotiated Rate |
$68,000.00 |
| Rate for Payer: Aetna Commercial |
$451.85
|
| Rate for Payer: Aetna Commercial |
$451.85
|
| Rate for Payer: Aetna Medicare |
$451.85
|
| Rate for Payer: Aetna Medicare |
$451.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$591.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$591.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$591.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$591.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$591.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$591.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$591.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$591.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$444.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$444.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$519.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$519.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$497.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$497.04
|
| Rate for Payer: Cash Price |
$541.94
|
| Rate for Payer: Cash Price |
$530.74
|
| Rate for Payer: Centivo All Commercial |
$700.37
|
| Rate for Payer: Centivo All Commercial |
$700.37
|
| Rate for Payer: Cigna All Commercial |
$451.85
|
| Rate for Payer: Cigna All Commercial |
$451.85
|
| Rate for Payer: CORVEL All Commercial |
$451.85
|
| Rate for Payer: CORVEL All Commercial |
$451.85
|
| Rate for Payer: Coventry All Commercial |
$542.22
|
| Rate for Payer: Coventry All Commercial |
$542.22
|
| Rate for Payer: Encore All Commercial |
$451.85
|
| Rate for Payer: Encore All Commercial |
$451.85
|
| Rate for Payer: Frontpath All Commercial |
$627.15
|
| Rate for Payer: Frontpath All Commercial |
$627.15
|
| Rate for Payer: Humana ChoiceCare |
$482.93
|
| Rate for Payer: Humana ChoiceCare |
$482.93
|
| Rate for Payer: Humana Medicare |
$451.85
|
| Rate for Payer: Humana Medicare |
$451.85
|
| Rate for Payer: Lucent All Commercial |
$632.59
|
| Rate for Payer: Lucent All Commercial |
$632.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$725.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$725.00
|
| Rate for Payer: Managed Health Services Medicaid |
$444.25
|
| Rate for Payer: Managed Health Services Medicaid |
$444.25
|
| Rate for Payer: MDWise Medicaid |
$444.25
|
| Rate for Payer: MDWise Medicaid |
$444.25
|
| Rate for Payer: PHCS All Commercial |
$451.85
|
| Rate for Payer: PHCS All Commercial |
$451.85
|
| Rate for Payer: PHP All Commercial |
$769.56
|
| Rate for Payer: PHP All Commercial |
$769.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$451.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$451.85
|
| Rate for Payer: Sagamore Health Network All Products |
$451.85
|
| Rate for Payer: Sagamore Health Network All Products |
$451.85
|
| Rate for Payer: Signature Care EPO |
$655.35
|
| Rate for Payer: Signature Care EPO |
$655.35
|
| Rate for Payer: Signature Care PPO |
$655.35
|
| Rate for Payer: Signature Care PPO |
$655.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$68,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$68,000.00
|
| Rate for Payer: United Healthcare Commercial |
$500.49
|
| Rate for Payer: United Healthcare Commercial |
$500.49
|
| Rate for Payer: United Healthcare Medicare |
$442.28
|
| Rate for Payer: United Healthcare Medicare |
$442.28
|
|
|
PR FEMORAL FX, OPEN TX
|
Professional
|
Both
|
$2,195.86
|
|
|
Service Code
|
CPT 27236
|
| Hospital Charge Code |
z27236
|
| Min. Negotiated Rate |
$1,076.73 |
| Max. Negotiated Rate |
$165,500.00 |
| Rate for Payer: Aetna Commercial |
$1,108.37
|
| Rate for Payer: Aetna Commercial |
$1,108.37
|
| Rate for Payer: Aetna Medicare |
$1,108.37
|
| Rate for Payer: Aetna Medicare |
$1,108.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,514.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,514.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,514.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,514.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,514.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,514.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,514.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,514.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,080.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,080.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,274.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,274.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,219.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,219.21
|
| Rate for Payer: Cash Price |
$1,317.52
|
| Rate for Payer: Cash Price |
$1,292.08
|
| Rate for Payer: Centivo All Commercial |
$1,717.97
|
| Rate for Payer: Centivo All Commercial |
$1,717.97
|
| Rate for Payer: Cigna All Commercial |
$1,108.37
|
| Rate for Payer: Cigna All Commercial |
$1,108.37
|
| Rate for Payer: CORVEL All Commercial |
$1,108.37
|
| Rate for Payer: CORVEL All Commercial |
$1,108.37
|
| Rate for Payer: Coventry All Commercial |
$1,330.04
|
| Rate for Payer: Coventry All Commercial |
$1,330.04
|
| Rate for Payer: Encore All Commercial |
$1,108.37
|
| Rate for Payer: Encore All Commercial |
$1,108.37
|
| Rate for Payer: Frontpath All Commercial |
$1,551.03
|
| Rate for Payer: Frontpath All Commercial |
$1,551.03
|
| Rate for Payer: Humana ChoiceCare |
$1,170.03
|
| Rate for Payer: Humana ChoiceCare |
$1,170.03
|
| Rate for Payer: Humana Medicare |
$1,108.37
|
| Rate for Payer: Humana Medicare |
$1,108.37
|
| Rate for Payer: Lucent All Commercial |
$1,551.72
|
| Rate for Payer: Lucent All Commercial |
$1,551.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,766.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,766.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,080.01
|
| Rate for Payer: Managed Health Services Medicaid |
$1,080.01
|
| Rate for Payer: MDWise Medicaid |
$1,080.01
|
| Rate for Payer: MDWise Medicaid |
$1,080.01
|
| Rate for Payer: PHCS All Commercial |
$1,108.37
|
| Rate for Payer: PHCS All Commercial |
$1,108.37
|
| Rate for Payer: PHP All Commercial |
$1,873.51
|
| Rate for Payer: PHP All Commercial |
$1,873.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,108.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,108.37
|
| Rate for Payer: Sagamore Health Network All Products |
$1,108.37
|
| Rate for Payer: Sagamore Health Network All Products |
$1,108.37
|
| Rate for Payer: Signature Care EPO |
$1,560.60
|
| Rate for Payer: Signature Care EPO |
$1,560.60
|
| Rate for Payer: Signature Care PPO |
$1,560.60
|
| Rate for Payer: Signature Care PPO |
$1,560.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$165,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$165,500.00
|
| Rate for Payer: United Healthcare Commercial |
$1,302.09
|
| Rate for Payer: United Healthcare Commercial |
$1,302.09
|
| Rate for Payer: United Healthcare Medicare |
$1,076.73
|
| Rate for Payer: United Healthcare Medicare |
$1,076.73
|
|
|
PR FEMUR/KNEE SURG UNLISTED
|
Professional
|
Both
|
$1,026.30
|
|
|
Service Code
|
CPT 27599
|
| Hospital Charge Code |
z27599
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$872.36 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$0.01
|
| Rate for Payer: Cash Price |
$615.78
|
| Rate for Payer: Cash Price |
$615.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$872.36
|
| Rate for Payer: Signature Care EPO |
$654.27
|
| Rate for Payer: Signature Care PPO |
$654.27
|
|
|
PR FETAL CONTRACTN STRESS TEST
|
Professional
|
Both
|
$129.88
|
|
|
Service Code
|
CPT 59020
|
| Hospital Charge Code |
z59020
|
| Min. Negotiated Rate |
$56.09 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Aetna Commercial |
$64.21
|
| Rate for Payer: Aetna Commercial |
$64.21
|
| Rate for Payer: Aetna Medicare |
$64.21
|
| Rate for Payer: Aetna Medicare |
$64.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$83.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$83.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$83.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$83.21
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$83.21
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$83.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$83.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$83.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$63.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$63.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$73.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$73.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$70.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$70.63
|
| Rate for Payer: Cash Price |
$75.30
|
| Rate for Payer: Cash Price |
$77.93
|
| Rate for Payer: Centivo All Commercial |
$99.53
|
| Rate for Payer: Centivo All Commercial |
$99.53
|
| Rate for Payer: Cigna All Commercial |
$64.21
|
| Rate for Payer: Cigna All Commercial |
$64.21
|
| Rate for Payer: CORVEL All Commercial |
$64.21
|
| Rate for Payer: CORVEL All Commercial |
$64.21
|
| Rate for Payer: Coventry All Commercial |
$77.05
|
| Rate for Payer: Coventry All Commercial |
$77.05
|
| Rate for Payer: Encore All Commercial |
$64.21
|
| Rate for Payer: Encore All Commercial |
$64.21
|
| Rate for Payer: Frontpath All Commercial |
$88.19
|
| Rate for Payer: Frontpath All Commercial |
$88.19
|
| Rate for Payer: Humana ChoiceCare |
$56.09
|
| Rate for Payer: Humana ChoiceCare |
$56.09
|
| Rate for Payer: Humana Medicare |
$64.21
|
| Rate for Payer: Humana Medicare |
$64.21
|
| Rate for Payer: Lucent All Commercial |
$89.89
|
| Rate for Payer: Lucent All Commercial |
$89.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$90.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$90.00
|
| Rate for Payer: Managed Health Services Medicaid |
$63.88
|
| Rate for Payer: Managed Health Services Medicaid |
$63.88
|
| Rate for Payer: MDWise Medicaid |
$63.88
|
| Rate for Payer: MDWise Medicaid |
$63.88
|
| Rate for Payer: PHCS All Commercial |
$64.21
|
| Rate for Payer: PHCS All Commercial |
$64.21
|
| Rate for Payer: PHP All Commercial |
$82.83
|
| Rate for Payer: PHP All Commercial |
$82.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$64.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$64.21
|
| Rate for Payer: Sagamore Health Network All Products |
$64.21
|
| Rate for Payer: Sagamore Health Network All Products |
$64.21
|
| Rate for Payer: Signature Care EPO |
$73.10
|
| Rate for Payer: Signature Care EPO |
$73.10
|
| Rate for Payer: Signature Care PPO |
$73.10
|
| Rate for Payer: Signature Care PPO |
$73.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,400.00
|
| Rate for Payer: United Healthcare Commercial |
$77.75
|
| Rate for Payer: United Healthcare Commercial |
$77.75
|
|
|
PR FETAL NON-STRESS TEST
|
Professional
|
Both
|
$89.52
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
z59025
|
| Min. Negotiated Rate |
$37.67 |
| Max. Negotiated Rate |
$5,800.00 |
| Rate for Payer: Aetna Commercial |
$44.25
|
| Rate for Payer: Aetna Commercial |
$44.25
|
| Rate for Payer: Aetna Medicare |
$44.25
|
| Rate for Payer: Aetna Medicare |
$44.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$54.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$54.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$54.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$54.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$54.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$54.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$54.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$54.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$44.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$44.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.67
|
| Rate for Payer: Cash Price |
$52.39
|
| Rate for Payer: Cash Price |
$53.71
|
| Rate for Payer: Centivo All Commercial |
$68.59
|
| Rate for Payer: Centivo All Commercial |
$68.59
|
| Rate for Payer: Cigna All Commercial |
$44.25
|
| Rate for Payer: Cigna All Commercial |
$44.25
|
| Rate for Payer: CORVEL All Commercial |
$44.25
|
| Rate for Payer: CORVEL All Commercial |
$44.25
|
| Rate for Payer: Coventry All Commercial |
$53.10
|
| Rate for Payer: Coventry All Commercial |
$53.10
|
| Rate for Payer: Encore All Commercial |
$44.25
|
| Rate for Payer: Encore All Commercial |
$44.25
|
| Rate for Payer: Frontpath All Commercial |
$60.43
|
| Rate for Payer: Frontpath All Commercial |
$60.43
|
| Rate for Payer: Humana ChoiceCare |
$37.67
|
| Rate for Payer: Humana ChoiceCare |
$37.67
|
| Rate for Payer: Humana Medicare |
$44.25
|
| Rate for Payer: Humana Medicare |
$44.25
|
| Rate for Payer: Lucent All Commercial |
$61.95
|
| Rate for Payer: Lucent All Commercial |
$61.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$63.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$63.00
|
| Rate for Payer: Managed Health Services Medicaid |
$44.03
|
| Rate for Payer: Managed Health Services Medicaid |
$44.03
|
| Rate for Payer: MDWise Medicaid |
$44.03
|
| Rate for Payer: MDWise Medicaid |
$44.03
|
| Rate for Payer: PHCS All Commercial |
$44.25
|
| Rate for Payer: PHCS All Commercial |
$44.25
|
| Rate for Payer: PHP All Commercial |
$57.63
|
| Rate for Payer: PHP All Commercial |
$57.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.25
|
| Rate for Payer: Sagamore Health Network All Products |
$44.25
|
| Rate for Payer: Sagamore Health Network All Products |
$44.25
|
| Rate for Payer: Signature Care EPO |
$49.30
|
| Rate for Payer: Signature Care EPO |
$49.30
|
| Rate for Payer: Signature Care PPO |
$49.30
|
| Rate for Payer: Signature Care PPO |
$49.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,800.00
|
| Rate for Payer: United Healthcare Commercial |
$51.95
|
| Rate for Payer: United Healthcare Commercial |
$51.95
|
|
|
PR FILTERED SPEECH HEARING TEST
|
Professional
|
Both
|
$56.80
|
|
|
Service Code
|
CPT 92571
|
| Hospital Charge Code |
z92571
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$3,300.00 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$26.01
|
| Rate for Payer: Aetna Medicare |
$26.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$15.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$15.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$15.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$15.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$15.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$15.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$27.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$27.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$29.91
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$29.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$28.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$28.61
|
| Rate for Payer: Cash Price |
$34.08
|
| Rate for Payer: Cash Price |
$32.35
|
| Rate for Payer: Centivo All Commercial |
$40.32
|
| Rate for Payer: Centivo All Commercial |
$40.32
|
| Rate for Payer: Cigna All Commercial |
$26.01
|
| Rate for Payer: Cigna All Commercial |
$26.01
|
| Rate for Payer: CORVEL All Commercial |
$26.01
|
| Rate for Payer: CORVEL All Commercial |
$26.01
|
| Rate for Payer: Coventry All Commercial |
$31.21
|
| Rate for Payer: Coventry All Commercial |
$31.21
|
| Rate for Payer: Encore All Commercial |
$26.01
|
| Rate for Payer: Encore All Commercial |
$26.01
|
| Rate for Payer: Frontpath All Commercial |
$29.26
|
| Rate for Payer: Frontpath All Commercial |
$29.26
|
| Rate for Payer: Humana ChoiceCare |
$16.44
|
| Rate for Payer: Humana ChoiceCare |
$16.44
|
| Rate for Payer: Humana Medicare |
$26.01
|
| Rate for Payer: Humana Medicare |
$26.01
|
| Rate for Payer: Lucent All Commercial |
$36.41
|
| Rate for Payer: Lucent All Commercial |
$36.41
|
| 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 |
$27.93
|
| Rate for Payer: Managed Health Services Medicaid |
$27.93
|
| Rate for Payer: MDWise Medicaid |
$27.93
|
| Rate for Payer: MDWise Medicaid |
$27.93
|
| Rate for Payer: PHCS All Commercial |
$26.01
|
| Rate for Payer: PHCS All Commercial |
$26.01
|
| Rate for Payer: PHP All Commercial |
$39.10
|
| Rate for Payer: PHP All Commercial |
$39.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$26.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$26.01
|
| Rate for Payer: Sagamore Health Network All Products |
$26.01
|
| Rate for Payer: Sagamore Health Network All Products |
$26.01
|
| Rate for Payer: Signature Care EPO |
$22.11
|
| Rate for Payer: Signature Care EPO |
$22.11
|
| Rate for Payer: Signature Care PPO |
$22.11
|
| Rate for Payer: Signature Care PPO |
$22.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,300.00
|
| Rate for Payer: United Healthcare Commercial |
$18.05
|
| Rate for Payer: United Healthcare Commercial |
$18.05
|
| Rate for Payer: United Healthcare Medicare |
$26.96
|
| Rate for Payer: United Healthcare Medicare |
$26.96
|
|
|
PR FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION
|
Professional
|
Both
|
$187.88
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
z10021
|
| Min. Negotiated Rate |
$49.77 |
| Max. Negotiated Rate |
$6,200.00 |
| Rate for Payer: Aetna Commercial |
$51.59
|
| Rate for Payer: Aetna Commercial |
$51.59
|
| Rate for Payer: Aetna Medicare |
$51.59
|
| Rate for Payer: Aetna Medicare |
$51.59
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$142.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$142.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$142.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$142.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$142.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$142.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$142.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$142.98
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$49.77
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$49.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$92.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$92.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.75
|
| Rate for Payer: Cash Price |
$111.44
|
| Rate for Payer: Cash Price |
$112.73
|
| Rate for Payer: Centivo All Commercial |
$79.96
|
| Rate for Payer: Centivo All Commercial |
$79.96
|
| Rate for Payer: Cigna All Commercial |
$51.59
|
| Rate for Payer: Cigna All Commercial |
$51.59
|
| Rate for Payer: CORVEL All Commercial |
$51.59
|
| Rate for Payer: CORVEL All Commercial |
$51.59
|
| Rate for Payer: Coventry All Commercial |
$61.91
|
| Rate for Payer: Coventry All Commercial |
$61.91
|
| Rate for Payer: Encore All Commercial |
$51.59
|
| Rate for Payer: Encore All Commercial |
$51.59
|
| Rate for Payer: Frontpath All Commercial |
$70.73
|
| Rate for Payer: Frontpath All Commercial |
$70.73
|
| Rate for Payer: Humana ChoiceCare |
$68.32
|
| Rate for Payer: Humana ChoiceCare |
$68.32
|
| Rate for Payer: Humana Medicare |
$51.59
|
| Rate for Payer: Humana Medicare |
$51.59
|
| Rate for Payer: Lucent All Commercial |
$72.23
|
| Rate for Payer: Lucent All Commercial |
$72.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Managed Health Services Medicaid |
$92.41
|
| Rate for Payer: Managed Health Services Medicaid |
$92.41
|
| Rate for Payer: MDWise Medicaid |
$92.41
|
| Rate for Payer: MDWise Medicaid |
$92.41
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$49.77
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$49.77
|
| Rate for Payer: PHCS All Commercial |
$51.59
|
| Rate for Payer: PHCS All Commercial |
$51.59
|
| Rate for Payer: PHP All Commercial |
$70.15
|
| Rate for Payer: PHP All Commercial |
$70.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.59
|
| Rate for Payer: Sagamore Health Network All Products |
$51.59
|
| Rate for Payer: Sagamore Health Network All Products |
$51.59
|
| Rate for Payer: Signature Care EPO |
$139.40
|
| Rate for Payer: Signature Care EPO |
$139.40
|
| Rate for Payer: Signature Care PPO |
$139.40
|
| Rate for Payer: Signature Care PPO |
$139.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,200.00
|
| Rate for Payer: United Healthcare Commercial |
$77.75
|
| Rate for Payer: United Healthcare Commercial |
$77.75
|
| Rate for Payer: United Healthcare Medicare |
$92.87
|
| Rate for Payer: United Healthcare Medicare |
$92.87
|
|
|
PR FIT/INSERT INTRAVAG SUPPORT DEVICE
|
Professional
|
Both
|
$138.04
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
z57160
|
| Min. Negotiated Rate |
$31.66 |
| Max. Negotiated Rate |
$5,600.00 |
| Rate for Payer: Aetna Commercial |
$43.01
|
| Rate for Payer: Aetna Commercial |
$43.01
|
| Rate for Payer: Aetna Medicare |
$43.01
|
| Rate for Payer: Aetna Medicare |
$43.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$97.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$97.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$97.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$97.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$97.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$97.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$97.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$97.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$31.66
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$31.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$67.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$67.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.31
|
| Rate for Payer: Cash Price |
$81.68
|
| Rate for Payer: Cash Price |
$82.82
|
| Rate for Payer: Centivo All Commercial |
$66.67
|
| Rate for Payer: Centivo All Commercial |
$66.67
|
| Rate for Payer: Cigna All Commercial |
$43.01
|
| Rate for Payer: Cigna All Commercial |
$43.01
|
| Rate for Payer: CORVEL All Commercial |
$43.01
|
| Rate for Payer: CORVEL All Commercial |
$43.01
|
| Rate for Payer: Coventry All Commercial |
$51.61
|
| Rate for Payer: Coventry All Commercial |
$51.61
|
| Rate for Payer: Encore All Commercial |
$43.01
|
| Rate for Payer: Encore All Commercial |
$43.01
|
| Rate for Payer: Frontpath All Commercial |
$59.50
|
| Rate for Payer: Frontpath All Commercial |
$59.50
|
| Rate for Payer: Humana ChoiceCare |
$55.06
|
| Rate for Payer: Humana ChoiceCare |
$55.06
|
| Rate for Payer: Humana Medicare |
$43.01
|
| Rate for Payer: Humana Medicare |
$43.01
|
| Rate for Payer: Lucent All Commercial |
$60.21
|
| Rate for Payer: Lucent All Commercial |
$60.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$60.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$60.00
|
| Rate for Payer: Managed Health Services Medicaid |
$67.90
|
| Rate for Payer: Managed Health Services Medicaid |
$67.90
|
| Rate for Payer: MDWise Medicaid |
$67.90
|
| Rate for Payer: MDWise Medicaid |
$67.90
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$31.66
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$31.66
|
| Rate for Payer: PHCS All Commercial |
$43.01
|
| Rate for Payer: PHCS All Commercial |
$43.01
|
| Rate for Payer: PHP All Commercial |
$55.26
|
| Rate for Payer: PHP All Commercial |
$55.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.01
|
| Rate for Payer: Sagamore Health Network All Products |
$43.01
|
| Rate for Payer: Sagamore Health Network All Products |
$43.01
|
| Rate for Payer: Signature Care EPO |
$96.05
|
| Rate for Payer: Signature Care EPO |
$96.05
|
| Rate for Payer: Signature Care PPO |
$96.05
|
| Rate for Payer: Signature Care PPO |
$96.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,600.00
|
| Rate for Payer: United Healthcare Commercial |
$54.83
|
| Rate for Payer: United Healthcare Commercial |
$54.83
|
| Rate for Payer: United Healthcare Medicare |
$68.07
|
| Rate for Payer: United Healthcare Medicare |
$68.07
|
|
|
PR FIX INFRAPATELLA TENDON,PRIMARY
|
Professional
|
Both
|
$1,160.40
|
|
|
Service Code
|
CPT 27380
|
| Hospital Charge Code |
z27380
|
| Min. Negotiated Rate |
$569.82 |
| Max. Negotiated Rate |
$87,600.00 |
| Rate for Payer: Aetna Commercial |
$585.31
|
| Rate for Payer: Aetna Commercial |
$585.31
|
| Rate for Payer: Aetna Medicare |
$585.31
|
| Rate for Payer: Aetna Medicare |
$585.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$744.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$744.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$744.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$744.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$744.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$744.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$744.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$744.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$570.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$570.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$673.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$673.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$643.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$643.84
|
| Rate for Payer: Cash Price |
$696.24
|
| Rate for Payer: Cash Price |
$683.78
|
| Rate for Payer: Centivo All Commercial |
$907.23
|
| Rate for Payer: Centivo All Commercial |
$907.23
|
| Rate for Payer: Cigna All Commercial |
$585.31
|
| Rate for Payer: Cigna All Commercial |
$585.31
|
| Rate for Payer: CORVEL All Commercial |
$585.31
|
| Rate for Payer: CORVEL All Commercial |
$585.31
|
| Rate for Payer: Coventry All Commercial |
$702.37
|
| Rate for Payer: Coventry All Commercial |
$702.37
|
| Rate for Payer: Encore All Commercial |
$585.31
|
| Rate for Payer: Encore All Commercial |
$585.31
|
| Rate for Payer: Frontpath All Commercial |
$809.04
|
| Rate for Payer: Frontpath All Commercial |
$809.04
|
| Rate for Payer: Humana ChoiceCare |
$624.50
|
| Rate for Payer: Humana ChoiceCare |
$624.50
|
| Rate for Payer: Humana Medicare |
$585.31
|
| Rate for Payer: Humana Medicare |
$585.31
|
| Rate for Payer: Lucent All Commercial |
$819.43
|
| Rate for Payer: Lucent All Commercial |
$819.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$934.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$934.00
|
| Rate for Payer: Managed Health Services Medicaid |
$570.73
|
| Rate for Payer: Managed Health Services Medicaid |
$570.73
|
| Rate for Payer: MDWise Medicaid |
$570.73
|
| Rate for Payer: MDWise Medicaid |
$570.73
|
| Rate for Payer: PHCS All Commercial |
$585.31
|
| Rate for Payer: PHCS All Commercial |
$585.31
|
| Rate for Payer: PHP All Commercial |
$991.49
|
| Rate for Payer: PHP All Commercial |
$991.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$585.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$585.31
|
| Rate for Payer: Sagamore Health Network All Products |
$585.31
|
| Rate for Payer: Sagamore Health Network All Products |
$585.31
|
| Rate for Payer: Signature Care EPO |
$835.55
|
| Rate for Payer: Signature Care EPO |
$835.55
|
| Rate for Payer: Signature Care PPO |
$835.55
|
| Rate for Payer: Signature Care PPO |
$835.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,600.00
|
| Rate for Payer: United Healthcare Commercial |
$631.75
|
| Rate for Payer: United Healthcare Commercial |
$631.75
|
| Rate for Payer: United Healthcare Medicare |
$569.82
|
| Rate for Payer: United Healthcare Medicare |
$569.82
|
|
|
PR FIX QUAD/HAMSTR MUSC RUPT,PRIMARY
|
Professional
|
Both
|
$1,133.24
|
|
|
Service Code
|
CPT 27385
|
| Hospital Charge Code |
z27385
|
| Min. Negotiated Rate |
$554.95 |
| Max. Negotiated Rate |
$85,300.00 |
| Rate for Payer: Aetna Commercial |
$570.22
|
| Rate for Payer: Aetna Commercial |
$570.22
|
| Rate for Payer: Aetna Medicare |
$570.22
|
| Rate for Payer: Aetna Medicare |
$570.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$802.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$557.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$557.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$655.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$655.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$627.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$627.24
|
| Rate for Payer: Cash Price |
$679.94
|
| Rate for Payer: Cash Price |
$665.94
|
| Rate for Payer: Centivo All Commercial |
$883.84
|
| Rate for Payer: Centivo All Commercial |
$883.84
|
| Rate for Payer: Cigna All Commercial |
$570.22
|
| Rate for Payer: Cigna All Commercial |
$570.22
|
| Rate for Payer: CORVEL All Commercial |
$570.22
|
| Rate for Payer: CORVEL All Commercial |
$570.22
|
| Rate for Payer: Coventry All Commercial |
$684.26
|
| Rate for Payer: Coventry All Commercial |
$684.26
|
| Rate for Payer: Encore All Commercial |
$570.22
|
| Rate for Payer: Encore All Commercial |
$570.22
|
| Rate for Payer: Frontpath All Commercial |
$786.40
|
| Rate for Payer: Frontpath All Commercial |
$786.40
|
| Rate for Payer: Humana ChoiceCare |
$666.82
|
| Rate for Payer: Humana ChoiceCare |
$666.82
|
| Rate for Payer: Humana Medicare |
$570.22
|
| Rate for Payer: Humana Medicare |
$570.22
|
| Rate for Payer: Lucent All Commercial |
$798.31
|
| Rate for Payer: Lucent All Commercial |
$798.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$910.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$910.00
|
| Rate for Payer: Managed Health Services Medicaid |
$557.38
|
| Rate for Payer: Managed Health Services Medicaid |
$557.38
|
| Rate for Payer: MDWise Medicaid |
$557.38
|
| Rate for Payer: MDWise Medicaid |
$557.38
|
| Rate for Payer: PHCS All Commercial |
$570.22
|
| Rate for Payer: PHCS All Commercial |
$570.22
|
| Rate for Payer: PHP All Commercial |
$965.61
|
| Rate for Payer: PHP All Commercial |
$965.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$570.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$570.22
|
| Rate for Payer: Sagamore Health Network All Products |
$570.22
|
| Rate for Payer: Sagamore Health Network All Products |
$570.22
|
| Rate for Payer: Signature Care EPO |
$891.65
|
| Rate for Payer: Signature Care EPO |
$891.65
|
| Rate for Payer: Signature Care PPO |
$891.65
|
| Rate for Payer: Signature Care PPO |
$891.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$85,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$85,300.00
|
| Rate for Payer: United Healthcare Commercial |
$677.16
|
| Rate for Payer: United Healthcare Commercial |
$677.16
|
| Rate for Payer: United Healthcare Medicare |
$554.95
|
| Rate for Payer: United Healthcare Medicare |
$554.95
|
|
|
PR FOOT/TOES SURGERY PROC UNLISTED
|
Professional
|
Both
|
$508.53
|
|
|
Service Code
|
CPT 28899
|
| Hospital Charge Code |
z28899
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$432.25 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$0.01
|
| Rate for Payer: Cash Price |
$305.12
|
| Rate for Payer: Cash Price |
$305.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$432.25
|
| Rate for Payer: Signature Care EPO |
$324.19
|
| Rate for Payer: Signature Care PPO |
$324.19
|
|
|
PR FOREARM/WRIST SURGERY UNLISTED
|
Professional
|
Both
|
$805.13
|
|
|
Service Code
|
CPT 25999
|
| Hospital Charge Code |
z25999
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$684.36 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$0.01
|
| Rate for Payer: Cash Price |
$483.08
|
| Rate for Payer: Cash Price |
$483.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$684.36
|
| Rate for Payer: Signature Care EPO |
$513.27
|
| Rate for Payer: Signature Care PPO |
$513.27
|
|
|
PR FORM SKIN PEDICLE FLAP FACE,GEN,HAND
|
Professional
|
Both
|
$1,644.04
|
|
|
Service Code
|
CPT 15574
|
| Hospital Charge Code |
z15574
|
| Min. Negotiated Rate |
$376.34 |
| Max. Negotiated Rate |
$82,200.00 |
| Rate for Payer: Aetna Commercial |
$689.91
|
| Rate for Payer: Aetna Commercial |
$689.91
|
| Rate for Payer: Aetna Medicare |
$689.91
|
| Rate for Payer: Aetna Medicare |
$689.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$912.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$912.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$912.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$912.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$912.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$912.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$912.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$912.73
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$376.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$376.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$808.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$808.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$793.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$793.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$758.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$758.90
|
| Rate for Payer: Cash Price |
$959.56
|
| Rate for Payer: Cash Price |
$986.42
|
| Rate for Payer: Centivo All Commercial |
$1,069.36
|
| Rate for Payer: Centivo All Commercial |
$1,069.36
|
| Rate for Payer: Cigna All Commercial |
$689.91
|
| Rate for Payer: Cigna All Commercial |
$689.91
|
| Rate for Payer: CORVEL All Commercial |
$689.91
|
| Rate for Payer: CORVEL All Commercial |
$689.91
|
| Rate for Payer: Coventry All Commercial |
$827.89
|
| Rate for Payer: Coventry All Commercial |
$827.89
|
| Rate for Payer: Encore All Commercial |
$689.91
|
| Rate for Payer: Encore All Commercial |
$689.91
|
| Rate for Payer: Frontpath All Commercial |
$948.52
|
| Rate for Payer: Frontpath All Commercial |
$948.52
|
| Rate for Payer: Humana ChoiceCare |
$662.03
|
| Rate for Payer: Humana ChoiceCare |
$662.03
|
| Rate for Payer: Humana Medicare |
$689.91
|
| Rate for Payer: Humana Medicare |
$689.91
|
| Rate for Payer: Lucent All Commercial |
$965.87
|
| Rate for Payer: Lucent All Commercial |
$965.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$891.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$891.00
|
| Rate for Payer: Managed Health Services Medicaid |
$808.60
|
| Rate for Payer: Managed Health Services Medicaid |
$808.60
|
| Rate for Payer: MDWise Medicaid |
$808.60
|
| Rate for Payer: MDWise Medicaid |
$808.60
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$376.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$376.34
|
| Rate for Payer: PHCS All Commercial |
$689.91
|
| Rate for Payer: PHCS All Commercial |
$689.91
|
| Rate for Payer: PHP All Commercial |
$936.06
|
| Rate for Payer: PHP All Commercial |
$936.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$689.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$689.91
|
| Rate for Payer: Sagamore Health Network All Products |
$689.91
|
| Rate for Payer: Sagamore Health Network All Products |
$689.91
|
| Rate for Payer: Signature Care EPO |
$774.35
|
| Rate for Payer: Signature Care EPO |
$774.35
|
| Rate for Payer: Signature Care PPO |
$774.35
|
| Rate for Payer: Signature Care PPO |
$774.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$82,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$82,200.00
|
| Rate for Payer: United Healthcare Commercial |
$819.98
|
| Rate for Payer: United Healthcare Commercial |
$819.98
|
| Rate for Payer: United Healthcare Medicare |
$799.63
|
| Rate for Payer: United Healthcare Medicare |
$799.63
|
|
|
PR FRAGMENT KIDNEY STONE/ ESWL
|
Professional
|
Both
|
$1,338.00
|
|
|
Service Code
|
CPT 50590
|
| Hospital Charge Code |
z50590
|
| Min. Negotiated Rate |
$348.52 |
| Max. Negotiated Rate |
$832.27 |
| Rate for Payer: Aetna Commercial |
$536.95
|
| Rate for Payer: Aetna Medicare |
$536.95
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$348.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$679.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$617.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$590.64
|
| Rate for Payer: Cash Price |
$802.80
|
| Rate for Payer: Centivo All Commercial |
$832.27
|
| Rate for Payer: Cigna All Commercial |
$536.95
|
| Rate for Payer: CORVEL All Commercial |
$536.95
|
| Rate for Payer: Coventry All Commercial |
$644.34
|
| Rate for Payer: Encore All Commercial |
$536.95
|
| Rate for Payer: Frontpath All Commercial |
$734.53
|
| Rate for Payer: Humana ChoiceCare |
$500.28
|
| Rate for Payer: Humana Medicare |
$536.95
|
| Rate for Payer: Lucent All Commercial |
$751.73
|
| Rate for Payer: Managed Health Services Medicaid |
$679.67
|
| Rate for Payer: MDWise Medicaid |
$679.67
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$348.52
|
| Rate for Payer: PHCS All Commercial |
$536.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$536.95
|
| Rate for Payer: Sagamore Health Network All Products |
$536.95
|
| Rate for Payer: United Healthcare Commercial |
$694.26
|
| Rate for Payer: United Healthcare Medicare |
$675.39
|
|
|
PR FREEING BOWEL ADHESION,ENTEROLYSIS
|
Professional
|
Both
|
$1,973.34
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
z44005
|
| Min. Negotiated Rate |
$970.56 |
| Max. Negotiated Rate |
$139,400.00 |
| Rate for Payer: Aetna Commercial |
$1,011.13
|
| Rate for Payer: Aetna Commercial |
$1,011.13
|
| Rate for Payer: Aetna Medicare |
$1,011.13
|
| Rate for Payer: Aetna Medicare |
$1,011.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,079.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,079.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,079.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,079.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,079.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,079.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,079.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,079.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$970.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$970.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,162.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,162.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,112.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,112.24
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cash Price |
$1,165.99
|
| Rate for Payer: Centivo All Commercial |
$1,567.25
|
| Rate for Payer: Centivo All Commercial |
$1,567.25
|
| Rate for Payer: Cigna All Commercial |
$1,011.13
|
| Rate for Payer: Cigna All Commercial |
$1,011.13
|
| Rate for Payer: CORVEL All Commercial |
$1,011.13
|
| Rate for Payer: CORVEL All Commercial |
$1,011.13
|
| Rate for Payer: Coventry All Commercial |
$1,213.36
|
| Rate for Payer: Coventry All Commercial |
$1,213.36
|
| Rate for Payer: Encore All Commercial |
$1,011.13
|
| Rate for Payer: Encore All Commercial |
$1,011.13
|
| Rate for Payer: Frontpath All Commercial |
$1,445.21
|
| Rate for Payer: Frontpath All Commercial |
$1,445.21
|
| Rate for Payer: Humana ChoiceCare |
$1,054.26
|
| Rate for Payer: Humana ChoiceCare |
$1,054.26
|
| Rate for Payer: Humana Medicare |
$1,011.13
|
| Rate for Payer: Humana Medicare |
$1,011.13
|
| Rate for Payer: Lucent All Commercial |
$1,415.58
|
| Rate for Payer: Lucent All Commercial |
$1,415.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,494.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,494.00
|
| Rate for Payer: Managed Health Services Medicaid |
$970.56
|
| Rate for Payer: Managed Health Services Medicaid |
$970.56
|
| Rate for Payer: MDWise Medicaid |
$970.56
|
| Rate for Payer: MDWise Medicaid |
$970.56
|
| Rate for Payer: PHCS All Commercial |
$1,011.13
|
| Rate for Payer: PHCS All Commercial |
$1,011.13
|
| Rate for Payer: PHP All Commercial |
$1,700.41
|
| Rate for Payer: PHP All Commercial |
$1,700.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,011.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,011.13
|
| Rate for Payer: Sagamore Health Network All Products |
$1,011.13
|
| Rate for Payer: Sagamore Health Network All Products |
$1,011.13
|
| Rate for Payer: Signature Care EPO |
$1,326.85
|
| Rate for Payer: Signature Care EPO |
$1,326.85
|
| Rate for Payer: Signature Care PPO |
$1,326.85
|
| Rate for Payer: Signature Care PPO |
$1,326.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$139,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$139,400.00
|
| Rate for Payer: United Healthcare Commercial |
$1,170.19
|
| Rate for Payer: United Healthcare Commercial |
$1,170.19
|
| Rate for Payer: United Healthcare Medicare |
$971.66
|
| Rate for Payer: United Healthcare Medicare |
$971.66
|
|
|
PR FTH/GF FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20SQCM/<
|
Professional
|
Both
|
$1,731.48
|
|
|
Service Code
|
CPT 15240
|
| Hospital Charge Code |
z15240
|
| Min. Negotiated Rate |
$402.13 |
| Max. Negotiated Rate |
$88,900.00 |
| Rate for Payer: Aetna Commercial |
$739.07
|
| Rate for Payer: Aetna Commercial |
$739.07
|
| Rate for Payer: Aetna Medicare |
$739.07
|
| Rate for Payer: Aetna Medicare |
$739.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$925.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$925.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$925.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$925.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$925.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$925.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$925.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$925.61
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$402.13
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$402.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$851.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$851.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$849.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$849.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$812.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$812.98
|
| Rate for Payer: Cash Price |
$1,016.90
|
| Rate for Payer: Cash Price |
$1,038.89
|
| Rate for Payer: Centivo All Commercial |
$1,145.56
|
| Rate for Payer: Centivo All Commercial |
$1,145.56
|
| Rate for Payer: Cigna All Commercial |
$739.07
|
| Rate for Payer: Cigna All Commercial |
$739.07
|
| Rate for Payer: CORVEL All Commercial |
$739.07
|
| Rate for Payer: CORVEL All Commercial |
$739.07
|
| Rate for Payer: Coventry All Commercial |
$886.88
|
| Rate for Payer: Coventry All Commercial |
$886.88
|
| Rate for Payer: Encore All Commercial |
$739.07
|
| Rate for Payer: Encore All Commercial |
$739.07
|
| Rate for Payer: Frontpath All Commercial |
$1,006.54
|
| Rate for Payer: Frontpath All Commercial |
$1,006.54
|
| Rate for Payer: Humana ChoiceCare |
$631.07
|
| Rate for Payer: Humana ChoiceCare |
$631.07
|
| Rate for Payer: Humana Medicare |
$739.07
|
| Rate for Payer: Humana Medicare |
$739.07
|
| Rate for Payer: Lucent All Commercial |
$1,034.70
|
| Rate for Payer: Lucent All Commercial |
$1,034.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$963.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$963.00
|
| Rate for Payer: Managed Health Services Medicaid |
$851.61
|
| Rate for Payer: Managed Health Services Medicaid |
$851.61
|
| Rate for Payer: MDWise Medicaid |
$851.61
|
| Rate for Payer: MDWise Medicaid |
$851.61
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$402.13
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$402.13
|
| Rate for Payer: PHCS All Commercial |
$739.07
|
| Rate for Payer: PHCS All Commercial |
$739.07
|
| Rate for Payer: PHP All Commercial |
$1,012.25
|
| Rate for Payer: PHP All Commercial |
$1,012.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$739.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$739.07
|
| Rate for Payer: Sagamore Health Network All Products |
$739.07
|
| Rate for Payer: Sagamore Health Network All Products |
$739.07
|
| Rate for Payer: Signature Care EPO |
$788.80
|
| Rate for Payer: Signature Care EPO |
$788.80
|
| Rate for Payer: Signature Care PPO |
$788.80
|
| Rate for Payer: Signature Care PPO |
$788.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$88,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$88,900.00
|
| Rate for Payer: United Healthcare Commercial |
$846.64
|
| Rate for Payer: United Healthcare Commercial |
$846.64
|
| Rate for Payer: United Healthcare Medicare |
$847.42
|
| Rate for Payer: United Healthcare Medicare |
$847.42
|
|
|
PR FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<
|
Professional
|
Both
|
$1,867.60
|
|
|
Service Code
|
CPT 15260
|
| Hospital Charge Code |
z15260
|
| Min. Negotiated Rate |
$426.52 |
| Max. Negotiated Rate |
$94,900.00 |
| Rate for Payer: Aetna Commercial |
$788.15
|
| Rate for Payer: Aetna Commercial |
$788.15
|
| Rate for Payer: Aetna Medicare |
$788.15
|
| Rate for Payer: Aetna Medicare |
$788.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$896.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$896.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$896.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$896.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$896.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$896.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$896.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$896.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$426.52
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$426.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$918.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$918.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$906.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$906.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$866.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$866.97
|
| Rate for Payer: Cash Price |
$1,096.39
|
| Rate for Payer: Cash Price |
$1,120.56
|
| Rate for Payer: Centivo All Commercial |
$1,221.63
|
| Rate for Payer: Centivo All Commercial |
$1,221.63
|
| Rate for Payer: Cigna All Commercial |
$788.15
|
| Rate for Payer: Cigna All Commercial |
$788.15
|
| Rate for Payer: CORVEL All Commercial |
$788.15
|
| Rate for Payer: CORVEL All Commercial |
$788.15
|
| Rate for Payer: Coventry All Commercial |
$945.78
|
| Rate for Payer: Coventry All Commercial |
$945.78
|
| Rate for Payer: Encore All Commercial |
$788.15
|
| Rate for Payer: Encore All Commercial |
$788.15
|
| Rate for Payer: Frontpath All Commercial |
$1,068.78
|
| Rate for Payer: Frontpath All Commercial |
$1,068.78
|
| Rate for Payer: Humana ChoiceCare |
$687.17
|
| Rate for Payer: Humana ChoiceCare |
$687.17
|
| Rate for Payer: Humana Medicare |
$788.15
|
| Rate for Payer: Humana Medicare |
$788.15
|
| Rate for Payer: Lucent All Commercial |
$1,103.41
|
| Rate for Payer: Lucent All Commercial |
$1,103.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,028.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,028.00
|
| Rate for Payer: Managed Health Services Medicaid |
$918.56
|
| Rate for Payer: Managed Health Services Medicaid |
$918.56
|
| Rate for Payer: MDWise Medicaid |
$918.56
|
| Rate for Payer: MDWise Medicaid |
$918.56
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$426.52
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$426.52
|
| Rate for Payer: PHCS All Commercial |
$788.15
|
| Rate for Payer: PHCS All Commercial |
$788.15
|
| Rate for Payer: PHP All Commercial |
$1,079.69
|
| Rate for Payer: PHP All Commercial |
$1,079.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$788.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$788.15
|
| Rate for Payer: Sagamore Health Network All Products |
$788.15
|
| Rate for Payer: Sagamore Health Network All Products |
$788.15
|
| Rate for Payer: Signature Care EPO |
$816.85
|
| Rate for Payer: Signature Care EPO |
$816.85
|
| Rate for Payer: Signature Care PPO |
$816.85
|
| Rate for Payer: Signature Care PPO |
$816.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94,900.00
|
| Rate for Payer: United Healthcare Commercial |
$919.10
|
| Rate for Payer: United Healthcare Commercial |
$919.10
|
| Rate for Payer: United Healthcare Medicare |
$913.66
|
| Rate for Payer: United Healthcare Medicare |
$913.66
|
|
|
PR FULL ROUT OBSTE CARE,CESAREAN DELIV
|
Professional
|
Both
|
$4,832.18
|
|
|
Service Code
|
CPT 59510
|
| Hospital Charge Code |
z59510
|
| Min. Negotiated Rate |
$1,689.44 |
| Max. Negotiated Rate |
$312,000.00 |
| Rate for Payer: Aetna Commercial |
$2,411.74
|
| Rate for Payer: Aetna Commercial |
$2,411.74
|
| Rate for Payer: Aetna Medicare |
$2,411.74
|
| Rate for Payer: Aetna Medicare |
$2,411.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,200.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$2,376.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$2,376.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,773.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,773.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,652.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,652.91
|
| Rate for Payer: Cash Price |
$2,899.31
|
| Rate for Payer: Cash Price |
$2,810.29
|
| Rate for Payer: Centivo All Commercial |
$3,738.20
|
| Rate for Payer: Centivo All Commercial |
$3,738.20
|
| Rate for Payer: Cigna All Commercial |
$2,411.74
|
| Rate for Payer: Cigna All Commercial |
$2,411.74
|
| Rate for Payer: CORVEL All Commercial |
$2,411.74
|
| Rate for Payer: CORVEL All Commercial |
$2,411.74
|
| Rate for Payer: Coventry All Commercial |
$2,894.09
|
| Rate for Payer: Coventry All Commercial |
$2,894.09
|
| Rate for Payer: Encore All Commercial |
$2,411.74
|
| Rate for Payer: Encore All Commercial |
$2,411.74
|
| Rate for Payer: Frontpath All Commercial |
$3,422.49
|
| Rate for Payer: Frontpath All Commercial |
$3,422.49
|
| Rate for Payer: Humana ChoiceCare |
$1,689.44
|
| Rate for Payer: Humana ChoiceCare |
$1,689.44
|
| Rate for Payer: Humana Medicare |
$2,411.74
|
| Rate for Payer: Humana Medicare |
$2,411.74
|
| Rate for Payer: Lucent All Commercial |
$3,376.44
|
| Rate for Payer: Lucent All Commercial |
$3,376.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,360.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,360.00
|
| Rate for Payer: Managed Health Services Medicaid |
$2,376.66
|
| Rate for Payer: Managed Health Services Medicaid |
$2,376.66
|
| Rate for Payer: MDWise Medicaid |
$2,376.66
|
| Rate for Payer: MDWise Medicaid |
$2,376.66
|
| Rate for Payer: PHCS All Commercial |
$2,411.74
|
| Rate for Payer: PHCS All Commercial |
$2,411.74
|
| Rate for Payer: PHP All Commercial |
$3,091.32
|
| Rate for Payer: PHP All Commercial |
$3,091.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,411.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,411.74
|
| Rate for Payer: Sagamore Health Network All Products |
$2,411.74
|
| Rate for Payer: Sagamore Health Network All Products |
$2,411.74
|
| Rate for Payer: Signature Care EPO |
$2,177.70
|
| Rate for Payer: Signature Care EPO |
$2,177.70
|
| Rate for Payer: Signature Care PPO |
$2,177.70
|
| Rate for Payer: Signature Care PPO |
$2,177.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$312,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$312,000.00
|
| Rate for Payer: United Healthcare Commercial |
$2,225.69
|
| Rate for Payer: United Healthcare Commercial |
$2,225.69
|
| Rate for Payer: United Healthcare Medicare |
$2,341.91
|
| Rate for Payer: United Healthcare Medicare |
$2,341.91
|
|
|
PR FULL ROUT OBSTE CARE,VAGINAL DELIV
|
Professional
|
Both
|
$4,376.28
|
|
|
Service Code
|
CPT 59400
|
| Hospital Charge Code |
z59400
|
| Min. Negotiated Rate |
$1,490.71 |
| Max. Negotiated Rate |
$284,000.00 |
| Rate for Payer: Aetna Commercial |
$2,197.27
|
| Rate for Payer: Aetna Commercial |
$2,197.27
|
| Rate for Payer: Aetna Medicare |
$2,197.27
|
| Rate for Payer: Aetna Medicare |
$2,197.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,200.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$2,152.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$2,152.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,526.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,526.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,417.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,417.00
|
| Rate for Payer: Cash Price |
$2,625.77
|
| Rate for Payer: Cash Price |
$2,557.37
|
| Rate for Payer: Centivo All Commercial |
$3,405.77
|
| Rate for Payer: Centivo All Commercial |
$3,405.77
|
| Rate for Payer: Cigna All Commercial |
$2,197.27
|
| Rate for Payer: Cigna All Commercial |
$2,197.27
|
| Rate for Payer: CORVEL All Commercial |
$2,197.27
|
| Rate for Payer: CORVEL All Commercial |
$2,197.27
|
| Rate for Payer: Coventry All Commercial |
$2,636.72
|
| Rate for Payer: Coventry All Commercial |
$2,636.72
|
| Rate for Payer: Encore All Commercial |
$2,197.27
|
| Rate for Payer: Encore All Commercial |
$2,197.27
|
| Rate for Payer: Frontpath All Commercial |
$3,092.42
|
| Rate for Payer: Frontpath All Commercial |
$3,092.42
|
| Rate for Payer: Humana ChoiceCare |
$1,490.71
|
| Rate for Payer: Humana ChoiceCare |
$1,490.71
|
| Rate for Payer: Humana Medicare |
$2,197.27
|
| Rate for Payer: Humana Medicare |
$2,197.27
|
| Rate for Payer: Lucent All Commercial |
$3,076.18
|
| Rate for Payer: Lucent All Commercial |
$3,076.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,058.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,058.00
|
| Rate for Payer: Managed Health Services Medicaid |
$2,152.43
|
| Rate for Payer: Managed Health Services Medicaid |
$2,152.43
|
| Rate for Payer: MDWise Medicaid |
$2,152.43
|
| Rate for Payer: MDWise Medicaid |
$2,152.43
|
| Rate for Payer: PHCS All Commercial |
$2,197.27
|
| Rate for Payer: PHCS All Commercial |
$2,197.27
|
| Rate for Payer: PHP All Commercial |
$2,813.11
|
| Rate for Payer: PHP All Commercial |
$2,813.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,197.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,197.27
|
| Rate for Payer: Sagamore Health Network All Products |
$2,197.27
|
| Rate for Payer: Sagamore Health Network All Products |
$2,197.27
|
| Rate for Payer: Signature Care EPO |
$1,922.70
|
| Rate for Payer: Signature Care EPO |
$1,922.70
|
| Rate for Payer: Signature Care PPO |
$1,922.70
|
| Rate for Payer: Signature Care PPO |
$1,922.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$284,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$284,000.00
|
| Rate for Payer: United Healthcare Commercial |
$1,965.55
|
| Rate for Payer: United Healthcare Commercial |
$1,965.55
|
| Rate for Payer: United Healthcare Medicare |
$2,131.14
|
| Rate for Payer: United Healthcare Medicare |
$2,131.14
|
|
