|
PR FUSION FINGER TENDONS,DIP JT STABIL
|
Professional
|
Both
|
$1,214.72
|
|
|
Service Code
|
CPT 26474
|
| Hospital Charge Code |
z26474
|
| Min. Negotiated Rate |
$597.44 |
| Max. Negotiated Rate |
$1,042.89 |
| Rate for Payer: Aetna Commercial |
$619.59
|
| Rate for Payer: Aetna Commercial |
$619.59
|
| Rate for Payer: Aetna Medicare |
$619.59
|
| Rate for Payer: Aetna Medicare |
$619.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$597.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$597.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$712.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$712.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$681.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$681.55
|
| Rate for Payer: Cash Price |
$728.83
|
| Rate for Payer: Cash Price |
$719.23
|
| Rate for Payer: Centivo All Commercial |
$960.36
|
| Rate for Payer: Centivo All Commercial |
$960.36
|
| Rate for Payer: Cigna All Commercial |
$619.59
|
| Rate for Payer: Cigna All Commercial |
$619.59
|
| Rate for Payer: CORVEL All Commercial |
$619.59
|
| Rate for Payer: CORVEL All Commercial |
$619.59
|
| Rate for Payer: Coventry All Commercial |
$743.51
|
| Rate for Payer: Coventry All Commercial |
$743.51
|
| Rate for Payer: Encore All Commercial |
$619.59
|
| Rate for Payer: Encore All Commercial |
$619.59
|
| Rate for Payer: Frontpath All Commercial |
$844.61
|
| Rate for Payer: Frontpath All Commercial |
$844.61
|
| Rate for Payer: Humana ChoiceCare |
$698.00
|
| Rate for Payer: Humana ChoiceCare |
$698.00
|
| Rate for Payer: Humana Medicare |
$619.59
|
| Rate for Payer: Humana Medicare |
$619.59
|
| Rate for Payer: Lucent All Commercial |
$867.43
|
| Rate for Payer: Lucent All Commercial |
$867.43
|
| Rate for Payer: Managed Health Services Medicaid |
$597.44
|
| Rate for Payer: Managed Health Services Medicaid |
$597.44
|
| Rate for Payer: MDWise Medicaid |
$597.44
|
| Rate for Payer: MDWise Medicaid |
$597.44
|
| Rate for Payer: PHCS All Commercial |
$619.59
|
| Rate for Payer: PHCS All Commercial |
$619.59
|
| Rate for Payer: PHP All Commercial |
$1,042.89
|
| Rate for Payer: PHP All Commercial |
$1,042.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$619.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$619.59
|
| Rate for Payer: Sagamore Health Network All Products |
$619.59
|
| Rate for Payer: Sagamore Health Network All Products |
$619.59
|
| Rate for Payer: Signature Care EPO |
$956.79
|
| Rate for Payer: Signature Care EPO |
$956.79
|
| Rate for Payer: Signature Care PPO |
$956.79
|
| Rate for Payer: Signature Care PPO |
$956.79
|
| Rate for Payer: United Healthcare Commercial |
$614.85
|
| Rate for Payer: United Healthcare Commercial |
$614.85
|
| Rate for Payer: United Healthcare Medicare |
$599.36
|
| Rate for Payer: United Healthcare Medicare |
$599.36
|
|
|
PR FUSION MC-P JT
|
Professional
|
Both
|
$1,369.36
|
|
|
Service Code
|
CPT 26850
|
| Hospital Charge Code |
z26850
|
| Min. Negotiated Rate |
$673.51 |
| Max. Negotiated Rate |
$103,900.00 |
| Rate for Payer: Aetna Commercial |
$697.99
|
| Rate for Payer: Aetna Commercial |
$697.99
|
| Rate for Payer: Aetna Medicare |
$697.99
|
| Rate for Payer: Aetna Medicare |
$697.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$750.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$750.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$750.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$750.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$750.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$750.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$750.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$750.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$673.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$673.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$802.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$802.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$767.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$767.79
|
| Rate for Payer: Cash Price |
$821.62
|
| Rate for Payer: Cash Price |
$810.88
|
| Rate for Payer: Centivo All Commercial |
$1,081.88
|
| Rate for Payer: Centivo All Commercial |
$1,081.88
|
| Rate for Payer: Cigna All Commercial |
$697.99
|
| Rate for Payer: Cigna All Commercial |
$697.99
|
| Rate for Payer: CORVEL All Commercial |
$697.99
|
| Rate for Payer: CORVEL All Commercial |
$697.99
|
| Rate for Payer: Coventry All Commercial |
$837.59
|
| Rate for Payer: Coventry All Commercial |
$837.59
|
| Rate for Payer: Encore All Commercial |
$697.99
|
| Rate for Payer: Encore All Commercial |
$697.99
|
| Rate for Payer: Frontpath All Commercial |
$953.08
|
| Rate for Payer: Frontpath All Commercial |
$953.08
|
| Rate for Payer: Humana ChoiceCare |
$808.17
|
| Rate for Payer: Humana ChoiceCare |
$808.17
|
| Rate for Payer: Humana Medicare |
$697.99
|
| Rate for Payer: Humana Medicare |
$697.99
|
| Rate for Payer: Lucent All Commercial |
$977.19
|
| Rate for Payer: Lucent All Commercial |
$977.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,108.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,108.00
|
| Rate for Payer: Managed Health Services Medicaid |
$673.51
|
| Rate for Payer: Managed Health Services Medicaid |
$673.51
|
| Rate for Payer: MDWise Medicaid |
$673.51
|
| Rate for Payer: MDWise Medicaid |
$673.51
|
| Rate for Payer: PHCS All Commercial |
$697.99
|
| Rate for Payer: PHCS All Commercial |
$697.99
|
| Rate for Payer: PHP All Commercial |
$1,175.77
|
| Rate for Payer: PHP All Commercial |
$1,175.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$697.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$697.99
|
| Rate for Payer: Sagamore Health Network All Products |
$697.99
|
| Rate for Payer: Sagamore Health Network All Products |
$697.99
|
| Rate for Payer: Signature Care EPO |
$1,099.46
|
| Rate for Payer: Signature Care EPO |
$1,099.46
|
| Rate for Payer: Signature Care PPO |
$1,099.46
|
| Rate for Payer: Signature Care PPO |
$1,099.46
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$103,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$103,900.00
|
| Rate for Payer: United Healthcare Commercial |
$731.29
|
| Rate for Payer: United Healthcare Commercial |
$731.29
|
| Rate for Payer: United Healthcare Medicare |
$675.73
|
| Rate for Payer: United Healthcare Medicare |
$675.73
|
|
|
PR GASTROSTOMY,OPEN,W/O TUBE CNSTR
|
Professional
|
Both
|
$1,279.36
|
|
|
Service Code
|
CPT 43830
|
| Hospital Charge Code |
z43830
|
| Min. Negotiated Rate |
$629.05 |
| Max. Negotiated Rate |
$90,300.00 |
| Rate for Payer: Aetna Commercial |
$653.10
|
| Rate for Payer: Aetna Commercial |
$653.10
|
| Rate for Payer: Aetna Medicare |
$653.10
|
| Rate for Payer: Aetna Medicare |
$653.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$631.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$631.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$631.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$631.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$631.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$631.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$631.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$631.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$629.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$629.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$751.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$751.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$718.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$718.41
|
| Rate for Payer: Cash Price |
$767.62
|
| Rate for Payer: Cash Price |
$754.86
|
| Rate for Payer: Centivo All Commercial |
$1,012.30
|
| Rate for Payer: Centivo All Commercial |
$1,012.30
|
| Rate for Payer: Cigna All Commercial |
$653.10
|
| Rate for Payer: Cigna All Commercial |
$653.10
|
| Rate for Payer: CORVEL All Commercial |
$653.10
|
| Rate for Payer: CORVEL All Commercial |
$653.10
|
| Rate for Payer: Coventry All Commercial |
$783.72
|
| Rate for Payer: Coventry All Commercial |
$783.72
|
| Rate for Payer: Encore All Commercial |
$653.10
|
| Rate for Payer: Encore All Commercial |
$653.10
|
| Rate for Payer: Frontpath All Commercial |
$927.59
|
| Rate for Payer: Frontpath All Commercial |
$927.59
|
| Rate for Payer: Humana ChoiceCare |
$655.91
|
| Rate for Payer: Humana ChoiceCare |
$655.91
|
| Rate for Payer: Humana Medicare |
$653.10
|
| Rate for Payer: Humana Medicare |
$653.10
|
| Rate for Payer: Lucent All Commercial |
$914.34
|
| Rate for Payer: Lucent All Commercial |
$914.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$967.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$967.00
|
| Rate for Payer: Managed Health Services Medicaid |
$629.24
|
| Rate for Payer: Managed Health Services Medicaid |
$629.24
|
| Rate for Payer: MDWise Medicaid |
$629.24
|
| Rate for Payer: MDWise Medicaid |
$629.24
|
| Rate for Payer: PHCS All Commercial |
$653.10
|
| Rate for Payer: PHCS All Commercial |
$653.10
|
| Rate for Payer: PHP All Commercial |
$1,100.84
|
| Rate for Payer: PHP All Commercial |
$1,100.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$653.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$653.10
|
| Rate for Payer: Sagamore Health Network All Products |
$653.10
|
| Rate for Payer: Sagamore Health Network All Products |
$653.10
|
| Rate for Payer: Signature Care EPO |
$822.80
|
| Rate for Payer: Signature Care EPO |
$822.80
|
| Rate for Payer: Signature Care PPO |
$822.80
|
| Rate for Payer: Signature Care PPO |
$822.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90,300.00
|
| Rate for Payer: United Healthcare Commercial |
$734.03
|
| Rate for Payer: United Healthcare Commercial |
$734.03
|
| Rate for Payer: United Healthcare Medicare |
$629.05
|
| Rate for Payer: United Healthcare Medicare |
$629.05
|
|
|
PR GASTROSTOMY,OPEN,W/TUBE CNSTR
|
Professional
|
Both
|
$1,894.28
|
|
|
Service Code
|
CPT 43832
|
| Hospital Charge Code |
z43832
|
| Min. Negotiated Rate |
$929.56 |
| Max. Negotiated Rate |
$133,400.00 |
| Rate for Payer: Aetna Commercial |
$966.84
|
| Rate for Payer: Aetna Commercial |
$966.84
|
| Rate for Payer: Aetna Medicare |
$966.84
|
| Rate for Payer: Aetna Medicare |
$966.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$963.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$963.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$963.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$963.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$963.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$963.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$963.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$963.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$931.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$931.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,111.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,111.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,063.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,063.52
|
| Rate for Payer: Cash Price |
$1,136.57
|
| Rate for Payer: Cash Price |
$1,115.47
|
| Rate for Payer: Centivo All Commercial |
$1,498.60
|
| Rate for Payer: Centivo All Commercial |
$1,498.60
|
| Rate for Payer: Cigna All Commercial |
$966.84
|
| Rate for Payer: Cigna All Commercial |
$966.84
|
| Rate for Payer: CORVEL All Commercial |
$966.84
|
| Rate for Payer: CORVEL All Commercial |
$966.84
|
| Rate for Payer: Coventry All Commercial |
$1,160.21
|
| Rate for Payer: Coventry All Commercial |
$1,160.21
|
| Rate for Payer: Encore All Commercial |
$966.84
|
| Rate for Payer: Encore All Commercial |
$966.84
|
| Rate for Payer: Frontpath All Commercial |
$1,382.76
|
| Rate for Payer: Frontpath All Commercial |
$1,382.76
|
| Rate for Payer: Humana ChoiceCare |
$1,027.66
|
| Rate for Payer: Humana ChoiceCare |
$1,027.66
|
| Rate for Payer: Humana Medicare |
$966.84
|
| Rate for Payer: Humana Medicare |
$966.84
|
| Rate for Payer: Lucent All Commercial |
$1,353.58
|
| Rate for Payer: Lucent All Commercial |
$1,353.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,429.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,429.00
|
| Rate for Payer: Managed Health Services Medicaid |
$931.68
|
| Rate for Payer: Managed Health Services Medicaid |
$931.68
|
| Rate for Payer: MDWise Medicaid |
$931.68
|
| Rate for Payer: MDWise Medicaid |
$931.68
|
| Rate for Payer: PHCS All Commercial |
$966.84
|
| Rate for Payer: PHCS All Commercial |
$966.84
|
| Rate for Payer: PHP All Commercial |
$1,626.72
|
| Rate for Payer: PHP All Commercial |
$1,626.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$966.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$966.84
|
| Rate for Payer: Sagamore Health Network All Products |
$966.84
|
| Rate for Payer: Sagamore Health Network All Products |
$966.84
|
| Rate for Payer: Signature Care EPO |
$1,289.45
|
| Rate for Payer: Signature Care EPO |
$1,289.45
|
| Rate for Payer: Signature Care PPO |
$1,289.45
|
| Rate for Payer: Signature Care PPO |
$1,289.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$133,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$133,400.00
|
| Rate for Payer: United Healthcare Commercial |
$1,131.66
|
| Rate for Payer: United Healthcare Commercial |
$1,131.66
|
| Rate for Payer: United Healthcare Medicare |
$929.56
|
| Rate for Payer: United Healthcare Medicare |
$929.56
|
|
|
PR GROUP PSYCHOTHERAPY
|
Professional
|
Both
|
$53.58
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
z90853
|
| Min. Negotiated Rate |
$4.81 |
| Max. Negotiated Rate |
$2,700.00 |
| Rate for Payer: Aetna Commercial |
$23.23
|
| Rate for Payer: Aetna Commercial |
$23.23
|
| Rate for Payer: Aetna Medicare |
$23.23
|
| Rate for Payer: Aetna Medicare |
$23.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$31.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$31.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$31.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$31.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$31.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$31.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$4.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$4.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$26.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$26.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$25.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$25.55
|
| Rate for Payer: Cash Price |
$32.15
|
| Rate for Payer: Cash Price |
$30.29
|
| Rate for Payer: Centivo All Commercial |
$36.01
|
| Rate for Payer: Centivo All Commercial |
$36.01
|
| Rate for Payer: Cigna All Commercial |
$23.23
|
| Rate for Payer: Cigna All Commercial |
$23.23
|
| Rate for Payer: CORVEL All Commercial |
$23.23
|
| Rate for Payer: CORVEL All Commercial |
$23.23
|
| Rate for Payer: Coventry All Commercial |
$27.88
|
| Rate for Payer: Coventry All Commercial |
$27.88
|
| Rate for Payer: Encore All Commercial |
$23.23
|
| Rate for Payer: Encore All Commercial |
$23.23
|
| Rate for Payer: Frontpath All Commercial |
$26.07
|
| Rate for Payer: Frontpath All Commercial |
$26.07
|
| Rate for Payer: Humana ChoiceCare |
$24.64
|
| Rate for Payer: Humana ChoiceCare |
$24.64
|
| Rate for Payer: Humana Medicare |
$23.23
|
| Rate for Payer: Humana Medicare |
$23.23
|
| Rate for Payer: Lucent All Commercial |
$32.52
|
| Rate for Payer: Lucent All Commercial |
$32.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.00
|
| Rate for Payer: Managed Health Services Medicaid |
$4.81
|
| Rate for Payer: Managed Health Services Medicaid |
$4.81
|
| Rate for Payer: MDWise Medicaid |
$4.81
|
| Rate for Payer: MDWise Medicaid |
$4.81
|
| Rate for Payer: PHCS All Commercial |
$23.23
|
| Rate for Payer: PHCS All Commercial |
$23.23
|
| Rate for Payer: PHP All Commercial |
$24.23
|
| Rate for Payer: PHP All Commercial |
$24.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23.23
|
| Rate for Payer: Sagamore Health Network All Products |
$23.23
|
| Rate for Payer: Sagamore Health Network All Products |
$23.23
|
| Rate for Payer: Signature Care EPO |
$34.85
|
| Rate for Payer: Signature Care EPO |
$34.85
|
| Rate for Payer: Signature Care PPO |
$34.85
|
| Rate for Payer: Signature Care PPO |
$34.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,700.00
|
| Rate for Payer: United Healthcare Commercial |
$35.56
|
| Rate for Payer: United Healthcare Commercial |
$35.56
|
| Rate for Payer: United Healthcare Medicare |
$25.24
|
| Rate for Payer: United Healthcare Medicare |
$25.24
|
|
|
PR HAND/FINGER SURGERY UNLISTED
|
Professional
|
Both
|
$1,187.00
|
|
|
Service Code
|
CPT 26989
|
| Hospital Charge Code |
z26989
|
| Rate for Payer: Cash Price |
$712.20
|
|
|
PR HEARING AID CHECK, BOTH EARS
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
z92593
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$30.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$30.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$30.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$30.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$55.39
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Frontpath All Commercial |
$37.76
|
| Rate for Payer: Humana ChoiceCare |
$30.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$85.00
|
| Rate for Payer: Managed Health Services Medicaid |
$55.39
|
| Rate for Payer: MDWise Medicaid |
$55.39
|
| Rate for Payer: Signature Care EPO |
$46.75
|
| Rate for Payer: Signature Care PPO |
$46.75
|
| Rate for Payer: United Healthcare Commercial |
$35.85
|
|
|
PR HEARING AID CHECK, ONE EAR
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
z92592
|
| Min. Negotiated Rate |
$19.93 |
| Max. Negotiated Rate |
$48.92 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$20.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$20.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$20.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$20.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$48.92
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Frontpath All Commercial |
$22.70
|
| Rate for Payer: Humana ChoiceCare |
$19.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.50
|
| Rate for Payer: Managed Health Services Medicaid |
$48.92
|
| Rate for Payer: MDWise Medicaid |
$48.92
|
| Rate for Payer: Signature Care EPO |
$31.45
|
| Rate for Payer: Signature Care PPO |
$31.45
|
| Rate for Payer: United Healthcare Commercial |
$21.90
|
|
|
PR HEARING AID EXAM, BOTH EARS
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
z92591
|
| Min. Negotiated Rate |
$63.09 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$110.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$110.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$110.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$110.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$63.09
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Frontpath All Commercial |
$73.10
|
| Rate for Payer: Humana ChoiceCare |
$68.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$297.50
|
| Rate for Payer: Managed Health Services Medicaid |
$63.09
|
| Rate for Payer: MDWise Medicaid |
$63.09
|
| Rate for Payer: Signature Care EPO |
$106.25
|
| Rate for Payer: Signature Care PPO |
$106.25
|
| Rate for Payer: United Healthcare Commercial |
$69.58
|
|
|
PR HEARING AID EXAM, ONE EAR
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
z92590
|
| Min. Negotiated Rate |
$45.48 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$70.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$70.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$70.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$70.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$53.85
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Frontpath All Commercial |
$57.33
|
| Rate for Payer: Humana ChoiceCare |
$45.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$212.50
|
| Rate for Payer: Managed Health Services Medicaid |
$53.85
|
| Rate for Payer: MDWise Medicaid |
$53.85
|
| Rate for Payer: Signature Care EPO |
$70.55
|
| Rate for Payer: Signature Care PPO |
$70.55
|
| Rate for Payer: United Healthcare Commercial |
$54.34
|
|
|
PR HEARING AID MONAURAL BTE
|
Professional
|
Both
|
$1,000.00
|
|
|
Service Code
|
CPT V5181
|
| Hospital Charge Code |
zV5181
|
| Min. Negotiated Rate |
$840.00 |
| Max. Negotiated Rate |
$848.84 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$840.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$840.00
|
| Rate for Payer: United Healthcare Commercial |
$848.84
|
|
|
PR HEART/LUNG RESUSCITATION (CPR)
|
Professional
|
Both
|
$605.16
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
z92950
|
| Min. Negotiated Rate |
$93.27 |
| Max. Negotiated Rate |
$25,900.00 |
| Rate for Payer: Aetna Commercial |
$175.70
|
| Rate for Payer: Aetna Commercial |
$175.70
|
| Rate for Payer: Aetna Medicare |
$175.70
|
| Rate for Payer: Aetna Medicare |
$175.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$269.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$269.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$269.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$269.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$269.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$269.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$269.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$269.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.27
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$297.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$297.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$202.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$202.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$193.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$193.27
|
| Rate for Payer: Cash Price |
$363.10
|
| Rate for Payer: Cash Price |
$359.57
|
| Rate for Payer: Centivo All Commercial |
$272.33
|
| Rate for Payer: Centivo All Commercial |
$272.33
|
| Rate for Payer: Cigna All Commercial |
$175.70
|
| Rate for Payer: Cigna All Commercial |
$175.70
|
| Rate for Payer: CORVEL All Commercial |
$175.70
|
| Rate for Payer: CORVEL All Commercial |
$175.70
|
| Rate for Payer: Coventry All Commercial |
$210.84
|
| Rate for Payer: Coventry All Commercial |
$210.84
|
| Rate for Payer: Encore All Commercial |
$175.70
|
| Rate for Payer: Encore All Commercial |
$175.70
|
| Rate for Payer: Frontpath All Commercial |
$203.34
|
| Rate for Payer: Frontpath All Commercial |
$203.34
|
| Rate for Payer: Humana ChoiceCare |
$246.74
|
| Rate for Payer: Humana ChoiceCare |
$246.74
|
| Rate for Payer: Humana Medicare |
$175.70
|
| Rate for Payer: Humana Medicare |
$175.70
|
| Rate for Payer: Lucent All Commercial |
$245.98
|
| Rate for Payer: Lucent All Commercial |
$245.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$276.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$276.00
|
| Rate for Payer: Managed Health Services Medicaid |
$297.64
|
| Rate for Payer: Managed Health Services Medicaid |
$297.64
|
| Rate for Payer: MDWise Medicaid |
$297.64
|
| Rate for Payer: MDWise Medicaid |
$297.64
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.27
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.27
|
| Rate for Payer: PHCS All Commercial |
$175.70
|
| Rate for Payer: PHCS All Commercial |
$175.70
|
| Rate for Payer: PHP All Commercial |
$247.44
|
| Rate for Payer: PHP All Commercial |
$247.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$175.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$175.70
|
| Rate for Payer: Sagamore Health Network All Products |
$175.70
|
| Rate for Payer: Sagamore Health Network All Products |
$175.70
|
| Rate for Payer: Signature Care EPO |
$282.20
|
| Rate for Payer: Signature Care EPO |
$282.20
|
| Rate for Payer: Signature Care PPO |
$282.20
|
| Rate for Payer: Signature Care PPO |
$282.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,900.00
|
| Rate for Payer: United Healthcare Commercial |
$213.19
|
| Rate for Payer: United Healthcare Commercial |
$213.19
|
| Rate for Payer: United Healthcare Medicare |
$299.64
|
| Rate for Payer: United Healthcare Medicare |
$299.64
|
|
|
PR HEMORRHOIDECTOMY,INT/EXT, 2+ COLUMNS/GROUPS
|
Professional
|
Both
|
$889.98
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
z46260
|
| Min. Negotiated Rate |
$434.64 |
| Max. Negotiated Rate |
$62,700.00 |
| Rate for Payer: Aetna Commercial |
$453.16
|
| Rate for Payer: Aetna Commercial |
$453.16
|
| Rate for Payer: Aetna Medicare |
$453.16
|
| Rate for Payer: Aetna Medicare |
$453.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$636.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$636.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$636.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$636.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$636.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$636.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$636.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$636.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$437.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$437.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$521.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$521.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$498.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$498.48
|
| Rate for Payer: Cash Price |
$533.99
|
| Rate for Payer: Cash Price |
$524.62
|
| Rate for Payer: Centivo All Commercial |
$702.40
|
| Rate for Payer: Centivo All Commercial |
$702.40
|
| Rate for Payer: Cigna All Commercial |
$453.16
|
| Rate for Payer: Cigna All Commercial |
$453.16
|
| Rate for Payer: CORVEL All Commercial |
$453.16
|
| Rate for Payer: CORVEL All Commercial |
$453.16
|
| Rate for Payer: Coventry All Commercial |
$543.79
|
| Rate for Payer: Coventry All Commercial |
$543.79
|
| Rate for Payer: Encore All Commercial |
$453.16
|
| Rate for Payer: Encore All Commercial |
$453.16
|
| Rate for Payer: Frontpath All Commercial |
$630.20
|
| Rate for Payer: Frontpath All Commercial |
$630.20
|
| Rate for Payer: Humana ChoiceCare |
$434.64
|
| Rate for Payer: Humana ChoiceCare |
$434.64
|
| Rate for Payer: Humana Medicare |
$453.16
|
| Rate for Payer: Humana Medicare |
$453.16
|
| Rate for Payer: Lucent All Commercial |
$634.42
|
| Rate for Payer: Lucent All Commercial |
$634.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$672.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$672.00
|
| Rate for Payer: Managed Health Services Medicaid |
$437.73
|
| Rate for Payer: Managed Health Services Medicaid |
$437.73
|
| Rate for Payer: MDWise Medicaid |
$437.73
|
| Rate for Payer: MDWise Medicaid |
$437.73
|
| Rate for Payer: PHCS All Commercial |
$453.16
|
| Rate for Payer: PHCS All Commercial |
$453.16
|
| Rate for Payer: PHP All Commercial |
$765.06
|
| Rate for Payer: PHP All Commercial |
$765.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$453.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$453.16
|
| Rate for Payer: Sagamore Health Network All Products |
$453.16
|
| Rate for Payer: Sagamore Health Network All Products |
$453.16
|
| Rate for Payer: Signature Care EPO |
$556.75
|
| Rate for Payer: Signature Care EPO |
$556.75
|
| Rate for Payer: Signature Care PPO |
$556.75
|
| Rate for Payer: Signature Care PPO |
$556.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62,700.00
|
| Rate for Payer: United Healthcare Commercial |
$481.33
|
| Rate for Payer: United Healthcare Commercial |
$481.33
|
| Rate for Payer: United Healthcare Medicare |
$437.18
|
| Rate for Payer: United Healthcare Medicare |
$437.18
|
|
|
PR HFO WITHOUT JOINTS PRE CST
|
Professional
|
Both
|
$10.76
|
|
|
Service Code
|
CPT L3923
|
| Hospital Charge Code |
zL3923
|
| Min. Negotiated Rate |
$10.76 |
| Max. Negotiated Rate |
$143.76 |
| Rate for Payer: Aetna Commercial |
$92.75
|
| Rate for Payer: Aetna Medicare |
$92.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$27.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$103.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$106.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$102.03
|
| Rate for Payer: Cash Price |
$6.46
|
| Rate for Payer: Centivo All Commercial |
$143.76
|
| Rate for Payer: Cigna All Commercial |
$92.75
|
| Rate for Payer: CORVEL All Commercial |
$92.75
|
| Rate for Payer: Coventry All Commercial |
$111.30
|
| Rate for Payer: Encore All Commercial |
$92.75
|
| Rate for Payer: Humana ChoiceCare |
$85.70
|
| Rate for Payer: Humana Medicare |
$92.75
|
| Rate for Payer: Lucent All Commercial |
$129.85
|
| Rate for Payer: Managed Health Services Medicaid |
$103.44
|
| Rate for Payer: MDWise Medicaid |
$103.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$27.65
|
| Rate for Payer: PHCS All Commercial |
$92.75
|
| Rate for Payer: PHP All Commercial |
$86.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$92.75
|
| Rate for Payer: Sagamore Health Network All Products |
$92.75
|
| Rate for Payer: Signature Care EPO |
$10.76
|
| Rate for Payer: Signature Care PPO |
$10.76
|
| Rate for Payer: United Healthcare Commercial |
$67.66
|
|
|
PR HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES
|
Professional
|
Both
|
$350.54
|
|
|
Service Code
|
CPT 99350
|
| Hospital Charge Code |
z99350
|
| Min. Negotiated Rate |
$163.66 |
| Max. Negotiated Rate |
$259.89 |
| Rate for Payer: Aetna Commercial |
$167.67
|
| Rate for Payer: Aetna Commercial |
$167.67
|
| Rate for Payer: Aetna Medicare |
$167.67
|
| Rate for Payer: Aetna Medicare |
$167.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$172.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$172.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$192.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$192.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$184.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$184.44
|
| Rate for Payer: Cash Price |
$207.17
|
| Rate for Payer: Cash Price |
$210.32
|
| Rate for Payer: Centivo All Commercial |
$259.89
|
| Rate for Payer: Centivo All Commercial |
$259.89
|
| Rate for Payer: Cigna All Commercial |
$167.67
|
| Rate for Payer: Cigna All Commercial |
$167.67
|
| Rate for Payer: CORVEL All Commercial |
$167.67
|
| Rate for Payer: CORVEL All Commercial |
$167.67
|
| Rate for Payer: Coventry All Commercial |
$201.20
|
| Rate for Payer: Coventry All Commercial |
$201.20
|
| Rate for Payer: Encore All Commercial |
$167.67
|
| Rate for Payer: Encore All Commercial |
$167.67
|
| Rate for Payer: Frontpath All Commercial |
$180.34
|
| Rate for Payer: Frontpath All Commercial |
$180.34
|
| Rate for Payer: Humana ChoiceCare |
$167.57
|
| Rate for Payer: Humana ChoiceCare |
$167.57
|
| Rate for Payer: Humana Medicare |
$167.67
|
| Rate for Payer: Humana Medicare |
$167.67
|
| Rate for Payer: Lucent All Commercial |
$234.74
|
| Rate for Payer: Lucent All Commercial |
$234.74
|
| Rate for Payer: Managed Health Services Medicaid |
$172.41
|
| Rate for Payer: Managed Health Services Medicaid |
$172.41
|
| Rate for Payer: MDWise Medicaid |
$172.41
|
| Rate for Payer: MDWise Medicaid |
$172.41
|
| Rate for Payer: PHCS All Commercial |
$167.67
|
| Rate for Payer: PHCS All Commercial |
$167.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$167.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$167.67
|
| Rate for Payer: Sagamore Health Network All Products |
$167.67
|
| Rate for Payer: Sagamore Health Network All Products |
$167.67
|
| Rate for Payer: United Healthcare Commercial |
$163.66
|
| Rate for Payer: United Healthcare Commercial |
$163.66
|
| Rate for Payer: United Healthcare Medicare |
$172.64
|
| Rate for Payer: United Healthcare Medicare |
$172.64
|
|
|
PR HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES
|
Professional
|
Both
|
$145.42
|
|
|
Service Code
|
CPT 99348
|
| Hospital Charge Code |
z99348
|
| Min. Negotiated Rate |
$71.03 |
| Max. Negotiated Rate |
$122.12 |
| Rate for Payer: Aetna Commercial |
$78.79
|
| Rate for Payer: Aetna Commercial |
$78.79
|
| Rate for Payer: Aetna Medicare |
$78.79
|
| Rate for Payer: Aetna Medicare |
$78.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$71.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$71.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$90.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$90.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$86.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$86.67
|
| Rate for Payer: Cash Price |
$85.24
|
| Rate for Payer: Cash Price |
$87.25
|
| Rate for Payer: Centivo All Commercial |
$122.12
|
| Rate for Payer: Centivo All Commercial |
$122.12
|
| Rate for Payer: Cigna All Commercial |
$78.79
|
| Rate for Payer: Cigna All Commercial |
$78.79
|
| Rate for Payer: CORVEL All Commercial |
$78.79
|
| Rate for Payer: CORVEL All Commercial |
$78.79
|
| Rate for Payer: Coventry All Commercial |
$94.55
|
| Rate for Payer: Coventry All Commercial |
$94.55
|
| Rate for Payer: Encore All Commercial |
$78.79
|
| Rate for Payer: Encore All Commercial |
$78.79
|
| Rate for Payer: Frontpath All Commercial |
$84.33
|
| Rate for Payer: Frontpath All Commercial |
$84.33
|
| Rate for Payer: Humana ChoiceCare |
$73.05
|
| Rate for Payer: Humana ChoiceCare |
$73.05
|
| Rate for Payer: Humana Medicare |
$78.79
|
| Rate for Payer: Humana Medicare |
$78.79
|
| Rate for Payer: Lucent All Commercial |
$110.31
|
| Rate for Payer: Lucent All Commercial |
$110.31
|
| Rate for Payer: Managed Health Services Medicaid |
$71.52
|
| Rate for Payer: Managed Health Services Medicaid |
$71.52
|
| Rate for Payer: MDWise Medicaid |
$71.52
|
| Rate for Payer: MDWise Medicaid |
$71.52
|
| Rate for Payer: PHCS All Commercial |
$78.79
|
| Rate for Payer: PHCS All Commercial |
$78.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$78.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$78.79
|
| Rate for Payer: Sagamore Health Network All Products |
$78.79
|
| Rate for Payer: Sagamore Health Network All Products |
$78.79
|
| Rate for Payer: United Healthcare Commercial |
$80.60
|
| Rate for Payer: United Healthcare Commercial |
$80.60
|
| Rate for Payer: United Healthcare Medicare |
$71.03
|
| Rate for Payer: United Healthcare Medicare |
$71.03
|
|
|
PR HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES
|
Professional
|
Both
|
$240.66
|
|
|
Service Code
|
CPT 99349
|
| Hospital Charge Code |
z99349
|
| Min. Negotiated Rate |
$113.36 |
| Max. Negotiated Rate |
$187.84 |
| Rate for Payer: Aetna Commercial |
$121.19
|
| Rate for Payer: Aetna Commercial |
$121.19
|
| Rate for Payer: Aetna Medicare |
$121.19
|
| Rate for Payer: Aetna Medicare |
$121.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$118.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$118.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$139.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$139.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$133.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$133.31
|
| Rate for Payer: Cash Price |
$141.92
|
| Rate for Payer: Cash Price |
$144.40
|
| Rate for Payer: Centivo All Commercial |
$187.84
|
| Rate for Payer: Centivo All Commercial |
$187.84
|
| Rate for Payer: Cigna All Commercial |
$121.19
|
| Rate for Payer: Cigna All Commercial |
$121.19
|
| Rate for Payer: CORVEL All Commercial |
$121.19
|
| Rate for Payer: CORVEL All Commercial |
$121.19
|
| Rate for Payer: Coventry All Commercial |
$145.43
|
| Rate for Payer: Coventry All Commercial |
$145.43
|
| Rate for Payer: Encore All Commercial |
$121.19
|
| Rate for Payer: Encore All Commercial |
$121.19
|
| Rate for Payer: Frontpath All Commercial |
$129.79
|
| Rate for Payer: Frontpath All Commercial |
$129.79
|
| Rate for Payer: Humana ChoiceCare |
$113.36
|
| Rate for Payer: Humana ChoiceCare |
$113.36
|
| Rate for Payer: Humana Medicare |
$121.19
|
| Rate for Payer: Humana Medicare |
$121.19
|
| Rate for Payer: Lucent All Commercial |
$169.67
|
| Rate for Payer: Lucent All Commercial |
$169.67
|
| Rate for Payer: Managed Health Services Medicaid |
$118.36
|
| Rate for Payer: Managed Health Services Medicaid |
$118.36
|
| Rate for Payer: MDWise Medicaid |
$118.36
|
| Rate for Payer: MDWise Medicaid |
$118.36
|
| Rate for Payer: PHCS All Commercial |
$121.19
|
| Rate for Payer: PHCS All Commercial |
$121.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$121.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$121.19
|
| Rate for Payer: Sagamore Health Network All Products |
$121.19
|
| Rate for Payer: Sagamore Health Network All Products |
$121.19
|
| Rate for Payer: United Healthcare Commercial |
$117.39
|
| Rate for Payer: United Healthcare Commercial |
$117.39
|
| Rate for Payer: United Healthcare Medicare |
$118.27
|
| Rate for Payer: United Healthcare Medicare |
$118.27
|
|
|
PR HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES
|
Professional
|
Both
|
$86.08
|
|
|
Service Code
|
CPT 99347
|
| Hospital Charge Code |
z99347
|
| Min. Negotiated Rate |
$41.83 |
| Max. Negotiated Rate |
$80.48 |
| Rate for Payer: Aetna Commercial |
$51.92
|
| Rate for Payer: Aetna Commercial |
$51.92
|
| Rate for Payer: Aetna Medicare |
$51.92
|
| Rate for Payer: Aetna Medicare |
$51.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$42.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$42.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$57.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$57.11
|
| Rate for Payer: Cash Price |
$50.20
|
| Rate for Payer: Cash Price |
$51.65
|
| Rate for Payer: Centivo All Commercial |
$80.48
|
| Rate for Payer: Centivo All Commercial |
$80.48
|
| Rate for Payer: Cigna All Commercial |
$51.92
|
| Rate for Payer: Cigna All Commercial |
$51.92
|
| Rate for Payer: CORVEL All Commercial |
$51.92
|
| Rate for Payer: CORVEL All Commercial |
$51.92
|
| Rate for Payer: Coventry All Commercial |
$62.30
|
| Rate for Payer: Coventry All Commercial |
$62.30
|
| Rate for Payer: Encore All Commercial |
$51.92
|
| Rate for Payer: Encore All Commercial |
$51.92
|
| Rate for Payer: Frontpath All Commercial |
$55.37
|
| Rate for Payer: Frontpath All Commercial |
$55.37
|
| Rate for Payer: Humana ChoiceCare |
$45.96
|
| Rate for Payer: Humana ChoiceCare |
$45.96
|
| Rate for Payer: Humana Medicare |
$51.92
|
| Rate for Payer: Humana Medicare |
$51.92
|
| Rate for Payer: Lucent All Commercial |
$72.69
|
| Rate for Payer: Lucent All Commercial |
$72.69
|
| Rate for Payer: Managed Health Services Medicaid |
$42.34
|
| Rate for Payer: Managed Health Services Medicaid |
$42.34
|
| Rate for Payer: MDWise Medicaid |
$42.34
|
| Rate for Payer: MDWise Medicaid |
$42.34
|
| Rate for Payer: PHCS All Commercial |
$51.92
|
| Rate for Payer: PHCS All Commercial |
$51.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.92
|
| Rate for Payer: Sagamore Health Network All Products |
$51.92
|
| Rate for Payer: Sagamore Health Network All Products |
$51.92
|
| Rate for Payer: United Healthcare Commercial |
$53.38
|
| Rate for Payer: United Healthcare Commercial |
$53.38
|
| Rate for Payer: United Healthcare Medicare |
$41.83
|
| Rate for Payer: United Healthcare Medicare |
$41.83
|
|
|
PR HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES
|
Professional
|
Both
|
$149.26
|
|
|
Service Code
|
CPT 99342
|
| Hospital Charge Code |
z99342
|
| Min. Negotiated Rate |
$72.97 |
| Max. Negotiated Rate |
$7,700.00 |
| Rate for Payer: Aetna Commercial |
$73.20
|
| Rate for Payer: Aetna Commercial |
$73.20
|
| Rate for Payer: Aetna Medicare |
$73.20
|
| Rate for Payer: Aetna Medicare |
$73.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$95.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$95.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$95.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$95.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$95.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$95.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$95.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$95.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$84.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$84.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$80.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$80.52
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cash Price |
$87.56
|
| Rate for Payer: Centivo All Commercial |
$113.46
|
| Rate for Payer: Centivo All Commercial |
$113.46
|
| Rate for Payer: Cigna All Commercial |
$73.20
|
| Rate for Payer: Cigna All Commercial |
$73.20
|
| Rate for Payer: CORVEL All Commercial |
$73.20
|
| Rate for Payer: CORVEL All Commercial |
$73.20
|
| Rate for Payer: Coventry All Commercial |
$87.84
|
| Rate for Payer: Coventry All Commercial |
$87.84
|
| Rate for Payer: Encore All Commercial |
$73.20
|
| Rate for Payer: Encore All Commercial |
$73.20
|
| Rate for Payer: Frontpath All Commercial |
$78.23
|
| Rate for Payer: Frontpath All Commercial |
$78.23
|
| Rate for Payer: Humana ChoiceCare |
$87.37
|
| Rate for Payer: Humana ChoiceCare |
$87.37
|
| Rate for Payer: Humana Medicare |
$73.20
|
| Rate for Payer: Humana Medicare |
$73.20
|
| Rate for Payer: Lucent All Commercial |
$102.48
|
| Rate for Payer: Lucent All Commercial |
$102.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$79.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$79.00
|
| Rate for Payer: Managed Health Services Medicaid |
$73.41
|
| Rate for Payer: Managed Health Services Medicaid |
$73.41
|
| Rate for Payer: MDWise Medicaid |
$73.41
|
| Rate for Payer: MDWise Medicaid |
$73.41
|
| Rate for Payer: PHCS All Commercial |
$73.20
|
| Rate for Payer: PHCS All Commercial |
$73.20
|
| Rate for Payer: PHP All Commercial |
$75.16
|
| Rate for Payer: PHP All Commercial |
$75.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$73.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$73.20
|
| Rate for Payer: Sagamore Health Network All Products |
$73.20
|
| Rate for Payer: Sagamore Health Network All Products |
$73.20
|
| Rate for Payer: Signature Care EPO |
$73.95
|
| Rate for Payer: Signature Care EPO |
$73.95
|
| Rate for Payer: Signature Care PPO |
$73.95
|
| Rate for Payer: Signature Care PPO |
$73.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,700.00
|
| Rate for Payer: United Healthcare Commercial |
$79.66
|
| Rate for Payer: United Healthcare Commercial |
$79.66
|
| Rate for Payer: United Healthcare Medicare |
$72.97
|
| Rate for Payer: United Healthcare Medicare |
$72.97
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN
|
Professional
|
Both
|
$392.36
|
|
|
Service Code
|
CPT 99236
|
| Hospital Charge Code |
z99236
|
| Min. Negotiated Rate |
$192.98 |
| Max. Negotiated Rate |
$20,500.00 |
| Rate for Payer: Aetna Commercial |
$200.48
|
| Rate for Payer: Aetna Commercial |
$200.48
|
| Rate for Payer: Aetna Medicare |
$200.48
|
| Rate for Payer: Aetna Medicare |
$200.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$226.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$226.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$226.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$226.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$226.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$226.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$226.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$226.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$192.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$192.98
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$230.55
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$230.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$220.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$220.53
|
| Rate for Payer: Cash Price |
$235.42
|
| Rate for Payer: Cash Price |
$233.35
|
| Rate for Payer: Centivo All Commercial |
$310.74
|
| Rate for Payer: Centivo All Commercial |
$310.74
|
| Rate for Payer: Cigna All Commercial |
$200.48
|
| Rate for Payer: Cigna All Commercial |
$200.48
|
| Rate for Payer: CORVEL All Commercial |
$200.48
|
| Rate for Payer: CORVEL All Commercial |
$200.48
|
| Rate for Payer: Coventry All Commercial |
$240.58
|
| Rate for Payer: Coventry All Commercial |
$240.58
|
| Rate for Payer: Encore All Commercial |
$200.48
|
| Rate for Payer: Encore All Commercial |
$200.48
|
| Rate for Payer: Frontpath All Commercial |
$216.27
|
| Rate for Payer: Frontpath All Commercial |
$216.27
|
| Rate for Payer: Humana ChoiceCare |
$214.03
|
| Rate for Payer: Humana ChoiceCare |
$214.03
|
| Rate for Payer: Humana Medicare |
$200.48
|
| Rate for Payer: Humana Medicare |
$200.48
|
| Rate for Payer: Lucent All Commercial |
$280.67
|
| Rate for Payer: Lucent All Commercial |
$280.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$209.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$209.00
|
| Rate for Payer: Managed Health Services Medicaid |
$192.98
|
| Rate for Payer: Managed Health Services Medicaid |
$192.98
|
| Rate for Payer: MDWise Medicaid |
$192.98
|
| Rate for Payer: MDWise Medicaid |
$192.98
|
| Rate for Payer: PHCS All Commercial |
$200.48
|
| Rate for Payer: PHCS All Commercial |
$200.48
|
| Rate for Payer: PHP All Commercial |
$200.29
|
| Rate for Payer: PHP All Commercial |
$200.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$200.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$200.48
|
| Rate for Payer: Sagamore Health Network All Products |
$200.48
|
| Rate for Payer: Sagamore Health Network All Products |
$200.48
|
| Rate for Payer: Signature Care EPO |
$240.55
|
| Rate for Payer: Signature Care EPO |
$240.55
|
| Rate for Payer: Signature Care PPO |
$240.55
|
| Rate for Payer: Signature Care PPO |
$240.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,500.00
|
| Rate for Payer: United Healthcare Commercial |
$210.83
|
| Rate for Payer: United Healthcare Commercial |
$210.83
|
| Rate for Payer: United Healthcare Medicare |
$194.46
|
| Rate for Payer: United Healthcare Medicare |
$194.46
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN
|
Professional
|
Both
|
$300.18
|
|
|
Service Code
|
CPT 99235
|
| Hospital Charge Code |
z99235
|
| Min. Negotiated Rate |
$147.64 |
| Max. Negotiated Rate |
$15,600.00 |
| Rate for Payer: Aetna Commercial |
$156.48
|
| Rate for Payer: Aetna Commercial |
$156.48
|
| Rate for Payer: Aetna Medicare |
$156.48
|
| Rate for Payer: Aetna Medicare |
$156.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$182.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$182.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$182.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$182.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$182.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$182.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$182.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$182.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$147.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$147.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$179.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$179.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$172.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$172.13
|
| Rate for Payer: Cash Price |
$180.11
|
| Rate for Payer: Cash Price |
$177.70
|
| Rate for Payer: Centivo All Commercial |
$242.54
|
| Rate for Payer: Centivo All Commercial |
$242.54
|
| Rate for Payer: Cigna All Commercial |
$156.48
|
| Rate for Payer: Cigna All Commercial |
$156.48
|
| Rate for Payer: CORVEL All Commercial |
$156.48
|
| Rate for Payer: CORVEL All Commercial |
$156.48
|
| Rate for Payer: Coventry All Commercial |
$187.78
|
| Rate for Payer: Coventry All Commercial |
$187.78
|
| Rate for Payer: Encore All Commercial |
$156.48
|
| Rate for Payer: Encore All Commercial |
$156.48
|
| Rate for Payer: Frontpath All Commercial |
$168.77
|
| Rate for Payer: Frontpath All Commercial |
$168.77
|
| Rate for Payer: Humana ChoiceCare |
$171.36
|
| Rate for Payer: Humana ChoiceCare |
$171.36
|
| Rate for Payer: Humana Medicare |
$156.48
|
| Rate for Payer: Humana Medicare |
$156.48
|
| Rate for Payer: Lucent All Commercial |
$219.07
|
| Rate for Payer: Lucent All Commercial |
$219.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$159.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$159.00
|
| Rate for Payer: Managed Health Services Medicaid |
$147.64
|
| Rate for Payer: Managed Health Services Medicaid |
$147.64
|
| Rate for Payer: MDWise Medicaid |
$147.64
|
| Rate for Payer: MDWise Medicaid |
$147.64
|
| Rate for Payer: PHCS All Commercial |
$156.48
|
| Rate for Payer: PHCS All Commercial |
$156.48
|
| Rate for Payer: PHP All Commercial |
$152.52
|
| Rate for Payer: PHP All Commercial |
$152.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$156.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$156.48
|
| Rate for Payer: Sagamore Health Network All Products |
$156.48
|
| Rate for Payer: Sagamore Health Network All Products |
$156.48
|
| Rate for Payer: Signature Care EPO |
$192.95
|
| Rate for Payer: Signature Care EPO |
$192.95
|
| Rate for Payer: Signature Care PPO |
$192.95
|
| Rate for Payer: Signature Care PPO |
$192.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,600.00
|
| Rate for Payer: United Healthcare Commercial |
$169.62
|
| Rate for Payer: United Healthcare Commercial |
$169.62
|
| Rate for Payer: United Healthcare Medicare |
$148.08
|
| Rate for Payer: United Healthcare Medicare |
$148.08
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN
|
Professional
|
Both
|
$183.44
|
|
|
Service Code
|
CPT 99234
|
| Hospital Charge Code |
z99234
|
| Min. Negotiated Rate |
$90.23 |
| Max. Negotiated Rate |
$9,600.00 |
| Rate for Payer: Aetna Commercial |
$122.97
|
| Rate for Payer: Aetna Commercial |
$122.97
|
| Rate for Payer: Aetna Medicare |
$122.97
|
| Rate for Payer: Aetna Medicare |
$122.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$136.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$136.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$136.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$136.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$136.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$136.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$136.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$136.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$90.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$90.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$141.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$141.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$135.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$135.27
|
| Rate for Payer: Cash Price |
$110.06
|
| Rate for Payer: Cash Price |
$109.49
|
| Rate for Payer: Centivo All Commercial |
$190.60
|
| Rate for Payer: Centivo All Commercial |
$190.60
|
| Rate for Payer: Cigna All Commercial |
$122.97
|
| Rate for Payer: Cigna All Commercial |
$122.97
|
| Rate for Payer: CORVEL All Commercial |
$122.97
|
| Rate for Payer: CORVEL All Commercial |
$122.97
|
| Rate for Payer: Coventry All Commercial |
$147.56
|
| Rate for Payer: Coventry All Commercial |
$147.56
|
| Rate for Payer: Encore All Commercial |
$122.97
|
| Rate for Payer: Encore All Commercial |
$122.97
|
| Rate for Payer: Frontpath All Commercial |
$133.33
|
| Rate for Payer: Frontpath All Commercial |
$133.33
|
| Rate for Payer: Humana ChoiceCare |
$129.72
|
| Rate for Payer: Humana ChoiceCare |
$129.72
|
| Rate for Payer: Humana Medicare |
$122.97
|
| Rate for Payer: Humana Medicare |
$122.97
|
| Rate for Payer: Lucent All Commercial |
$172.16
|
| Rate for Payer: Lucent All Commercial |
$172.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$98.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$98.00
|
| Rate for Payer: Managed Health Services Medicaid |
$90.23
|
| Rate for Payer: Managed Health Services Medicaid |
$90.23
|
| Rate for Payer: MDWise Medicaid |
$90.23
|
| Rate for Payer: MDWise Medicaid |
$90.23
|
| Rate for Payer: PHCS All Commercial |
$122.97
|
| Rate for Payer: PHCS All Commercial |
$122.97
|
| Rate for Payer: PHP All Commercial |
$93.97
|
| Rate for Payer: PHP All Commercial |
$93.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$122.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$122.97
|
| Rate for Payer: Sagamore Health Network All Products |
$122.97
|
| Rate for Payer: Sagamore Health Network All Products |
$122.97
|
| Rate for Payer: Signature Care EPO |
$146.20
|
| Rate for Payer: Signature Care EPO |
$146.20
|
| Rate for Payer: Signature Care PPO |
$146.20
|
| Rate for Payer: Signature Care PPO |
$146.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,600.00
|
| Rate for Payer: United Healthcare Commercial |
$129.10
|
| Rate for Payer: United Healthcare Commercial |
$129.10
|
| Rate for Payer: United Healthcare Medicare |
$91.24
|
| Rate for Payer: United Healthcare Medicare |
$91.24
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN
|
Professional
|
Both
|
$215.50
|
|
|
Service Code
|
CPT 99239
|
| Hospital Charge Code |
z99239
|
| Min. Negotiated Rate |
$92.54 |
| Max. Negotiated Rate |
$11,200.00 |
| Rate for Payer: Aetna Commercial |
$99.45
|
| Rate for Payer: Aetna Commercial |
$99.45
|
| Rate for Payer: Aetna Medicare |
$99.45
|
| Rate for Payer: Aetna Medicare |
$99.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$108.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$108.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$108.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$108.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$108.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$108.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$108.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$108.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$105.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$105.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$114.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$114.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$109.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$109.39
|
| Rate for Payer: Cash Price |
$129.30
|
| Rate for Payer: Cash Price |
$127.18
|
| Rate for Payer: Centivo All Commercial |
$154.15
|
| Rate for Payer: Centivo All Commercial |
$154.15
|
| Rate for Payer: Cigna All Commercial |
$99.45
|
| Rate for Payer: Cigna All Commercial |
$99.45
|
| Rate for Payer: CORVEL All Commercial |
$99.45
|
| Rate for Payer: CORVEL All Commercial |
$99.45
|
| Rate for Payer: Coventry All Commercial |
$119.34
|
| Rate for Payer: Coventry All Commercial |
$119.34
|
| Rate for Payer: Encore All Commercial |
$99.45
|
| Rate for Payer: Encore All Commercial |
$99.45
|
| Rate for Payer: Frontpath All Commercial |
$106.62
|
| Rate for Payer: Frontpath All Commercial |
$106.62
|
| Rate for Payer: Humana ChoiceCare |
$92.54
|
| Rate for Payer: Humana ChoiceCare |
$92.54
|
| Rate for Payer: Humana Medicare |
$99.45
|
| Rate for Payer: Humana Medicare |
$99.45
|
| Rate for Payer: Lucent All Commercial |
$139.23
|
| Rate for Payer: Lucent All Commercial |
$139.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$114.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$114.00
|
| Rate for Payer: Managed Health Services Medicaid |
$105.99
|
| Rate for Payer: Managed Health Services Medicaid |
$105.99
|
| Rate for Payer: MDWise Medicaid |
$105.99
|
| Rate for Payer: MDWise Medicaid |
$105.99
|
| Rate for Payer: PHCS All Commercial |
$99.45
|
| Rate for Payer: PHCS All Commercial |
$99.45
|
| Rate for Payer: PHP All Commercial |
$109.16
|
| Rate for Payer: PHP All Commercial |
$109.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$99.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$99.45
|
| Rate for Payer: Sagamore Health Network All Products |
$99.45
|
| Rate for Payer: Sagamore Health Network All Products |
$99.45
|
| Rate for Payer: Signature Care EPO |
$101.15
|
| Rate for Payer: Signature Care EPO |
$101.15
|
| Rate for Payer: Signature Care PPO |
$101.15
|
| Rate for Payer: Signature Care PPO |
$101.15
|
| 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 |
$97.88
|
| Rate for Payer: United Healthcare Commercial |
$97.88
|
| Rate for Payer: United Healthcare Medicare |
$105.98
|
| Rate for Payer: United Healthcare Medicare |
$105.98
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<
|
Professional
|
Both
|
$152.52
|
|
|
Service Code
|
CPT 99238
|
| Hospital Charge Code |
z99238
|
| Min. Negotiated Rate |
$67.34 |
| Max. Negotiated Rate |
$7,900.00 |
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: Aetna Medicare |
$67.86
|
| Rate for Payer: Aetna Medicare |
$67.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$76.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$76.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.02
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$74.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$74.65
|
| Rate for Payer: Cash Price |
$91.51
|
| Rate for Payer: Cash Price |
$89.77
|
| Rate for Payer: Centivo All Commercial |
$105.18
|
| Rate for Payer: Centivo All Commercial |
$105.18
|
| Rate for Payer: Cigna All Commercial |
$67.86
|
| Rate for Payer: Cigna All Commercial |
$67.86
|
| Rate for Payer: CORVEL All Commercial |
$67.86
|
| Rate for Payer: CORVEL All Commercial |
$67.86
|
| Rate for Payer: Coventry All Commercial |
$81.43
|
| Rate for Payer: Coventry All Commercial |
$81.43
|
| Rate for Payer: Encore All Commercial |
$67.86
|
| Rate for Payer: Encore All Commercial |
$67.86
|
| Rate for Payer: Frontpath All Commercial |
$72.95
|
| Rate for Payer: Frontpath All Commercial |
$72.95
|
| Rate for Payer: Humana ChoiceCare |
$67.88
|
| Rate for Payer: Humana ChoiceCare |
$67.88
|
| Rate for Payer: Humana Medicare |
$67.86
|
| Rate for Payer: Humana Medicare |
$67.86
|
| Rate for Payer: Lucent All Commercial |
$95.00
|
| Rate for Payer: Lucent All Commercial |
$95.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$81.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$81.00
|
| Rate for Payer: Managed Health Services Medicaid |
$75.02
|
| Rate for Payer: Managed Health Services Medicaid |
$75.02
|
| Rate for Payer: MDWise Medicaid |
$75.02
|
| Rate for Payer: MDWise Medicaid |
$75.02
|
| Rate for Payer: PHCS All Commercial |
$67.86
|
| Rate for Payer: PHCS All Commercial |
$67.86
|
| Rate for Payer: PHP All Commercial |
$77.06
|
| Rate for Payer: PHP All Commercial |
$77.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.86
|
| Rate for Payer: Sagamore Health Network All Products |
$67.86
|
| Rate for Payer: Sagamore Health Network All Products |
$67.86
|
| Rate for Payer: Signature Care EPO |
$73.95
|
| Rate for Payer: Signature Care EPO |
$73.95
|
| Rate for Payer: Signature Care PPO |
$73.95
|
| Rate for Payer: Signature Care PPO |
$73.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,900.00
|
| Rate for Payer: United Healthcare Commercial |
$67.34
|
| Rate for Payer: United Healthcare Commercial |
$67.34
|
| Rate for Payer: United Healthcare Medicare |
$74.81
|
| Rate for Payer: United Healthcare Medicare |
$74.81
|
|
|
PR HYMENOTOMY, SIMPLE INCISION
|
Professional
|
Both
|
$87.82
|
|
|
Service Code
|
CPT 56442
|
| Hospital Charge Code |
z56442
|
| Min. Negotiated Rate |
$43.04 |
| Max. Negotiated Rate |
$5,700.00 |
| Rate for Payer: Aetna Commercial |
$43.68
|
| Rate for Payer: Aetna Commercial |
$43.68
|
| Rate for Payer: Aetna Medicare |
$43.68
|
| Rate for Payer: Aetna Medicare |
$43.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$62.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$62.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$62.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$62.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$62.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$62.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$62.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$62.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$43.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$43.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.05
|
| Rate for Payer: Cash Price |
$52.69
|
| Rate for Payer: Cash Price |
$51.65
|
| Rate for Payer: Centivo All Commercial |
$67.70
|
| Rate for Payer: Centivo All Commercial |
$67.70
|
| Rate for Payer: Cigna All Commercial |
$43.68
|
| Rate for Payer: Cigna All Commercial |
$43.68
|
| Rate for Payer: CORVEL All Commercial |
$43.68
|
| Rate for Payer: CORVEL All Commercial |
$43.68
|
| Rate for Payer: Coventry All Commercial |
$52.42
|
| Rate for Payer: Coventry All Commercial |
$52.42
|
| Rate for Payer: Encore All Commercial |
$43.68
|
| Rate for Payer: Encore All Commercial |
$43.68
|
| Rate for Payer: Frontpath All Commercial |
$60.24
|
| Rate for Payer: Frontpath All Commercial |
$60.24
|
| Rate for Payer: Humana ChoiceCare |
$49.10
|
| Rate for Payer: Humana ChoiceCare |
$49.10
|
| Rate for Payer: Humana Medicare |
$43.68
|
| Rate for Payer: Humana Medicare |
$43.68
|
| Rate for Payer: Lucent All Commercial |
$61.15
|
| Rate for Payer: Lucent All Commercial |
$61.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$62.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$62.00
|
| Rate for Payer: Managed Health Services Medicaid |
$43.19
|
| Rate for Payer: Managed Health Services Medicaid |
$43.19
|
| Rate for Payer: MDWise Medicaid |
$43.19
|
| Rate for Payer: MDWise Medicaid |
$43.19
|
| Rate for Payer: PHCS All Commercial |
$43.68
|
| Rate for Payer: PHCS All Commercial |
$43.68
|
| Rate for Payer: PHP All Commercial |
$56.81
|
| Rate for Payer: PHP All Commercial |
$56.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.68
|
| Rate for Payer: Sagamore Health Network All Products |
$43.68
|
| Rate for Payer: Sagamore Health Network All Products |
$43.68
|
| Rate for Payer: Signature Care EPO |
$54.40
|
| Rate for Payer: Signature Care EPO |
$54.40
|
| Rate for Payer: Signature Care PPO |
$54.40
|
| Rate for Payer: Signature Care PPO |
$54.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,700.00
|
| Rate for Payer: United Healthcare Commercial |
$54.75
|
| Rate for Payer: United Healthcare Commercial |
$54.75
|
| Rate for Payer: United Healthcare Medicare |
$43.04
|
| Rate for Payer: United Healthcare Medicare |
$43.04
|
|
