|
PR IMMUNOTHERAPY, 2+ INJECTIONS
|
Professional
|
Both
|
$22.42
|
|
|
Service Code
|
CPT 95117
|
| Hospital Charge Code |
z95117
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$1,300.00 |
| Rate for Payer: Aetna Commercial |
$10.44
|
| Rate for Payer: Aetna Commercial |
$10.44
|
| Rate for Payer: Aetna Medicare |
$10.44
|
| Rate for Payer: Aetna Medicare |
$10.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$19.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$19.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$19.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$19.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$19.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$19.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$19.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$19.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$11.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$11.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$11.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$11.48
|
| Rate for Payer: Cash Price |
$13.45
|
| Rate for Payer: Cash Price |
$12.48
|
| Rate for Payer: Centivo All Commercial |
$16.18
|
| Rate for Payer: Centivo All Commercial |
$16.18
|
| Rate for Payer: Cigna All Commercial |
$10.44
|
| Rate for Payer: Cigna All Commercial |
$10.44
|
| Rate for Payer: CORVEL All Commercial |
$10.44
|
| Rate for Payer: CORVEL All Commercial |
$10.44
|
| Rate for Payer: Coventry All Commercial |
$12.53
|
| Rate for Payer: Coventry All Commercial |
$12.53
|
| Rate for Payer: Encore All Commercial |
$10.44
|
| Rate for Payer: Encore All Commercial |
$10.44
|
| Rate for Payer: Frontpath All Commercial |
$17.99
|
| Rate for Payer: Frontpath All Commercial |
$17.99
|
| Rate for Payer: Humana ChoiceCare |
$23.15
|
| Rate for Payer: Humana ChoiceCare |
$23.15
|
| Rate for Payer: Humana Medicare |
$10.44
|
| Rate for Payer: Humana Medicare |
$10.44
|
| Rate for Payer: Lucent All Commercial |
$14.62
|
| Rate for Payer: Lucent All Commercial |
$14.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14.00
|
| Rate for Payer: Managed Health Services Medicaid |
$11.03
|
| Rate for Payer: Managed Health Services Medicaid |
$11.03
|
| Rate for Payer: MDWise Medicaid |
$11.03
|
| Rate for Payer: MDWise Medicaid |
$11.03
|
| Rate for Payer: PHCS All Commercial |
$10.44
|
| Rate for Payer: PHCS All Commercial |
$10.44
|
| Rate for Payer: PHP All Commercial |
$11.96
|
| Rate for Payer: PHP All Commercial |
$11.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$10.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$10.44
|
| Rate for Payer: Sagamore Health Network All Products |
$10.44
|
| Rate for Payer: Sagamore Health Network All Products |
$10.44
|
| Rate for Payer: Signature Care EPO |
$16.05
|
| Rate for Payer: Signature Care EPO |
$16.05
|
| Rate for Payer: Signature Care PPO |
$16.05
|
| Rate for Payer: Signature Care PPO |
$16.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,300.00
|
| Rate for Payer: United Healthcare Commercial |
$14.20
|
| Rate for Payer: United Healthcare Commercial |
$14.20
|
| Rate for Payer: United Healthcare Medicare |
$10.40
|
| Rate for Payer: United Healthcare Medicare |
$10.40
|
|
|
PR IMMUNOTHERAPY, ONE INJECTION
|
Professional
|
Both
|
$18.74
|
|
|
Service Code
|
CPT 95115
|
| Hospital Charge Code |
z95115
|
| Min. Negotiated Rate |
$8.57 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Aetna Commercial |
$8.57
|
| Rate for Payer: Aetna Commercial |
$8.57
|
| Rate for Payer: Aetna Medicare |
$8.57
|
| Rate for Payer: Aetna Medicare |
$8.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$15.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$15.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$15.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$15.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$15.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$15.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$9.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$9.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$9.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$9.43
|
| Rate for Payer: Cash Price |
$11.24
|
| Rate for Payer: Cash Price |
$10.67
|
| Rate for Payer: Centivo All Commercial |
$13.28
|
| Rate for Payer: Centivo All Commercial |
$13.28
|
| Rate for Payer: Cigna All Commercial |
$8.57
|
| Rate for Payer: Cigna All Commercial |
$8.57
|
| Rate for Payer: CORVEL All Commercial |
$8.57
|
| Rate for Payer: CORVEL All Commercial |
$8.57
|
| Rate for Payer: Coventry All Commercial |
$10.28
|
| Rate for Payer: Coventry All Commercial |
$10.28
|
| Rate for Payer: Encore All Commercial |
$8.57
|
| Rate for Payer: Encore All Commercial |
$8.57
|
| Rate for Payer: Frontpath All Commercial |
$14.19
|
| Rate for Payer: Frontpath All Commercial |
$14.19
|
| Rate for Payer: Humana ChoiceCare |
$18.15
|
| Rate for Payer: Humana ChoiceCare |
$18.15
|
| Rate for Payer: Humana Medicare |
$8.57
|
| Rate for Payer: Humana Medicare |
$8.57
|
| Rate for Payer: Lucent All Commercial |
$12.00
|
| Rate for Payer: Lucent All Commercial |
$12.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12.00
|
| Rate for Payer: Managed Health Services Medicaid |
$9.22
|
| Rate for Payer: Managed Health Services Medicaid |
$9.22
|
| Rate for Payer: MDWise Medicaid |
$9.22
|
| Rate for Payer: MDWise Medicaid |
$9.22
|
| Rate for Payer: PHCS All Commercial |
$8.57
|
| Rate for Payer: PHCS All Commercial |
$8.57
|
| Rate for Payer: PHP All Commercial |
$10.23
|
| Rate for Payer: PHP All Commercial |
$10.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$8.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$8.57
|
| Rate for Payer: Sagamore Health Network All Products |
$8.57
|
| Rate for Payer: Sagamore Health Network All Products |
$8.57
|
| Rate for Payer: Signature Care EPO |
$11.90
|
| Rate for Payer: Signature Care EPO |
$11.90
|
| Rate for Payer: Signature Care PPO |
$11.90
|
| Rate for Payer: Signature Care PPO |
$11.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.00
|
| Rate for Payer: United Healthcare Commercial |
$11.71
|
| Rate for Payer: United Healthcare Commercial |
$11.71
|
| Rate for Payer: United Healthcare Medicare |
$8.89
|
| Rate for Payer: United Healthcare Medicare |
$8.89
|
|
|
PR IMPLANT,HORMONE,SUBCUTANEOUS
|
Professional
|
Both
|
$175.06
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
z11980
|
| Min. Negotiated Rate |
$51.83 |
| Max. Negotiated Rate |
$6,200.00 |
| Rate for Payer: Aetna Commercial |
$51.83
|
| Rate for Payer: Aetna Commercial |
$51.83
|
| Rate for Payer: Aetna Medicare |
$51.83
|
| Rate for Payer: Aetna Medicare |
$51.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$123.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$123.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$123.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$123.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$123.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$123.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$123.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$123.13
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$55.37
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$55.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$86.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$86.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$57.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$57.01
|
| Rate for Payer: Cash Price |
$102.86
|
| Rate for Payer: Cash Price |
$105.04
|
| Rate for Payer: Centivo All Commercial |
$80.34
|
| Rate for Payer: Centivo All Commercial |
$80.34
|
| Rate for Payer: Cigna All Commercial |
$51.83
|
| Rate for Payer: Cigna All Commercial |
$51.83
|
| Rate for Payer: CORVEL All Commercial |
$51.83
|
| Rate for Payer: CORVEL All Commercial |
$51.83
|
| Rate for Payer: Coventry All Commercial |
$62.20
|
| Rate for Payer: Coventry All Commercial |
$62.20
|
| Rate for Payer: Encore All Commercial |
$51.83
|
| Rate for Payer: Encore All Commercial |
$51.83
|
| Rate for Payer: Frontpath All Commercial |
$71.01
|
| Rate for Payer: Frontpath All Commercial |
$71.01
|
| Rate for Payer: Humana ChoiceCare |
$76.78
|
| Rate for Payer: Humana ChoiceCare |
$76.78
|
| Rate for Payer: Humana Medicare |
$51.83
|
| Rate for Payer: Humana Medicare |
$51.83
|
| Rate for Payer: Lucent All Commercial |
$72.56
|
| Rate for Payer: Lucent All Commercial |
$72.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$68.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$68.00
|
| Rate for Payer: Managed Health Services Medicaid |
$86.10
|
| Rate for Payer: Managed Health Services Medicaid |
$86.10
|
| Rate for Payer: MDWise Medicaid |
$86.10
|
| Rate for Payer: MDWise Medicaid |
$86.10
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$55.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$55.37
|
| Rate for Payer: PHCS All Commercial |
$51.83
|
| Rate for Payer: PHCS All Commercial |
$51.83
|
| Rate for Payer: PHP All Commercial |
$71.10
|
| Rate for Payer: PHP All Commercial |
$71.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.83
|
| Rate for Payer: Sagamore Health Network All Products |
$51.83
|
| Rate for Payer: Sagamore Health Network All Products |
$51.83
|
| Rate for Payer: Signature Care EPO |
$107.10
|
| Rate for Payer: Signature Care EPO |
$107.10
|
| Rate for Payer: Signature Care PPO |
$107.10
|
| Rate for Payer: Signature Care PPO |
$107.10
|
| 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 |
$91.34
|
| Rate for Payer: United Healthcare Commercial |
$91.34
|
| Rate for Payer: United Healthcare Medicare |
$85.72
|
| Rate for Payer: United Healthcare Medicare |
$85.72
|
|
|
PR INC/DRAIN PERITONSIL ABSCESS
|
Professional
|
Both
|
$358.64
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
z42700
|
| Min. Negotiated Rate |
$108.98 |
| Max. Negotiated Rate |
$17,900.00 |
| Rate for Payer: Aetna Commercial |
$126.60
|
| Rate for Payer: Aetna Commercial |
$126.60
|
| Rate for Payer: Aetna Medicare |
$126.60
|
| Rate for Payer: Aetna Medicare |
$126.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$162.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$162.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$162.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$162.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$162.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$162.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$162.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$162.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$108.98
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$108.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$176.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$176.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$145.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$145.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$139.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$139.26
|
| Rate for Payer: Cash Price |
$212.28
|
| Rate for Payer: Cash Price |
$215.18
|
| Rate for Payer: Centivo All Commercial |
$196.23
|
| Rate for Payer: Centivo All Commercial |
$196.23
|
| Rate for Payer: Cigna All Commercial |
$126.60
|
| Rate for Payer: Cigna All Commercial |
$126.60
|
| Rate for Payer: CORVEL All Commercial |
$126.60
|
| Rate for Payer: CORVEL All Commercial |
$126.60
|
| Rate for Payer: Coventry All Commercial |
$151.92
|
| Rate for Payer: Coventry All Commercial |
$151.92
|
| Rate for Payer: Encore All Commercial |
$126.60
|
| Rate for Payer: Encore All Commercial |
$126.60
|
| Rate for Payer: Frontpath All Commercial |
$172.87
|
| Rate for Payer: Frontpath All Commercial |
$172.87
|
| Rate for Payer: Humana ChoiceCare |
$145.93
|
| Rate for Payer: Humana ChoiceCare |
$145.93
|
| Rate for Payer: Humana Medicare |
$126.60
|
| Rate for Payer: Humana Medicare |
$126.60
|
| Rate for Payer: Lucent All Commercial |
$177.24
|
| Rate for Payer: Lucent All Commercial |
$177.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$191.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$191.00
|
| Rate for Payer: Managed Health Services Medicaid |
$176.39
|
| Rate for Payer: Managed Health Services Medicaid |
$176.39
|
| Rate for Payer: MDWise Medicaid |
$176.39
|
| Rate for Payer: MDWise Medicaid |
$176.39
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$108.98
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$108.98
|
| Rate for Payer: PHCS All Commercial |
$126.60
|
| Rate for Payer: PHCS All Commercial |
$126.60
|
| Rate for Payer: PHP All Commercial |
$217.86
|
| Rate for Payer: PHP All Commercial |
$217.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$126.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$126.60
|
| Rate for Payer: Sagamore Health Network All Products |
$126.60
|
| Rate for Payer: Sagamore Health Network All Products |
$126.60
|
| 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 |
$17,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,900.00
|
| Rate for Payer: United Healthcare Commercial |
$146.98
|
| Rate for Payer: United Healthcare Commercial |
$146.98
|
| Rate for Payer: United Healthcare Medicare |
$176.90
|
| Rate for Payer: United Healthcare Medicare |
$176.90
|
|
|
PR INCIS ACHILLES TENDON+LOCAL ANESTH
|
Professional
|
Both
|
$613.80
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
z27605
|
| Min. Negotiated Rate |
$93.09 |
| Max. Negotiated Rate |
$26,000.00 |
| Rate for Payer: Aetna Commercial |
$173.60
|
| Rate for Payer: Aetna Commercial |
$173.60
|
| Rate for Payer: Aetna Medicare |
$173.60
|
| Rate for Payer: Aetna Medicare |
$173.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$379.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$379.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$379.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$379.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$379.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$379.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$379.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$379.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.09
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$301.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$301.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$199.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$199.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$190.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$190.96
|
| Rate for Payer: Cash Price |
$368.28
|
| Rate for Payer: Cash Price |
$362.00
|
| Rate for Payer: Centivo All Commercial |
$269.08
|
| Rate for Payer: Centivo All Commercial |
$269.08
|
| Rate for Payer: Cigna All Commercial |
$173.60
|
| Rate for Payer: Cigna All Commercial |
$173.60
|
| Rate for Payer: CORVEL All Commercial |
$173.60
|
| Rate for Payer: CORVEL All Commercial |
$173.60
|
| Rate for Payer: Coventry All Commercial |
$208.32
|
| Rate for Payer: Coventry All Commercial |
$208.32
|
| Rate for Payer: Encore All Commercial |
$173.60
|
| Rate for Payer: Encore All Commercial |
$173.60
|
| Rate for Payer: Frontpath All Commercial |
$234.61
|
| Rate for Payer: Frontpath All Commercial |
$234.61
|
| Rate for Payer: Humana ChoiceCare |
$225.26
|
| Rate for Payer: Humana ChoiceCare |
$225.26
|
| Rate for Payer: Humana Medicare |
$173.60
|
| Rate for Payer: Humana Medicare |
$173.60
|
| Rate for Payer: Lucent All Commercial |
$243.04
|
| Rate for Payer: Lucent All Commercial |
$243.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$277.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$277.00
|
| Rate for Payer: Managed Health Services Medicaid |
$301.89
|
| Rate for Payer: Managed Health Services Medicaid |
$301.89
|
| Rate for Payer: MDWise Medicaid |
$301.89
|
| Rate for Payer: MDWise Medicaid |
$301.89
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.09
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.09
|
| Rate for Payer: PHCS All Commercial |
$173.60
|
| Rate for Payer: PHCS All Commercial |
$173.60
|
| Rate for Payer: PHP All Commercial |
$294.31
|
| Rate for Payer: PHP All Commercial |
$294.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$173.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$173.60
|
| Rate for Payer: Sagamore Health Network All Products |
$173.60
|
| Rate for Payer: Sagamore Health Network All Products |
$173.60
|
| Rate for Payer: Signature Care EPO |
$533.92
|
| Rate for Payer: Signature Care EPO |
$533.92
|
| Rate for Payer: Signature Care PPO |
$533.92
|
| Rate for Payer: Signature Care PPO |
$533.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,000.00
|
| Rate for Payer: United Healthcare Commercial |
$220.41
|
| Rate for Payer: United Healthcare Commercial |
$220.41
|
| Rate for Payer: United Healthcare Medicare |
$301.67
|
| Rate for Payer: United Healthcare Medicare |
$301.67
|
|
|
PR INCIS DEEP FINGR/HAND BONE LESN
|
Professional
|
Both
|
$1,033.90
|
|
|
Service Code
|
CPT 26034
|
| Hospital Charge Code |
z26034
|
| Min. Negotiated Rate |
$504.47 |
| Max. Negotiated Rate |
$77,600.00 |
| Rate for Payer: Aetna Commercial |
$516.63
|
| Rate for Payer: Aetna Commercial |
$516.63
|
| Rate for Payer: Aetna Medicare |
$516.63
|
| Rate for Payer: Aetna Medicare |
$516.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$703.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$703.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$703.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$703.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$703.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$703.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$703.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$703.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$508.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$508.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$594.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$594.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$568.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$568.29
|
| Rate for Payer: Cash Price |
$620.34
|
| Rate for Payer: Cash Price |
$605.36
|
| Rate for Payer: Centivo All Commercial |
$800.78
|
| Rate for Payer: Centivo All Commercial |
$800.78
|
| Rate for Payer: Cigna All Commercial |
$516.63
|
| Rate for Payer: Cigna All Commercial |
$516.63
|
| Rate for Payer: CORVEL All Commercial |
$516.63
|
| Rate for Payer: CORVEL All Commercial |
$516.63
|
| Rate for Payer: Coventry All Commercial |
$619.96
|
| Rate for Payer: Coventry All Commercial |
$619.96
|
| Rate for Payer: Encore All Commercial |
$516.63
|
| Rate for Payer: Encore All Commercial |
$516.63
|
| Rate for Payer: Frontpath All Commercial |
$712.28
|
| Rate for Payer: Frontpath All Commercial |
$712.28
|
| Rate for Payer: Humana ChoiceCare |
$542.74
|
| Rate for Payer: Humana ChoiceCare |
$542.74
|
| Rate for Payer: Humana Medicare |
$516.63
|
| Rate for Payer: Humana Medicare |
$516.63
|
| Rate for Payer: Lucent All Commercial |
$723.28
|
| Rate for Payer: Lucent All Commercial |
$723.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$827.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$827.00
|
| Rate for Payer: Managed Health Services Medicaid |
$508.51
|
| Rate for Payer: Managed Health Services Medicaid |
$508.51
|
| Rate for Payer: MDWise Medicaid |
$508.51
|
| Rate for Payer: MDWise Medicaid |
$508.51
|
| Rate for Payer: PHCS All Commercial |
$516.63
|
| Rate for Payer: PHCS All Commercial |
$516.63
|
| Rate for Payer: PHP All Commercial |
$877.77
|
| Rate for Payer: PHP All Commercial |
$877.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$516.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$516.63
|
| Rate for Payer: Sagamore Health Network All Products |
$516.63
|
| Rate for Payer: Sagamore Health Network All Products |
$516.63
|
| Rate for Payer: Signature Care EPO |
$722.50
|
| Rate for Payer: Signature Care EPO |
$722.50
|
| Rate for Payer: Signature Care PPO |
$722.50
|
| Rate for Payer: Signature Care PPO |
$722.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$77,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$77,600.00
|
| Rate for Payer: United Healthcare Commercial |
$562.39
|
| Rate for Payer: United Healthcare Commercial |
$562.39
|
| Rate for Payer: United Healthcare Medicare |
$504.47
|
| Rate for Payer: United Healthcare Medicare |
$504.47
|
|
|
PR INCIS/DRAIN ARM,DEEP ABSC/HEMATOMA
|
Professional
|
Both
|
$662.58
|
|
|
Service Code
|
CPT 23930
|
| Hospital Charge Code |
z23930
|
| Min. Negotiated Rate |
$110.74 |
| Max. Negotiated Rate |
$29,900.00 |
| Rate for Payer: Aetna Commercial |
$200.35
|
| Rate for Payer: Aetna Commercial |
$200.35
|
| Rate for Payer: Aetna Medicare |
$200.35
|
| Rate for Payer: Aetna Medicare |
$200.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$365.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$365.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$365.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$365.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$365.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$365.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$365.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$365.65
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$110.74
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$110.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$325.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$325.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$230.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$230.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$220.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$220.38
|
| Rate for Payer: Cash Price |
$392.71
|
| Rate for Payer: Cash Price |
$397.55
|
| Rate for Payer: Centivo All Commercial |
$310.54
|
| Rate for Payer: Centivo All Commercial |
$310.54
|
| Rate for Payer: Cigna All Commercial |
$200.35
|
| Rate for Payer: Cigna All Commercial |
$200.35
|
| Rate for Payer: CORVEL All Commercial |
$200.35
|
| Rate for Payer: CORVEL All Commercial |
$200.35
|
| Rate for Payer: Coventry All Commercial |
$240.42
|
| Rate for Payer: Coventry All Commercial |
$240.42
|
| Rate for Payer: Encore All Commercial |
$200.35
|
| Rate for Payer: Encore All Commercial |
$200.35
|
| Rate for Payer: Frontpath All Commercial |
$279.63
|
| Rate for Payer: Frontpath All Commercial |
$279.63
|
| Rate for Payer: Humana ChoiceCare |
$228.30
|
| Rate for Payer: Humana ChoiceCare |
$228.30
|
| Rate for Payer: Humana Medicare |
$200.35
|
| Rate for Payer: Humana Medicare |
$200.35
|
| Rate for Payer: Lucent All Commercial |
$280.49
|
| Rate for Payer: Lucent All Commercial |
$280.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$319.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$319.00
|
| Rate for Payer: Managed Health Services Medicaid |
$325.88
|
| Rate for Payer: Managed Health Services Medicaid |
$325.88
|
| Rate for Payer: MDWise Medicaid |
$325.88
|
| Rate for Payer: MDWise Medicaid |
$325.88
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$110.74
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$110.74
|
| Rate for Payer: PHCS All Commercial |
$200.35
|
| Rate for Payer: PHCS All Commercial |
$200.35
|
| Rate for Payer: PHP All Commercial |
$338.85
|
| Rate for Payer: PHP All Commercial |
$338.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$200.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$200.35
|
| Rate for Payer: Sagamore Health Network All Products |
$200.35
|
| Rate for Payer: Sagamore Health Network All Products |
$200.35
|
| Rate for Payer: Signature Care EPO |
$326.40
|
| Rate for Payer: Signature Care EPO |
$326.40
|
| Rate for Payer: Signature Care PPO |
$326.40
|
| Rate for Payer: Signature Care PPO |
$326.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29,900.00
|
| Rate for Payer: United Healthcare Commercial |
$232.39
|
| Rate for Payer: United Healthcare Commercial |
$232.39
|
| Rate for Payer: United Healthcare Medicare |
$327.26
|
| Rate for Payer: United Healthcare Medicare |
$327.26
|
|
|
PR INCIS/DRAIN ARM/ELBOW INFECT BURSA
|
Professional
|
Both
|
$561.64
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
z23931
|
| Min. Negotiated Rate |
$82.37 |
| Max. Negotiated Rate |
$22,600.00 |
| Rate for Payer: Aetna Commercial |
$149.50
|
| Rate for Payer: Aetna Commercial |
$149.50
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$283.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$283.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$283.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$283.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$283.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$283.68
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$82.37
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$82.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$276.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$276.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$164.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$164.45
|
| Rate for Payer: Cash Price |
$332.22
|
| Rate for Payer: Cash Price |
$336.98
|
| Rate for Payer: Centivo All Commercial |
$231.72
|
| Rate for Payer: Centivo All Commercial |
$231.72
|
| Rate for Payer: Cigna All Commercial |
$149.50
|
| Rate for Payer: Cigna All Commercial |
$149.50
|
| Rate for Payer: CORVEL All Commercial |
$149.50
|
| Rate for Payer: CORVEL All Commercial |
$149.50
|
| Rate for Payer: Coventry All Commercial |
$179.40
|
| Rate for Payer: Coventry All Commercial |
$179.40
|
| Rate for Payer: Encore All Commercial |
$149.50
|
| Rate for Payer: Encore All Commercial |
$149.50
|
| Rate for Payer: Frontpath All Commercial |
$205.48
|
| Rate for Payer: Frontpath All Commercial |
$205.48
|
| Rate for Payer: Humana ChoiceCare |
$169.70
|
| Rate for Payer: Humana ChoiceCare |
$169.70
|
| Rate for Payer: Humana Medicare |
$149.50
|
| Rate for Payer: Humana Medicare |
$149.50
|
| Rate for Payer: Lucent All Commercial |
$209.30
|
| Rate for Payer: Lucent All Commercial |
$209.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$241.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$241.00
|
| Rate for Payer: Managed Health Services Medicaid |
$276.23
|
| Rate for Payer: Managed Health Services Medicaid |
$276.23
|
| Rate for Payer: MDWise Medicaid |
$276.23
|
| Rate for Payer: MDWise Medicaid |
$276.23
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$82.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$82.37
|
| Rate for Payer: PHCS All Commercial |
$149.50
|
| Rate for Payer: PHCS All Commercial |
$149.50
|
| Rate for Payer: PHP All Commercial |
$255.33
|
| Rate for Payer: PHP All Commercial |
$255.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$149.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$149.50
|
| Rate for Payer: Sagamore Health Network All Products |
$149.50
|
| Rate for Payer: Sagamore Health Network All Products |
$149.50
|
| Rate for Payer: Signature Care EPO |
$243.56
|
| Rate for Payer: Signature Care EPO |
$243.56
|
| Rate for Payer: Signature Care PPO |
$243.56
|
| Rate for Payer: Signature Care PPO |
$243.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$22,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$22,600.00
|
| Rate for Payer: United Healthcare Commercial |
$166.55
|
| Rate for Payer: United Healthcare Commercial |
$166.55
|
| Rate for Payer: United Healthcare Medicare |
$276.85
|
| Rate for Payer: United Healthcare Medicare |
$276.85
|
|
|
PR INCIS/DRAIN FOREARM DEEP ABSCESS
|
Professional
|
Both
|
$1,285.30
|
|
|
Service Code
|
CPT 25028
|
| Hospital Charge Code |
z25028
|
| Min. Negotiated Rate |
$524.30 |
| Max. Negotiated Rate |
$97,300.00 |
| Rate for Payer: Aetna Commercial |
$661.27
|
| Rate for Payer: Aetna Commercial |
$661.27
|
| Rate for Payer: Aetna Medicare |
$661.27
|
| Rate for Payer: Aetna Medicare |
$661.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$524.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$524.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$524.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$524.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$524.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$524.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$524.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$524.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$632.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$632.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$760.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$760.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$727.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$727.40
|
| Rate for Payer: Cash Price |
$771.18
|
| Rate for Payer: Cash Price |
$759.67
|
| Rate for Payer: Centivo All Commercial |
$1,024.97
|
| Rate for Payer: Centivo All Commercial |
$1,024.97
|
| Rate for Payer: Cigna All Commercial |
$661.27
|
| Rate for Payer: Cigna All Commercial |
$661.27
|
| Rate for Payer: CORVEL All Commercial |
$661.27
|
| Rate for Payer: CORVEL All Commercial |
$661.27
|
| Rate for Payer: Coventry All Commercial |
$793.52
|
| Rate for Payer: Coventry All Commercial |
$793.52
|
| Rate for Payer: Encore All Commercial |
$661.27
|
| Rate for Payer: Encore All Commercial |
$661.27
|
| Rate for Payer: Frontpath All Commercial |
$898.52
|
| Rate for Payer: Frontpath All Commercial |
$898.52
|
| Rate for Payer: Humana ChoiceCare |
$567.74
|
| Rate for Payer: Humana ChoiceCare |
$567.74
|
| Rate for Payer: Humana Medicare |
$661.27
|
| Rate for Payer: Humana Medicare |
$661.27
|
| Rate for Payer: Lucent All Commercial |
$925.78
|
| Rate for Payer: Lucent All Commercial |
$925.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,038.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,038.00
|
| Rate for Payer: Managed Health Services Medicaid |
$632.16
|
| Rate for Payer: Managed Health Services Medicaid |
$632.16
|
| Rate for Payer: MDWise Medicaid |
$632.16
|
| Rate for Payer: MDWise Medicaid |
$632.16
|
| Rate for Payer: PHCS All Commercial |
$661.27
|
| Rate for Payer: PHCS All Commercial |
$661.27
|
| Rate for Payer: PHP All Commercial |
$1,101.53
|
| Rate for Payer: PHP All Commercial |
$1,101.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$661.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$661.27
|
| Rate for Payer: Sagamore Health Network All Products |
$661.27
|
| Rate for Payer: Sagamore Health Network All Products |
$661.27
|
| Rate for Payer: Signature Care EPO |
$777.75
|
| Rate for Payer: Signature Care EPO |
$777.75
|
| Rate for Payer: Signature Care PPO |
$777.75
|
| Rate for Payer: Signature Care PPO |
$777.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$97,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$97,300.00
|
| Rate for Payer: United Healthcare Commercial |
$541.00
|
| Rate for Payer: United Healthcare Commercial |
$541.00
|
| Rate for Payer: United Healthcare Medicare |
$633.06
|
| Rate for Payer: United Healthcare Medicare |
$633.06
|
|
|
PR INCIS/DRAIN PELVIS/HIP,OPEN BONE
|
Professional
|
Both
|
$1,825.80
|
|
|
Service Code
|
CPT 26992
|
| Hospital Charge Code |
z26992
|
| Min. Negotiated Rate |
$912.90 |
| Max. Negotiated Rate |
$140,400.00 |
| Rate for Payer: Aetna Commercial |
$941.20
|
| Rate for Payer: Aetna Commercial |
$941.20
|
| Rate for Payer: Aetna Medicare |
$941.20
|
| Rate for Payer: Aetna Medicare |
$941.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,221.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,221.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,221.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,221.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,221.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,221.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,221.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,221.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$918.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$918.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,082.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,082.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,035.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,035.32
|
| Rate for Payer: Cash Price |
$1,095.48
|
| Rate for Payer: Cash Price |
$1,120.26
|
| Rate for Payer: Centivo All Commercial |
$1,458.86
|
| Rate for Payer: Centivo All Commercial |
$1,458.86
|
| Rate for Payer: Cigna All Commercial |
$941.20
|
| Rate for Payer: Cigna All Commercial |
$941.20
|
| Rate for Payer: CORVEL All Commercial |
$941.20
|
| Rate for Payer: CORVEL All Commercial |
$941.20
|
| Rate for Payer: Coventry All Commercial |
$1,129.44
|
| Rate for Payer: Coventry All Commercial |
$1,129.44
|
| Rate for Payer: Encore All Commercial |
$941.20
|
| Rate for Payer: Encore All Commercial |
$941.20
|
| Rate for Payer: Frontpath All Commercial |
$1,310.58
|
| Rate for Payer: Frontpath All Commercial |
$1,310.58
|
| Rate for Payer: Humana ChoiceCare |
$1,020.43
|
| Rate for Payer: Humana ChoiceCare |
$1,020.43
|
| Rate for Payer: Humana Medicare |
$941.20
|
| Rate for Payer: Humana Medicare |
$941.20
|
| Rate for Payer: Lucent All Commercial |
$1,317.68
|
| Rate for Payer: Lucent All Commercial |
$1,317.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,497.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,497.00
|
| Rate for Payer: Managed Health Services Medicaid |
$918.31
|
| Rate for Payer: Managed Health Services Medicaid |
$918.31
|
| Rate for Payer: MDWise Medicaid |
$918.31
|
| Rate for Payer: MDWise Medicaid |
$918.31
|
| Rate for Payer: PHCS All Commercial |
$941.20
|
| Rate for Payer: PHCS All Commercial |
$941.20
|
| Rate for Payer: PHP All Commercial |
$1,588.44
|
| Rate for Payer: PHP All Commercial |
$1,588.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$941.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$941.20
|
| Rate for Payer: Sagamore Health Network All Products |
$941.20
|
| Rate for Payer: Sagamore Health Network All Products |
$941.20
|
| Rate for Payer: Signature Care EPO |
$1,393.15
|
| Rate for Payer: Signature Care EPO |
$1,393.15
|
| Rate for Payer: Signature Care PPO |
$1,393.15
|
| Rate for Payer: Signature Care PPO |
$1,393.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$140,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$140,400.00
|
| Rate for Payer: United Healthcare Commercial |
$1,041.70
|
| Rate for Payer: United Healthcare Commercial |
$1,041.70
|
| Rate for Payer: United Healthcare Medicare |
$912.90
|
| Rate for Payer: United Healthcare Medicare |
$912.90
|
|
|
PR INCIS/DRAIN SHLDR ABSC/HEMA,DEEP
|
Professional
|
Both
|
$800.48
|
|
|
Service Code
|
CPT 23030
|
| Hospital Charge Code |
z23030
|
| Min. Negotiated Rate |
$131.33 |
| Max. Negotiated Rate |
$35,500.00 |
| Rate for Payer: Aetna Commercial |
$237.56
|
| Rate for Payer: Aetna Commercial |
$237.56
|
| Rate for Payer: Aetna Medicare |
$237.56
|
| Rate for Payer: Aetna Medicare |
$237.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$439.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$439.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$439.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$439.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$439.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$439.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$439.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$439.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$131.33
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$131.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$399.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$399.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$273.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$273.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$261.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$261.32
|
| Rate for Payer: Cash Price |
$486.95
|
| Rate for Payer: Cash Price |
$480.29
|
| Rate for Payer: Centivo All Commercial |
$368.22
|
| Rate for Payer: Centivo All Commercial |
$368.22
|
| Rate for Payer: Cigna All Commercial |
$237.56
|
| Rate for Payer: Cigna All Commercial |
$237.56
|
| Rate for Payer: CORVEL All Commercial |
$237.56
|
| Rate for Payer: CORVEL All Commercial |
$237.56
|
| Rate for Payer: Coventry All Commercial |
$285.07
|
| Rate for Payer: Coventry All Commercial |
$285.07
|
| Rate for Payer: Encore All Commercial |
$237.56
|
| Rate for Payer: Encore All Commercial |
$237.56
|
| Rate for Payer: Frontpath All Commercial |
$331.20
|
| Rate for Payer: Frontpath All Commercial |
$331.20
|
| Rate for Payer: Humana ChoiceCare |
$275.26
|
| Rate for Payer: Humana ChoiceCare |
$275.26
|
| Rate for Payer: Humana Medicare |
$237.56
|
| Rate for Payer: Humana Medicare |
$237.56
|
| Rate for Payer: Lucent All Commercial |
$332.58
|
| Rate for Payer: Lucent All Commercial |
$332.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$378.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$378.00
|
| Rate for Payer: Managed Health Services Medicaid |
$399.17
|
| Rate for Payer: Managed Health Services Medicaid |
$399.17
|
| Rate for Payer: MDWise Medicaid |
$399.17
|
| Rate for Payer: MDWise Medicaid |
$399.17
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$131.33
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$131.33
|
| Rate for Payer: PHCS All Commercial |
$237.56
|
| Rate for Payer: PHCS All Commercial |
$237.56
|
| Rate for Payer: PHP All Commercial |
$401.36
|
| Rate for Payer: PHP All Commercial |
$401.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$237.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$237.56
|
| Rate for Payer: Sagamore Health Network All Products |
$237.56
|
| Rate for Payer: Sagamore Health Network All Products |
$237.56
|
| Rate for Payer: Signature Care EPO |
$373.15
|
| Rate for Payer: Signature Care EPO |
$373.15
|
| Rate for Payer: Signature Care PPO |
$373.15
|
| Rate for Payer: Signature Care PPO |
$373.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,500.00
|
| Rate for Payer: United Healthcare Commercial |
$276.43
|
| Rate for Payer: United Healthcare Commercial |
$276.43
|
| Rate for Payer: United Healthcare Medicare |
$400.24
|
| Rate for Payer: United Healthcare Medicare |
$400.24
|
|
|
PR INCIS/DRAIN THIGH/KNEE ABSCESS,DEEP
|
Professional
|
Both
|
$1,246.44
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
z27301
|
| Min. Negotiated Rate |
$261.28 |
| Max. Negotiated Rate |
$70,800.00 |
| Rate for Payer: Aetna Commercial |
$472.23
|
| Rate for Payer: Aetna Commercial |
$472.23
|
| Rate for Payer: Aetna Medicare |
$472.23
|
| Rate for Payer: Aetna Medicare |
$472.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$711.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$711.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$711.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$711.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$711.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$711.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$711.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$711.00
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$261.28
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$261.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$613.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$613.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$543.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$543.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$519.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$519.45
|
| Rate for Payer: Cash Price |
$747.86
|
| Rate for Payer: Cash Price |
$734.48
|
| Rate for Payer: Centivo All Commercial |
$731.96
|
| Rate for Payer: Centivo All Commercial |
$731.96
|
| Rate for Payer: Cigna All Commercial |
$472.23
|
| Rate for Payer: Cigna All Commercial |
$472.23
|
| Rate for Payer: CORVEL All Commercial |
$472.23
|
| Rate for Payer: CORVEL All Commercial |
$472.23
|
| Rate for Payer: Coventry All Commercial |
$566.68
|
| Rate for Payer: Coventry All Commercial |
$566.68
|
| Rate for Payer: Encore All Commercial |
$472.23
|
| Rate for Payer: Encore All Commercial |
$472.23
|
| Rate for Payer: Frontpath All Commercial |
$658.40
|
| Rate for Payer: Frontpath All Commercial |
$658.40
|
| Rate for Payer: Humana ChoiceCare |
$506.41
|
| Rate for Payer: Humana ChoiceCare |
$506.41
|
| Rate for Payer: Humana Medicare |
$472.23
|
| Rate for Payer: Humana Medicare |
$472.23
|
| Rate for Payer: Lucent All Commercial |
$661.12
|
| Rate for Payer: Lucent All Commercial |
$661.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$756.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$756.00
|
| Rate for Payer: Managed Health Services Medicaid |
$613.05
|
| Rate for Payer: Managed Health Services Medicaid |
$613.05
|
| Rate for Payer: MDWise Medicaid |
$613.05
|
| Rate for Payer: MDWise Medicaid |
$613.05
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$261.28
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$261.28
|
| Rate for Payer: PHCS All Commercial |
$472.23
|
| Rate for Payer: PHCS All Commercial |
$472.23
|
| Rate for Payer: PHP All Commercial |
$801.93
|
| Rate for Payer: PHP All Commercial |
$801.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$472.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$472.23
|
| Rate for Payer: Sagamore Health Network All Products |
$472.23
|
| Rate for Payer: Sagamore Health Network All Products |
$472.23
|
| Rate for Payer: Signature Care EPO |
$794.75
|
| Rate for Payer: Signature Care EPO |
$794.75
|
| Rate for Payer: Signature Care PPO |
$794.75
|
| Rate for Payer: Signature Care PPO |
$794.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,800.00
|
| Rate for Payer: United Healthcare Commercial |
$530.75
|
| Rate for Payer: United Healthcare Commercial |
$530.75
|
| Rate for Payer: United Healthcare Medicare |
$612.07
|
| Rate for Payer: United Healthcare Medicare |
$612.07
|
|
|
PR INCISE EXTERNAL HEMORRHOID
|
Professional
|
Both
|
$384.54
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
z46083
|
| Min. Negotiated Rate |
$64.05 |
| Max. Negotiated Rate |
$14,300.00 |
| Rate for Payer: Aetna Commercial |
$102.80
|
| Rate for Payer: Aetna Commercial |
$102.80
|
| Rate for Payer: Aetna Medicare |
$102.80
|
| Rate for Payer: Aetna Medicare |
$102.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$235.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$235.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$235.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$235.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$235.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$235.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$235.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$235.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$64.05
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$64.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$189.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$189.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$118.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$118.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$113.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$113.08
|
| Rate for Payer: Cash Price |
$227.06
|
| Rate for Payer: Cash Price |
$230.72
|
| Rate for Payer: Centivo All Commercial |
$159.34
|
| Rate for Payer: Centivo All Commercial |
$159.34
|
| Rate for Payer: Cigna All Commercial |
$102.80
|
| Rate for Payer: Cigna All Commercial |
$102.80
|
| Rate for Payer: CORVEL All Commercial |
$102.80
|
| Rate for Payer: CORVEL All Commercial |
$102.80
|
| Rate for Payer: Coventry All Commercial |
$123.36
|
| Rate for Payer: Coventry All Commercial |
$123.36
|
| Rate for Payer: Encore All Commercial |
$102.80
|
| Rate for Payer: Encore All Commercial |
$102.80
|
| Rate for Payer: Frontpath All Commercial |
$142.18
|
| Rate for Payer: Frontpath All Commercial |
$142.18
|
| Rate for Payer: Humana ChoiceCare |
$104.28
|
| Rate for Payer: Humana ChoiceCare |
$104.28
|
| Rate for Payer: Humana Medicare |
$102.80
|
| Rate for Payer: Humana Medicare |
$102.80
|
| Rate for Payer: Lucent All Commercial |
$143.92
|
| Rate for Payer: Lucent All Commercial |
$143.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$153.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$153.00
|
| Rate for Payer: Managed Health Services Medicaid |
$189.13
|
| Rate for Payer: Managed Health Services Medicaid |
$189.13
|
| Rate for Payer: MDWise Medicaid |
$189.13
|
| Rate for Payer: MDWise Medicaid |
$189.13
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$64.05
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$64.05
|
| Rate for Payer: PHCS All Commercial |
$102.80
|
| Rate for Payer: PHCS All Commercial |
$102.80
|
| Rate for Payer: PHP All Commercial |
$174.06
|
| Rate for Payer: PHP All Commercial |
$174.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.80
|
| Rate for Payer: Sagamore Health Network All Products |
$102.80
|
| Rate for Payer: Sagamore Health Network All Products |
$102.80
|
| Rate for Payer: Signature Care EPO |
$215.05
|
| Rate for Payer: Signature Care EPO |
$215.05
|
| Rate for Payer: Signature Care PPO |
$215.05
|
| Rate for Payer: Signature Care PPO |
$215.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,300.00
|
| Rate for Payer: United Healthcare Commercial |
$112.35
|
| Rate for Payer: United Healthcare Commercial |
$112.35
|
| Rate for Payer: United Healthcare Medicare |
$189.22
|
| Rate for Payer: United Healthcare Medicare |
$189.22
|
|
|
PR INCISE FINGER TENDON SHEATH
|
Professional
|
Both
|
$1,092.20
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
z26055
|
| Min. Negotiated Rate |
$150.37 |
| Max. Negotiated Rate |
$41,100.00 |
| Rate for Payer: Aetna Commercial |
$272.39
|
| Rate for Payer: Aetna Commercial |
$272.39
|
| Rate for Payer: Aetna Medicare |
$272.39
|
| Rate for Payer: Aetna Medicare |
$272.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,000.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,000.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,000.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,000.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,000.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,000.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,000.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,000.00
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$150.37
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$150.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$537.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$537.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.63
|
| Rate for Payer: Cash Price |
$648.97
|
| Rate for Payer: Cash Price |
$655.32
|
| Rate for Payer: Centivo All Commercial |
$422.20
|
| Rate for Payer: Centivo All Commercial |
$422.20
|
| Rate for Payer: Cigna All Commercial |
$272.39
|
| Rate for Payer: Cigna All Commercial |
$272.39
|
| Rate for Payer: CORVEL All Commercial |
$272.39
|
| Rate for Payer: CORVEL All Commercial |
$272.39
|
| Rate for Payer: Coventry All Commercial |
$326.87
|
| Rate for Payer: Coventry All Commercial |
$326.87
|
| Rate for Payer: Encore All Commercial |
$272.39
|
| Rate for Payer: Encore All Commercial |
$272.39
|
| Rate for Payer: Frontpath All Commercial |
$374.00
|
| Rate for Payer: Frontpath All Commercial |
$374.00
|
| Rate for Payer: Humana ChoiceCare |
$281.86
|
| Rate for Payer: Humana ChoiceCare |
$281.86
|
| Rate for Payer: Humana Medicare |
$272.39
|
| Rate for Payer: Humana Medicare |
$272.39
|
| Rate for Payer: Lucent All Commercial |
$381.35
|
| Rate for Payer: Lucent All Commercial |
$381.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$439.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$439.00
|
| Rate for Payer: Managed Health Services Medicaid |
$537.19
|
| Rate for Payer: Managed Health Services Medicaid |
$537.19
|
| Rate for Payer: MDWise Medicaid |
$537.19
|
| Rate for Payer: MDWise Medicaid |
$537.19
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$150.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$150.37
|
| Rate for Payer: PHCS All Commercial |
$272.39
|
| Rate for Payer: PHCS All Commercial |
$272.39
|
| Rate for Payer: PHP All Commercial |
$465.69
|
| Rate for Payer: PHP All Commercial |
$465.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.39
|
| Rate for Payer: Sagamore Health Network All Products |
$272.39
|
| Rate for Payer: Sagamore Health Network All Products |
$272.39
|
| Rate for Payer: Signature Care EPO |
$891.89
|
| Rate for Payer: Signature Care EPO |
$891.89
|
| Rate for Payer: Signature Care PPO |
$891.89
|
| Rate for Payer: Signature Care PPO |
$891.89
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,100.00
|
| Rate for Payer: United Healthcare Commercial |
$307.03
|
| Rate for Payer: United Healthcare Commercial |
$307.03
|
| Rate for Payer: United Healthcare Medicare |
$540.81
|
| Rate for Payer: United Healthcare Medicare |
$540.81
|
|
|
PR INCISE WRIST/FOREARM TENDON
|
Professional
|
Both
|
$820.76
|
|
|
Service Code
|
CPT 25290
|
| Hospital Charge Code |
z25290
|
| Min. Negotiated Rate |
$400.32 |
| Max. Negotiated Rate |
$61,500.00 |
| Rate for Payer: Aetna Commercial |
$409.25
|
| Rate for Payer: Aetna Commercial |
$409.25
|
| Rate for Payer: Aetna Medicare |
$409.25
|
| Rate for Payer: Aetna Medicare |
$409.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$661.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$661.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$661.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$661.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$661.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$661.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$661.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$661.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$403.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$403.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$470.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$470.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$450.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$450.18
|
| Rate for Payer: Cash Price |
$492.46
|
| Rate for Payer: Cash Price |
$480.38
|
| Rate for Payer: Centivo All Commercial |
$634.34
|
| Rate for Payer: Centivo All Commercial |
$634.34
|
| Rate for Payer: Cigna All Commercial |
$409.25
|
| Rate for Payer: Cigna All Commercial |
$409.25
|
| Rate for Payer: CORVEL All Commercial |
$409.25
|
| Rate for Payer: CORVEL All Commercial |
$409.25
|
| Rate for Payer: Coventry All Commercial |
$491.10
|
| Rate for Payer: Coventry All Commercial |
$491.10
|
| Rate for Payer: Encore All Commercial |
$409.25
|
| Rate for Payer: Encore All Commercial |
$409.25
|
| Rate for Payer: Frontpath All Commercial |
$564.17
|
| Rate for Payer: Frontpath All Commercial |
$564.17
|
| Rate for Payer: Humana ChoiceCare |
$840.61
|
| Rate for Payer: Humana ChoiceCare |
$840.61
|
| Rate for Payer: Humana Medicare |
$409.25
|
| Rate for Payer: Humana Medicare |
$409.25
|
| Rate for Payer: Lucent All Commercial |
$572.95
|
| Rate for Payer: Lucent All Commercial |
$572.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$657.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$657.00
|
| Rate for Payer: Managed Health Services Medicaid |
$403.68
|
| Rate for Payer: Managed Health Services Medicaid |
$403.68
|
| Rate for Payer: MDWise Medicaid |
$403.68
|
| Rate for Payer: MDWise Medicaid |
$403.68
|
| Rate for Payer: PHCS All Commercial |
$409.25
|
| Rate for Payer: PHCS All Commercial |
$409.25
|
| Rate for Payer: PHP All Commercial |
$696.55
|
| Rate for Payer: PHP All Commercial |
$696.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$409.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$409.25
|
| Rate for Payer: Sagamore Health Network All Products |
$409.25
|
| Rate for Payer: Sagamore Health Network All Products |
$409.25
|
| Rate for Payer: Signature Care EPO |
$695.73
|
| Rate for Payer: Signature Care EPO |
$695.73
|
| Rate for Payer: Signature Care PPO |
$695.73
|
| Rate for Payer: Signature Care PPO |
$695.73
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$61,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$61,500.00
|
| Rate for Payer: United Healthcare Commercial |
$561.29
|
| Rate for Payer: United Healthcare Commercial |
$561.29
|
| Rate for Payer: United Healthcare Medicare |
$400.32
|
| Rate for Payer: United Healthcare Medicare |
$400.32
|
|
|
PR INCISIONAL BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$1,260.28
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
z11106
|
| Min. Negotiated Rate |
$38.78 |
| Max. Negotiated Rate |
$142.20 |
| Rate for Payer: Aetna Commercial |
$53.54
|
| Rate for Payer: Aetna Medicare |
$53.54
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$38.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$141.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$58.89
|
| Rate for Payer: Cash Price |
$756.17
|
| Rate for Payer: Centivo All Commercial |
$82.99
|
| Rate for Payer: Cigna All Commercial |
$53.54
|
| Rate for Payer: CORVEL All Commercial |
$53.54
|
| Rate for Payer: Coventry All Commercial |
$64.25
|
| Rate for Payer: Encore All Commercial |
$53.54
|
| Rate for Payer: Frontpath All Commercial |
$73.03
|
| Rate for Payer: Humana ChoiceCare |
$57.85
|
| Rate for Payer: Humana Medicare |
$53.54
|
| Rate for Payer: Lucent All Commercial |
$74.96
|
| Rate for Payer: Managed Health Services Medicaid |
$141.71
|
| Rate for Payer: MDWise Medicaid |
$141.71
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$38.78
|
| Rate for Payer: PHCS All Commercial |
$53.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$53.54
|
| Rate for Payer: Sagamore Health Network All Products |
$53.54
|
| Rate for Payer: United Healthcare Commercial |
$73.74
|
| Rate for Payer: United Healthcare Medicare |
$142.20
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Professional
|
Both
|
$400.56
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
z10061
|
| Min. Negotiated Rate |
$93.44 |
| Max. Negotiated Rate |
$20,600.00 |
| Rate for Payer: Aetna Commercial |
$171.85
|
| Rate for Payer: Aetna Commercial |
$171.85
|
| Rate for Payer: Aetna Medicare |
$171.85
|
| Rate for Payer: Aetna Medicare |
$171.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$201.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$201.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$201.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$201.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$201.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$201.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$201.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$201.56
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.44
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$197.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$197.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$189.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$189.03
|
| Rate for Payer: Cash Price |
$233.69
|
| Rate for Payer: Cash Price |
$240.34
|
| Rate for Payer: Centivo All Commercial |
$266.37
|
| Rate for Payer: Centivo All Commercial |
$266.37
|
| Rate for Payer: Cigna All Commercial |
$171.85
|
| Rate for Payer: Cigna All Commercial |
$171.85
|
| Rate for Payer: CORVEL All Commercial |
$171.85
|
| Rate for Payer: CORVEL All Commercial |
$171.85
|
| Rate for Payer: Coventry All Commercial |
$206.22
|
| Rate for Payer: Coventry All Commercial |
$206.22
|
| Rate for Payer: Encore All Commercial |
$171.85
|
| Rate for Payer: Encore All Commercial |
$171.85
|
| Rate for Payer: Frontpath All Commercial |
$234.00
|
| Rate for Payer: Frontpath All Commercial |
$234.00
|
| Rate for Payer: Humana ChoiceCare |
$146.75
|
| Rate for Payer: Humana ChoiceCare |
$146.75
|
| Rate for Payer: Humana Medicare |
$171.85
|
| Rate for Payer: Humana Medicare |
$171.85
|
| Rate for Payer: Lucent All Commercial |
$240.59
|
| Rate for Payer: Lucent All Commercial |
$240.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$223.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$223.00
|
| Rate for Payer: Managed Health Services Medicaid |
$197.01
|
| Rate for Payer: Managed Health Services Medicaid |
$197.01
|
| Rate for Payer: MDWise Medicaid |
$197.01
|
| Rate for Payer: MDWise Medicaid |
$197.01
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.44
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.44
|
| Rate for Payer: PHCS All Commercial |
$171.85
|
| Rate for Payer: PHCS All Commercial |
$171.85
|
| Rate for Payer: PHP All Commercial |
$234.68
|
| Rate for Payer: PHP All Commercial |
$234.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$171.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$171.85
|
| Rate for Payer: Sagamore Health Network All Products |
$171.85
|
| Rate for Payer: Sagamore Health Network All Products |
$171.85
|
| Rate for Payer: Signature Care EPO |
$174.25
|
| Rate for Payer: Signature Care EPO |
$174.25
|
| Rate for Payer: Signature Care PPO |
$174.25
|
| Rate for Payer: Signature Care PPO |
$174.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,600.00
|
| Rate for Payer: United Healthcare Commercial |
$178.20
|
| Rate for Payer: United Healthcare Commercial |
$178.20
|
| Rate for Payer: United Healthcare Medicare |
$194.74
|
| Rate for Payer: United Healthcare Medicare |
$194.74
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$237.64
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
z10060
|
| Min. Negotiated Rate |
$59.75 |
| Max. Negotiated Rate |
$11,900.00 |
| Rate for Payer: Aetna Commercial |
$98.34
|
| Rate for Payer: Aetna Commercial |
$98.34
|
| Rate for Payer: Aetna Medicare |
$98.34
|
| Rate for Payer: Aetna Medicare |
$98.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$112.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$112.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$112.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$112.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$112.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$112.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$112.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$112.64
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$59.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$59.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$116.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$116.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$113.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$113.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$108.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$108.17
|
| Rate for Payer: Cash Price |
$138.12
|
| Rate for Payer: Cash Price |
$142.58
|
| Rate for Payer: Centivo All Commercial |
$152.43
|
| Rate for Payer: Centivo All Commercial |
$152.43
|
| Rate for Payer: Cigna All Commercial |
$98.34
|
| Rate for Payer: Cigna All Commercial |
$98.34
|
| Rate for Payer: CORVEL All Commercial |
$98.34
|
| Rate for Payer: CORVEL All Commercial |
$98.34
|
| Rate for Payer: Coventry All Commercial |
$118.01
|
| Rate for Payer: Coventry All Commercial |
$118.01
|
| Rate for Payer: Encore All Commercial |
$98.34
|
| Rate for Payer: Encore All Commercial |
$98.34
|
| Rate for Payer: Frontpath All Commercial |
$132.26
|
| Rate for Payer: Frontpath All Commercial |
$132.26
|
| Rate for Payer: Humana ChoiceCare |
$78.25
|
| Rate for Payer: Humana ChoiceCare |
$78.25
|
| Rate for Payer: Humana Medicare |
$98.34
|
| Rate for Payer: Humana Medicare |
$98.34
|
| Rate for Payer: Lucent All Commercial |
$137.68
|
| Rate for Payer: Lucent All Commercial |
$137.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$128.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$128.00
|
| Rate for Payer: Managed Health Services Medicaid |
$116.88
|
| Rate for Payer: Managed Health Services Medicaid |
$116.88
|
| Rate for Payer: MDWise Medicaid |
$116.88
|
| Rate for Payer: MDWise Medicaid |
$116.88
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$59.75
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$59.75
|
| Rate for Payer: PHCS All Commercial |
$98.34
|
| Rate for Payer: PHCS All Commercial |
$98.34
|
| Rate for Payer: PHP All Commercial |
$135.00
|
| Rate for Payer: PHP All Commercial |
$135.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$98.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$98.34
|
| Rate for Payer: Sagamore Health Network All Products |
$98.34
|
| Rate for Payer: Sagamore Health Network All Products |
$98.34
|
| Rate for Payer: Signature Care EPO |
$99.74
|
| Rate for Payer: Signature Care EPO |
$99.74
|
| Rate for Payer: Signature Care PPO |
$99.74
|
| Rate for Payer: Signature Care PPO |
$99.74
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,900.00
|
| Rate for Payer: United Healthcare Commercial |
$99.94
|
| Rate for Payer: United Healthcare Commercial |
$99.94
|
| Rate for Payer: United Healthcare Medicare |
$115.10
|
| Rate for Payer: United Healthcare Medicare |
$115.10
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$483.26
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
z10180
|
| Min. Negotiated Rate |
$91.02 |
| Max. Negotiated Rate |
$19,700.00 |
| Rate for Payer: Aetna Commercial |
$164.26
|
| Rate for Payer: Aetna Commercial |
$164.26
|
| Rate for Payer: Aetna Medicare |
$164.26
|
| Rate for Payer: Aetna Medicare |
$164.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$233.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$233.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$233.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$233.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$233.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$233.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$233.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$233.27
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$91.02
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$91.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$237.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$237.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$188.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$188.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$180.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$180.69
|
| Rate for Payer: Cash Price |
$285.18
|
| Rate for Payer: Cash Price |
$289.96
|
| Rate for Payer: Centivo All Commercial |
$254.60
|
| Rate for Payer: Centivo All Commercial |
$254.60
|
| Rate for Payer: Cigna All Commercial |
$164.26
|
| Rate for Payer: Cigna All Commercial |
$164.26
|
| Rate for Payer: CORVEL All Commercial |
$164.26
|
| Rate for Payer: CORVEL All Commercial |
$164.26
|
| Rate for Payer: Coventry All Commercial |
$197.11
|
| Rate for Payer: Coventry All Commercial |
$197.11
|
| Rate for Payer: Encore All Commercial |
$164.26
|
| Rate for Payer: Encore All Commercial |
$164.26
|
| Rate for Payer: Frontpath All Commercial |
$229.12
|
| Rate for Payer: Frontpath All Commercial |
$229.12
|
| Rate for Payer: Humana ChoiceCare |
$159.38
|
| Rate for Payer: Humana ChoiceCare |
$159.38
|
| Rate for Payer: Humana Medicare |
$164.26
|
| Rate for Payer: Humana Medicare |
$164.26
|
| Rate for Payer: Lucent All Commercial |
$229.96
|
| Rate for Payer: Lucent All Commercial |
$229.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$214.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$214.00
|
| Rate for Payer: Managed Health Services Medicaid |
$237.68
|
| Rate for Payer: Managed Health Services Medicaid |
$237.68
|
| Rate for Payer: MDWise Medicaid |
$237.68
|
| Rate for Payer: MDWise Medicaid |
$237.68
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$91.02
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$91.02
|
| Rate for Payer: PHCS All Commercial |
$164.26
|
| Rate for Payer: PHCS All Commercial |
$164.26
|
| Rate for Payer: PHP All Commercial |
$224.35
|
| Rate for Payer: PHP All Commercial |
$224.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$164.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$164.26
|
| Rate for Payer: Sagamore Health Network All Products |
$164.26
|
| Rate for Payer: Sagamore Health Network All Products |
$164.26
|
| Rate for Payer: Signature Care EPO |
$225.25
|
| Rate for Payer: Signature Care EPO |
$225.25
|
| Rate for Payer: Signature Care PPO |
$225.25
|
| Rate for Payer: Signature Care PPO |
$225.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,700.00
|
| Rate for Payer: United Healthcare Commercial |
$188.78
|
| Rate for Payer: United Healthcare Commercial |
$188.78
|
| Rate for Payer: United Healthcare Medicare |
$237.65
|
| Rate for Payer: United Healthcare Medicare |
$237.65
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST COMPLICATED
|
Professional
|
Both
|
$634.62
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
z10081
|
| Min. Negotiated Rate |
$87.38 |
| Max. Negotiated Rate |
$19,000.00 |
| Rate for Payer: Aetna Commercial |
$159.76
|
| Rate for Payer: Aetna Commercial |
$159.76
|
| Rate for Payer: Aetna Medicare |
$159.76
|
| Rate for Payer: Aetna Medicare |
$159.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$257.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$257.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$257.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$257.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$257.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$257.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$257.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$257.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$87.38
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$87.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$312.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$312.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$183.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$183.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$175.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$175.74
|
| Rate for Payer: Cash Price |
$375.29
|
| Rate for Payer: Cash Price |
$380.77
|
| Rate for Payer: Centivo All Commercial |
$247.63
|
| Rate for Payer: Centivo All Commercial |
$247.63
|
| Rate for Payer: Cigna All Commercial |
$159.76
|
| Rate for Payer: Cigna All Commercial |
$159.76
|
| Rate for Payer: CORVEL All Commercial |
$159.76
|
| Rate for Payer: CORVEL All Commercial |
$159.76
|
| Rate for Payer: Coventry All Commercial |
$191.71
|
| Rate for Payer: Coventry All Commercial |
$191.71
|
| Rate for Payer: Encore All Commercial |
$159.76
|
| Rate for Payer: Encore All Commercial |
$159.76
|
| Rate for Payer: Frontpath All Commercial |
$220.54
|
| Rate for Payer: Frontpath All Commercial |
$220.54
|
| Rate for Payer: Humana ChoiceCare |
$148.32
|
| Rate for Payer: Humana ChoiceCare |
$148.32
|
| Rate for Payer: Humana Medicare |
$159.76
|
| Rate for Payer: Humana Medicare |
$159.76
|
| Rate for Payer: Lucent All Commercial |
$223.66
|
| Rate for Payer: Lucent All Commercial |
$223.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$206.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$206.00
|
| Rate for Payer: Managed Health Services Medicaid |
$312.13
|
| Rate for Payer: Managed Health Services Medicaid |
$312.13
|
| Rate for Payer: MDWise Medicaid |
$312.13
|
| Rate for Payer: MDWise Medicaid |
$312.13
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$87.38
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$87.38
|
| Rate for Payer: PHCS All Commercial |
$159.76
|
| Rate for Payer: PHCS All Commercial |
$159.76
|
| Rate for Payer: PHP All Commercial |
$216.46
|
| Rate for Payer: PHP All Commercial |
$216.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$159.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$159.76
|
| Rate for Payer: Sagamore Health Network All Products |
$159.76
|
| Rate for Payer: Sagamore Health Network All Products |
$159.76
|
| Rate for Payer: Signature Care EPO |
$279.28
|
| Rate for Payer: Signature Care EPO |
$279.28
|
| Rate for Payer: Signature Care PPO |
$279.28
|
| Rate for Payer: Signature Care PPO |
$279.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19,000.00
|
| Rate for Payer: United Healthcare Commercial |
$179.09
|
| Rate for Payer: United Healthcare Commercial |
$179.09
|
| Rate for Payer: United Healthcare Medicare |
$312.74
|
| Rate for Payer: United Healthcare Medicare |
$312.74
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST SIMPLE
|
Professional
|
Both
|
$463.34
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
z10080
|
| Min. Negotiated Rate |
$53.47 |
| Max. Negotiated Rate |
$11,700.00 |
| Rate for Payer: Aetna Commercial |
$97.45
|
| Rate for Payer: Aetna Commercial |
$97.45
|
| Rate for Payer: Aetna Medicare |
$97.45
|
| Rate for Payer: Aetna Medicare |
$97.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$163.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$163.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$163.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$163.21
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$163.21
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$163.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$163.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$163.21
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$53.47
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$53.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$227.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$227.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$112.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$112.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$107.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$107.19
|
| Rate for Payer: Cash Price |
$274.98
|
| Rate for Payer: Cash Price |
$278.00
|
| Rate for Payer: Centivo All Commercial |
$151.05
|
| Rate for Payer: Centivo All Commercial |
$151.05
|
| Rate for Payer: Cigna All Commercial |
$97.45
|
| Rate for Payer: Cigna All Commercial |
$97.45
|
| Rate for Payer: CORVEL All Commercial |
$97.45
|
| Rate for Payer: CORVEL All Commercial |
$97.45
|
| Rate for Payer: Coventry All Commercial |
$116.94
|
| Rate for Payer: Coventry All Commercial |
$116.94
|
| Rate for Payer: Encore All Commercial |
$97.45
|
| Rate for Payer: Encore All Commercial |
$97.45
|
| Rate for Payer: Frontpath All Commercial |
$133.33
|
| Rate for Payer: Frontpath All Commercial |
$133.33
|
| Rate for Payer: Humana ChoiceCare |
$84.27
|
| Rate for Payer: Humana ChoiceCare |
$84.27
|
| Rate for Payer: Humana Medicare |
$97.45
|
| Rate for Payer: Humana Medicare |
$97.45
|
| Rate for Payer: Lucent All Commercial |
$136.43
|
| Rate for Payer: Lucent All Commercial |
$136.43
|
| 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 |
$227.89
|
| Rate for Payer: Managed Health Services Medicaid |
$227.89
|
| Rate for Payer: MDWise Medicaid |
$227.89
|
| Rate for Payer: MDWise Medicaid |
$227.89
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$53.47
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$53.47
|
| Rate for Payer: PHCS All Commercial |
$97.45
|
| Rate for Payer: PHCS All Commercial |
$97.45
|
| Rate for Payer: PHP All Commercial |
$132.75
|
| Rate for Payer: PHP All Commercial |
$132.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$97.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$97.45
|
| Rate for Payer: Sagamore Health Network All Products |
$97.45
|
| Rate for Payer: Sagamore Health Network All Products |
$97.45
|
| Rate for Payer: Signature Care EPO |
$205.14
|
| Rate for Payer: Signature Care EPO |
$205.14
|
| Rate for Payer: Signature Care PPO |
$205.14
|
| Rate for Payer: Signature Care PPO |
$205.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,700.00
|
| Rate for Payer: United Healthcare Commercial |
$102.15
|
| Rate for Payer: United Healthcare Commercial |
$102.15
|
| Rate for Payer: United Healthcare Medicare |
$229.15
|
| Rate for Payer: United Healthcare Medicare |
$229.15
|
|
|
PR INCISION EARDRUM,ASPIR
|
Professional
|
Both
|
$355.52
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
z69420
|
| Min. Negotiated Rate |
$61.43 |
| Max. Negotiated Rate |
$17,000.00 |
| Rate for Payer: Aetna Commercial |
$112.33
|
| Rate for Payer: Aetna Commercial |
$112.33
|
| Rate for Payer: Aetna Commercial |
$112.33
|
| Rate for Payer: Aetna Commercial |
$112.33
|
| Rate for Payer: Aetna Medicare |
$112.33
|
| Rate for Payer: Aetna Medicare |
$112.33
|
| Rate for Payer: Aetna Medicare |
$112.33
|
| Rate for Payer: Aetna Medicare |
$112.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$204.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$204.41
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$61.43
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$61.43
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$61.43
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$61.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$174.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$174.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$174.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$174.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$129.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$129.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$129.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$129.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$123.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$123.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$123.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$123.56
|
| Rate for Payer: Cash Price |
$420.98
|
| Rate for Payer: Cash Price |
$213.31
|
| Rate for Payer: Cash Price |
$426.62
|
| Rate for Payer: Cash Price |
$210.49
|
| Rate for Payer: Centivo All Commercial |
$174.11
|
| Rate for Payer: Centivo All Commercial |
$174.11
|
| Rate for Payer: Centivo All Commercial |
$174.11
|
| Rate for Payer: Centivo All Commercial |
$174.11
|
| Rate for Payer: Cigna All Commercial |
$112.33
|
| Rate for Payer: Cigna All Commercial |
$112.33
|
| Rate for Payer: Cigna All Commercial |
$112.33
|
| Rate for Payer: Cigna All Commercial |
$112.33
|
| Rate for Payer: CORVEL All Commercial |
$112.33
|
| Rate for Payer: CORVEL All Commercial |
$112.33
|
| Rate for Payer: CORVEL All Commercial |
$112.33
|
| Rate for Payer: CORVEL All Commercial |
$112.33
|
| Rate for Payer: Coventry All Commercial |
$134.80
|
| Rate for Payer: Coventry All Commercial |
$134.80
|
| Rate for Payer: Coventry All Commercial |
$134.80
|
| Rate for Payer: Coventry All Commercial |
$134.80
|
| Rate for Payer: Encore All Commercial |
$112.33
|
| Rate for Payer: Encore All Commercial |
$112.33
|
| Rate for Payer: Encore All Commercial |
$112.33
|
| Rate for Payer: Encore All Commercial |
$112.33
|
| Rate for Payer: Frontpath All Commercial |
$152.84
|
| Rate for Payer: Frontpath All Commercial |
$152.84
|
| Rate for Payer: Frontpath All Commercial |
$152.84
|
| Rate for Payer: Frontpath All Commercial |
$152.84
|
| Rate for Payer: Humana ChoiceCare |
$118.24
|
| Rate for Payer: Humana ChoiceCare |
$118.24
|
| Rate for Payer: Humana ChoiceCare |
$118.24
|
| Rate for Payer: Humana ChoiceCare |
$118.24
|
| Rate for Payer: Humana Medicare |
$112.33
|
| Rate for Payer: Humana Medicare |
$112.33
|
| Rate for Payer: Humana Medicare |
$112.33
|
| Rate for Payer: Humana Medicare |
$112.33
|
| Rate for Payer: Lucent All Commercial |
$157.26
|
| Rate for Payer: Lucent All Commercial |
$157.26
|
| Rate for Payer: Lucent All Commercial |
$157.26
|
| Rate for Payer: Lucent All Commercial |
$157.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$181.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$181.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$181.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$181.00
|
| Rate for Payer: Managed Health Services Medicaid |
$174.86
|
| Rate for Payer: Managed Health Services Medicaid |
$174.86
|
| Rate for Payer: Managed Health Services Medicaid |
$174.86
|
| Rate for Payer: Managed Health Services Medicaid |
$174.86
|
| Rate for Payer: MDWise Medicaid |
$174.86
|
| Rate for Payer: MDWise Medicaid |
$174.86
|
| Rate for Payer: MDWise Medicaid |
$174.86
|
| Rate for Payer: MDWise Medicaid |
$174.86
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$61.43
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$61.43
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$61.43
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$61.43
|
| Rate for Payer: PHCS All Commercial |
$112.33
|
| Rate for Payer: PHCS All Commercial |
$112.33
|
| Rate for Payer: PHCS All Commercial |
$112.33
|
| Rate for Payer: PHCS All Commercial |
$112.33
|
| Rate for Payer: PHP All Commercial |
$143.46
|
| Rate for Payer: PHP All Commercial |
$143.46
|
| Rate for Payer: PHP All Commercial |
$143.46
|
| Rate for Payer: PHP All Commercial |
$143.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$112.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$112.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$112.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$112.33
|
| Rate for Payer: Sagamore Health Network All Products |
$112.33
|
| Rate for Payer: Sagamore Health Network All Products |
$112.33
|
| Rate for Payer: Sagamore Health Network All Products |
$112.33
|
| Rate for Payer: Sagamore Health Network All Products |
$112.33
|
| Rate for Payer: Signature Care EPO |
$190.96
|
| Rate for Payer: Signature Care EPO |
$190.96
|
| Rate for Payer: Signature Care EPO |
$190.96
|
| Rate for Payer: Signature Care EPO |
$190.96
|
| Rate for Payer: Signature Care PPO |
$190.96
|
| Rate for Payer: Signature Care PPO |
$190.96
|
| Rate for Payer: Signature Care PPO |
$190.96
|
| Rate for Payer: Signature Care PPO |
$190.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,000.00
|
| Rate for Payer: United Healthcare Commercial |
$128.81
|
| Rate for Payer: United Healthcare Commercial |
$128.81
|
| Rate for Payer: United Healthcare Commercial |
$128.81
|
| Rate for Payer: United Healthcare Commercial |
$128.81
|
| Rate for Payer: United Healthcare Medicare |
$175.41
|
| Rate for Payer: United Healthcare Medicare |
$175.41
|
| Rate for Payer: United Healthcare Medicare |
$175.41
|
| Rate for Payer: United Healthcare Medicare |
$175.41
|
|
|
PR INCISION EARDRUM,ASPIR,GEN ANESTH
|
Professional
|
Both
|
$279.16
|
|
|
Service Code
|
CPT 69421
|
| Hospital Charge Code |
z69421
|
| Min. Negotiated Rate |
$139.54 |
| Max. Negotiated Rate |
$21,500.00 |
| Rate for Payer: Aetna Commercial |
$142.55
|
| Rate for Payer: Aetna Commercial |
$142.55
|
| Rate for Payer: Aetna Commercial |
$142.55
|
| Rate for Payer: Aetna Commercial |
$142.55
|
| Rate for Payer: Aetna Medicare |
$142.55
|
| Rate for Payer: Aetna Medicare |
$142.55
|
| Rate for Payer: Aetna Medicare |
$142.55
|
| Rate for Payer: Aetna Medicare |
$142.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$165.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$165.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$139.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$139.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$139.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$139.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$163.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$163.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$163.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$163.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$156.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$156.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$156.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$156.81
|
| Rate for Payer: Cash Price |
$167.50
|
| Rate for Payer: Cash Price |
$340.46
|
| Rate for Payer: Cash Price |
$334.99
|
| Rate for Payer: Cash Price |
$170.23
|
| Rate for Payer: Centivo All Commercial |
$220.95
|
| Rate for Payer: Centivo All Commercial |
$220.95
|
| Rate for Payer: Centivo All Commercial |
$220.95
|
| Rate for Payer: Centivo All Commercial |
$220.95
|
| Rate for Payer: Cigna All Commercial |
$142.55
|
| Rate for Payer: Cigna All Commercial |
$142.55
|
| Rate for Payer: Cigna All Commercial |
$142.55
|
| Rate for Payer: Cigna All Commercial |
$142.55
|
| Rate for Payer: CORVEL All Commercial |
$142.55
|
| Rate for Payer: CORVEL All Commercial |
$142.55
|
| Rate for Payer: CORVEL All Commercial |
$142.55
|
| Rate for Payer: CORVEL All Commercial |
$142.55
|
| Rate for Payer: Coventry All Commercial |
$171.06
|
| Rate for Payer: Coventry All Commercial |
$171.06
|
| Rate for Payer: Coventry All Commercial |
$171.06
|
| Rate for Payer: Coventry All Commercial |
$171.06
|
| Rate for Payer: Encore All Commercial |
$142.55
|
| Rate for Payer: Encore All Commercial |
$142.55
|
| Rate for Payer: Encore All Commercial |
$142.55
|
| Rate for Payer: Encore All Commercial |
$142.55
|
| Rate for Payer: Frontpath All Commercial |
$193.83
|
| Rate for Payer: Frontpath All Commercial |
$193.83
|
| Rate for Payer: Frontpath All Commercial |
$193.83
|
| Rate for Payer: Frontpath All Commercial |
$193.83
|
| Rate for Payer: Humana ChoiceCare |
$157.80
|
| Rate for Payer: Humana ChoiceCare |
$157.80
|
| Rate for Payer: Humana ChoiceCare |
$157.80
|
| Rate for Payer: Humana ChoiceCare |
$157.80
|
| Rate for Payer: Humana Medicare |
$142.55
|
| Rate for Payer: Humana Medicare |
$142.55
|
| Rate for Payer: Humana Medicare |
$142.55
|
| Rate for Payer: Humana Medicare |
$142.55
|
| Rate for Payer: Lucent All Commercial |
$199.57
|
| Rate for Payer: Lucent All Commercial |
$199.57
|
| Rate for Payer: Lucent All Commercial |
$199.57
|
| Rate for Payer: Lucent All Commercial |
$199.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$229.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$229.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$229.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$229.00
|
| Rate for Payer: Managed Health Services Medicaid |
$139.54
|
| Rate for Payer: Managed Health Services Medicaid |
$139.54
|
| Rate for Payer: Managed Health Services Medicaid |
$139.54
|
| Rate for Payer: Managed Health Services Medicaid |
$139.54
|
| Rate for Payer: MDWise Medicaid |
$139.54
|
| Rate for Payer: MDWise Medicaid |
$139.54
|
| Rate for Payer: MDWise Medicaid |
$139.54
|
| Rate for Payer: MDWise Medicaid |
$139.54
|
| Rate for Payer: PHCS All Commercial |
$142.55
|
| Rate for Payer: PHCS All Commercial |
$142.55
|
| Rate for Payer: PHCS All Commercial |
$142.55
|
| Rate for Payer: PHCS All Commercial |
$142.55
|
| Rate for Payer: PHP All Commercial |
$181.45
|
| Rate for Payer: PHP All Commercial |
$181.45
|
| Rate for Payer: PHP All Commercial |
$181.45
|
| Rate for Payer: PHP All Commercial |
$181.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$142.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$142.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$142.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$142.55
|
| Rate for Payer: Sagamore Health Network All Products |
$142.55
|
| Rate for Payer: Sagamore Health Network All Products |
$142.55
|
| Rate for Payer: Sagamore Health Network All Products |
$142.55
|
| Rate for Payer: Sagamore Health Network All Products |
$142.55
|
| Rate for Payer: Signature Care EPO |
$183.60
|
| Rate for Payer: Signature Care EPO |
$183.60
|
| Rate for Payer: Signature Care EPO |
$183.60
|
| Rate for Payer: Signature Care EPO |
$183.60
|
| Rate for Payer: Signature Care PPO |
$183.60
|
| Rate for Payer: Signature Care PPO |
$183.60
|
| Rate for Payer: Signature Care PPO |
$183.60
|
| Rate for Payer: Signature Care PPO |
$183.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21,500.00
|
| Rate for Payer: United Healthcare Commercial |
$163.24
|
| Rate for Payer: United Healthcare Commercial |
$163.24
|
| Rate for Payer: United Healthcare Commercial |
$163.24
|
| Rate for Payer: United Healthcare Commercial |
$163.24
|
| Rate for Payer: United Healthcare Medicare |
$139.58
|
| Rate for Payer: United Healthcare Medicare |
$139.58
|
| Rate for Payer: United Healthcare Medicare |
$139.58
|
| Rate for Payer: United Healthcare Medicare |
$139.58
|
|
|
PR INCISION OF TONGUE FOLD
|
Professional
|
Both
|
$401.32
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
z41010
|
| Min. Negotiated Rate |
$59.10 |
| Max. Negotiated Rate |
$14,500.00 |
| Rate for Payer: Aetna Commercial |
$102.82
|
| Rate for Payer: Aetna Commercial |
$102.82
|
| Rate for Payer: Aetna Medicare |
$102.82
|
| Rate for Payer: Aetna Medicare |
$102.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$165.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$165.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$165.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$165.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$165.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$165.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$165.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$165.29
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$59.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$59.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$118.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$118.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$113.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$113.10
|
| Rate for Payer: Cash Price |
$239.16
|
| Rate for Payer: Cash Price |
$240.79
|
| Rate for Payer: Centivo All Commercial |
$159.37
|
| Rate for Payer: Centivo All Commercial |
$159.37
|
| Rate for Payer: Cigna All Commercial |
$102.82
|
| Rate for Payer: Cigna All Commercial |
$102.82
|
| Rate for Payer: CORVEL All Commercial |
$102.82
|
| Rate for Payer: CORVEL All Commercial |
$102.82
|
| Rate for Payer: Coventry All Commercial |
$123.38
|
| Rate for Payer: Coventry All Commercial |
$123.38
|
| Rate for Payer: Encore All Commercial |
$102.82
|
| Rate for Payer: Encore All Commercial |
$102.82
|
| Rate for Payer: Frontpath All Commercial |
$139.63
|
| Rate for Payer: Frontpath All Commercial |
$139.63
|
| Rate for Payer: Humana ChoiceCare |
$115.22
|
| Rate for Payer: Humana ChoiceCare |
$115.22
|
| Rate for Payer: Humana Medicare |
$102.82
|
| Rate for Payer: Humana Medicare |
$102.82
|
| Rate for Payer: Lucent All Commercial |
$143.95
|
| Rate for Payer: Lucent All Commercial |
$143.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.00
|
| Rate for Payer: Managed Health Services Medicaid |
$197.39
|
| Rate for Payer: Managed Health Services Medicaid |
$197.39
|
| Rate for Payer: MDWise Medicaid |
$197.39
|
| Rate for Payer: MDWise Medicaid |
$197.39
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$59.10
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$59.10
|
| Rate for Payer: PHCS All Commercial |
$102.82
|
| Rate for Payer: PHCS All Commercial |
$102.82
|
| Rate for Payer: PHP All Commercial |
$176.41
|
| Rate for Payer: PHP All Commercial |
$176.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.82
|
| Rate for Payer: Sagamore Health Network All Products |
$102.82
|
| Rate for Payer: Sagamore Health Network All Products |
$102.82
|
| Rate for Payer: Signature Care EPO |
$244.80
|
| Rate for Payer: Signature Care EPO |
$244.80
|
| Rate for Payer: Signature Care PPO |
$244.80
|
| Rate for Payer: Signature Care PPO |
$244.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,500.00
|
| Rate for Payer: United Healthcare Commercial |
$115.98
|
| Rate for Payer: United Healthcare Commercial |
$115.98
|
| Rate for Payer: United Healthcare Medicare |
$199.30
|
| Rate for Payer: United Healthcare Medicare |
$199.30
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMP
|
Professional
|
Both
|
$491.80
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
z10121
|
| Min. Negotiated Rate |
$93.61 |
| Max. Negotiated Rate |
$20,600.00 |
| Rate for Payer: Aetna Commercial |
$172.11
|
| Rate for Payer: Aetna Commercial |
$172.11
|
| Rate for Payer: Aetna Medicare |
$172.11
|
| Rate for Payer: Aetna Medicare |
$172.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$311.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$311.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$311.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$311.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$311.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$311.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$311.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$311.54
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.61
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$93.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$241.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$241.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$197.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$197.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$189.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$189.32
|
| Rate for Payer: Cash Price |
$289.70
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Centivo All Commercial |
$266.77
|
| Rate for Payer: Centivo All Commercial |
$266.77
|
| Rate for Payer: Cigna All Commercial |
$172.11
|
| Rate for Payer: Cigna All Commercial |
$172.11
|
| Rate for Payer: CORVEL All Commercial |
$172.11
|
| Rate for Payer: CORVEL All Commercial |
$172.11
|
| Rate for Payer: Coventry All Commercial |
$206.53
|
| Rate for Payer: Coventry All Commercial |
$206.53
|
| Rate for Payer: Encore All Commercial |
$172.11
|
| Rate for Payer: Encore All Commercial |
$172.11
|
| Rate for Payer: Frontpath All Commercial |
$236.11
|
| Rate for Payer: Frontpath All Commercial |
$236.11
|
| Rate for Payer: Humana ChoiceCare |
$168.86
|
| Rate for Payer: Humana ChoiceCare |
$168.86
|
| Rate for Payer: Humana Medicare |
$172.11
|
| Rate for Payer: Humana Medicare |
$172.11
|
| Rate for Payer: Lucent All Commercial |
$240.95
|
| Rate for Payer: Lucent All Commercial |
$240.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$223.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$223.00
|
| Rate for Payer: Managed Health Services Medicaid |
$241.89
|
| Rate for Payer: Managed Health Services Medicaid |
$241.89
|
| Rate for Payer: MDWise Medicaid |
$241.89
|
| Rate for Payer: MDWise Medicaid |
$241.89
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.61
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$93.61
|
| Rate for Payer: PHCS All Commercial |
$172.11
|
| Rate for Payer: PHCS All Commercial |
$172.11
|
| Rate for Payer: PHP All Commercial |
$234.26
|
| Rate for Payer: PHP All Commercial |
$234.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$172.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$172.11
|
| Rate for Payer: Sagamore Health Network All Products |
$172.11
|
| Rate for Payer: Sagamore Health Network All Products |
$172.11
|
| Rate for Payer: Signature Care EPO |
$247.35
|
| Rate for Payer: Signature Care EPO |
$247.35
|
| Rate for Payer: Signature Care PPO |
$247.35
|
| Rate for Payer: Signature Care PPO |
$247.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,600.00
|
| Rate for Payer: United Healthcare Commercial |
$200.61
|
| Rate for Payer: United Healthcare Commercial |
$200.61
|
| Rate for Payer: United Healthcare Medicare |
$241.42
|
| Rate for Payer: United Healthcare Medicare |
$241.42
|
|
