|
PR HYSTEROSCOPY,UTERUS,UNL PROC
|
Professional
|
Both
|
$663.70
|
|
|
Service Code
|
CPT 58579
|
| Hospital Charge Code |
z58579
|
| Rate for Payer: Cash Price |
$411.49
|
|
|
PR HYSTEROSCOPY,W/ENDO BX
|
Professional
|
Both
|
$2,444.22
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
z58558
|
| Min. Negotiated Rate |
$117.66 |
| Max. Negotiated Rate |
$28,000.00 |
| Rate for Payer: Aetna Commercial |
$216.13
|
| Rate for Payer: Aetna Commercial |
$216.13
|
| Rate for Payer: Aetna Medicare |
$216.13
|
| Rate for Payer: Aetna Medicare |
$216.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,934.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,934.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,934.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,934.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,934.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,934.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,934.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,934.43
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$117.66
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$117.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,194.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,194.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$248.55
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$248.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$237.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$237.74
|
| Rate for Payer: Cash Price |
$1,505.77
|
| Rate for Payer: Cash Price |
$1,515.42
|
| Rate for Payer: Centivo All Commercial |
$335.00
|
| Rate for Payer: Centivo All Commercial |
$335.00
|
| Rate for Payer: Cigna All Commercial |
$216.13
|
| Rate for Payer: Cigna All Commercial |
$216.13
|
| Rate for Payer: CORVEL All Commercial |
$216.13
|
| Rate for Payer: CORVEL All Commercial |
$216.13
|
| Rate for Payer: Coventry All Commercial |
$259.36
|
| Rate for Payer: Coventry All Commercial |
$259.36
|
| Rate for Payer: Encore All Commercial |
$216.13
|
| Rate for Payer: Encore All Commercial |
$216.13
|
| Rate for Payer: Frontpath All Commercial |
$301.08
|
| Rate for Payer: Frontpath All Commercial |
$301.08
|
| Rate for Payer: Humana ChoiceCare |
$308.76
|
| Rate for Payer: Humana ChoiceCare |
$308.76
|
| Rate for Payer: Humana Medicare |
$216.13
|
| Rate for Payer: Humana Medicare |
$216.13
|
| Rate for Payer: Lucent All Commercial |
$302.58
|
| Rate for Payer: Lucent All Commercial |
$302.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$301.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$301.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,194.51
|
| Rate for Payer: Managed Health Services Medicaid |
$1,194.51
|
| Rate for Payer: MDWise Medicaid |
$1,194.51
|
| Rate for Payer: MDWise Medicaid |
$1,194.51
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$117.66
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$117.66
|
| Rate for Payer: PHCS All Commercial |
$216.13
|
| Rate for Payer: PHCS All Commercial |
$216.13
|
| Rate for Payer: PHP All Commercial |
$276.99
|
| Rate for Payer: PHP All Commercial |
$276.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$216.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$216.13
|
| Rate for Payer: Sagamore Health Network All Products |
$216.13
|
| Rate for Payer: Sagamore Health Network All Products |
$216.13
|
| Rate for Payer: Signature Care EPO |
$1,638.55
|
| Rate for Payer: Signature Care EPO |
$1,638.55
|
| Rate for Payer: Signature Care PPO |
$1,638.55
|
| Rate for Payer: Signature Care PPO |
$1,638.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28,000.00
|
| Rate for Payer: United Healthcare Commercial |
$305.65
|
| Rate for Payer: United Healthcare Commercial |
$305.65
|
| Rate for Payer: United Healthcare Medicare |
$1,222.11
|
| Rate for Payer: United Healthcare Medicare |
$1,222.11
|
|
|
PR HYSTEROSCOPY,W/ENDOMETRIAL ABLATION
|
Professional
|
Both
|
$3,887.22
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
z58563
|
| Min. Negotiated Rate |
$230.29 |
| Max. Negotiated Rate |
$29,700.00 |
| Rate for Payer: Aetna Commercial |
$230.29
|
| Rate for Payer: Aetna Commercial |
$230.29
|
| Rate for Payer: Aetna Medicare |
$230.29
|
| Rate for Payer: Aetna Medicare |
$230.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$3,197.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$3,197.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,197.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,197.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,197.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,197.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,197.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,197.32
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$230.63
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$230.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,892.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,892.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$264.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$264.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.32
|
| Rate for Payer: Cash Price |
$2,385.51
|
| Rate for Payer: Cash Price |
$2,410.08
|
| Rate for Payer: Centivo All Commercial |
$356.95
|
| Rate for Payer: Centivo All Commercial |
$356.95
|
| Rate for Payer: Cigna All Commercial |
$230.29
|
| Rate for Payer: Cigna All Commercial |
$230.29
|
| Rate for Payer: CORVEL All Commercial |
$230.29
|
| Rate for Payer: CORVEL All Commercial |
$230.29
|
| Rate for Payer: Coventry All Commercial |
$276.35
|
| Rate for Payer: Coventry All Commercial |
$276.35
|
| Rate for Payer: Encore All Commercial |
$230.29
|
| Rate for Payer: Encore All Commercial |
$230.29
|
| Rate for Payer: Frontpath All Commercial |
$321.23
|
| Rate for Payer: Frontpath All Commercial |
$321.23
|
| Rate for Payer: Humana ChoiceCare |
$398.31
|
| Rate for Payer: Humana ChoiceCare |
$398.31
|
| Rate for Payer: Humana Medicare |
$230.29
|
| Rate for Payer: Humana Medicare |
$230.29
|
| Rate for Payer: Lucent All Commercial |
$322.41
|
| Rate for Payer: Lucent All Commercial |
$322.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$320.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$320.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,892.40
|
| Rate for Payer: Managed Health Services Medicaid |
$1,892.40
|
| Rate for Payer: MDWise Medicaid |
$1,892.40
|
| Rate for Payer: MDWise Medicaid |
$1,892.40
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$230.63
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$230.63
|
| Rate for Payer: PHCS All Commercial |
$230.29
|
| Rate for Payer: PHCS All Commercial |
$230.29
|
| Rate for Payer: PHP All Commercial |
$294.69
|
| Rate for Payer: PHP All Commercial |
$294.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$230.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$230.29
|
| Rate for Payer: Sagamore Health Network All Products |
$230.29
|
| Rate for Payer: Sagamore Health Network All Products |
$230.29
|
| Rate for Payer: Signature Care EPO |
$2,404.65
|
| Rate for Payer: Signature Care EPO |
$2,404.65
|
| Rate for Payer: Signature Care PPO |
$2,404.65
|
| Rate for Payer: Signature Care PPO |
$2,404.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29,700.00
|
| Rate for Payer: United Healthcare Commercial |
$393.30
|
| Rate for Payer: United Healthcare Commercial |
$393.30
|
| Rate for Payer: United Healthcare Medicare |
$1,943.61
|
| Rate for Payer: United Healthcare Medicare |
$1,943.61
|
|
|
PR I&D BARTHOLIN GLAND ABSCESS
|
Professional
|
Both
|
$346.08
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
z56420
|
| Min. Negotiated Rate |
$57.62 |
| Max. Negotiated Rate |
$13,500.00 |
| Rate for Payer: Aetna Commercial |
$104.93
|
| Rate for Payer: Aetna Commercial |
$104.93
|
| Rate for Payer: Aetna Medicare |
$104.93
|
| Rate for Payer: Aetna Medicare |
$104.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$187.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$187.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$187.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$187.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$187.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$187.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$187.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$187.47
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$57.62
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$57.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$170.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$170.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$120.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$120.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$115.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$115.42
|
| Rate for Payer: Cash Price |
$211.05
|
| Rate for Payer: Cash Price |
$214.57
|
| Rate for Payer: Centivo All Commercial |
$162.64
|
| Rate for Payer: Centivo All Commercial |
$162.64
|
| Rate for Payer: Cigna All Commercial |
$104.93
|
| Rate for Payer: Cigna All Commercial |
$104.93
|
| Rate for Payer: CORVEL All Commercial |
$104.93
|
| Rate for Payer: CORVEL All Commercial |
$104.93
|
| Rate for Payer: Coventry All Commercial |
$125.92
|
| Rate for Payer: Coventry All Commercial |
$125.92
|
| Rate for Payer: Encore All Commercial |
$104.93
|
| Rate for Payer: Encore All Commercial |
$104.93
|
| Rate for Payer: Frontpath All Commercial |
$144.44
|
| Rate for Payer: Frontpath All Commercial |
$144.44
|
| Rate for Payer: Humana ChoiceCare |
$106.51
|
| Rate for Payer: Humana ChoiceCare |
$106.51
|
| Rate for Payer: Humana Medicare |
$104.93
|
| Rate for Payer: Humana Medicare |
$104.93
|
| Rate for Payer: Lucent All Commercial |
$146.90
|
| Rate for Payer: Lucent All Commercial |
$146.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.00
|
| Rate for Payer: Managed Health Services Medicaid |
$170.21
|
| Rate for Payer: Managed Health Services Medicaid |
$170.21
|
| Rate for Payer: MDWise Medicaid |
$170.21
|
| Rate for Payer: MDWise Medicaid |
$170.21
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$57.62
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$57.62
|
| Rate for Payer: PHCS All Commercial |
$104.93
|
| Rate for Payer: PHCS All Commercial |
$104.93
|
| Rate for Payer: PHP All Commercial |
$134.02
|
| Rate for Payer: PHP All Commercial |
$134.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$104.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$104.93
|
| Rate for Payer: Sagamore Health Network All Products |
$104.93
|
| Rate for Payer: Sagamore Health Network All Products |
$104.93
|
| Rate for Payer: Signature Care EPO |
$176.80
|
| Rate for Payer: Signature Care EPO |
$176.80
|
| Rate for Payer: Signature Care PPO |
$176.80
|
| Rate for Payer: Signature Care PPO |
$176.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,500.00
|
| Rate for Payer: United Healthcare Commercial |
$103.06
|
| Rate for Payer: United Healthcare Commercial |
$103.06
|
| Rate for Payer: United Healthcare Medicare |
$170.20
|
| Rate for Payer: United Healthcare Medicare |
$170.20
|
|
|
PR IDENTIFY SENTINEL NODE
|
Professional
|
Both
|
$152.66
|
|
|
Service Code
|
CPT 38792
|
| Hospital Charge Code |
z38792
|
| Min. Negotiated Rate |
$22.63 |
| Max. Negotiated Rate |
$4,600.00 |
| Rate for Payer: Aetna Commercial |
$31.11
|
| Rate for Payer: Aetna Commercial |
$31.11
|
| Rate for Payer: Aetna Medicare |
$31.11
|
| Rate for Payer: Aetna Medicare |
$31.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$76.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$76.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.98
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$22.63
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$22.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$35.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$35.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$34.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$34.22
|
| Rate for Payer: Cash Price |
$93.19
|
| Rate for Payer: Cash Price |
$94.65
|
| Rate for Payer: Centivo All Commercial |
$48.22
|
| Rate for Payer: Centivo All Commercial |
$48.22
|
| Rate for Payer: Cigna All Commercial |
$31.11
|
| Rate for Payer: Cigna All Commercial |
$31.11
|
| Rate for Payer: CORVEL All Commercial |
$31.11
|
| Rate for Payer: CORVEL All Commercial |
$31.11
|
| Rate for Payer: Coventry All Commercial |
$37.33
|
| Rate for Payer: Coventry All Commercial |
$37.33
|
| Rate for Payer: Encore All Commercial |
$31.11
|
| Rate for Payer: Encore All Commercial |
$31.11
|
| Rate for Payer: Frontpath All Commercial |
$43.12
|
| Rate for Payer: Frontpath All Commercial |
$43.12
|
| Rate for Payer: Humana ChoiceCare |
$46.73
|
| Rate for Payer: Humana ChoiceCare |
$46.73
|
| Rate for Payer: Humana Medicare |
$31.11
|
| Rate for Payer: Humana Medicare |
$31.11
|
| Rate for Payer: Lucent All Commercial |
$43.55
|
| Rate for Payer: Lucent All Commercial |
$43.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$49.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$49.00
|
| Rate for Payer: Managed Health Services Medicaid |
$75.09
|
| Rate for Payer: Managed Health Services Medicaid |
$75.09
|
| Rate for Payer: MDWise Medicaid |
$75.09
|
| Rate for Payer: MDWise Medicaid |
$75.09
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$22.63
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$22.63
|
| Rate for Payer: PHCS All Commercial |
$31.11
|
| Rate for Payer: PHCS All Commercial |
$31.11
|
| Rate for Payer: PHP All Commercial |
$41.54
|
| Rate for Payer: PHP All Commercial |
$41.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$31.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$31.11
|
| Rate for Payer: Sagamore Health Network All Products |
$31.11
|
| Rate for Payer: Sagamore Health Network All Products |
$31.11
|
| Rate for Payer: Signature Care EPO |
$65.88
|
| Rate for Payer: Signature Care EPO |
$65.88
|
| Rate for Payer: Signature Care PPO |
$65.88
|
| Rate for Payer: Signature Care PPO |
$65.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,600.00
|
| Rate for Payer: United Healthcare Commercial |
$44.93
|
| Rate for Payer: United Healthcare Commercial |
$44.93
|
| Rate for Payer: United Healthcare Medicare |
$75.15
|
| Rate for Payer: United Healthcare Medicare |
$75.15
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$316.38
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
z10140
|
| Min. Negotiated Rate |
$60.04 |
| Max. Negotiated Rate |
$13,200.00 |
| Rate for Payer: Aetna Commercial |
$110.38
|
| Rate for Payer: Aetna Commercial |
$110.38
|
| Rate for Payer: Aetna Medicare |
$110.38
|
| Rate for Payer: Aetna Medicare |
$110.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$120.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$120.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$120.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$120.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$120.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$120.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$120.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$120.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$60.04
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$60.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$155.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$155.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$126.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$126.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.42
|
| Rate for Payer: Cash Price |
$191.54
|
| Rate for Payer: Cash Price |
$196.16
|
| Rate for Payer: Centivo All Commercial |
$171.09
|
| Rate for Payer: Centivo All Commercial |
$171.09
|
| Rate for Payer: Cigna All Commercial |
$110.38
|
| Rate for Payer: Cigna All Commercial |
$110.38
|
| Rate for Payer: CORVEL All Commercial |
$110.38
|
| Rate for Payer: CORVEL All Commercial |
$110.38
|
| Rate for Payer: Coventry All Commercial |
$132.46
|
| Rate for Payer: Coventry All Commercial |
$132.46
|
| Rate for Payer: Encore All Commercial |
$110.38
|
| Rate for Payer: Encore All Commercial |
$110.38
|
| Rate for Payer: Frontpath All Commercial |
$150.42
|
| Rate for Payer: Frontpath All Commercial |
$150.42
|
| Rate for Payer: Humana ChoiceCare |
$105.41
|
| Rate for Payer: Humana ChoiceCare |
$105.41
|
| Rate for Payer: Humana Medicare |
$110.38
|
| Rate for Payer: Humana Medicare |
$110.38
|
| Rate for Payer: Lucent All Commercial |
$154.53
|
| Rate for Payer: Lucent All Commercial |
$154.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$143.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$143.00
|
| Rate for Payer: Managed Health Services Medicaid |
$155.60
|
| Rate for Payer: Managed Health Services Medicaid |
$155.60
|
| Rate for Payer: MDWise Medicaid |
$155.60
|
| Rate for Payer: MDWise Medicaid |
$155.60
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$60.04
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$60.04
|
| Rate for Payer: PHCS All Commercial |
$110.38
|
| Rate for Payer: PHCS All Commercial |
$110.38
|
| Rate for Payer: PHP All Commercial |
$150.47
|
| Rate for Payer: PHP All Commercial |
$150.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$110.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$110.38
|
| Rate for Payer: Sagamore Health Network All Products |
$110.38
|
| Rate for Payer: Sagamore Health Network All Products |
$110.38
|
| Rate for Payer: Signature Care EPO |
$136.18
|
| Rate for Payer: Signature Care EPO |
$136.18
|
| Rate for Payer: Signature Care PPO |
$136.18
|
| Rate for Payer: Signature Care PPO |
$136.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,200.00
|
| Rate for Payer: United Healthcare Commercial |
$127.99
|
| Rate for Payer: United Healthcare Commercial |
$127.99
|
| Rate for Payer: United Healthcare Medicare |
$154.47
|
| Rate for Payer: United Healthcare Medicare |
$154.47
|
|
|
PR I&D OF VULVA/PERINEUM ABSCESS
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
z56405
|
| Min. Negotiated Rate |
$69.25 |
| Max. Negotiated Rate |
$15,500.00 |
| Rate for Payer: Aetna Commercial |
$119.75
|
| Rate for Payer: Aetna Commercial |
$119.75
|
| Rate for Payer: Aetna Medicare |
$119.75
|
| Rate for Payer: Aetna Medicare |
$119.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$143.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$143.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$143.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$143.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$143.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$143.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$143.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$143.91
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$69.25
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$69.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$137.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$137.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$131.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$131.72
|
| Rate for Payer: Cash Price |
$167.54
|
| Rate for Payer: Cash Price |
$169.26
|
| Rate for Payer: Centivo All Commercial |
$185.61
|
| Rate for Payer: Centivo All Commercial |
$185.61
|
| Rate for Payer: Cigna All Commercial |
$119.75
|
| Rate for Payer: Cigna All Commercial |
$119.75
|
| Rate for Payer: CORVEL All Commercial |
$119.75
|
| Rate for Payer: CORVEL All Commercial |
$119.75
|
| Rate for Payer: Coventry All Commercial |
$143.70
|
| Rate for Payer: Coventry All Commercial |
$143.70
|
| Rate for Payer: Encore All Commercial |
$119.75
|
| Rate for Payer: Encore All Commercial |
$119.75
|
| Rate for Payer: Frontpath All Commercial |
$163.94
|
| Rate for Payer: Frontpath All Commercial |
$163.94
|
| Rate for Payer: Humana ChoiceCare |
$112.93
|
| Rate for Payer: Humana ChoiceCare |
$112.93
|
| Rate for Payer: Humana Medicare |
$119.75
|
| Rate for Payer: Humana Medicare |
$119.75
|
| Rate for Payer: Lucent All Commercial |
$167.65
|
| Rate for Payer: Lucent All Commercial |
$167.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$167.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$167.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.27
|
| Rate for Payer: Managed Health Services Medicaid |
$134.27
|
| Rate for Payer: MDWise Medicaid |
$134.27
|
| Rate for Payer: MDWise Medicaid |
$134.27
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$69.25
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$69.25
|
| Rate for Payer: PHCS All Commercial |
$119.75
|
| Rate for Payer: PHCS All Commercial |
$119.75
|
| Rate for Payer: PHP All Commercial |
$153.30
|
| Rate for Payer: PHP All Commercial |
$153.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$119.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$119.75
|
| Rate for Payer: Sagamore Health Network All Products |
$119.75
|
| Rate for Payer: Sagamore Health Network All Products |
$119.75
|
| Rate for Payer: Signature Care EPO |
$136.00
|
| Rate for Payer: Signature Care EPO |
$136.00
|
| Rate for Payer: Signature Care PPO |
$136.00
|
| Rate for Payer: Signature Care PPO |
$136.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,500.00
|
| Rate for Payer: United Healthcare Commercial |
$118.43
|
| Rate for Payer: United Healthcare Commercial |
$118.43
|
| Rate for Payer: United Healthcare Medicare |
$135.11
|
| Rate for Payer: United Healthcare Medicare |
$135.11
|
|
|
PR I&D PERIANAL ABSCESS,SUPERFICIAL
|
Professional
|
Both
|
$436.50
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
z46050
|
| Min. Negotiated Rate |
$76.82 |
| Max. Negotiated Rate |
$13,100.00 |
| Rate for Payer: Aetna Commercial |
$93.49
|
| Rate for Payer: Aetna Commercial |
$93.49
|
| Rate for Payer: Aetna Medicare |
$93.49
|
| Rate for Payer: Aetna Medicare |
$93.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$153.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$153.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$153.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$153.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$153.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$153.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$153.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$153.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$76.82
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$76.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$214.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$214.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$107.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$107.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$102.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$102.84
|
| Rate for Payer: Cash Price |
$267.08
|
| Rate for Payer: Cash Price |
$270.63
|
| Rate for Payer: Centivo All Commercial |
$144.91
|
| Rate for Payer: Centivo All Commercial |
$144.91
|
| Rate for Payer: Cigna All Commercial |
$93.49
|
| Rate for Payer: Cigna All Commercial |
$93.49
|
| Rate for Payer: CORVEL All Commercial |
$93.49
|
| Rate for Payer: CORVEL All Commercial |
$93.49
|
| Rate for Payer: Coventry All Commercial |
$112.19
|
| Rate for Payer: Coventry All Commercial |
$112.19
|
| Rate for Payer: Encore All Commercial |
$93.49
|
| Rate for Payer: Encore All Commercial |
$93.49
|
| Rate for Payer: Frontpath All Commercial |
$129.21
|
| Rate for Payer: Frontpath All Commercial |
$129.21
|
| Rate for Payer: Humana ChoiceCare |
$91.27
|
| Rate for Payer: Humana ChoiceCare |
$91.27
|
| Rate for Payer: Humana Medicare |
$93.49
|
| Rate for Payer: Humana Medicare |
$93.49
|
| Rate for Payer: Lucent All Commercial |
$130.89
|
| Rate for Payer: Lucent All Commercial |
$130.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$141.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$141.00
|
| Rate for Payer: Managed Health Services Medicaid |
$214.69
|
| Rate for Payer: Managed Health Services Medicaid |
$214.69
|
| Rate for Payer: MDWise Medicaid |
$214.69
|
| Rate for Payer: MDWise Medicaid |
$214.69
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$76.82
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$76.82
|
| Rate for Payer: PHCS All Commercial |
$93.49
|
| Rate for Payer: PHCS All Commercial |
$93.49
|
| Rate for Payer: PHP All Commercial |
$160.31
|
| Rate for Payer: PHP All Commercial |
$160.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$93.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$93.49
|
| Rate for Payer: Sagamore Health Network All Products |
$93.49
|
| Rate for Payer: Sagamore Health Network All Products |
$93.49
|
| Rate for Payer: Signature Care EPO |
$206.55
|
| Rate for Payer: Signature Care EPO |
$206.55
|
| Rate for Payer: Signature Care PPO |
$206.55
|
| Rate for Payer: Signature Care PPO |
$206.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,100.00
|
| Rate for Payer: United Healthcare Commercial |
$97.24
|
| Rate for Payer: United Healthcare Commercial |
$97.24
|
| Rate for Payer: United Healthcare Medicare |
$215.39
|
| Rate for Payer: United Healthcare Medicare |
$215.39
|
|
|
PR I&D PERIRECTAL ABSCESS
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
z46040
|
| Min. Negotiated Rate |
$220.27 |
| Max. Negotiated Rate |
$55,200.00 |
| Rate for Payer: Aetna Commercial |
$397.60
|
| Rate for Payer: Aetna Commercial |
$397.60
|
| Rate for Payer: Aetna Medicare |
$397.60
|
| Rate for Payer: Aetna Medicare |
$397.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$419.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$419.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$419.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$419.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$419.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$419.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$419.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$419.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$220.27
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$220.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$502.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$502.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$457.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$457.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$437.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$437.36
|
| Rate for Payer: Cash Price |
$623.46
|
| Rate for Payer: Cash Price |
$633.64
|
| Rate for Payer: Centivo All Commercial |
$616.28
|
| Rate for Payer: Centivo All Commercial |
$616.28
|
| Rate for Payer: Cigna All Commercial |
$397.60
|
| Rate for Payer: Cigna All Commercial |
$397.60
|
| Rate for Payer: CORVEL All Commercial |
$397.60
|
| Rate for Payer: CORVEL All Commercial |
$397.60
|
| Rate for Payer: Coventry All Commercial |
$477.12
|
| Rate for Payer: Coventry All Commercial |
$477.12
|
| Rate for Payer: Encore All Commercial |
$397.60
|
| Rate for Payer: Encore All Commercial |
$397.60
|
| Rate for Payer: Frontpath All Commercial |
$553.33
|
| Rate for Payer: Frontpath All Commercial |
$553.33
|
| Rate for Payer: Humana ChoiceCare |
$384.36
|
| Rate for Payer: Humana ChoiceCare |
$384.36
|
| Rate for Payer: Humana Medicare |
$397.60
|
| Rate for Payer: Humana Medicare |
$397.60
|
| Rate for Payer: Lucent All Commercial |
$556.64
|
| Rate for Payer: Lucent All Commercial |
$556.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$591.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$591.00
|
| Rate for Payer: Managed Health Services Medicaid |
$502.66
|
| Rate for Payer: Managed Health Services Medicaid |
$502.66
|
| Rate for Payer: MDWise Medicaid |
$502.66
|
| Rate for Payer: MDWise Medicaid |
$502.66
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$220.27
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$220.27
|
| Rate for Payer: PHCS All Commercial |
$397.60
|
| Rate for Payer: PHCS All Commercial |
$397.60
|
| Rate for Payer: PHP All Commercial |
$672.74
|
| Rate for Payer: PHP All Commercial |
$672.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$397.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$397.60
|
| Rate for Payer: Sagamore Health Network All Products |
$397.60
|
| Rate for Payer: Sagamore Health Network All Products |
$397.60
|
| Rate for Payer: Signature Care EPO |
$577.15
|
| Rate for Payer: Signature Care EPO |
$577.15
|
| Rate for Payer: Signature Care PPO |
$577.15
|
| Rate for Payer: Signature Care PPO |
$577.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,200.00
|
| Rate for Payer: United Healthcare Commercial |
$415.70
|
| Rate for Payer: United Healthcare Commercial |
$415.70
|
| Rate for Payer: United Healthcare Medicare |
$502.79
|
| Rate for Payer: United Healthcare Medicare |
$502.79
|
|
|
PR ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$549.86
|
|
|
Service Code
|
CPT 44382
|
| Hospital Charge Code |
z44382
|
| Min. Negotiated Rate |
$56.22 |
| Max. Negotiated Rate |
$272.66 |
| Rate for Payer: Aetna Commercial |
$68.58
|
| Rate for Payer: Aetna Commercial |
$68.58
|
| Rate for Payer: Aetna Medicare |
$68.58
|
| Rate for Payer: Aetna Medicare |
$68.58
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.22
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$270.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$270.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$75.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$75.44
|
| Rate for Payer: Cash Price |
$338.10
|
| Rate for Payer: Cash Price |
$340.91
|
| Rate for Payer: Centivo All Commercial |
$106.30
|
| Rate for Payer: Centivo All Commercial |
$106.30
|
| Rate for Payer: Cigna All Commercial |
$68.58
|
| Rate for Payer: Cigna All Commercial |
$68.58
|
| Rate for Payer: CORVEL All Commercial |
$68.58
|
| Rate for Payer: CORVEL All Commercial |
$68.58
|
| Rate for Payer: Coventry All Commercial |
$82.30
|
| Rate for Payer: Coventry All Commercial |
$82.30
|
| Rate for Payer: Encore All Commercial |
$68.58
|
| Rate for Payer: Encore All Commercial |
$68.58
|
| Rate for Payer: Frontpath All Commercial |
$93.04
|
| Rate for Payer: Frontpath All Commercial |
$93.04
|
| Rate for Payer: Humana ChoiceCare |
$85.87
|
| Rate for Payer: Humana ChoiceCare |
$85.87
|
| Rate for Payer: Humana Medicare |
$68.58
|
| Rate for Payer: Humana Medicare |
$68.58
|
| Rate for Payer: Lucent All Commercial |
$96.01
|
| Rate for Payer: Lucent All Commercial |
$96.01
|
| Rate for Payer: Managed Health Services Medicaid |
$270.44
|
| Rate for Payer: Managed Health Services Medicaid |
$270.44
|
| Rate for Payer: MDWise Medicaid |
$270.44
|
| Rate for Payer: MDWise Medicaid |
$270.44
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$56.22
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$56.22
|
| Rate for Payer: PHCS All Commercial |
$68.58
|
| Rate for Payer: PHCS All Commercial |
$68.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.58
|
| Rate for Payer: Sagamore Health Network All Products |
$68.58
|
| Rate for Payer: Sagamore Health Network All Products |
$68.58
|
| Rate for Payer: United Healthcare Commercial |
$94.85
|
| Rate for Payer: United Healthcare Commercial |
$94.85
|
| Rate for Payer: United Healthcare Medicare |
$272.66
|
| Rate for Payer: United Healthcare Medicare |
$272.66
|
|
|
PRIMIDONE 50 MG ORAL TAB
|
Facility
|
OP
|
$2.41
|
|
|
Service Code
|
NDC 50268068615
|
| Hospital Charge Code |
11129
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$2.24 |
| Rate for Payer: Aetna Commercial |
$2.03
|
| Rate for Payer: Aetna Medicare |
$0.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$0.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$0.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$0.85
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: Centivo All Commercial |
$1.31
|
| Rate for Payer: Cigna All Commercial |
$2.08
|
| Rate for Payer: CORVEL All Commercial |
$2.24
|
| Rate for Payer: Coventry All Commercial |
$2.12
|
| Rate for Payer: Encore All Commercial |
$2.22
|
| Rate for Payer: Frontpath All Commercial |
$2.22
|
| Rate for Payer: Humana ChoiceCare |
$2.08
|
| Rate for Payer: Humana Medicare |
$0.77
|
| Rate for Payer: Lucent All Commercial |
$1.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2.17
|
| Rate for Payer: PHCS All Commercial |
$1.81
|
| Rate for Payer: PHP All Commercial |
$1.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$0.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1.86
|
| Rate for Payer: Signature Care EPO |
$2.00
|
| Rate for Payer: Signature Care PPO |
$2.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2.05
|
| Rate for Payer: United Healthcare Commercial |
$1.90
|
| Rate for Payer: United Healthcare Medicare |
$0.77
|
|
|
PRIMIDONE 50 MG ORAL TAB
|
Facility
|
IP
|
$2.41
|
|
|
Service Code
|
NDC 50268068615
|
| Hospital Charge Code |
11129
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$2.24 |
| Rate for Payer: Aetna Commercial |
$2.08
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: Cigna All Commercial |
$2.08
|
| Rate for Payer: CORVEL All Commercial |
$2.24
|
| Rate for Payer: Coventry All Commercial |
$2.12
|
| Rate for Payer: Encore All Commercial |
$2.22
|
| Rate for Payer: Frontpath All Commercial |
$2.22
|
| Rate for Payer: Humana ChoiceCare |
$2.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2.17
|
| Rate for Payer: PHCS All Commercial |
$1.81
|
| Rate for Payer: PHP All Commercial |
$1.83
|
| Rate for Payer: Sagamore Health Network All Products |
$1.86
|
| Rate for Payer: Signature Care EPO |
$2.00
|
| Rate for Payer: Signature Care PPO |
$2.12
|
| Rate for Payer: United Healthcare Commercial |
$1.90
|
|
|
PR IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID
|
Professional
|
Both
|
$38.64
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
z90471
|
| Min. Negotiated Rate |
$14.44 |
| Max. Negotiated Rate |
$2,300.00 |
| Rate for Payer: Aetna Commercial |
$15.70
|
| Rate for Payer: Aetna Commercial |
$15.70
|
| Rate for Payer: Aetna Medicare |
$15.70
|
| Rate for Payer: Aetna Medicare |
$15.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.27
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Centivo All Commercial |
$24.34
|
| Rate for Payer: Centivo All Commercial |
$24.34
|
| Rate for Payer: Cigna All Commercial |
$15.70
|
| Rate for Payer: Cigna All Commercial |
$15.70
|
| Rate for Payer: CORVEL All Commercial |
$15.70
|
| Rate for Payer: CORVEL All Commercial |
$15.70
|
| Rate for Payer: Coventry All Commercial |
$18.84
|
| Rate for Payer: Coventry All Commercial |
$18.84
|
| Rate for Payer: Encore All Commercial |
$15.70
|
| Rate for Payer: Encore All Commercial |
$15.70
|
| Rate for Payer: Frontpath All Commercial |
$17.67
|
| Rate for Payer: Frontpath All Commercial |
$17.67
|
| Rate for Payer: Humana ChoiceCare |
$14.44
|
| Rate for Payer: Humana ChoiceCare |
$14.44
|
| Rate for Payer: Humana Medicare |
$15.70
|
| Rate for Payer: Humana Medicare |
$15.70
|
| Rate for Payer: Lucent All Commercial |
$21.98
|
| Rate for Payer: Lucent All Commercial |
$21.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$25.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$25.00
|
| Rate for Payer: Managed Health Services Medicaid |
$15.00
|
| Rate for Payer: Managed Health Services Medicaid |
$15.00
|
| Rate for Payer: MDWise Medicaid |
$15.00
|
| Rate for Payer: MDWise Medicaid |
$15.00
|
| Rate for Payer: PHCS All Commercial |
$15.70
|
| Rate for Payer: PHCS All Commercial |
$15.70
|
| Rate for Payer: PHP All Commercial |
$26.72
|
| Rate for Payer: PHP All Commercial |
$26.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$15.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$15.70
|
| Rate for Payer: Sagamore Health Network All Products |
$15.70
|
| Rate for Payer: Sagamore Health Network All Products |
$15.70
|
| Rate for Payer: Signature Care EPO |
$15.00
|
| Rate for Payer: Signature Care EPO |
$15.00
|
| Rate for Payer: Signature Care PPO |
$15.00
|
| Rate for Payer: Signature Care PPO |
$15.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,300.00
|
| Rate for Payer: United Healthcare Commercial |
$19.59
|
| Rate for Payer: United Healthcare Commercial |
$19.59
|
| Rate for Payer: United Healthcare Medicare |
$18.43
|
| Rate for Payer: United Healthcare Medicare |
$18.43
|
|
|
PR IMMUNIZ,ADMIN,EACH ADDL
|
Professional
|
Both
|
$27.50
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
z90472
|
| Min. Negotiated Rate |
$7.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: Aetna Commercial |
$11.89
|
| Rate for Payer: Aetna Commercial |
$11.89
|
| Rate for Payer: Aetna Medicare |
$11.89
|
| Rate for Payer: Aetna Medicare |
$11.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$12.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$13.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$13.08
|
| Rate for Payer: Cash Price |
$17.05
|
| Rate for Payer: Cash Price |
$16.43
|
| Rate for Payer: Centivo All Commercial |
$18.43
|
| Rate for Payer: Centivo All Commercial |
$18.43
|
| Rate for Payer: Cigna All Commercial |
$11.89
|
| Rate for Payer: Cigna All Commercial |
$11.89
|
| Rate for Payer: CORVEL All Commercial |
$11.89
|
| Rate for Payer: CORVEL All Commercial |
$11.89
|
| Rate for Payer: Coventry All Commercial |
$14.27
|
| Rate for Payer: Coventry All Commercial |
$14.27
|
| Rate for Payer: Encore All Commercial |
$11.89
|
| Rate for Payer: Encore All Commercial |
$11.89
|
| Rate for Payer: Frontpath All Commercial |
$13.42
|
| Rate for Payer: Frontpath All Commercial |
$13.42
|
| Rate for Payer: Humana ChoiceCare |
$12.99
|
| Rate for Payer: Humana ChoiceCare |
$12.99
|
| Rate for Payer: Humana Medicare |
$11.89
|
| Rate for Payer: Humana Medicare |
$11.89
|
| Rate for Payer: Lucent All Commercial |
$16.65
|
| Rate for Payer: Lucent All Commercial |
$16.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.00
|
| Rate for Payer: Managed Health Services Medicaid |
$15.00
|
| Rate for Payer: Managed Health Services Medicaid |
$15.00
|
| Rate for Payer: MDWise Medicaid |
$15.00
|
| Rate for Payer: MDWise Medicaid |
$15.00
|
| Rate for Payer: PHCS All Commercial |
$11.89
|
| Rate for Payer: PHCS All Commercial |
$11.89
|
| Rate for Payer: PHP All Commercial |
$19.21
|
| Rate for Payer: PHP All Commercial |
$19.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$11.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$11.89
|
| Rate for Payer: Sagamore Health Network All Products |
$11.89
|
| Rate for Payer: Sagamore Health Network All Products |
$11.89
|
| Rate for Payer: Signature Care EPO |
$7.50
|
| Rate for Payer: Signature Care EPO |
$7.50
|
| Rate for Payer: Signature Care PPO |
$7.50
|
| Rate for Payer: Signature Care PPO |
$7.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,600.00
|
| Rate for Payer: United Healthcare Commercial |
$7.61
|
| Rate for Payer: United Healthcare Commercial |
$7.61
|
| Rate for Payer: United Healthcare Medicare |
$13.25
|
| Rate for Payer: United Healthcare Medicare |
$13.25
|
|
|
PR IMMUNIZ ADMIN,INTRANASAL/ORAL,1 VAC/TOX
|
Professional
|
Both
|
$31.28
|
|
|
Service Code
|
CPT 90473
|
| Hospital Charge Code |
z90473
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$1,900.00 |
| Rate for Payer: Aetna Commercial |
$15.70
|
| Rate for Payer: Aetna Commercial |
$15.70
|
| Rate for Payer: Aetna Medicare |
$15.70
|
| Rate for Payer: Aetna Medicare |
$15.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.27
|
| Rate for Payer: Cash Price |
$19.39
|
| Rate for Payer: Cash Price |
$18.74
|
| Rate for Payer: Centivo All Commercial |
$24.34
|
| Rate for Payer: Centivo All Commercial |
$24.34
|
| Rate for Payer: Cigna All Commercial |
$15.70
|
| Rate for Payer: Cigna All Commercial |
$15.70
|
| Rate for Payer: CORVEL All Commercial |
$15.70
|
| Rate for Payer: CORVEL All Commercial |
$15.70
|
| Rate for Payer: Coventry All Commercial |
$18.84
|
| Rate for Payer: Coventry All Commercial |
$18.84
|
| Rate for Payer: Encore All Commercial |
$15.70
|
| Rate for Payer: Encore All Commercial |
$15.70
|
| Rate for Payer: Frontpath All Commercial |
$17.67
|
| Rate for Payer: Frontpath All Commercial |
$17.67
|
| Rate for Payer: Humana ChoiceCare |
$14.44
|
| Rate for Payer: Humana ChoiceCare |
$14.44
|
| Rate for Payer: Humana Medicare |
$15.70
|
| Rate for Payer: Humana Medicare |
$15.70
|
| Rate for Payer: Lucent All Commercial |
$21.98
|
| Rate for Payer: Lucent All Commercial |
$21.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$20.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$20.00
|
| Rate for Payer: Managed Health Services Medicaid |
$15.00
|
| Rate for Payer: Managed Health Services Medicaid |
$15.00
|
| Rate for Payer: MDWise Medicaid |
$15.00
|
| Rate for Payer: MDWise Medicaid |
$15.00
|
| Rate for Payer: PHCS All Commercial |
$15.70
|
| Rate for Payer: PHCS All Commercial |
$15.70
|
| Rate for Payer: PHP All Commercial |
$21.92
|
| Rate for Payer: PHP All Commercial |
$21.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$15.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$15.70
|
| Rate for Payer: Sagamore Health Network All Products |
$15.70
|
| Rate for Payer: Sagamore Health Network All Products |
$15.70
|
| Rate for Payer: Signature Care EPO |
$17.00
|
| Rate for Payer: Signature Care EPO |
$17.00
|
| Rate for Payer: Signature Care PPO |
$17.00
|
| Rate for Payer: Signature Care PPO |
$17.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,900.00
|
| Rate for Payer: United Healthcare Commercial |
$8.00
|
| Rate for Payer: United Healthcare Commercial |
$8.00
|
| Rate for Payer: United Healthcare Medicare |
$15.11
|
| Rate for Payer: United Healthcare Medicare |
$15.11
|
|
|
PR IMMUNIZ ADMIN,INTRANASAL/ORAL,EACH ADDL
|
Professional
|
Both
|
$22.58
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
z90474
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$1,300.00 |
| Rate for Payer: Aetna Commercial |
$11.89
|
| Rate for Payer: Aetna Commercial |
$11.89
|
| Rate for Payer: Aetna Medicare |
$11.89
|
| Rate for Payer: Aetna Medicare |
$11.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$12.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$13.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$13.08
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: Cash Price |
$13.44
|
| Rate for Payer: Centivo All Commercial |
$18.43
|
| Rate for Payer: Centivo All Commercial |
$18.43
|
| Rate for Payer: Cigna All Commercial |
$11.89
|
| Rate for Payer: Cigna All Commercial |
$11.89
|
| Rate for Payer: CORVEL All Commercial |
$11.89
|
| Rate for Payer: CORVEL All Commercial |
$11.89
|
| Rate for Payer: Coventry All Commercial |
$14.27
|
| Rate for Payer: Coventry All Commercial |
$14.27
|
| Rate for Payer: Encore All Commercial |
$11.89
|
| Rate for Payer: Encore All Commercial |
$11.89
|
| Rate for Payer: Frontpath All Commercial |
$13.42
|
| Rate for Payer: Frontpath All Commercial |
$13.42
|
| Rate for Payer: Humana ChoiceCare |
$12.99
|
| Rate for Payer: Humana ChoiceCare |
$12.99
|
| Rate for Payer: Humana Medicare |
$11.89
|
| Rate for Payer: Humana Medicare |
$11.89
|
| Rate for Payer: Lucent All Commercial |
$16.65
|
| Rate for Payer: Lucent All Commercial |
$16.65
|
| 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 |
$15.00
|
| Rate for Payer: Managed Health Services Medicaid |
$15.00
|
| Rate for Payer: MDWise Medicaid |
$15.00
|
| Rate for Payer: MDWise Medicaid |
$15.00
|
| Rate for Payer: PHCS All Commercial |
$11.89
|
| Rate for Payer: PHCS All Commercial |
$11.89
|
| Rate for Payer: PHP All Commercial |
$15.72
|
| Rate for Payer: PHP All Commercial |
$15.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$11.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$11.89
|
| Rate for Payer: Sagamore Health Network All Products |
$11.89
|
| Rate for Payer: Sagamore Health Network All Products |
$11.89
|
| Rate for Payer: Signature Care EPO |
$17.00
|
| Rate for Payer: Signature Care EPO |
$17.00
|
| Rate for Payer: Signature Care PPO |
$17.00
|
| Rate for Payer: Signature Care PPO |
$17.00
|
| 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 |
$7.28
|
| Rate for Payer: United Healthcare Commercial |
$7.28
|
| Rate for Payer: United Healthcare Medicare |
$10.84
|
| Rate for Payer: United Healthcare Medicare |
$10.84
|
|
|
PR IMMUNIZ ADMIN, THRU AGE 18, ANY ROUTE,W COUNSEL, 1ST VACCINE/TOXOID
|
Professional
|
Both
|
$41.20
|
|
|
Service Code
|
CPT 90460
|
| Hospital Charge Code |
z90460
|
| Min. Negotiated Rate |
$14.44 |
| Max. Negotiated Rate |
$2,500.00 |
| Rate for Payer: Aetna Commercial |
$15.70
|
| Rate for Payer: Aetna Commercial |
$15.70
|
| Rate for Payer: Aetna Medicare |
$15.70
|
| Rate for Payer: Aetna Medicare |
$15.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.27
|
| Rate for Payer: Cash Price |
$26.67
|
| Rate for Payer: Cash Price |
$25.54
|
| Rate for Payer: Centivo All Commercial |
$24.34
|
| Rate for Payer: Centivo All Commercial |
$24.34
|
| Rate for Payer: Cigna All Commercial |
$15.70
|
| Rate for Payer: Cigna All Commercial |
$15.70
|
| Rate for Payer: CORVEL All Commercial |
$15.70
|
| Rate for Payer: CORVEL All Commercial |
$15.70
|
| Rate for Payer: Coventry All Commercial |
$18.84
|
| Rate for Payer: Coventry All Commercial |
$18.84
|
| Rate for Payer: Encore All Commercial |
$15.70
|
| Rate for Payer: Encore All Commercial |
$15.70
|
| Rate for Payer: Frontpath All Commercial |
$17.67
|
| Rate for Payer: Frontpath All Commercial |
$17.67
|
| Rate for Payer: Humana ChoiceCare |
$14.44
|
| Rate for Payer: Humana ChoiceCare |
$14.44
|
| Rate for Payer: Humana Medicare |
$15.70
|
| Rate for Payer: Humana Medicare |
$15.70
|
| Rate for Payer: Lucent All Commercial |
$21.98
|
| Rate for Payer: Lucent All Commercial |
$21.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$27.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$27.00
|
| Rate for Payer: Managed Health Services Medicaid |
$21.16
|
| Rate for Payer: Managed Health Services Medicaid |
$21.16
|
| Rate for Payer: MDWise Medicaid |
$21.16
|
| Rate for Payer: MDWise Medicaid |
$21.16
|
| Rate for Payer: PHCS All Commercial |
$15.70
|
| Rate for Payer: PHCS All Commercial |
$15.70
|
| Rate for Payer: PHP All Commercial |
$29.87
|
| Rate for Payer: PHP All Commercial |
$29.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$15.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$15.70
|
| Rate for Payer: Sagamore Health Network All Products |
$15.70
|
| Rate for Payer: Sagamore Health Network All Products |
$15.70
|
| Rate for Payer: Signature Care EPO |
$23.75
|
| Rate for Payer: Signature Care EPO |
$23.75
|
| Rate for Payer: Signature Care PPO |
$23.75
|
| Rate for Payer: Signature Care PPO |
$23.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,500.00
|
| Rate for Payer: United Healthcare Commercial |
$22.90
|
| Rate for Payer: United Healthcare Commercial |
$22.90
|
| Rate for Payer: United Healthcare Medicare |
$20.60
|
| Rate for Payer: United Healthcare Medicare |
$20.60
|
|
|
PR IMMUNIZ ADMIN THRU AGE 18 ANY ROUTE,W COUNSEL EA ADD VACCINE/TOXOID
|
Professional
|
Both
|
$18.84
|
|
|
Service Code
|
CPT 90461
|
| Hospital Charge Code |
z90461
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$1,200.00 |
| Rate for Payer: Aetna Commercial |
$11.89
|
| Rate for Payer: Aetna Commercial |
$11.89
|
| Rate for Payer: Aetna Medicare |
$11.89
|
| Rate for Payer: Aetna Medicare |
$11.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$12.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$12.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$8.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$8.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$13.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$13.08
|
| Rate for Payer: Cash Price |
$11.68
|
| Rate for Payer: Cash Price |
$10.29
|
| Rate for Payer: Centivo All Commercial |
$18.43
|
| Rate for Payer: Centivo All Commercial |
$18.43
|
| Rate for Payer: Cigna All Commercial |
$11.89
|
| Rate for Payer: Cigna All Commercial |
$11.89
|
| Rate for Payer: CORVEL All Commercial |
$11.89
|
| Rate for Payer: CORVEL All Commercial |
$11.89
|
| Rate for Payer: Coventry All Commercial |
$14.27
|
| Rate for Payer: Coventry All Commercial |
$14.27
|
| Rate for Payer: Encore All Commercial |
$11.89
|
| Rate for Payer: Encore All Commercial |
$11.89
|
| Rate for Payer: Frontpath All Commercial |
$13.42
|
| Rate for Payer: Frontpath All Commercial |
$13.42
|
| Rate for Payer: Humana ChoiceCare |
$12.99
|
| Rate for Payer: Humana ChoiceCare |
$12.99
|
| Rate for Payer: Humana Medicare |
$11.89
|
| Rate for Payer: Humana Medicare |
$11.89
|
| Rate for Payer: Lucent All Commercial |
$16.65
|
| Rate for Payer: Lucent All Commercial |
$16.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13.00
|
| Rate for Payer: Managed Health Services Medicaid |
$8.17
|
| Rate for Payer: Managed Health Services Medicaid |
$8.17
|
| Rate for Payer: MDWise Medicaid |
$8.17
|
| Rate for Payer: MDWise Medicaid |
$8.17
|
| Rate for Payer: PHCS All Commercial |
$11.89
|
| Rate for Payer: PHCS All Commercial |
$11.89
|
| Rate for Payer: PHP All Commercial |
$13.66
|
| Rate for Payer: PHP All Commercial |
$13.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$11.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$11.89
|
| Rate for Payer: Sagamore Health Network All Products |
$11.89
|
| Rate for Payer: Sagamore Health Network All Products |
$11.89
|
| Rate for Payer: Signature Care EPO |
$12.17
|
| Rate for Payer: Signature Care EPO |
$12.17
|
| Rate for Payer: Signature Care PPO |
$12.17
|
| Rate for Payer: Signature Care PPO |
$12.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,200.00
|
| Rate for Payer: United Healthcare Commercial |
$11.59
|
| Rate for Payer: United Healthcare Commercial |
$11.59
|
| Rate for Payer: United Healthcare Medicare |
$9.42
|
| Rate for Payer: United Healthcare Medicare |
$9.42
|
|
|
PR IMMUNIZE COUNSEL 16-30 MINS
|
Professional
|
Both
|
$115.76
|
|
|
Service Code
|
CPT G0311
|
| Hospital Charge Code |
zG0311
|
| Min. Negotiated Rate |
$56.72 |
| Max. Negotiated Rate |
$56.72 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$56.72
|
| Rate for Payer: Cash Price |
$71.77
|
| Rate for Payer: Managed Health Services Medicaid |
$56.72
|
| Rate for Payer: MDWise Medicaid |
$56.72
|
|
|
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 |
$13.90
|
| Rate for Payer: Cash Price |
$12.90
|
| 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 |
$11.62
|
| Rate for Payer: Cash Price |
$11.02
|
| 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 |
$106.29
|
| Rate for Payer: Cash Price |
$108.54
|
| 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 Medicare |
$55.37
|
| Rate for Payer: Molina Healthcare of OH 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 |
$219.36
|
| Rate for Payer: Cash Price |
$222.36
|
| 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 Medicare |
$108.98
|
| Rate for Payer: Molina Healthcare of OH 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 |
$380.56
|
| Rate for Payer: Cash Price |
$374.07
|
| 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 Medicare |
$93.09
|
| Rate for Payer: Molina Healthcare of OH 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 |
$641.02
|
| Rate for Payer: Cash Price |
$625.54
|
| 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
|
|
