|
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 |
$405.80
|
| Rate for Payer: Cash Price |
$410.80
|
| 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 Medicare |
$110.74
|
| Rate for Payer: Molina Healthcare of OH 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 |
$343.29
|
| Rate for Payer: Cash Price |
$348.22
|
| 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 Medicare |
$82.37
|
| Rate for Payer: Molina Healthcare of OH 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 |
$796.89
|
| Rate for Payer: Cash Price |
$784.99
|
| 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 |
$1,132.00
|
| Rate for Payer: Cash Price |
$1,157.60
|
| 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 |
$503.18
|
| Rate for Payer: Cash Price |
$496.30
|
| 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 Medicare |
$131.33
|
| Rate for Payer: Molina Healthcare of OH 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 |
$772.79
|
| Rate for Payer: Cash Price |
$758.97
|
| 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 Medicare |
$261.28
|
| Rate for Payer: Molina Healthcare of OH 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 |
$234.63
|
| Rate for Payer: Cash Price |
$238.41
|
| 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 Medicare |
$64.05
|
| Rate for Payer: Molina Healthcare of OH 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 |
$670.60
|
| Rate for Payer: Cash Price |
$677.16
|
| 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 Medicare |
$150.37
|
| Rate for Payer: Molina Healthcare of OH 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 |
$508.87
|
| Rate for Payer: Cash Price |
$496.40
|
| 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 |
$781.37
|
| 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 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 |
$241.48
|
| Rate for Payer: Cash Price |
$248.35
|
| 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 Medicare |
$93.44
|
| Rate for Payer: Molina Healthcare of OH 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 |
$142.72
|
| Rate for Payer: Cash Price |
$147.34
|
| 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 Medicare |
$59.75
|
| Rate for Payer: Molina Healthcare of OH 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 |
$294.69
|
| Rate for Payer: Cash Price |
$299.62
|
| 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 Medicare |
$91.02
|
| Rate for Payer: Molina Healthcare of OH 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 |
$387.80
|
| Rate for Payer: Cash Price |
$393.46
|
| 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 Medicare |
$87.38
|
| Rate for Payer: Molina Healthcare of OH 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 |
$284.15
|
| Rate for Payer: Cash Price |
$287.27
|
| 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 Medicare |
$53.47
|
| Rate for Payer: Molina Healthcare of OH 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 |
$435.02
|
| Rate for Payer: Cash Price |
$220.42
|
| Rate for Payer: Cash Price |
$440.84
|
| Rate for Payer: Cash Price |
$217.51
|
| 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 Medicare |
$61.43
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$61.43
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$61.43
|
| Rate for Payer: Molina Healthcare of OH 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 |
$173.08
|
| Rate for Payer: Cash Price |
$351.81
|
| Rate for Payer: Cash Price |
$346.16
|
| Rate for Payer: Cash Price |
$175.91
|
| 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 |
$247.13
|
| Rate for Payer: Cash Price |
$248.82
|
| 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 Medicare |
$59.10
|
| Rate for Payer: Molina Healthcare of OH 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 |
$299.36
|
| Rate for Payer: Cash Price |
$304.92
|
| 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 Medicare |
$93.61
|
| Rate for Payer: Molina Healthcare of OH 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
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Professional
|
Both
|
$283.72
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
z10120
|
| Min. Negotiated Rate |
$52.60 |
| Max. Negotiated Rate |
$11,800.00 |
| Rate for Payer: Aetna Commercial |
$97.10
|
| Rate for Payer: Aetna Commercial |
$97.10
|
| Rate for Payer: Aetna Medicare |
$97.10
|
| Rate for Payer: Aetna Medicare |
$97.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$172.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$172.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$172.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$172.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$172.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$172.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$172.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$172.46
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$52.60
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$52.60
|
| 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 Just 4 Me |
$111.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$111.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$106.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$106.81
|
| Rate for Payer: Cash Price |
$170.97
|
| Rate for Payer: Cash Price |
$175.91
|
| Rate for Payer: Centivo All Commercial |
$150.50
|
| Rate for Payer: Centivo All Commercial |
$150.50
|
| Rate for Payer: Cigna All Commercial |
$97.10
|
| Rate for Payer: Cigna All Commercial |
$97.10
|
| Rate for Payer: CORVEL All Commercial |
$97.10
|
| Rate for Payer: CORVEL All Commercial |
$97.10
|
| Rate for Payer: Coventry All Commercial |
$116.52
|
| Rate for Payer: Coventry All Commercial |
$116.52
|
| Rate for Payer: Encore All Commercial |
$97.10
|
| Rate for Payer: Encore All Commercial |
$97.10
|
| Rate for Payer: Frontpath All Commercial |
$130.61
|
| Rate for Payer: Frontpath All Commercial |
$130.61
|
| Rate for Payer: Humana ChoiceCare |
$81.52
|
| Rate for Payer: Humana ChoiceCare |
$81.52
|
| Rate for Payer: Humana Medicare |
$97.10
|
| Rate for Payer: Humana Medicare |
$97.10
|
| Rate for Payer: Lucent All Commercial |
$135.94
|
| Rate for Payer: Lucent All Commercial |
$135.94
|
| 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 |
$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: Molina Healthcare of OH Medicare |
$52.60
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$52.60
|
| Rate for Payer: PHCS All Commercial |
$97.10
|
| Rate for Payer: PHCS All Commercial |
$97.10
|
| Rate for Payer: PHP All Commercial |
$134.00
|
| Rate for Payer: PHP All Commercial |
$134.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$97.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$97.10
|
| Rate for Payer: Sagamore Health Network All Products |
$97.10
|
| Rate for Payer: Sagamore Health Network All Products |
$97.10
|
| Rate for Payer: Signature Care EPO |
$122.46
|
| Rate for Payer: Signature Care EPO |
$122.46
|
| Rate for Payer: Signature Care PPO |
$122.46
|
| Rate for Payer: Signature Care PPO |
$122.46
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,800.00
|
| Rate for Payer: United Healthcare Commercial |
$98.01
|
| Rate for Payer: United Healthcare Commercial |
$98.01
|
| Rate for Payer: United Healthcare Medicare |
$137.88
|
| Rate for Payer: United Healthcare Medicare |
$137.88
|
|
|
PR INCISION SUBCUT TOE TENDON
|
Professional
|
Both
|
$443.34
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
z28010
|
| Min. Negotiated Rate |
$157.84 |
| Max. Negotiated Rate |
$303.61 |
| Rate for Payer: Aetna Commercial |
$195.88
|
| Rate for Payer: Aetna Commercial |
$195.88
|
| Rate for Payer: Aetna Medicare |
$195.88
|
| Rate for Payer: Aetna Medicare |
$195.88
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$157.84
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$157.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$218.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$218.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$225.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$225.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$215.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$215.47
|
| Rate for Payer: Cash Price |
$266.30
|
| Rate for Payer: Cash Price |
$274.87
|
| Rate for Payer: Centivo All Commercial |
$303.61
|
| Rate for Payer: Centivo All Commercial |
$303.61
|
| Rate for Payer: Cigna All Commercial |
$195.88
|
| Rate for Payer: Cigna All Commercial |
$195.88
|
| Rate for Payer: CORVEL All Commercial |
$195.88
|
| Rate for Payer: CORVEL All Commercial |
$195.88
|
| Rate for Payer: Coventry All Commercial |
$235.06
|
| Rate for Payer: Coventry All Commercial |
$235.06
|
| Rate for Payer: Encore All Commercial |
$195.88
|
| Rate for Payer: Encore All Commercial |
$195.88
|
| Rate for Payer: Frontpath All Commercial |
$263.39
|
| Rate for Payer: Frontpath All Commercial |
$263.39
|
| Rate for Payer: Humana ChoiceCare |
$224.97
|
| Rate for Payer: Humana ChoiceCare |
$224.97
|
| Rate for Payer: Humana Medicare |
$195.88
|
| Rate for Payer: Humana Medicare |
$195.88
|
| Rate for Payer: Lucent All Commercial |
$274.23
|
| Rate for Payer: Lucent All Commercial |
$274.23
|
| Rate for Payer: Managed Health Services Medicaid |
$218.06
|
| Rate for Payer: Managed Health Services Medicaid |
$218.06
|
| Rate for Payer: MDWise Medicaid |
$218.06
|
| Rate for Payer: MDWise Medicaid |
$218.06
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$157.84
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$157.84
|
| Rate for Payer: PHCS All Commercial |
$195.88
|
| Rate for Payer: PHCS All Commercial |
$195.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$195.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$195.88
|
| Rate for Payer: Sagamore Health Network All Products |
$195.88
|
| Rate for Payer: Sagamore Health Network All Products |
$195.88
|
| Rate for Payer: United Healthcare Commercial |
$236.03
|
| Rate for Payer: United Healthcare Commercial |
$236.03
|
| Rate for Payer: United Healthcare Medicare |
$214.76
|
| Rate for Payer: United Healthcare Medicare |
$214.76
|
|
|
PR INCISION SUBCUT TOE TENDON,>1
|
Professional
|
Both
|
$597.08
|
|
|
Service Code
|
CPT 28011
|
| Hospital Charge Code |
z28011
|
| Min. Negotiated Rate |
$164.39 |
| Max. Negotiated Rate |
$409.98 |
| Rate for Payer: Aetna Commercial |
$264.50
|
| Rate for Payer: Aetna Commercial |
$264.50
|
| Rate for Payer: Aetna Medicare |
$264.50
|
| Rate for Payer: Aetna Medicare |
$264.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$164.39
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$164.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$293.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$293.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$304.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$304.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$290.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$290.95
|
| Rate for Payer: Cash Price |
$358.94
|
| Rate for Payer: Cash Price |
$370.19
|
| Rate for Payer: Centivo All Commercial |
$409.98
|
| Rate for Payer: Centivo All Commercial |
$409.98
|
| Rate for Payer: Cigna All Commercial |
$264.50
|
| Rate for Payer: Cigna All Commercial |
$264.50
|
| Rate for Payer: CORVEL All Commercial |
$264.50
|
| Rate for Payer: CORVEL All Commercial |
$264.50
|
| Rate for Payer: Coventry All Commercial |
$317.40
|
| Rate for Payer: Coventry All Commercial |
$317.40
|
| Rate for Payer: Encore All Commercial |
$264.50
|
| Rate for Payer: Encore All Commercial |
$264.50
|
| Rate for Payer: Frontpath All Commercial |
$357.23
|
| Rate for Payer: Frontpath All Commercial |
$357.23
|
| Rate for Payer: Humana ChoiceCare |
$322.46
|
| Rate for Payer: Humana ChoiceCare |
$322.46
|
| Rate for Payer: Humana Medicare |
$264.50
|
| Rate for Payer: Humana Medicare |
$264.50
|
| Rate for Payer: Lucent All Commercial |
$370.30
|
| Rate for Payer: Lucent All Commercial |
$370.30
|
| Rate for Payer: Managed Health Services Medicaid |
$293.67
|
| Rate for Payer: Managed Health Services Medicaid |
$293.67
|
| Rate for Payer: MDWise Medicaid |
$293.67
|
| Rate for Payer: MDWise Medicaid |
$293.67
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$164.39
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$164.39
|
| Rate for Payer: PHCS All Commercial |
$264.50
|
| Rate for Payer: PHCS All Commercial |
$264.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$264.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$264.50
|
| Rate for Payer: Sagamore Health Network All Products |
$264.50
|
| Rate for Payer: Sagamore Health Network All Products |
$264.50
|
| Rate for Payer: United Healthcare Commercial |
$333.13
|
| Rate for Payer: United Healthcare Commercial |
$333.13
|
| Rate for Payer: United Healthcare Medicare |
$289.47
|
| Rate for Payer: United Healthcare Medicare |
$289.47
|
|
|
PR INCIS TENDON SHEATH,RADIAL STYLOID
|
Professional
|
Both
|
$654.22
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
z25000
|
| Min. Negotiated Rate |
$318.08 |
| Max. Negotiated Rate |
$48,900.00 |
| Rate for Payer: Aetna Commercial |
$323.15
|
| Rate for Payer: Aetna Commercial |
$323.15
|
| Rate for Payer: Aetna Medicare |
$323.15
|
| Rate for Payer: Aetna Medicare |
$323.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$405.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$405.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$405.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$405.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$405.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$405.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$405.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$405.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$321.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$321.77
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$371.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$371.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$355.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$355.46
|
| Rate for Payer: Cash Price |
$405.62
|
| Rate for Payer: Cash Price |
$394.42
|
| Rate for Payer: Centivo All Commercial |
$500.88
|
| Rate for Payer: Centivo All Commercial |
$500.88
|
| Rate for Payer: Cigna All Commercial |
$323.15
|
| Rate for Payer: Cigna All Commercial |
$323.15
|
| Rate for Payer: CORVEL All Commercial |
$323.15
|
| Rate for Payer: CORVEL All Commercial |
$323.15
|
| Rate for Payer: Coventry All Commercial |
$387.78
|
| Rate for Payer: Coventry All Commercial |
$387.78
|
| Rate for Payer: Encore All Commercial |
$323.15
|
| Rate for Payer: Encore All Commercial |
$323.15
|
| Rate for Payer: Frontpath All Commercial |
$442.34
|
| Rate for Payer: Frontpath All Commercial |
$442.34
|
| Rate for Payer: Humana ChoiceCare |
$430.12
|
| Rate for Payer: Humana ChoiceCare |
$430.12
|
| Rate for Payer: Humana Medicare |
$323.15
|
| Rate for Payer: Humana Medicare |
$323.15
|
| Rate for Payer: Lucent All Commercial |
$452.41
|
| Rate for Payer: Lucent All Commercial |
$452.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$522.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$522.00
|
| Rate for Payer: Managed Health Services Medicaid |
$321.77
|
| Rate for Payer: Managed Health Services Medicaid |
$321.77
|
| Rate for Payer: MDWise Medicaid |
$321.77
|
| Rate for Payer: MDWise Medicaid |
$321.77
|
| Rate for Payer: PHCS All Commercial |
$323.15
|
| Rate for Payer: PHCS All Commercial |
$323.15
|
| Rate for Payer: PHP All Commercial |
$553.46
|
| Rate for Payer: PHP All Commercial |
$553.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$323.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$323.15
|
| Rate for Payer: Sagamore Health Network All Products |
$323.15
|
| Rate for Payer: Sagamore Health Network All Products |
$323.15
|
| Rate for Payer: Signature Care EPO |
$542.45
|
| Rate for Payer: Signature Care EPO |
$542.45
|
| Rate for Payer: Signature Care PPO |
$542.45
|
| Rate for Payer: Signature Care PPO |
$542.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$48,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$48,900.00
|
| Rate for Payer: United Healthcare Commercial |
$366.11
|
| Rate for Payer: United Healthcare Commercial |
$366.11
|
| Rate for Payer: United Healthcare Medicare |
$318.08
|
| Rate for Payer: United Healthcare Medicare |
$318.08
|
|
|
PR INDUCED AB BY VAG SUPPOS
|
Professional
|
Both
|
$768.84
|
|
|
Service Code
|
CPT 59855
|
| Hospital Charge Code |
z59855
|
| Min. Negotiated Rate |
$377.40 |
| Max. Negotiated Rate |
$50,300.00 |
| Rate for Payer: Aetna Commercial |
$388.54
|
| Rate for Payer: Aetna Commercial |
$388.54
|
| Rate for Payer: Aetna Medicare |
$388.54
|
| Rate for Payer: Aetna Medicare |
$388.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$543.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$543.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$543.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$543.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$543.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$543.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$543.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$543.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$378.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$378.15
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$446.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$446.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$427.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$427.39
|
| Rate for Payer: Cash Price |
$476.68
|
| Rate for Payer: Cash Price |
$468.50
|
| Rate for Payer: Centivo All Commercial |
$602.24
|
| Rate for Payer: Centivo All Commercial |
$602.24
|
| Rate for Payer: Cigna All Commercial |
$388.54
|
| Rate for Payer: Cigna All Commercial |
$388.54
|
| Rate for Payer: CORVEL All Commercial |
$388.54
|
| Rate for Payer: CORVEL All Commercial |
$388.54
|
| Rate for Payer: Coventry All Commercial |
$466.25
|
| Rate for Payer: Coventry All Commercial |
$466.25
|
| Rate for Payer: Encore All Commercial |
$388.54
|
| Rate for Payer: Encore All Commercial |
$388.54
|
| Rate for Payer: Frontpath All Commercial |
$551.13
|
| Rate for Payer: Frontpath All Commercial |
$551.13
|
| Rate for Payer: Humana ChoiceCare |
$377.40
|
| Rate for Payer: Humana ChoiceCare |
$377.40
|
| Rate for Payer: Humana Medicare |
$388.54
|
| Rate for Payer: Humana Medicare |
$388.54
|
| Rate for Payer: Lucent All Commercial |
$543.96
|
| Rate for Payer: Lucent All Commercial |
$543.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$542.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$542.00
|
| Rate for Payer: Managed Health Services Medicaid |
$378.15
|
| Rate for Payer: Managed Health Services Medicaid |
$378.15
|
| Rate for Payer: MDWise Medicaid |
$378.15
|
| Rate for Payer: MDWise Medicaid |
$378.15
|
| Rate for Payer: PHCS All Commercial |
$388.54
|
| Rate for Payer: PHCS All Commercial |
$388.54
|
| Rate for Payer: PHP All Commercial |
$498.72
|
| Rate for Payer: PHP All Commercial |
$498.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$388.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$388.54
|
| Rate for Payer: Sagamore Health Network All Products |
$388.54
|
| Rate for Payer: Sagamore Health Network All Products |
$388.54
|
| Rate for Payer: Signature Care EPO |
$485.35
|
| Rate for Payer: Signature Care EPO |
$485.35
|
| Rate for Payer: Signature Care PPO |
$485.35
|
| Rate for Payer: Signature Care PPO |
$485.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,300.00
|
| Rate for Payer: United Healthcare Commercial |
$462.13
|
| Rate for Payer: United Healthcare Commercial |
$462.13
|
| Rate for Payer: United Healthcare Medicare |
$377.82
|
| Rate for Payer: United Healthcare Medicare |
$377.82
|
|
|
PR INDUCED ABORTN BY DIL/EVAC
|
Professional
|
Both
|
$774.82
|
|
|
Service Code
|
CPT 59841
|
| Hospital Charge Code |
z59841
|
| Min. Negotiated Rate |
$220.16 |
| Max. Negotiated Rate |
$44,100.00 |
| Rate for Payer: Aetna Commercial |
$341.04
|
| Rate for Payer: Aetna Commercial |
$341.04
|
| Rate for Payer: Aetna Medicare |
$341.04
|
| Rate for Payer: Aetna Medicare |
$341.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$500.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$500.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$500.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$500.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$500.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$500.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$500.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$500.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$220.16
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$220.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$381.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$381.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$392.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$392.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$375.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$375.14
|
| Rate for Payer: Cash Price |
$472.54
|
| Rate for Payer: Cash Price |
$480.39
|
| Rate for Payer: Centivo All Commercial |
$528.61
|
| Rate for Payer: Centivo All Commercial |
$528.61
|
| Rate for Payer: Cigna All Commercial |
$341.04
|
| Rate for Payer: Cigna All Commercial |
$341.04
|
| Rate for Payer: CORVEL All Commercial |
$341.04
|
| Rate for Payer: CORVEL All Commercial |
$341.04
|
| Rate for Payer: Coventry All Commercial |
$409.25
|
| Rate for Payer: Coventry All Commercial |
$409.25
|
| Rate for Payer: Encore All Commercial |
$341.04
|
| Rate for Payer: Encore All Commercial |
$341.04
|
| Rate for Payer: Frontpath All Commercial |
$484.16
|
| Rate for Payer: Frontpath All Commercial |
$484.16
|
| Rate for Payer: Humana ChoiceCare |
$321.01
|
| Rate for Payer: Humana ChoiceCare |
$321.01
|
| Rate for Payer: Humana Medicare |
$341.04
|
| Rate for Payer: Humana Medicare |
$341.04
|
| Rate for Payer: Lucent All Commercial |
$477.46
|
| Rate for Payer: Lucent All Commercial |
$477.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$475.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$475.00
|
| Rate for Payer: Managed Health Services Medicaid |
$381.08
|
| Rate for Payer: Managed Health Services Medicaid |
$381.08
|
| Rate for Payer: MDWise Medicaid |
$381.08
|
| Rate for Payer: MDWise Medicaid |
$381.08
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$220.16
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$220.16
|
| Rate for Payer: PHCS All Commercial |
$341.04
|
| Rate for Payer: PHCS All Commercial |
$341.04
|
| Rate for Payer: PHP All Commercial |
$436.63
|
| Rate for Payer: PHP All Commercial |
$436.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$341.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$341.04
|
| Rate for Payer: Sagamore Health Network All Products |
$341.04
|
| Rate for Payer: Sagamore Health Network All Products |
$341.04
|
| Rate for Payer: Signature Care EPO |
$394.40
|
| Rate for Payer: Signature Care EPO |
$394.40
|
| Rate for Payer: Signature Care PPO |
$394.40
|
| Rate for Payer: Signature Care PPO |
$394.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,100.00
|
| Rate for Payer: United Healthcare Commercial |
$397.18
|
| Rate for Payer: United Healthcare Commercial |
$397.18
|
| Rate for Payer: United Healthcare Medicare |
$381.08
|
| Rate for Payer: United Healthcare Medicare |
$381.08
|
|
