|
PR INSERT EMERGENCY ENDOTRACH AIRWAY
|
Professional
|
Both
|
$259.04
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
z31500
|
| Min. Negotiated Rate |
$127.40 |
| Max. Negotiated Rate |
$19,700.00 |
| Rate for Payer: Aetna Commercial |
$133.31
|
| Rate for Payer: Aetna Commercial |
$133.31
|
| Rate for Payer: Aetna Medicare |
$133.31
|
| Rate for Payer: Aetna Medicare |
$133.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$159.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$159.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$159.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$159.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$159.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$159.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$159.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$159.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$127.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$127.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$153.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$153.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$146.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$146.64
|
| Rate for Payer: Cash Price |
$160.60
|
| Rate for Payer: Cash Price |
$158.99
|
| Rate for Payer: Centivo All Commercial |
$206.63
|
| Rate for Payer: Centivo All Commercial |
$206.63
|
| Rate for Payer: Cigna All Commercial |
$133.31
|
| Rate for Payer: Cigna All Commercial |
$133.31
|
| Rate for Payer: CORVEL All Commercial |
$133.31
|
| Rate for Payer: CORVEL All Commercial |
$133.31
|
| Rate for Payer: Coventry All Commercial |
$159.97
|
| Rate for Payer: Coventry All Commercial |
$159.97
|
| Rate for Payer: Encore All Commercial |
$133.31
|
| Rate for Payer: Encore All Commercial |
$133.31
|
| Rate for Payer: Frontpath All Commercial |
$185.61
|
| Rate for Payer: Frontpath All Commercial |
$185.61
|
| Rate for Payer: Humana ChoiceCare |
$133.64
|
| Rate for Payer: Humana ChoiceCare |
$133.64
|
| Rate for Payer: Humana Medicare |
$133.31
|
| Rate for Payer: Humana Medicare |
$133.31
|
| Rate for Payer: Lucent All Commercial |
$186.63
|
| Rate for Payer: Lucent All Commercial |
$186.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$210.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$210.00
|
| Rate for Payer: Managed Health Services Medicaid |
$127.40
|
| Rate for Payer: Managed Health Services Medicaid |
$127.40
|
| Rate for Payer: MDWise Medicaid |
$127.40
|
| Rate for Payer: MDWise Medicaid |
$127.40
|
| Rate for Payer: PHCS All Commercial |
$133.31
|
| Rate for Payer: PHCS All Commercial |
$133.31
|
| Rate for Payer: PHP All Commercial |
$179.51
|
| Rate for Payer: PHP All Commercial |
$179.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$133.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$133.31
|
| Rate for Payer: Sagamore Health Network All Products |
$133.31
|
| Rate for Payer: Sagamore Health Network All Products |
$133.31
|
| Rate for Payer: Signature Care EPO |
$156.40
|
| Rate for Payer: Signature Care EPO |
$156.40
|
| Rate for Payer: Signature Care PPO |
$156.40
|
| Rate for Payer: Signature Care PPO |
$156.40
|
| 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 |
$128.68
|
| Rate for Payer: United Healthcare Commercial |
$128.68
|
| Rate for Payer: United Healthcare Medicare |
$128.22
|
| Rate for Payer: United Healthcare Medicare |
$128.22
|
|
|
PR INSERT INTRAUTERINE DEVICE
|
Professional
|
Both
|
$203.04
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
z58300
|
| Min. Negotiated Rate |
$37.18 |
| Max. Negotiated Rate |
$6,200.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$124.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$124.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$124.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$124.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$124.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$124.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$124.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$124.82
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$37.18
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$37.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$101.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$101.08
|
| Rate for Payer: Cash Price |
$125.88
|
| Rate for Payer: Cash Price |
$127.42
|
| Rate for Payer: Frontpath All Commercial |
$63.95
|
| Rate for Payer: Frontpath All Commercial |
$63.95
|
| Rate for Payer: Humana ChoiceCare |
$62.37
|
| Rate for Payer: Humana ChoiceCare |
$62.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Managed Health Services Medicaid |
$101.08
|
| Rate for Payer: Managed Health Services Medicaid |
$101.08
|
| Rate for Payer: MDWise Medicaid |
$101.08
|
| Rate for Payer: MDWise Medicaid |
$101.08
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$37.18
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$37.18
|
| Rate for Payer: PHP All Commercial |
$61.65
|
| Rate for Payer: PHP All Commercial |
$61.65
|
| Rate for Payer: Signature Care EPO |
$117.30
|
| Rate for Payer: Signature Care EPO |
$117.30
|
| Rate for Payer: Signature Care PPO |
$117.30
|
| Rate for Payer: Signature Care PPO |
$117.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,200.00
|
| Rate for Payer: United Healthcare Commercial |
$63.26
|
| Rate for Payer: United Healthcare Commercial |
$63.26
|
| Rate for Payer: United Healthcare Medicare |
$101.52
|
| Rate for Payer: United Healthcare Medicare |
$101.52
|
|
|
PR INSERTION DRUG DELIVERY IMPLANT
|
Professional
|
Both
|
$185.80
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
z11981
|
| Min. Negotiated Rate |
$37.41 |
| Max. Negotiated Rate |
$6,900.00 |
| Rate for Payer: Aetna Commercial |
$58.88
|
| Rate for Payer: Aetna Commercial |
$58.88
|
| Rate for Payer: Aetna Medicare |
$58.88
|
| Rate for Payer: Aetna Medicare |
$58.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$150.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$37.41
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$37.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$91.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$91.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$67.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$67.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$64.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$64.77
|
| Rate for Payer: Cash Price |
$113.00
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Centivo All Commercial |
$91.26
|
| Rate for Payer: Centivo All Commercial |
$91.26
|
| Rate for Payer: Cigna All Commercial |
$58.88
|
| Rate for Payer: Cigna All Commercial |
$58.88
|
| Rate for Payer: CORVEL All Commercial |
$58.88
|
| Rate for Payer: CORVEL All Commercial |
$58.88
|
| Rate for Payer: Coventry All Commercial |
$70.66
|
| Rate for Payer: Coventry All Commercial |
$70.66
|
| Rate for Payer: Encore All Commercial |
$58.88
|
| Rate for Payer: Encore All Commercial |
$58.88
|
| Rate for Payer: Frontpath All Commercial |
$83.06
|
| Rate for Payer: Frontpath All Commercial |
$83.06
|
| Rate for Payer: Humana ChoiceCare |
$81.42
|
| Rate for Payer: Humana ChoiceCare |
$81.42
|
| Rate for Payer: Humana Medicare |
$58.88
|
| Rate for Payer: Humana Medicare |
$58.88
|
| Rate for Payer: Lucent All Commercial |
$82.43
|
| Rate for Payer: Lucent All Commercial |
$82.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$75.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$75.00
|
| Rate for Payer: Managed Health Services Medicaid |
$91.38
|
| Rate for Payer: Managed Health Services Medicaid |
$91.38
|
| Rate for Payer: MDWise Medicaid |
$91.38
|
| Rate for Payer: MDWise Medicaid |
$91.38
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$37.41
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$37.41
|
| Rate for Payer: PHCS All Commercial |
$58.88
|
| Rate for Payer: PHCS All Commercial |
$58.88
|
| Rate for Payer: PHP All Commercial |
$79.09
|
| Rate for Payer: PHP All Commercial |
$79.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.88
|
| Rate for Payer: Sagamore Health Network All Products |
$58.88
|
| Rate for Payer: Sagamore Health Network All Products |
$58.88
|
| Rate for Payer: Signature Care EPO |
$132.60
|
| Rate for Payer: Signature Care EPO |
$132.60
|
| Rate for Payer: Signature Care PPO |
$132.60
|
| Rate for Payer: Signature Care PPO |
$132.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,900.00
|
| Rate for Payer: United Healthcare Commercial |
$96.04
|
| Rate for Payer: United Healthcare Commercial |
$96.04
|
| Rate for Payer: United Healthcare Medicare |
$91.13
|
| Rate for Payer: United Healthcare Medicare |
$91.13
|
|
|
PR INSERTION INDWELLING TUNNELED PLEURAL CATHETER
|
Professional
|
Both
|
$1,438.12
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
z32550
|
| Min. Negotiated Rate |
$158.77 |
| Max. Negotiated Rate |
$28,400.00 |
| Rate for Payer: Aetna Commercial |
$192.00
|
| Rate for Payer: Aetna Commercial |
$192.00
|
| Rate for Payer: Aetna Medicare |
$192.00
|
| Rate for Payer: Aetna Medicare |
$192.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,165.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,165.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,165.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,165.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,165.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,165.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,165.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,165.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$158.77
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$158.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$697.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$697.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$220.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$220.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$211.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$211.20
|
| Rate for Payer: Cash Price |
$879.72
|
| Rate for Payer: Cash Price |
$891.63
|
| Rate for Payer: Centivo All Commercial |
$297.60
|
| Rate for Payer: Centivo All Commercial |
$297.60
|
| Rate for Payer: Cigna All Commercial |
$192.00
|
| Rate for Payer: Cigna All Commercial |
$192.00
|
| Rate for Payer: CORVEL All Commercial |
$192.00
|
| Rate for Payer: CORVEL All Commercial |
$192.00
|
| Rate for Payer: Coventry All Commercial |
$230.40
|
| Rate for Payer: Coventry All Commercial |
$230.40
|
| Rate for Payer: Encore All Commercial |
$192.00
|
| Rate for Payer: Encore All Commercial |
$192.00
|
| Rate for Payer: Frontpath All Commercial |
$265.77
|
| Rate for Payer: Frontpath All Commercial |
$265.77
|
| Rate for Payer: Humana ChoiceCare |
$246.50
|
| Rate for Payer: Humana ChoiceCare |
$246.50
|
| Rate for Payer: Humana Medicare |
$192.00
|
| Rate for Payer: Humana Medicare |
$192.00
|
| Rate for Payer: Lucent All Commercial |
$268.80
|
| Rate for Payer: Lucent All Commercial |
$268.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$303.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$303.00
|
| Rate for Payer: Managed Health Services Medicaid |
$697.87
|
| Rate for Payer: Managed Health Services Medicaid |
$697.87
|
| Rate for Payer: MDWise Medicaid |
$697.87
|
| Rate for Payer: MDWise Medicaid |
$697.87
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$158.77
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$158.77
|
| Rate for Payer: PHCS All Commercial |
$192.00
|
| Rate for Payer: PHCS All Commercial |
$192.00
|
| Rate for Payer: PHP All Commercial |
$258.24
|
| Rate for Payer: PHP All Commercial |
$258.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$192.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$192.00
|
| Rate for Payer: Sagamore Health Network All Products |
$192.00
|
| Rate for Payer: Sagamore Health Network All Products |
$192.00
|
| Rate for Payer: Signature Care EPO |
$981.66
|
| Rate for Payer: Signature Care EPO |
$981.66
|
| Rate for Payer: Signature Care PPO |
$981.66
|
| Rate for Payer: Signature Care PPO |
$981.66
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28,400.00
|
| Rate for Payer: United Healthcare Commercial |
$267.21
|
| Rate for Payer: United Healthcare Commercial |
$267.21
|
| Rate for Payer: United Healthcare Medicare |
$719.06
|
| Rate for Payer: United Healthcare Medicare |
$719.06
|
|
|
PR INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG
|
Professional
|
Both
|
$7,856.78
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
z33285
|
| Min. Negotiated Rate |
$73.05 |
| Max. Negotiated Rate |
$11,900.00 |
| Rate for Payer: Aetna Commercial |
$80.53
|
| Rate for Payer: Aetna Commercial |
$80.53
|
| Rate for Payer: Aetna Medicare |
$80.53
|
| Rate for Payer: Aetna Medicare |
$80.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$4,835.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$4,835.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,835.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,835.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$4,835.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$4,835.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,835.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,835.29
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$73.05
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$73.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3,752.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3,752.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$92.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$92.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$88.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$88.58
|
| Rate for Payer: Cash Price |
$4,730.61
|
| Rate for Payer: Cash Price |
$4,871.20
|
| Rate for Payer: Centivo All Commercial |
$124.82
|
| Rate for Payer: Centivo All Commercial |
$124.82
|
| Rate for Payer: Cigna All Commercial |
$80.53
|
| Rate for Payer: Cigna All Commercial |
$80.53
|
| Rate for Payer: CORVEL All Commercial |
$80.53
|
| Rate for Payer: CORVEL All Commercial |
$80.53
|
| Rate for Payer: Coventry All Commercial |
$96.64
|
| Rate for Payer: Coventry All Commercial |
$96.64
|
| Rate for Payer: Encore All Commercial |
$80.53
|
| Rate for Payer: Encore All Commercial |
$80.53
|
| Rate for Payer: Frontpath All Commercial |
$114.72
|
| Rate for Payer: Frontpath All Commercial |
$114.72
|
| Rate for Payer: Humana ChoiceCare |
$108.63
|
| Rate for Payer: Humana ChoiceCare |
$108.63
|
| Rate for Payer: Humana Medicare |
$80.53
|
| Rate for Payer: Humana Medicare |
$80.53
|
| Rate for Payer: Lucent All Commercial |
$112.74
|
| Rate for Payer: Lucent All Commercial |
$112.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$127.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$127.00
|
| Rate for Payer: Managed Health Services Medicaid |
$3,752.74
|
| Rate for Payer: Managed Health Services Medicaid |
$3,752.74
|
| Rate for Payer: MDWise Medicaid |
$3,752.74
|
| Rate for Payer: MDWise Medicaid |
$3,752.74
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$73.05
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$73.05
|
| Rate for Payer: PHCS All Commercial |
$80.53
|
| Rate for Payer: PHCS All Commercial |
$80.53
|
| Rate for Payer: PHP All Commercial |
$108.45
|
| Rate for Payer: PHP All Commercial |
$108.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$80.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$80.53
|
| Rate for Payer: Sagamore Health Network All Products |
$80.53
|
| Rate for Payer: Sagamore Health Network All Products |
$80.53
|
| Rate for Payer: Signature Care EPO |
$6,822.59
|
| Rate for Payer: Signature Care EPO |
$6,822.59
|
| Rate for Payer: Signature Care PPO |
$6,822.59
|
| Rate for Payer: Signature Care PPO |
$6,822.59
|
| 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 |
$107.68
|
| Rate for Payer: United Healthcare Commercial |
$107.68
|
| Rate for Payer: United Healthcare Medicare |
$3,928.39
|
| Rate for Payer: United Healthcare Medicare |
$3,928.39
|
|
|
PR INSERT,NON-INDWELLING BLADDER CATHETER
|
Professional
|
Both
|
$81.04
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
z51701
|
| Min. Negotiated Rate |
$19.57 |
| Max. Negotiated Rate |
$3,100.00 |
| Rate for Payer: Aetna Commercial |
$24.20
|
| Rate for Payer: Aetna Commercial |
$24.20
|
| Rate for Payer: Aetna Medicare |
$24.20
|
| Rate for Payer: Aetna Medicare |
$24.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$125.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$125.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$125.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$125.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$125.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$125.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$125.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$125.17
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$19.57
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$19.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$40.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$40.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.62
|
| Rate for Payer: Cash Price |
$49.33
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Centivo All Commercial |
$37.51
|
| Rate for Payer: Centivo All Commercial |
$37.51
|
| Rate for Payer: Cigna All Commercial |
$24.20
|
| Rate for Payer: Cigna All Commercial |
$24.20
|
| Rate for Payer: CORVEL All Commercial |
$24.20
|
| Rate for Payer: CORVEL All Commercial |
$24.20
|
| Rate for Payer: Coventry All Commercial |
$29.04
|
| Rate for Payer: Coventry All Commercial |
$29.04
|
| Rate for Payer: Encore All Commercial |
$24.20
|
| Rate for Payer: Encore All Commercial |
$24.20
|
| Rate for Payer: Frontpath All Commercial |
$33.83
|
| Rate for Payer: Frontpath All Commercial |
$33.83
|
| Rate for Payer: Humana ChoiceCare |
$26.34
|
| Rate for Payer: Humana ChoiceCare |
$26.34
|
| Rate for Payer: Humana Medicare |
$24.20
|
| Rate for Payer: Humana Medicare |
$24.20
|
| Rate for Payer: Lucent All Commercial |
$33.88
|
| Rate for Payer: Lucent All Commercial |
$33.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$33.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$33.00
|
| Rate for Payer: Managed Health Services Medicaid |
$40.73
|
| Rate for Payer: Managed Health Services Medicaid |
$40.73
|
| Rate for Payer: MDWise Medicaid |
$40.73
|
| Rate for Payer: MDWise Medicaid |
$40.73
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$19.57
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$19.57
|
| Rate for Payer: PHCS All Commercial |
$24.20
|
| Rate for Payer: PHCS All Commercial |
$24.20
|
| Rate for Payer: PHP All Commercial |
$42.64
|
| Rate for Payer: PHP All Commercial |
$42.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.20
|
| Rate for Payer: Sagamore Health Network All Products |
$24.20
|
| Rate for Payer: Sagamore Health Network All Products |
$24.20
|
| Rate for Payer: Signature Care EPO |
$71.32
|
| Rate for Payer: Signature Care EPO |
$71.32
|
| Rate for Payer: Signature Care PPO |
$71.32
|
| Rate for Payer: Signature Care PPO |
$71.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,100.00
|
| Rate for Payer: United Healthcare Commercial |
$33.55
|
| Rate for Payer: United Healthcare Commercial |
$33.55
|
| Rate for Payer: United Healthcare Medicare |
$40.52
|
| Rate for Payer: United Healthcare Medicare |
$40.52
|
|
|
PR INSERT NON-TUNNEL CV CATH
|
Professional
|
Both
|
$392.18
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
z36556
|
| Min. Negotiated Rate |
$48.72 |
| Max. Negotiated Rate |
$11,800.00 |
| Rate for Payer: Aetna Commercial |
$79.67
|
| Rate for Payer: Aetna Commercial |
$79.67
|
| Rate for Payer: Aetna Medicare |
$79.67
|
| Rate for Payer: Aetna Medicare |
$79.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$358.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$358.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$358.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$358.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$358.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$358.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$358.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$358.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$48.72
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$48.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$192.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$192.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$91.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$91.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$87.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$87.64
|
| Rate for Payer: Cash Price |
$241.85
|
| Rate for Payer: Cash Price |
$243.15
|
| Rate for Payer: Centivo All Commercial |
$123.49
|
| Rate for Payer: Centivo All Commercial |
$123.49
|
| Rate for Payer: Cigna All Commercial |
$79.67
|
| Rate for Payer: Cigna All Commercial |
$79.67
|
| Rate for Payer: CORVEL All Commercial |
$79.67
|
| Rate for Payer: CORVEL All Commercial |
$79.67
|
| Rate for Payer: Coventry All Commercial |
$95.60
|
| Rate for Payer: Coventry All Commercial |
$95.60
|
| Rate for Payer: Encore All Commercial |
$79.67
|
| Rate for Payer: Encore All Commercial |
$79.67
|
| Rate for Payer: Frontpath All Commercial |
$110.10
|
| Rate for Payer: Frontpath All Commercial |
$110.10
|
| Rate for Payer: Humana ChoiceCare |
$160.89
|
| Rate for Payer: Humana ChoiceCare |
$160.89
|
| Rate for Payer: Humana Medicare |
$79.67
|
| Rate for Payer: Humana Medicare |
$79.67
|
| Rate for Payer: Lucent All Commercial |
$111.54
|
| Rate for Payer: Lucent All Commercial |
$111.54
|
| 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 |
$192.89
|
| Rate for Payer: Managed Health Services Medicaid |
$192.89
|
| Rate for Payer: MDWise Medicaid |
$192.89
|
| Rate for Payer: MDWise Medicaid |
$192.89
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$48.72
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$48.72
|
| Rate for Payer: PHCS All Commercial |
$79.67
|
| Rate for Payer: PHCS All Commercial |
$79.67
|
| Rate for Payer: PHP All Commercial |
$130.34
|
| Rate for Payer: PHP All Commercial |
$130.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$79.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$79.67
|
| Rate for Payer: Sagamore Health Network All Products |
$79.67
|
| Rate for Payer: Sagamore Health Network All Products |
$79.67
|
| Rate for Payer: Signature Care EPO |
$348.82
|
| Rate for Payer: Signature Care EPO |
$348.82
|
| Rate for Payer: Signature Care PPO |
$348.82
|
| Rate for Payer: Signature Care PPO |
$348.82
|
| 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 |
$143.50
|
| Rate for Payer: United Healthcare Commercial |
$143.50
|
| Rate for Payer: United Healthcare Medicare |
$195.04
|
| Rate for Payer: United Healthcare Medicare |
$195.04
|
|
|
PR INSERT,TEMP INDWELLING BLAD CATH,COMP
|
Professional
|
Both
|
$532.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
z51703
|
| Min. Negotiated Rate |
$44.11 |
| Max. Negotiated Rate |
$136.73 |
| Rate for Payer: Aetna Commercial |
$71.99
|
| Rate for Payer: Aetna Medicare |
$71.99
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$44.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$136.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$82.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$79.19
|
| Rate for Payer: Cash Price |
$329.84
|
| Rate for Payer: Centivo All Commercial |
$111.58
|
| Rate for Payer: Cigna All Commercial |
$71.99
|
| Rate for Payer: CORVEL All Commercial |
$71.99
|
| Rate for Payer: Coventry All Commercial |
$86.39
|
| Rate for Payer: Encore All Commercial |
$71.99
|
| Rate for Payer: Frontpath All Commercial |
$99.31
|
| Rate for Payer: Humana ChoiceCare |
$77.20
|
| Rate for Payer: Humana Medicare |
$71.99
|
| Rate for Payer: Lucent All Commercial |
$100.79
|
| Rate for Payer: Managed Health Services Medicaid |
$136.73
|
| Rate for Payer: MDWise Medicaid |
$136.73
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$44.11
|
| Rate for Payer: PHCS All Commercial |
$71.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$71.99
|
| Rate for Payer: Sagamore Health Network All Products |
$71.99
|
| Rate for Payer: United Healthcare Commercial |
$101.25
|
| Rate for Payer: United Healthcare Medicare |
$136.66
|
|
|
PR INSERT,TEMP INDWELLING BLAD CATH,SIMPLE
|
Professional
|
Both
|
$111.46
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
z51702
|
| Min. Negotiated Rate |
$23.92 |
| Max. Negotiated Rate |
$56.87 |
| Rate for Payer: Aetna Commercial |
$24.04
|
| Rate for Payer: Aetna Medicare |
$24.04
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$23.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$56.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.44
|
| Rate for Payer: Cash Price |
$69.11
|
| Rate for Payer: Centivo All Commercial |
$37.26
|
| Rate for Payer: Cigna All Commercial |
$24.04
|
| Rate for Payer: CORVEL All Commercial |
$24.04
|
| Rate for Payer: Coventry All Commercial |
$28.85
|
| Rate for Payer: Encore All Commercial |
$24.04
|
| Rate for Payer: Frontpath All Commercial |
$33.33
|
| Rate for Payer: Humana ChoiceCare |
$28.07
|
| Rate for Payer: Humana Medicare |
$24.04
|
| Rate for Payer: Lucent All Commercial |
$33.66
|
| Rate for Payer: Managed Health Services Medicaid |
$56.87
|
| Rate for Payer: MDWise Medicaid |
$56.87
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$23.92
|
| Rate for Payer: PHCS All Commercial |
$24.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.04
|
| Rate for Payer: Sagamore Health Network All Products |
$24.04
|
| Rate for Payer: United Healthcare Commercial |
$36.86
|
| Rate for Payer: United Healthcare Medicare |
$56.02
|
|
|
PR INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$666.22
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
z33216
|
| Min. Negotiated Rate |
$327.67 |
| Max. Negotiated Rate |
$50,800.00 |
| Rate for Payer: Aetna Commercial |
$343.57
|
| Rate for Payer: Aetna Commercial |
$343.57
|
| Rate for Payer: Aetna Medicare |
$343.57
|
| Rate for Payer: Aetna Medicare |
$343.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$540.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$540.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$540.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$540.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$540.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$540.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$540.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$540.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$327.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$327.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$395.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$395.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$377.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$377.93
|
| Rate for Payer: Cash Price |
$413.06
|
| Rate for Payer: Cash Price |
$410.09
|
| Rate for Payer: Centivo All Commercial |
$532.53
|
| Rate for Payer: Centivo All Commercial |
$532.53
|
| Rate for Payer: Cigna All Commercial |
$343.57
|
| Rate for Payer: Cigna All Commercial |
$343.57
|
| Rate for Payer: CORVEL All Commercial |
$343.57
|
| Rate for Payer: CORVEL All Commercial |
$343.57
|
| Rate for Payer: Coventry All Commercial |
$412.28
|
| Rate for Payer: Coventry All Commercial |
$412.28
|
| Rate for Payer: Encore All Commercial |
$343.57
|
| Rate for Payer: Encore All Commercial |
$343.57
|
| Rate for Payer: Frontpath All Commercial |
$485.55
|
| Rate for Payer: Frontpath All Commercial |
$485.55
|
| Rate for Payer: Humana ChoiceCare |
$481.77
|
| Rate for Payer: Humana ChoiceCare |
$481.77
|
| Rate for Payer: Humana Medicare |
$343.57
|
| Rate for Payer: Humana Medicare |
$343.57
|
| Rate for Payer: Lucent All Commercial |
$481.00
|
| Rate for Payer: Lucent All Commercial |
$481.00
|
| 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 |
$327.67
|
| Rate for Payer: Managed Health Services Medicaid |
$327.67
|
| Rate for Payer: MDWise Medicaid |
$327.67
|
| Rate for Payer: MDWise Medicaid |
$327.67
|
| Rate for Payer: PHCS All Commercial |
$343.57
|
| Rate for Payer: PHCS All Commercial |
$343.57
|
| Rate for Payer: PHP All Commercial |
$463.01
|
| Rate for Payer: PHP All Commercial |
$463.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$343.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$343.57
|
| Rate for Payer: Sagamore Health Network All Products |
$343.57
|
| Rate for Payer: Sagamore Health Network All Products |
$343.57
|
| Rate for Payer: Signature Care EPO |
$561.00
|
| Rate for Payer: Signature Care EPO |
$561.00
|
| Rate for Payer: Signature Care PPO |
$561.00
|
| Rate for Payer: Signature Care PPO |
$561.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,800.00
|
| Rate for Payer: United Healthcare Commercial |
$456.65
|
| Rate for Payer: United Healthcare Commercial |
$456.65
|
| Rate for Payer: United Healthcare Medicare |
$330.72
|
| Rate for Payer: United Healthcare Medicare |
$330.72
|
|
|
PR INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN
|
Professional
|
Both
|
$907.42
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
z33224
|
| Min. Negotiated Rate |
$446.31 |
| Max. Negotiated Rate |
$69,600.00 |
| Rate for Payer: Aetna Commercial |
$472.60
|
| Rate for Payer: Aetna Commercial |
$472.60
|
| Rate for Payer: Aetna Medicare |
$472.60
|
| Rate for Payer: Aetna Medicare |
$472.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$625.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$625.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$625.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$625.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$625.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$625.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$625.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$625.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$446.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$446.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$543.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$543.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$519.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$519.86
|
| Rate for Payer: Cash Price |
$562.60
|
| Rate for Payer: Cash Price |
$561.36
|
| Rate for Payer: Centivo All Commercial |
$732.53
|
| Rate for Payer: Centivo All Commercial |
$732.53
|
| Rate for Payer: Cigna All Commercial |
$472.60
|
| Rate for Payer: Cigna All Commercial |
$472.60
|
| Rate for Payer: CORVEL All Commercial |
$472.60
|
| Rate for Payer: CORVEL All Commercial |
$472.60
|
| Rate for Payer: Coventry All Commercial |
$567.12
|
| Rate for Payer: Coventry All Commercial |
$567.12
|
| Rate for Payer: Encore All Commercial |
$472.60
|
| Rate for Payer: Encore All Commercial |
$472.60
|
| Rate for Payer: Frontpath All Commercial |
$675.34
|
| Rate for Payer: Frontpath All Commercial |
$675.34
|
| Rate for Payer: Humana ChoiceCare |
$638.41
|
| Rate for Payer: Humana ChoiceCare |
$638.41
|
| Rate for Payer: Humana Medicare |
$472.60
|
| Rate for Payer: Humana Medicare |
$472.60
|
| Rate for Payer: Lucent All Commercial |
$661.64
|
| Rate for Payer: Lucent All Commercial |
$661.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.00
|
| Rate for Payer: Managed Health Services Medicaid |
$446.31
|
| Rate for Payer: Managed Health Services Medicaid |
$446.31
|
| Rate for Payer: MDWise Medicaid |
$446.31
|
| Rate for Payer: MDWise Medicaid |
$446.31
|
| Rate for Payer: PHCS All Commercial |
$472.60
|
| Rate for Payer: PHCS All Commercial |
$472.60
|
| Rate for Payer: PHP All Commercial |
$633.80
|
| Rate for Payer: PHP All Commercial |
$633.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$472.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$472.60
|
| Rate for Payer: Sagamore Health Network All Products |
$472.60
|
| Rate for Payer: Sagamore Health Network All Products |
$472.60
|
| Rate for Payer: Signature Care EPO |
$731.00
|
| Rate for Payer: Signature Care EPO |
$731.00
|
| Rate for Payer: Signature Care PPO |
$731.00
|
| Rate for Payer: Signature Care PPO |
$731.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69,600.00
|
| Rate for Payer: United Healthcare Commercial |
$617.89
|
| Rate for Payer: United Healthcare Commercial |
$617.89
|
| Rate for Payer: United Healthcare Medicare |
$452.71
|
| Rate for Payer: United Healthcare Medicare |
$452.71
|
|
|
PR INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN
|
Professional
|
Both
|
$818.24
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
z33225
|
| Min. Negotiated Rate |
$313.80 |
| Max. Negotiated Rate |
$62,900.00 |
| Rate for Payer: Aetna Commercial |
$428.81
|
| Rate for Payer: Aetna Commercial |
$428.81
|
| Rate for Payer: Aetna Medicare |
$428.81
|
| Rate for Payer: Aetna Medicare |
$428.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$313.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$313.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$313.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$313.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$313.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$313.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$313.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$313.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$402.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$402.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$493.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$493.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$471.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$471.69
|
| Rate for Payer: Cash Price |
$507.31
|
| Rate for Payer: Cash Price |
$506.87
|
| Rate for Payer: Centivo All Commercial |
$664.66
|
| Rate for Payer: Centivo All Commercial |
$664.66
|
| Rate for Payer: Cigna All Commercial |
$428.81
|
| Rate for Payer: Cigna All Commercial |
$428.81
|
| Rate for Payer: CORVEL All Commercial |
$428.81
|
| Rate for Payer: CORVEL All Commercial |
$428.81
|
| Rate for Payer: Coventry All Commercial |
$514.57
|
| Rate for Payer: Coventry All Commercial |
$514.57
|
| Rate for Payer: Encore All Commercial |
$428.81
|
| Rate for Payer: Encore All Commercial |
$428.81
|
| Rate for Payer: Frontpath All Commercial |
$614.41
|
| Rate for Payer: Frontpath All Commercial |
$614.41
|
| Rate for Payer: Humana ChoiceCare |
$567.74
|
| Rate for Payer: Humana ChoiceCare |
$567.74
|
| Rate for Payer: Humana Medicare |
$428.81
|
| Rate for Payer: Humana Medicare |
$428.81
|
| Rate for Payer: Lucent All Commercial |
$600.33
|
| Rate for Payer: Lucent All Commercial |
$600.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$671.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$671.00
|
| Rate for Payer: Managed Health Services Medicaid |
$402.10
|
| Rate for Payer: Managed Health Services Medicaid |
$402.10
|
| Rate for Payer: MDWise Medicaid |
$402.10
|
| Rate for Payer: MDWise Medicaid |
$402.10
|
| Rate for Payer: PHCS All Commercial |
$428.81
|
| Rate for Payer: PHCS All Commercial |
$428.81
|
| Rate for Payer: PHP All Commercial |
$572.76
|
| Rate for Payer: PHP All Commercial |
$572.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$428.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$428.81
|
| Rate for Payer: Sagamore Health Network All Products |
$428.81
|
| Rate for Payer: Sagamore Health Network All Products |
$428.81
|
| Rate for Payer: Signature Care EPO |
$650.25
|
| Rate for Payer: Signature Care EPO |
$650.25
|
| Rate for Payer: Signature Care PPO |
$650.25
|
| Rate for Payer: Signature Care PPO |
$650.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62,900.00
|
| Rate for Payer: United Healthcare Commercial |
$557.80
|
| Rate for Payer: United Healthcare Commercial |
$557.80
|
| Rate for Payer: United Healthcare Medicare |
$409.12
|
| Rate for Payer: United Healthcare Medicare |
$409.12
|
|
|
PR INSJ INTRAPERITONEAL CATHETER W/IMG GUID
|
Professional
|
Both
|
$1,804.16
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
z49418
|
| Min. Negotiated Rate |
$189.88 |
| Max. Negotiated Rate |
$26,200.00 |
| Rate for Payer: Aetna Commercial |
$189.88
|
| Rate for Payer: Aetna Commercial |
$189.88
|
| Rate for Payer: Aetna Medicare |
$189.88
|
| Rate for Payer: Aetna Medicare |
$189.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,964.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,964.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,964.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,964.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,964.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,964.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,964.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,964.36
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$202.45
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$202.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$877.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$877.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$218.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$218.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$208.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$208.87
|
| Rate for Payer: Cash Price |
$1,118.58
|
| Rate for Payer: Cash Price |
$1,105.60
|
| Rate for Payer: Centivo All Commercial |
$294.31
|
| Rate for Payer: Centivo All Commercial |
$294.31
|
| Rate for Payer: Cigna All Commercial |
$189.88
|
| Rate for Payer: Cigna All Commercial |
$189.88
|
| Rate for Payer: CORVEL All Commercial |
$189.88
|
| Rate for Payer: CORVEL All Commercial |
$189.88
|
| Rate for Payer: Coventry All Commercial |
$227.86
|
| Rate for Payer: Coventry All Commercial |
$227.86
|
| Rate for Payer: Encore All Commercial |
$189.88
|
| Rate for Payer: Encore All Commercial |
$189.88
|
| Rate for Payer: Frontpath All Commercial |
$259.04
|
| Rate for Payer: Frontpath All Commercial |
$259.04
|
| Rate for Payer: Humana ChoiceCare |
$267.23
|
| Rate for Payer: Humana ChoiceCare |
$267.23
|
| Rate for Payer: Humana Medicare |
$189.88
|
| Rate for Payer: Humana Medicare |
$189.88
|
| Rate for Payer: Lucent All Commercial |
$265.83
|
| Rate for Payer: Lucent All Commercial |
$265.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$281.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$281.00
|
| Rate for Payer: Managed Health Services Medicaid |
$877.06
|
| Rate for Payer: Managed Health Services Medicaid |
$877.06
|
| Rate for Payer: MDWise Medicaid |
$877.06
|
| Rate for Payer: MDWise Medicaid |
$877.06
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$202.45
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$202.45
|
| Rate for Payer: PHCS All Commercial |
$189.88
|
| Rate for Payer: PHCS All Commercial |
$189.88
|
| Rate for Payer: PHP All Commercial |
$319.99
|
| Rate for Payer: PHP All Commercial |
$319.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$189.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$189.88
|
| Rate for Payer: Sagamore Health Network All Products |
$189.88
|
| Rate for Payer: Sagamore Health Network All Products |
$189.88
|
| Rate for Payer: Signature Care EPO |
$1,604.83
|
| Rate for Payer: Signature Care EPO |
$1,604.83
|
| Rate for Payer: Signature Care PPO |
$1,604.83
|
| Rate for Payer: Signature Care PPO |
$1,604.83
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26,200.00
|
| Rate for Payer: United Healthcare Commercial |
$292.49
|
| Rate for Payer: United Healthcare Commercial |
$292.49
|
| Rate for Payer: United Healthcare Medicare |
$902.08
|
| Rate for Payer: United Healthcare Medicare |
$902.08
|
|
|
PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y
|
Professional
|
Both
|
$349.10
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
z36555
|
| Min. Negotiated Rate |
$43.42 |
| Max. Negotiated Rate |
$12,000.00 |
| Rate for Payer: Aetna Commercial |
$81.36
|
| Rate for Payer: Aetna Commercial |
$81.36
|
| Rate for Payer: Aetna Medicare |
$81.36
|
| Rate for Payer: Aetna Medicare |
$81.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$418.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$418.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$418.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$418.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$418.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$418.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$418.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$418.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$43.42
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$43.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$171.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$171.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.50
|
| Rate for Payer: Cash Price |
$216.13
|
| Rate for Payer: Cash Price |
$216.44
|
| Rate for Payer: Centivo All Commercial |
$126.11
|
| Rate for Payer: Centivo All Commercial |
$126.11
|
| Rate for Payer: Cigna All Commercial |
$81.36
|
| Rate for Payer: Cigna All Commercial |
$81.36
|
| Rate for Payer: CORVEL All Commercial |
$81.36
|
| Rate for Payer: CORVEL All Commercial |
$81.36
|
| Rate for Payer: Coventry All Commercial |
$97.63
|
| Rate for Payer: Coventry All Commercial |
$97.63
|
| Rate for Payer: Encore All Commercial |
$81.36
|
| Rate for Payer: Encore All Commercial |
$81.36
|
| Rate for Payer: Frontpath All Commercial |
$110.80
|
| Rate for Payer: Frontpath All Commercial |
$110.80
|
| Rate for Payer: Humana ChoiceCare |
$170.76
|
| Rate for Payer: Humana ChoiceCare |
$170.76
|
| Rate for Payer: Humana Medicare |
$81.36
|
| Rate for Payer: Humana Medicare |
$81.36
|
| Rate for Payer: Lucent All Commercial |
$113.90
|
| Rate for Payer: Lucent All Commercial |
$113.90
|
| 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 |
$171.70
|
| Rate for Payer: Managed Health Services Medicaid |
$171.70
|
| Rate for Payer: MDWise Medicaid |
$171.70
|
| Rate for Payer: MDWise Medicaid |
$171.70
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$43.42
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$43.42
|
| Rate for Payer: PHCS All Commercial |
$81.36
|
| Rate for Payer: PHCS All Commercial |
$81.36
|
| Rate for Payer: PHP All Commercial |
$132.98
|
| Rate for Payer: PHP All Commercial |
$132.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.36
|
| Rate for Payer: Sagamore Health Network All Products |
$81.36
|
| Rate for Payer: Sagamore Health Network All Products |
$81.36
|
| Rate for Payer: Signature Care EPO |
$310.93
|
| Rate for Payer: Signature Care EPO |
$310.93
|
| Rate for Payer: Signature Care PPO |
$310.93
|
| Rate for Payer: Signature Care PPO |
$310.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,000.00
|
| Rate for Payer: United Healthcare Commercial |
$151.53
|
| Rate for Payer: United Healthcare Commercial |
$151.53
|
| Rate for Payer: United Healthcare Medicare |
$174.30
|
| Rate for Payer: United Healthcare Medicare |
$174.30
|
|
|
PR INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR
|
Professional
|
Both
|
$1,626.68
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
z33249
|
| Min. Negotiated Rate |
$800.06 |
| Max. Negotiated Rate |
$124,400.00 |
| Rate for Payer: Aetna Commercial |
$844.84
|
| Rate for Payer: Aetna Commercial |
$844.84
|
| Rate for Payer: Aetna Medicare |
$844.84
|
| Rate for Payer: Aetna Medicare |
$844.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,354.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,354.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,354.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,354.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,354.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,354.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,354.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,354.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$800.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$800.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$971.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$971.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$929.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$929.32
|
| Rate for Payer: Cash Price |
$1,008.54
|
| Rate for Payer: Cash Price |
$1,003.63
|
| Rate for Payer: Centivo All Commercial |
$1,309.50
|
| Rate for Payer: Centivo All Commercial |
$1,309.50
|
| Rate for Payer: Cigna All Commercial |
$844.84
|
| Rate for Payer: Cigna All Commercial |
$844.84
|
| Rate for Payer: CORVEL All Commercial |
$844.84
|
| Rate for Payer: CORVEL All Commercial |
$844.84
|
| Rate for Payer: Coventry All Commercial |
$1,013.81
|
| Rate for Payer: Coventry All Commercial |
$1,013.81
|
| Rate for Payer: Encore All Commercial |
$844.84
|
| Rate for Payer: Encore All Commercial |
$844.84
|
| Rate for Payer: Frontpath All Commercial |
$1,201.32
|
| Rate for Payer: Frontpath All Commercial |
$1,201.32
|
| Rate for Payer: Humana ChoiceCare |
$1,094.86
|
| Rate for Payer: Humana ChoiceCare |
$1,094.86
|
| Rate for Payer: Humana Medicare |
$844.84
|
| Rate for Payer: Humana Medicare |
$844.84
|
| Rate for Payer: Lucent All Commercial |
$1,182.78
|
| Rate for Payer: Lucent All Commercial |
$1,182.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,327.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,327.00
|
| Rate for Payer: Managed Health Services Medicaid |
$800.06
|
| Rate for Payer: Managed Health Services Medicaid |
$800.06
|
| Rate for Payer: MDWise Medicaid |
$800.06
|
| Rate for Payer: MDWise Medicaid |
$800.06
|
| Rate for Payer: PHCS All Commercial |
$844.84
|
| Rate for Payer: PHCS All Commercial |
$844.84
|
| Rate for Payer: PHP All Commercial |
$1,133.14
|
| Rate for Payer: PHP All Commercial |
$1,133.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$844.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$844.84
|
| Rate for Payer: Sagamore Health Network All Products |
$844.84
|
| Rate for Payer: Sagamore Health Network All Products |
$844.84
|
| Rate for Payer: Signature Care EPO |
$1,320.05
|
| Rate for Payer: Signature Care EPO |
$1,320.05
|
| Rate for Payer: Signature Care PPO |
$1,320.05
|
| Rate for Payer: Signature Care PPO |
$1,320.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$124,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$124,400.00
|
| Rate for Payer: United Healthcare Commercial |
$1,098.56
|
| Rate for Payer: United Healthcare Commercial |
$1,098.56
|
| Rate for Payer: United Healthcare Medicare |
$809.38
|
| Rate for Payer: United Healthcare Medicare |
$809.38
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,793.60
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
z36561
|
| Min. Negotiated Rate |
$240.07 |
| Max. Negotiated Rate |
$46,000.00 |
| Rate for Payer: Aetna Commercial |
$311.27
|
| Rate for Payer: Aetna Commercial |
$311.27
|
| Rate for Payer: Aetna Medicare |
$311.27
|
| Rate for Payer: Aetna Medicare |
$311.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,681.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,681.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,681.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,681.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,681.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,681.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,681.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,681.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$240.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$240.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$868.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$868.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$357.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$357.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$342.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$342.40
|
| Rate for Payer: Cash Price |
$1,095.08
|
| Rate for Payer: Cash Price |
$1,112.03
|
| Rate for Payer: Centivo All Commercial |
$482.47
|
| Rate for Payer: Centivo All Commercial |
$482.47
|
| Rate for Payer: Cigna All Commercial |
$311.27
|
| Rate for Payer: Cigna All Commercial |
$311.27
|
| Rate for Payer: CORVEL All Commercial |
$311.27
|
| Rate for Payer: CORVEL All Commercial |
$311.27
|
| Rate for Payer: Coventry All Commercial |
$373.52
|
| Rate for Payer: Coventry All Commercial |
$373.52
|
| Rate for Payer: Encore All Commercial |
$311.27
|
| Rate for Payer: Encore All Commercial |
$311.27
|
| Rate for Payer: Frontpath All Commercial |
$433.33
|
| Rate for Payer: Frontpath All Commercial |
$433.33
|
| Rate for Payer: Humana ChoiceCare |
$441.17
|
| Rate for Payer: Humana ChoiceCare |
$441.17
|
| Rate for Payer: Humana Medicare |
$311.27
|
| Rate for Payer: Humana Medicare |
$311.27
|
| Rate for Payer: Lucent All Commercial |
$435.78
|
| Rate for Payer: Lucent All Commercial |
$435.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$490.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$490.00
|
| Rate for Payer: Managed Health Services Medicaid |
$868.72
|
| Rate for Payer: Managed Health Services Medicaid |
$868.72
|
| Rate for Payer: MDWise Medicaid |
$868.72
|
| Rate for Payer: MDWise Medicaid |
$868.72
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$240.07
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$240.07
|
| Rate for Payer: PHCS All Commercial |
$311.27
|
| Rate for Payer: PHCS All Commercial |
$311.27
|
| Rate for Payer: PHP All Commercial |
$508.21
|
| Rate for Payer: PHP All Commercial |
$508.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$311.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$311.27
|
| Rate for Payer: Sagamore Health Network All Products |
$311.27
|
| Rate for Payer: Sagamore Health Network All Products |
$311.27
|
| Rate for Payer: Signature Care EPO |
$1,632.60
|
| Rate for Payer: Signature Care EPO |
$1,632.60
|
| Rate for Payer: Signature Care PPO |
$1,632.60
|
| Rate for Payer: Signature Care PPO |
$1,632.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,000.00
|
| Rate for Payer: United Healthcare Commercial |
$403.05
|
| Rate for Payer: United Healthcare Commercial |
$403.05
|
| Rate for Payer: United Healthcare Medicare |
$896.80
|
| Rate for Payer: United Healthcare Medicare |
$896.80
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PUMP
|
Professional
|
Both
|
$2,045.22
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
z36563
|
| Min. Negotiated Rate |
$253.03 |
| Max. Negotiated Rate |
$49,800.00 |
| Rate for Payer: Aetna Commercial |
$336.03
|
| Rate for Payer: Aetna Commercial |
$336.03
|
| Rate for Payer: Aetna Medicare |
$336.03
|
| Rate for Payer: Aetna Medicare |
$336.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,574.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,574.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,574.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,574.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,574.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,574.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,574.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,574.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$253.03
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$253.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$973.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$973.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$386.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$386.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$369.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$369.63
|
| Rate for Payer: Cash Price |
$1,226.72
|
| Rate for Payer: Cash Price |
$1,268.04
|
| Rate for Payer: Centivo All Commercial |
$520.85
|
| Rate for Payer: Centivo All Commercial |
$520.85
|
| Rate for Payer: Cigna All Commercial |
$336.03
|
| Rate for Payer: Cigna All Commercial |
$336.03
|
| Rate for Payer: CORVEL All Commercial |
$336.03
|
| Rate for Payer: CORVEL All Commercial |
$336.03
|
| Rate for Payer: Coventry All Commercial |
$403.24
|
| Rate for Payer: Coventry All Commercial |
$403.24
|
| Rate for Payer: Encore All Commercial |
$336.03
|
| Rate for Payer: Encore All Commercial |
$336.03
|
| Rate for Payer: Frontpath All Commercial |
$478.44
|
| Rate for Payer: Frontpath All Commercial |
$478.44
|
| Rate for Payer: Humana ChoiceCare |
$458.22
|
| Rate for Payer: Humana ChoiceCare |
$458.22
|
| Rate for Payer: Humana Medicare |
$336.03
|
| Rate for Payer: Humana Medicare |
$336.03
|
| Rate for Payer: Lucent All Commercial |
$470.44
|
| Rate for Payer: Lucent All Commercial |
$470.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$531.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$531.00
|
| Rate for Payer: Managed Health Services Medicaid |
$973.14
|
| Rate for Payer: Managed Health Services Medicaid |
$973.14
|
| Rate for Payer: MDWise Medicaid |
$973.14
|
| Rate for Payer: MDWise Medicaid |
$973.14
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$253.03
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$253.03
|
| Rate for Payer: PHCS All Commercial |
$336.03
|
| Rate for Payer: PHCS All Commercial |
$336.03
|
| Rate for Payer: PHP All Commercial |
$550.57
|
| Rate for Payer: PHP All Commercial |
$550.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$336.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$336.03
|
| Rate for Payer: Sagamore Health Network All Products |
$336.03
|
| Rate for Payer: Sagamore Health Network All Products |
$336.03
|
| Rate for Payer: Signature Care EPO |
$1,624.72
|
| Rate for Payer: Signature Care EPO |
$1,624.72
|
| Rate for Payer: Signature Care PPO |
$1,624.72
|
| Rate for Payer: Signature Care PPO |
$1,624.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$49,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$49,800.00
|
| Rate for Payer: United Healthcare Commercial |
$418.13
|
| Rate for Payer: United Healthcare Commercial |
$418.13
|
| Rate for Payer: United Healthcare Medicare |
$1,022.61
|
| Rate for Payer: United Healthcare Medicare |
$1,022.61
|
|
|
PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT
|
Professional
|
Both
|
$924.18
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
z33208
|
| Min. Negotiated Rate |
$454.54 |
| Max. Negotiated Rate |
$70,600.00 |
| Rate for Payer: Aetna Commercial |
$478.69
|
| Rate for Payer: Aetna Commercial |
$478.69
|
| Rate for Payer: Aetna Medicare |
$478.69
|
| Rate for Payer: Aetna Medicare |
$478.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$814.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$814.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$814.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$814.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$814.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$814.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$814.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$814.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$454.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$454.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$550.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$550.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$526.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$526.56
|
| Rate for Payer: Cash Price |
$572.99
|
| Rate for Payer: Cash Price |
$569.27
|
| Rate for Payer: Centivo All Commercial |
$741.97
|
| Rate for Payer: Centivo All Commercial |
$741.97
|
| Rate for Payer: Cigna All Commercial |
$478.69
|
| Rate for Payer: Cigna All Commercial |
$478.69
|
| Rate for Payer: CORVEL All Commercial |
$478.69
|
| Rate for Payer: CORVEL All Commercial |
$478.69
|
| Rate for Payer: Coventry All Commercial |
$574.43
|
| Rate for Payer: Coventry All Commercial |
$574.43
|
| Rate for Payer: Encore All Commercial |
$478.69
|
| Rate for Payer: Encore All Commercial |
$478.69
|
| Rate for Payer: Frontpath All Commercial |
$680.62
|
| Rate for Payer: Frontpath All Commercial |
$680.62
|
| Rate for Payer: Humana ChoiceCare |
$627.84
|
| Rate for Payer: Humana ChoiceCare |
$627.84
|
| Rate for Payer: Humana Medicare |
$478.69
|
| Rate for Payer: Humana Medicare |
$478.69
|
| Rate for Payer: Lucent All Commercial |
$670.17
|
| Rate for Payer: Lucent All Commercial |
$670.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$753.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$753.00
|
| Rate for Payer: Managed Health Services Medicaid |
$454.54
|
| Rate for Payer: Managed Health Services Medicaid |
$454.54
|
| Rate for Payer: MDWise Medicaid |
$454.54
|
| Rate for Payer: MDWise Medicaid |
$454.54
|
| Rate for Payer: PHCS All Commercial |
$478.69
|
| Rate for Payer: PHCS All Commercial |
$478.69
|
| Rate for Payer: PHP All Commercial |
$642.73
|
| Rate for Payer: PHP All Commercial |
$642.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$478.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$478.69
|
| Rate for Payer: Sagamore Health Network All Products |
$478.69
|
| Rate for Payer: Sagamore Health Network All Products |
$478.69
|
| Rate for Payer: Signature Care EPO |
$757.35
|
| Rate for Payer: Signature Care EPO |
$757.35
|
| Rate for Payer: Signature Care PPO |
$757.35
|
| Rate for Payer: Signature Care PPO |
$757.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,600.00
|
| Rate for Payer: United Healthcare Commercial |
$634.64
|
| Rate for Payer: United Healthcare Commercial |
$634.64
|
| Rate for Payer: United Healthcare Medicare |
$459.09
|
| Rate for Payer: United Healthcare Medicare |
$459.09
|
|
|
PR INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR
|
Professional
|
Both
|
$853.88
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
z33207
|
| Min. Negotiated Rate |
$419.97 |
| Max. Negotiated Rate |
$65,200.00 |
| Rate for Payer: Aetna Commercial |
$441.23
|
| Rate for Payer: Aetna Commercial |
$441.23
|
| Rate for Payer: Aetna Medicare |
$441.23
|
| Rate for Payer: Aetna Medicare |
$441.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$802.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$419.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$419.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$507.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$507.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$485.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$485.35
|
| Rate for Payer: Cash Price |
$529.41
|
| Rate for Payer: Cash Price |
$525.62
|
| Rate for Payer: Centivo All Commercial |
$683.91
|
| Rate for Payer: Centivo All Commercial |
$683.91
|
| Rate for Payer: Cigna All Commercial |
$441.23
|
| Rate for Payer: Cigna All Commercial |
$441.23
|
| Rate for Payer: CORVEL All Commercial |
$441.23
|
| Rate for Payer: CORVEL All Commercial |
$441.23
|
| Rate for Payer: Coventry All Commercial |
$529.48
|
| Rate for Payer: Coventry All Commercial |
$529.48
|
| Rate for Payer: Encore All Commercial |
$441.23
|
| Rate for Payer: Encore All Commercial |
$441.23
|
| Rate for Payer: Frontpath All Commercial |
$627.21
|
| Rate for Payer: Frontpath All Commercial |
$627.21
|
| Rate for Payer: Humana ChoiceCare |
$619.11
|
| Rate for Payer: Humana ChoiceCare |
$619.11
|
| Rate for Payer: Humana Medicare |
$441.23
|
| Rate for Payer: Humana Medicare |
$441.23
|
| Rate for Payer: Lucent All Commercial |
$617.72
|
| Rate for Payer: Lucent All Commercial |
$617.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$695.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$695.00
|
| Rate for Payer: Managed Health Services Medicaid |
$419.97
|
| Rate for Payer: Managed Health Services Medicaid |
$419.97
|
| Rate for Payer: MDWise Medicaid |
$419.97
|
| Rate for Payer: MDWise Medicaid |
$419.97
|
| Rate for Payer: PHCS All Commercial |
$441.23
|
| Rate for Payer: PHCS All Commercial |
$441.23
|
| Rate for Payer: PHP All Commercial |
$593.44
|
| Rate for Payer: PHP All Commercial |
$593.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$441.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$441.23
|
| Rate for Payer: Sagamore Health Network All Products |
$441.23
|
| Rate for Payer: Sagamore Health Network All Products |
$441.23
|
| Rate for Payer: Signature Care EPO |
$719.10
|
| Rate for Payer: Signature Care EPO |
$719.10
|
| Rate for Payer: Signature Care PPO |
$719.10
|
| Rate for Payer: Signature Care PPO |
$719.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$65,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$65,200.00
|
| Rate for Payer: United Healthcare Commercial |
$588.50
|
| Rate for Payer: United Healthcare Commercial |
$588.50
|
| Rate for Payer: United Healthcare Medicare |
$423.89
|
| Rate for Payer: United Healthcare Medicare |
$423.89
|
|
|
PR INS/RPLC PERPH SAC/GSTRC NPG/RCVR PCKT CRTJ&CONN
|
Professional
|
Both
|
$747.08
|
|
|
Service Code
|
CPT 64590
|
| Hospital Charge Code |
z64590
|
| Min. Negotiated Rate |
$81.85 |
| Max. Negotiated Rate |
$403.20 |
| Rate for Payer: Aetna Commercial |
$150.68
|
| Rate for Payer: Aetna Medicare |
$150.68
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$81.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$403.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$173.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$165.75
|
| Rate for Payer: Cash Price |
$463.19
|
| Rate for Payer: Centivo All Commercial |
$233.55
|
| Rate for Payer: Cigna All Commercial |
$150.68
|
| Rate for Payer: CORVEL All Commercial |
$150.68
|
| Rate for Payer: Coventry All Commercial |
$180.82
|
| Rate for Payer: Encore All Commercial |
$150.68
|
| Rate for Payer: Frontpath All Commercial |
$206.64
|
| Rate for Payer: Humana ChoiceCare |
$233.17
|
| Rate for Payer: Humana Medicare |
$150.68
|
| Rate for Payer: Lucent All Commercial |
$210.95
|
| Rate for Payer: Managed Health Services Medicaid |
$403.20
|
| Rate for Payer: MDWise Medicaid |
$403.20
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$81.85
|
| Rate for Payer: PHCS All Commercial |
$150.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$150.68
|
| Rate for Payer: Sagamore Health Network All Products |
$150.68
|
| Rate for Payer: United Healthcare Commercial |
$198.25
|
| Rate for Payer: United Healthcare Medicare |
$239.19
|
|
|
PR INTER DEVC REMOTE 30D
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
CPT G2066
|
| Hospital Charge Code |
zG2066
|
| Min. Negotiated Rate |
$32.33 |
| Max. Negotiated Rate |
$61.11 |
| Rate for Payer: Cash Price |
$152.52
|
| Rate for Payer: Humana ChoiceCare |
$32.33
|
| Rate for Payer: Signature Care EPO |
$45.25
|
| Rate for Payer: Signature Care PPO |
$45.25
|
| Rate for Payer: United Healthcare Commercial |
$61.11
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$130.64
|
|
|
Service Code
|
CPT 93261
|
| Hospital Charge Code |
z93261
|
| Min. Negotiated Rate |
$64.26 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$68.15
|
| Rate for Payer: Aetna Commercial |
$68.15
|
| Rate for Payer: Aetna Medicare |
$68.15
|
| Rate for Payer: Aetna Medicare |
$68.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$83.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$83.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$83.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$83.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$83.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$83.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$83.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$83.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$64.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$64.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$74.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$74.97
|
| Rate for Payer: Cash Price |
$80.59
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Centivo All Commercial |
$105.63
|
| Rate for Payer: Centivo All Commercial |
$105.63
|
| Rate for Payer: Cigna All Commercial |
$68.15
|
| Rate for Payer: Cigna All Commercial |
$68.15
|
| Rate for Payer: CORVEL All Commercial |
$68.15
|
| Rate for Payer: CORVEL All Commercial |
$68.15
|
| Rate for Payer: Coventry All Commercial |
$81.78
|
| Rate for Payer: Coventry All Commercial |
$81.78
|
| Rate for Payer: Encore All Commercial |
$68.15
|
| Rate for Payer: Encore All Commercial |
$68.15
|
| Rate for Payer: Frontpath All Commercial |
$76.82
|
| Rate for Payer: Frontpath All Commercial |
$76.82
|
| Rate for Payer: Humana ChoiceCare |
$79.66
|
| Rate for Payer: Humana ChoiceCare |
$79.66
|
| Rate for Payer: Humana Medicare |
$68.15
|
| Rate for Payer: Humana Medicare |
$68.15
|
| Rate for Payer: Lucent All Commercial |
$95.41
|
| Rate for Payer: Lucent All Commercial |
$95.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$107.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$107.00
|
| Rate for Payer: Managed Health Services Medicaid |
$64.26
|
| Rate for Payer: Managed Health Services Medicaid |
$64.26
|
| Rate for Payer: MDWise Medicaid |
$64.26
|
| Rate for Payer: MDWise Medicaid |
$64.26
|
| Rate for Payer: PHCS All Commercial |
$68.15
|
| Rate for Payer: PHCS All Commercial |
$68.15
|
| Rate for Payer: PHP All Commercial |
$95.54
|
| Rate for Payer: PHP All Commercial |
$95.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.15
|
| Rate for Payer: Sagamore Health Network All Products |
$68.15
|
| Rate for Payer: Sagamore Health Network All Products |
$68.15
|
| Rate for Payer: Signature Care EPO |
$91.99
|
| Rate for Payer: Signature Care EPO |
$91.99
|
| Rate for Payer: Signature Care PPO |
$91.99
|
| Rate for Payer: Signature Care PPO |
$91.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,000.00
|
| Rate for Payer: United Healthcare Commercial |
$73.76
|
| Rate for Payer: United Healthcare Commercial |
$73.76
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$95.28
|
|
|
Service Code
|
CPT 93292
|
| Hospital Charge Code |
z93292
|
| Min. Negotiated Rate |
$43.91 |
| Max. Negotiated Rate |
$7,200.00 |
| Rate for Payer: Aetna Commercial |
$49.00
|
| Rate for Payer: Aetna Commercial |
$49.00
|
| Rate for Payer: Aetna Medicare |
$49.00
|
| Rate for Payer: Aetna Medicare |
$49.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$52.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$52.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$52.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$52.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$52.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$52.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$52.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$52.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$46.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$46.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.90
|
| Rate for Payer: Cash Price |
$58.17
|
| Rate for Payer: Cash Price |
$59.07
|
| Rate for Payer: Centivo All Commercial |
$75.95
|
| Rate for Payer: Centivo All Commercial |
$75.95
|
| Rate for Payer: Cigna All Commercial |
$49.00
|
| Rate for Payer: Cigna All Commercial |
$49.00
|
| Rate for Payer: CORVEL All Commercial |
$49.00
|
| Rate for Payer: CORVEL All Commercial |
$49.00
|
| Rate for Payer: Coventry All Commercial |
$58.80
|
| Rate for Payer: Coventry All Commercial |
$58.80
|
| Rate for Payer: Encore All Commercial |
$49.00
|
| Rate for Payer: Encore All Commercial |
$49.00
|
| Rate for Payer: Frontpath All Commercial |
$55.15
|
| Rate for Payer: Frontpath All Commercial |
$55.15
|
| Rate for Payer: Humana ChoiceCare |
$47.74
|
| Rate for Payer: Humana ChoiceCare |
$47.74
|
| Rate for Payer: Humana Medicare |
$49.00
|
| Rate for Payer: Humana Medicare |
$49.00
|
| Rate for Payer: Lucent All Commercial |
$68.60
|
| Rate for Payer: Lucent All Commercial |
$68.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.00
|
| Rate for Payer: Managed Health Services Medicaid |
$46.86
|
| Rate for Payer: Managed Health Services Medicaid |
$46.86
|
| Rate for Payer: MDWise Medicaid |
$46.86
|
| Rate for Payer: MDWise Medicaid |
$46.86
|
| Rate for Payer: PHCS All Commercial |
$49.00
|
| Rate for Payer: PHCS All Commercial |
$49.00
|
| Rate for Payer: PHP All Commercial |
$68.96
|
| Rate for Payer: PHP All Commercial |
$68.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$49.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$49.00
|
| Rate for Payer: Sagamore Health Network All Products |
$49.00
|
| Rate for Payer: Sagamore Health Network All Products |
$49.00
|
| Rate for Payer: Signature Care EPO |
$52.63
|
| Rate for Payer: Signature Care EPO |
$52.63
|
| Rate for Payer: Signature Care PPO |
$52.63
|
| Rate for Payer: Signature Care PPO |
$52.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,200.00
|
| Rate for Payer: United Healthcare Commercial |
$43.91
|
| Rate for Payer: United Healthcare Commercial |
$43.91
|
|
|
PR INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB
|
Professional
|
Both
|
$68.68
|
|
|
Service Code
|
CPT 93295
|
| Hospital Charge Code |
z93295
|
| Min. Negotiated Rate |
$33.78 |
| Max. Negotiated Rate |
$5,200.00 |
| Rate for Payer: Aetna Commercial |
$35.76
|
| Rate for Payer: Aetna Commercial |
$35.76
|
| Rate for Payer: Aetna Medicare |
$35.76
|
| Rate for Payer: Aetna Medicare |
$35.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$95.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$95.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$95.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$95.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$95.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$95.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$95.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$95.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$33.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$33.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.34
|
| Rate for Payer: Cash Price |
$42.58
|
| Rate for Payer: Cash Price |
$42.32
|
| Rate for Payer: Centivo All Commercial |
$55.43
|
| Rate for Payer: Centivo All Commercial |
$55.43
|
| Rate for Payer: Cigna All Commercial |
$35.76
|
| Rate for Payer: Cigna All Commercial |
$35.76
|
| Rate for Payer: CORVEL All Commercial |
$35.76
|
| Rate for Payer: CORVEL All Commercial |
$35.76
|
| Rate for Payer: Coventry All Commercial |
$42.91
|
| Rate for Payer: Coventry All Commercial |
$42.91
|
| Rate for Payer: Encore All Commercial |
$35.76
|
| Rate for Payer: Encore All Commercial |
$35.76
|
| Rate for Payer: Frontpath All Commercial |
$40.68
|
| Rate for Payer: Frontpath All Commercial |
$40.68
|
| Rate for Payer: Humana ChoiceCare |
$86.87
|
| Rate for Payer: Humana ChoiceCare |
$86.87
|
| Rate for Payer: Humana Medicare |
$35.76
|
| Rate for Payer: Humana Medicare |
$35.76
|
| Rate for Payer: Lucent All Commercial |
$50.06
|
| Rate for Payer: Lucent All Commercial |
$50.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$56.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$56.00
|
| Rate for Payer: Managed Health Services Medicaid |
$33.78
|
| Rate for Payer: Managed Health Services Medicaid |
$33.78
|
| Rate for Payer: MDWise Medicaid |
$33.78
|
| Rate for Payer: MDWise Medicaid |
$33.78
|
| Rate for Payer: PHCS All Commercial |
$35.76
|
| Rate for Payer: PHCS All Commercial |
$35.76
|
| Rate for Payer: PHP All Commercial |
$50.17
|
| Rate for Payer: PHP All Commercial |
$50.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$35.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$35.76
|
| Rate for Payer: Sagamore Health Network All Products |
$35.76
|
| Rate for Payer: Sagamore Health Network All Products |
$35.76
|
| Rate for Payer: Signature Care EPO |
$60.79
|
| Rate for Payer: Signature Care EPO |
$60.79
|
| Rate for Payer: Signature Care PPO |
$60.79
|
| Rate for Payer: Signature Care PPO |
$60.79
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,200.00
|
| Rate for Payer: United Healthcare Commercial |
$79.90
|
| Rate for Payer: United Healthcare Commercial |
$79.90
|
| Rate for Payer: United Healthcare Medicare |
$34.13
|
| Rate for Payer: United Healthcare Medicare |
$34.13
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$104.78
|
|
|
Service Code
|
CPT 93288
|
| Hospital Charge Code |
z93288
|
| Min. Negotiated Rate |
$50.54 |
| Max. Negotiated Rate |
$8,000.00 |
| Rate for Payer: Aetna Commercial |
$54.92
|
| Rate for Payer: Aetna Commercial |
$54.92
|
| Rate for Payer: Aetna Medicare |
$54.92
|
| Rate for Payer: Aetna Medicare |
$54.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$60.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$60.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$60.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$60.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$60.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$60.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$60.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$60.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$51.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$51.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$63.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$63.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$60.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$60.41
|
| Rate for Payer: Cash Price |
$64.33
|
| Rate for Payer: Cash Price |
$64.96
|
| Rate for Payer: Centivo All Commercial |
$85.13
|
| Rate for Payer: Centivo All Commercial |
$85.13
|
| Rate for Payer: Cigna All Commercial |
$54.92
|
| Rate for Payer: Cigna All Commercial |
$54.92
|
| Rate for Payer: CORVEL All Commercial |
$54.92
|
| Rate for Payer: CORVEL All Commercial |
$54.92
|
| Rate for Payer: Coventry All Commercial |
$65.90
|
| Rate for Payer: Coventry All Commercial |
$65.90
|
| Rate for Payer: Encore All Commercial |
$54.92
|
| Rate for Payer: Encore All Commercial |
$54.92
|
| Rate for Payer: Frontpath All Commercial |
$61.75
|
| Rate for Payer: Frontpath All Commercial |
$61.75
|
| Rate for Payer: Humana ChoiceCare |
$54.94
|
| Rate for Payer: Humana ChoiceCare |
$54.94
|
| Rate for Payer: Humana Medicare |
$54.92
|
| Rate for Payer: Humana Medicare |
$54.92
|
| Rate for Payer: Lucent All Commercial |
$76.89
|
| Rate for Payer: Lucent All Commercial |
$76.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$85.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$85.00
|
| Rate for Payer: Managed Health Services Medicaid |
$51.53
|
| Rate for Payer: Managed Health Services Medicaid |
$51.53
|
| Rate for Payer: MDWise Medicaid |
$51.53
|
| Rate for Payer: MDWise Medicaid |
$51.53
|
| Rate for Payer: PHCS All Commercial |
$54.92
|
| Rate for Payer: PHCS All Commercial |
$54.92
|
| Rate for Payer: PHP All Commercial |
$76.26
|
| Rate for Payer: PHP All Commercial |
$76.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$54.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$54.92
|
| Rate for Payer: Sagamore Health Network All Products |
$54.92
|
| Rate for Payer: Sagamore Health Network All Products |
$54.92
|
| Rate for Payer: Signature Care EPO |
$60.84
|
| Rate for Payer: Signature Care EPO |
$60.84
|
| Rate for Payer: Signature Care PPO |
$60.84
|
| Rate for Payer: Signature Care PPO |
$60.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,000.00
|
| Rate for Payer: United Healthcare Commercial |
$50.54
|
| Rate for Payer: United Healthcare Commercial |
$50.54
|
|
