|
PR KNEE SCOPE,MED OR LAT MENIS REPAIR
|
Professional
|
Both
|
$1,278.62
|
|
|
Service Code
|
CPT 29882
|
| Hospital Charge Code |
z29882
|
| Min. Negotiated Rate |
$626.53 |
| Max. Negotiated Rate |
$96,300.00 |
| Rate for Payer: Aetna Commercial |
$642.62
|
| Rate for Payer: Aetna Commercial |
$642.62
|
| Rate for Payer: Aetna Medicare |
$642.62
|
| Rate for Payer: Aetna Medicare |
$642.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$872.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$872.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$872.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$872.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$872.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$872.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$872.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$872.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$628.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$628.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$739.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$739.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$706.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$706.88
|
| Rate for Payer: Cash Price |
$767.17
|
| Rate for Payer: Cash Price |
$751.84
|
| Rate for Payer: Centivo All Commercial |
$996.06
|
| Rate for Payer: Centivo All Commercial |
$996.06
|
| Rate for Payer: Cigna All Commercial |
$642.62
|
| Rate for Payer: Cigna All Commercial |
$642.62
|
| Rate for Payer: CORVEL All Commercial |
$642.62
|
| Rate for Payer: CORVEL All Commercial |
$642.62
|
| Rate for Payer: Coventry All Commercial |
$771.14
|
| Rate for Payer: Coventry All Commercial |
$771.14
|
| Rate for Payer: Encore All Commercial |
$642.62
|
| Rate for Payer: Encore All Commercial |
$642.62
|
| Rate for Payer: Frontpath All Commercial |
$893.59
|
| Rate for Payer: Frontpath All Commercial |
$893.59
|
| Rate for Payer: Humana ChoiceCare |
$692.92
|
| Rate for Payer: Humana ChoiceCare |
$692.92
|
| Rate for Payer: Humana Medicare |
$642.62
|
| Rate for Payer: Humana Medicare |
$642.62
|
| Rate for Payer: Lucent All Commercial |
$899.67
|
| Rate for Payer: Lucent All Commercial |
$899.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,028.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,028.00
|
| Rate for Payer: Managed Health Services Medicaid |
$628.88
|
| Rate for Payer: Managed Health Services Medicaid |
$628.88
|
| Rate for Payer: MDWise Medicaid |
$628.88
|
| Rate for Payer: MDWise Medicaid |
$628.88
|
| Rate for Payer: PHCS All Commercial |
$642.62
|
| Rate for Payer: PHCS All Commercial |
$642.62
|
| Rate for Payer: PHP All Commercial |
$1,090.17
|
| Rate for Payer: PHP All Commercial |
$1,090.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$642.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$642.62
|
| Rate for Payer: Sagamore Health Network All Products |
$642.62
|
| Rate for Payer: Sagamore Health Network All Products |
$642.62
|
| Rate for Payer: Signature Care EPO |
$917.15
|
| Rate for Payer: Signature Care EPO |
$917.15
|
| Rate for Payer: Signature Care PPO |
$917.15
|
| Rate for Payer: Signature Care PPO |
$917.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$96,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$96,300.00
|
| Rate for Payer: United Healthcare Commercial |
$748.39
|
| Rate for Payer: United Healthcare Commercial |
$748.39
|
| Rate for Payer: United Healthcare Medicare |
$626.53
|
| Rate for Payer: United Healthcare Medicare |
$626.53
|
|
|
PR KNEE SCOPE,PART SYNOVECT
|
Professional
|
Both
|
$925.62
|
|
|
Service Code
|
CPT 29875
|
| Hospital Charge Code |
z29875
|
| Min. Negotiated Rate |
$452.29 |
| Max. Negotiated Rate |
$69,500.00 |
| Rate for Payer: Aetna Commercial |
$463.23
|
| Rate for Payer: Aetna Commercial |
$463.23
|
| Rate for Payer: Aetna Medicare |
$463.23
|
| Rate for Payer: Aetna Medicare |
$463.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$657.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$657.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$657.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$657.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$657.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$657.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$657.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$657.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$455.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$455.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$532.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$532.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$509.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$509.55
|
| Rate for Payer: Cash Price |
$555.37
|
| Rate for Payer: Cash Price |
$542.75
|
| Rate for Payer: Centivo All Commercial |
$718.01
|
| Rate for Payer: Centivo All Commercial |
$718.01
|
| Rate for Payer: Cigna All Commercial |
$463.23
|
| Rate for Payer: Cigna All Commercial |
$463.23
|
| Rate for Payer: CORVEL All Commercial |
$463.23
|
| Rate for Payer: CORVEL All Commercial |
$463.23
|
| Rate for Payer: Coventry All Commercial |
$555.88
|
| Rate for Payer: Coventry All Commercial |
$555.88
|
| Rate for Payer: Encore All Commercial |
$463.23
|
| Rate for Payer: Encore All Commercial |
$463.23
|
| Rate for Payer: Frontpath All Commercial |
$642.82
|
| Rate for Payer: Frontpath All Commercial |
$642.82
|
| Rate for Payer: Humana ChoiceCare |
$527.97
|
| Rate for Payer: Humana ChoiceCare |
$527.97
|
| Rate for Payer: Humana Medicare |
$463.23
|
| Rate for Payer: Humana Medicare |
$463.23
|
| Rate for Payer: Lucent All Commercial |
$648.52
|
| Rate for Payer: Lucent All Commercial |
$648.52
|
| 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 |
$455.25
|
| Rate for Payer: Managed Health Services Medicaid |
$455.25
|
| Rate for Payer: MDWise Medicaid |
$455.25
|
| Rate for Payer: MDWise Medicaid |
$455.25
|
| Rate for Payer: PHCS All Commercial |
$463.23
|
| Rate for Payer: PHCS All Commercial |
$463.23
|
| Rate for Payer: PHP All Commercial |
$786.98
|
| Rate for Payer: PHP All Commercial |
$786.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$463.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$463.23
|
| Rate for Payer: Sagamore Health Network All Products |
$463.23
|
| Rate for Payer: Sagamore Health Network All Products |
$463.23
|
| Rate for Payer: Signature Care EPO |
$701.25
|
| Rate for Payer: Signature Care EPO |
$701.25
|
| Rate for Payer: Signature Care PPO |
$701.25
|
| Rate for Payer: Signature Care PPO |
$701.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69,500.00
|
| Rate for Payer: United Healthcare Commercial |
$532.20
|
| Rate for Payer: United Healthcare Commercial |
$532.20
|
| Rate for Payer: United Healthcare Medicare |
$452.29
|
| Rate for Payer: United Healthcare Medicare |
$452.29
|
|
|
PR KNEE SCOPE,REMV LOOSE BODY
|
Professional
|
Both
|
$976.24
|
|
|
Service Code
|
CPT 29874
|
| Hospital Charge Code |
z29874
|
| Min. Negotiated Rate |
$488.12 |
| Max. Negotiated Rate |
$75,000.00 |
| Rate for Payer: Aetna Commercial |
$500.59
|
| Rate for Payer: Aetna Commercial |
$500.59
|
| Rate for Payer: Aetna Medicare |
$500.59
|
| Rate for Payer: Aetna Medicare |
$500.59
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$720.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$720.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$720.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$720.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$720.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$720.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$720.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$720.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$492.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$492.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$575.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$575.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$550.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$550.65
|
| Rate for Payer: Cash Price |
$585.74
|
| Rate for Payer: Cash Price |
$601.09
|
| Rate for Payer: Centivo All Commercial |
$775.91
|
| Rate for Payer: Centivo All Commercial |
$775.91
|
| Rate for Payer: Cigna All Commercial |
$500.59
|
| Rate for Payer: Cigna All Commercial |
$500.59
|
| Rate for Payer: CORVEL All Commercial |
$500.59
|
| Rate for Payer: CORVEL All Commercial |
$500.59
|
| Rate for Payer: Coventry All Commercial |
$600.71
|
| Rate for Payer: Coventry All Commercial |
$600.71
|
| Rate for Payer: Encore All Commercial |
$500.59
|
| Rate for Payer: Encore All Commercial |
$500.59
|
| Rate for Payer: Frontpath All Commercial |
$695.25
|
| Rate for Payer: Frontpath All Commercial |
$695.25
|
| Rate for Payer: Humana ChoiceCare |
$569.36
|
| Rate for Payer: Humana ChoiceCare |
$569.36
|
| Rate for Payer: Humana Medicare |
$500.59
|
| Rate for Payer: Humana Medicare |
$500.59
|
| Rate for Payer: Lucent All Commercial |
$700.83
|
| Rate for Payer: Lucent All Commercial |
$700.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$801.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$801.00
|
| Rate for Payer: Managed Health Services Medicaid |
$492.73
|
| Rate for Payer: Managed Health Services Medicaid |
$492.73
|
| Rate for Payer: MDWise Medicaid |
$492.73
|
| Rate for Payer: MDWise Medicaid |
$492.73
|
| Rate for Payer: PHCS All Commercial |
$500.59
|
| Rate for Payer: PHCS All Commercial |
$500.59
|
| Rate for Payer: PHP All Commercial |
$849.33
|
| Rate for Payer: PHP All Commercial |
$849.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$500.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$500.59
|
| Rate for Payer: Sagamore Health Network All Products |
$500.59
|
| Rate for Payer: Sagamore Health Network All Products |
$500.59
|
| Rate for Payer: Signature Care EPO |
$756.50
|
| Rate for Payer: Signature Care EPO |
$756.50
|
| Rate for Payer: Signature Care PPO |
$756.50
|
| Rate for Payer: Signature Care PPO |
$756.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$75,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$75,000.00
|
| Rate for Payer: United Healthcare Commercial |
$577.69
|
| Rate for Payer: United Healthcare Commercial |
$577.69
|
| Rate for Payer: United Healthcare Medicare |
$488.12
|
| Rate for Payer: United Healthcare Medicare |
$488.12
|
|
|
PR KNEE SCOPE,SHAVE ARTICULAR CART
|
Professional
|
Both
|
$1,154.32
|
|
|
Service Code
|
CPT 29877
|
| Hospital Charge Code |
z29877
|
| Min. Negotiated Rate |
$564.74 |
| Max. Negotiated Rate |
$86,800.00 |
| Rate for Payer: Aetna Commercial |
$579.31
|
| Rate for Payer: Aetna Commercial |
$579.31
|
| Rate for Payer: Aetna Medicare |
$579.31
|
| Rate for Payer: Aetna Medicare |
$579.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$753.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$753.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$753.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$753.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$753.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$753.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$753.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$753.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$567.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$567.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$666.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$666.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$637.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$637.24
|
| Rate for Payer: Cash Price |
$692.59
|
| Rate for Payer: Cash Price |
$677.69
|
| Rate for Payer: Centivo All Commercial |
$897.93
|
| Rate for Payer: Centivo All Commercial |
$897.93
|
| Rate for Payer: Cigna All Commercial |
$579.31
|
| Rate for Payer: Cigna All Commercial |
$579.31
|
| Rate for Payer: CORVEL All Commercial |
$579.31
|
| Rate for Payer: CORVEL All Commercial |
$579.31
|
| Rate for Payer: Coventry All Commercial |
$695.17
|
| Rate for Payer: Coventry All Commercial |
$695.17
|
| Rate for Payer: Encore All Commercial |
$579.31
|
| Rate for Payer: Encore All Commercial |
$579.31
|
| Rate for Payer: Frontpath All Commercial |
$805.62
|
| Rate for Payer: Frontpath All Commercial |
$805.62
|
| Rate for Payer: Humana ChoiceCare |
$612.20
|
| Rate for Payer: Humana ChoiceCare |
$612.20
|
| Rate for Payer: Humana Medicare |
$579.31
|
| Rate for Payer: Humana Medicare |
$579.31
|
| Rate for Payer: Lucent All Commercial |
$811.03
|
| Rate for Payer: Lucent All Commercial |
$811.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$926.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$926.00
|
| Rate for Payer: Managed Health Services Medicaid |
$567.74
|
| Rate for Payer: Managed Health Services Medicaid |
$567.74
|
| Rate for Payer: MDWise Medicaid |
$567.74
|
| Rate for Payer: MDWise Medicaid |
$567.74
|
| Rate for Payer: PHCS All Commercial |
$579.31
|
| Rate for Payer: PHCS All Commercial |
$579.31
|
| Rate for Payer: PHP All Commercial |
$982.65
|
| Rate for Payer: PHP All Commercial |
$982.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$579.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$579.31
|
| Rate for Payer: Sagamore Health Network All Products |
$579.31
|
| Rate for Payer: Sagamore Health Network All Products |
$579.31
|
| Rate for Payer: Signature Care EPO |
$812.60
|
| Rate for Payer: Signature Care EPO |
$812.60
|
| Rate for Payer: Signature Care PPO |
$812.60
|
| Rate for Payer: Signature Care PPO |
$812.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$86,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$86,800.00
|
| Rate for Payer: United Healthcare Commercial |
$662.73
|
| Rate for Payer: United Healthcare Commercial |
$662.73
|
| Rate for Payer: United Healthcare Medicare |
$564.74
|
| Rate for Payer: United Healthcare Medicare |
$564.74
|
|
|
PR KNEE SCOPE/SURG/INCOND FX AID+FIXAT
|
Professional
|
Both
|
$1,716.72
|
|
|
Service Code
|
CPT 29851
|
| Hospital Charge Code |
z29851
|
| Min. Negotiated Rate |
$841.13 |
| Max. Negotiated Rate |
$1,339.11 |
| Rate for Payer: Aetna Commercial |
$863.94
|
| Rate for Payer: Aetna Medicare |
$863.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$844.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$993.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$950.33
|
| Rate for Payer: Cash Price |
$1,030.03
|
| Rate for Payer: Centivo All Commercial |
$1,339.11
|
| Rate for Payer: Cigna All Commercial |
$863.94
|
| Rate for Payer: CORVEL All Commercial |
$863.94
|
| Rate for Payer: Coventry All Commercial |
$1,036.73
|
| Rate for Payer: Encore All Commercial |
$863.94
|
| Rate for Payer: Frontpath All Commercial |
$1,206.87
|
| Rate for Payer: Humana ChoiceCare |
$1,004.00
|
| Rate for Payer: Humana Medicare |
$863.94
|
| Rate for Payer: Lucent All Commercial |
$1,209.52
|
| Rate for Payer: Managed Health Services Medicaid |
$844.35
|
| Rate for Payer: MDWise Medicaid |
$844.35
|
| Rate for Payer: PHCS All Commercial |
$863.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$863.94
|
| Rate for Payer: Sagamore Health Network All Products |
$863.94
|
| Rate for Payer: United Healthcare Commercial |
$1,019.43
|
| Rate for Payer: United Healthcare Medicare |
$841.13
|
|
|
PR KNEE SCOPE, W/LATERAL RELEASE
|
Professional
|
Both
|
$978.28
|
|
|
Service Code
|
CPT 29873
|
| Hospital Charge Code |
z29873
|
| Min. Negotiated Rate |
$489.14 |
| Max. Negotiated Rate |
$75,200.00 |
| Rate for Payer: Aetna Commercial |
$501.43
|
| Rate for Payer: Aetna Commercial |
$501.43
|
| Rate for Payer: Aetna Medicare |
$501.43
|
| Rate for Payer: Aetna Medicare |
$501.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,294.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,294.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,294.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,294.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,294.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,294.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,294.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,294.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$494.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$494.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$576.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$576.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$551.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$551.57
|
| Rate for Payer: Cash Price |
$586.97
|
| Rate for Payer: Cash Price |
$602.92
|
| Rate for Payer: Centivo All Commercial |
$777.22
|
| Rate for Payer: Centivo All Commercial |
$777.22
|
| Rate for Payer: Cigna All Commercial |
$501.43
|
| Rate for Payer: Cigna All Commercial |
$501.43
|
| Rate for Payer: CORVEL All Commercial |
$501.43
|
| Rate for Payer: CORVEL All Commercial |
$501.43
|
| Rate for Payer: Coventry All Commercial |
$601.72
|
| Rate for Payer: Coventry All Commercial |
$601.72
|
| Rate for Payer: Encore All Commercial |
$501.43
|
| Rate for Payer: Encore All Commercial |
$501.43
|
| Rate for Payer: Frontpath All Commercial |
$692.77
|
| Rate for Payer: Frontpath All Commercial |
$692.77
|
| Rate for Payer: Humana ChoiceCare |
$541.97
|
| Rate for Payer: Humana ChoiceCare |
$541.97
|
| Rate for Payer: Humana Medicare |
$501.43
|
| Rate for Payer: Humana Medicare |
$501.43
|
| Rate for Payer: Lucent All Commercial |
$702.00
|
| Rate for Payer: Lucent All Commercial |
$702.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$802.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$802.00
|
| Rate for Payer: Managed Health Services Medicaid |
$494.23
|
| Rate for Payer: Managed Health Services Medicaid |
$494.23
|
| Rate for Payer: MDWise Medicaid |
$494.23
|
| Rate for Payer: MDWise Medicaid |
$494.23
|
| Rate for Payer: PHCS All Commercial |
$501.43
|
| Rate for Payer: PHCS All Commercial |
$501.43
|
| Rate for Payer: PHP All Commercial |
$851.10
|
| Rate for Payer: PHP All Commercial |
$851.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$501.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$501.43
|
| Rate for Payer: Sagamore Health Network All Products |
$501.43
|
| Rate for Payer: Sagamore Health Network All Products |
$501.43
|
| Rate for Payer: Signature Care EPO |
$851.82
|
| Rate for Payer: Signature Care EPO |
$851.82
|
| Rate for Payer: Signature Care PPO |
$851.82
|
| Rate for Payer: Signature Care PPO |
$851.82
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$75,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$75,200.00
|
| Rate for Payer: United Healthcare Commercial |
$547.65
|
| Rate for Payer: United Healthcare Commercial |
$547.65
|
| Rate for Payer: United Healthcare Medicare |
$489.14
|
| Rate for Payer: United Healthcare Medicare |
$489.14
|
|
|
PR LABYRINTHOTOMY W PERFUSION VESTIBULOACTIVE DRUGS,TRANSCRANIAL
|
Professional
|
Both
|
$423.66
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
z69801
|
| Min. Negotiated Rate |
$101.26 |
| Max. Negotiated Rate |
$17,500.00 |
| Rate for Payer: Aetna Commercial |
$116.60
|
| Rate for Payer: Aetna Commercial |
$116.60
|
| Rate for Payer: Aetna Medicare |
$116.60
|
| Rate for Payer: Aetna Medicare |
$116.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$385.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$385.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$385.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$385.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$385.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$385.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$385.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$385.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$101.26
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$101.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$208.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$208.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$134.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$134.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.26
|
| Rate for Payer: Cash Price |
$251.28
|
| Rate for Payer: Cash Price |
$254.20
|
| Rate for Payer: Centivo All Commercial |
$180.73
|
| Rate for Payer: Centivo All Commercial |
$180.73
|
| Rate for Payer: Cigna All Commercial |
$116.60
|
| Rate for Payer: Cigna All Commercial |
$116.60
|
| Rate for Payer: CORVEL All Commercial |
$116.60
|
| Rate for Payer: CORVEL All Commercial |
$116.60
|
| Rate for Payer: Coventry All Commercial |
$139.92
|
| Rate for Payer: Coventry All Commercial |
$139.92
|
| Rate for Payer: Encore All Commercial |
$116.60
|
| Rate for Payer: Encore All Commercial |
$116.60
|
| Rate for Payer: Frontpath All Commercial |
$160.26
|
| Rate for Payer: Frontpath All Commercial |
$160.26
|
| Rate for Payer: Humana ChoiceCare |
$732.03
|
| Rate for Payer: Humana ChoiceCare |
$732.03
|
| Rate for Payer: Humana Medicare |
$116.60
|
| Rate for Payer: Humana Medicare |
$116.60
|
| Rate for Payer: Lucent All Commercial |
$163.24
|
| Rate for Payer: Lucent All Commercial |
$163.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$186.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$186.00
|
| Rate for Payer: Managed Health Services Medicaid |
$208.37
|
| Rate for Payer: Managed Health Services Medicaid |
$208.37
|
| Rate for Payer: MDWise Medicaid |
$208.37
|
| Rate for Payer: MDWise Medicaid |
$208.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$101.26
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$101.26
|
| Rate for Payer: PHCS All Commercial |
$116.60
|
| Rate for Payer: PHCS All Commercial |
$116.60
|
| Rate for Payer: PHP All Commercial |
$147.71
|
| Rate for Payer: PHP All Commercial |
$147.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.60
|
| Rate for Payer: Sagamore Health Network All Products |
$116.60
|
| Rate for Payer: Sagamore Health Network All Products |
$116.60
|
| Rate for Payer: Signature Care EPO |
$318.22
|
| Rate for Payer: Signature Care EPO |
$318.22
|
| Rate for Payer: Signature Care PPO |
$318.22
|
| Rate for Payer: Signature Care PPO |
$318.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,500.00
|
| Rate for Payer: United Healthcare Commercial |
$804.94
|
| Rate for Payer: United Healthcare Commercial |
$804.94
|
| Rate for Payer: United Healthcare Medicare |
$209.40
|
| Rate for Payer: United Healthcare Medicare |
$209.40
|
|
|
PR LAP,ABDOMEN,ASPIRATE CYST
|
Professional
|
Both
|
$684.38
|
|
|
Service Code
|
CPT 49322
|
| Hospital Charge Code |
z49322
|
| Min. Negotiated Rate |
$336.31 |
| Max. Negotiated Rate |
$48,300.00 |
| Rate for Payer: Aetna Commercial |
$348.38
|
| Rate for Payer: Aetna Commercial |
$348.38
|
| Rate for Payer: Aetna Medicare |
$348.38
|
| Rate for Payer: Aetna Medicare |
$348.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$490.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$490.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$490.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$490.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$490.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$490.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$490.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$490.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$336.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$336.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$400.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$400.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$383.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$383.22
|
| Rate for Payer: Cash Price |
$410.63
|
| Rate for Payer: Cash Price |
$403.57
|
| Rate for Payer: Centivo All Commercial |
$539.99
|
| Rate for Payer: Centivo All Commercial |
$539.99
|
| Rate for Payer: Cigna All Commercial |
$348.38
|
| Rate for Payer: Cigna All Commercial |
$348.38
|
| Rate for Payer: CORVEL All Commercial |
$348.38
|
| Rate for Payer: CORVEL All Commercial |
$348.38
|
| Rate for Payer: Coventry All Commercial |
$418.06
|
| Rate for Payer: Coventry All Commercial |
$418.06
|
| Rate for Payer: Encore All Commercial |
$348.38
|
| Rate for Payer: Encore All Commercial |
$348.38
|
| Rate for Payer: Frontpath All Commercial |
$493.88
|
| Rate for Payer: Frontpath All Commercial |
$493.88
|
| Rate for Payer: Humana ChoiceCare |
$395.45
|
| Rate for Payer: Humana ChoiceCare |
$395.45
|
| Rate for Payer: Humana Medicare |
$348.38
|
| Rate for Payer: Humana Medicare |
$348.38
|
| Rate for Payer: Lucent All Commercial |
$487.73
|
| Rate for Payer: Lucent All Commercial |
$487.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$517.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$517.00
|
| Rate for Payer: Managed Health Services Medicaid |
$336.61
|
| Rate for Payer: Managed Health Services Medicaid |
$336.61
|
| Rate for Payer: MDWise Medicaid |
$336.61
|
| Rate for Payer: MDWise Medicaid |
$336.61
|
| Rate for Payer: PHCS All Commercial |
$348.38
|
| Rate for Payer: PHCS All Commercial |
$348.38
|
| Rate for Payer: PHP All Commercial |
$588.54
|
| Rate for Payer: PHP All Commercial |
$588.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$348.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$348.38
|
| Rate for Payer: Sagamore Health Network All Products |
$348.38
|
| Rate for Payer: Sagamore Health Network All Products |
$348.38
|
| Rate for Payer: Signature Care EPO |
$500.65
|
| Rate for Payer: Signature Care EPO |
$500.65
|
| Rate for Payer: Signature Care PPO |
$500.65
|
| Rate for Payer: Signature Care PPO |
$500.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$48,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$48,300.00
|
| Rate for Payer: United Healthcare Commercial |
$403.75
|
| Rate for Payer: United Healthcare Commercial |
$403.75
|
| Rate for Payer: United Healthcare Medicare |
$336.31
|
| Rate for Payer: United Healthcare Medicare |
$336.31
|
|
|
PR LAP,ABD/PERIT/OMENTUM,UNLIST
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
CPT 49329
|
| Hospital Charge Code |
z49329
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$624.75 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$0.01
|
| Rate for Payer: Cash Price |
$441.00
|
| Rate for Payer: Cash Price |
$441.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$624.75
|
| Rate for Payer: Signature Care EPO |
$468.56
|
| Rate for Payer: Signature Care PPO |
$468.56
|
|
|
PR LAP,APPENDECTOMY
|
Professional
|
Both
|
$1,096.92
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
z44970
|
| Min. Negotiated Rate |
$538.73 |
| Max. Negotiated Rate |
$77,300.00 |
| Rate for Payer: Aetna Commercial |
$558.86
|
| Rate for Payer: Aetna Commercial |
$558.86
|
| Rate for Payer: Aetna Medicare |
$558.86
|
| Rate for Payer: Aetna Medicare |
$558.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$673.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$673.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$673.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$673.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$673.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$673.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$673.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$673.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$539.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$539.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$642.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$642.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$614.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$614.75
|
| Rate for Payer: Cash Price |
$658.15
|
| Rate for Payer: Cash Price |
$646.48
|
| Rate for Payer: Centivo All Commercial |
$866.23
|
| Rate for Payer: Centivo All Commercial |
$866.23
|
| Rate for Payer: Cigna All Commercial |
$558.86
|
| Rate for Payer: Cigna All Commercial |
$558.86
|
| Rate for Payer: CORVEL All Commercial |
$558.86
|
| Rate for Payer: CORVEL All Commercial |
$558.86
|
| Rate for Payer: Coventry All Commercial |
$670.63
|
| Rate for Payer: Coventry All Commercial |
$670.63
|
| Rate for Payer: Encore All Commercial |
$558.86
|
| Rate for Payer: Encore All Commercial |
$558.86
|
| Rate for Payer: Frontpath All Commercial |
$795.54
|
| Rate for Payer: Frontpath All Commercial |
$795.54
|
| Rate for Payer: Humana ChoiceCare |
$584.85
|
| Rate for Payer: Humana ChoiceCare |
$584.85
|
| Rate for Payer: Humana Medicare |
$558.86
|
| Rate for Payer: Humana Medicare |
$558.86
|
| Rate for Payer: Lucent All Commercial |
$782.40
|
| Rate for Payer: Lucent All Commercial |
$782.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.00
|
| Rate for Payer: Managed Health Services Medicaid |
$539.51
|
| Rate for Payer: Managed Health Services Medicaid |
$539.51
|
| Rate for Payer: MDWise Medicaid |
$539.51
|
| Rate for Payer: MDWise Medicaid |
$539.51
|
| Rate for Payer: PHCS All Commercial |
$558.86
|
| Rate for Payer: PHCS All Commercial |
$558.86
|
| Rate for Payer: PHP All Commercial |
$942.78
|
| Rate for Payer: PHP All Commercial |
$942.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$558.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$558.86
|
| Rate for Payer: Sagamore Health Network All Products |
$558.86
|
| Rate for Payer: Sagamore Health Network All Products |
$558.86
|
| Rate for Payer: Signature Care EPO |
$747.15
|
| Rate for Payer: Signature Care EPO |
$747.15
|
| Rate for Payer: Signature Care PPO |
$747.15
|
| Rate for Payer: Signature Care PPO |
$747.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$77,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$77,300.00
|
| Rate for Payer: United Healthcare Commercial |
$629.04
|
| Rate for Payer: United Healthcare Commercial |
$629.04
|
| Rate for Payer: United Healthcare Medicare |
$538.73
|
| Rate for Payer: United Healthcare Medicare |
$538.73
|
|
|
PR LAP,APPENDIX UNLISTED PROCED
|
Professional
|
Both
|
$1,588.00
|
|
|
Service Code
|
CPT 44979
|
| Hospital Charge Code |
z44979
|
| Rate for Payer: Cash Price |
$952.80
|
|
|
PR LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS > 250 GRAM
|
Professional
|
Both
|
$1,892.82
|
|
|
Service Code
|
CPT 58572
|
| Hospital Charge Code |
z58572
|
| Min. Negotiated Rate |
$925.20 |
| Max. Negotiated Rate |
$126,100.00 |
| Rate for Payer: Aetna Commercial |
$977.67
|
| Rate for Payer: Aetna Commercial |
$977.67
|
| Rate for Payer: Aetna Medicare |
$977.67
|
| Rate for Payer: Aetna Medicare |
$977.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$925.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$925.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,124.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,124.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,075.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,075.44
|
| Rate for Payer: Cash Price |
$1,135.69
|
| Rate for Payer: Cash Price |
$1,128.66
|
| Rate for Payer: Centivo All Commercial |
$1,515.39
|
| Rate for Payer: Centivo All Commercial |
$1,515.39
|
| Rate for Payer: Cigna All Commercial |
$977.67
|
| Rate for Payer: Cigna All Commercial |
$977.67
|
| Rate for Payer: CORVEL All Commercial |
$977.67
|
| Rate for Payer: CORVEL All Commercial |
$977.67
|
| Rate for Payer: Coventry All Commercial |
$1,173.20
|
| Rate for Payer: Coventry All Commercial |
$1,173.20
|
| Rate for Payer: Encore All Commercial |
$977.67
|
| Rate for Payer: Encore All Commercial |
$977.67
|
| Rate for Payer: Frontpath All Commercial |
$1,357.60
|
| Rate for Payer: Frontpath All Commercial |
$1,357.60
|
| Rate for Payer: Humana ChoiceCare |
$1,145.17
|
| Rate for Payer: Humana ChoiceCare |
$1,145.17
|
| Rate for Payer: Humana Medicare |
$977.67
|
| Rate for Payer: Humana Medicare |
$977.67
|
| Rate for Payer: Lucent All Commercial |
$1,368.74
|
| Rate for Payer: Lucent All Commercial |
$1,368.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,358.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,358.00
|
| Rate for Payer: Managed Health Services Medicaid |
$925.20
|
| Rate for Payer: Managed Health Services Medicaid |
$925.20
|
| Rate for Payer: MDWise Medicaid |
$925.20
|
| Rate for Payer: MDWise Medicaid |
$925.20
|
| Rate for Payer: PHCS All Commercial |
$977.67
|
| Rate for Payer: PHCS All Commercial |
$977.67
|
| Rate for Payer: PHP All Commercial |
$1,249.26
|
| Rate for Payer: PHP All Commercial |
$1,249.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$977.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$977.67
|
| Rate for Payer: Sagamore Health Network All Products |
$977.67
|
| Rate for Payer: Sagamore Health Network All Products |
$977.67
|
| Rate for Payer: Signature Care EPO |
$1,264.59
|
| Rate for Payer: Signature Care EPO |
$1,264.59
|
| Rate for Payer: Signature Care PPO |
$1,264.59
|
| Rate for Payer: Signature Care PPO |
$1,264.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126,100.00
|
| Rate for Payer: United Healthcare Commercial |
$1,290.85
|
| Rate for Payer: United Healthcare Commercial |
$1,290.85
|
| Rate for Payer: United Healthcare Medicare |
$946.41
|
| Rate for Payer: United Healthcare Medicare |
$946.41
|
|
|
PR LAPAROSCOPY TOT HYSTERECTOMY UTERUS >250 GRAM W TUBE/OVARY
|
Professional
|
Both
|
$2,259.22
|
|
|
Service Code
|
CPT 58573
|
| Hospital Charge Code |
z58573
|
| Min. Negotiated Rate |
$1,108.63 |
| Max. Negotiated Rate |
$147,700.00 |
| Rate for Payer: Aetna Commercial |
$1,146.83
|
| Rate for Payer: Aetna Commercial |
$1,146.83
|
| Rate for Payer: Aetna Medicare |
$1,146.83
|
| Rate for Payer: Aetna Medicare |
$1,146.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,111.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,111.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,318.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,318.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,261.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,261.51
|
| Rate for Payer: Cash Price |
$1,355.53
|
| Rate for Payer: Cash Price |
$1,330.36
|
| Rate for Payer: Centivo All Commercial |
$1,777.59
|
| Rate for Payer: Centivo All Commercial |
$1,777.59
|
| Rate for Payer: Cigna All Commercial |
$1,146.83
|
| Rate for Payer: Cigna All Commercial |
$1,146.83
|
| Rate for Payer: CORVEL All Commercial |
$1,146.83
|
| Rate for Payer: CORVEL All Commercial |
$1,146.83
|
| Rate for Payer: Coventry All Commercial |
$1,376.20
|
| Rate for Payer: Coventry All Commercial |
$1,376.20
|
| Rate for Payer: Encore All Commercial |
$1,146.83
|
| Rate for Payer: Encore All Commercial |
$1,146.83
|
| Rate for Payer: Frontpath All Commercial |
$1,593.80
|
| Rate for Payer: Frontpath All Commercial |
$1,593.80
|
| Rate for Payer: Humana ChoiceCare |
$1,296.35
|
| Rate for Payer: Humana ChoiceCare |
$1,296.35
|
| Rate for Payer: Humana Medicare |
$1,146.83
|
| Rate for Payer: Humana Medicare |
$1,146.83
|
| Rate for Payer: Lucent All Commercial |
$1,605.56
|
| Rate for Payer: Lucent All Commercial |
$1,605.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,591.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,591.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,111.17
|
| Rate for Payer: Managed Health Services Medicaid |
$1,111.17
|
| Rate for Payer: MDWise Medicaid |
$1,111.17
|
| Rate for Payer: MDWise Medicaid |
$1,111.17
|
| Rate for Payer: PHCS All Commercial |
$1,146.83
|
| Rate for Payer: PHCS All Commercial |
$1,146.83
|
| Rate for Payer: PHP All Commercial |
$1,463.39
|
| Rate for Payer: PHP All Commercial |
$1,463.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,146.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,146.83
|
| Rate for Payer: Sagamore Health Network All Products |
$1,146.83
|
| Rate for Payer: Sagamore Health Network All Products |
$1,146.83
|
| Rate for Payer: Signature Care EPO |
$1,431.52
|
| Rate for Payer: Signature Care EPO |
$1,431.52
|
| Rate for Payer: Signature Care PPO |
$1,431.52
|
| Rate for Payer: Signature Care PPO |
$1,431.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$147,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$147,700.00
|
| Rate for Payer: United Healthcare Commercial |
$1,462.61
|
| Rate for Payer: United Healthcare Commercial |
$1,462.61
|
| Rate for Payer: United Healthcare Medicare |
$1,108.63
|
| Rate for Payer: United Healthcare Medicare |
$1,108.63
|
|
|
PR LAPAROSCOPY W TOT HYSTERECT UTERUS 250 GRAM OR LESS
|
Professional
|
Both
|
$1,499.48
|
|
|
Service Code
|
CPT 58570
|
| Hospital Charge Code |
z58570
|
| Min. Negotiated Rate |
$736.78 |
| Max. Negotiated Rate |
$98,200.00 |
| Rate for Payer: Aetna Commercial |
$759.82
|
| Rate for Payer: Aetna Commercial |
$759.82
|
| Rate for Payer: Aetna Medicare |
$759.82
|
| Rate for Payer: Aetna Medicare |
$759.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$737.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$737.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$873.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$873.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$835.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$835.80
|
| Rate for Payer: Cash Price |
$899.69
|
| Rate for Payer: Cash Price |
$884.14
|
| Rate for Payer: Centivo All Commercial |
$1,177.72
|
| Rate for Payer: Centivo All Commercial |
$1,177.72
|
| Rate for Payer: Cigna All Commercial |
$759.82
|
| Rate for Payer: Cigna All Commercial |
$759.82
|
| Rate for Payer: CORVEL All Commercial |
$759.82
|
| Rate for Payer: CORVEL All Commercial |
$759.82
|
| Rate for Payer: Coventry All Commercial |
$911.78
|
| Rate for Payer: Coventry All Commercial |
$911.78
|
| Rate for Payer: Encore All Commercial |
$759.82
|
| Rate for Payer: Encore All Commercial |
$759.82
|
| Rate for Payer: Frontpath All Commercial |
$1,054.09
|
| Rate for Payer: Frontpath All Commercial |
$1,054.09
|
| Rate for Payer: Humana ChoiceCare |
$922.30
|
| Rate for Payer: Humana ChoiceCare |
$922.30
|
| Rate for Payer: Humana Medicare |
$759.82
|
| Rate for Payer: Humana Medicare |
$759.82
|
| Rate for Payer: Lucent All Commercial |
$1,063.75
|
| Rate for Payer: Lucent All Commercial |
$1,063.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,057.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,057.00
|
| Rate for Payer: Managed Health Services Medicaid |
$737.50
|
| Rate for Payer: Managed Health Services Medicaid |
$737.50
|
| Rate for Payer: MDWise Medicaid |
$737.50
|
| Rate for Payer: MDWise Medicaid |
$737.50
|
| Rate for Payer: PHCS All Commercial |
$759.82
|
| Rate for Payer: PHCS All Commercial |
$759.82
|
| Rate for Payer: PHP All Commercial |
$972.54
|
| Rate for Payer: PHP All Commercial |
$972.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$759.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$759.82
|
| Rate for Payer: Sagamore Health Network All Products |
$759.82
|
| Rate for Payer: Sagamore Health Network All Products |
$759.82
|
| Rate for Payer: Signature Care EPO |
$1,018.47
|
| Rate for Payer: Signature Care EPO |
$1,018.47
|
| Rate for Payer: Signature Care PPO |
$1,018.47
|
| Rate for Payer: Signature Care PPO |
$1,018.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$98,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$98,200.00
|
| Rate for Payer: United Healthcare Commercial |
$1,037.33
|
| Rate for Payer: United Healthcare Commercial |
$1,037.33
|
| Rate for Payer: United Healthcare Medicare |
$736.78
|
| Rate for Payer: United Healthcare Medicare |
$736.78
|
|
|
PR LAPAROSCOPY W TOT HYSTERECTUTERUS <=250 GRAM W TUBE/OVARY
|
Professional
|
Both
|
$1,687.70
|
|
|
Service Code
|
CPT 58571
|
| Hospital Charge Code |
z58571
|
| Min. Negotiated Rate |
$827.75 |
| Max. Negotiated Rate |
$110,300.00 |
| Rate for Payer: Aetna Commercial |
$855.50
|
| Rate for Payer: Aetna Commercial |
$855.50
|
| Rate for Payer: Aetna Medicare |
$855.50
|
| Rate for Payer: Aetna Medicare |
$855.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$830.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$830.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$983.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$983.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$941.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$941.05
|
| Rate for Payer: Cash Price |
$1,012.62
|
| Rate for Payer: Cash Price |
$993.30
|
| Rate for Payer: Centivo All Commercial |
$1,326.03
|
| Rate for Payer: Centivo All Commercial |
$1,326.03
|
| Rate for Payer: Cigna All Commercial |
$855.50
|
| Rate for Payer: Cigna All Commercial |
$855.50
|
| Rate for Payer: CORVEL All Commercial |
$855.50
|
| Rate for Payer: CORVEL All Commercial |
$855.50
|
| Rate for Payer: Coventry All Commercial |
$1,026.60
|
| Rate for Payer: Coventry All Commercial |
$1,026.60
|
| Rate for Payer: Encore All Commercial |
$855.50
|
| Rate for Payer: Encore All Commercial |
$855.50
|
| Rate for Payer: Frontpath All Commercial |
$1,187.33
|
| Rate for Payer: Frontpath All Commercial |
$1,187.33
|
| Rate for Payer: Humana ChoiceCare |
$1,012.83
|
| Rate for Payer: Humana ChoiceCare |
$1,012.83
|
| Rate for Payer: Humana Medicare |
$855.50
|
| Rate for Payer: Humana Medicare |
$855.50
|
| Rate for Payer: Lucent All Commercial |
$1,197.70
|
| Rate for Payer: Lucent All Commercial |
$1,197.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,188.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,188.00
|
| Rate for Payer: Managed Health Services Medicaid |
$830.08
|
| Rate for Payer: Managed Health Services Medicaid |
$830.08
|
| Rate for Payer: MDWise Medicaid |
$830.08
|
| Rate for Payer: MDWise Medicaid |
$830.08
|
| Rate for Payer: PHCS All Commercial |
$855.50
|
| Rate for Payer: PHCS All Commercial |
$855.50
|
| Rate for Payer: PHP All Commercial |
$1,092.63
|
| Rate for Payer: PHP All Commercial |
$1,092.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$855.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$855.50
|
| Rate for Payer: Sagamore Health Network All Products |
$855.50
|
| Rate for Payer: Sagamore Health Network All Products |
$855.50
|
| Rate for Payer: Signature Care EPO |
$1,118.45
|
| Rate for Payer: Signature Care EPO |
$1,118.45
|
| Rate for Payer: Signature Care PPO |
$1,118.45
|
| Rate for Payer: Signature Care PPO |
$1,118.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$110,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$110,300.00
|
| Rate for Payer: United Healthcare Commercial |
$1,140.59
|
| Rate for Payer: United Healthcare Commercial |
$1,140.59
|
| Rate for Payer: United Healthcare Medicare |
$827.75
|
| Rate for Payer: United Healthcare Medicare |
$827.75
|
|
|
PR LAP,CHOLECYSTECTOMY
|
Professional
|
Both
|
$1,178.08
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
z47562
|
| Min. Negotiated Rate |
$589.04 |
| Max. Negotiated Rate |
$84,500.00 |
| Rate for Payer: Aetna Commercial |
$612.38
|
| Rate for Payer: Aetna Commercial |
$612.38
|
| Rate for Payer: Aetna Medicare |
$612.38
|
| Rate for Payer: Aetna Medicare |
$612.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$892.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$892.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$892.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$892.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$892.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$892.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$892.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$892.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$590.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$590.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.62
|
| Rate for Payer: Cash Price |
$706.85
|
| Rate for Payer: Cash Price |
$720.18
|
| Rate for Payer: Centivo All Commercial |
$949.19
|
| Rate for Payer: Centivo All Commercial |
$949.19
|
| Rate for Payer: Cigna All Commercial |
$612.38
|
| Rate for Payer: Cigna All Commercial |
$612.38
|
| Rate for Payer: CORVEL All Commercial |
$612.38
|
| Rate for Payer: CORVEL All Commercial |
$612.38
|
| Rate for Payer: Coventry All Commercial |
$734.86
|
| Rate for Payer: Coventry All Commercial |
$734.86
|
| Rate for Payer: Encore All Commercial |
$612.38
|
| Rate for Payer: Encore All Commercial |
$612.38
|
| Rate for Payer: Frontpath All Commercial |
$873.86
|
| Rate for Payer: Frontpath All Commercial |
$873.86
|
| Rate for Payer: Humana ChoiceCare |
$736.13
|
| Rate for Payer: Humana ChoiceCare |
$736.13
|
| Rate for Payer: Humana Medicare |
$612.38
|
| Rate for Payer: Humana Medicare |
$612.38
|
| Rate for Payer: Lucent All Commercial |
$857.33
|
| Rate for Payer: Lucent All Commercial |
$857.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$906.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$906.00
|
| Rate for Payer: Managed Health Services Medicaid |
$590.35
|
| Rate for Payer: Managed Health Services Medicaid |
$590.35
|
| Rate for Payer: MDWise Medicaid |
$590.35
|
| Rate for Payer: MDWise Medicaid |
$590.35
|
| Rate for Payer: PHCS All Commercial |
$612.38
|
| Rate for Payer: PHCS All Commercial |
$612.38
|
| Rate for Payer: PHP All Commercial |
$1,030.83
|
| Rate for Payer: PHP All Commercial |
$1,030.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$612.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$612.38
|
| Rate for Payer: Sagamore Health Network All Products |
$612.38
|
| Rate for Payer: Sagamore Health Network All Products |
$612.38
|
| Rate for Payer: Signature Care EPO |
$931.60
|
| Rate for Payer: Signature Care EPO |
$931.60
|
| Rate for Payer: Signature Care PPO |
$931.60
|
| Rate for Payer: Signature Care PPO |
$931.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$84,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$84,500.00
|
| Rate for Payer: United Healthcare Commercial |
$783.93
|
| Rate for Payer: United Healthcare Commercial |
$783.93
|
| Rate for Payer: United Healthcare Medicare |
$589.04
|
| Rate for Payer: United Healthcare Medicare |
$589.04
|
|
|
PR LAP,CHOLECYSTECTOMY/EXPLORE
|
Professional
|
Both
|
$2,026.32
|
|
|
Service Code
|
CPT 47564
|
| Hospital Charge Code |
z47564
|
| Min. Negotiated Rate |
$926.74 |
| Max. Negotiated Rate |
$142,900.00 |
| Rate for Payer: Aetna Commercial |
$1,034.32
|
| Rate for Payer: Aetna Commercial |
$1,034.32
|
| Rate for Payer: Aetna Medicare |
$1,034.32
|
| Rate for Payer: Aetna Medicare |
$1,034.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,139.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,139.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,139.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,139.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,139.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,139.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,139.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,139.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$996.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$996.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,189.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,189.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,137.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,137.75
|
| Rate for Payer: Cash Price |
$1,215.79
|
| Rate for Payer: Cash Price |
$1,194.96
|
| Rate for Payer: Centivo All Commercial |
$1,603.20
|
| Rate for Payer: Centivo All Commercial |
$1,603.20
|
| Rate for Payer: Cigna All Commercial |
$1,034.32
|
| Rate for Payer: Cigna All Commercial |
$1,034.32
|
| Rate for Payer: CORVEL All Commercial |
$1,034.32
|
| Rate for Payer: CORVEL All Commercial |
$1,034.32
|
| Rate for Payer: Coventry All Commercial |
$1,241.18
|
| Rate for Payer: Coventry All Commercial |
$1,241.18
|
| Rate for Payer: Encore All Commercial |
$1,034.32
|
| Rate for Payer: Encore All Commercial |
$1,034.32
|
| Rate for Payer: Frontpath All Commercial |
$1,476.92
|
| Rate for Payer: Frontpath All Commercial |
$1,476.92
|
| Rate for Payer: Humana ChoiceCare |
$926.74
|
| Rate for Payer: Humana ChoiceCare |
$926.74
|
| Rate for Payer: Humana Medicare |
$1,034.32
|
| Rate for Payer: Humana Medicare |
$1,034.32
|
| Rate for Payer: Lucent All Commercial |
$1,448.05
|
| Rate for Payer: Lucent All Commercial |
$1,448.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,531.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,531.00
|
| Rate for Payer: Managed Health Services Medicaid |
$996.62
|
| Rate for Payer: Managed Health Services Medicaid |
$996.62
|
| Rate for Payer: MDWise Medicaid |
$996.62
|
| Rate for Payer: MDWise Medicaid |
$996.62
|
| Rate for Payer: PHCS All Commercial |
$1,034.32
|
| Rate for Payer: PHCS All Commercial |
$1,034.32
|
| Rate for Payer: PHP All Commercial |
$1,742.66
|
| Rate for Payer: PHP All Commercial |
$1,742.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,034.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,034.32
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.32
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.32
|
| Rate for Payer: Signature Care EPO |
$1,172.15
|
| Rate for Payer: Signature Care EPO |
$1,172.15
|
| Rate for Payer: Signature Care PPO |
$1,172.15
|
| Rate for Payer: Signature Care PPO |
$1,172.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$142,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$142,900.00
|
| Rate for Payer: United Healthcare Commercial |
$928.40
|
| Rate for Payer: United Healthcare Commercial |
$928.40
|
| Rate for Payer: United Healthcare Medicare |
$995.80
|
| Rate for Payer: United Healthcare Medicare |
$995.80
|
|
|
PR LAP,CHOLECYSTECTOMY/GRAPH
|
Professional
|
Both
|
$1,304.40
|
|
|
Service Code
|
CPT 47563
|
| Hospital Charge Code |
z47563
|
| Min. Negotiated Rate |
$641.56 |
| Max. Negotiated Rate |
$92,100.00 |
| Rate for Payer: Aetna Commercial |
$666.42
|
| Rate for Payer: Aetna Commercial |
$666.42
|
| Rate for Payer: Aetna Medicare |
$666.42
|
| Rate for Payer: Aetna Medicare |
$666.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$965.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$965.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$965.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$965.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$965.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$965.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$965.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$965.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$641.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$641.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$766.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$766.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$733.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$733.06
|
| Rate for Payer: Cash Price |
$782.64
|
| Rate for Payer: Cash Price |
$770.04
|
| Rate for Payer: Centivo All Commercial |
$1,032.95
|
| Rate for Payer: Centivo All Commercial |
$1,032.95
|
| Rate for Payer: Cigna All Commercial |
$666.42
|
| Rate for Payer: Cigna All Commercial |
$666.42
|
| Rate for Payer: CORVEL All Commercial |
$666.42
|
| Rate for Payer: CORVEL All Commercial |
$666.42
|
| Rate for Payer: Coventry All Commercial |
$799.70
|
| Rate for Payer: Coventry All Commercial |
$799.70
|
| Rate for Payer: Encore All Commercial |
$666.42
|
| Rate for Payer: Encore All Commercial |
$666.42
|
| Rate for Payer: Frontpath All Commercial |
$951.20
|
| Rate for Payer: Frontpath All Commercial |
$951.20
|
| Rate for Payer: Humana ChoiceCare |
$790.21
|
| Rate for Payer: Humana ChoiceCare |
$790.21
|
| Rate for Payer: Humana Medicare |
$666.42
|
| Rate for Payer: Humana Medicare |
$666.42
|
| Rate for Payer: Lucent All Commercial |
$932.99
|
| Rate for Payer: Lucent All Commercial |
$932.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$987.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$987.00
|
| Rate for Payer: Managed Health Services Medicaid |
$641.56
|
| Rate for Payer: Managed Health Services Medicaid |
$641.56
|
| Rate for Payer: MDWise Medicaid |
$641.56
|
| Rate for Payer: MDWise Medicaid |
$641.56
|
| Rate for Payer: PHCS All Commercial |
$666.42
|
| Rate for Payer: PHCS All Commercial |
$666.42
|
| Rate for Payer: PHP All Commercial |
$1,122.98
|
| Rate for Payer: PHP All Commercial |
$1,122.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$666.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$666.42
|
| Rate for Payer: Sagamore Health Network All Products |
$666.42
|
| Rate for Payer: Sagamore Health Network All Products |
$666.42
|
| Rate for Payer: Signature Care EPO |
$999.60
|
| Rate for Payer: Signature Care EPO |
$999.60
|
| Rate for Payer: Signature Care PPO |
$999.60
|
| Rate for Payer: Signature Care PPO |
$999.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92,100.00
|
| Rate for Payer: United Healthcare Commercial |
$802.71
|
| Rate for Payer: United Healthcare Commercial |
$802.71
|
| Rate for Payer: United Healthcare Medicare |
$641.70
|
| Rate for Payer: United Healthcare Medicare |
$641.70
|
|
|
PR LAP,DIAGNOSTIC ABDOMEN
|
Professional
|
Both
|
$601.34
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
z49320
|
| Min. Negotiated Rate |
$294.48 |
| Max. Negotiated Rate |
$42,300.00 |
| Rate for Payer: Aetna Commercial |
$304.94
|
| Rate for Payer: Aetna Commercial |
$304.94
|
| Rate for Payer: Aetna Medicare |
$304.94
|
| Rate for Payer: Aetna Medicare |
$304.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$442.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$295.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$295.76
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$350.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$350.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$335.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$335.43
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cash Price |
$353.38
|
| Rate for Payer: Centivo All Commercial |
$472.66
|
| Rate for Payer: Centivo All Commercial |
$472.66
|
| Rate for Payer: Cigna All Commercial |
$304.94
|
| Rate for Payer: Cigna All Commercial |
$304.94
|
| Rate for Payer: CORVEL All Commercial |
$304.94
|
| Rate for Payer: CORVEL All Commercial |
$304.94
|
| Rate for Payer: Coventry All Commercial |
$365.93
|
| Rate for Payer: Coventry All Commercial |
$365.93
|
| Rate for Payer: Encore All Commercial |
$304.94
|
| Rate for Payer: Encore All Commercial |
$304.94
|
| Rate for Payer: Frontpath All Commercial |
$431.85
|
| Rate for Payer: Frontpath All Commercial |
$431.85
|
| Rate for Payer: Humana ChoiceCare |
$352.25
|
| Rate for Payer: Humana ChoiceCare |
$352.25
|
| Rate for Payer: Humana Medicare |
$304.94
|
| Rate for Payer: Humana Medicare |
$304.94
|
| Rate for Payer: Lucent All Commercial |
$426.92
|
| Rate for Payer: Lucent All Commercial |
$426.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$453.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$453.00
|
| Rate for Payer: Managed Health Services Medicaid |
$295.76
|
| Rate for Payer: Managed Health Services Medicaid |
$295.76
|
| Rate for Payer: MDWise Medicaid |
$295.76
|
| Rate for Payer: MDWise Medicaid |
$295.76
|
| Rate for Payer: PHCS All Commercial |
$304.94
|
| Rate for Payer: PHCS All Commercial |
$304.94
|
| Rate for Payer: PHP All Commercial |
$515.34
|
| Rate for Payer: PHP All Commercial |
$515.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$304.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$304.94
|
| Rate for Payer: Sagamore Health Network All Products |
$304.94
|
| Rate for Payer: Sagamore Health Network All Products |
$304.94
|
| Rate for Payer: Signature Care EPO |
$445.40
|
| Rate for Payer: Signature Care EPO |
$445.40
|
| Rate for Payer: Signature Care PPO |
$445.40
|
| Rate for Payer: Signature Care PPO |
$445.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,300.00
|
| Rate for Payer: United Healthcare Commercial |
$352.56
|
| Rate for Payer: United Healthcare Commercial |
$352.56
|
| Rate for Payer: United Healthcare Medicare |
$294.48
|
| Rate for Payer: United Healthcare Medicare |
$294.48
|
|
|
PR LAP,DX SURGICAL ABD W/BIOPSY
|
Professional
|
Both
|
$630.52
|
|
|
Service Code
|
CPT 49321
|
| Hospital Charge Code |
z49321
|
| Min. Negotiated Rate |
$309.23 |
| Max. Negotiated Rate |
$44,400.00 |
| Rate for Payer: Aetna Commercial |
$320.31
|
| Rate for Payer: Aetna Commercial |
$320.31
|
| Rate for Payer: Aetna Medicare |
$320.31
|
| Rate for Payer: Aetna Medicare |
$320.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$471.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$471.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$471.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$471.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$471.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$471.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$471.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$471.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$310.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$310.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$368.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$368.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$352.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$352.34
|
| Rate for Payer: Cash Price |
$378.31
|
| Rate for Payer: Cash Price |
$371.08
|
| Rate for Payer: Centivo All Commercial |
$496.48
|
| Rate for Payer: Centivo All Commercial |
$496.48
|
| Rate for Payer: Cigna All Commercial |
$320.31
|
| Rate for Payer: Cigna All Commercial |
$320.31
|
| Rate for Payer: CORVEL All Commercial |
$320.31
|
| Rate for Payer: CORVEL All Commercial |
$320.31
|
| Rate for Payer: Coventry All Commercial |
$384.37
|
| Rate for Payer: Coventry All Commercial |
$384.37
|
| Rate for Payer: Encore All Commercial |
$320.31
|
| Rate for Payer: Encore All Commercial |
$320.31
|
| Rate for Payer: Frontpath All Commercial |
$452.48
|
| Rate for Payer: Frontpath All Commercial |
$452.48
|
| Rate for Payer: Humana ChoiceCare |
$367.26
|
| Rate for Payer: Humana ChoiceCare |
$367.26
|
| Rate for Payer: Humana Medicare |
$320.31
|
| Rate for Payer: Humana Medicare |
$320.31
|
| Rate for Payer: Lucent All Commercial |
$448.43
|
| Rate for Payer: Lucent All Commercial |
$448.43
|
| 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 |
$310.11
|
| Rate for Payer: Managed Health Services Medicaid |
$310.11
|
| Rate for Payer: MDWise Medicaid |
$310.11
|
| Rate for Payer: MDWise Medicaid |
$310.11
|
| Rate for Payer: PHCS All Commercial |
$320.31
|
| Rate for Payer: PHCS All Commercial |
$320.31
|
| Rate for Payer: PHP All Commercial |
$541.15
|
| Rate for Payer: PHP All Commercial |
$541.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$320.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$320.31
|
| Rate for Payer: Sagamore Health Network All Products |
$320.31
|
| Rate for Payer: Sagamore Health Network All Products |
$320.31
|
| Rate for Payer: Signature Care EPO |
$464.10
|
| Rate for Payer: Signature Care EPO |
$464.10
|
| Rate for Payer: Signature Care PPO |
$464.10
|
| Rate for Payer: Signature Care PPO |
$464.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,400.00
|
| Rate for Payer: United Healthcare Commercial |
$371.16
|
| Rate for Payer: United Healthcare Commercial |
$371.16
|
| Rate for Payer: United Healthcare Medicare |
$309.23
|
| Rate for Payer: United Healthcare Medicare |
$309.23
|
|
|
PR LAP,FULGURATE/EXCISE LESIONS
|
Professional
|
Both
|
$1,322.62
|
|
|
Service Code
|
CPT 58662
|
| Hospital Charge Code |
z58662
|
| Min. Negotiated Rate |
$649.51 |
| Max. Negotiated Rate |
$86,500.00 |
| Rate for Payer: Aetna Commercial |
$670.52
|
| Rate for Payer: Aetna Commercial |
$670.52
|
| Rate for Payer: Aetna Medicare |
$670.52
|
| Rate for Payer: Aetna Medicare |
$670.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$930.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$930.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$930.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$930.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$930.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$930.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$930.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$930.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$650.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$650.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$771.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$771.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$737.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$737.57
|
| Rate for Payer: Cash Price |
$793.57
|
| Rate for Payer: Cash Price |
$779.41
|
| Rate for Payer: Centivo All Commercial |
$1,039.31
|
| Rate for Payer: Centivo All Commercial |
$1,039.31
|
| Rate for Payer: Cigna All Commercial |
$670.52
|
| Rate for Payer: Cigna All Commercial |
$670.52
|
| Rate for Payer: CORVEL All Commercial |
$670.52
|
| Rate for Payer: CORVEL All Commercial |
$670.52
|
| Rate for Payer: Coventry All Commercial |
$804.62
|
| Rate for Payer: Coventry All Commercial |
$804.62
|
| Rate for Payer: Encore All Commercial |
$670.52
|
| Rate for Payer: Encore All Commercial |
$670.52
|
| Rate for Payer: Frontpath All Commercial |
$932.63
|
| Rate for Payer: Frontpath All Commercial |
$932.63
|
| Rate for Payer: Humana ChoiceCare |
$782.53
|
| Rate for Payer: Humana ChoiceCare |
$782.53
|
| Rate for Payer: Humana Medicare |
$670.52
|
| Rate for Payer: Humana Medicare |
$670.52
|
| Rate for Payer: Lucent All Commercial |
$938.73
|
| Rate for Payer: Lucent All Commercial |
$938.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$932.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$932.00
|
| Rate for Payer: Managed Health Services Medicaid |
$650.52
|
| Rate for Payer: Managed Health Services Medicaid |
$650.52
|
| Rate for Payer: MDWise Medicaid |
$650.52
|
| Rate for Payer: MDWise Medicaid |
$650.52
|
| Rate for Payer: PHCS All Commercial |
$670.52
|
| Rate for Payer: PHCS All Commercial |
$670.52
|
| Rate for Payer: PHP All Commercial |
$857.36
|
| Rate for Payer: PHP All Commercial |
$857.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$670.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$670.52
|
| Rate for Payer: Sagamore Health Network All Products |
$670.52
|
| Rate for Payer: Sagamore Health Network All Products |
$670.52
|
| Rate for Payer: Signature Care EPO |
$879.75
|
| Rate for Payer: Signature Care EPO |
$879.75
|
| Rate for Payer: Signature Care PPO |
$879.75
|
| Rate for Payer: Signature Care PPO |
$879.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$86,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$86,500.00
|
| Rate for Payer: United Healthcare Commercial |
$797.19
|
| Rate for Payer: United Healthcare Commercial |
$797.19
|
| Rate for Payer: United Healthcare Medicare |
$649.51
|
| Rate for Payer: United Healthcare Medicare |
$649.51
|
|
|
PR LAP,HERNIA REPAIR PROC,UNLIST
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
CPT 49659
|
| Hospital Charge Code |
z49659
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$624.75 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$0.01
|
| Rate for Payer: Cash Price |
$441.00
|
| Rate for Payer: Cash Price |
$441.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$624.75
|
| Rate for Payer: Signature Care EPO |
$468.56
|
| Rate for Payer: Signature Care PPO |
$468.56
|
|
|
PR LAP,INGUINAL HERNIA REPR,INITIAL
|
Professional
|
Both
|
$1,551.04
|
|
|
Service Code
|
CPT 49650
|
| Hospital Charge Code |
z49650
|
| Min. Negotiated Rate |
$387.76 |
| Max. Negotiated Rate |
$55,600.00 |
| Rate for Payer: Aetna Commercial |
$401.71
|
| Rate for Payer: Aetna Commercial |
$401.71
|
| Rate for Payer: Aetna Commercial |
$401.71
|
| Rate for Payer: Aetna Commercial |
$401.71
|
| Rate for Payer: Aetna Medicare |
$401.71
|
| Rate for Payer: Aetna Medicare |
$401.71
|
| Rate for Payer: Aetna Medicare |
$401.71
|
| Rate for Payer: Aetna Medicare |
$401.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$516.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$516.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$389.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$389.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$389.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$389.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$461.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$461.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$461.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$461.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$441.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$441.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$441.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$441.88
|
| Rate for Payer: Cash Price |
$474.91
|
| Rate for Payer: Cash Price |
$949.82
|
| Rate for Payer: Cash Price |
$930.62
|
| Rate for Payer: Cash Price |
$465.31
|
| Rate for Payer: Centivo All Commercial |
$622.65
|
| Rate for Payer: Centivo All Commercial |
$622.65
|
| Rate for Payer: Centivo All Commercial |
$622.65
|
| Rate for Payer: Centivo All Commercial |
$622.65
|
| Rate for Payer: Cigna All Commercial |
$401.71
|
| Rate for Payer: Cigna All Commercial |
$401.71
|
| Rate for Payer: Cigna All Commercial |
$401.71
|
| Rate for Payer: Cigna All Commercial |
$401.71
|
| Rate for Payer: CORVEL All Commercial |
$401.71
|
| Rate for Payer: CORVEL All Commercial |
$401.71
|
| Rate for Payer: CORVEL All Commercial |
$401.71
|
| Rate for Payer: CORVEL All Commercial |
$401.71
|
| Rate for Payer: Coventry All Commercial |
$482.05
|
| Rate for Payer: Coventry All Commercial |
$482.05
|
| Rate for Payer: Coventry All Commercial |
$482.05
|
| Rate for Payer: Coventry All Commercial |
$482.05
|
| Rate for Payer: Encore All Commercial |
$401.71
|
| Rate for Payer: Encore All Commercial |
$401.71
|
| Rate for Payer: Encore All Commercial |
$401.71
|
| Rate for Payer: Encore All Commercial |
$401.71
|
| Rate for Payer: Frontpath All Commercial |
$569.58
|
| Rate for Payer: Frontpath All Commercial |
$569.58
|
| Rate for Payer: Frontpath All Commercial |
$569.58
|
| Rate for Payer: Frontpath All Commercial |
$569.58
|
| Rate for Payer: Humana ChoiceCare |
$433.89
|
| Rate for Payer: Humana ChoiceCare |
$433.89
|
| Rate for Payer: Humana ChoiceCare |
$433.89
|
| Rate for Payer: Humana ChoiceCare |
$433.89
|
| Rate for Payer: Humana Medicare |
$401.71
|
| Rate for Payer: Humana Medicare |
$401.71
|
| Rate for Payer: Humana Medicare |
$401.71
|
| Rate for Payer: Humana Medicare |
$401.71
|
| Rate for Payer: Lucent All Commercial |
$562.39
|
| Rate for Payer: Lucent All Commercial |
$562.39
|
| Rate for Payer: Lucent All Commercial |
$562.39
|
| Rate for Payer: Lucent All Commercial |
$562.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$596.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$596.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$596.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$596.00
|
| Rate for Payer: Managed Health Services Medicaid |
$389.30
|
| Rate for Payer: Managed Health Services Medicaid |
$389.30
|
| Rate for Payer: Managed Health Services Medicaid |
$389.30
|
| Rate for Payer: Managed Health Services Medicaid |
$389.30
|
| Rate for Payer: MDWise Medicaid |
$389.30
|
| Rate for Payer: MDWise Medicaid |
$389.30
|
| Rate for Payer: MDWise Medicaid |
$389.30
|
| Rate for Payer: MDWise Medicaid |
$389.30
|
| Rate for Payer: PHCS All Commercial |
$401.71
|
| Rate for Payer: PHCS All Commercial |
$401.71
|
| Rate for Payer: PHCS All Commercial |
$401.71
|
| Rate for Payer: PHCS All Commercial |
$401.71
|
| Rate for Payer: PHP All Commercial |
$678.59
|
| Rate for Payer: PHP All Commercial |
$678.59
|
| Rate for Payer: PHP All Commercial |
$678.59
|
| Rate for Payer: PHP All Commercial |
$678.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$401.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$401.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$401.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$401.71
|
| Rate for Payer: Sagamore Health Network All Products |
$401.71
|
| Rate for Payer: Sagamore Health Network All Products |
$401.71
|
| Rate for Payer: Sagamore Health Network All Products |
$401.71
|
| Rate for Payer: Sagamore Health Network All Products |
$401.71
|
| Rate for Payer: Signature Care EPO |
$548.25
|
| Rate for Payer: Signature Care EPO |
$548.25
|
| Rate for Payer: Signature Care EPO |
$548.25
|
| Rate for Payer: Signature Care EPO |
$548.25
|
| Rate for Payer: Signature Care PPO |
$548.25
|
| Rate for Payer: Signature Care PPO |
$548.25
|
| Rate for Payer: Signature Care PPO |
$548.25
|
| Rate for Payer: Signature Care PPO |
$548.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,600.00
|
| Rate for Payer: United Healthcare Commercial |
$448.61
|
| Rate for Payer: United Healthcare Commercial |
$448.61
|
| Rate for Payer: United Healthcare Commercial |
$448.61
|
| Rate for Payer: United Healthcare Commercial |
$448.61
|
| Rate for Payer: United Healthcare Medicare |
$387.76
|
| Rate for Payer: United Healthcare Medicare |
$387.76
|
| Rate for Payer: United Healthcare Medicare |
$387.76
|
| Rate for Payer: United Healthcare Medicare |
$387.76
|
|
|
PR LAP,INGUINAL HERNIA REPR,RECUR
|
Professional
|
Both
|
$1,032.40
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
z49651
|
| Min. Negotiated Rate |
$506.08 |
| Max. Negotiated Rate |
$72,600.00 |
| Rate for Payer: Aetna Commercial |
$524.36
|
| Rate for Payer: Aetna Commercial |
$524.36
|
| Rate for Payer: Aetna Medicare |
$524.36
|
| Rate for Payer: Aetna Medicare |
$524.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$662.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$662.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$662.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$662.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$662.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$662.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$662.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$662.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$507.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$507.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$603.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$603.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$576.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$576.80
|
| Rate for Payer: Cash Price |
$619.44
|
| Rate for Payer: Cash Price |
$607.30
|
| Rate for Payer: Centivo All Commercial |
$812.76
|
| Rate for Payer: Centivo All Commercial |
$812.76
|
| Rate for Payer: Cigna All Commercial |
$524.36
|
| Rate for Payer: Cigna All Commercial |
$524.36
|
| Rate for Payer: CORVEL All Commercial |
$524.36
|
| Rate for Payer: CORVEL All Commercial |
$524.36
|
| Rate for Payer: Coventry All Commercial |
$629.23
|
| Rate for Payer: Coventry All Commercial |
$629.23
|
| Rate for Payer: Encore All Commercial |
$524.36
|
| Rate for Payer: Encore All Commercial |
$524.36
|
| Rate for Payer: Frontpath All Commercial |
$744.30
|
| Rate for Payer: Frontpath All Commercial |
$744.30
|
| Rate for Payer: Humana ChoiceCare |
$562.34
|
| Rate for Payer: Humana ChoiceCare |
$562.34
|
| Rate for Payer: Humana Medicare |
$524.36
|
| Rate for Payer: Humana Medicare |
$524.36
|
| Rate for Payer: Lucent All Commercial |
$734.10
|
| Rate for Payer: Lucent All Commercial |
$734.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$778.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$778.00
|
| Rate for Payer: Managed Health Services Medicaid |
$507.78
|
| Rate for Payer: Managed Health Services Medicaid |
$507.78
|
| Rate for Payer: MDWise Medicaid |
$507.78
|
| Rate for Payer: MDWise Medicaid |
$507.78
|
| Rate for Payer: PHCS All Commercial |
$524.36
|
| Rate for Payer: PHCS All Commercial |
$524.36
|
| Rate for Payer: PHP All Commercial |
$885.65
|
| Rate for Payer: PHP All Commercial |
$885.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$524.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$524.36
|
| Rate for Payer: Sagamore Health Network All Products |
$524.36
|
| Rate for Payer: Sagamore Health Network All Products |
$524.36
|
| Rate for Payer: Signature Care EPO |
$712.30
|
| Rate for Payer: Signature Care EPO |
$712.30
|
| Rate for Payer: Signature Care PPO |
$712.30
|
| Rate for Payer: Signature Care PPO |
$712.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$72,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$72,600.00
|
| Rate for Payer: United Healthcare Commercial |
$580.41
|
| Rate for Payer: United Healthcare Commercial |
$580.41
|
| Rate for Payer: United Healthcare Medicare |
$506.08
|
| Rate for Payer: United Healthcare Medicare |
$506.08
|
|
|
PR LAP INSERTION TUNNELED INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$700.44
|
|
|
Service Code
|
CPT 49324
|
| Hospital Charge Code |
z49324
|
| Min. Negotiated Rate |
$344.50 |
| Max. Negotiated Rate |
$49,500.00 |
| Rate for Payer: Aetna Commercial |
$358.89
|
| Rate for Payer: Aetna Commercial |
$358.89
|
| Rate for Payer: Aetna Medicare |
$358.89
|
| Rate for Payer: Aetna Medicare |
$358.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$528.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$528.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$528.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$528.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$528.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$528.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$528.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$528.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$344.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$344.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$412.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$412.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$394.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$394.78
|
| Rate for Payer: Cash Price |
$420.26
|
| Rate for Payer: Cash Price |
$413.86
|
| Rate for Payer: Centivo All Commercial |
$556.28
|
| Rate for Payer: Centivo All Commercial |
$556.28
|
| Rate for Payer: Cigna All Commercial |
$358.89
|
| Rate for Payer: Cigna All Commercial |
$358.89
|
| Rate for Payer: CORVEL All Commercial |
$358.89
|
| Rate for Payer: CORVEL All Commercial |
$358.89
|
| Rate for Payer: Coventry All Commercial |
$430.67
|
| Rate for Payer: Coventry All Commercial |
$430.67
|
| Rate for Payer: Encore All Commercial |
$358.89
|
| Rate for Payer: Encore All Commercial |
$358.89
|
| Rate for Payer: Frontpath All Commercial |
$512.59
|
| Rate for Payer: Frontpath All Commercial |
$512.59
|
| Rate for Payer: Humana ChoiceCare |
$385.39
|
| Rate for Payer: Humana ChoiceCare |
$385.39
|
| Rate for Payer: Humana Medicare |
$358.89
|
| Rate for Payer: Humana Medicare |
$358.89
|
| Rate for Payer: Lucent All Commercial |
$502.45
|
| Rate for Payer: Lucent All Commercial |
$502.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$530.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$530.00
|
| Rate for Payer: Managed Health Services Medicaid |
$344.50
|
| Rate for Payer: Managed Health Services Medicaid |
$344.50
|
| Rate for Payer: MDWise Medicaid |
$344.50
|
| Rate for Payer: MDWise Medicaid |
$344.50
|
| Rate for Payer: PHCS All Commercial |
$358.89
|
| Rate for Payer: PHCS All Commercial |
$358.89
|
| Rate for Payer: PHP All Commercial |
$603.54
|
| Rate for Payer: PHP All Commercial |
$603.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$358.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$358.89
|
| Rate for Payer: Sagamore Health Network All Products |
$358.89
|
| Rate for Payer: Sagamore Health Network All Products |
$358.89
|
| Rate for Payer: Signature Care EPO |
$484.50
|
| Rate for Payer: Signature Care EPO |
$484.50
|
| Rate for Payer: Signature Care PPO |
$484.50
|
| Rate for Payer: Signature Care PPO |
$484.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$49,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$49,500.00
|
| Rate for Payer: United Healthcare Commercial |
$420.34
|
| Rate for Payer: United Healthcare Commercial |
$420.34
|
| Rate for Payer: United Healthcare Medicare |
$344.88
|
| Rate for Payer: United Healthcare Medicare |
$344.88
|
|
