|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$91.36
|
|
|
Service Code
|
CPT 93291
|
| Hospital Charge Code |
z93291
|
| Min. Negotiated Rate |
$44.74 |
| Max. Negotiated Rate |
$7,000.00 |
| Rate for Payer: Aetna Commercial |
$48.32
|
| Rate for Payer: Aetna Commercial |
$48.32
|
| Rate for Payer: Aetna Medicare |
$48.32
|
| Rate for Payer: Aetna Medicare |
$48.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$57.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$57.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$57.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$57.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$57.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$57.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$44.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$44.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$55.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$55.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.15
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cash Price |
$56.64
|
| Rate for Payer: Centivo All Commercial |
$74.90
|
| Rate for Payer: Centivo All Commercial |
$74.90
|
| Rate for Payer: Cigna All Commercial |
$48.32
|
| Rate for Payer: Cigna All Commercial |
$48.32
|
| Rate for Payer: CORVEL All Commercial |
$48.32
|
| Rate for Payer: CORVEL All Commercial |
$48.32
|
| Rate for Payer: Coventry All Commercial |
$57.98
|
| Rate for Payer: Coventry All Commercial |
$57.98
|
| Rate for Payer: Encore All Commercial |
$48.32
|
| Rate for Payer: Encore All Commercial |
$48.32
|
| Rate for Payer: Frontpath All Commercial |
$54.19
|
| Rate for Payer: Frontpath All Commercial |
$54.19
|
| Rate for Payer: Humana ChoiceCare |
$52.69
|
| Rate for Payer: Humana ChoiceCare |
$52.69
|
| Rate for Payer: Humana Medicare |
$48.32
|
| Rate for Payer: Humana Medicare |
$48.32
|
| Rate for Payer: Lucent All Commercial |
$67.65
|
| Rate for Payer: Lucent All Commercial |
$67.65
|
| 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 |
$44.74
|
| Rate for Payer: Managed Health Services Medicaid |
$44.74
|
| Rate for Payer: MDWise Medicaid |
$44.74
|
| Rate for Payer: MDWise Medicaid |
$44.74
|
| Rate for Payer: PHCS All Commercial |
$48.32
|
| Rate for Payer: PHCS All Commercial |
$48.32
|
| Rate for Payer: PHP All Commercial |
$67.14
|
| Rate for Payer: PHP All Commercial |
$67.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$48.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$48.32
|
| Rate for Payer: Sagamore Health Network All Products |
$48.32
|
| Rate for Payer: Sagamore Health Network All Products |
$48.32
|
| Rate for Payer: Signature Care EPO |
$58.24
|
| Rate for Payer: Signature Care EPO |
$58.24
|
| Rate for Payer: Signature Care PPO |
$58.24
|
| Rate for Payer: Signature Care PPO |
$58.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,000.00
|
| Rate for Payer: United Healthcare Commercial |
$48.46
|
| Rate for Payer: United Healthcare Commercial |
$48.46
|
|
|
PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB
|
Professional
|
Both
|
$134.70
|
|
|
Service Code
|
CPT 93289
|
| Hospital Charge Code |
z93289
|
| Min. Negotiated Rate |
$66.25 |
| Max. Negotiated Rate |
$10,300.00 |
| Rate for Payer: Aetna Commercial |
$70.67
|
| Rate for Payer: Aetna Commercial |
$70.67
|
| Rate for Payer: Aetna Medicare |
$70.67
|
| Rate for Payer: Aetna Medicare |
$70.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$93.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$93.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$93.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$93.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$93.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$93.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$66.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$66.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$81.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$81.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$77.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$77.74
|
| Rate for Payer: Cash Price |
$83.25
|
| Rate for Payer: Cash Price |
$83.51
|
| Rate for Payer: Centivo All Commercial |
$109.54
|
| Rate for Payer: Centivo All Commercial |
$109.54
|
| Rate for Payer: Cigna All Commercial |
$70.67
|
| Rate for Payer: Cigna All Commercial |
$70.67
|
| Rate for Payer: CORVEL All Commercial |
$70.67
|
| Rate for Payer: CORVEL All Commercial |
$70.67
|
| Rate for Payer: Coventry All Commercial |
$84.80
|
| Rate for Payer: Coventry All Commercial |
$84.80
|
| Rate for Payer: Encore All Commercial |
$70.67
|
| Rate for Payer: Encore All Commercial |
$70.67
|
| Rate for Payer: Frontpath All Commercial |
$79.64
|
| Rate for Payer: Frontpath All Commercial |
$79.64
|
| Rate for Payer: Humana ChoiceCare |
$85.14
|
| Rate for Payer: Humana ChoiceCare |
$85.14
|
| Rate for Payer: Humana Medicare |
$70.67
|
| Rate for Payer: Humana Medicare |
$70.67
|
| Rate for Payer: Lucent All Commercial |
$98.94
|
| Rate for Payer: Lucent All Commercial |
$98.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$110.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$110.00
|
| Rate for Payer: Managed Health Services Medicaid |
$66.25
|
| Rate for Payer: Managed Health Services Medicaid |
$66.25
|
| Rate for Payer: MDWise Medicaid |
$66.25
|
| Rate for Payer: MDWise Medicaid |
$66.25
|
| Rate for Payer: PHCS All Commercial |
$70.67
|
| Rate for Payer: PHCS All Commercial |
$70.67
|
| Rate for Payer: PHP All Commercial |
$98.70
|
| Rate for Payer: PHP All Commercial |
$98.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$70.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$70.67
|
| Rate for Payer: Sagamore Health Network All Products |
$70.67
|
| Rate for Payer: Sagamore Health Network All Products |
$70.67
|
| Rate for Payer: Signature Care EPO |
$95.85
|
| Rate for Payer: Signature Care EPO |
$95.85
|
| Rate for Payer: Signature Care PPO |
$95.85
|
| Rate for Payer: Signature Care PPO |
$95.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,300.00
|
| Rate for Payer: United Healthcare Commercial |
$78.31
|
| Rate for Payer: United Healthcare Commercial |
$78.31
|
|
|
PR INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS
|
Professional
|
Both
|
$14.50
|
|
|
Service Code
|
CPT 95024
|
| Hospital Charge Code |
z95024
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$0.82
|
| Rate for Payer: Aetna Commercial |
$0.82
|
| Rate for Payer: Aetna Medicare |
$0.82
|
| Rate for Payer: Aetna Medicare |
$0.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$5.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$5.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5.74
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$0.86
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$0.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$7.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$7.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$0.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$0.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$0.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$0.90
|
| Rate for Payer: Cash Price |
$8.82
|
| Rate for Payer: Cash Price |
$8.99
|
| Rate for Payer: Centivo All Commercial |
$1.27
|
| Rate for Payer: Centivo All Commercial |
$1.27
|
| Rate for Payer: Cigna All Commercial |
$0.82
|
| Rate for Payer: Cigna All Commercial |
$0.82
|
| Rate for Payer: CORVEL All Commercial |
$0.82
|
| Rate for Payer: CORVEL All Commercial |
$0.82
|
| Rate for Payer: Coventry All Commercial |
$0.98
|
| Rate for Payer: Coventry All Commercial |
$0.98
|
| Rate for Payer: Encore All Commercial |
$0.82
|
| Rate for Payer: Encore All Commercial |
$0.82
|
| Rate for Payer: Frontpath All Commercial |
$1.08
|
| Rate for Payer: Frontpath All Commercial |
$1.08
|
| Rate for Payer: Humana ChoiceCare |
$7.04
|
| Rate for Payer: Humana ChoiceCare |
$7.04
|
| Rate for Payer: Humana Medicare |
$0.82
|
| Rate for Payer: Humana Medicare |
$0.82
|
| Rate for Payer: Lucent All Commercial |
$1.15
|
| Rate for Payer: Lucent All Commercial |
$1.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1.00
|
| Rate for Payer: Managed Health Services Medicaid |
$7.13
|
| Rate for Payer: Managed Health Services Medicaid |
$7.13
|
| Rate for Payer: MDWise Medicaid |
$7.13
|
| Rate for Payer: MDWise Medicaid |
$7.13
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$0.86
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$0.86
|
| Rate for Payer: PHCS All Commercial |
$0.82
|
| Rate for Payer: PHCS All Commercial |
$0.82
|
| Rate for Payer: PHP All Commercial |
$0.91
|
| Rate for Payer: PHP All Commercial |
$0.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$0.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$0.82
|
| Rate for Payer: Sagamore Health Network All Products |
$0.82
|
| Rate for Payer: Sagamore Health Network All Products |
$0.82
|
| Rate for Payer: Signature Care EPO |
$6.52
|
| Rate for Payer: Signature Care EPO |
$6.52
|
| Rate for Payer: Signature Care PPO |
$6.52
|
| Rate for Payer: Signature Care PPO |
$6.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$100.00
|
| Rate for Payer: United Healthcare Commercial |
$7.76
|
| Rate for Payer: United Healthcare Commercial |
$7.76
|
| Rate for Payer: United Healthcare Medicare |
$7.11
|
| Rate for Payer: United Healthcare Medicare |
$7.11
|
|
|
PR INTRANASAL BIOPSY
|
Professional
|
Both
|
$261.36
|
|
|
Service Code
|
CPT 30100
|
| Hospital Charge Code |
z30100
|
| Min. Negotiated Rate |
$48.53 |
| Max. Negotiated Rate |
$9,500.00 |
| Rate for Payer: Aetna Commercial |
$63.11
|
| Rate for Payer: Aetna Commercial |
$63.11
|
| Rate for Payer: Aetna Medicare |
$63.11
|
| Rate for Payer: Aetna Medicare |
$63.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$91.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$91.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$91.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$91.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$91.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$91.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$91.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$91.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$48.53
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$48.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$128.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$128.55
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$72.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$72.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$69.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$69.42
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cash Price |
$162.04
|
| Rate for Payer: Centivo All Commercial |
$97.82
|
| Rate for Payer: Centivo All Commercial |
$97.82
|
| Rate for Payer: Cigna All Commercial |
$63.11
|
| Rate for Payer: Cigna All Commercial |
$63.11
|
| Rate for Payer: CORVEL All Commercial |
$63.11
|
| Rate for Payer: CORVEL All Commercial |
$63.11
|
| Rate for Payer: Coventry All Commercial |
$75.73
|
| Rate for Payer: Coventry All Commercial |
$75.73
|
| Rate for Payer: Encore All Commercial |
$63.11
|
| Rate for Payer: Encore All Commercial |
$63.11
|
| Rate for Payer: Frontpath All Commercial |
$85.98
|
| Rate for Payer: Frontpath All Commercial |
$85.98
|
| Rate for Payer: Humana ChoiceCare |
$78.90
|
| Rate for Payer: Humana ChoiceCare |
$78.90
|
| Rate for Payer: Humana Medicare |
$63.11
|
| Rate for Payer: Humana Medicare |
$63.11
|
| Rate for Payer: Lucent All Commercial |
$88.35
|
| Rate for Payer: Lucent All Commercial |
$88.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$101.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$101.00
|
| Rate for Payer: Managed Health Services Medicaid |
$128.55
|
| Rate for Payer: Managed Health Services Medicaid |
$128.55
|
| Rate for Payer: MDWise Medicaid |
$128.55
|
| Rate for Payer: MDWise Medicaid |
$128.55
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$48.53
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$48.53
|
| Rate for Payer: PHCS All Commercial |
$63.11
|
| Rate for Payer: PHCS All Commercial |
$63.11
|
| Rate for Payer: PHP All Commercial |
$86.63
|
| Rate for Payer: PHP All Commercial |
$86.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$63.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$63.11
|
| Rate for Payer: Sagamore Health Network All Products |
$63.11
|
| Rate for Payer: Sagamore Health Network All Products |
$63.11
|
| Rate for Payer: Signature Care EPO |
$153.85
|
| Rate for Payer: Signature Care EPO |
$153.85
|
| Rate for Payer: Signature Care PPO |
$153.85
|
| Rate for Payer: Signature Care PPO |
$153.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,500.00
|
| Rate for Payer: United Healthcare Commercial |
$76.55
|
| Rate for Payer: United Healthcare Commercial |
$76.55
|
| Rate for Payer: United Healthcare Medicare |
$129.64
|
| Rate for Payer: United Healthcare Medicare |
$129.64
|
|
|
PR INTRAOPERATIVE SENTINEL LYMPH NODE ID W DYE INJECTION
|
Professional
|
Both
|
$246.88
|
|
|
Service Code
|
CPT 38900
|
| Hospital Charge Code |
z38900
|
| Min. Negotiated Rate |
$121.28 |
| Max. Negotiated Rate |
$18,600.00 |
| Rate for Payer: Aetna Commercial |
$126.69
|
| Rate for Payer: Aetna Commercial |
$126.69
|
| Rate for Payer: Aetna Medicare |
$126.69
|
| Rate for Payer: Aetna Medicare |
$126.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$165.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$165.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$165.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$165.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$165.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$165.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$165.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$165.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$121.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$121.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$145.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$145.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$139.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$139.36
|
| Rate for Payer: Cash Price |
$153.07
|
| Rate for Payer: Cash Price |
$150.39
|
| Rate for Payer: Centivo All Commercial |
$196.37
|
| Rate for Payer: Centivo All Commercial |
$196.37
|
| Rate for Payer: Cigna All Commercial |
$126.69
|
| Rate for Payer: Cigna All Commercial |
$126.69
|
| Rate for Payer: CORVEL All Commercial |
$126.69
|
| Rate for Payer: CORVEL All Commercial |
$126.69
|
| Rate for Payer: Coventry All Commercial |
$152.03
|
| Rate for Payer: Coventry All Commercial |
$152.03
|
| Rate for Payer: Encore All Commercial |
$126.69
|
| Rate for Payer: Encore All Commercial |
$126.69
|
| Rate for Payer: Frontpath All Commercial |
$182.25
|
| Rate for Payer: Frontpath All Commercial |
$182.25
|
| Rate for Payer: Humana ChoiceCare |
$167.88
|
| Rate for Payer: Humana ChoiceCare |
$167.88
|
| Rate for Payer: Humana Medicare |
$126.69
|
| Rate for Payer: Humana Medicare |
$126.69
|
| Rate for Payer: Lucent All Commercial |
$177.37
|
| Rate for Payer: Lucent All Commercial |
$177.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$199.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$199.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.42
|
| Rate for Payer: Managed Health Services Medicaid |
$121.42
|
| Rate for Payer: MDWise Medicaid |
$121.42
|
| Rate for Payer: MDWise Medicaid |
$121.42
|
| Rate for Payer: PHCS All Commercial |
$126.69
|
| Rate for Payer: PHCS All Commercial |
$126.69
|
| Rate for Payer: PHP All Commercial |
$169.79
|
| Rate for Payer: PHP All Commercial |
$169.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$126.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$126.69
|
| Rate for Payer: Sagamore Health Network All Products |
$126.69
|
| Rate for Payer: Sagamore Health Network All Products |
$126.69
|
| Rate for Payer: Signature Care EPO |
$142.15
|
| Rate for Payer: Signature Care EPO |
$142.15
|
| Rate for Payer: Signature Care PPO |
$142.15
|
| Rate for Payer: Signature Care PPO |
$142.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,600.00
|
| Rate for Payer: United Healthcare Commercial |
$168.83
|
| Rate for Payer: United Healthcare Commercial |
$168.83
|
| Rate for Payer: United Healthcare Medicare |
$121.28
|
| Rate for Payer: United Healthcare Medicare |
$121.28
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES
|
Professional
|
Both
|
$348.88
|
|
|
Service Code
|
CPT 99255
|
| Hospital Charge Code |
z99255
|
| Min. Negotiated Rate |
$174.44 |
| Max. Negotiated Rate |
$18,400.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$208.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$208.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$208.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$208.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$208.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$208.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$208.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$208.20
|
| Rate for Payer: Cash Price |
$218.74
|
| Rate for Payer: Cash Price |
$216.31
|
| Rate for Payer: Frontpath All Commercial |
$198.27
|
| Rate for Payer: Frontpath All Commercial |
$198.27
|
| Rate for Payer: Humana ChoiceCare |
$222.38
|
| Rate for Payer: Humana ChoiceCare |
$222.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$188.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$188.00
|
| Rate for Payer: PHP All Commercial |
$179.67
|
| Rate for Payer: PHP All Commercial |
$179.67
|
| Rate for Payer: Signature Care EPO |
$204.85
|
| Rate for Payer: Signature Care EPO |
$204.85
|
| Rate for Payer: Signature Care PPO |
$204.85
|
| Rate for Payer: Signature Care PPO |
$204.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,400.00
|
| Rate for Payer: United Healthcare Commercial |
$204.93
|
| Rate for Payer: United Healthcare Commercial |
$204.93
|
| Rate for Payer: United Healthcare Medicare |
$174.44
|
| Rate for Payer: United Healthcare Medicare |
$174.44
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES
|
Professional
|
Both
|
$186.62
|
|
|
Service Code
|
CPT 99253
|
| Hospital Charge Code |
z99253
|
| Min. Negotiated Rate |
$93.31 |
| Max. Negotiated Rate |
$9,900.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$116.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$116.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$116.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$116.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$116.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$116.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$116.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$116.27
|
| Rate for Payer: Cash Price |
$116.92
|
| Rate for Payer: Cash Price |
$115.70
|
| Rate for Payer: Frontpath All Commercial |
$113.73
|
| Rate for Payer: Frontpath All Commercial |
$113.73
|
| Rate for Payer: Humana ChoiceCare |
$111.79
|
| Rate for Payer: Humana ChoiceCare |
$111.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$100.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$100.00
|
| Rate for Payer: PHP All Commercial |
$96.10
|
| Rate for Payer: PHP All Commercial |
$96.10
|
| Rate for Payer: Signature Care EPO |
$102.85
|
| Rate for Payer: Signature Care EPO |
$102.85
|
| Rate for Payer: Signature Care PPO |
$102.85
|
| Rate for Payer: Signature Care PPO |
$102.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,900.00
|
| Rate for Payer: United Healthcare Commercial |
$116.27
|
| Rate for Payer: United Healthcare Commercial |
$116.27
|
| Rate for Payer: United Healthcare Medicare |
$93.31
|
| Rate for Payer: United Healthcare Medicare |
$93.31
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$259.28
|
|
|
Service Code
|
CPT 99254
|
| Hospital Charge Code |
z99254
|
| Min. Negotiated Rate |
$129.64 |
| Max. Negotiated Rate |
$13,700.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$168.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$168.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$168.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$168.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$168.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$168.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.22
|
| Rate for Payer: Cash Price |
$162.29
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Frontpath All Commercial |
$163.72
|
| Rate for Payer: Frontpath All Commercial |
$163.72
|
| Rate for Payer: Humana ChoiceCare |
$161.32
|
| Rate for Payer: Humana ChoiceCare |
$161.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$140.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$140.00
|
| Rate for Payer: PHP All Commercial |
$133.53
|
| Rate for Payer: PHP All Commercial |
$133.53
|
| Rate for Payer: Signature Care EPO |
$148.75
|
| Rate for Payer: Signature Care EPO |
$148.75
|
| Rate for Payer: Signature Care PPO |
$148.75
|
| Rate for Payer: Signature Care PPO |
$148.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,700.00
|
| Rate for Payer: United Healthcare Commercial |
$168.22
|
| Rate for Payer: United Healthcare Commercial |
$168.22
|
| Rate for Payer: United Healthcare Medicare |
$129.64
|
| Rate for Payer: United Healthcare Medicare |
$129.64
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES
|
Professional
|
Both
|
$133.64
|
|
|
Service Code
|
CPT 99252
|
| Hospital Charge Code |
z99252
|
| Min. Negotiated Rate |
$66.82 |
| Max. Negotiated Rate |
$7,100.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$85.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$85.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$85.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$85.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$85.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$85.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$85.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$85.00
|
| Rate for Payer: Cash Price |
$83.50
|
| Rate for Payer: Cash Price |
$82.86
|
| Rate for Payer: Frontpath All Commercial |
$73.19
|
| Rate for Payer: Frontpath All Commercial |
$73.19
|
| Rate for Payer: Humana ChoiceCare |
$81.56
|
| Rate for Payer: Humana ChoiceCare |
$81.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$72.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$72.00
|
| Rate for Payer: PHP All Commercial |
$68.83
|
| Rate for Payer: PHP All Commercial |
$68.83
|
| Rate for Payer: Signature Care EPO |
$75.65
|
| Rate for Payer: Signature Care EPO |
$75.65
|
| Rate for Payer: Signature Care PPO |
$75.65
|
| Rate for Payer: Signature Care PPO |
$75.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,100.00
|
| Rate for Payer: United Healthcare Commercial |
$76.58
|
| Rate for Payer: United Healthcare Commercial |
$76.58
|
| Rate for Payer: United Healthcare Medicare |
$66.82
|
| Rate for Payer: United Healthcare Medicare |
$66.82
|
|
|
PR IRRIGATION MAXILLARY SINUS
|
Professional
|
Both
|
$345.64
|
|
|
Service Code
|
CPT 31000
|
| Hospital Charge Code |
z31000
|
| Min. Negotiated Rate |
$55.89 |
| Max. Negotiated Rate |
$15,500.00 |
| Rate for Payer: Aetna Commercial |
$102.04
|
| Rate for Payer: Aetna Commercial |
$102.04
|
| Rate for Payer: Aetna Medicare |
$102.04
|
| Rate for Payer: Aetna Medicare |
$102.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$115.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$115.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$115.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$115.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$115.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$115.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$115.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$115.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$55.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$55.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$170.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$170.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$117.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$117.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$112.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$112.24
|
| Rate for Payer: Cash Price |
$210.68
|
| Rate for Payer: Cash Price |
$214.30
|
| Rate for Payer: Centivo All Commercial |
$158.16
|
| Rate for Payer: Centivo All Commercial |
$158.16
|
| Rate for Payer: Cigna All Commercial |
$102.04
|
| Rate for Payer: Cigna All Commercial |
$102.04
|
| Rate for Payer: CORVEL All Commercial |
$102.04
|
| Rate for Payer: CORVEL All Commercial |
$102.04
|
| Rate for Payer: Coventry All Commercial |
$122.45
|
| Rate for Payer: Coventry All Commercial |
$122.45
|
| Rate for Payer: Encore All Commercial |
$102.04
|
| Rate for Payer: Encore All Commercial |
$102.04
|
| Rate for Payer: Frontpath All Commercial |
$138.83
|
| Rate for Payer: Frontpath All Commercial |
$138.83
|
| Rate for Payer: Humana ChoiceCare |
$113.17
|
| Rate for Payer: Humana ChoiceCare |
$113.17
|
| Rate for Payer: Humana Medicare |
$102.04
|
| Rate for Payer: Humana Medicare |
$102.04
|
| Rate for Payer: Lucent All Commercial |
$142.86
|
| Rate for Payer: Lucent All Commercial |
$142.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$166.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$166.00
|
| Rate for Payer: Managed Health Services Medicaid |
$170.00
|
| Rate for Payer: Managed Health Services Medicaid |
$170.00
|
| Rate for Payer: MDWise Medicaid |
$170.00
|
| Rate for Payer: MDWise Medicaid |
$170.00
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$55.89
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$55.89
|
| Rate for Payer: PHCS All Commercial |
$102.04
|
| Rate for Payer: PHCS All Commercial |
$102.04
|
| Rate for Payer: PHP All Commercial |
$141.30
|
| Rate for Payer: PHP All Commercial |
$141.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.04
|
| Rate for Payer: Sagamore Health Network All Products |
$102.04
|
| Rate for Payer: Sagamore Health Network All Products |
$102.04
|
| Rate for Payer: Signature Care EPO |
$208.25
|
| Rate for Payer: Signature Care EPO |
$208.25
|
| Rate for Payer: Signature Care PPO |
$208.25
|
| Rate for Payer: Signature Care PPO |
$208.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,500.00
|
| Rate for Payer: United Healthcare Commercial |
$111.46
|
| Rate for Payer: United Healthcare Commercial |
$111.46
|
| Rate for Payer: United Healthcare Medicare |
$169.90
|
| Rate for Payer: United Healthcare Medicare |
$169.90
|
|
|
PR KNEE ARTHROSCOPY/SURGERY MED AND LAT
|
Professional
|
Both
|
$1,046.18
|
|
|
Service Code
|
CPT 29880
|
| Hospital Charge Code |
z29880
|
| Min. Negotiated Rate |
$511.65 |
| Max. Negotiated Rate |
$78,700.00 |
| 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 |
$860.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$860.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$860.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$860.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$860.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$860.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$860.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$860.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$514.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$514.55
|
| 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 |
$648.63
|
| Rate for Payer: Cash Price |
$634.45
|
| 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 |
$728.14
|
| Rate for Payer: Frontpath All Commercial |
$728.14
|
| Rate for Payer: Humana ChoiceCare |
$690.54
|
| Rate for Payer: Humana ChoiceCare |
$690.54
|
| 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 |
$839.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$839.00
|
| Rate for Payer: Managed Health Services Medicaid |
$514.55
|
| Rate for Payer: Managed Health Services Medicaid |
$514.55
|
| Rate for Payer: MDWise Medicaid |
$514.55
|
| Rate for Payer: MDWise Medicaid |
$514.55
|
| Rate for Payer: PHCS All Commercial |
$524.36
|
| Rate for Payer: PHCS All Commercial |
$524.36
|
| Rate for Payer: PHP All Commercial |
$890.27
|
| Rate for Payer: PHP All Commercial |
$890.27
|
| 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 |
$891.41
|
| Rate for Payer: Signature Care EPO |
$891.41
|
| Rate for Payer: Signature Care PPO |
$891.41
|
| Rate for Payer: Signature Care PPO |
$891.41
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$78,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$78,700.00
|
| Rate for Payer: United Healthcare Commercial |
$741.23
|
| Rate for Payer: United Healthcare Commercial |
$741.23
|
| Rate for Payer: United Healthcare Medicare |
$511.65
|
| Rate for Payer: United Healthcare Medicare |
$511.65
|
|
|
PR KNEE ARTHROSCOPY/SURGERY MED OR LAT
|
Professional
|
Both
|
$985.82
|
|
|
Service Code
|
CPT 29881
|
| Hospital Charge Code |
z29881
|
| Min. Negotiated Rate |
$492.91 |
| Max. Negotiated Rate |
$75,800.00 |
| Rate for Payer: Aetna Commercial |
$505.17
|
| Rate for Payer: Aetna Commercial |
$505.17
|
| Rate for Payer: Aetna Medicare |
$505.17
|
| Rate for Payer: Aetna Medicare |
$505.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$791.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$791.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$791.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$791.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$791.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$791.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$791.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$791.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$496.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$496.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$580.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$580.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$555.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$555.69
|
| Rate for Payer: Cash Price |
$611.21
|
| Rate for Payer: Cash Price |
$625.32
|
| Rate for Payer: Centivo All Commercial |
$783.01
|
| Rate for Payer: Centivo All Commercial |
$783.01
|
| Rate for Payer: Cigna All Commercial |
$505.17
|
| Rate for Payer: Cigna All Commercial |
$505.17
|
| Rate for Payer: CORVEL All Commercial |
$505.17
|
| Rate for Payer: CORVEL All Commercial |
$505.17
|
| Rate for Payer: Coventry All Commercial |
$606.20
|
| Rate for Payer: Coventry All Commercial |
$606.20
|
| Rate for Payer: Encore All Commercial |
$505.17
|
| Rate for Payer: Encore All Commercial |
$505.17
|
| Rate for Payer: Frontpath All Commercial |
$701.12
|
| Rate for Payer: Frontpath All Commercial |
$701.12
|
| Rate for Payer: Humana ChoiceCare |
$639.95
|
| Rate for Payer: Humana ChoiceCare |
$639.95
|
| Rate for Payer: Humana Medicare |
$505.17
|
| Rate for Payer: Humana Medicare |
$505.17
|
| Rate for Payer: Lucent All Commercial |
$707.24
|
| Rate for Payer: Lucent All Commercial |
$707.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$808.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$808.00
|
| Rate for Payer: Managed Health Services Medicaid |
$496.06
|
| Rate for Payer: Managed Health Services Medicaid |
$496.06
|
| Rate for Payer: MDWise Medicaid |
$496.06
|
| Rate for Payer: MDWise Medicaid |
$496.06
|
| Rate for Payer: PHCS All Commercial |
$505.17
|
| Rate for Payer: PHCS All Commercial |
$505.17
|
| Rate for Payer: PHP All Commercial |
$857.67
|
| Rate for Payer: PHP All Commercial |
$857.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$505.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$505.17
|
| Rate for Payer: Sagamore Health Network All Products |
$505.17
|
| Rate for Payer: Sagamore Health Network All Products |
$505.17
|
| Rate for Payer: Signature Care EPO |
$850.00
|
| Rate for Payer: Signature Care EPO |
$850.00
|
| Rate for Payer: Signature Care PPO |
$850.00
|
| Rate for Payer: Signature Care PPO |
$850.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$75,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$75,800.00
|
| Rate for Payer: United Healthcare Commercial |
$690.29
|
| Rate for Payer: United Healthcare Commercial |
$690.29
|
| Rate for Payer: United Healthcare Medicare |
$492.91
|
| Rate for Payer: United Healthcare Medicare |
$492.91
|
|
|
PR KNEE SCOPE,ABRASN ARTHROPLASTY
|
Professional
|
Both
|
$1,229.04
|
|
|
Service Code
|
CPT 29879
|
| Hospital Charge Code |
z29879
|
| Min. Negotiated Rate |
$600.90 |
| Max. Negotiated Rate |
$92,400.00 |
| Rate for Payer: Aetna Commercial |
$616.35
|
| Rate for Payer: Aetna Commercial |
$616.35
|
| Rate for Payer: Aetna Medicare |
$616.35
|
| Rate for Payer: Aetna Medicare |
$616.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$817.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$817.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$817.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$817.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$817.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$817.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$817.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$817.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$604.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$604.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$708.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$708.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$677.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$677.99
|
| Rate for Payer: Cash Price |
$762.00
|
| Rate for Payer: Cash Price |
$745.12
|
| Rate for Payer: Centivo All Commercial |
$955.34
|
| Rate for Payer: Centivo All Commercial |
$955.34
|
| Rate for Payer: Cigna All Commercial |
$616.35
|
| Rate for Payer: Cigna All Commercial |
$616.35
|
| Rate for Payer: CORVEL All Commercial |
$616.35
|
| Rate for Payer: CORVEL All Commercial |
$616.35
|
| Rate for Payer: Coventry All Commercial |
$739.62
|
| Rate for Payer: Coventry All Commercial |
$739.62
|
| Rate for Payer: Encore All Commercial |
$616.35
|
| Rate for Payer: Encore All Commercial |
$616.35
|
| Rate for Payer: Frontpath All Commercial |
$857.94
|
| Rate for Payer: Frontpath All Commercial |
$857.94
|
| Rate for Payer: Humana ChoiceCare |
$659.45
|
| Rate for Payer: Humana ChoiceCare |
$659.45
|
| Rate for Payer: Humana Medicare |
$616.35
|
| Rate for Payer: Humana Medicare |
$616.35
|
| Rate for Payer: Lucent All Commercial |
$862.89
|
| Rate for Payer: Lucent All Commercial |
$862.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$985.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$985.00
|
| Rate for Payer: Managed Health Services Medicaid |
$604.49
|
| Rate for Payer: Managed Health Services Medicaid |
$604.49
|
| Rate for Payer: MDWise Medicaid |
$604.49
|
| Rate for Payer: MDWise Medicaid |
$604.49
|
| Rate for Payer: PHCS All Commercial |
$616.35
|
| Rate for Payer: PHCS All Commercial |
$616.35
|
| Rate for Payer: PHP All Commercial |
$1,045.56
|
| Rate for Payer: PHP All Commercial |
$1,045.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$616.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$616.35
|
| Rate for Payer: Sagamore Health Network All Products |
$616.35
|
| Rate for Payer: Sagamore Health Network All Products |
$616.35
|
| Rate for Payer: Signature Care EPO |
$875.50
|
| Rate for Payer: Signature Care EPO |
$875.50
|
| Rate for Payer: Signature Care PPO |
$875.50
|
| Rate for Payer: Signature Care PPO |
$875.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92,400.00
|
| Rate for Payer: United Healthcare Commercial |
$709.64
|
| Rate for Payer: United Healthcare Commercial |
$709.64
|
| Rate for Payer: United Healthcare Medicare |
$600.90
|
| Rate for Payer: United Healthcare Medicare |
$600.90
|
|
|
PR KNEE SCOPE,AID ANT CRUCIATE REPAIR
|
Professional
|
Both
|
$1,799.54
|
|
|
Service Code
|
CPT 29888
|
| Hospital Charge Code |
z29888
|
| Min. Negotiated Rate |
$883.67 |
| Max. Negotiated Rate |
$135,900.00 |
| Rate for Payer: Aetna Commercial |
$910.25
|
| Rate for Payer: Aetna Commercial |
$910.25
|
| Rate for Payer: Aetna Medicare |
$910.25
|
| Rate for Payer: Aetna Medicare |
$910.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,381.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,381.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,381.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,381.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,381.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,381.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,381.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,381.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$885.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$885.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,046.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,046.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,001.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,001.27
|
| Rate for Payer: Cash Price |
$1,115.71
|
| Rate for Payer: Cash Price |
$1,095.75
|
| Rate for Payer: Centivo All Commercial |
$1,410.89
|
| Rate for Payer: Centivo All Commercial |
$1,410.89
|
| Rate for Payer: Cigna All Commercial |
$910.25
|
| Rate for Payer: Cigna All Commercial |
$910.25
|
| Rate for Payer: CORVEL All Commercial |
$910.25
|
| Rate for Payer: CORVEL All Commercial |
$910.25
|
| Rate for Payer: Coventry All Commercial |
$1,092.30
|
| Rate for Payer: Coventry All Commercial |
$1,092.30
|
| Rate for Payer: Encore All Commercial |
$910.25
|
| Rate for Payer: Encore All Commercial |
$910.25
|
| Rate for Payer: Frontpath All Commercial |
$1,269.50
|
| Rate for Payer: Frontpath All Commercial |
$1,269.50
|
| Rate for Payer: Humana ChoiceCare |
$1,056.49
|
| Rate for Payer: Humana ChoiceCare |
$1,056.49
|
| Rate for Payer: Humana Medicare |
$910.25
|
| Rate for Payer: Humana Medicare |
$910.25
|
| Rate for Payer: Lucent All Commercial |
$1,274.35
|
| Rate for Payer: Lucent All Commercial |
$1,274.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,449.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,449.00
|
| Rate for Payer: Managed Health Services Medicaid |
$885.08
|
| Rate for Payer: Managed Health Services Medicaid |
$885.08
|
| Rate for Payer: MDWise Medicaid |
$885.08
|
| Rate for Payer: MDWise Medicaid |
$885.08
|
| Rate for Payer: PHCS All Commercial |
$910.25
|
| Rate for Payer: PHCS All Commercial |
$910.25
|
| Rate for Payer: PHP All Commercial |
$1,537.59
|
| Rate for Payer: PHP All Commercial |
$1,537.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$910.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$910.25
|
| Rate for Payer: Sagamore Health Network All Products |
$910.25
|
| Rate for Payer: Sagamore Health Network All Products |
$910.25
|
| Rate for Payer: Signature Care EPO |
$1,409.30
|
| Rate for Payer: Signature Care EPO |
$1,409.30
|
| Rate for Payer: Signature Care PPO |
$1,409.30
|
| Rate for Payer: Signature Care PPO |
$1,409.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$135,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$135,900.00
|
| Rate for Payer: United Healthcare Commercial |
$1,084.83
|
| Rate for Payer: United Healthcare Commercial |
$1,084.83
|
| Rate for Payer: United Healthcare Medicare |
$883.67
|
| Rate for Payer: United Healthcare Medicare |
$883.67
|
|
|
PR KNEE SCOPE,AID POST CRUC REPAIR
|
Professional
|
Both
|
$2,259.26
|
|
|
Service Code
|
CPT 29889
|
| Hospital Charge Code |
z29889
|
| Min. Negotiated Rate |
$1,106.56 |
| Max. Negotiated Rate |
$1,925.42 |
| Rate for Payer: Aetna Commercial |
$1,136.95
|
| Rate for Payer: Aetna Commercial |
$1,136.95
|
| Rate for Payer: Aetna Medicare |
$1,136.95
|
| Rate for Payer: Aetna Medicare |
$1,136.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,111.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,111.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,307.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,307.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,250.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,250.64
|
| Rate for Payer: Cash Price |
$1,400.74
|
| Rate for Payer: Cash Price |
$1,372.13
|
| Rate for Payer: Centivo All Commercial |
$1,762.27
|
| Rate for Payer: Centivo All Commercial |
$1,762.27
|
| Rate for Payer: Cigna All Commercial |
$1,136.95
|
| Rate for Payer: Cigna All Commercial |
$1,136.95
|
| Rate for Payer: CORVEL All Commercial |
$1,136.95
|
| Rate for Payer: CORVEL All Commercial |
$1,136.95
|
| Rate for Payer: Coventry All Commercial |
$1,364.34
|
| Rate for Payer: Coventry All Commercial |
$1,364.34
|
| Rate for Payer: Encore All Commercial |
$1,136.95
|
| Rate for Payer: Encore All Commercial |
$1,136.95
|
| Rate for Payer: Frontpath All Commercial |
$1,588.86
|
| Rate for Payer: Frontpath All Commercial |
$1,588.86
|
| Rate for Payer: Humana ChoiceCare |
$1,243.81
|
| Rate for Payer: Humana ChoiceCare |
$1,243.81
|
| Rate for Payer: Humana Medicare |
$1,136.95
|
| Rate for Payer: Humana Medicare |
$1,136.95
|
| Rate for Payer: Lucent All Commercial |
$1,591.73
|
| Rate for Payer: Lucent All Commercial |
$1,591.73
|
| Rate for Payer: Managed Health Services Medicaid |
$1,111.20
|
| Rate for Payer: Managed Health Services Medicaid |
$1,111.20
|
| Rate for Payer: MDWise Medicaid |
$1,111.20
|
| Rate for Payer: MDWise Medicaid |
$1,111.20
|
| Rate for Payer: PHCS All Commercial |
$1,136.95
|
| Rate for Payer: PHCS All Commercial |
$1,136.95
|
| Rate for Payer: PHP All Commercial |
$1,925.42
|
| Rate for Payer: PHP All Commercial |
$1,925.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,136.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,136.95
|
| Rate for Payer: Sagamore Health Network All Products |
$1,136.95
|
| Rate for Payer: Sagamore Health Network All Products |
$1,136.95
|
| Rate for Payer: Signature Care EPO |
$1,650.70
|
| Rate for Payer: Signature Care EPO |
$1,650.70
|
| Rate for Payer: Signature Care PPO |
$1,650.70
|
| Rate for Payer: Signature Care PPO |
$1,650.70
|
| Rate for Payer: United Healthcare Commercial |
$1,324.88
|
| Rate for Payer: United Healthcare Commercial |
$1,324.88
|
| Rate for Payer: United Healthcare Medicare |
$1,106.56
|
| Rate for Payer: United Healthcare Medicare |
$1,106.56
|
|
|
PR KNEE SCOPE,CLEAN/DRAIN
|
Professional
|
Both
|
$960.40
|
|
|
Service Code
|
CPT 29871
|
| Hospital Charge Code |
z29871
|
| Min. Negotiated Rate |
$469.60 |
| Max. Negotiated Rate |
$72,200.00 |
| Rate for Payer: Aetna Commercial |
$480.13
|
| Rate for Payer: Aetna Commercial |
$480.13
|
| Rate for Payer: Aetna Medicare |
$480.13
|
| Rate for Payer: Aetna Medicare |
$480.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$672.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$472.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$472.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$552.15
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$552.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$528.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$528.14
|
| Rate for Payer: Cash Price |
$595.45
|
| Rate for Payer: Cash Price |
$582.30
|
| Rate for Payer: Centivo All Commercial |
$744.20
|
| Rate for Payer: Centivo All Commercial |
$744.20
|
| Rate for Payer: Cigna All Commercial |
$480.13
|
| Rate for Payer: Cigna All Commercial |
$480.13
|
| Rate for Payer: CORVEL All Commercial |
$480.13
|
| Rate for Payer: CORVEL All Commercial |
$480.13
|
| Rate for Payer: Coventry All Commercial |
$576.16
|
| Rate for Payer: Coventry All Commercial |
$576.16
|
| Rate for Payer: Encore All Commercial |
$480.13
|
| Rate for Payer: Encore All Commercial |
$480.13
|
| Rate for Payer: Frontpath All Commercial |
$666.35
|
| Rate for Payer: Frontpath All Commercial |
$666.35
|
| Rate for Payer: Humana ChoiceCare |
$540.20
|
| Rate for Payer: Humana ChoiceCare |
$540.20
|
| Rate for Payer: Humana Medicare |
$480.13
|
| Rate for Payer: Humana Medicare |
$480.13
|
| Rate for Payer: Lucent All Commercial |
$672.18
|
| Rate for Payer: Lucent All Commercial |
$672.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$770.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$770.00
|
| Rate for Payer: Managed Health Services Medicaid |
$472.36
|
| Rate for Payer: Managed Health Services Medicaid |
$472.36
|
| Rate for Payer: MDWise Medicaid |
$472.36
|
| Rate for Payer: MDWise Medicaid |
$472.36
|
| Rate for Payer: PHCS All Commercial |
$480.13
|
| Rate for Payer: PHCS All Commercial |
$480.13
|
| Rate for Payer: PHP All Commercial |
$817.10
|
| Rate for Payer: PHP All Commercial |
$817.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$480.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$480.13
|
| Rate for Payer: Sagamore Health Network All Products |
$480.13
|
| Rate for Payer: Sagamore Health Network All Products |
$480.13
|
| Rate for Payer: Signature Care EPO |
$716.55
|
| Rate for Payer: Signature Care EPO |
$716.55
|
| Rate for Payer: Signature Care PPO |
$716.55
|
| Rate for Payer: Signature Care PPO |
$716.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$72,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$72,200.00
|
| Rate for Payer: United Healthcare Commercial |
$550.16
|
| Rate for Payer: United Healthcare Commercial |
$550.16
|
| Rate for Payer: United Healthcare Medicare |
$469.60
|
| Rate for Payer: United Healthcare Medicare |
$469.60
|
|
|
PR KNEE SCOPE,FULL SYNOVECT
|
Professional
|
Both
|
$1,213.00
|
|
|
Service Code
|
CPT 29876
|
| Hospital Charge Code |
z29876
|
| Min. Negotiated Rate |
$592.99 |
| Max. Negotiated Rate |
$91,200.00 |
| Rate for Payer: Aetna Commercial |
$609.06
|
| Rate for Payer: Aetna Commercial |
$609.06
|
| Rate for Payer: Aetna Medicare |
$609.06
|
| Rate for Payer: Aetna Medicare |
$609.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$815.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$815.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$815.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$815.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$815.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$815.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$596.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$596.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$700.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$700.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$669.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$669.97
|
| Rate for Payer: Cash Price |
$752.06
|
| Rate for Payer: Cash Price |
$735.31
|
| Rate for Payer: Centivo All Commercial |
$944.04
|
| Rate for Payer: Centivo All Commercial |
$944.04
|
| Rate for Payer: Cigna All Commercial |
$609.06
|
| Rate for Payer: Cigna All Commercial |
$609.06
|
| Rate for Payer: CORVEL All Commercial |
$609.06
|
| Rate for Payer: CORVEL All Commercial |
$609.06
|
| Rate for Payer: Coventry All Commercial |
$730.87
|
| Rate for Payer: Coventry All Commercial |
$730.87
|
| Rate for Payer: Encore All Commercial |
$609.06
|
| Rate for Payer: Encore All Commercial |
$609.06
|
| Rate for Payer: Frontpath All Commercial |
$847.28
|
| Rate for Payer: Frontpath All Commercial |
$847.28
|
| Rate for Payer: Humana ChoiceCare |
$649.88
|
| Rate for Payer: Humana ChoiceCare |
$649.88
|
| Rate for Payer: Humana Medicare |
$609.06
|
| Rate for Payer: Humana Medicare |
$609.06
|
| Rate for Payer: Lucent All Commercial |
$852.68
|
| Rate for Payer: Lucent All Commercial |
$852.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$972.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$972.00
|
| Rate for Payer: Managed Health Services Medicaid |
$596.60
|
| Rate for Payer: Managed Health Services Medicaid |
$596.60
|
| Rate for Payer: MDWise Medicaid |
$596.60
|
| Rate for Payer: MDWise Medicaid |
$596.60
|
| Rate for Payer: PHCS All Commercial |
$609.06
|
| Rate for Payer: PHCS All Commercial |
$609.06
|
| Rate for Payer: PHP All Commercial |
$1,031.80
|
| Rate for Payer: PHP All Commercial |
$1,031.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$609.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$609.06
|
| Rate for Payer: Sagamore Health Network All Products |
$609.06
|
| Rate for Payer: Sagamore Health Network All Products |
$609.06
|
| Rate for Payer: Signature Care EPO |
$863.60
|
| Rate for Payer: Signature Care EPO |
$863.60
|
| Rate for Payer: Signature Care PPO |
$863.60
|
| Rate for Payer: Signature Care PPO |
$863.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$91,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$91,200.00
|
| Rate for Payer: United Healthcare Commercial |
$700.79
|
| Rate for Payer: United Healthcare Commercial |
$700.79
|
| Rate for Payer: United Healthcare Medicare |
$592.99
|
| Rate for Payer: United Healthcare Medicare |
$592.99
|
|
|
PR KNEE SCOPE,LYSIS OF ADHESNS
|
Professional
|
Both
|
$1,152.36
|
|
|
Service Code
|
CPT 29884
|
| Hospital Charge Code |
z29884
|
| Min. Negotiated Rate |
$563.32 |
| Max. Negotiated Rate |
$86,600.00 |
| Rate for Payer: Aetna Commercial |
$576.58
|
| Rate for Payer: Aetna Commercial |
$576.58
|
| Rate for Payer: Aetna Medicare |
$576.58
|
| Rate for Payer: Aetna Medicare |
$576.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$768.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$768.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$768.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$768.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$768.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$768.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$566.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$566.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$663.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$663.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$634.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$634.24
|
| Rate for Payer: Cash Price |
$714.46
|
| Rate for Payer: Cash Price |
$698.52
|
| Rate for Payer: Centivo All Commercial |
$893.70
|
| Rate for Payer: Centivo All Commercial |
$893.70
|
| Rate for Payer: Cigna All Commercial |
$576.58
|
| Rate for Payer: Cigna All Commercial |
$576.58
|
| Rate for Payer: CORVEL All Commercial |
$576.58
|
| Rate for Payer: CORVEL All Commercial |
$576.58
|
| Rate for Payer: Coventry All Commercial |
$691.90
|
| Rate for Payer: Coventry All Commercial |
$691.90
|
| Rate for Payer: Encore All Commercial |
$576.58
|
| Rate for Payer: Encore All Commercial |
$576.58
|
| Rate for Payer: Frontpath All Commercial |
$801.19
|
| Rate for Payer: Frontpath All Commercial |
$801.19
|
| Rate for Payer: Humana ChoiceCare |
$609.56
|
| Rate for Payer: Humana ChoiceCare |
$609.56
|
| Rate for Payer: Humana Medicare |
$576.58
|
| Rate for Payer: Humana Medicare |
$576.58
|
| Rate for Payer: Lucent All Commercial |
$807.21
|
| Rate for Payer: Lucent All Commercial |
$807.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$924.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$924.00
|
| Rate for Payer: Managed Health Services Medicaid |
$566.78
|
| Rate for Payer: Managed Health Services Medicaid |
$566.78
|
| Rate for Payer: MDWise Medicaid |
$566.78
|
| Rate for Payer: MDWise Medicaid |
$566.78
|
| Rate for Payer: PHCS All Commercial |
$576.58
|
| Rate for Payer: PHCS All Commercial |
$576.58
|
| Rate for Payer: PHP All Commercial |
$980.18
|
| Rate for Payer: PHP All Commercial |
$980.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$576.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$576.58
|
| Rate for Payer: Sagamore Health Network All Products |
$576.58
|
| Rate for Payer: Sagamore Health Network All Products |
$576.58
|
| Rate for Payer: Signature Care EPO |
$809.20
|
| Rate for Payer: Signature Care EPO |
$809.20
|
| Rate for Payer: Signature Care PPO |
$809.20
|
| Rate for Payer: Signature Care PPO |
$809.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$86,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$86,600.00
|
| Rate for Payer: United Healthcare Commercial |
$660.73
|
| Rate for Payer: United Healthcare Commercial |
$660.73
|
| Rate for Payer: United Healthcare Medicare |
$563.32
|
| Rate for Payer: United Healthcare Medicare |
$563.32
|
|
|
PR KNEE SCOPE,MED+LAT MENIS REPAIR
|
Professional
|
Both
|
$1,559.94
|
|
|
Service Code
|
CPT 29883
|
| Hospital Charge Code |
z29883
|
| Min. Negotiated Rate |
$764.56 |
| Max. Negotiated Rate |
$117,600.00 |
| Rate for Payer: Aetna Commercial |
$782.61
|
| Rate for Payer: Aetna Commercial |
$782.61
|
| Rate for Payer: Aetna Medicare |
$782.61
|
| Rate for Payer: Aetna Medicare |
$782.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$948.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$948.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$948.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$948.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$948.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$948.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$948.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$948.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$767.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$767.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$900.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$900.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$860.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$860.87
|
| Rate for Payer: Cash Price |
$967.16
|
| Rate for Payer: Cash Price |
$948.05
|
| Rate for Payer: Centivo All Commercial |
$1,213.05
|
| Rate for Payer: Centivo All Commercial |
$1,213.05
|
| Rate for Payer: Cigna All Commercial |
$782.61
|
| Rate for Payer: Cigna All Commercial |
$782.61
|
| Rate for Payer: CORVEL All Commercial |
$782.61
|
| Rate for Payer: CORVEL All Commercial |
$782.61
|
| Rate for Payer: Coventry All Commercial |
$939.13
|
| Rate for Payer: Coventry All Commercial |
$939.13
|
| Rate for Payer: Encore All Commercial |
$782.61
|
| Rate for Payer: Encore All Commercial |
$782.61
|
| Rate for Payer: Frontpath All Commercial |
$1,091.06
|
| Rate for Payer: Frontpath All Commercial |
$1,091.06
|
| Rate for Payer: Humana ChoiceCare |
$877.64
|
| Rate for Payer: Humana ChoiceCare |
$877.64
|
| Rate for Payer: Humana Medicare |
$782.61
|
| Rate for Payer: Humana Medicare |
$782.61
|
| Rate for Payer: Lucent All Commercial |
$1,095.65
|
| Rate for Payer: Lucent All Commercial |
$1,095.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,254.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,254.00
|
| Rate for Payer: Managed Health Services Medicaid |
$767.24
|
| Rate for Payer: Managed Health Services Medicaid |
$767.24
|
| Rate for Payer: MDWise Medicaid |
$767.24
|
| Rate for Payer: MDWise Medicaid |
$767.24
|
| Rate for Payer: PHCS All Commercial |
$782.61
|
| Rate for Payer: PHCS All Commercial |
$782.61
|
| Rate for Payer: PHP All Commercial |
$1,330.33
|
| Rate for Payer: PHP All Commercial |
$1,330.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$782.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$782.61
|
| Rate for Payer: Sagamore Health Network All Products |
$782.61
|
| Rate for Payer: Sagamore Health Network All Products |
$782.61
|
| Rate for Payer: Signature Care EPO |
$1,160.25
|
| Rate for Payer: Signature Care EPO |
$1,160.25
|
| Rate for Payer: Signature Care PPO |
$1,160.25
|
| Rate for Payer: Signature Care PPO |
$1,160.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117,600.00
|
| Rate for Payer: United Healthcare Commercial |
$914.08
|
| Rate for Payer: United Healthcare Commercial |
$914.08
|
| Rate for Payer: United Healthcare Medicare |
$764.56
|
| Rate for Payer: United Healthcare Medicare |
$764.56
|
|
|
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 |
$792.74
|
| Rate for Payer: Cash Price |
$776.90
|
| 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 |
$573.88
|
| Rate for Payer: Cash Price |
$560.84
|
| 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 |
$605.27
|
| Rate for Payer: Cash Price |
$621.13
|
| 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 |
$715.68
|
| Rate for Payer: Cash Price |
$700.28
|
| 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 |
$1,064.37
|
| 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 |
$606.53
|
| Rate for Payer: Cash Price |
$623.01
|
| 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
|
|
