|
PR NARCOSYNTHESIS
|
Professional
|
Both
|
$308.66
|
|
|
Service Code
|
CPT 90865
|
| Hospital Charge Code |
z90865
|
| Min. Negotiated Rate |
$114.10 |
| Max. Negotiated Rate |
$14,300.00 |
| Rate for Payer: Aetna Commercial |
$121.85
|
| Rate for Payer: Aetna Commercial |
$121.85
|
| Rate for Payer: Aetna Medicare |
$121.85
|
| Rate for Payer: Aetna Medicare |
$121.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$160.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$160.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$160.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$160.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$160.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$160.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$160.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$160.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$140.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$140.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$134.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$134.03
|
| Rate for Payer: Cash Price |
$182.52
|
| Rate for Payer: Cash Price |
$185.20
|
| Rate for Payer: Centivo All Commercial |
$188.87
|
| Rate for Payer: Centivo All Commercial |
$188.87
|
| Rate for Payer: Cigna All Commercial |
$121.85
|
| Rate for Payer: Cigna All Commercial |
$121.85
|
| Rate for Payer: CORVEL All Commercial |
$121.85
|
| Rate for Payer: CORVEL All Commercial |
$121.85
|
| Rate for Payer: Coventry All Commercial |
$146.22
|
| Rate for Payer: Coventry All Commercial |
$146.22
|
| Rate for Payer: Encore All Commercial |
$121.85
|
| Rate for Payer: Encore All Commercial |
$121.85
|
| Rate for Payer: Frontpath All Commercial |
$137.02
|
| Rate for Payer: Frontpath All Commercial |
$137.02
|
| Rate for Payer: Humana ChoiceCare |
$114.10
|
| Rate for Payer: Humana ChoiceCare |
$114.10
|
| Rate for Payer: Humana Medicare |
$121.85
|
| Rate for Payer: Humana Medicare |
$121.85
|
| Rate for Payer: Lucent All Commercial |
$170.59
|
| Rate for Payer: Lucent All Commercial |
$170.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.00
|
| Rate for Payer: PHCS All Commercial |
$121.85
|
| Rate for Payer: PHCS All Commercial |
$121.85
|
| Rate for Payer: PHP All Commercial |
$126.39
|
| Rate for Payer: PHP All Commercial |
$126.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$121.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$121.85
|
| Rate for Payer: Sagamore Health Network All Products |
$121.85
|
| Rate for Payer: Sagamore Health Network All Products |
$121.85
|
| Rate for Payer: Signature Care EPO |
$181.90
|
| Rate for Payer: Signature Care EPO |
$181.90
|
| Rate for Payer: Signature Care PPO |
$181.90
|
| Rate for Payer: Signature Care PPO |
$181.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,300.00
|
| Rate for Payer: United Healthcare Commercial |
$161.49
|
| Rate for Payer: United Healthcare Commercial |
$161.49
|
| Rate for Payer: United Healthcare Medicare |
$152.10
|
| Rate for Payer: United Healthcare Medicare |
$152.10
|
|
|
PR NASAL ENDOSCOPY,DX
|
Professional
|
Both
|
$346.64
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
z31231
|
| Min. Negotiated Rate |
$32.36 |
| Max. Negotiated Rate |
$9,100.00 |
| Rate for Payer: Aetna Commercial |
$59.94
|
| Rate for Payer: Aetna Commercial |
$59.94
|
| Rate for Payer: Aetna Medicare |
$59.94
|
| Rate for Payer: Aetna Medicare |
$59.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$224.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$224.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$224.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$224.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$224.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$224.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$224.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$224.03
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$32.36
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$32.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$170.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$170.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$68.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$68.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$65.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$65.93
|
| Rate for Payer: Cash Price |
$206.95
|
| Rate for Payer: Cash Price |
$207.98
|
| Rate for Payer: Centivo All Commercial |
$92.91
|
| Rate for Payer: Centivo All Commercial |
$92.91
|
| Rate for Payer: Cigna All Commercial |
$59.94
|
| Rate for Payer: Cigna All Commercial |
$59.94
|
| Rate for Payer: CORVEL All Commercial |
$59.94
|
| Rate for Payer: CORVEL All Commercial |
$59.94
|
| Rate for Payer: Coventry All Commercial |
$71.93
|
| Rate for Payer: Coventry All Commercial |
$71.93
|
| Rate for Payer: Encore All Commercial |
$59.94
|
| Rate for Payer: Encore All Commercial |
$59.94
|
| Rate for Payer: Frontpath All Commercial |
$82.25
|
| Rate for Payer: Frontpath All Commercial |
$82.25
|
| Rate for Payer: Humana ChoiceCare |
$89.17
|
| Rate for Payer: Humana ChoiceCare |
$89.17
|
| Rate for Payer: Humana Medicare |
$59.94
|
| Rate for Payer: Humana Medicare |
$59.94
|
| Rate for Payer: Lucent All Commercial |
$83.92
|
| Rate for Payer: Lucent All Commercial |
$83.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.00
|
| Rate for Payer: Managed Health Services Medicaid |
$170.49
|
| Rate for Payer: Managed Health Services Medicaid |
$170.49
|
| Rate for Payer: MDWise Medicaid |
$170.49
|
| Rate for Payer: MDWise Medicaid |
$170.49
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$32.36
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$32.36
|
| Rate for Payer: PHCS All Commercial |
$59.94
|
| Rate for Payer: PHCS All Commercial |
$59.94
|
| Rate for Payer: PHP All Commercial |
$82.48
|
| Rate for Payer: PHP All Commercial |
$82.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$59.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$59.94
|
| Rate for Payer: Sagamore Health Network All Products |
$59.94
|
| Rate for Payer: Sagamore Health Network All Products |
$59.94
|
| Rate for Payer: Signature Care EPO |
$237.15
|
| Rate for Payer: Signature Care EPO |
$237.15
|
| Rate for Payer: Signature Care PPO |
$237.15
|
| Rate for Payer: Signature Care PPO |
$237.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,100.00
|
| Rate for Payer: United Healthcare Commercial |
$85.55
|
| Rate for Payer: United Healthcare Commercial |
$85.55
|
| Rate for Payer: United Healthcare Medicare |
$172.46
|
| Rate for Payer: United Healthcare Medicare |
$172.46
|
|
|
PR NASAL/SINUS NDSC SURG W/BX POLYPC/DBRDMT SPX
|
Professional
|
Both
|
$477.54
|
|
|
Service Code
|
CPT 31237
|
| Hospital Charge Code |
z31237
|
| Min. Negotiated Rate |
$83.69 |
| Max. Negotiated Rate |
$22,400.00 |
| Rate for Payer: Aetna Commercial |
$149.19
|
| Rate for Payer: Aetna Commercial |
$149.19
|
| Rate for Payer: Aetna Medicare |
$149.19
|
| Rate for Payer: Aetna Medicare |
$149.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$300.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$300.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$300.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$300.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$300.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$300.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$300.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$300.60
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$83.69
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$83.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$234.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$234.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$164.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$164.11
|
| Rate for Payer: Cash Price |
$281.80
|
| Rate for Payer: Cash Price |
$286.52
|
| Rate for Payer: Centivo All Commercial |
$231.24
|
| Rate for Payer: Centivo All Commercial |
$231.24
|
| Rate for Payer: Cigna All Commercial |
$149.19
|
| Rate for Payer: Cigna All Commercial |
$149.19
|
| Rate for Payer: CORVEL All Commercial |
$149.19
|
| Rate for Payer: CORVEL All Commercial |
$149.19
|
| Rate for Payer: Coventry All Commercial |
$179.03
|
| Rate for Payer: Coventry All Commercial |
$179.03
|
| Rate for Payer: Encore All Commercial |
$149.19
|
| Rate for Payer: Encore All Commercial |
$149.19
|
| Rate for Payer: Frontpath All Commercial |
$205.41
|
| Rate for Payer: Frontpath All Commercial |
$205.41
|
| Rate for Payer: Humana ChoiceCare |
$221.68
|
| Rate for Payer: Humana ChoiceCare |
$221.68
|
| Rate for Payer: Humana Medicare |
$149.19
|
| Rate for Payer: Humana Medicare |
$149.19
|
| Rate for Payer: Lucent All Commercial |
$208.87
|
| Rate for Payer: Lucent All Commercial |
$208.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$239.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$239.00
|
| Rate for Payer: Managed Health Services Medicaid |
$234.87
|
| Rate for Payer: Managed Health Services Medicaid |
$234.87
|
| Rate for Payer: MDWise Medicaid |
$234.87
|
| Rate for Payer: MDWise Medicaid |
$234.87
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$83.69
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$83.69
|
| Rate for Payer: PHCS All Commercial |
$149.19
|
| Rate for Payer: PHCS All Commercial |
$149.19
|
| Rate for Payer: PHP All Commercial |
$203.95
|
| Rate for Payer: PHP All Commercial |
$203.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$149.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$149.19
|
| Rate for Payer: Sagamore Health Network All Products |
$149.19
|
| Rate for Payer: Sagamore Health Network All Products |
$149.19
|
| Rate for Payer: Signature Care EPO |
$409.82
|
| Rate for Payer: Signature Care EPO |
$409.82
|
| Rate for Payer: Signature Care PPO |
$409.82
|
| Rate for Payer: Signature Care PPO |
$409.82
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$22,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$22,400.00
|
| Rate for Payer: United Healthcare Commercial |
$206.48
|
| Rate for Payer: United Healthcare Commercial |
$206.48
|
| Rate for Payer: United Healthcare Medicare |
$234.83
|
| Rate for Payer: United Healthcare Medicare |
$234.83
|
|
|
PR NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMORRHAGE
|
Professional
|
Both
|
$464.80
|
|
|
Service Code
|
CPT 31238
|
| Hospital Charge Code |
z31238
|
| Min. Negotiated Rate |
$94.84 |
| Max. Negotiated Rate |
$23,400.00 |
| Rate for Payer: Aetna Commercial |
$156.22
|
| Rate for Payer: Aetna Commercial |
$156.22
|
| Rate for Payer: Aetna Medicare |
$156.22
|
| Rate for Payer: Aetna Medicare |
$156.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$331.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$331.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$331.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$331.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$331.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$331.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$331.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$331.60
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$94.84
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$94.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$228.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$228.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$179.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$179.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$171.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$171.84
|
| Rate for Payer: Cash Price |
$275.26
|
| Rate for Payer: Cash Price |
$278.88
|
| Rate for Payer: Centivo All Commercial |
$242.14
|
| Rate for Payer: Centivo All Commercial |
$242.14
|
| Rate for Payer: Cigna All Commercial |
$156.22
|
| Rate for Payer: Cigna All Commercial |
$156.22
|
| Rate for Payer: CORVEL All Commercial |
$156.22
|
| Rate for Payer: CORVEL All Commercial |
$156.22
|
| Rate for Payer: Coventry All Commercial |
$187.46
|
| Rate for Payer: Coventry All Commercial |
$187.46
|
| Rate for Payer: Encore All Commercial |
$156.22
|
| Rate for Payer: Encore All Commercial |
$156.22
|
| Rate for Payer: Frontpath All Commercial |
$215.16
|
| Rate for Payer: Frontpath All Commercial |
$215.16
|
| Rate for Payer: Humana ChoiceCare |
$243.13
|
| Rate for Payer: Humana ChoiceCare |
$243.13
|
| Rate for Payer: Humana Medicare |
$156.22
|
| Rate for Payer: Humana Medicare |
$156.22
|
| Rate for Payer: Lucent All Commercial |
$218.71
|
| Rate for Payer: Lucent All Commercial |
$218.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$250.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$250.00
|
| Rate for Payer: Managed Health Services Medicaid |
$228.61
|
| Rate for Payer: Managed Health Services Medicaid |
$228.61
|
| Rate for Payer: MDWise Medicaid |
$228.61
|
| Rate for Payer: MDWise Medicaid |
$228.61
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$94.84
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$94.84
|
| Rate for Payer: PHCS All Commercial |
$156.22
|
| Rate for Payer: PHCS All Commercial |
$156.22
|
| Rate for Payer: PHP All Commercial |
$213.18
|
| Rate for Payer: PHP All Commercial |
$213.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$156.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$156.22
|
| Rate for Payer: Sagamore Health Network All Products |
$156.22
|
| Rate for Payer: Sagamore Health Network All Products |
$156.22
|
| Rate for Payer: Signature Care EPO |
$400.61
|
| Rate for Payer: Signature Care EPO |
$400.61
|
| Rate for Payer: Signature Care PPO |
$400.61
|
| Rate for Payer: Signature Care PPO |
$400.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$23,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$23,400.00
|
| Rate for Payer: United Healthcare Commercial |
$224.20
|
| Rate for Payer: United Healthcare Commercial |
$224.20
|
| Rate for Payer: United Healthcare Medicare |
$229.38
|
| Rate for Payer: United Healthcare Medicare |
$229.38
|
|
|
PR NASOPHARYNGOSCOPY
|
Professional
|
Both
|
$218.06
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
z92511
|
| Min. Negotiated Rate |
$24.62 |
| Max. Negotiated Rate |
$4,300.00 |
| Rate for Payer: Aetna Commercial |
$35.77
|
| Rate for Payer: Aetna Commercial |
$35.77
|
| Rate for Payer: Aetna Medicare |
$35.77
|
| Rate for Payer: Aetna Medicare |
$35.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$115.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$115.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$115.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$115.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$115.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$115.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$115.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$115.91
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$24.62
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$24.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$107.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$107.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.35
|
| Rate for Payer: Cash Price |
$129.41
|
| Rate for Payer: Cash Price |
$130.84
|
| Rate for Payer: Centivo All Commercial |
$55.44
|
| Rate for Payer: Centivo All Commercial |
$55.44
|
| Rate for Payer: Cigna All Commercial |
$35.77
|
| Rate for Payer: Cigna All Commercial |
$35.77
|
| Rate for Payer: CORVEL All Commercial |
$35.77
|
| Rate for Payer: CORVEL All Commercial |
$35.77
|
| Rate for Payer: Coventry All Commercial |
$42.92
|
| Rate for Payer: Coventry All Commercial |
$42.92
|
| Rate for Payer: Encore All Commercial |
$35.77
|
| Rate for Payer: Encore All Commercial |
$35.77
|
| Rate for Payer: Frontpath All Commercial |
$40.52
|
| Rate for Payer: Frontpath All Commercial |
$40.52
|
| Rate for Payer: Humana ChoiceCare |
$69.16
|
| Rate for Payer: Humana ChoiceCare |
$69.16
|
| Rate for Payer: Humana Medicare |
$35.77
|
| Rate for Payer: Humana Medicare |
$35.77
|
| Rate for Payer: Lucent All Commercial |
$50.08
|
| Rate for Payer: Lucent All Commercial |
$50.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$47.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$47.00
|
| Rate for Payer: Managed Health Services Medicaid |
$107.25
|
| Rate for Payer: Managed Health Services Medicaid |
$107.25
|
| Rate for Payer: MDWise Medicaid |
$107.25
|
| Rate for Payer: MDWise Medicaid |
$107.25
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$24.62
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$24.62
|
| Rate for Payer: PHCS All Commercial |
$35.77
|
| Rate for Payer: PHCS All Commercial |
$35.77
|
| Rate for Payer: PHP All Commercial |
$50.68
|
| Rate for Payer: PHP All Commercial |
$50.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$35.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$35.77
|
| Rate for Payer: Sagamore Health Network All Products |
$35.77
|
| Rate for Payer: Sagamore Health Network All Products |
$35.77
|
| Rate for Payer: Signature Care EPO |
$165.75
|
| Rate for Payer: Signature Care EPO |
$165.75
|
| Rate for Payer: Signature Care PPO |
$165.75
|
| Rate for Payer: Signature Care PPO |
$165.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,300.00
|
| Rate for Payer: United Healthcare Commercial |
$67.65
|
| Rate for Payer: United Healthcare Commercial |
$67.65
|
| Rate for Payer: United Healthcare Medicare |
$107.84
|
| Rate for Payer: United Healthcare Medicare |
$107.84
|
|
|
PR NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$573.12
|
|
|
Service Code
|
CPT 44386
|
| Hospital Charge Code |
z44386
|
| Min. Negotiated Rate |
$83.78 |
| Max. Negotiated Rate |
$284.18 |
| Rate for Payer: Aetna Commercial |
$83.78
|
| Rate for Payer: Aetna Commercial |
$83.78
|
| Rate for Payer: Aetna Medicare |
$83.78
|
| Rate for Payer: Aetna Medicare |
$83.78
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$90.67
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$90.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$281.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$281.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$96.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$96.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$92.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$92.16
|
| Rate for Payer: Cash Price |
$341.02
|
| Rate for Payer: Cash Price |
$343.87
|
| Rate for Payer: Centivo All Commercial |
$129.86
|
| Rate for Payer: Centivo All Commercial |
$129.86
|
| Rate for Payer: Cigna All Commercial |
$83.78
|
| Rate for Payer: Cigna All Commercial |
$83.78
|
| Rate for Payer: CORVEL All Commercial |
$83.78
|
| Rate for Payer: CORVEL All Commercial |
$83.78
|
| Rate for Payer: Coventry All Commercial |
$100.54
|
| Rate for Payer: Coventry All Commercial |
$100.54
|
| Rate for Payer: Encore All Commercial |
$83.78
|
| Rate for Payer: Encore All Commercial |
$83.78
|
| Rate for Payer: Frontpath All Commercial |
$115.12
|
| Rate for Payer: Frontpath All Commercial |
$115.12
|
| Rate for Payer: Humana ChoiceCare |
$136.29
|
| Rate for Payer: Humana ChoiceCare |
$136.29
|
| Rate for Payer: Humana Medicare |
$83.78
|
| Rate for Payer: Humana Medicare |
$83.78
|
| Rate for Payer: Lucent All Commercial |
$117.29
|
| Rate for Payer: Lucent All Commercial |
$117.29
|
| Rate for Payer: Managed Health Services Medicaid |
$281.88
|
| Rate for Payer: Managed Health Services Medicaid |
$281.88
|
| Rate for Payer: MDWise Medicaid |
$281.88
|
| Rate for Payer: MDWise Medicaid |
$281.88
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$90.67
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$90.67
|
| Rate for Payer: PHCS All Commercial |
$83.78
|
| Rate for Payer: PHCS All Commercial |
$83.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$83.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$83.78
|
| Rate for Payer: Sagamore Health Network All Products |
$83.78
|
| Rate for Payer: Sagamore Health Network All Products |
$83.78
|
| Rate for Payer: United Healthcare Commercial |
$142.78
|
| Rate for Payer: United Healthcare Commercial |
$142.78
|
| Rate for Payer: United Healthcare Medicare |
$284.18
|
| Rate for Payer: United Healthcare Medicare |
$284.18
|
|
|
PR NEEDLE BIOPSY LIVER,W OTHR PROC
|
Professional
|
Both
|
$184.64
|
|
|
Service Code
|
CPT 47001
|
| Hospital Charge Code |
z47001
|
| Min. Negotiated Rate |
$90.81 |
| Max. Negotiated Rate |
$13,100.00 |
| Rate for Payer: Aetna Commercial |
$95.11
|
| Rate for Payer: Aetna Commercial |
$95.11
|
| Rate for Payer: Aetna Medicare |
$95.11
|
| Rate for Payer: Aetna Medicare |
$95.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$150.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$150.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$90.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$90.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$109.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$109.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$104.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$104.62
|
| Rate for Payer: Cash Price |
$110.78
|
| Rate for Payer: Cash Price |
$109.70
|
| Rate for Payer: Centivo All Commercial |
$147.42
|
| Rate for Payer: Centivo All Commercial |
$147.42
|
| Rate for Payer: Cigna All Commercial |
$95.11
|
| Rate for Payer: Cigna All Commercial |
$95.11
|
| Rate for Payer: CORVEL All Commercial |
$95.11
|
| Rate for Payer: CORVEL All Commercial |
$95.11
|
| Rate for Payer: Coventry All Commercial |
$114.13
|
| Rate for Payer: Coventry All Commercial |
$114.13
|
| Rate for Payer: Encore All Commercial |
$95.11
|
| Rate for Payer: Encore All Commercial |
$95.11
|
| Rate for Payer: Frontpath All Commercial |
$136.79
|
| Rate for Payer: Frontpath All Commercial |
$136.79
|
| Rate for Payer: Humana ChoiceCare |
$117.84
|
| Rate for Payer: Humana ChoiceCare |
$117.84
|
| Rate for Payer: Humana Medicare |
$95.11
|
| Rate for Payer: Humana Medicare |
$95.11
|
| Rate for Payer: Lucent All Commercial |
$133.15
|
| Rate for Payer: Lucent All Commercial |
$133.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$141.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$141.00
|
| Rate for Payer: Managed Health Services Medicaid |
$90.81
|
| Rate for Payer: Managed Health Services Medicaid |
$90.81
|
| Rate for Payer: MDWise Medicaid |
$90.81
|
| Rate for Payer: MDWise Medicaid |
$90.81
|
| Rate for Payer: PHCS All Commercial |
$95.11
|
| Rate for Payer: PHCS All Commercial |
$95.11
|
| Rate for Payer: PHP All Commercial |
$159.99
|
| Rate for Payer: PHP All Commercial |
$159.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$95.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$95.11
|
| Rate for Payer: Sagamore Health Network All Products |
$95.11
|
| Rate for Payer: Sagamore Health Network All Products |
$95.11
|
| 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 |
$13,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,100.00
|
| Rate for Payer: United Healthcare Commercial |
$115.18
|
| Rate for Payer: United Healthcare Commercial |
$115.18
|
| Rate for Payer: United Healthcare Medicare |
$91.42
|
| Rate for Payer: United Healthcare Medicare |
$91.42
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME <= 50 SQ CM
|
Professional
|
Both
|
$660.58
|
|
|
Service Code
|
CPT 97607
|
| Hospital Charge Code |
z97607
|
| Min. Negotiated Rate |
$13.45 |
| Max. Negotiated Rate |
$330.29 |
| Rate for Payer: Aetna Commercial |
$20.77
|
| Rate for Payer: Aetna Commercial |
$20.77
|
| Rate for Payer: Aetna Medicare |
$20.77
|
| Rate for Payer: Aetna Medicare |
$20.77
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$23.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$23.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$315.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$315.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$23.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$23.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22.85
|
| Rate for Payer: Cash Price |
$385.09
|
| Rate for Payer: Cash Price |
$396.35
|
| Rate for Payer: Centivo All Commercial |
$32.19
|
| Rate for Payer: Centivo All Commercial |
$32.19
|
| Rate for Payer: Cigna All Commercial |
$20.77
|
| Rate for Payer: Cigna All Commercial |
$20.77
|
| Rate for Payer: CORVEL All Commercial |
$20.77
|
| Rate for Payer: CORVEL All Commercial |
$20.77
|
| Rate for Payer: Coventry All Commercial |
$24.92
|
| Rate for Payer: Coventry All Commercial |
$24.92
|
| Rate for Payer: Encore All Commercial |
$20.77
|
| Rate for Payer: Encore All Commercial |
$20.77
|
| Rate for Payer: Frontpath All Commercial |
$24.85
|
| Rate for Payer: Frontpath All Commercial |
$24.85
|
| Rate for Payer: Humana ChoiceCare |
$13.45
|
| Rate for Payer: Humana ChoiceCare |
$13.45
|
| Rate for Payer: Humana Medicare |
$20.77
|
| Rate for Payer: Humana Medicare |
$20.77
|
| Rate for Payer: Lucent All Commercial |
$29.08
|
| Rate for Payer: Lucent All Commercial |
$29.08
|
| Rate for Payer: Managed Health Services Medicaid |
$315.68
|
| Rate for Payer: Managed Health Services Medicaid |
$315.68
|
| Rate for Payer: MDWise Medicaid |
$315.68
|
| Rate for Payer: MDWise Medicaid |
$315.68
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$23.75
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$23.75
|
| Rate for Payer: PHCS All Commercial |
$20.77
|
| Rate for Payer: PHCS All Commercial |
$20.77
|
| Rate for Payer: PHP All Commercial |
$19.77
|
| Rate for Payer: PHP All Commercial |
$19.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20.77
|
| Rate for Payer: Sagamore Health Network All Products |
$20.77
|
| Rate for Payer: Sagamore Health Network All Products |
$20.77
|
| Rate for Payer: Signature Care EPO |
$303.83
|
| Rate for Payer: Signature Care EPO |
$303.83
|
| Rate for Payer: Signature Care PPO |
$303.83
|
| Rate for Payer: Signature Care PPO |
$303.83
|
| Rate for Payer: United Healthcare Commercial |
$186.82
|
| Rate for Payer: United Healthcare Commercial |
$186.82
|
| Rate for Payer: United Healthcare Medicare |
$330.29
|
| Rate for Payer: United Healthcare Medicare |
$330.29
|
|
|
PR NERVOUS SYSTEM SURGERY UNLISTED
|
Professional
|
Both
|
$1,181.54
|
|
|
Service Code
|
CPT 64999
|
| Hospital Charge Code |
z64999
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,004.31 |
| 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 |
$708.92
|
| Rate for Payer: Cash Price |
$708.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,004.31
|
| Rate for Payer: Signature Care EPO |
$753.24
|
| Rate for Payer: Signature Care PPO |
$753.24
|
|
|
PR NEUROPLASTY OTHER ARM/LEG NERVE,OPEN
|
Professional
|
Both
|
$914.64
|
|
|
Service Code
|
CPT 64708
|
| Hospital Charge Code |
z64708
|
| Min. Negotiated Rate |
$457.32 |
| Max. Negotiated Rate |
$70,300.00 |
| Rate for Payer: Aetna Commercial |
$469.55
|
| Rate for Payer: Aetna Commercial |
$469.55
|
| Rate for Payer: Aetna Medicare |
$469.55
|
| Rate for Payer: Aetna Medicare |
$469.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$599.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$599.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$599.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$599.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$599.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$599.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$599.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$599.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$468.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$468.55
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$539.98
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$539.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$516.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$516.50
|
| Rate for Payer: Cash Price |
$548.78
|
| Rate for Payer: Cash Price |
$571.58
|
| Rate for Payer: Centivo All Commercial |
$727.80
|
| Rate for Payer: Centivo All Commercial |
$727.80
|
| Rate for Payer: Cigna All Commercial |
$469.55
|
| Rate for Payer: Cigna All Commercial |
$469.55
|
| Rate for Payer: CORVEL All Commercial |
$469.55
|
| Rate for Payer: CORVEL All Commercial |
$469.55
|
| Rate for Payer: Coventry All Commercial |
$563.46
|
| Rate for Payer: Coventry All Commercial |
$563.46
|
| Rate for Payer: Encore All Commercial |
$469.55
|
| Rate for Payer: Encore All Commercial |
$469.55
|
| Rate for Payer: Frontpath All Commercial |
$647.57
|
| Rate for Payer: Frontpath All Commercial |
$647.57
|
| Rate for Payer: Humana ChoiceCare |
$559.75
|
| Rate for Payer: Humana ChoiceCare |
$559.75
|
| Rate for Payer: Humana Medicare |
$469.55
|
| Rate for Payer: Humana Medicare |
$469.55
|
| Rate for Payer: Lucent All Commercial |
$657.37
|
| Rate for Payer: Lucent All Commercial |
$657.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$750.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$750.00
|
| Rate for Payer: Managed Health Services Medicaid |
$468.55
|
| Rate for Payer: Managed Health Services Medicaid |
$468.55
|
| Rate for Payer: MDWise Medicaid |
$468.55
|
| Rate for Payer: MDWise Medicaid |
$468.55
|
| Rate for Payer: PHCS All Commercial |
$469.55
|
| Rate for Payer: PHCS All Commercial |
$469.55
|
| Rate for Payer: PHP All Commercial |
$800.30
|
| Rate for Payer: PHP All Commercial |
$800.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$469.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$469.55
|
| Rate for Payer: Sagamore Health Network All Products |
$469.55
|
| Rate for Payer: Sagamore Health Network All Products |
$469.55
|
| Rate for Payer: Signature Care EPO |
$640.05
|
| Rate for Payer: Signature Care EPO |
$640.05
|
| Rate for Payer: Signature Care PPO |
$640.05
|
| Rate for Payer: Signature Care PPO |
$640.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,300.00
|
| Rate for Payer: United Healthcare Commercial |
$513.28
|
| Rate for Payer: United Healthcare Commercial |
$513.28
|
| Rate for Payer: United Healthcare Medicare |
$457.32
|
| Rate for Payer: United Healthcare Medicare |
$457.32
|
|
|
PR NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES
|
Professional
|
Both
|
$94.22
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
z64455
|
| Min. Negotiated Rate |
$25.87 |
| Max. Negotiated Rate |
$4,800.00 |
| Rate for Payer: Aetna Commercial |
$32.38
|
| Rate for Payer: Aetna Commercial |
$32.38
|
| Rate for Payer: Aetna Medicare |
$32.38
|
| Rate for Payer: Aetna Medicare |
$32.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$68.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$68.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$68.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$68.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$68.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$68.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$68.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$68.39
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.87
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$46.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$46.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$35.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$35.62
|
| Rate for Payer: Cash Price |
$55.10
|
| Rate for Payer: Cash Price |
$56.53
|
| Rate for Payer: Centivo All Commercial |
$50.19
|
| Rate for Payer: Centivo All Commercial |
$50.19
|
| Rate for Payer: Cigna All Commercial |
$32.38
|
| Rate for Payer: Cigna All Commercial |
$32.38
|
| Rate for Payer: CORVEL All Commercial |
$32.38
|
| Rate for Payer: CORVEL All Commercial |
$32.38
|
| Rate for Payer: Coventry All Commercial |
$38.86
|
| Rate for Payer: Coventry All Commercial |
$38.86
|
| Rate for Payer: Encore All Commercial |
$32.38
|
| Rate for Payer: Encore All Commercial |
$32.38
|
| Rate for Payer: Frontpath All Commercial |
$44.17
|
| Rate for Payer: Frontpath All Commercial |
$44.17
|
| Rate for Payer: Humana ChoiceCare |
$49.87
|
| Rate for Payer: Humana ChoiceCare |
$49.87
|
| Rate for Payer: Humana Medicare |
$32.38
|
| Rate for Payer: Humana Medicare |
$32.38
|
| Rate for Payer: Lucent All Commercial |
$45.33
|
| Rate for Payer: Lucent All Commercial |
$45.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$51.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$51.00
|
| Rate for Payer: Managed Health Services Medicaid |
$46.34
|
| Rate for Payer: Managed Health Services Medicaid |
$46.34
|
| Rate for Payer: MDWise Medicaid |
$46.34
|
| Rate for Payer: MDWise Medicaid |
$46.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$25.87
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$25.87
|
| Rate for Payer: PHCS All Commercial |
$32.38
|
| Rate for Payer: PHCS All Commercial |
$32.38
|
| Rate for Payer: PHP All Commercial |
$49.85
|
| Rate for Payer: PHP All Commercial |
$49.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$32.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$32.38
|
| Rate for Payer: Sagamore Health Network All Products |
$32.38
|
| Rate for Payer: Sagamore Health Network All Products |
$32.38
|
| Rate for Payer: Signature Care EPO |
$78.25
|
| Rate for Payer: Signature Care EPO |
$78.25
|
| Rate for Payer: Signature Care PPO |
$78.25
|
| Rate for Payer: Signature Care PPO |
$78.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,800.00
|
| Rate for Payer: United Healthcare Commercial |
$46.18
|
| Rate for Payer: United Healthcare Commercial |
$46.18
|
| Rate for Payer: United Healthcare Medicare |
$45.92
|
| Rate for Payer: United Healthcare Medicare |
$45.92
|
|
|
PR NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS
|
Professional
|
Both
|
$1,097.70
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
z50430
|
| Min. Negotiated Rate |
$135.09 |
| Max. Negotiated Rate |
$578.26 |
| Rate for Payer: Aetna Commercial |
$144.42
|
| Rate for Payer: Aetna Medicare |
$144.42
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$135.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$568.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$166.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$158.86
|
| Rate for Payer: Cash Price |
$658.62
|
| Rate for Payer: Centivo All Commercial |
$223.85
|
| Rate for Payer: Cigna All Commercial |
$144.42
|
| Rate for Payer: CORVEL All Commercial |
$144.42
|
| Rate for Payer: Coventry All Commercial |
$173.30
|
| Rate for Payer: Encore All Commercial |
$144.42
|
| Rate for Payer: Frontpath All Commercial |
$196.40
|
| Rate for Payer: Humana ChoiceCare |
$166.78
|
| Rate for Payer: Humana Medicare |
$144.42
|
| Rate for Payer: Lucent All Commercial |
$202.19
|
| Rate for Payer: Managed Health Services Medicaid |
$568.43
|
| Rate for Payer: MDWise Medicaid |
$568.43
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$135.09
|
| Rate for Payer: PHCS All Commercial |
$144.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$144.42
|
| Rate for Payer: Sagamore Health Network All Products |
$144.42
|
| Rate for Payer: United Healthcare Commercial |
$207.93
|
| Rate for Payer: United Healthcare Medicare |
$578.26
|
|
|
PR NONINVASV OXYGEN SATUR;SINGLE
|
Professional
|
Both
|
$4.62
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
z94760
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: Aetna Commercial |
$2.03
|
| Rate for Payer: Aetna Commercial |
$2.03
|
| Rate for Payer: Aetna Medicare |
$2.03
|
| Rate for Payer: Aetna Medicare |
$2.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$4.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$4.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$4.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$4.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$2.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$2.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2.23
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: Cash Price |
$2.35
|
| Rate for Payer: Centivo All Commercial |
$3.15
|
| Rate for Payer: Centivo All Commercial |
$3.15
|
| Rate for Payer: Cigna All Commercial |
$2.03
|
| Rate for Payer: Cigna All Commercial |
$2.03
|
| Rate for Payer: CORVEL All Commercial |
$2.03
|
| Rate for Payer: CORVEL All Commercial |
$2.03
|
| Rate for Payer: Coventry All Commercial |
$2.44
|
| Rate for Payer: Coventry All Commercial |
$2.44
|
| Rate for Payer: Encore All Commercial |
$2.03
|
| Rate for Payer: Encore All Commercial |
$2.03
|
| Rate for Payer: Frontpath All Commercial |
$2.50
|
| Rate for Payer: Frontpath All Commercial |
$2.50
|
| Rate for Payer: Humana ChoiceCare |
$2.37
|
| Rate for Payer: Humana ChoiceCare |
$2.37
|
| Rate for Payer: Humana Medicare |
$2.03
|
| Rate for Payer: Humana Medicare |
$2.03
|
| Rate for Payer: Lucent All Commercial |
$2.84
|
| Rate for Payer: Lucent All Commercial |
$2.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3.00
|
| Rate for Payer: Managed Health Services Medicaid |
$2.27
|
| Rate for Payer: Managed Health Services Medicaid |
$2.27
|
| Rate for Payer: MDWise Medicaid |
$2.27
|
| Rate for Payer: MDWise Medicaid |
$2.27
|
| Rate for Payer: PHCS All Commercial |
$2.03
|
| Rate for Payer: PHCS All Commercial |
$2.03
|
| Rate for Payer: PHP All Commercial |
$2.65
|
| Rate for Payer: PHP All Commercial |
$2.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2.03
|
| Rate for Payer: Sagamore Health Network All Products |
$2.03
|
| Rate for Payer: Sagamore Health Network All Products |
$2.03
|
| Rate for Payer: Signature Care EPO |
$2.55
|
| Rate for Payer: Signature Care EPO |
$2.55
|
| Rate for Payer: Signature Care PPO |
$2.55
|
| Rate for Payer: Signature Care PPO |
$2.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$200.00
|
| Rate for Payer: United Healthcare Commercial |
$3.03
|
| Rate for Payer: United Healthcare Commercial |
$3.03
|
| Rate for Payer: United Healthcare Medicare |
$1.96
|
| Rate for Payer: United Healthcare Medicare |
$1.96
|
|
|
PR NONPHYSICIAN TELEPHONE ASSESSMENT 11-20 MIN
|
Professional
|
Both
|
$46.20
|
|
|
Service Code
|
CPT 98967
|
| Hospital Charge Code |
z98967
|
| Min. Negotiated Rate |
$20.58 |
| Max. Negotiated Rate |
$2,600.00 |
| Rate for Payer: Aetna Commercial |
$21.36
|
| Rate for Payer: Aetna Commercial |
$21.36
|
| Rate for Payer: Aetna Medicare |
$21.36
|
| Rate for Payer: Aetna Medicare |
$21.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$31.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$31.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$31.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$31.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$31.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$31.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23.50
|
| Rate for Payer: Cash Price |
$27.08
|
| Rate for Payer: Cash Price |
$27.72
|
| Rate for Payer: Centivo All Commercial |
$33.11
|
| Rate for Payer: Centivo All Commercial |
$33.11
|
| Rate for Payer: Cigna All Commercial |
$21.36
|
| Rate for Payer: Cigna All Commercial |
$21.36
|
| Rate for Payer: CORVEL All Commercial |
$21.36
|
| Rate for Payer: CORVEL All Commercial |
$21.36
|
| Rate for Payer: Coventry All Commercial |
$25.63
|
| Rate for Payer: Coventry All Commercial |
$25.63
|
| Rate for Payer: Encore All Commercial |
$21.36
|
| Rate for Payer: Encore All Commercial |
$21.36
|
| Rate for Payer: Frontpath All Commercial |
$22.72
|
| Rate for Payer: Frontpath All Commercial |
$22.72
|
| Rate for Payer: Humana ChoiceCare |
$20.97
|
| Rate for Payer: Humana ChoiceCare |
$20.97
|
| Rate for Payer: Humana Medicare |
$21.36
|
| Rate for Payer: Humana Medicare |
$21.36
|
| Rate for Payer: Lucent All Commercial |
$29.90
|
| Rate for Payer: Lucent All Commercial |
$29.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$28.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$28.00
|
| Rate for Payer: PHCS All Commercial |
$21.36
|
| Rate for Payer: PHCS All Commercial |
$21.36
|
| Rate for Payer: PHP All Commercial |
$24.91
|
| Rate for Payer: PHP All Commercial |
$24.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$21.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$21.36
|
| Rate for Payer: Sagamore Health Network All Products |
$21.36
|
| Rate for Payer: Sagamore Health Network All Products |
$21.36
|
| Rate for Payer: Signature Care EPO |
$20.58
|
| Rate for Payer: Signature Care EPO |
$20.58
|
| Rate for Payer: Signature Care PPO |
$20.58
|
| Rate for Payer: Signature Care PPO |
$20.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,600.00
|
| Rate for Payer: United Healthcare Commercial |
$30.11
|
| Rate for Payer: United Healthcare Commercial |
$30.11
|
| Rate for Payer: United Healthcare Medicare |
$22.57
|
| Rate for Payer: United Healthcare Medicare |
$22.57
|
|
|
PR NONPHYSICIAN TELEPHONE ASSESSMENT 21-30 MIN
|
Professional
|
Both
|
$64.08
|
|
|
Service Code
|
CPT 98968
|
| Hospital Charge Code |
z98968
|
| Min. Negotiated Rate |
$30.55 |
| Max. Negotiated Rate |
$3,600.00 |
| Rate for Payer: Aetna Commercial |
$30.96
|
| Rate for Payer: Aetna Commercial |
$30.96
|
| Rate for Payer: Aetna Medicare |
$30.96
|
| Rate for Payer: Aetna Medicare |
$30.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$46.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$46.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$46.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$46.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$46.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$46.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$46.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$46.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$35.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$35.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$34.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$34.06
|
| Rate for Payer: Cash Price |
$38.09
|
| Rate for Payer: Cash Price |
$38.45
|
| Rate for Payer: Centivo All Commercial |
$47.99
|
| Rate for Payer: Centivo All Commercial |
$47.99
|
| Rate for Payer: Cigna All Commercial |
$30.96
|
| Rate for Payer: Cigna All Commercial |
$30.96
|
| Rate for Payer: CORVEL All Commercial |
$30.96
|
| Rate for Payer: CORVEL All Commercial |
$30.96
|
| Rate for Payer: Coventry All Commercial |
$37.15
|
| Rate for Payer: Coventry All Commercial |
$37.15
|
| Rate for Payer: Encore All Commercial |
$30.96
|
| Rate for Payer: Encore All Commercial |
$30.96
|
| Rate for Payer: Frontpath All Commercial |
$33.17
|
| Rate for Payer: Frontpath All Commercial |
$33.17
|
| Rate for Payer: Humana ChoiceCare |
$31.63
|
| Rate for Payer: Humana ChoiceCare |
$31.63
|
| Rate for Payer: Humana Medicare |
$30.96
|
| Rate for Payer: Humana Medicare |
$30.96
|
| Rate for Payer: Lucent All Commercial |
$43.34
|
| Rate for Payer: Lucent All Commercial |
$43.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$39.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$39.00
|
| Rate for Payer: PHCS All Commercial |
$30.96
|
| Rate for Payer: PHCS All Commercial |
$30.96
|
| Rate for Payer: PHP All Commercial |
$35.55
|
| Rate for Payer: PHP All Commercial |
$35.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.96
|
| Rate for Payer: Sagamore Health Network All Products |
$30.96
|
| Rate for Payer: Sagamore Health Network All Products |
$30.96
|
| Rate for Payer: Signature Care EPO |
$30.55
|
| Rate for Payer: Signature Care EPO |
$30.55
|
| Rate for Payer: Signature Care PPO |
$30.55
|
| Rate for Payer: Signature Care PPO |
$30.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,600.00
|
| Rate for Payer: United Healthcare Commercial |
$44.98
|
| Rate for Payer: United Healthcare Commercial |
$44.98
|
| Rate for Payer: United Healthcare Medicare |
$31.74
|
| Rate for Payer: United Healthcare Medicare |
$31.74
|
|
|
PR NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 MIN
|
Professional
|
Both
|
$24.68
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
z98966
|
| Min. Negotiated Rate |
$10.66 |
| Max. Negotiated Rate |
$1,300.00 |
| Rate for Payer: Aetna Commercial |
$10.99
|
| Rate for Payer: Aetna Commercial |
$10.99
|
| Rate for Payer: Aetna Medicare |
$10.99
|
| Rate for Payer: Aetna Medicare |
$10.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$16.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$16.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$16.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$16.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$16.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$16.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.09
|
| Rate for Payer: Cash Price |
$14.81
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Centivo All Commercial |
$17.03
|
| Rate for Payer: Centivo All Commercial |
$17.03
|
| Rate for Payer: Cigna All Commercial |
$10.99
|
| Rate for Payer: Cigna All Commercial |
$10.99
|
| Rate for Payer: CORVEL All Commercial |
$10.99
|
| Rate for Payer: CORVEL All Commercial |
$10.99
|
| Rate for Payer: Coventry All Commercial |
$13.19
|
| Rate for Payer: Coventry All Commercial |
$13.19
|
| Rate for Payer: Encore All Commercial |
$10.99
|
| Rate for Payer: Encore All Commercial |
$10.99
|
| Rate for Payer: Frontpath All Commercial |
$11.69
|
| Rate for Payer: Frontpath All Commercial |
$11.69
|
| Rate for Payer: Humana ChoiceCare |
$10.66
|
| Rate for Payer: Humana ChoiceCare |
$10.66
|
| Rate for Payer: Humana Medicare |
$10.99
|
| Rate for Payer: Humana Medicare |
$10.99
|
| Rate for Payer: Lucent All Commercial |
$15.39
|
| Rate for Payer: Lucent All Commercial |
$15.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14.00
|
| Rate for Payer: PHCS All Commercial |
$10.99
|
| Rate for Payer: PHCS All Commercial |
$10.99
|
| Rate for Payer: PHP All Commercial |
$12.64
|
| Rate for Payer: PHP All Commercial |
$12.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$10.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$10.99
|
| Rate for Payer: Sagamore Health Network All Products |
$10.99
|
| Rate for Payer: Sagamore Health Network All Products |
$10.99
|
| Rate for Payer: Signature Care EPO |
$10.94
|
| Rate for Payer: Signature Care EPO |
$10.94
|
| Rate for Payer: Signature Care PPO |
$10.94
|
| Rate for Payer: Signature Care PPO |
$10.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,300.00
|
| Rate for Payer: United Healthcare Commercial |
$14.85
|
| Rate for Payer: United Healthcare Commercial |
$14.85
|
| Rate for Payer: United Healthcare Medicare |
$12.34
|
| Rate for Payer: United Healthcare Medicare |
$12.34
|
|
|
PR NURSING FACILITY DSCHRG MGMT 30 MIN/< TOT TIME
|
Professional
|
Both
|
$154.04
|
|
|
Service Code
|
CPT 99315
|
| Hospital Charge Code |
z99315
|
| Min. Negotiated Rate |
$58.87 |
| Max. Negotiated Rate |
$8,000.00 |
| Rate for Payer: Aetna Commercial |
$68.17
|
| Rate for Payer: Aetna Commercial |
$68.17
|
| Rate for Payer: Aetna Medicare |
$68.17
|
| Rate for Payer: Aetna Medicare |
$68.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$72.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$72.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$72.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$72.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$72.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$72.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$72.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$72.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.76
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$74.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$74.99
|
| Rate for Payer: Cash Price |
$92.42
|
| Rate for Payer: Cash Price |
$90.67
|
| Rate for Payer: Centivo All Commercial |
$105.66
|
| Rate for Payer: Centivo All Commercial |
$105.66
|
| Rate for Payer: Cigna All Commercial |
$68.17
|
| Rate for Payer: Cigna All Commercial |
$68.17
|
| Rate for Payer: CORVEL All Commercial |
$68.17
|
| Rate for Payer: CORVEL All Commercial |
$68.17
|
| Rate for Payer: Coventry All Commercial |
$81.80
|
| Rate for Payer: Coventry All Commercial |
$81.80
|
| Rate for Payer: Encore All Commercial |
$68.17
|
| Rate for Payer: Encore All Commercial |
$68.17
|
| Rate for Payer: Frontpath All Commercial |
$73.27
|
| Rate for Payer: Frontpath All Commercial |
$73.27
|
| Rate for Payer: Humana ChoiceCare |
$62.88
|
| Rate for Payer: Humana ChoiceCare |
$62.88
|
| Rate for Payer: Humana Medicare |
$68.17
|
| Rate for Payer: Humana Medicare |
$68.17
|
| Rate for Payer: Lucent All Commercial |
$95.44
|
| Rate for Payer: Lucent All Commercial |
$95.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$81.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$81.00
|
| Rate for Payer: Managed Health Services Medicaid |
$75.76
|
| Rate for Payer: Managed Health Services Medicaid |
$75.76
|
| Rate for Payer: MDWise Medicaid |
$75.76
|
| Rate for Payer: MDWise Medicaid |
$75.76
|
| Rate for Payer: PHCS All Commercial |
$68.17
|
| Rate for Payer: PHCS All Commercial |
$68.17
|
| Rate for Payer: PHP All Commercial |
$77.82
|
| Rate for Payer: PHP All Commercial |
$77.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.17
|
| Rate for Payer: Sagamore Health Network All Products |
$68.17
|
| Rate for Payer: Sagamore Health Network All Products |
$68.17
|
| Rate for Payer: Signature Care EPO |
$61.20
|
| Rate for Payer: Signature Care EPO |
$61.20
|
| Rate for Payer: Signature Care PPO |
$61.20
|
| Rate for Payer: Signature Care PPO |
$61.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,000.00
|
| Rate for Payer: United Healthcare Commercial |
$58.87
|
| Rate for Payer: United Healthcare Commercial |
$58.87
|
| Rate for Payer: United Healthcare Medicare |
$75.56
|
| Rate for Payer: United Healthcare Medicare |
$75.56
|
|
|
PR OBSTE CARE,VAG DELIV+POSTPARTUM
|
Professional
|
Both
|
$1,943.12
|
|
|
Service Code
|
CPT 59410
|
| Hospital Charge Code |
z59410
|
| Min. Negotiated Rate |
$834.36 |
| Max. Negotiated Rate |
$125,100.00 |
| Rate for Payer: Aetna Commercial |
$969.31
|
| Rate for Payer: Aetna Commercial |
$969.31
|
| Rate for Payer: Aetna Medicare |
$969.31
|
| Rate for Payer: Aetna Medicare |
$969.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,089.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,089.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,089.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,089.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,089.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,089.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,089.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,089.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$955.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$955.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,114.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,114.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,066.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,066.24
|
| Rate for Payer: Cash Price |
$1,165.87
|
| Rate for Payer: Cash Price |
$1,126.64
|
| Rate for Payer: Centivo All Commercial |
$1,502.43
|
| Rate for Payer: Centivo All Commercial |
$1,502.43
|
| Rate for Payer: Cigna All Commercial |
$969.31
|
| Rate for Payer: Cigna All Commercial |
$969.31
|
| Rate for Payer: CORVEL All Commercial |
$969.31
|
| Rate for Payer: CORVEL All Commercial |
$969.31
|
| Rate for Payer: Coventry All Commercial |
$1,163.17
|
| Rate for Payer: Coventry All Commercial |
$1,163.17
|
| Rate for Payer: Encore All Commercial |
$969.31
|
| Rate for Payer: Encore All Commercial |
$969.31
|
| Rate for Payer: Frontpath All Commercial |
$1,377.84
|
| Rate for Payer: Frontpath All Commercial |
$1,377.84
|
| Rate for Payer: Humana ChoiceCare |
$834.36
|
| Rate for Payer: Humana ChoiceCare |
$834.36
|
| Rate for Payer: Humana Medicare |
$969.31
|
| Rate for Payer: Humana Medicare |
$969.31
|
| Rate for Payer: Lucent All Commercial |
$1,357.03
|
| Rate for Payer: Lucent All Commercial |
$1,357.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,347.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,347.00
|
| Rate for Payer: Managed Health Services Medicaid |
$955.70
|
| Rate for Payer: Managed Health Services Medicaid |
$955.70
|
| Rate for Payer: MDWise Medicaid |
$955.70
|
| Rate for Payer: MDWise Medicaid |
$955.70
|
| Rate for Payer: PHCS All Commercial |
$969.31
|
| Rate for Payer: PHCS All Commercial |
$969.31
|
| Rate for Payer: PHP All Commercial |
$1,239.31
|
| Rate for Payer: PHP All Commercial |
$1,239.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$969.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$969.31
|
| Rate for Payer: Sagamore Health Network All Products |
$969.31
|
| Rate for Payer: Sagamore Health Network All Products |
$969.31
|
| Rate for Payer: Signature Care EPO |
$1,071.00
|
| Rate for Payer: Signature Care EPO |
$1,071.00
|
| Rate for Payer: Signature Care PPO |
$1,071.00
|
| Rate for Payer: Signature Care PPO |
$1,071.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$125,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$125,100.00
|
| Rate for Payer: United Healthcare Commercial |
$1,011.59
|
| Rate for Payer: United Healthcare Commercial |
$1,011.59
|
| Rate for Payer: United Healthcare Medicare |
$938.87
|
| Rate for Payer: United Healthcare Medicare |
$938.87
|
|
|
PR OBSTETRICAL CARE,VAG DELIV ONLY
|
Professional
|
Both
|
$1,434.66
|
|
|
Service Code
|
CPT 59409
|
| Hospital Charge Code |
z59409
|
| Min. Negotiated Rate |
$705.62 |
| Max. Negotiated Rate |
$94,400.00 |
| Rate for Payer: Aetna Commercial |
$732.66
|
| Rate for Payer: Aetna Commercial |
$732.66
|
| Rate for Payer: Aetna Medicare |
$732.66
|
| Rate for Payer: Aetna Medicare |
$732.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$987.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$987.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$987.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$987.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$987.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$987.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$987.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$987.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$705.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$705.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$842.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$842.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$805.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$805.93
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$850.45
|
| Rate for Payer: Centivo All Commercial |
$1,135.62
|
| Rate for Payer: Centivo All Commercial |
$1,135.62
|
| Rate for Payer: Cigna All Commercial |
$732.66
|
| Rate for Payer: Cigna All Commercial |
$732.66
|
| Rate for Payer: CORVEL All Commercial |
$732.66
|
| Rate for Payer: CORVEL All Commercial |
$732.66
|
| Rate for Payer: Coventry All Commercial |
$879.19
|
| Rate for Payer: Coventry All Commercial |
$879.19
|
| Rate for Payer: Encore All Commercial |
$732.66
|
| Rate for Payer: Encore All Commercial |
$732.66
|
| Rate for Payer: Frontpath All Commercial |
$1,044.98
|
| Rate for Payer: Frontpath All Commercial |
$1,044.98
|
| Rate for Payer: Humana ChoiceCare |
$746.56
|
| Rate for Payer: Humana ChoiceCare |
$746.56
|
| Rate for Payer: Humana Medicare |
$732.66
|
| Rate for Payer: Humana Medicare |
$732.66
|
| Rate for Payer: Lucent All Commercial |
$1,025.72
|
| Rate for Payer: Lucent All Commercial |
$1,025.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,017.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,017.00
|
| Rate for Payer: Managed Health Services Medicaid |
$705.62
|
| Rate for Payer: Managed Health Services Medicaid |
$705.62
|
| Rate for Payer: MDWise Medicaid |
$705.62
|
| Rate for Payer: MDWise Medicaid |
$705.62
|
| Rate for Payer: PHCS All Commercial |
$732.66
|
| Rate for Payer: PHCS All Commercial |
$732.66
|
| Rate for Payer: PHP All Commercial |
$935.50
|
| Rate for Payer: PHP All Commercial |
$935.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$732.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$732.66
|
| Rate for Payer: Sagamore Health Network All Products |
$732.66
|
| Rate for Payer: Sagamore Health Network All Products |
$732.66
|
| Rate for Payer: Signature Care EPO |
$957.95
|
| Rate for Payer: Signature Care EPO |
$957.95
|
| Rate for Payer: Signature Care PPO |
$957.95
|
| Rate for Payer: Signature Care PPO |
$957.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94,400.00
|
| Rate for Payer: United Healthcare Commercial |
$872.23
|
| Rate for Payer: United Healthcare Commercial |
$872.23
|
| Rate for Payer: United Healthcare Medicare |
$708.71
|
| Rate for Payer: United Healthcare Medicare |
$708.71
|
|
|
PR OBTAINING SCREEN PAP SMEAR
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
zQ0091
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$57.80 |
| Rate for Payer: Aetna Commercial |
$17.81
|
| Rate for Payer: Aetna Medicare |
$17.81
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$14.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$40.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$20.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$19.59
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Centivo All Commercial |
$27.61
|
| Rate for Payer: Cigna All Commercial |
$17.81
|
| Rate for Payer: CORVEL All Commercial |
$17.81
|
| Rate for Payer: Coventry All Commercial |
$21.37
|
| Rate for Payer: Encore All Commercial |
$17.81
|
| Rate for Payer: Humana Medicare |
$17.81
|
| Rate for Payer: Lucent All Commercial |
$24.93
|
| Rate for Payer: Managed Health Services Medicaid |
$40.81
|
| Rate for Payer: MDWise Medicaid |
$40.81
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$14.69
|
| Rate for Payer: PHCS All Commercial |
$17.81
|
| Rate for Payer: PHP All Commercial |
$12.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$17.81
|
| Rate for Payer: Sagamore Health Network All Products |
$17.81
|
| Rate for Payer: Signature Care EPO |
$57.80
|
| Rate for Payer: Signature Care PPO |
$57.80
|
| Rate for Payer: United Healthcare Commercial |
$18.29
|
|
|
PROCAINAMIDE 500 MG/ML INJ SOLN
|
Facility
|
IP
|
$2,424.00
|
|
|
Service Code
|
HCPCS J2690
|
| Hospital Charge Code |
6563
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1,818.00 |
| Max. Negotiated Rate |
$2,254.32 |
| Rate for Payer: Aetna Commercial |
$2,094.34
|
| Rate for Payer: Cash Price |
$1,454.40
|
| Rate for Payer: Cigna All Commercial |
$2,091.91
|
| Rate for Payer: CORVEL All Commercial |
$2,254.32
|
| Rate for Payer: Coventry All Commercial |
$2,133.12
|
| Rate for Payer: Encore All Commercial |
$2,231.29
|
| Rate for Payer: Frontpath All Commercial |
$2,230.08
|
| Rate for Payer: Humana ChoiceCare |
$2,093.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,181.60
|
| Rate for Payer: PHCS All Commercial |
$1,818.00
|
| Rate for Payer: PHP All Commercial |
$1,838.36
|
| Rate for Payer: Sagamore Health Network All Products |
$1,871.33
|
| Rate for Payer: Signature Care EPO |
$2,011.92
|
| Rate for Payer: Signature Care PPO |
$2,133.12
|
| Rate for Payer: United Healthcare Commercial |
$1,910.11
|
|
|
PROCAINAMIDE 500 MG/ML INJ SOLN
|
Facility
|
OP
|
$2,424.00
|
|
|
Service Code
|
HCPCS J2690
|
| Hospital Charge Code |
6563
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$751.44 |
| Max. Negotiated Rate |
$2,254.32 |
| Rate for Payer: Aetna Commercial |
$2,045.86
|
| Rate for Payer: Aetna Medicare |
$775.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$751.44
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,392.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,515.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$892.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$853.25
|
| Rate for Payer: Cash Price |
$1,454.40
|
| Rate for Payer: Centivo All Commercial |
$1,318.66
|
| Rate for Payer: Cigna All Commercial |
$2,091.91
|
| Rate for Payer: CORVEL All Commercial |
$2,254.32
|
| Rate for Payer: Coventry All Commercial |
$2,133.12
|
| Rate for Payer: Encore All Commercial |
$2,231.29
|
| Rate for Payer: Frontpath All Commercial |
$2,230.08
|
| Rate for Payer: Humana ChoiceCare |
$2,093.61
|
| Rate for Payer: Humana Medicare |
$775.68
|
| Rate for Payer: Lucent All Commercial |
$1,318.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,181.60
|
| Rate for Payer: PHCS All Commercial |
$1,818.00
|
| Rate for Payer: PHP All Commercial |
$1,838.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$945.36
|
| Rate for Payer: Sagamore Health Network All Products |
$1,871.33
|
| Rate for Payer: Signature Care EPO |
$2,011.92
|
| Rate for Payer: Signature Care PPO |
$2,133.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,060.40
|
| Rate for Payer: United Healthcare Commercial |
$1,910.11
|
| Rate for Payer: United Healthcare Medicare |
$775.68
|
|
|
PROCHLORPERAZINE 25 MG RECT SUPP
|
Facility
|
IP
|
$68.61
|
|
|
Service Code
|
HCPCS J8498
|
| Hospital Charge Code |
11138
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$51.46 |
| Max. Negotiated Rate |
$63.81 |
| Rate for Payer: Aetna Commercial |
$59.28
|
| Rate for Payer: Cash Price |
$41.17
|
| Rate for Payer: Cigna All Commercial |
$59.21
|
| Rate for Payer: CORVEL All Commercial |
$63.81
|
| Rate for Payer: Coventry All Commercial |
$60.38
|
| Rate for Payer: Encore All Commercial |
$63.16
|
| Rate for Payer: Frontpath All Commercial |
$63.12
|
| Rate for Payer: Humana ChoiceCare |
$59.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$61.75
|
| Rate for Payer: PHCS All Commercial |
$51.46
|
| Rate for Payer: PHP All Commercial |
$52.04
|
| Rate for Payer: Sagamore Health Network All Products |
$52.97
|
| Rate for Payer: Signature Care EPO |
$56.95
|
| Rate for Payer: Signature Care PPO |
$60.38
|
| Rate for Payer: United Healthcare Commercial |
$54.07
|
|
|
PROCHLORPERAZINE 25 MG RECT SUPP
|
Facility
|
OP
|
$68.61
|
|
|
Service Code
|
HCPCS J8498
|
| Hospital Charge Code |
11138
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.27 |
| Max. Negotiated Rate |
$63.81 |
| Rate for Payer: Aetna Commercial |
$57.91
|
| Rate for Payer: Aetna Medicare |
$21.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$21.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$39.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$42.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$25.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$24.15
|
| Rate for Payer: Cash Price |
$41.17
|
| Rate for Payer: Centivo All Commercial |
$37.33
|
| Rate for Payer: Cigna All Commercial |
$59.21
|
| Rate for Payer: CORVEL All Commercial |
$63.81
|
| Rate for Payer: Coventry All Commercial |
$60.38
|
| Rate for Payer: Encore All Commercial |
$63.16
|
| Rate for Payer: Frontpath All Commercial |
$63.12
|
| Rate for Payer: Humana ChoiceCare |
$59.26
|
| Rate for Payer: Humana Medicare |
$21.96
|
| Rate for Payer: Lucent All Commercial |
$37.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$61.75
|
| Rate for Payer: PHCS All Commercial |
$51.46
|
| Rate for Payer: PHP All Commercial |
$52.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$26.76
|
| Rate for Payer: Sagamore Health Network All Products |
$52.97
|
| Rate for Payer: Signature Care EPO |
$56.95
|
| Rate for Payer: Signature Care PPO |
$60.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$58.32
|
| Rate for Payer: United Healthcare Commercial |
$54.07
|
| Rate for Payer: United Healthcare Medicare |
$21.96
|
|
|
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN
|
Facility
|
OP
|
$25.94
|
|
|
Service Code
|
HCPCS J0780
|
| Hospital Charge Code |
152840
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.04 |
| Max. Negotiated Rate |
$24.13 |
| Rate for Payer: Aetna Commercial |
$21.90
|
| Rate for Payer: Aetna Medicare |
$8.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$8.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$14.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$9.13
|
| Rate for Payer: Cash Price |
$15.57
|
| Rate for Payer: Centivo All Commercial |
$14.11
|
| Rate for Payer: Cigna All Commercial |
$22.39
|
| Rate for Payer: CORVEL All Commercial |
$24.13
|
| Rate for Payer: Coventry All Commercial |
$22.83
|
| Rate for Payer: Encore All Commercial |
$23.88
|
| Rate for Payer: Frontpath All Commercial |
$23.87
|
| Rate for Payer: Humana ChoiceCare |
$22.41
|
| Rate for Payer: Humana Medicare |
$8.30
|
| Rate for Payer: Lucent All Commercial |
$14.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$23.35
|
| Rate for Payer: PHCS All Commercial |
$19.46
|
| Rate for Payer: PHP All Commercial |
$19.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$10.12
|
| Rate for Payer: Sagamore Health Network All Products |
$20.03
|
| Rate for Payer: Signature Care EPO |
$21.53
|
| Rate for Payer: Signature Care PPO |
$22.83
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$22.05
|
| Rate for Payer: United Healthcare Commercial |
$20.44
|
| Rate for Payer: United Healthcare Medicare |
$8.30
|
|
