|
PROMETHAZINE 25 MG RECT SUPP
|
Facility
|
IP
|
$23.09
|
|
|
Service Code
|
HCPCS J8498
|
| Hospital Charge Code |
11144
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.31 |
| Max. Negotiated Rate |
$21.47 |
| Rate for Payer: Aetna Commercial |
$19.95
|
| Rate for Payer: Cash Price |
$13.85
|
| Rate for Payer: Cigna All Commercial |
$19.92
|
| Rate for Payer: CORVEL All Commercial |
$21.47
|
| Rate for Payer: Coventry All Commercial |
$20.32
|
| Rate for Payer: Encore All Commercial |
$21.25
|
| Rate for Payer: Frontpath All Commercial |
$21.24
|
| Rate for Payer: Humana ChoiceCare |
$19.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$20.78
|
| Rate for Payer: PHCS All Commercial |
$17.31
|
| Rate for Payer: PHP All Commercial |
$17.51
|
| Rate for Payer: Sagamore Health Network All Products |
$17.82
|
| Rate for Payer: Signature Care EPO |
$19.16
|
| Rate for Payer: Signature Care PPO |
$20.32
|
| Rate for Payer: United Healthcare Commercial |
$18.19
|
|
|
PROMETHAZINE 25 MG RECT SUPP
|
Facility
|
OP
|
$23.09
|
|
|
Service Code
|
HCPCS J8498
|
| Hospital Charge Code |
11144
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$21.47 |
| Rate for Payer: Aetna Commercial |
$19.48
|
| Rate for Payer: Aetna Medicare |
$7.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$7.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$13.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$14.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$8.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$8.13
|
| Rate for Payer: Cash Price |
$13.85
|
| Rate for Payer: Centivo All Commercial |
$12.56
|
| Rate for Payer: Cigna All Commercial |
$19.92
|
| Rate for Payer: CORVEL All Commercial |
$21.47
|
| Rate for Payer: Coventry All Commercial |
$20.32
|
| Rate for Payer: Encore All Commercial |
$21.25
|
| Rate for Payer: Frontpath All Commercial |
$21.24
|
| Rate for Payer: Humana ChoiceCare |
$19.94
|
| Rate for Payer: Humana Medicare |
$7.39
|
| Rate for Payer: Lucent All Commercial |
$12.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$20.78
|
| Rate for Payer: PHCS All Commercial |
$17.31
|
| Rate for Payer: PHP All Commercial |
$17.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$9.00
|
| Rate for Payer: Sagamore Health Network All Products |
$17.82
|
| Rate for Payer: Signature Care EPO |
$19.16
|
| Rate for Payer: Signature Care PPO |
$20.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$19.62
|
| Rate for Payer: United Healthcare Commercial |
$18.19
|
| Rate for Payer: United Healthcare Medicare |
$7.39
|
|
|
PROPARACAINE 0.5 % OPHT DROP
|
Facility
|
OP
|
$209.37
|
|
|
Service Code
|
NDC 61314001601
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$194.71 |
| Rate for Payer: Aetna Commercial |
$176.71
|
| Rate for Payer: Aetna Medicare |
$67.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$9.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$64.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$120.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$130.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$9.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$77.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$73.70
|
| Rate for Payer: Cash Price |
$125.62
|
| Rate for Payer: Cash Price |
$125.62
|
| Rate for Payer: Centivo All Commercial |
$113.90
|
| Rate for Payer: Cigna All Commercial |
$180.69
|
| Rate for Payer: CORVEL All Commercial |
$194.71
|
| Rate for Payer: Coventry All Commercial |
$184.25
|
| Rate for Payer: Encore All Commercial |
$192.73
|
| Rate for Payer: Frontpath All Commercial |
$192.62
|
| Rate for Payer: Humana ChoiceCare |
$180.83
|
| Rate for Payer: Humana Medicare |
$67.00
|
| Rate for Payer: Lucent All Commercial |
$113.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$188.43
|
| Rate for Payer: Managed Health Services Medicaid |
$9.56
|
| Rate for Payer: MDWise Medicaid |
$9.56
|
| Rate for Payer: PHCS All Commercial |
$157.03
|
| Rate for Payer: PHP All Commercial |
$158.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.65
|
| Rate for Payer: Sagamore Health Network All Products |
$161.63
|
| Rate for Payer: Signature Care EPO |
$173.78
|
| Rate for Payer: Signature Care PPO |
$184.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$177.96
|
| Rate for Payer: United Healthcare Commercial |
$164.98
|
| Rate for Payer: United Healthcare Medicare |
$67.00
|
|
|
PROPARACAINE 0.5 % OPHT DROP
|
Facility
|
IP
|
$209.37
|
|
|
Service Code
|
NDC 61314001601
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$157.03 |
| Max. Negotiated Rate |
$194.71 |
| Rate for Payer: Aetna Commercial |
$180.90
|
| Rate for Payer: Cash Price |
$125.62
|
| Rate for Payer: Cigna All Commercial |
$180.69
|
| Rate for Payer: CORVEL All Commercial |
$194.71
|
| Rate for Payer: Coventry All Commercial |
$184.25
|
| Rate for Payer: Encore All Commercial |
$192.73
|
| Rate for Payer: Frontpath All Commercial |
$192.62
|
| Rate for Payer: Humana ChoiceCare |
$180.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$188.43
|
| Rate for Payer: PHCS All Commercial |
$157.03
|
| Rate for Payer: PHP All Commercial |
$158.79
|
| Rate for Payer: Sagamore Health Network All Products |
$161.63
|
| Rate for Payer: Signature Care EPO |
$173.78
|
| Rate for Payer: Signature Care PPO |
$184.25
|
| Rate for Payer: United Healthcare Commercial |
$164.98
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Professional
|
Both
|
$799.38
|
|
|
Service Code
|
CPT 38531
|
| Hospital Charge Code |
z38531
|
| Min. Negotiated Rate |
$401.09 |
| Max. Negotiated Rate |
$641.58 |
| Rate for Payer: Aetna Commercial |
$413.92
|
| Rate for Payer: Aetna Medicare |
$413.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$402.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$476.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$455.31
|
| Rate for Payer: Cash Price |
$479.63
|
| Rate for Payer: Centivo All Commercial |
$641.58
|
| Rate for Payer: Cigna All Commercial |
$413.92
|
| Rate for Payer: CORVEL All Commercial |
$413.92
|
| Rate for Payer: Coventry All Commercial |
$496.70
|
| Rate for Payer: Encore All Commercial |
$413.92
|
| Rate for Payer: Frontpath All Commercial |
$584.87
|
| Rate for Payer: Humana ChoiceCare |
$538.27
|
| Rate for Payer: Humana Medicare |
$413.92
|
| Rate for Payer: Lucent All Commercial |
$579.49
|
| Rate for Payer: Managed Health Services Medicaid |
$402.20
|
| Rate for Payer: MDWise Medicaid |
$402.20
|
| Rate for Payer: PHCS All Commercial |
$413.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$413.92
|
| Rate for Payer: Sagamore Health Network All Products |
$413.92
|
| Rate for Payer: United Healthcare Commercial |
$528.26
|
| Rate for Payer: United Healthcare Medicare |
$401.09
|
|
|
PR OPEN FIXATN MID HUMERUS FRACTURE
|
Professional
|
Both
|
$1,632.08
|
|
|
Service Code
|
CPT 24515
|
| Hospital Charge Code |
z24515
|
| Min. Negotiated Rate |
$799.80 |
| Max. Negotiated Rate |
$123,000.00 |
| Rate for Payer: Aetna Commercial |
$821.39
|
| Rate for Payer: Aetna Commercial |
$821.39
|
| Rate for Payer: Aetna Medicare |
$821.39
|
| Rate for Payer: Aetna Medicare |
$821.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,085.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,085.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$802.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$802.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$944.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$944.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$903.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$903.53
|
| Rate for Payer: Cash Price |
$979.25
|
| Rate for Payer: Cash Price |
$959.76
|
| Rate for Payer: Centivo All Commercial |
$1,273.15
|
| Rate for Payer: Centivo All Commercial |
$1,273.15
|
| Rate for Payer: Cigna All Commercial |
$821.39
|
| Rate for Payer: Cigna All Commercial |
$821.39
|
| Rate for Payer: CORVEL All Commercial |
$821.39
|
| Rate for Payer: CORVEL All Commercial |
$821.39
|
| Rate for Payer: Coventry All Commercial |
$985.67
|
| Rate for Payer: Coventry All Commercial |
$985.67
|
| Rate for Payer: Encore All Commercial |
$821.39
|
| Rate for Payer: Encore All Commercial |
$821.39
|
| Rate for Payer: Frontpath All Commercial |
$1,143.94
|
| Rate for Payer: Frontpath All Commercial |
$1,143.94
|
| Rate for Payer: Humana ChoiceCare |
$918.40
|
| Rate for Payer: Humana ChoiceCare |
$918.40
|
| Rate for Payer: Humana Medicare |
$821.39
|
| Rate for Payer: Humana Medicare |
$821.39
|
| Rate for Payer: Lucent All Commercial |
$1,149.95
|
| Rate for Payer: Lucent All Commercial |
$1,149.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,312.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,312.00
|
| Rate for Payer: Managed Health Services Medicaid |
$802.72
|
| Rate for Payer: Managed Health Services Medicaid |
$802.72
|
| Rate for Payer: MDWise Medicaid |
$802.72
|
| Rate for Payer: MDWise Medicaid |
$802.72
|
| Rate for Payer: PHCS All Commercial |
$821.39
|
| Rate for Payer: PHCS All Commercial |
$821.39
|
| Rate for Payer: PHP All Commercial |
$1,391.66
|
| Rate for Payer: PHP All Commercial |
$1,391.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$821.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$821.39
|
| Rate for Payer: Sagamore Health Network All Products |
$821.39
|
| Rate for Payer: Sagamore Health Network All Products |
$821.39
|
| Rate for Payer: Signature Care EPO |
$1,228.25
|
| Rate for Payer: Signature Care EPO |
$1,228.25
|
| Rate for Payer: Signature Care PPO |
$1,228.25
|
| Rate for Payer: Signature Care PPO |
$1,228.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$123,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$123,000.00
|
| Rate for Payer: United Healthcare Commercial |
$949.15
|
| Rate for Payer: United Healthcare Commercial |
$949.15
|
| Rate for Payer: United Healthcare Medicare |
$799.80
|
| Rate for Payer: United Healthcare Medicare |
$799.80
|
|
|
PR OPEN FIX INTER/SUBTROCH FX,IMPLNT
|
Professional
|
Both
|
$2,254.84
|
|
|
Service Code
|
CPT 27245
|
| Hospital Charge Code |
z27245
|
| Min. Negotiated Rate |
$1,106.64 |
| Max. Negotiated Rate |
$170,100.00 |
| Rate for Payer: Aetna Commercial |
$1,139.21
|
| Rate for Payer: Aetna Commercial |
$1,139.21
|
| Rate for Payer: Aetna Medicare |
$1,139.21
|
| Rate for Payer: Aetna Medicare |
$1,139.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,802.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,802.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,802.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,802.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,802.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,802.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,802.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,802.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,109.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,109.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,310.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,310.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,253.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,253.13
|
| Rate for Payer: Cash Price |
$1,352.90
|
| Rate for Payer: Cash Price |
$1,327.97
|
| Rate for Payer: Centivo All Commercial |
$1,765.78
|
| Rate for Payer: Centivo All Commercial |
$1,765.78
|
| Rate for Payer: Cigna All Commercial |
$1,139.21
|
| Rate for Payer: Cigna All Commercial |
$1,139.21
|
| Rate for Payer: CORVEL All Commercial |
$1,139.21
|
| Rate for Payer: CORVEL All Commercial |
$1,139.21
|
| Rate for Payer: Coventry All Commercial |
$1,367.05
|
| Rate for Payer: Coventry All Commercial |
$1,367.05
|
| Rate for Payer: Encore All Commercial |
$1,139.21
|
| Rate for Payer: Encore All Commercial |
$1,139.21
|
| Rate for Payer: Frontpath All Commercial |
$1,594.41
|
| Rate for Payer: Frontpath All Commercial |
$1,594.41
|
| Rate for Payer: Humana ChoiceCare |
$1,497.44
|
| Rate for Payer: Humana ChoiceCare |
$1,497.44
|
| Rate for Payer: Humana Medicare |
$1,139.21
|
| Rate for Payer: Humana Medicare |
$1,139.21
|
| Rate for Payer: Lucent All Commercial |
$1,594.89
|
| Rate for Payer: Lucent All Commercial |
$1,594.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,815.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,815.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,109.01
|
| Rate for Payer: Managed Health Services Medicaid |
$1,109.01
|
| Rate for Payer: MDWise Medicaid |
$1,109.01
|
| Rate for Payer: MDWise Medicaid |
$1,109.01
|
| Rate for Payer: PHCS All Commercial |
$1,139.21
|
| Rate for Payer: PHCS All Commercial |
$1,139.21
|
| Rate for Payer: PHP All Commercial |
$1,925.56
|
| Rate for Payer: PHP All Commercial |
$1,925.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,139.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,139.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,139.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,139.21
|
| Rate for Payer: Signature Care EPO |
$1,936.66
|
| Rate for Payer: Signature Care EPO |
$1,936.66
|
| Rate for Payer: Signature Care PPO |
$1,936.66
|
| Rate for Payer: Signature Care PPO |
$1,936.66
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$170,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$170,100.00
|
| Rate for Payer: United Healthcare Commercial |
$1,386.08
|
| Rate for Payer: United Healthcare Commercial |
$1,386.08
|
| Rate for Payer: United Healthcare Medicare |
$1,106.64
|
| Rate for Payer: United Healthcare Medicare |
$1,106.64
|
|
|
PR OPEN IMPLANTATION NEA SACRAL NERVE
|
Professional
|
Both
|
$1,190.30
|
|
|
Service Code
|
CPT 64581
|
| Hospital Charge Code |
z64581
|
| Min. Negotiated Rate |
$598.20 |
| Max. Negotiated Rate |
$962.91 |
| Rate for Payer: Aetna Commercial |
$619.41
|
| Rate for Payer: Aetna Medicare |
$619.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$599.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$712.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$681.35
|
| Rate for Payer: Cash Price |
$714.18
|
| Rate for Payer: Centivo All Commercial |
$960.09
|
| Rate for Payer: Cigna All Commercial |
$619.41
|
| Rate for Payer: CORVEL All Commercial |
$619.41
|
| Rate for Payer: Coventry All Commercial |
$743.29
|
| Rate for Payer: Encore All Commercial |
$619.41
|
| Rate for Payer: Frontpath All Commercial |
$854.58
|
| Rate for Payer: Humana ChoiceCare |
$962.91
|
| Rate for Payer: Humana Medicare |
$619.41
|
| Rate for Payer: Lucent All Commercial |
$867.17
|
| Rate for Payer: Managed Health Services Medicaid |
$599.45
|
| Rate for Payer: MDWise Medicaid |
$599.45
|
| Rate for Payer: PHCS All Commercial |
$619.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$619.41
|
| Rate for Payer: Sagamore Health Network All Products |
$619.41
|
| Rate for Payer: United Healthcare Commercial |
$939.03
|
| Rate for Payer: United Healthcare Medicare |
$598.20
|
|
|
PR OPEN PROX HUMERAL FRACTURE PROSHETIC REPLACEMENT
|
Professional
|
Both
|
$2,275.52
|
|
|
Service Code
|
CPT 23616
|
| Hospital Charge Code |
z23616
|
| Min. Negotiated Rate |
$1,116.42 |
| Max. Negotiated Rate |
$171,600.00 |
| Rate for Payer: Aetna Commercial |
$1,147.80
|
| Rate for Payer: Aetna Commercial |
$1,147.80
|
| Rate for Payer: Aetna Medicare |
$1,147.80
|
| Rate for Payer: Aetna Medicare |
$1,147.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2,019.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2,019.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,019.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,019.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,019.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,019.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,019.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,019.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,119.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,119.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,319.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,319.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,262.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,262.58
|
| Rate for Payer: Cash Price |
$1,365.31
|
| Rate for Payer: Cash Price |
$1,339.70
|
| Rate for Payer: Centivo All Commercial |
$1,779.09
|
| Rate for Payer: Centivo All Commercial |
$1,779.09
|
| Rate for Payer: Cigna All Commercial |
$1,147.80
|
| Rate for Payer: Cigna All Commercial |
$1,147.80
|
| Rate for Payer: CORVEL All Commercial |
$1,147.80
|
| Rate for Payer: CORVEL All Commercial |
$1,147.80
|
| Rate for Payer: Coventry All Commercial |
$1,377.36
|
| Rate for Payer: Coventry All Commercial |
$1,377.36
|
| Rate for Payer: Encore All Commercial |
$1,147.80
|
| Rate for Payer: Encore All Commercial |
$1,147.80
|
| Rate for Payer: Frontpath All Commercial |
$1,605.34
|
| Rate for Payer: Frontpath All Commercial |
$1,605.34
|
| Rate for Payer: Humana ChoiceCare |
$1,558.41
|
| Rate for Payer: Humana ChoiceCare |
$1,558.41
|
| Rate for Payer: Humana Medicare |
$1,147.80
|
| Rate for Payer: Humana Medicare |
$1,147.80
|
| Rate for Payer: Lucent All Commercial |
$1,606.92
|
| Rate for Payer: Lucent All Commercial |
$1,606.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,831.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,831.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,119.19
|
| Rate for Payer: Managed Health Services Medicaid |
$1,119.19
|
| Rate for Payer: MDWise Medicaid |
$1,119.19
|
| Rate for Payer: MDWise Medicaid |
$1,119.19
|
| Rate for Payer: PHCS All Commercial |
$1,147.80
|
| Rate for Payer: PHCS All Commercial |
$1,147.80
|
| Rate for Payer: PHP All Commercial |
$1,942.57
|
| Rate for Payer: PHP All Commercial |
$1,942.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,147.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,147.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,147.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,147.80
|
| Rate for Payer: Signature Care EPO |
$1,951.26
|
| Rate for Payer: Signature Care EPO |
$1,951.26
|
| Rate for Payer: Signature Care PPO |
$1,951.26
|
| Rate for Payer: Signature Care PPO |
$1,951.26
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$171,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$171,600.00
|
| Rate for Payer: United Healthcare Commercial |
$1,405.03
|
| Rate for Payer: United Healthcare Commercial |
$1,405.03
|
| Rate for Payer: United Healthcare Medicare |
$1,116.42
|
| Rate for Payer: United Healthcare Medicare |
$1,116.42
|
|
|
PR OPEN ROD FIXATN HUMERAL SHAFT FX
|
Professional
|
Both
|
$1,589.22
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
z24516
|
| Min. Negotiated Rate |
$779.54 |
| Max. Negotiated Rate |
$119,900.00 |
| Rate for Payer: Aetna Commercial |
$800.62
|
| Rate for Payer: Aetna Commercial |
$800.62
|
| Rate for Payer: Aetna Medicare |
$800.62
|
| Rate for Payer: Aetna Medicare |
$800.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,097.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,097.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,097.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,097.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,097.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,097.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,097.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,097.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$781.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$781.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$920.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$920.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$880.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$880.68
|
| Rate for Payer: Cash Price |
$953.53
|
| Rate for Payer: Cash Price |
$935.45
|
| Rate for Payer: Centivo All Commercial |
$1,240.96
|
| Rate for Payer: Centivo All Commercial |
$1,240.96
|
| Rate for Payer: Cigna All Commercial |
$800.62
|
| Rate for Payer: Cigna All Commercial |
$800.62
|
| Rate for Payer: CORVEL All Commercial |
$800.62
|
| Rate for Payer: CORVEL All Commercial |
$800.62
|
| Rate for Payer: Coventry All Commercial |
$960.74
|
| Rate for Payer: Coventry All Commercial |
$960.74
|
| Rate for Payer: Encore All Commercial |
$800.62
|
| Rate for Payer: Encore All Commercial |
$800.62
|
| Rate for Payer: Frontpath All Commercial |
$1,117.35
|
| Rate for Payer: Frontpath All Commercial |
$1,117.35
|
| Rate for Payer: Humana ChoiceCare |
$907.72
|
| Rate for Payer: Humana ChoiceCare |
$907.72
|
| Rate for Payer: Humana Medicare |
$800.62
|
| Rate for Payer: Humana Medicare |
$800.62
|
| Rate for Payer: Lucent All Commercial |
$1,120.87
|
| Rate for Payer: Lucent All Commercial |
$1,120.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,278.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,278.00
|
| Rate for Payer: Managed Health Services Medicaid |
$781.64
|
| Rate for Payer: Managed Health Services Medicaid |
$781.64
|
| Rate for Payer: MDWise Medicaid |
$781.64
|
| Rate for Payer: MDWise Medicaid |
$781.64
|
| Rate for Payer: PHCS All Commercial |
$800.62
|
| Rate for Payer: PHCS All Commercial |
$800.62
|
| Rate for Payer: PHP All Commercial |
$1,356.40
|
| Rate for Payer: PHP All Commercial |
$1,356.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$800.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$800.62
|
| Rate for Payer: Sagamore Health Network All Products |
$800.62
|
| Rate for Payer: Sagamore Health Network All Products |
$800.62
|
| Rate for Payer: Signature Care EPO |
$1,215.50
|
| Rate for Payer: Signature Care EPO |
$1,215.50
|
| Rate for Payer: Signature Care PPO |
$1,215.50
|
| Rate for Payer: Signature Care PPO |
$1,215.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$119,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$119,900.00
|
| Rate for Payer: United Healthcare Commercial |
$939.59
|
| Rate for Payer: United Healthcare Commercial |
$939.59
|
| Rate for Payer: United Healthcare Medicare |
$779.54
|
| Rate for Payer: United Healthcare Medicare |
$779.54
|
|
|
PR OPEN RX A-C JT DISLOC
|
Professional
|
Both
|
$1,067.82
|
|
|
Service Code
|
CPT 23550
|
| Hospital Charge Code |
z23550
|
| Min. Negotiated Rate |
$523.08 |
| Max. Negotiated Rate |
$80,400.00 |
| Rate for Payer: Aetna Commercial |
$535.79
|
| Rate for Payer: Aetna Commercial |
$535.79
|
| Rate for Payer: Aetna Medicare |
$535.79
|
| Rate for Payer: Aetna Medicare |
$535.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$747.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$747.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$747.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$747.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$747.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$747.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$747.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$747.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$525.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$525.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$616.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$616.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$589.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$589.37
|
| Rate for Payer: Cash Price |
$640.69
|
| Rate for Payer: Cash Price |
$627.70
|
| Rate for Payer: Centivo All Commercial |
$830.47
|
| Rate for Payer: Centivo All Commercial |
$830.47
|
| Rate for Payer: Cigna All Commercial |
$535.79
|
| Rate for Payer: Cigna All Commercial |
$535.79
|
| Rate for Payer: CORVEL All Commercial |
$535.79
|
| Rate for Payer: CORVEL All Commercial |
$535.79
|
| Rate for Payer: Coventry All Commercial |
$642.95
|
| Rate for Payer: Coventry All Commercial |
$642.95
|
| Rate for Payer: Encore All Commercial |
$535.79
|
| Rate for Payer: Encore All Commercial |
$535.79
|
| Rate for Payer: Frontpath All Commercial |
$742.81
|
| Rate for Payer: Frontpath All Commercial |
$742.81
|
| Rate for Payer: Humana ChoiceCare |
$592.19
|
| Rate for Payer: Humana ChoiceCare |
$592.19
|
| Rate for Payer: Humana Medicare |
$535.79
|
| Rate for Payer: Humana Medicare |
$535.79
|
| Rate for Payer: Lucent All Commercial |
$750.11
|
| Rate for Payer: Lucent All Commercial |
$750.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$858.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$858.00
|
| Rate for Payer: Managed Health Services Medicaid |
$525.20
|
| Rate for Payer: Managed Health Services Medicaid |
$525.20
|
| Rate for Payer: MDWise Medicaid |
$525.20
|
| Rate for Payer: MDWise Medicaid |
$525.20
|
| Rate for Payer: PHCS All Commercial |
$535.79
|
| Rate for Payer: PHCS All Commercial |
$535.79
|
| Rate for Payer: PHP All Commercial |
$910.16
|
| Rate for Payer: PHP All Commercial |
$910.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$535.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$535.79
|
| Rate for Payer: Sagamore Health Network All Products |
$535.79
|
| Rate for Payer: Sagamore Health Network All Products |
$535.79
|
| Rate for Payer: Signature Care EPO |
$791.35
|
| Rate for Payer: Signature Care EPO |
$791.35
|
| Rate for Payer: Signature Care PPO |
$791.35
|
| Rate for Payer: Signature Care PPO |
$791.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$80,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$80,400.00
|
| Rate for Payer: United Healthcare Commercial |
$613.91
|
| Rate for Payer: United Healthcare Commercial |
$613.91
|
| Rate for Payer: United Healthcare Medicare |
$523.08
|
| Rate for Payer: United Healthcare Medicare |
$523.08
|
|
|
PR OPEN RX A-C JT DISLOC,FASCIAL GRFT
|
Professional
|
Both
|
$1,210.80
|
|
|
Service Code
|
CPT 23552
|
| Hospital Charge Code |
z23552
|
| Min. Negotiated Rate |
$591.29 |
| Max. Negotiated Rate |
$90,900.00 |
| Rate for Payer: Aetna Commercial |
$611.82
|
| Rate for Payer: Aetna Commercial |
$611.82
|
| Rate for Payer: Aetna Medicare |
$611.82
|
| Rate for Payer: Aetna Medicare |
$611.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$802.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$802.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$595.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$595.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$703.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$703.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.00
|
| Rate for Payer: Cash Price |
$726.48
|
| Rate for Payer: Cash Price |
$709.55
|
| Rate for Payer: Centivo All Commercial |
$948.32
|
| Rate for Payer: Centivo All Commercial |
$948.32
|
| Rate for Payer: Cigna All Commercial |
$611.82
|
| Rate for Payer: Cigna All Commercial |
$611.82
|
| Rate for Payer: CORVEL All Commercial |
$611.82
|
| Rate for Payer: CORVEL All Commercial |
$611.82
|
| Rate for Payer: Coventry All Commercial |
$734.18
|
| Rate for Payer: Coventry All Commercial |
$734.18
|
| Rate for Payer: Encore All Commercial |
$611.82
|
| Rate for Payer: Encore All Commercial |
$611.82
|
| Rate for Payer: Frontpath All Commercial |
$849.55
|
| Rate for Payer: Frontpath All Commercial |
$849.55
|
| Rate for Payer: Humana ChoiceCare |
$686.59
|
| Rate for Payer: Humana ChoiceCare |
$686.59
|
| Rate for Payer: Humana Medicare |
$611.82
|
| Rate for Payer: Humana Medicare |
$611.82
|
| Rate for Payer: Lucent All Commercial |
$856.55
|
| Rate for Payer: Lucent All Commercial |
$856.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$970.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$970.00
|
| Rate for Payer: Managed Health Services Medicaid |
$595.52
|
| Rate for Payer: Managed Health Services Medicaid |
$595.52
|
| Rate for Payer: MDWise Medicaid |
$595.52
|
| Rate for Payer: MDWise Medicaid |
$595.52
|
| Rate for Payer: PHCS All Commercial |
$611.82
|
| Rate for Payer: PHCS All Commercial |
$611.82
|
| Rate for Payer: PHP All Commercial |
$1,028.85
|
| Rate for Payer: PHP All Commercial |
$1,028.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$611.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$611.82
|
| Rate for Payer: Sagamore Health Network All Products |
$611.82
|
| Rate for Payer: Sagamore Health Network All Products |
$611.82
|
| 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 |
$90,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90,900.00
|
| Rate for Payer: United Healthcare Commercial |
$707.29
|
| Rate for Payer: United Healthcare Commercial |
$707.29
|
| Rate for Payer: United Healthcare Medicare |
$591.29
|
| Rate for Payer: United Healthcare Medicare |
$591.29
|
|
|
PR OPEN RX BILAT TIB PLAT FX
|
Professional
|
Both
|
$2,143.10
|
|
|
Service Code
|
CPT 27536
|
| Hospital Charge Code |
z27536
|
| Min. Negotiated Rate |
$1,071.55 |
| Max. Negotiated Rate |
$164,800.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,366.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,366.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,366.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,366.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,366.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,366.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,366.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,366.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,075.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,075.35
|
| Rate for Payer: Cash Price |
$1,311.83
|
| Rate for Payer: Cash Price |
$1,285.86
|
| Rate for Payer: Frontpath All Commercial |
$1,542.03
|
| Rate for Payer: Frontpath All Commercial |
$1,542.03
|
| Rate for Payer: Humana ChoiceCare |
$1,194.75
|
| Rate for Payer: Humana ChoiceCare |
$1,194.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,758.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,758.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,075.35
|
| Rate for Payer: Managed Health Services Medicaid |
$1,075.35
|
| Rate for Payer: MDWise Medicaid |
$1,075.35
|
| Rate for Payer: MDWise Medicaid |
$1,075.35
|
| Rate for Payer: PHP All Commercial |
$1,864.50
|
| Rate for Payer: PHP All Commercial |
$1,864.50
|
| Rate for Payer: Signature Care EPO |
$1,592.90
|
| Rate for Payer: Signature Care EPO |
$1,592.90
|
| Rate for Payer: Signature Care PPO |
$1,592.90
|
| Rate for Payer: Signature Care PPO |
$1,592.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$164,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$164,800.00
|
| Rate for Payer: United Healthcare Commercial |
$1,298.85
|
| Rate for Payer: United Healthcare Commercial |
$1,298.85
|
| Rate for Payer: United Healthcare Medicare |
$1,071.55
|
| Rate for Payer: United Healthcare Medicare |
$1,071.55
|
|
|
PR OPEN RX C-MC DISLOC,COMPLEX
|
Professional
|
Both
|
$1,161.04
|
|
|
Service Code
|
CPT 26686
|
| Hospital Charge Code |
z26686
|
| Min. Negotiated Rate |
$567.99 |
| Max. Negotiated Rate |
$87,300.00 |
| Rate for Payer: Aetna Commercial |
$582.91
|
| Rate for Payer: Aetna Commercial |
$582.91
|
| Rate for Payer: Aetna Medicare |
$582.91
|
| Rate for Payer: Aetna Medicare |
$582.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$756.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$756.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$756.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$756.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$756.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$756.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$756.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$756.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$571.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$571.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$670.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$670.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$641.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$641.20
|
| Rate for Payer: Cash Price |
$696.62
|
| Rate for Payer: Cash Price |
$681.59
|
| Rate for Payer: Centivo All Commercial |
$903.51
|
| Rate for Payer: Centivo All Commercial |
$903.51
|
| Rate for Payer: Cigna All Commercial |
$582.91
|
| Rate for Payer: Cigna All Commercial |
$582.91
|
| Rate for Payer: CORVEL All Commercial |
$582.91
|
| Rate for Payer: CORVEL All Commercial |
$582.91
|
| Rate for Payer: Coventry All Commercial |
$699.49
|
| Rate for Payer: Coventry All Commercial |
$699.49
|
| Rate for Payer: Encore All Commercial |
$582.91
|
| Rate for Payer: Encore All Commercial |
$582.91
|
| Rate for Payer: Frontpath All Commercial |
$810.46
|
| Rate for Payer: Frontpath All Commercial |
$810.46
|
| Rate for Payer: Humana ChoiceCare |
$643.53
|
| Rate for Payer: Humana ChoiceCare |
$643.53
|
| Rate for Payer: Humana Medicare |
$582.91
|
| Rate for Payer: Humana Medicare |
$582.91
|
| Rate for Payer: Lucent All Commercial |
$816.07
|
| Rate for Payer: Lucent All Commercial |
$816.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$931.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$931.00
|
| Rate for Payer: Managed Health Services Medicaid |
$571.04
|
| Rate for Payer: Managed Health Services Medicaid |
$571.04
|
| Rate for Payer: MDWise Medicaid |
$571.04
|
| Rate for Payer: MDWise Medicaid |
$571.04
|
| Rate for Payer: PHCS All Commercial |
$582.91
|
| Rate for Payer: PHCS All Commercial |
$582.91
|
| Rate for Payer: PHP All Commercial |
$988.29
|
| Rate for Payer: PHP All Commercial |
$988.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$582.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$582.91
|
| Rate for Payer: Sagamore Health Network All Products |
$582.91
|
| Rate for Payer: Sagamore Health Network All Products |
$582.91
|
| Rate for Payer: Signature Care EPO |
$871.25
|
| Rate for Payer: Signature Care EPO |
$871.25
|
| Rate for Payer: Signature Care PPO |
$871.25
|
| Rate for Payer: Signature Care PPO |
$871.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,300.00
|
| Rate for Payer: United Healthcare Commercial |
$660.49
|
| Rate for Payer: United Healthcare Commercial |
$660.49
|
| Rate for Payer: United Healthcare Medicare |
$567.99
|
| Rate for Payer: United Healthcare Medicare |
$567.99
|
|
|
PR OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR
|
Professional
|
Both
|
$1,382.48
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
z25607
|
| Min. Negotiated Rate |
$675.21 |
| Max. Negotiated Rate |
$103,800.00 |
| Rate for Payer: Aetna Commercial |
$689.81
|
| Rate for Payer: Aetna Commercial |
$689.81
|
| Rate for Payer: Aetna Medicare |
$689.81
|
| Rate for Payer: Aetna Medicare |
$689.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$819.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$819.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$819.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$819.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$819.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$819.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$819.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$819.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$679.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$679.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$793.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$793.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$758.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$758.79
|
| Rate for Payer: Cash Price |
$829.49
|
| Rate for Payer: Cash Price |
$810.25
|
| Rate for Payer: Centivo All Commercial |
$1,069.21
|
| Rate for Payer: Centivo All Commercial |
$1,069.21
|
| Rate for Payer: Cigna All Commercial |
$689.81
|
| Rate for Payer: Cigna All Commercial |
$689.81
|
| Rate for Payer: CORVEL All Commercial |
$689.81
|
| Rate for Payer: CORVEL All Commercial |
$689.81
|
| Rate for Payer: Coventry All Commercial |
$827.77
|
| Rate for Payer: Coventry All Commercial |
$827.77
|
| Rate for Payer: Encore All Commercial |
$689.81
|
| Rate for Payer: Encore All Commercial |
$689.81
|
| Rate for Payer: Frontpath All Commercial |
$955.29
|
| Rate for Payer: Frontpath All Commercial |
$955.29
|
| Rate for Payer: Humana ChoiceCare |
$680.43
|
| Rate for Payer: Humana ChoiceCare |
$680.43
|
| Rate for Payer: Humana Medicare |
$689.81
|
| Rate for Payer: Humana Medicare |
$689.81
|
| Rate for Payer: Lucent All Commercial |
$965.73
|
| Rate for Payer: Lucent All Commercial |
$965.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,107.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,107.00
|
| Rate for Payer: Managed Health Services Medicaid |
$679.96
|
| Rate for Payer: Managed Health Services Medicaid |
$679.96
|
| Rate for Payer: MDWise Medicaid |
$679.96
|
| Rate for Payer: MDWise Medicaid |
$679.96
|
| Rate for Payer: PHCS All Commercial |
$689.81
|
| Rate for Payer: PHCS All Commercial |
$689.81
|
| Rate for Payer: PHP All Commercial |
$1,174.86
|
| Rate for Payer: PHP All Commercial |
$1,174.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$689.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$689.81
|
| Rate for Payer: Sagamore Health Network All Products |
$689.81
|
| Rate for Payer: Sagamore Health Network All Products |
$689.81
|
| Rate for Payer: Signature Care EPO |
$923.95
|
| Rate for Payer: Signature Care EPO |
$923.95
|
| Rate for Payer: Signature Care PPO |
$923.95
|
| Rate for Payer: Signature Care PPO |
$923.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$103,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$103,800.00
|
| Rate for Payer: United Healthcare Commercial |
$763.28
|
| Rate for Payer: United Healthcare Commercial |
$763.28
|
| Rate for Payer: United Healthcare Medicare |
$675.21
|
| Rate for Payer: United Healthcare Medicare |
$675.21
|
|
|
PR OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 2 FRAG
|
Professional
|
Both
|
$1,542.74
|
|
|
Service Code
|
CPT 25608
|
| Hospital Charge Code |
z25608
|
| Min. Negotiated Rate |
$753.92 |
| Max. Negotiated Rate |
$115,900.00 |
| Rate for Payer: Aetna Commercial |
$771.82
|
| Rate for Payer: Aetna Commercial |
$771.82
|
| Rate for Payer: Aetna Medicare |
$771.82
|
| Rate for Payer: Aetna Medicare |
$771.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$980.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$980.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$980.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$980.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$980.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$980.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$980.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$980.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$758.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$758.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$887.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$887.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$849.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$849.00
|
| Rate for Payer: Cash Price |
$925.64
|
| Rate for Payer: Cash Price |
$904.70
|
| Rate for Payer: Centivo All Commercial |
$1,196.32
|
| Rate for Payer: Centivo All Commercial |
$1,196.32
|
| Rate for Payer: Cigna All Commercial |
$771.82
|
| Rate for Payer: Cigna All Commercial |
$771.82
|
| Rate for Payer: CORVEL All Commercial |
$771.82
|
| Rate for Payer: CORVEL All Commercial |
$771.82
|
| Rate for Payer: Coventry All Commercial |
$926.18
|
| Rate for Payer: Coventry All Commercial |
$926.18
|
| Rate for Payer: Encore All Commercial |
$771.82
|
| Rate for Payer: Encore All Commercial |
$771.82
|
| Rate for Payer: Frontpath All Commercial |
$1,071.42
|
| Rate for Payer: Frontpath All Commercial |
$1,071.42
|
| Rate for Payer: Humana ChoiceCare |
$773.37
|
| Rate for Payer: Humana ChoiceCare |
$773.37
|
| Rate for Payer: Humana Medicare |
$771.82
|
| Rate for Payer: Humana Medicare |
$771.82
|
| Rate for Payer: Lucent All Commercial |
$1,080.55
|
| Rate for Payer: Lucent All Commercial |
$1,080.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,236.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,236.00
|
| Rate for Payer: Managed Health Services Medicaid |
$758.78
|
| Rate for Payer: Managed Health Services Medicaid |
$758.78
|
| Rate for Payer: MDWise Medicaid |
$758.78
|
| Rate for Payer: MDWise Medicaid |
$758.78
|
| Rate for Payer: PHCS All Commercial |
$771.82
|
| Rate for Payer: PHCS All Commercial |
$771.82
|
| Rate for Payer: PHP All Commercial |
$1,311.83
|
| Rate for Payer: PHP All Commercial |
$1,311.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$771.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$771.82
|
| Rate for Payer: Sagamore Health Network All Products |
$771.82
|
| Rate for Payer: Sagamore Health Network All Products |
$771.82
|
| Rate for Payer: Signature Care EPO |
$1,049.75
|
| Rate for Payer: Signature Care EPO |
$1,049.75
|
| Rate for Payer: Signature Care PPO |
$1,049.75
|
| Rate for Payer: Signature Care PPO |
$1,049.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$115,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$115,900.00
|
| Rate for Payer: United Healthcare Commercial |
$871.21
|
| Rate for Payer: United Healthcare Commercial |
$871.21
|
| Rate for Payer: United Healthcare Medicare |
$753.92
|
| Rate for Payer: United Healthcare Medicare |
$753.92
|
|
|
PR OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG
|
Professional
|
Both
|
$1,954.34
|
|
|
Service Code
|
CPT 25609
|
| Hospital Charge Code |
z25609
|
| Min. Negotiated Rate |
$956.51 |
| Max. Negotiated Rate |
$147,100.00 |
| Rate for Payer: Aetna Commercial |
$980.28
|
| Rate for Payer: Aetna Commercial |
$980.28
|
| Rate for Payer: Aetna Medicare |
$980.28
|
| Rate for Payer: Aetna Medicare |
$980.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,250.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,250.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,250.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,250.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,250.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,250.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,250.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,250.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$961.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$961.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,127.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,127.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,078.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,078.31
|
| Rate for Payer: Cash Price |
$1,172.60
|
| Rate for Payer: Cash Price |
$1,147.81
|
| Rate for Payer: Centivo All Commercial |
$1,519.43
|
| Rate for Payer: Centivo All Commercial |
$1,519.43
|
| Rate for Payer: Cigna All Commercial |
$980.28
|
| Rate for Payer: Cigna All Commercial |
$980.28
|
| Rate for Payer: CORVEL All Commercial |
$980.28
|
| Rate for Payer: CORVEL All Commercial |
$980.28
|
| Rate for Payer: Coventry All Commercial |
$1,176.34
|
| Rate for Payer: Coventry All Commercial |
$1,176.34
|
| Rate for Payer: Encore All Commercial |
$980.28
|
| Rate for Payer: Encore All Commercial |
$980.28
|
| Rate for Payer: Frontpath All Commercial |
$1,361.26
|
| Rate for Payer: Frontpath All Commercial |
$1,361.26
|
| Rate for Payer: Humana ChoiceCare |
$986.33
|
| Rate for Payer: Humana ChoiceCare |
$986.33
|
| Rate for Payer: Humana Medicare |
$980.28
|
| Rate for Payer: Humana Medicare |
$980.28
|
| Rate for Payer: Lucent All Commercial |
$1,372.39
|
| Rate for Payer: Lucent All Commercial |
$1,372.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,569.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,569.00
|
| Rate for Payer: Managed Health Services Medicaid |
$961.22
|
| Rate for Payer: Managed Health Services Medicaid |
$961.22
|
| Rate for Payer: MDWise Medicaid |
$961.22
|
| Rate for Payer: MDWise Medicaid |
$961.22
|
| Rate for Payer: PHCS All Commercial |
$980.28
|
| Rate for Payer: PHCS All Commercial |
$980.28
|
| Rate for Payer: PHP All Commercial |
$1,664.32
|
| Rate for Payer: PHP All Commercial |
$1,664.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$980.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$980.28
|
| Rate for Payer: Sagamore Health Network All Products |
$980.28
|
| Rate for Payer: Sagamore Health Network All Products |
$980.28
|
| Rate for Payer: Signature Care EPO |
$1,338.75
|
| Rate for Payer: Signature Care EPO |
$1,338.75
|
| Rate for Payer: Signature Care PPO |
$1,338.75
|
| Rate for Payer: Signature Care PPO |
$1,338.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$147,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$147,100.00
|
| Rate for Payer: United Healthcare Commercial |
$1,113.05
|
| Rate for Payer: United Healthcare Commercial |
$1,113.05
|
| Rate for Payer: United Healthcare Medicare |
$956.51
|
| Rate for Payer: United Healthcare Medicare |
$956.51
|
|
|
PR OPEN RX FEMUR FX+INTRAMED ROD
|
Professional
|
Both
|
$2,461.24
|
|
|
Service Code
|
CPT 27506
|
| Hospital Charge Code |
z27506
|
| Min. Negotiated Rate |
$1,207.41 |
| Max. Negotiated Rate |
$185,600.00 |
| Rate for Payer: Aetna Commercial |
$1,241.77
|
| Rate for Payer: Aetna Commercial |
$1,241.77
|
| Rate for Payer: Aetna Medicare |
$1,241.77
|
| Rate for Payer: Aetna Medicare |
$1,241.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,621.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,621.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,621.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,621.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,621.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,621.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,621.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,621.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,210.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,210.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,428.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,428.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,365.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,365.95
|
| Rate for Payer: Cash Price |
$1,476.74
|
| Rate for Payer: Cash Price |
$1,448.89
|
| Rate for Payer: Centivo All Commercial |
$1,924.74
|
| Rate for Payer: Centivo All Commercial |
$1,924.74
|
| Rate for Payer: Cigna All Commercial |
$1,241.77
|
| Rate for Payer: Cigna All Commercial |
$1,241.77
|
| Rate for Payer: CORVEL All Commercial |
$1,241.77
|
| Rate for Payer: CORVEL All Commercial |
$1,241.77
|
| Rate for Payer: Coventry All Commercial |
$1,490.12
|
| Rate for Payer: Coventry All Commercial |
$1,490.12
|
| Rate for Payer: Encore All Commercial |
$1,241.77
|
| Rate for Payer: Encore All Commercial |
$1,241.77
|
| Rate for Payer: Frontpath All Commercial |
$1,736.84
|
| Rate for Payer: Frontpath All Commercial |
$1,736.84
|
| Rate for Payer: Humana ChoiceCare |
$1,325.28
|
| Rate for Payer: Humana ChoiceCare |
$1,325.28
|
| Rate for Payer: Humana Medicare |
$1,241.77
|
| Rate for Payer: Humana Medicare |
$1,241.77
|
| Rate for Payer: Lucent All Commercial |
$1,738.48
|
| Rate for Payer: Lucent All Commercial |
$1,738.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,980.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,980.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,210.53
|
| Rate for Payer: Managed Health Services Medicaid |
$1,210.53
|
| Rate for Payer: MDWise Medicaid |
$1,210.53
|
| Rate for Payer: MDWise Medicaid |
$1,210.53
|
| Rate for Payer: PHCS All Commercial |
$1,241.77
|
| Rate for Payer: PHCS All Commercial |
$1,241.77
|
| Rate for Payer: PHP All Commercial |
$2,100.89
|
| Rate for Payer: PHP All Commercial |
$2,100.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,241.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,241.77
|
| Rate for Payer: Sagamore Health Network All Products |
$1,241.77
|
| Rate for Payer: Sagamore Health Network All Products |
$1,241.77
|
| Rate for Payer: Signature Care EPO |
$1,766.30
|
| Rate for Payer: Signature Care EPO |
$1,766.30
|
| Rate for Payer: Signature Care PPO |
$1,766.30
|
| Rate for Payer: Signature Care PPO |
$1,766.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$185,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$185,600.00
|
| Rate for Payer: United Healthcare Commercial |
$1,457.98
|
| Rate for Payer: United Healthcare Commercial |
$1,457.98
|
| Rate for Payer: United Healthcare Medicare |
$1,207.41
|
| Rate for Payer: United Healthcare Medicare |
$1,207.41
|
|
|
PR OPEN RX GR TUBEROSITY FX
|
Professional
|
Both
|
$1,451.66
|
|
|
Service Code
|
CPT 23630
|
| Hospital Charge Code |
z23630
|
| Min. Negotiated Rate |
$607.66 |
| Max. Negotiated Rate |
$109,200.00 |
| Rate for Payer: Aetna Commercial |
$726.45
|
| Rate for Payer: Aetna Commercial |
$726.45
|
| Rate for Payer: Aetna Medicare |
$726.45
|
| Rate for Payer: Aetna Medicare |
$726.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$758.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$758.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$758.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$758.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$758.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$758.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$758.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$758.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$713.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$713.98
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$835.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$835.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$799.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$799.10
|
| Rate for Payer: Cash Price |
$871.00
|
| Rate for Payer: Cash Price |
$851.94
|
| Rate for Payer: Centivo All Commercial |
$1,126.00
|
| Rate for Payer: Centivo All Commercial |
$1,126.00
|
| Rate for Payer: Cigna All Commercial |
$726.45
|
| Rate for Payer: Cigna All Commercial |
$726.45
|
| Rate for Payer: CORVEL All Commercial |
$726.45
|
| Rate for Payer: CORVEL All Commercial |
$726.45
|
| Rate for Payer: Coventry All Commercial |
$871.74
|
| Rate for Payer: Coventry All Commercial |
$871.74
|
| Rate for Payer: Encore All Commercial |
$726.45
|
| Rate for Payer: Encore All Commercial |
$726.45
|
| Rate for Payer: Frontpath All Commercial |
$1,009.67
|
| Rate for Payer: Frontpath All Commercial |
$1,009.67
|
| Rate for Payer: Humana ChoiceCare |
$607.66
|
| Rate for Payer: Humana ChoiceCare |
$607.66
|
| Rate for Payer: Humana Medicare |
$726.45
|
| Rate for Payer: Humana Medicare |
$726.45
|
| Rate for Payer: Lucent All Commercial |
$1,017.03
|
| Rate for Payer: Lucent All Commercial |
$1,017.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,164.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,164.00
|
| Rate for Payer: Managed Health Services Medicaid |
$713.98
|
| Rate for Payer: Managed Health Services Medicaid |
$713.98
|
| Rate for Payer: MDWise Medicaid |
$713.98
|
| Rate for Payer: MDWise Medicaid |
$713.98
|
| Rate for Payer: PHCS All Commercial |
$726.45
|
| Rate for Payer: PHCS All Commercial |
$726.45
|
| Rate for Payer: PHP All Commercial |
$1,235.31
|
| Rate for Payer: PHP All Commercial |
$1,235.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$726.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$726.45
|
| Rate for Payer: Sagamore Health Network All Products |
$726.45
|
| Rate for Payer: Sagamore Health Network All Products |
$726.45
|
| 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 |
$109,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$109,200.00
|
| Rate for Payer: United Healthcare Commercial |
$807.73
|
| Rate for Payer: United Healthcare Commercial |
$807.73
|
| Rate for Payer: United Healthcare Medicare |
$709.95
|
| Rate for Payer: United Healthcare Medicare |
$709.95
|
|
|
PR OPEN RX PATELLA FX
|
Professional
|
Both
|
$1,397.50
|
|
|
Service Code
|
CPT 27524
|
| Hospital Charge Code |
z27524
|
| Min. Negotiated Rate |
$684.65 |
| Max. Negotiated Rate |
$105,300.00 |
| Rate for Payer: Aetna Commercial |
$702.72
|
| Rate for Payer: Aetna Commercial |
$702.72
|
| Rate for Payer: Aetna Medicare |
$702.72
|
| Rate for Payer: Aetna Medicare |
$702.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$969.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$969.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$969.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$969.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$969.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$969.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$969.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$969.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$687.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$687.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$808.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$808.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$772.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$772.99
|
| Rate for Payer: Cash Price |
$838.50
|
| Rate for Payer: Cash Price |
$821.58
|
| Rate for Payer: Centivo All Commercial |
$1,089.22
|
| Rate for Payer: Centivo All Commercial |
$1,089.22
|
| Rate for Payer: Cigna All Commercial |
$702.72
|
| Rate for Payer: Cigna All Commercial |
$702.72
|
| Rate for Payer: CORVEL All Commercial |
$702.72
|
| Rate for Payer: CORVEL All Commercial |
$702.72
|
| Rate for Payer: Coventry All Commercial |
$843.26
|
| Rate for Payer: Coventry All Commercial |
$843.26
|
| Rate for Payer: Encore All Commercial |
$702.72
|
| Rate for Payer: Encore All Commercial |
$702.72
|
| Rate for Payer: Frontpath All Commercial |
$979.06
|
| Rate for Payer: Frontpath All Commercial |
$979.06
|
| Rate for Payer: Humana ChoiceCare |
$795.58
|
| Rate for Payer: Humana ChoiceCare |
$795.58
|
| Rate for Payer: Humana Medicare |
$702.72
|
| Rate for Payer: Humana Medicare |
$702.72
|
| Rate for Payer: Lucent All Commercial |
$983.81
|
| Rate for Payer: Lucent All Commercial |
$983.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,123.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,123.00
|
| Rate for Payer: Managed Health Services Medicaid |
$687.35
|
| Rate for Payer: Managed Health Services Medicaid |
$687.35
|
| Rate for Payer: MDWise Medicaid |
$687.35
|
| Rate for Payer: MDWise Medicaid |
$687.35
|
| Rate for Payer: PHCS All Commercial |
$702.72
|
| Rate for Payer: PHCS All Commercial |
$702.72
|
| Rate for Payer: PHP All Commercial |
$1,191.29
|
| Rate for Payer: PHP All Commercial |
$1,191.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$702.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$702.72
|
| Rate for Payer: Sagamore Health Network All Products |
$702.72
|
| Rate for Payer: Sagamore Health Network All Products |
$702.72
|
| Rate for Payer: Signature Care EPO |
$1,060.80
|
| Rate for Payer: Signature Care EPO |
$1,060.80
|
| Rate for Payer: Signature Care PPO |
$1,060.80
|
| Rate for Payer: Signature Care PPO |
$1,060.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$105,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$105,300.00
|
| Rate for Payer: United Healthcare Commercial |
$816.86
|
| Rate for Payer: United Healthcare Commercial |
$816.86
|
| Rate for Payer: United Healthcare Medicare |
$684.65
|
| Rate for Payer: United Healthcare Medicare |
$684.65
|
|
|
PR OPEN RX TIBIA SHAFT FX,SCREWS
|
Professional
|
Both
|
$1,658.40
|
|
|
Service Code
|
CPT 27758
|
| Hospital Charge Code |
z27758
|
| Min. Negotiated Rate |
$812.38 |
| Max. Negotiated Rate |
$124,900.00 |
| Rate for Payer: Aetna Commercial |
$835.04
|
| Rate for Payer: Aetna Commercial |
$835.04
|
| Rate for Payer: Aetna Medicare |
$835.04
|
| Rate for Payer: Aetna Medicare |
$835.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,188.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,188.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,188.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,188.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,188.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,188.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,188.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,188.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$815.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$815.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$960.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$960.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$918.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$918.54
|
| Rate for Payer: Cash Price |
$995.04
|
| Rate for Payer: Cash Price |
$974.86
|
| Rate for Payer: Centivo All Commercial |
$1,294.31
|
| Rate for Payer: Centivo All Commercial |
$1,294.31
|
| Rate for Payer: Cigna All Commercial |
$835.04
|
| Rate for Payer: Cigna All Commercial |
$835.04
|
| Rate for Payer: CORVEL All Commercial |
$835.04
|
| Rate for Payer: CORVEL All Commercial |
$835.04
|
| Rate for Payer: Coventry All Commercial |
$1,002.05
|
| Rate for Payer: Coventry All Commercial |
$1,002.05
|
| Rate for Payer: Encore All Commercial |
$835.04
|
| Rate for Payer: Encore All Commercial |
$835.04
|
| Rate for Payer: Frontpath All Commercial |
$1,164.48
|
| Rate for Payer: Frontpath All Commercial |
$1,164.48
|
| Rate for Payer: Humana ChoiceCare |
$911.54
|
| Rate for Payer: Humana ChoiceCare |
$911.54
|
| Rate for Payer: Humana Medicare |
$835.04
|
| Rate for Payer: Humana Medicare |
$835.04
|
| Rate for Payer: Lucent All Commercial |
$1,169.06
|
| Rate for Payer: Lucent All Commercial |
$1,169.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,333.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,333.00
|
| Rate for Payer: Managed Health Services Medicaid |
$815.66
|
| Rate for Payer: Managed Health Services Medicaid |
$815.66
|
| Rate for Payer: MDWise Medicaid |
$815.66
|
| Rate for Payer: MDWise Medicaid |
$815.66
|
| Rate for Payer: PHCS All Commercial |
$835.04
|
| Rate for Payer: PHCS All Commercial |
$835.04
|
| Rate for Payer: PHP All Commercial |
$1,413.54
|
| Rate for Payer: PHP All Commercial |
$1,413.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$835.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$835.04
|
| Rate for Payer: Sagamore Health Network All Products |
$835.04
|
| Rate for Payer: Sagamore Health Network All Products |
$835.04
|
| Rate for Payer: Signature Care EPO |
$1,217.20
|
| Rate for Payer: Signature Care EPO |
$1,217.20
|
| Rate for Payer: Signature Care PPO |
$1,217.20
|
| Rate for Payer: Signature Care PPO |
$1,217.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$124,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$124,900.00
|
| Rate for Payer: United Healthcare Commercial |
$966.74
|
| Rate for Payer: United Healthcare Commercial |
$966.74
|
| Rate for Payer: United Healthcare Medicare |
$812.38
|
| Rate for Payer: United Healthcare Medicare |
$812.38
|
|
|
PR OPEN RX ULNAR STYLOID FX
|
Professional
|
Both
|
$1,165.54
|
|
|
Service Code
|
CPT 25652
|
| Hospital Charge Code |
z25652
|
| Min. Negotiated Rate |
$569.71 |
| Max. Negotiated Rate |
$87,600.00 |
| Rate for Payer: Aetna Commercial |
$582.93
|
| Rate for Payer: Aetna Commercial |
$582.93
|
| Rate for Payer: Aetna Medicare |
$582.93
|
| Rate for Payer: Aetna Medicare |
$582.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$725.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$725.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$725.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$725.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$725.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$725.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$725.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$725.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$573.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$573.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$670.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$670.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$641.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$641.22
|
| Rate for Payer: Cash Price |
$699.32
|
| Rate for Payer: Cash Price |
$683.65
|
| Rate for Payer: Centivo All Commercial |
$903.54
|
| Rate for Payer: Centivo All Commercial |
$903.54
|
| Rate for Payer: Cigna All Commercial |
$582.93
|
| Rate for Payer: Cigna All Commercial |
$582.93
|
| Rate for Payer: CORVEL All Commercial |
$582.93
|
| Rate for Payer: CORVEL All Commercial |
$582.93
|
| Rate for Payer: Coventry All Commercial |
$699.52
|
| Rate for Payer: Coventry All Commercial |
$699.52
|
| Rate for Payer: Encore All Commercial |
$582.93
|
| Rate for Payer: Encore All Commercial |
$582.93
|
| Rate for Payer: Frontpath All Commercial |
$806.91
|
| Rate for Payer: Frontpath All Commercial |
$806.91
|
| Rate for Payer: Humana ChoiceCare |
$632.07
|
| Rate for Payer: Humana ChoiceCare |
$632.07
|
| Rate for Payer: Humana Medicare |
$582.93
|
| Rate for Payer: Humana Medicare |
$582.93
|
| Rate for Payer: Lucent All Commercial |
$816.10
|
| Rate for Payer: Lucent All Commercial |
$816.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$934.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$934.00
|
| Rate for Payer: Managed Health Services Medicaid |
$573.26
|
| Rate for Payer: Managed Health Services Medicaid |
$573.26
|
| Rate for Payer: MDWise Medicaid |
$573.26
|
| Rate for Payer: MDWise Medicaid |
$573.26
|
| Rate for Payer: PHCS All Commercial |
$582.93
|
| Rate for Payer: PHCS All Commercial |
$582.93
|
| Rate for Payer: PHP All Commercial |
$991.29
|
| Rate for Payer: PHP All Commercial |
$991.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$582.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$582.93
|
| Rate for Payer: Sagamore Health Network All Products |
$582.93
|
| Rate for Payer: Sagamore Health Network All Products |
$582.93
|
| Rate for Payer: Signature Care EPO |
$840.65
|
| Rate for Payer: Signature Care EPO |
$840.65
|
| Rate for Payer: Signature Care PPO |
$840.65
|
| Rate for Payer: Signature Care PPO |
$840.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,600.00
|
| Rate for Payer: United Healthcare Commercial |
$658.75
|
| Rate for Payer: United Healthcare Commercial |
$658.75
|
| Rate for Payer: United Healthcare Medicare |
$569.71
|
| Rate for Payer: United Healthcare Medicare |
$569.71
|
|
|
PR OPEN STOMACH,REULCER,SUTURE
|
Professional
|
Both
|
$2,443.00
|
|
|
Service Code
|
CPT 43501
|
| Hospital Charge Code |
z43501
|
| Min. Negotiated Rate |
$1,178.10 |
| Max. Negotiated Rate |
$171,800.00 |
| Rate for Payer: Aetna Commercial |
$1,248.46
|
| Rate for Payer: Aetna Commercial |
$1,248.46
|
| Rate for Payer: Aetna Medicare |
$1,248.46
|
| Rate for Payer: Aetna Medicare |
$1,248.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,178.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,178.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,178.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,178.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,178.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,178.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,178.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,178.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,201.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,201.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,435.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,435.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,373.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,373.31
|
| Rate for Payer: Cash Price |
$1,465.80
|
| Rate for Payer: Cash Price |
$1,437.06
|
| Rate for Payer: Centivo All Commercial |
$1,935.11
|
| Rate for Payer: Centivo All Commercial |
$1,935.11
|
| Rate for Payer: Cigna All Commercial |
$1,248.46
|
| Rate for Payer: Cigna All Commercial |
$1,248.46
|
| Rate for Payer: CORVEL All Commercial |
$1,248.46
|
| Rate for Payer: CORVEL All Commercial |
$1,248.46
|
| Rate for Payer: Coventry All Commercial |
$1,498.15
|
| Rate for Payer: Coventry All Commercial |
$1,498.15
|
| Rate for Payer: Encore All Commercial |
$1,248.46
|
| Rate for Payer: Encore All Commercial |
$1,248.46
|
| Rate for Payer: Frontpath All Commercial |
$1,789.10
|
| Rate for Payer: Frontpath All Commercial |
$1,789.10
|
| Rate for Payer: Humana ChoiceCare |
$1,301.88
|
| Rate for Payer: Humana ChoiceCare |
$1,301.88
|
| Rate for Payer: Humana Medicare |
$1,248.46
|
| Rate for Payer: Humana Medicare |
$1,248.46
|
| Rate for Payer: Lucent All Commercial |
$1,747.84
|
| Rate for Payer: Lucent All Commercial |
$1,747.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,841.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,841.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,201.56
|
| Rate for Payer: Managed Health Services Medicaid |
$1,201.56
|
| Rate for Payer: MDWise Medicaid |
$1,201.56
|
| Rate for Payer: MDWise Medicaid |
$1,201.56
|
| Rate for Payer: PHCS All Commercial |
$1,248.46
|
| Rate for Payer: PHCS All Commercial |
$1,248.46
|
| Rate for Payer: PHP All Commercial |
$2,095.72
|
| Rate for Payer: PHP All Commercial |
$2,095.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,248.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,248.46
|
| Rate for Payer: Sagamore Health Network All Products |
$1,248.46
|
| Rate for Payer: Sagamore Health Network All Products |
$1,248.46
|
| Rate for Payer: Signature Care EPO |
$1,632.85
|
| Rate for Payer: Signature Care EPO |
$1,632.85
|
| Rate for Payer: Signature Care PPO |
$1,632.85
|
| Rate for Payer: Signature Care PPO |
$1,632.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$171,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$171,800.00
|
| Rate for Payer: United Healthcare Commercial |
$1,433.06
|
| Rate for Payer: United Healthcare Commercial |
$1,433.06
|
| Rate for Payer: United Healthcare Medicare |
$1,197.55
|
| Rate for Payer: United Healthcare Medicare |
$1,197.55
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$1,419.24
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
z27814
|
| Min. Negotiated Rate |
$695.60 |
| Max. Negotiated Rate |
$106,900.00 |
| Rate for Payer: Aetna Commercial |
$714.14
|
| Rate for Payer: Aetna Commercial |
$714.14
|
| Rate for Payer: Aetna Medicare |
$714.14
|
| Rate for Payer: Aetna Medicare |
$714.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,035.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,035.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,035.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,035.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,035.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,035.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,035.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,035.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$698.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$698.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$821.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$821.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$785.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$785.55
|
| Rate for Payer: Cash Price |
$851.54
|
| Rate for Payer: Cash Price |
$834.72
|
| Rate for Payer: Centivo All Commercial |
$1,106.92
|
| Rate for Payer: Centivo All Commercial |
$1,106.92
|
| Rate for Payer: Cigna All Commercial |
$714.14
|
| Rate for Payer: Cigna All Commercial |
$714.14
|
| Rate for Payer: CORVEL All Commercial |
$714.14
|
| Rate for Payer: CORVEL All Commercial |
$714.14
|
| Rate for Payer: Coventry All Commercial |
$856.97
|
| Rate for Payer: Coventry All Commercial |
$856.97
|
| Rate for Payer: Encore All Commercial |
$714.14
|
| Rate for Payer: Encore All Commercial |
$714.14
|
| Rate for Payer: Frontpath All Commercial |
$992.29
|
| Rate for Payer: Frontpath All Commercial |
$992.29
|
| Rate for Payer: Humana ChoiceCare |
$839.98
|
| Rate for Payer: Humana ChoiceCare |
$839.98
|
| Rate for Payer: Humana Medicare |
$714.14
|
| Rate for Payer: Humana Medicare |
$714.14
|
| Rate for Payer: Lucent All Commercial |
$999.80
|
| Rate for Payer: Lucent All Commercial |
$999.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,141.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,141.00
|
| Rate for Payer: Managed Health Services Medicaid |
$698.04
|
| Rate for Payer: Managed Health Services Medicaid |
$698.04
|
| Rate for Payer: MDWise Medicaid |
$698.04
|
| Rate for Payer: MDWise Medicaid |
$698.04
|
| Rate for Payer: PHCS All Commercial |
$714.14
|
| Rate for Payer: PHCS All Commercial |
$714.14
|
| Rate for Payer: PHP All Commercial |
$1,210.34
|
| Rate for Payer: PHP All Commercial |
$1,210.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$714.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$714.14
|
| Rate for Payer: Sagamore Health Network All Products |
$714.14
|
| Rate for Payer: Sagamore Health Network All Products |
$714.14
|
| Rate for Payer: Signature Care EPO |
$1,125.40
|
| Rate for Payer: Signature Care EPO |
$1,125.40
|
| Rate for Payer: Signature Care PPO |
$1,125.40
|
| Rate for Payer: Signature Care PPO |
$1,125.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$106,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$106,900.00
|
| Rate for Payer: United Healthcare Commercial |
$842.13
|
| Rate for Payer: United Healthcare Commercial |
$842.13
|
| Rate for Payer: United Healthcare Medicare |
$695.60
|
| Rate for Payer: United Healthcare Medicare |
$695.60
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE
|
Professional
|
Both
|
$2,085.12
|
|
|
Service Code
|
CPT 28415
|
| Hospital Charge Code |
z28415
|
| Min. Negotiated Rate |
$1,025.54 |
| Max. Negotiated Rate |
$1,638.43 |
| Rate for Payer: Aetna Commercial |
$1,057.05
|
| Rate for Payer: Aetna Commercial |
$1,057.05
|
| Rate for Payer: Aetna Medicare |
$1,057.05
|
| Rate for Payer: Aetna Medicare |
$1,057.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,025.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,025.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,215.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,215.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,162.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,162.76
|
| Rate for Payer: Cash Price |
$1,230.76
|
| Rate for Payer: Cash Price |
$1,251.07
|
| Rate for Payer: Centivo All Commercial |
$1,638.43
|
| Rate for Payer: Centivo All Commercial |
$1,638.43
|
| Rate for Payer: Cigna All Commercial |
$1,057.05
|
| Rate for Payer: Cigna All Commercial |
$1,057.05
|
| Rate for Payer: CORVEL All Commercial |
$1,057.05
|
| Rate for Payer: CORVEL All Commercial |
$1,057.05
|
| Rate for Payer: Coventry All Commercial |
$1,268.46
|
| Rate for Payer: Coventry All Commercial |
$1,268.46
|
| Rate for Payer: Encore All Commercial |
$1,057.05
|
| Rate for Payer: Encore All Commercial |
$1,057.05
|
| Rate for Payer: Frontpath All Commercial |
$1,459.37
|
| Rate for Payer: Frontpath All Commercial |
$1,459.37
|
| Rate for Payer: Humana ChoiceCare |
$1,273.84
|
| Rate for Payer: Humana ChoiceCare |
$1,273.84
|
| Rate for Payer: Humana Medicare |
$1,057.05
|
| Rate for Payer: Humana Medicare |
$1,057.05
|
| Rate for Payer: Lucent All Commercial |
$1,479.87
|
| Rate for Payer: Lucent All Commercial |
$1,479.87
|
| Rate for Payer: Managed Health Services Medicaid |
$1,025.54
|
| Rate for Payer: Managed Health Services Medicaid |
$1,025.54
|
| Rate for Payer: MDWise Medicaid |
$1,025.54
|
| Rate for Payer: MDWise Medicaid |
$1,025.54
|
| Rate for Payer: PHCS All Commercial |
$1,057.05
|
| Rate for Payer: PHCS All Commercial |
$1,057.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,057.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,057.05
|
| Rate for Payer: Sagamore Health Network All Products |
$1,057.05
|
| Rate for Payer: Sagamore Health Network All Products |
$1,057.05
|
| Rate for Payer: United Healthcare Commercial |
$1,250.61
|
| Rate for Payer: United Healthcare Commercial |
$1,250.61
|
| Rate for Payer: United Healthcare Medicare |
$1,025.63
|
| Rate for Payer: United Healthcare Medicare |
$1,025.63
|
|
