|
PR RECONSTR TOTAL SHOULDER IMPLANT
|
Professional
|
Both
|
$2,653.32
|
|
|
Service Code
|
CPT 23472
|
| Hospital Charge Code |
z23472
|
| Min. Negotiated Rate |
$1,304.54 |
| Max. Negotiated Rate |
$200,500.00 |
| Rate for Payer: Aetna Commercial |
$1,344.46
|
| Rate for Payer: Aetna Commercial |
$1,344.46
|
| Rate for Payer: Aetna Medicare |
$1,344.46
|
| Rate for Payer: Aetna Medicare |
$1,344.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,673.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,673.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,673.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,673.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,673.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,673.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,673.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,673.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,305.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,305.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,546.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,546.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,478.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,478.91
|
| Rate for Payer: Cash Price |
$1,591.99
|
| Rate for Payer: Cash Price |
$1,565.45
|
| Rate for Payer: Centivo All Commercial |
$2,083.91
|
| Rate for Payer: Centivo All Commercial |
$2,083.91
|
| Rate for Payer: Cigna All Commercial |
$1,344.46
|
| Rate for Payer: Cigna All Commercial |
$1,344.46
|
| Rate for Payer: CORVEL All Commercial |
$1,344.46
|
| Rate for Payer: CORVEL All Commercial |
$1,344.46
|
| Rate for Payer: Coventry All Commercial |
$1,613.35
|
| Rate for Payer: Coventry All Commercial |
$1,613.35
|
| Rate for Payer: Encore All Commercial |
$1,344.46
|
| Rate for Payer: Encore All Commercial |
$1,344.46
|
| Rate for Payer: Frontpath All Commercial |
$1,881.57
|
| Rate for Payer: Frontpath All Commercial |
$1,881.57
|
| Rate for Payer: Humana ChoiceCare |
$1,561.10
|
| Rate for Payer: Humana ChoiceCare |
$1,561.10
|
| Rate for Payer: Humana Medicare |
$1,344.46
|
| Rate for Payer: Humana Medicare |
$1,344.46
|
| Rate for Payer: Lucent All Commercial |
$1,882.24
|
| Rate for Payer: Lucent All Commercial |
$1,882.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,139.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,139.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,305.01
|
| Rate for Payer: Managed Health Services Medicaid |
$1,305.01
|
| Rate for Payer: MDWise Medicaid |
$1,305.01
|
| Rate for Payer: MDWise Medicaid |
$1,305.01
|
| Rate for Payer: PHCS All Commercial |
$1,344.46
|
| Rate for Payer: PHCS All Commercial |
$1,344.46
|
| Rate for Payer: PHP All Commercial |
$2,269.91
|
| Rate for Payer: PHP All Commercial |
$2,269.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,344.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,344.46
|
| Rate for Payer: Sagamore Health Network All Products |
$1,344.46
|
| Rate for Payer: Sagamore Health Network All Products |
$1,344.46
|
| Rate for Payer: Signature Care EPO |
$2,063.80
|
| Rate for Payer: Signature Care EPO |
$2,063.80
|
| Rate for Payer: Signature Care PPO |
$2,063.80
|
| Rate for Payer: Signature Care PPO |
$2,063.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$200,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$200,500.00
|
| Rate for Payer: United Healthcare Commercial |
$1,656.36
|
| Rate for Payer: United Healthcare Commercial |
$1,656.36
|
| Rate for Payer: United Healthcare Medicare |
$1,304.54
|
| Rate for Payer: United Healthcare Medicare |
$1,304.54
|
|
|
PR RECONSTRUC OF NAIL BED
|
Professional
|
Both
|
$344.22
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
z11760
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$12,400.00 |
| Rate for Payer: Aetna Commercial |
$104.48
|
| Rate for Payer: Aetna Commercial |
$104.48
|
| Rate for Payer: Aetna Medicare |
$104.48
|
| Rate for Payer: Aetna Medicare |
$104.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$220.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$220.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$220.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$220.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$220.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$220.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$220.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$220.56
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.58
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$169.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$169.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$120.15
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$120.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$114.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$114.93
|
| Rate for Payer: Cash Price |
$205.22
|
| Rate for Payer: Cash Price |
$206.53
|
| Rate for Payer: Centivo All Commercial |
$161.94
|
| Rate for Payer: Centivo All Commercial |
$161.94
|
| Rate for Payer: Cigna All Commercial |
$104.48
|
| Rate for Payer: Cigna All Commercial |
$104.48
|
| Rate for Payer: CORVEL All Commercial |
$104.48
|
| Rate for Payer: CORVEL All Commercial |
$104.48
|
| Rate for Payer: Coventry All Commercial |
$125.38
|
| Rate for Payer: Coventry All Commercial |
$125.38
|
| Rate for Payer: Encore All Commercial |
$104.48
|
| Rate for Payer: Encore All Commercial |
$104.48
|
| Rate for Payer: Frontpath All Commercial |
$142.32
|
| Rate for Payer: Frontpath All Commercial |
$142.32
|
| Rate for Payer: Humana ChoiceCare |
$124.81
|
| Rate for Payer: Humana ChoiceCare |
$124.81
|
| Rate for Payer: Humana Medicare |
$104.48
|
| Rate for Payer: Humana Medicare |
$104.48
|
| Rate for Payer: Lucent All Commercial |
$146.27
|
| Rate for Payer: Lucent All Commercial |
$146.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$135.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$135.00
|
| Rate for Payer: Managed Health Services Medicaid |
$169.30
|
| Rate for Payer: Managed Health Services Medicaid |
$169.30
|
| Rate for Payer: MDWise Medicaid |
$169.30
|
| Rate for Payer: MDWise Medicaid |
$169.30
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$56.58
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$56.58
|
| Rate for Payer: PHCS All Commercial |
$104.48
|
| Rate for Payer: PHCS All Commercial |
$104.48
|
| Rate for Payer: PHP All Commercial |
$141.61
|
| Rate for Payer: PHP All Commercial |
$141.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$104.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$104.48
|
| Rate for Payer: Sagamore Health Network All Products |
$104.48
|
| Rate for Payer: Sagamore Health Network All Products |
$104.48
|
| Rate for Payer: Signature Care EPO |
$182.98
|
| Rate for Payer: Signature Care EPO |
$182.98
|
| Rate for Payer: Signature Care PPO |
$182.98
|
| Rate for Payer: Signature Care PPO |
$182.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,400.00
|
| Rate for Payer: United Healthcare Commercial |
$140.71
|
| Rate for Payer: United Healthcare Commercial |
$140.71
|
| Rate for Payer: United Healthcare Medicare |
$171.02
|
| Rate for Payer: United Healthcare Medicare |
$171.02
|
|
|
PR RECONSTRUCT RADIAL HEAD W IMPLANT
|
Professional
|
Both
|
$1,266.56
|
|
|
Service Code
|
CPT 24366
|
| Hospital Charge Code |
z24366
|
| Min. Negotiated Rate |
$620.66 |
| Max. Negotiated Rate |
$95,400.00 |
| Rate for Payer: Aetna Commercial |
$637.25
|
| Rate for Payer: Aetna Commercial |
$637.25
|
| Rate for Payer: Aetna Medicare |
$637.25
|
| Rate for Payer: Aetna Medicare |
$637.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$906.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$622.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$622.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$732.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$732.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$700.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$700.98
|
| Rate for Payer: Cash Price |
$759.94
|
| Rate for Payer: Cash Price |
$744.79
|
| Rate for Payer: Centivo All Commercial |
$987.74
|
| Rate for Payer: Centivo All Commercial |
$987.74
|
| Rate for Payer: Cigna All Commercial |
$637.25
|
| Rate for Payer: Cigna All Commercial |
$637.25
|
| Rate for Payer: CORVEL All Commercial |
$637.25
|
| Rate for Payer: CORVEL All Commercial |
$637.25
|
| Rate for Payer: Coventry All Commercial |
$764.70
|
| Rate for Payer: Coventry All Commercial |
$764.70
|
| Rate for Payer: Encore All Commercial |
$637.25
|
| Rate for Payer: Encore All Commercial |
$637.25
|
| Rate for Payer: Frontpath All Commercial |
$885.26
|
| Rate for Payer: Frontpath All Commercial |
$885.26
|
| Rate for Payer: Humana ChoiceCare |
$726.12
|
| Rate for Payer: Humana ChoiceCare |
$726.12
|
| Rate for Payer: Humana Medicare |
$637.25
|
| Rate for Payer: Humana Medicare |
$637.25
|
| Rate for Payer: Lucent All Commercial |
$892.15
|
| Rate for Payer: Lucent All Commercial |
$892.15
|
| 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 |
$622.94
|
| Rate for Payer: Managed Health Services Medicaid |
$622.94
|
| Rate for Payer: MDWise Medicaid |
$622.94
|
| Rate for Payer: MDWise Medicaid |
$622.94
|
| Rate for Payer: PHCS All Commercial |
$637.25
|
| Rate for Payer: PHCS All Commercial |
$637.25
|
| Rate for Payer: PHP All Commercial |
$1,079.94
|
| Rate for Payer: PHP All Commercial |
$1,079.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$637.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$637.25
|
| Rate for Payer: Sagamore Health Network All Products |
$637.25
|
| Rate for Payer: Sagamore Health Network All Products |
$637.25
|
| Rate for Payer: Signature Care EPO |
$969.00
|
| Rate for Payer: Signature Care EPO |
$969.00
|
| Rate for Payer: Signature Care PPO |
$969.00
|
| Rate for Payer: Signature Care PPO |
$969.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$95,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$95,400.00
|
| Rate for Payer: United Healthcare Commercial |
$737.84
|
| Rate for Payer: United Healthcare Commercial |
$737.84
|
| Rate for Payer: United Healthcare Medicare |
$620.66
|
| Rate for Payer: United Healthcare Medicare |
$620.66
|
|
|
PR REFOREARM TEND/MUSC,EXTEN,PRIM,EA
|
Professional
|
Both
|
$927.68
|
|
|
Service Code
|
CPT 25270
|
| Hospital Charge Code |
z25270
|
| Min. Negotiated Rate |
$453.50 |
| Max. Negotiated Rate |
$69,700.00 |
| Rate for Payer: Aetna Commercial |
$462.98
|
| Rate for Payer: Aetna Commercial |
$462.98
|
| Rate for Payer: Aetna Medicare |
$462.98
|
| Rate for Payer: Aetna Medicare |
$462.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$790.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$790.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$790.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$790.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$790.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$790.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$790.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$790.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$456.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$456.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$532.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$532.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$509.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$509.28
|
| Rate for Payer: Cash Price |
$556.61
|
| Rate for Payer: Cash Price |
$544.20
|
| Rate for Payer: Centivo All Commercial |
$717.62
|
| Rate for Payer: Centivo All Commercial |
$717.62
|
| Rate for Payer: Cigna All Commercial |
$462.98
|
| Rate for Payer: Cigna All Commercial |
$462.98
|
| Rate for Payer: CORVEL All Commercial |
$462.98
|
| Rate for Payer: CORVEL All Commercial |
$462.98
|
| Rate for Payer: Coventry All Commercial |
$555.58
|
| Rate for Payer: Coventry All Commercial |
$555.58
|
| Rate for Payer: Encore All Commercial |
$462.98
|
| Rate for Payer: Encore All Commercial |
$462.98
|
| Rate for Payer: Frontpath All Commercial |
$639.03
|
| Rate for Payer: Frontpath All Commercial |
$639.03
|
| Rate for Payer: Humana ChoiceCare |
$756.61
|
| Rate for Payer: Humana ChoiceCare |
$756.61
|
| Rate for Payer: Humana Medicare |
$462.98
|
| Rate for Payer: Humana Medicare |
$462.98
|
| Rate for Payer: Lucent All Commercial |
$648.17
|
| Rate for Payer: Lucent All Commercial |
$648.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$744.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$744.00
|
| Rate for Payer: Managed Health Services Medicaid |
$456.27
|
| Rate for Payer: Managed Health Services Medicaid |
$456.27
|
| Rate for Payer: MDWise Medicaid |
$456.27
|
| Rate for Payer: MDWise Medicaid |
$456.27
|
| Rate for Payer: PHCS All Commercial |
$462.98
|
| Rate for Payer: PHCS All Commercial |
$462.98
|
| Rate for Payer: PHP All Commercial |
$789.08
|
| Rate for Payer: PHP All Commercial |
$789.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$462.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$462.98
|
| Rate for Payer: Sagamore Health Network All Products |
$462.98
|
| Rate for Payer: Sagamore Health Network All Products |
$462.98
|
| Rate for Payer: Signature Care EPO |
$787.07
|
| Rate for Payer: Signature Care EPO |
$787.07
|
| Rate for Payer: Signature Care PPO |
$787.07
|
| Rate for Payer: Signature Care PPO |
$787.07
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69,700.00
|
| Rate for Payer: United Healthcare Commercial |
$582.35
|
| Rate for Payer: United Healthcare Commercial |
$582.35
|
| Rate for Payer: United Healthcare Medicare |
$453.50
|
| Rate for Payer: United Healthcare Medicare |
$453.50
|
|
|
PR REINSERT BI/TRICEPS TENDON,DISTAL
|
Professional
|
Both
|
$1,437.82
|
|
|
Service Code
|
CPT 24342
|
| Hospital Charge Code |
z24342
|
| Min. Negotiated Rate |
$704.63 |
| Max. Negotiated Rate |
$108,300.00 |
| Rate for Payer: Aetna Commercial |
$724.05
|
| Rate for Payer: Aetna Commercial |
$724.05
|
| Rate for Payer: Aetna Medicare |
$724.05
|
| Rate for Payer: Aetna Medicare |
$724.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,012.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,012.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,012.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,012.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,012.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,012.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,012.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,012.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$707.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$707.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$832.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$832.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$796.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$796.46
|
| Rate for Payer: Cash Price |
$862.69
|
| Rate for Payer: Cash Price |
$845.56
|
| Rate for Payer: Centivo All Commercial |
$1,122.28
|
| Rate for Payer: Centivo All Commercial |
$1,122.28
|
| Rate for Payer: Cigna All Commercial |
$724.05
|
| Rate for Payer: Cigna All Commercial |
$724.05
|
| Rate for Payer: CORVEL All Commercial |
$724.05
|
| Rate for Payer: CORVEL All Commercial |
$724.05
|
| Rate for Payer: Coventry All Commercial |
$868.86
|
| Rate for Payer: Coventry All Commercial |
$868.86
|
| Rate for Payer: Encore All Commercial |
$724.05
|
| Rate for Payer: Encore All Commercial |
$724.05
|
| Rate for Payer: Frontpath All Commercial |
$1,007.44
|
| Rate for Payer: Frontpath All Commercial |
$1,007.44
|
| Rate for Payer: Humana ChoiceCare |
$835.78
|
| Rate for Payer: Humana ChoiceCare |
$835.78
|
| Rate for Payer: Humana Medicare |
$724.05
|
| Rate for Payer: Humana Medicare |
$724.05
|
| Rate for Payer: Lucent All Commercial |
$1,013.67
|
| Rate for Payer: Lucent All Commercial |
$1,013.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,156.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,156.00
|
| Rate for Payer: Managed Health Services Medicaid |
$707.17
|
| Rate for Payer: Managed Health Services Medicaid |
$707.17
|
| Rate for Payer: MDWise Medicaid |
$707.17
|
| Rate for Payer: MDWise Medicaid |
$707.17
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$1,226.06
|
| Rate for Payer: PHP All Commercial |
$1,226.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$724.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$724.05
|
| Rate for Payer: Sagamore Health Network All Products |
$724.05
|
| Rate for Payer: Sagamore Health Network All Products |
$724.05
|
| Rate for Payer: Signature Care EPO |
$1,116.05
|
| Rate for Payer: Signature Care EPO |
$1,116.05
|
| Rate for Payer: Signature Care PPO |
$1,116.05
|
| Rate for Payer: Signature Care PPO |
$1,116.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$108,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$108,300.00
|
| Rate for Payer: United Healthcare Commercial |
$849.38
|
| Rate for Payer: United Healthcare Commercial |
$849.38
|
| Rate for Payer: United Healthcare Medicare |
$704.63
|
| Rate for Payer: United Healthcare Medicare |
$704.63
|
|
|
PR RELEASE I-P JT CONTRACTURE
|
Professional
|
Both
|
$1,277.54
|
|
|
Service Code
|
CPT 26525
|
| Hospital Charge Code |
z26525
|
| Min. Negotiated Rate |
$628.34 |
| Max. Negotiated Rate |
$97,100.00 |
| Rate for Payer: Aetna Commercial |
$652.90
|
| Rate for Payer: Aetna Commercial |
$652.90
|
| Rate for Payer: Aetna Medicare |
$652.90
|
| Rate for Payer: Aetna Medicare |
$652.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$702.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$702.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$702.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$702.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$702.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$702.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$702.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$702.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$628.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$628.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$750.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$750.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$718.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$718.19
|
| Rate for Payer: Cash Price |
$766.52
|
| Rate for Payer: Cash Price |
$757.50
|
| Rate for Payer: Centivo All Commercial |
$1,012.00
|
| Rate for Payer: Centivo All Commercial |
$1,012.00
|
| Rate for Payer: Cigna All Commercial |
$652.90
|
| Rate for Payer: Cigna All Commercial |
$652.90
|
| Rate for Payer: CORVEL All Commercial |
$652.90
|
| Rate for Payer: CORVEL All Commercial |
$652.90
|
| Rate for Payer: Coventry All Commercial |
$783.48
|
| Rate for Payer: Coventry All Commercial |
$783.48
|
| Rate for Payer: Encore All Commercial |
$652.90
|
| Rate for Payer: Encore All Commercial |
$652.90
|
| Rate for Payer: Frontpath All Commercial |
$885.73
|
| Rate for Payer: Frontpath All Commercial |
$885.73
|
| Rate for Payer: Humana ChoiceCare |
$801.83
|
| Rate for Payer: Humana ChoiceCare |
$801.83
|
| Rate for Payer: Humana Medicare |
$652.90
|
| Rate for Payer: Humana Medicare |
$652.90
|
| Rate for Payer: Lucent All Commercial |
$914.06
|
| Rate for Payer: Lucent All Commercial |
$914.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,035.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,035.00
|
| Rate for Payer: Managed Health Services Medicaid |
$628.34
|
| Rate for Payer: Managed Health Services Medicaid |
$628.34
|
| Rate for Payer: MDWise Medicaid |
$628.34
|
| Rate for Payer: MDWise Medicaid |
$628.34
|
| Rate for Payer: PHCS All Commercial |
$652.90
|
| Rate for Payer: PHCS All Commercial |
$652.90
|
| Rate for Payer: PHP All Commercial |
$1,098.38
|
| Rate for Payer: PHP All Commercial |
$1,098.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$652.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$652.90
|
| Rate for Payer: Sagamore Health Network All Products |
$652.90
|
| Rate for Payer: Sagamore Health Network All Products |
$652.90
|
| Rate for Payer: Signature Care EPO |
$1,031.83
|
| Rate for Payer: Signature Care EPO |
$1,031.83
|
| Rate for Payer: Signature Care PPO |
$1,031.83
|
| Rate for Payer: Signature Care PPO |
$1,031.83
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$97,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$97,100.00
|
| Rate for Payer: United Healthcare Commercial |
$684.11
|
| Rate for Payer: United Healthcare Commercial |
$684.11
|
| Rate for Payer: United Healthcare Medicare |
$631.25
|
| Rate for Payer: United Healthcare Medicare |
$631.25
|
|
|
PR RELEASE PALM CONTRACT,OPEN,PARTIAL
|
Professional
|
Both
|
$887.54
|
|
|
Service Code
|
CPT 26045
|
| Hospital Charge Code |
z26045
|
| Min. Negotiated Rate |
$433.06 |
| Max. Negotiated Rate |
$66,600.00 |
| Rate for Payer: Aetna Commercial |
$442.42
|
| Rate for Payer: Aetna Commercial |
$442.42
|
| Rate for Payer: Aetna Medicare |
$442.42
|
| Rate for Payer: Aetna Medicare |
$442.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$661.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$661.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$661.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$661.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$661.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$661.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$661.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$661.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$436.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$436.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$508.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$508.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$486.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$486.66
|
| Rate for Payer: Cash Price |
$532.52
|
| Rate for Payer: Cash Price |
$519.67
|
| Rate for Payer: Centivo All Commercial |
$685.75
|
| Rate for Payer: Centivo All Commercial |
$685.75
|
| Rate for Payer: Cigna All Commercial |
$442.42
|
| Rate for Payer: Cigna All Commercial |
$442.42
|
| Rate for Payer: CORVEL All Commercial |
$442.42
|
| Rate for Payer: CORVEL All Commercial |
$442.42
|
| Rate for Payer: Coventry All Commercial |
$530.90
|
| Rate for Payer: Coventry All Commercial |
$530.90
|
| Rate for Payer: Encore All Commercial |
$442.42
|
| Rate for Payer: Encore All Commercial |
$442.42
|
| Rate for Payer: Frontpath All Commercial |
$610.53
|
| Rate for Payer: Frontpath All Commercial |
$610.53
|
| Rate for Payer: Humana ChoiceCare |
$483.87
|
| Rate for Payer: Humana ChoiceCare |
$483.87
|
| Rate for Payer: Humana Medicare |
$442.42
|
| Rate for Payer: Humana Medicare |
$442.42
|
| Rate for Payer: Lucent All Commercial |
$619.39
|
| Rate for Payer: Lucent All Commercial |
$619.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$710.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$710.00
|
| Rate for Payer: Managed Health Services Medicaid |
$436.52
|
| Rate for Payer: Managed Health Services Medicaid |
$436.52
|
| Rate for Payer: MDWise Medicaid |
$436.52
|
| Rate for Payer: MDWise Medicaid |
$436.52
|
| Rate for Payer: PHCS All Commercial |
$442.42
|
| Rate for Payer: PHCS All Commercial |
$442.42
|
| Rate for Payer: PHP All Commercial |
$753.52
|
| Rate for Payer: PHP All Commercial |
$753.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$442.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$442.42
|
| Rate for Payer: Sagamore Health Network All Products |
$442.42
|
| Rate for Payer: Sagamore Health Network All Products |
$442.42
|
| Rate for Payer: Signature Care EPO |
$643.45
|
| Rate for Payer: Signature Care EPO |
$643.45
|
| Rate for Payer: Signature Care PPO |
$643.45
|
| Rate for Payer: Signature Care PPO |
$643.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$66,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$66,600.00
|
| Rate for Payer: United Healthcare Commercial |
$491.21
|
| Rate for Payer: United Healthcare Commercial |
$491.21
|
| Rate for Payer: United Healthcare Medicare |
$433.06
|
| Rate for Payer: United Healthcare Medicare |
$433.06
|
|
|
PR RELEASE SHLDR JOINT CONTRACTURE
|
Professional
|
Both
|
$1,282.94
|
|
|
Service Code
|
CPT 23020
|
| Hospital Charge Code |
z23020
|
| Min. Negotiated Rate |
$628.24 |
| Max. Negotiated Rate |
$998.87 |
| Rate for Payer: Aetna Commercial |
$644.43
|
| Rate for Payer: Aetna Medicare |
$644.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$631.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$741.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$708.87
|
| Rate for Payer: Cash Price |
$769.76
|
| Rate for Payer: Centivo All Commercial |
$998.87
|
| Rate for Payer: Cigna All Commercial |
$644.43
|
| Rate for Payer: CORVEL All Commercial |
$644.43
|
| Rate for Payer: Coventry All Commercial |
$773.32
|
| Rate for Payer: Encore All Commercial |
$644.43
|
| Rate for Payer: Frontpath All Commercial |
$895.86
|
| Rate for Payer: Humana ChoiceCare |
$718.56
|
| Rate for Payer: Humana Medicare |
$644.43
|
| Rate for Payer: Lucent All Commercial |
$902.20
|
| Rate for Payer: Managed Health Services Medicaid |
$631.00
|
| Rate for Payer: MDWise Medicaid |
$631.00
|
| Rate for Payer: PHCS All Commercial |
$644.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$644.43
|
| Rate for Payer: Sagamore Health Network All Products |
$644.43
|
| Rate for Payer: United Healthcare Commercial |
$743.73
|
| Rate for Payer: United Healthcare Medicare |
$628.24
|
|
|
PR RELEASE TIB/FIB/ANKLE FLEX TENDON,EA
|
Professional
|
Both
|
$790.62
|
|
|
Service Code
|
CPT 27680
|
| Hospital Charge Code |
z27680
|
| Min. Negotiated Rate |
$383.49 |
| Max. Negotiated Rate |
$59,000.00 |
| Rate for Payer: Aetna Commercial |
$393.16
|
| Rate for Payer: Aetna Commercial |
$393.16
|
| Rate for Payer: Aetna Medicare |
$393.16
|
| Rate for Payer: Aetna Medicare |
$393.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$557.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$557.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$557.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$557.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$557.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$557.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$557.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$557.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$388.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$388.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$452.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$452.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$432.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$432.48
|
| Rate for Payer: Cash Price |
$474.37
|
| Rate for Payer: Cash Price |
$460.19
|
| Rate for Payer: Centivo All Commercial |
$609.40
|
| Rate for Payer: Centivo All Commercial |
$609.40
|
| Rate for Payer: Cigna All Commercial |
$393.16
|
| Rate for Payer: Cigna All Commercial |
$393.16
|
| Rate for Payer: CORVEL All Commercial |
$393.16
|
| Rate for Payer: CORVEL All Commercial |
$393.16
|
| Rate for Payer: Coventry All Commercial |
$471.79
|
| Rate for Payer: Coventry All Commercial |
$471.79
|
| Rate for Payer: Encore All Commercial |
$393.16
|
| Rate for Payer: Encore All Commercial |
$393.16
|
| Rate for Payer: Frontpath All Commercial |
$539.58
|
| Rate for Payer: Frontpath All Commercial |
$539.58
|
| Rate for Payer: Humana ChoiceCare |
$470.38
|
| Rate for Payer: Humana ChoiceCare |
$470.38
|
| Rate for Payer: Humana Medicare |
$393.16
|
| Rate for Payer: Humana Medicare |
$393.16
|
| Rate for Payer: Lucent All Commercial |
$550.42
|
| Rate for Payer: Lucent All Commercial |
$550.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.00
|
| Rate for Payer: Managed Health Services Medicaid |
$388.86
|
| Rate for Payer: Managed Health Services Medicaid |
$388.86
|
| Rate for Payer: MDWise Medicaid |
$388.86
|
| Rate for Payer: MDWise Medicaid |
$388.86
|
| Rate for Payer: PHCS All Commercial |
$393.16
|
| Rate for Payer: PHCS All Commercial |
$393.16
|
| Rate for Payer: PHP All Commercial |
$667.28
|
| Rate for Payer: PHP All Commercial |
$667.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$393.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$393.16
|
| Rate for Payer: Sagamore Health Network All Products |
$393.16
|
| Rate for Payer: Sagamore Health Network All Products |
$393.16
|
| Rate for Payer: Signature Care EPO |
$636.65
|
| Rate for Payer: Signature Care EPO |
$636.65
|
| Rate for Payer: Signature Care PPO |
$636.65
|
| Rate for Payer: Signature Care PPO |
$636.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$59,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$59,000.00
|
| Rate for Payer: United Healthcare Commercial |
$471.98
|
| Rate for Payer: United Healthcare Commercial |
$471.98
|
| Rate for Payer: United Healthcare Medicare |
$383.49
|
| Rate for Payer: United Healthcare Medicare |
$383.49
|
|
|
PR RELOCATION OF SKIN POCKET FOR PACEMAKER
|
Professional
|
Both
|
$617.48
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
z33222
|
| Min. Negotiated Rate |
$303.70 |
| Max. Negotiated Rate |
$46,900.00 |
| Rate for Payer: Aetna Commercial |
$316.66
|
| Rate for Payer: Aetna Commercial |
$316.66
|
| Rate for Payer: Aetna Medicare |
$316.66
|
| Rate for Payer: Aetna Medicare |
$316.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$501.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$501.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$303.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$303.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$364.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$364.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$348.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$348.33
|
| Rate for Payer: Cash Price |
$370.49
|
| Rate for Payer: Cash Price |
$366.37
|
| Rate for Payer: Centivo All Commercial |
$490.82
|
| Rate for Payer: Centivo All Commercial |
$490.82
|
| Rate for Payer: Cigna All Commercial |
$316.66
|
| Rate for Payer: Cigna All Commercial |
$316.66
|
| Rate for Payer: CORVEL All Commercial |
$316.66
|
| Rate for Payer: CORVEL All Commercial |
$316.66
|
| Rate for Payer: Coventry All Commercial |
$379.99
|
| Rate for Payer: Coventry All Commercial |
$379.99
|
| Rate for Payer: Encore All Commercial |
$316.66
|
| Rate for Payer: Encore All Commercial |
$316.66
|
| Rate for Payer: Frontpath All Commercial |
$445.25
|
| Rate for Payer: Frontpath All Commercial |
$445.25
|
| Rate for Payer: Humana ChoiceCare |
$446.53
|
| Rate for Payer: Humana ChoiceCare |
$446.53
|
| Rate for Payer: Humana Medicare |
$316.66
|
| Rate for Payer: Humana Medicare |
$316.66
|
| Rate for Payer: Lucent All Commercial |
$443.32
|
| Rate for Payer: Lucent All Commercial |
$443.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$501.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$501.00
|
| Rate for Payer: Managed Health Services Medicaid |
$303.70
|
| Rate for Payer: Managed Health Services Medicaid |
$303.70
|
| Rate for Payer: MDWise Medicaid |
$303.70
|
| Rate for Payer: MDWise Medicaid |
$303.70
|
| Rate for Payer: PHCS All Commercial |
$316.66
|
| Rate for Payer: PHCS All Commercial |
$316.66
|
| Rate for Payer: PHP All Commercial |
$427.43
|
| Rate for Payer: PHP All Commercial |
$427.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$316.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$316.66
|
| Rate for Payer: Sagamore Health Network All Products |
$316.66
|
| Rate for Payer: Sagamore Health Network All Products |
$316.66
|
| Rate for Payer: Signature Care EPO |
$518.50
|
| Rate for Payer: Signature Care EPO |
$518.50
|
| Rate for Payer: Signature Care PPO |
$518.50
|
| Rate for Payer: Signature Care PPO |
$518.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,900.00
|
| Rate for Payer: United Healthcare Commercial |
$414.76
|
| Rate for Payer: United Healthcare Commercial |
$414.76
|
| Rate for Payer: United Healthcare Medicare |
$305.31
|
| Rate for Payer: United Healthcare Medicare |
$305.31
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$47.68
|
|
|
Service Code
|
CPT 93297
|
| Hospital Charge Code |
z93297
|
| Min. Negotiated Rate |
$23.84 |
| Max. Negotiated Rate |
$3,700.00 |
| Rate for Payer: Aetna Commercial |
$25.18
|
| Rate for Payer: Aetna Commercial |
$25.18
|
| Rate for Payer: Aetna Medicare |
$25.18
|
| Rate for Payer: Aetna Medicare |
$25.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$36.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$36.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$36.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$36.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$36.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$36.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$36.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$36.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$55.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$55.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$28.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$28.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$27.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$27.70
|
| Rate for Payer: Cash Price |
$28.61
|
| Rate for Payer: Cash Price |
$67.75
|
| Rate for Payer: Centivo All Commercial |
$39.03
|
| Rate for Payer: Centivo All Commercial |
$39.03
|
| Rate for Payer: Cigna All Commercial |
$25.18
|
| Rate for Payer: Cigna All Commercial |
$25.18
|
| Rate for Payer: CORVEL All Commercial |
$25.18
|
| Rate for Payer: CORVEL All Commercial |
$25.18
|
| Rate for Payer: Coventry All Commercial |
$30.22
|
| Rate for Payer: Coventry All Commercial |
$30.22
|
| Rate for Payer: Encore All Commercial |
$25.18
|
| Rate for Payer: Encore All Commercial |
$25.18
|
| Rate for Payer: Frontpath All Commercial |
$28.75
|
| Rate for Payer: Frontpath All Commercial |
$28.75
|
| Rate for Payer: Humana ChoiceCare |
$33.73
|
| Rate for Payer: Humana ChoiceCare |
$33.73
|
| Rate for Payer: Humana Medicare |
$25.18
|
| Rate for Payer: Humana Medicare |
$25.18
|
| Rate for Payer: Lucent All Commercial |
$35.25
|
| Rate for Payer: Lucent All Commercial |
$35.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$39.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$39.00
|
| Rate for Payer: Managed Health Services Medicaid |
$55.54
|
| Rate for Payer: Managed Health Services Medicaid |
$55.54
|
| Rate for Payer: MDWise Medicaid |
$55.54
|
| Rate for Payer: MDWise Medicaid |
$55.54
|
| Rate for Payer: PHCS All Commercial |
$25.18
|
| Rate for Payer: PHCS All Commercial |
$25.18
|
| Rate for Payer: PHP All Commercial |
$35.05
|
| Rate for Payer: PHP All Commercial |
$35.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25.18
|
| Rate for Payer: Sagamore Health Network All Products |
$25.18
|
| Rate for Payer: Sagamore Health Network All Products |
$25.18
|
| Rate for Payer: Signature Care EPO |
$37.97
|
| Rate for Payer: Signature Care EPO |
$37.97
|
| Rate for Payer: Signature Care PPO |
$37.97
|
| Rate for Payer: Signature Care PPO |
$37.97
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,700.00
|
| Rate for Payer: United Healthcare Commercial |
$31.03
|
| Rate for Payer: United Healthcare Commercial |
$31.03
|
| Rate for Payer: United Healthcare Medicare |
$23.84
|
| Rate for Payer: United Healthcare Medicare |
$23.84
|
|
|
PR REM INTERROG PM/LDLS PM <90 D PHYS/QHP
|
Professional
|
Both
|
$55.38
|
|
|
Service Code
|
CPT 93294
|
| Hospital Charge Code |
z93294
|
| Min. Negotiated Rate |
$27.23 |
| Max. Negotiated Rate |
$4,300.00 |
| Rate for Payer: Aetna Commercial |
$28.88
|
| Rate for Payer: Aetna Commercial |
$28.88
|
| Rate for Payer: Aetna Medicare |
$28.88
|
| Rate for Payer: Aetna Medicare |
$28.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$52.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$52.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$52.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$52.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$52.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$52.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$52.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$52.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$27.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$27.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$33.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$33.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$31.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$31.77
|
| Rate for Payer: Cash Price |
$33.23
|
| Rate for Payer: Cash Price |
$33.22
|
| Rate for Payer: Centivo All Commercial |
$44.76
|
| Rate for Payer: Centivo All Commercial |
$44.76
|
| Rate for Payer: Cigna All Commercial |
$28.88
|
| Rate for Payer: Cigna All Commercial |
$28.88
|
| Rate for Payer: CORVEL All Commercial |
$28.88
|
| Rate for Payer: CORVEL All Commercial |
$28.88
|
| Rate for Payer: Coventry All Commercial |
$34.66
|
| Rate for Payer: Coventry All Commercial |
$34.66
|
| Rate for Payer: Encore All Commercial |
$28.88
|
| Rate for Payer: Encore All Commercial |
$28.88
|
| Rate for Payer: Frontpath All Commercial |
$32.85
|
| Rate for Payer: Frontpath All Commercial |
$32.85
|
| Rate for Payer: Humana ChoiceCare |
$48.04
|
| Rate for Payer: Humana ChoiceCare |
$48.04
|
| Rate for Payer: Humana Medicare |
$28.88
|
| Rate for Payer: Humana Medicare |
$28.88
|
| Rate for Payer: Lucent All Commercial |
$40.43
|
| Rate for Payer: Lucent All Commercial |
$40.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$45.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$45.00
|
| Rate for Payer: Managed Health Services Medicaid |
$27.23
|
| Rate for Payer: Managed Health Services Medicaid |
$27.23
|
| Rate for Payer: MDWise Medicaid |
$27.23
|
| Rate for Payer: MDWise Medicaid |
$27.23
|
| Rate for Payer: PHCS All Commercial |
$28.88
|
| Rate for Payer: PHCS All Commercial |
$28.88
|
| Rate for Payer: PHP All Commercial |
$40.71
|
| Rate for Payer: PHP All Commercial |
$40.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$28.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$28.88
|
| Rate for Payer: Sagamore Health Network All Products |
$28.88
|
| Rate for Payer: Sagamore Health Network All Products |
$28.88
|
| Rate for Payer: Signature Care EPO |
$49.10
|
| Rate for Payer: Signature Care EPO |
$49.10
|
| Rate for Payer: Signature Care PPO |
$49.10
|
| Rate for Payer: Signature Care PPO |
$49.10
|
| 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 |
$44.19
|
| Rate for Payer: United Healthcare Commercial |
$44.19
|
| Rate for Payer: United Healthcare Medicare |
$27.69
|
| Rate for Payer: United Healthcare Medicare |
$27.69
|
|
|
PR REM INTERROG PM/LDLS PM/IDS <90 D PHYS/QHP
|
Professional
|
Both
|
$40.08
|
|
|
Service Code
|
CPT 93296
|
| Hospital Charge Code |
z93296
|
| Min. Negotiated Rate |
$19.18 |
| Max. Negotiated Rate |
$3,100.00 |
| Rate for Payer: Aetna Commercial |
$21.34
|
| Rate for Payer: Aetna Commercial |
$21.34
|
| Rate for Payer: Aetna Medicare |
$21.34
|
| Rate for Payer: Aetna Medicare |
$21.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$49.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$49.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$49.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$49.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$49.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$49.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$19.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$19.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23.47
|
| Rate for Payer: Cash Price |
$24.05
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Centivo All Commercial |
$33.08
|
| Rate for Payer: Centivo All Commercial |
$33.08
|
| Rate for Payer: Cigna All Commercial |
$21.34
|
| Rate for Payer: Cigna All Commercial |
$21.34
|
| Rate for Payer: CORVEL All Commercial |
$21.34
|
| Rate for Payer: CORVEL All Commercial |
$21.34
|
| Rate for Payer: Coventry All Commercial |
$25.61
|
| Rate for Payer: Coventry All Commercial |
$25.61
|
| Rate for Payer: Encore All Commercial |
$21.34
|
| Rate for Payer: Encore All Commercial |
$21.34
|
| Rate for Payer: Frontpath All Commercial |
$24.05
|
| Rate for Payer: Frontpath All Commercial |
$24.05
|
| Rate for Payer: Humana ChoiceCare |
$45.30
|
| Rate for Payer: Humana ChoiceCare |
$45.30
|
| Rate for Payer: Humana Medicare |
$21.34
|
| Rate for Payer: Humana Medicare |
$21.34
|
| Rate for Payer: Lucent All Commercial |
$29.88
|
| Rate for Payer: Lucent All Commercial |
$29.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$33.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$33.00
|
| Rate for Payer: Managed Health Services Medicaid |
$19.18
|
| Rate for Payer: Managed Health Services Medicaid |
$19.18
|
| Rate for Payer: MDWise Medicaid |
$19.18
|
| Rate for Payer: MDWise Medicaid |
$19.18
|
| Rate for Payer: PHCS All Commercial |
$21.34
|
| Rate for Payer: PHCS All Commercial |
$21.34
|
| Rate for Payer: PHP All Commercial |
$29.45
|
| Rate for Payer: PHP All Commercial |
$29.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$21.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$21.34
|
| Rate for Payer: Sagamore Health Network All Products |
$21.34
|
| Rate for Payer: Sagamore Health Network All Products |
$21.34
|
| Rate for Payer: Signature Care EPO |
$36.28
|
| Rate for Payer: Signature Care EPO |
$36.28
|
| Rate for Payer: Signature Care PPO |
$36.28
|
| Rate for Payer: Signature Care PPO |
$36.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,100.00
|
| Rate for Payer: United Healthcare Commercial |
$41.66
|
| Rate for Payer: United Healthcare Commercial |
$41.66
|
| Rate for Payer: United Healthcare Medicare |
$20.04
|
| Rate for Payer: United Healthcare Medicare |
$20.04
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$48.28
|
|
|
Service Code
|
CPT 93298
|
| Hospital Charge Code |
z93298
|
| Min. Negotiated Rate |
$24.14 |
| Max. Negotiated Rate |
$3,700.00 |
| Rate for Payer: Aetna Commercial |
$25.18
|
| Rate for Payer: Aetna Commercial |
$25.18
|
| Rate for Payer: Aetna Medicare |
$25.18
|
| Rate for Payer: Aetna Medicare |
$25.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$42.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$42.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$42.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$42.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$42.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$42.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$92.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$92.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$28.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$28.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$27.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$27.70
|
| Rate for Payer: Cash Price |
$28.97
|
| Rate for Payer: Cash Price |
$113.26
|
| Rate for Payer: Centivo All Commercial |
$39.03
|
| Rate for Payer: Centivo All Commercial |
$39.03
|
| Rate for Payer: Cigna All Commercial |
$25.18
|
| Rate for Payer: Cigna All Commercial |
$25.18
|
| Rate for Payer: CORVEL All Commercial |
$25.18
|
| Rate for Payer: CORVEL All Commercial |
$25.18
|
| Rate for Payer: Coventry All Commercial |
$30.22
|
| Rate for Payer: Coventry All Commercial |
$30.22
|
| Rate for Payer: Encore All Commercial |
$25.18
|
| Rate for Payer: Encore All Commercial |
$25.18
|
| Rate for Payer: Frontpath All Commercial |
$28.75
|
| Rate for Payer: Frontpath All Commercial |
$28.75
|
| Rate for Payer: Humana ChoiceCare |
$38.68
|
| Rate for Payer: Humana ChoiceCare |
$38.68
|
| Rate for Payer: Humana Medicare |
$25.18
|
| Rate for Payer: Humana Medicare |
$25.18
|
| Rate for Payer: Lucent All Commercial |
$35.25
|
| Rate for Payer: Lucent All Commercial |
$35.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$40.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$40.00
|
| Rate for Payer: Managed Health Services Medicaid |
$92.84
|
| Rate for Payer: Managed Health Services Medicaid |
$92.84
|
| Rate for Payer: MDWise Medicaid |
$92.84
|
| Rate for Payer: MDWise Medicaid |
$92.84
|
| Rate for Payer: PHCS All Commercial |
$25.18
|
| Rate for Payer: PHCS All Commercial |
$25.18
|
| Rate for Payer: PHP All Commercial |
$35.49
|
| Rate for Payer: PHP All Commercial |
$35.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25.18
|
| Rate for Payer: Sagamore Health Network All Products |
$25.18
|
| Rate for Payer: Sagamore Health Network All Products |
$25.18
|
| Rate for Payer: Signature Care EPO |
$42.81
|
| Rate for Payer: Signature Care EPO |
$42.81
|
| Rate for Payer: Signature Care PPO |
$42.81
|
| Rate for Payer: Signature Care PPO |
$42.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,700.00
|
| Rate for Payer: United Healthcare Commercial |
$35.58
|
| Rate for Payer: United Healthcare Commercial |
$35.58
|
| Rate for Payer: United Healthcare Medicare |
$24.14
|
| Rate for Payer: United Healthcare Medicare |
$24.14
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Professional
|
Both
|
$88.86
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
z99454
|
| Min. Negotiated Rate |
$42.73 |
| Max. Negotiated Rate |
$77.48 |
| Rate for Payer: Aetna Commercial |
$49.99
|
| Rate for Payer: Aetna Commercial |
$49.99
|
| Rate for Payer: Aetna Medicare |
$49.99
|
| Rate for Payer: Aetna Medicare |
$49.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$42.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$42.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$57.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$57.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.99
|
| Rate for Payer: Cash Price |
$52.13
|
| Rate for Payer: Cash Price |
$53.32
|
| Rate for Payer: Centivo All Commercial |
$77.48
|
| Rate for Payer: Centivo All Commercial |
$77.48
|
| Rate for Payer: Cigna All Commercial |
$49.99
|
| Rate for Payer: Cigna All Commercial |
$49.99
|
| Rate for Payer: CORVEL All Commercial |
$49.99
|
| Rate for Payer: CORVEL All Commercial |
$49.99
|
| Rate for Payer: Coventry All Commercial |
$59.99
|
| Rate for Payer: Coventry All Commercial |
$59.99
|
| Rate for Payer: Encore All Commercial |
$49.99
|
| Rate for Payer: Encore All Commercial |
$49.99
|
| Rate for Payer: Frontpath All Commercial |
$52.97
|
| Rate for Payer: Frontpath All Commercial |
$52.97
|
| Rate for Payer: Humana ChoiceCare |
$62.52
|
| Rate for Payer: Humana ChoiceCare |
$62.52
|
| Rate for Payer: Humana Medicare |
$49.99
|
| Rate for Payer: Humana Medicare |
$49.99
|
| Rate for Payer: Lucent All Commercial |
$69.99
|
| Rate for Payer: Lucent All Commercial |
$69.99
|
| Rate for Payer: Managed Health Services Medicaid |
$42.73
|
| Rate for Payer: Managed Health Services Medicaid |
$42.73
|
| Rate for Payer: MDWise Medicaid |
$42.73
|
| Rate for Payer: MDWise Medicaid |
$42.73
|
| Rate for Payer: PHCS All Commercial |
$49.99
|
| Rate for Payer: PHCS All Commercial |
$49.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$49.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$49.99
|
| Rate for Payer: Sagamore Health Network All Products |
$49.99
|
| Rate for Payer: Sagamore Health Network All Products |
$49.99
|
| Rate for Payer: United Healthcare Commercial |
$61.76
|
| Rate for Payer: United Healthcare Commercial |
$61.76
|
| Rate for Payer: United Healthcare Medicare |
$44.43
|
| Rate for Payer: United Healthcare Medicare |
$44.43
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Professional
|
Both
|
$36.24
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
z99453
|
| Min. Negotiated Rate |
$16.88 |
| Max. Negotiated Rate |
$26.32 |
| Rate for Payer: Aetna Commercial |
$16.98
|
| Rate for Payer: Aetna Commercial |
$16.98
|
| Rate for Payer: Aetna Medicare |
$16.98
|
| Rate for Payer: Aetna Medicare |
$16.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$19.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$19.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18.68
|
| Rate for Payer: Cash Price |
$20.26
|
| Rate for Payer: Cash Price |
$21.74
|
| Rate for Payer: Centivo All Commercial |
$26.32
|
| Rate for Payer: Centivo All Commercial |
$26.32
|
| Rate for Payer: Cigna All Commercial |
$16.98
|
| Rate for Payer: Cigna All Commercial |
$16.98
|
| Rate for Payer: CORVEL All Commercial |
$16.98
|
| Rate for Payer: CORVEL All Commercial |
$16.98
|
| Rate for Payer: Coventry All Commercial |
$20.38
|
| Rate for Payer: Coventry All Commercial |
$20.38
|
| Rate for Payer: Encore All Commercial |
$16.98
|
| Rate for Payer: Encore All Commercial |
$16.98
|
| Rate for Payer: Frontpath All Commercial |
$18.14
|
| Rate for Payer: Frontpath All Commercial |
$18.14
|
| Rate for Payer: Humana ChoiceCare |
$18.82
|
| Rate for Payer: Humana ChoiceCare |
$18.82
|
| Rate for Payer: Humana Medicare |
$16.98
|
| Rate for Payer: Humana Medicare |
$16.98
|
| Rate for Payer: Lucent All Commercial |
$23.77
|
| Rate for Payer: Lucent All Commercial |
$23.77
|
| Rate for Payer: Managed Health Services Medicaid |
$17.83
|
| Rate for Payer: Managed Health Services Medicaid |
$17.83
|
| Rate for Payer: MDWise Medicaid |
$17.83
|
| Rate for Payer: MDWise Medicaid |
$17.83
|
| Rate for Payer: PHCS All Commercial |
$16.98
|
| Rate for Payer: PHCS All Commercial |
$16.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16.98
|
| Rate for Payer: Sagamore Health Network All Products |
$16.98
|
| Rate for Payer: Sagamore Health Network All Products |
$16.98
|
| Rate for Payer: United Healthcare Commercial |
$18.65
|
| Rate for Payer: United Healthcare Commercial |
$18.65
|
| Rate for Payer: United Healthcare Medicare |
$16.88
|
| Rate for Payer: United Healthcare Medicare |
$16.88
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING 1ST 20 MIN MONTH
|
Professional
|
Both
|
$92.24
|
|
|
Service Code
|
CPT 99457
|
| Hospital Charge Code |
z99457
|
| Min. Negotiated Rate |
$25.36 |
| Max. Negotiated Rate |
$45.79 |
| Rate for Payer: Aetna Commercial |
$29.54
|
| Rate for Payer: Aetna Commercial |
$29.54
|
| Rate for Payer: Aetna Medicare |
$29.54
|
| Rate for Payer: Aetna Medicare |
$29.54
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.36
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$45.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$45.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$33.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$33.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.49
|
| Rate for Payer: Cash Price |
$53.51
|
| Rate for Payer: Cash Price |
$55.34
|
| Rate for Payer: Centivo All Commercial |
$45.79
|
| Rate for Payer: Centivo All Commercial |
$45.79
|
| Rate for Payer: Cigna All Commercial |
$29.54
|
| Rate for Payer: Cigna All Commercial |
$29.54
|
| Rate for Payer: CORVEL All Commercial |
$29.54
|
| Rate for Payer: CORVEL All Commercial |
$29.54
|
| Rate for Payer: Coventry All Commercial |
$35.45
|
| Rate for Payer: Coventry All Commercial |
$35.45
|
| Rate for Payer: Encore All Commercial |
$29.54
|
| Rate for Payer: Encore All Commercial |
$29.54
|
| Rate for Payer: Frontpath All Commercial |
$31.74
|
| Rate for Payer: Frontpath All Commercial |
$31.74
|
| Rate for Payer: Humana ChoiceCare |
$32.78
|
| Rate for Payer: Humana ChoiceCare |
$32.78
|
| Rate for Payer: Humana Medicare |
$29.54
|
| Rate for Payer: Humana Medicare |
$29.54
|
| Rate for Payer: Lucent All Commercial |
$41.36
|
| Rate for Payer: Lucent All Commercial |
$41.36
|
| Rate for Payer: Managed Health Services Medicaid |
$45.37
|
| Rate for Payer: Managed Health Services Medicaid |
$45.37
|
| Rate for Payer: MDWise Medicaid |
$45.37
|
| Rate for Payer: MDWise Medicaid |
$45.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$25.36
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$25.36
|
| Rate for Payer: PHCS All Commercial |
$29.54
|
| Rate for Payer: PHCS All Commercial |
$29.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.54
|
| Rate for Payer: Sagamore Health Network All Products |
$29.54
|
| Rate for Payer: Sagamore Health Network All Products |
$29.54
|
| Rate for Payer: United Healthcare Commercial |
$32.70
|
| Rate for Payer: United Healthcare Commercial |
$32.70
|
| Rate for Payer: United Healthcare Medicare |
$44.59
|
| Rate for Payer: United Healthcare Medicare |
$44.59
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO
|
Professional
|
Both
|
$74.44
|
|
|
Service Code
|
CPT 99458
|
| Hospital Charge Code |
z99458
|
| Min. Negotiated Rate |
$29.53 |
| Max. Negotiated Rate |
$45.79 |
| Rate for Payer: Aetna Commercial |
$29.54
|
| Rate for Payer: Aetna Commercial |
$29.54
|
| Rate for Payer: Aetna Medicare |
$29.54
|
| Rate for Payer: Aetna Medicare |
$29.54
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$29.53
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$29.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$33.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$33.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.49
|
| Rate for Payer: Cash Price |
$43.75
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Centivo All Commercial |
$45.79
|
| Rate for Payer: Centivo All Commercial |
$45.79
|
| Rate for Payer: Cigna All Commercial |
$29.54
|
| Rate for Payer: Cigna All Commercial |
$29.54
|
| Rate for Payer: CORVEL All Commercial |
$29.54
|
| Rate for Payer: CORVEL All Commercial |
$29.54
|
| Rate for Payer: Coventry All Commercial |
$35.45
|
| Rate for Payer: Coventry All Commercial |
$35.45
|
| Rate for Payer: Encore All Commercial |
$29.54
|
| Rate for Payer: Encore All Commercial |
$29.54
|
| Rate for Payer: Frontpath All Commercial |
$31.74
|
| Rate for Payer: Frontpath All Commercial |
$31.74
|
| Rate for Payer: Humana ChoiceCare |
$32.97
|
| Rate for Payer: Humana ChoiceCare |
$32.97
|
| Rate for Payer: Humana Medicare |
$29.54
|
| Rate for Payer: Humana Medicare |
$29.54
|
| Rate for Payer: Lucent All Commercial |
$41.36
|
| Rate for Payer: Lucent All Commercial |
$41.36
|
| Rate for Payer: Managed Health Services Medicaid |
$36.61
|
| Rate for Payer: Managed Health Services Medicaid |
$36.61
|
| Rate for Payer: MDWise Medicaid |
$36.61
|
| Rate for Payer: MDWise Medicaid |
$36.61
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$29.53
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$29.53
|
| Rate for Payer: PHCS All Commercial |
$29.54
|
| Rate for Payer: PHCS All Commercial |
$29.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.54
|
| Rate for Payer: Sagamore Health Network All Products |
$29.54
|
| Rate for Payer: Sagamore Health Network All Products |
$29.54
|
| Rate for Payer: United Healthcare Commercial |
$32.93
|
| Rate for Payer: United Healthcare Commercial |
$32.93
|
| Rate for Payer: United Healthcare Medicare |
$36.46
|
| Rate for Payer: United Healthcare Medicare |
$36.46
|
|
|
PR REMOTE THERAPEUTIC MNTR 1ST SETUP&PT EDUCAJ EQP
|
Professional
|
Both
|
$36.24
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
z98975
|
| Min. Negotiated Rate |
$16.88 |
| Max. Negotiated Rate |
$26.57 |
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: Aetna Medicare |
$17.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$19.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18.85
|
| Rate for Payer: Cash Price |
$21.74
|
| Rate for Payer: Centivo All Commercial |
$26.57
|
| Rate for Payer: Cigna All Commercial |
$17.14
|
| Rate for Payer: CORVEL All Commercial |
$17.14
|
| Rate for Payer: Coventry All Commercial |
$20.57
|
| Rate for Payer: Encore All Commercial |
$17.14
|
| Rate for Payer: Humana ChoiceCare |
$17.30
|
| Rate for Payer: Humana Medicare |
$17.14
|
| Rate for Payer: Lucent All Commercial |
$24.00
|
| Rate for Payer: Managed Health Services Medicaid |
$17.83
|
| Rate for Payer: MDWise Medicaid |
$17.83
|
| Rate for Payer: PHCS All Commercial |
$17.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$17.14
|
| Rate for Payer: Sagamore Health Network All Products |
$17.14
|
| Rate for Payer: United Healthcare Commercial |
$19.23
|
| Rate for Payer: United Healthcare Medicare |
$16.88
|
|
|
PR REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN
|
Professional
|
Both
|
$95.36
|
|
|
Service Code
|
CPT 98980
|
| Hospital Charge Code |
z98980
|
| Min. Negotiated Rate |
$23.98 |
| Max. Negotiated Rate |
$46.90 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$29.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$23.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$46.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.88
|
| Rate for Payer: Cash Price |
$57.22
|
| Rate for Payer: Centivo All Commercial |
$46.33
|
| Rate for Payer: Cigna All Commercial |
$29.89
|
| Rate for Payer: CORVEL All Commercial |
$29.89
|
| Rate for Payer: Coventry All Commercial |
$35.87
|
| Rate for Payer: Encore All Commercial |
$29.89
|
| Rate for Payer: Humana ChoiceCare |
$29.37
|
| Rate for Payer: Humana Medicare |
$29.89
|
| Rate for Payer: Lucent All Commercial |
$41.85
|
| Rate for Payer: Managed Health Services Medicaid |
$46.90
|
| Rate for Payer: MDWise Medicaid |
$46.90
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$23.98
|
| Rate for Payer: PHCS All Commercial |
$29.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.89
|
| Rate for Payer: Sagamore Health Network All Products |
$29.89
|
| Rate for Payer: United Healthcare Commercial |
$33.08
|
| Rate for Payer: United Healthcare Medicare |
$45.22
|
|
|
PR REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN
|
Professional
|
Both
|
$75.66
|
|
|
Service Code
|
CPT 98981
|
| Hospital Charge Code |
z98981
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$46.03 |
| Rate for Payer: Aetna Commercial |
$29.70
|
| Rate for Payer: Aetna Medicare |
$29.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$24.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$37.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.67
|
| Rate for Payer: Cash Price |
$45.40
|
| Rate for Payer: Centivo All Commercial |
$46.03
|
| Rate for Payer: Cigna All Commercial |
$29.70
|
| Rate for Payer: CORVEL All Commercial |
$29.70
|
| Rate for Payer: Coventry All Commercial |
$35.64
|
| Rate for Payer: Encore All Commercial |
$29.70
|
| Rate for Payer: Humana ChoiceCare |
$28.72
|
| Rate for Payer: Humana Medicare |
$29.70
|
| Rate for Payer: Lucent All Commercial |
$41.58
|
| Rate for Payer: Managed Health Services Medicaid |
$37.21
|
| Rate for Payer: MDWise Medicaid |
$37.21
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$24.00
|
| Rate for Payer: PHCS All Commercial |
$29.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.70
|
| Rate for Payer: Sagamore Health Network All Products |
$29.70
|
| Rate for Payer: United Healthcare Commercial |
$32.93
|
| Rate for Payer: United Healthcare Medicare |
$36.46
|
|
|
PR REMOVAL ADENOIDS,PRIMARY,<12 Y/O
|
Professional
|
Both
|
$400.78
|
|
|
Service Code
|
CPT 42830
|
| Hospital Charge Code |
z42830
|
| Min. Negotiated Rate |
$195.22 |
| Max. Negotiated Rate |
$28,000.00 |
| Rate for Payer: Aetna Commercial |
$198.89
|
| Rate for Payer: Aetna Commercial |
$198.89
|
| Rate for Payer: Aetna Medicare |
$198.89
|
| Rate for Payer: Aetna Medicare |
$198.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$228.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$228.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$228.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$228.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$228.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$228.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$228.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$228.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$197.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$228.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$228.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$218.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$218.78
|
| Rate for Payer: Cash Price |
$240.47
|
| Rate for Payer: Cash Price |
$234.26
|
| Rate for Payer: Centivo All Commercial |
$308.28
|
| Rate for Payer: Centivo All Commercial |
$308.28
|
| Rate for Payer: Cigna All Commercial |
$198.89
|
| Rate for Payer: Cigna All Commercial |
$198.89
|
| Rate for Payer: CORVEL All Commercial |
$198.89
|
| Rate for Payer: CORVEL All Commercial |
$198.89
|
| Rate for Payer: Coventry All Commercial |
$238.67
|
| Rate for Payer: Coventry All Commercial |
$238.67
|
| Rate for Payer: Encore All Commercial |
$198.89
|
| Rate for Payer: Encore All Commercial |
$198.89
|
| Rate for Payer: Frontpath All Commercial |
$271.49
|
| Rate for Payer: Frontpath All Commercial |
$271.49
|
| Rate for Payer: Humana ChoiceCare |
$226.16
|
| Rate for Payer: Humana ChoiceCare |
$226.16
|
| Rate for Payer: Humana Medicare |
$198.89
|
| Rate for Payer: Humana Medicare |
$198.89
|
| Rate for Payer: Lucent All Commercial |
$278.45
|
| Rate for Payer: Lucent All Commercial |
$278.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$300.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$300.00
|
| Rate for Payer: Managed Health Services Medicaid |
$197.12
|
| Rate for Payer: Managed Health Services Medicaid |
$197.12
|
| Rate for Payer: MDWise Medicaid |
$197.12
|
| Rate for Payer: MDWise Medicaid |
$197.12
|
| Rate for Payer: PHCS All Commercial |
$198.89
|
| Rate for Payer: PHCS All Commercial |
$198.89
|
| Rate for Payer: PHP All Commercial |
$341.64
|
| Rate for Payer: PHP All Commercial |
$341.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.89
|
| Rate for Payer: Sagamore Health Network All Products |
$198.89
|
| Rate for Payer: Sagamore Health Network All Products |
$198.89
|
| Rate for Payer: Signature Care EPO |
$290.70
|
| Rate for Payer: Signature Care EPO |
$290.70
|
| Rate for Payer: Signature Care PPO |
$290.70
|
| Rate for Payer: Signature Care PPO |
$290.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28,000.00
|
| Rate for Payer: United Healthcare Commercial |
$225.25
|
| Rate for Payer: United Healthcare Commercial |
$225.25
|
| Rate for Payer: United Healthcare Medicare |
$195.22
|
| Rate for Payer: United Healthcare Medicare |
$195.22
|
|
|
PR REMOVAL ANAL FISTULA,INTERSPNINCTERIC
|
Professional
|
Both
|
$1,044.32
|
|
|
Service Code
|
CPT 46275
|
| Hospital Charge Code |
z46275
|
| Min. Negotiated Rate |
$245.50 |
| Max. Negotiated Rate |
$55,100.00 |
| Rate for Payer: Aetna Commercial |
$397.05
|
| Rate for Payer: Aetna Commercial |
$397.05
|
| Rate for Payer: Aetna Medicare |
$397.05
|
| Rate for Payer: Aetna Medicare |
$397.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$470.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$470.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$245.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$245.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$513.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$513.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$456.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$456.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$436.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$436.75
|
| Rate for Payer: Cash Price |
$617.28
|
| Rate for Payer: Cash Price |
$626.59
|
| Rate for Payer: Centivo All Commercial |
$615.43
|
| Rate for Payer: Centivo All Commercial |
$615.43
|
| Rate for Payer: Cigna All Commercial |
$397.05
|
| Rate for Payer: Cigna All Commercial |
$397.05
|
| Rate for Payer: CORVEL All Commercial |
$397.05
|
| Rate for Payer: CORVEL All Commercial |
$397.05
|
| Rate for Payer: Coventry All Commercial |
$476.46
|
| Rate for Payer: Coventry All Commercial |
$476.46
|
| Rate for Payer: Encore All Commercial |
$397.05
|
| Rate for Payer: Encore All Commercial |
$397.05
|
| Rate for Payer: Frontpath All Commercial |
$546.98
|
| Rate for Payer: Frontpath All Commercial |
$546.98
|
| Rate for Payer: Humana ChoiceCare |
$339.16
|
| Rate for Payer: Humana ChoiceCare |
$339.16
|
| Rate for Payer: Humana Medicare |
$397.05
|
| Rate for Payer: Humana Medicare |
$397.05
|
| Rate for Payer: Lucent All Commercial |
$555.87
|
| Rate for Payer: Lucent All Commercial |
$555.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$591.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$591.00
|
| Rate for Payer: Managed Health Services Medicaid |
$513.64
|
| Rate for Payer: Managed Health Services Medicaid |
$513.64
|
| Rate for Payer: MDWise Medicaid |
$513.64
|
| Rate for Payer: MDWise Medicaid |
$513.64
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$245.50
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$245.50
|
| Rate for Payer: PHCS All Commercial |
$397.05
|
| Rate for Payer: PHCS All Commercial |
$397.05
|
| Rate for Payer: PHP All Commercial |
$672.50
|
| Rate for Payer: PHP All Commercial |
$672.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$397.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$397.05
|
| Rate for Payer: Sagamore Health Network All Products |
$397.05
|
| Rate for Payer: Sagamore Health Network All Products |
$397.05
|
| Rate for Payer: Signature Care EPO |
$502.35
|
| Rate for Payer: Signature Care EPO |
$502.35
|
| Rate for Payer: Signature Care PPO |
$502.35
|
| Rate for Payer: Signature Care PPO |
$502.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,100.00
|
| Rate for Payer: United Healthcare Commercial |
$408.64
|
| Rate for Payer: United Healthcare Commercial |
$408.64
|
| Rate for Payer: United Healthcare Medicare |
$514.40
|
| Rate for Payer: United Healthcare Medicare |
$514.40
|
|
|
PR REMOVAL ANAL FISTULA,SUBCUTANEOUS
|
Professional
|
Both
|
$985.30
|
|
|
Service Code
|
CPT 46270
|
| Hospital Charge Code |
z46270
|
| Min. Negotiated Rate |
$207.12 |
| Max. Negotiated Rate |
$52,200.00 |
| Rate for Payer: Aetna Commercial |
$375.39
|
| Rate for Payer: Aetna Commercial |
$375.39
|
| Rate for Payer: Aetna Medicare |
$375.39
|
| Rate for Payer: Aetna Medicare |
$375.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$382.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$382.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$382.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$382.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$382.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$382.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$382.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$382.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$207.12
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$207.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$484.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$484.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$431.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$431.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$412.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$412.93
|
| Rate for Payer: Cash Price |
$583.55
|
| Rate for Payer: Cash Price |
$591.18
|
| Rate for Payer: Centivo All Commercial |
$581.85
|
| Rate for Payer: Centivo All Commercial |
$581.85
|
| Rate for Payer: Cigna All Commercial |
$375.39
|
| Rate for Payer: Cigna All Commercial |
$375.39
|
| Rate for Payer: CORVEL All Commercial |
$375.39
|
| Rate for Payer: CORVEL All Commercial |
$375.39
|
| Rate for Payer: Coventry All Commercial |
$450.47
|
| Rate for Payer: Coventry All Commercial |
$450.47
|
| Rate for Payer: Encore All Commercial |
$375.39
|
| Rate for Payer: Encore All Commercial |
$375.39
|
| Rate for Payer: Frontpath All Commercial |
$518.73
|
| Rate for Payer: Frontpath All Commercial |
$518.73
|
| Rate for Payer: Humana ChoiceCare |
$294.11
|
| Rate for Payer: Humana ChoiceCare |
$294.11
|
| Rate for Payer: Humana Medicare |
$375.39
|
| Rate for Payer: Humana Medicare |
$375.39
|
| Rate for Payer: Lucent All Commercial |
$525.55
|
| Rate for Payer: Lucent All Commercial |
$525.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.00
|
| Rate for Payer: Managed Health Services Medicaid |
$484.60
|
| Rate for Payer: Managed Health Services Medicaid |
$484.60
|
| Rate for Payer: MDWise Medicaid |
$484.60
|
| Rate for Payer: MDWise Medicaid |
$484.60
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$207.12
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$207.12
|
| Rate for Payer: PHCS All Commercial |
$375.39
|
| Rate for Payer: PHCS All Commercial |
$375.39
|
| Rate for Payer: PHP All Commercial |
$636.49
|
| Rate for Payer: PHP All Commercial |
$636.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$375.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$375.39
|
| Rate for Payer: Sagamore Health Network All Products |
$375.39
|
| Rate for Payer: Sagamore Health Network All Products |
$375.39
|
| Rate for Payer: Signature Care EPO |
$468.35
|
| Rate for Payer: Signature Care EPO |
$468.35
|
| Rate for Payer: Signature Care PPO |
$468.35
|
| Rate for Payer: Signature Care PPO |
$468.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$52,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$52,200.00
|
| Rate for Payer: United Healthcare Commercial |
$380.75
|
| Rate for Payer: United Healthcare Commercial |
$380.75
|
| Rate for Payer: United Healthcare Medicare |
$486.29
|
| Rate for Payer: United Healthcare Medicare |
$486.29
|
|
|
PR REMOVAL ARM/ELBOW F.B.,DEEP
|
Professional
|
Both
|
$999.02
|
|
|
Service Code
|
CPT 24201
|
| Hospital Charge Code |
z24201
|
| Min. Negotiated Rate |
$188.95 |
| Max. Negotiated Rate |
$51,300.00 |
| Rate for Payer: Aetna Commercial |
$341.02
|
| Rate for Payer: Aetna Commercial |
$341.02
|
| Rate for Payer: Aetna Medicare |
$341.02
|
| Rate for Payer: Aetna Medicare |
$341.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$568.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$568.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$568.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$568.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$568.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$568.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$568.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$568.71
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$188.95
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$188.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$561.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$561.77
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$392.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$392.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$375.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$375.12
|
| Rate for Payer: Cash Price |
$685.32
|
| Rate for Payer: Cash Price |
$599.41
|
| Rate for Payer: Centivo All Commercial |
$528.58
|
| Rate for Payer: Centivo All Commercial |
$528.58
|
| Rate for Payer: Cigna All Commercial |
$341.02
|
| Rate for Payer: Cigna All Commercial |
$341.02
|
| Rate for Payer: CORVEL All Commercial |
$341.02
|
| Rate for Payer: CORVEL All Commercial |
$341.02
|
| Rate for Payer: Coventry All Commercial |
$409.22
|
| Rate for Payer: Coventry All Commercial |
$409.22
|
| Rate for Payer: Encore All Commercial |
$341.02
|
| Rate for Payer: Encore All Commercial |
$341.02
|
| Rate for Payer: Frontpath All Commercial |
$475.23
|
| Rate for Payer: Frontpath All Commercial |
$475.23
|
| Rate for Payer: Humana ChoiceCare |
$380.06
|
| Rate for Payer: Humana ChoiceCare |
$380.06
|
| Rate for Payer: Humana Medicare |
$341.02
|
| Rate for Payer: Humana Medicare |
$341.02
|
| Rate for Payer: Lucent All Commercial |
$477.43
|
| Rate for Payer: Lucent All Commercial |
$477.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$548.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$548.00
|
| Rate for Payer: Managed Health Services Medicaid |
$561.77
|
| Rate for Payer: Managed Health Services Medicaid |
$561.77
|
| Rate for Payer: MDWise Medicaid |
$561.77
|
| Rate for Payer: MDWise Medicaid |
$561.77
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$188.95
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$188.95
|
| Rate for Payer: PHCS All Commercial |
$341.02
|
| Rate for Payer: PHCS All Commercial |
$341.02
|
| Rate for Payer: PHP All Commercial |
$580.91
|
| Rate for Payer: PHP All Commercial |
$580.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$341.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$341.02
|
| Rate for Payer: Sagamore Health Network All Products |
$341.02
|
| Rate for Payer: Sagamore Health Network All Products |
$341.02
|
| Rate for Payer: Signature Care EPO |
$586.50
|
| Rate for Payer: Signature Care EPO |
$586.50
|
| Rate for Payer: Signature Care PPO |
$586.50
|
| Rate for Payer: Signature Care PPO |
$586.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$51,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$51,300.00
|
| Rate for Payer: United Healthcare Commercial |
$387.03
|
| Rate for Payer: United Healthcare Commercial |
$387.03
|
| Rate for Payer: United Healthcare Medicare |
$499.51
|
| Rate for Payer: United Healthcare Medicare |
$499.51
|
|
