|
PR REMOVAL IMPLANT DEEP
|
Professional
|
Both
|
$1,111.74
|
|
|
Service Code
|
CPT 20680
|
| Hospital Charge Code |
z20680
|
| Min. Negotiated Rate |
$214.39 |
| Max. Negotiated Rate |
$58,600.00 |
| Rate for Payer: Aetna Commercial |
$390.86
|
| Rate for Payer: Aetna Commercial |
$390.86
|
| Rate for Payer: Aetna Medicare |
$390.86
|
| Rate for Payer: Aetna Medicare |
$390.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$623.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$623.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$623.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$623.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$623.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$623.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$623.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$623.38
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$214.39
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$214.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$546.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$546.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$449.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$449.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$429.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$429.95
|
| Rate for Payer: Cash Price |
$678.37
|
| Rate for Payer: Cash Price |
$689.28
|
| Rate for Payer: Centivo All Commercial |
$605.83
|
| Rate for Payer: Centivo All Commercial |
$605.83
|
| Rate for Payer: Cigna All Commercial |
$390.86
|
| Rate for Payer: Cigna All Commercial |
$390.86
|
| Rate for Payer: CORVEL All Commercial |
$390.86
|
| Rate for Payer: CORVEL All Commercial |
$390.86
|
| Rate for Payer: Coventry All Commercial |
$469.03
|
| Rate for Payer: Coventry All Commercial |
$469.03
|
| Rate for Payer: Encore All Commercial |
$390.86
|
| Rate for Payer: Encore All Commercial |
$390.86
|
| Rate for Payer: Frontpath All Commercial |
$540.71
|
| Rate for Payer: Frontpath All Commercial |
$540.71
|
| Rate for Payer: Humana ChoiceCare |
$304.01
|
| Rate for Payer: Humana ChoiceCare |
$304.01
|
| Rate for Payer: Humana Medicare |
$390.86
|
| Rate for Payer: Humana Medicare |
$390.86
|
| Rate for Payer: Lucent All Commercial |
$547.20
|
| Rate for Payer: Lucent All Commercial |
$547.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$625.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$625.00
|
| Rate for Payer: Managed Health Services Medicaid |
$546.80
|
| Rate for Payer: Managed Health Services Medicaid |
$546.80
|
| Rate for Payer: MDWise Medicaid |
$546.80
|
| Rate for Payer: MDWise Medicaid |
$546.80
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$214.39
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$214.39
|
| Rate for Payer: PHCS All Commercial |
$390.86
|
| Rate for Payer: PHCS All Commercial |
$390.86
|
| Rate for Payer: PHP All Commercial |
$663.15
|
| Rate for Payer: PHP All Commercial |
$663.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.86
|
| Rate for Payer: Sagamore Health Network All Products |
$390.86
|
| Rate for Payer: Sagamore Health Network All Products |
$390.86
|
| Rate for Payer: Signature Care EPO |
$499.20
|
| Rate for Payer: Signature Care EPO |
$499.20
|
| Rate for Payer: Signature Care PPO |
$499.20
|
| Rate for Payer: Signature Care PPO |
$499.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$58,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$58,600.00
|
| Rate for Payer: United Healthcare Commercial |
$448.31
|
| Rate for Payer: United Healthcare Commercial |
$448.31
|
| Rate for Payer: United Healthcare Medicare |
$547.07
|
| Rate for Payer: United Healthcare Medicare |
$547.07
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
z20670
|
| Min. Negotiated Rate |
$77.53 |
| Max. Negotiated Rate |
$20,300.00 |
| Rate for Payer: Aetna Commercial |
$134.50
|
| Rate for Payer: Aetna Commercial |
$134.50
|
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$257.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$257.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$257.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$257.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$257.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$257.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$257.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$257.12
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$77.53
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$77.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$323.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$323.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$154.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$154.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$147.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$147.95
|
| Rate for Payer: Cash Price |
$403.56
|
| Rate for Payer: Cash Price |
$407.34
|
| Rate for Payer: Centivo All Commercial |
$208.47
|
| Rate for Payer: Centivo All Commercial |
$208.47
|
| Rate for Payer: Cigna All Commercial |
$134.50
|
| Rate for Payer: Cigna All Commercial |
$134.50
|
| Rate for Payer: CORVEL All Commercial |
$134.50
|
| Rate for Payer: CORVEL All Commercial |
$134.50
|
| Rate for Payer: Coventry All Commercial |
$161.40
|
| Rate for Payer: Coventry All Commercial |
$161.40
|
| Rate for Payer: Encore All Commercial |
$134.50
|
| Rate for Payer: Encore All Commercial |
$134.50
|
| Rate for Payer: Frontpath All Commercial |
$183.77
|
| Rate for Payer: Frontpath All Commercial |
$183.77
|
| Rate for Payer: Humana ChoiceCare |
$164.76
|
| Rate for Payer: Humana ChoiceCare |
$164.76
|
| Rate for Payer: Humana Medicare |
$134.50
|
| Rate for Payer: Humana Medicare |
$134.50
|
| Rate for Payer: Lucent All Commercial |
$188.30
|
| Rate for Payer: Lucent All Commercial |
$188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$216.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$216.00
|
| Rate for Payer: Managed Health Services Medicaid |
$323.14
|
| Rate for Payer: Managed Health Services Medicaid |
$323.14
|
| Rate for Payer: MDWise Medicaid |
$323.14
|
| Rate for Payer: MDWise Medicaid |
$323.14
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$77.53
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$77.53
|
| Rate for Payer: PHCS All Commercial |
$134.50
|
| Rate for Payer: PHCS All Commercial |
$134.50
|
| Rate for Payer: PHP All Commercial |
$229.31
|
| Rate for Payer: PHP All Commercial |
$229.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$134.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$134.50
|
| Rate for Payer: Sagamore Health Network All Products |
$134.50
|
| Rate for Payer: Sagamore Health Network All Products |
$134.50
|
| Rate for Payer: Signature Care EPO |
$466.65
|
| Rate for Payer: Signature Care EPO |
$466.65
|
| Rate for Payer: Signature Care PPO |
$466.65
|
| Rate for Payer: Signature Care PPO |
$466.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,300.00
|
| Rate for Payer: United Healthcare Commercial |
$160.58
|
| Rate for Payer: United Healthcare Commercial |
$160.58
|
| Rate for Payer: United Healthcare Medicare |
$325.45
|
| Rate for Payer: United Healthcare Medicare |
$325.45
|
|
|
PR REMOVAL INTACT BREAST IMPLANT
|
Professional
|
Both
|
$1,023.02
|
|
|
Service Code
|
CPT 19328
|
| Hospital Charge Code |
z19328
|
| Min. Negotiated Rate |
$402.62 |
| Max. Negotiated Rate |
$61,800.00 |
| Rate for Payer: Aetna Commercial |
$515.46
|
| Rate for Payer: Aetna Commercial |
$515.46
|
| Rate for Payer: Aetna Medicare |
$515.46
|
| Rate for Payer: Aetna Medicare |
$515.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$487.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$487.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$487.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$487.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$487.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$487.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$487.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$487.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$503.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$503.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$592.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$592.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$567.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$567.01
|
| Rate for Payer: Cash Price |
$634.27
|
| Rate for Payer: Cash Price |
$623.19
|
| Rate for Payer: Centivo All Commercial |
$798.96
|
| Rate for Payer: Centivo All Commercial |
$798.96
|
| Rate for Payer: Cigna All Commercial |
$515.46
|
| Rate for Payer: Cigna All Commercial |
$515.46
|
| Rate for Payer: CORVEL All Commercial |
$515.46
|
| Rate for Payer: CORVEL All Commercial |
$515.46
|
| Rate for Payer: Coventry All Commercial |
$618.55
|
| Rate for Payer: Coventry All Commercial |
$618.55
|
| Rate for Payer: Encore All Commercial |
$515.46
|
| Rate for Payer: Encore All Commercial |
$515.46
|
| Rate for Payer: Frontpath All Commercial |
$714.13
|
| Rate for Payer: Frontpath All Commercial |
$714.13
|
| Rate for Payer: Humana ChoiceCare |
$402.62
|
| Rate for Payer: Humana ChoiceCare |
$402.62
|
| Rate for Payer: Humana Medicare |
$515.46
|
| Rate for Payer: Humana Medicare |
$515.46
|
| Rate for Payer: Lucent All Commercial |
$721.64
|
| Rate for Payer: Lucent All Commercial |
$721.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$670.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$670.00
|
| Rate for Payer: Managed Health Services Medicaid |
$503.16
|
| Rate for Payer: Managed Health Services Medicaid |
$503.16
|
| Rate for Payer: MDWise Medicaid |
$503.16
|
| Rate for Payer: MDWise Medicaid |
$503.16
|
| Rate for Payer: PHCS All Commercial |
$515.46
|
| Rate for Payer: PHCS All Commercial |
$515.46
|
| Rate for Payer: PHP All Commercial |
$703.59
|
| Rate for Payer: PHP All Commercial |
$703.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$515.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$515.46
|
| Rate for Payer: Sagamore Health Network All Products |
$515.46
|
| Rate for Payer: Sagamore Health Network All Products |
$515.46
|
| Rate for Payer: Signature Care EPO |
$447.95
|
| Rate for Payer: Signature Care EPO |
$447.95
|
| Rate for Payer: Signature Care PPO |
$447.95
|
| Rate for Payer: Signature Care PPO |
$447.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$61,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$61,800.00
|
| Rate for Payer: United Healthcare Commercial |
$520.26
|
| Rate for Payer: United Healthcare Commercial |
$520.26
|
| Rate for Payer: United Healthcare Medicare |
$502.57
|
| Rate for Payer: United Healthcare Medicare |
$502.57
|
|
|
PR REMOVAL OF COCCYX
|
Professional
|
Both
|
$937.38
|
|
|
Service Code
|
CPT 27080
|
| Hospital Charge Code |
z27080
|
| Min. Negotiated Rate |
$461.04 |
| Max. Negotiated Rate |
$71,000.00 |
| Rate for Payer: Aetna Commercial |
$474.44
|
| Rate for Payer: Aetna Commercial |
$474.44
|
| Rate for Payer: Aetna Medicare |
$474.44
|
| Rate for Payer: Aetna Medicare |
$474.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$605.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$605.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$605.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$605.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$605.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$605.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$605.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$605.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$461.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$461.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$545.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$545.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$521.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$521.88
|
| Rate for Payer: Cash Price |
$581.18
|
| Rate for Payer: Cash Price |
$572.26
|
| Rate for Payer: Centivo All Commercial |
$735.38
|
| Rate for Payer: Centivo All Commercial |
$735.38
|
| Rate for Payer: Cigna All Commercial |
$474.44
|
| Rate for Payer: Cigna All Commercial |
$474.44
|
| Rate for Payer: CORVEL All Commercial |
$474.44
|
| Rate for Payer: CORVEL All Commercial |
$474.44
|
| Rate for Payer: Coventry All Commercial |
$569.33
|
| Rate for Payer: Coventry All Commercial |
$569.33
|
| Rate for Payer: Encore All Commercial |
$474.44
|
| Rate for Payer: Encore All Commercial |
$474.44
|
| Rate for Payer: Frontpath All Commercial |
$667.11
|
| Rate for Payer: Frontpath All Commercial |
$667.11
|
| Rate for Payer: Humana ChoiceCare |
$487.68
|
| Rate for Payer: Humana ChoiceCare |
$487.68
|
| Rate for Payer: Humana Medicare |
$474.44
|
| Rate for Payer: Humana Medicare |
$474.44
|
| Rate for Payer: Lucent All Commercial |
$664.22
|
| Rate for Payer: Lucent All Commercial |
$664.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$757.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$757.00
|
| Rate for Payer: Managed Health Services Medicaid |
$461.04
|
| Rate for Payer: Managed Health Services Medicaid |
$461.04
|
| Rate for Payer: MDWise Medicaid |
$461.04
|
| Rate for Payer: MDWise Medicaid |
$461.04
|
| Rate for Payer: PHCS All Commercial |
$474.44
|
| Rate for Payer: PHCS All Commercial |
$474.44
|
| Rate for Payer: PHP All Commercial |
$803.02
|
| Rate for Payer: PHP All Commercial |
$803.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$474.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$474.44
|
| Rate for Payer: Sagamore Health Network All Products |
$474.44
|
| Rate for Payer: Sagamore Health Network All Products |
$474.44
|
| Rate for Payer: Signature Care EPO |
$668.10
|
| Rate for Payer: Signature Care EPO |
$668.10
|
| Rate for Payer: Signature Care PPO |
$668.10
|
| Rate for Payer: Signature Care PPO |
$668.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71,000.00
|
| Rate for Payer: United Healthcare Commercial |
$530.34
|
| Rate for Payer: United Healthcare Commercial |
$530.34
|
| Rate for Payer: United Healthcare Medicare |
$461.50
|
| Rate for Payer: United Healthcare Medicare |
$461.50
|
|
|
PR REMOVAL OF CONTRACEPTIVE CAPSUL
|
Professional
|
Both
|
$268.76
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
z11976
|
| Min. Negotiated Rate |
$52.05 |
| Max. Negotiated Rate |
$10,400.00 |
| Rate for Payer: Aetna Commercial |
$87.28
|
| Rate for Payer: Aetna Commercial |
$87.28
|
| Rate for Payer: Aetna Medicare |
$87.28
|
| Rate for Payer: Aetna Medicare |
$87.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$168.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$168.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$168.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$168.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$168.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$168.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.27
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$52.05
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$52.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$132.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$132.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$100.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$100.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$96.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$96.01
|
| Rate for Payer: Cash Price |
$163.39
|
| Rate for Payer: Cash Price |
$166.63
|
| Rate for Payer: Centivo All Commercial |
$135.28
|
| Rate for Payer: Centivo All Commercial |
$135.28
|
| Rate for Payer: Cigna All Commercial |
$87.28
|
| Rate for Payer: Cigna All Commercial |
$87.28
|
| Rate for Payer: CORVEL All Commercial |
$87.28
|
| Rate for Payer: CORVEL All Commercial |
$87.28
|
| Rate for Payer: Coventry All Commercial |
$104.74
|
| Rate for Payer: Coventry All Commercial |
$104.74
|
| Rate for Payer: Encore All Commercial |
$87.28
|
| Rate for Payer: Encore All Commercial |
$87.28
|
| Rate for Payer: Frontpath All Commercial |
$121.78
|
| Rate for Payer: Frontpath All Commercial |
$121.78
|
| Rate for Payer: Humana ChoiceCare |
$94.28
|
| Rate for Payer: Humana ChoiceCare |
$94.28
|
| Rate for Payer: Humana Medicare |
$87.28
|
| Rate for Payer: Humana Medicare |
$87.28
|
| Rate for Payer: Lucent All Commercial |
$122.19
|
| Rate for Payer: Lucent All Commercial |
$122.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$112.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$112.00
|
| Rate for Payer: Managed Health Services Medicaid |
$132.18
|
| Rate for Payer: Managed Health Services Medicaid |
$132.18
|
| Rate for Payer: MDWise Medicaid |
$132.18
|
| Rate for Payer: MDWise Medicaid |
$132.18
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$52.05
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$52.05
|
| Rate for Payer: PHCS All Commercial |
$87.28
|
| Rate for Payer: PHCS All Commercial |
$87.28
|
| Rate for Payer: PHP All Commercial |
$117.86
|
| Rate for Payer: PHP All Commercial |
$117.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$87.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$87.28
|
| Rate for Payer: Sagamore Health Network All Products |
$87.28
|
| Rate for Payer: Sagamore Health Network All Products |
$87.28
|
| Rate for Payer: Signature Care EPO |
$144.50
|
| Rate for Payer: Signature Care EPO |
$144.50
|
| Rate for Payer: Signature Care PPO |
$144.50
|
| Rate for Payer: Signature Care PPO |
$144.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,400.00
|
| Rate for Payer: United Healthcare Commercial |
$108.69
|
| Rate for Payer: United Healthcare Commercial |
$108.69
|
| Rate for Payer: United Healthcare Medicare |
$131.77
|
| Rate for Payer: United Healthcare Medicare |
$131.77
|
|
|
PR REMOVAL OF ELBOW BURSA
|
Professional
|
Both
|
$661.10
|
|
|
Service Code
|
CPT 24105
|
| Hospital Charge Code |
z24105
|
| Min. Negotiated Rate |
$330.55 |
| Max. Negotiated Rate |
$50,800.00 |
| Rate for Payer: Aetna Commercial |
$336.61
|
| Rate for Payer: Aetna Commercial |
$336.61
|
| Rate for Payer: Aetna Medicare |
$336.61
|
| Rate for Payer: Aetna Medicare |
$336.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$383.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$383.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$383.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$383.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$383.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$383.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$383.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$383.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$334.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$334.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$387.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$387.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$370.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$370.27
|
| Rate for Payer: Cash Price |
$409.88
|
| Rate for Payer: Cash Price |
$421.84
|
| Rate for Payer: Centivo All Commercial |
$521.75
|
| Rate for Payer: Centivo All Commercial |
$521.75
|
| Rate for Payer: Cigna All Commercial |
$336.61
|
| Rate for Payer: Cigna All Commercial |
$336.61
|
| Rate for Payer: CORVEL All Commercial |
$336.61
|
| Rate for Payer: CORVEL All Commercial |
$336.61
|
| Rate for Payer: Coventry All Commercial |
$403.93
|
| Rate for Payer: Coventry All Commercial |
$403.93
|
| Rate for Payer: Encore All Commercial |
$336.61
|
| Rate for Payer: Encore All Commercial |
$336.61
|
| Rate for Payer: Frontpath All Commercial |
$462.45
|
| Rate for Payer: Frontpath All Commercial |
$462.45
|
| Rate for Payer: Humana ChoiceCare |
$342.81
|
| Rate for Payer: Humana ChoiceCare |
$342.81
|
| Rate for Payer: Humana Medicare |
$336.61
|
| Rate for Payer: Humana Medicare |
$336.61
|
| Rate for Payer: Lucent All Commercial |
$471.25
|
| Rate for Payer: Lucent All Commercial |
$471.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$542.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$542.00
|
| Rate for Payer: Managed Health Services Medicaid |
$334.64
|
| Rate for Payer: Managed Health Services Medicaid |
$334.64
|
| Rate for Payer: MDWise Medicaid |
$334.64
|
| Rate for Payer: MDWise Medicaid |
$334.64
|
| Rate for Payer: PHCS All Commercial |
$336.61
|
| Rate for Payer: PHCS All Commercial |
$336.61
|
| Rate for Payer: PHP All Commercial |
$575.16
|
| Rate for Payer: PHP All Commercial |
$575.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$336.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$336.61
|
| Rate for Payer: Sagamore Health Network All Products |
$336.61
|
| Rate for Payer: Sagamore Health Network All Products |
$336.61
|
| Rate for Payer: Signature Care EPO |
$458.15
|
| Rate for Payer: Signature Care EPO |
$458.15
|
| Rate for Payer: Signature Care PPO |
$458.15
|
| Rate for Payer: Signature Care PPO |
$458.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,800.00
|
| Rate for Payer: United Healthcare Commercial |
$353.69
|
| Rate for Payer: United Healthcare Commercial |
$353.69
|
| Rate for Payer: United Healthcare Medicare |
$330.55
|
| Rate for Payer: United Healthcare Medicare |
$330.55
|
|
|
PR REMOVAL OF EPIDIDYMIS,UNILAT
|
Professional
|
Both
|
$768.52
|
|
|
Service Code
|
CPT 54860
|
| Hospital Charge Code |
z54860
|
| Min. Negotiated Rate |
$382.70 |
| Max. Negotiated Rate |
$611.48 |
| Rate for Payer: Aetna Commercial |
$394.50
|
| Rate for Payer: Aetna Medicare |
$394.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$386.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$453.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$433.95
|
| Rate for Payer: Cash Price |
$476.48
|
| Rate for Payer: Centivo All Commercial |
$611.48
|
| Rate for Payer: Cigna All Commercial |
$394.50
|
| Rate for Payer: CORVEL All Commercial |
$394.50
|
| Rate for Payer: Coventry All Commercial |
$473.40
|
| Rate for Payer: Encore All Commercial |
$394.50
|
| Rate for Payer: Frontpath All Commercial |
$539.25
|
| Rate for Payer: Humana ChoiceCare |
$457.12
|
| Rate for Payer: Humana Medicare |
$394.50
|
| Rate for Payer: Lucent All Commercial |
$552.30
|
| Rate for Payer: Managed Health Services Medicaid |
$386.29
|
| Rate for Payer: MDWise Medicaid |
$386.29
|
| Rate for Payer: PHCS All Commercial |
$394.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$394.50
|
| Rate for Payer: Sagamore Health Network All Products |
$394.50
|
| Rate for Payer: United Healthcare Commercial |
$512.18
|
| Rate for Payer: United Healthcare Medicare |
$382.70
|
|
|
PR REMOVAL OF FALLOPIAN TUBE
|
Professional
|
Both
|
$1,481.36
|
|
|
Service Code
|
CPT 58700
|
| Hospital Charge Code |
z58700
|
| Min. Negotiated Rate |
$727.83 |
| Max. Negotiated Rate |
$97,000.00 |
| Rate for Payer: Aetna Commercial |
$753.18
|
| Rate for Payer: Aetna Commercial |
$753.18
|
| Rate for Payer: Aetna Medicare |
$753.18
|
| Rate for Payer: Aetna Medicare |
$753.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$956.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$956.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$956.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$956.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$956.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$956.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$956.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$956.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$728.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$728.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$866.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$866.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$828.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$828.50
|
| Rate for Payer: Cash Price |
$918.44
|
| Rate for Payer: Cash Price |
$902.51
|
| Rate for Payer: Centivo All Commercial |
$1,167.43
|
| Rate for Payer: Centivo All Commercial |
$1,167.43
|
| Rate for Payer: Cigna All Commercial |
$753.18
|
| Rate for Payer: Cigna All Commercial |
$753.18
|
| Rate for Payer: CORVEL All Commercial |
$753.18
|
| Rate for Payer: CORVEL All Commercial |
$753.18
|
| Rate for Payer: Coventry All Commercial |
$903.82
|
| Rate for Payer: Coventry All Commercial |
$903.82
|
| Rate for Payer: Encore All Commercial |
$753.18
|
| Rate for Payer: Encore All Commercial |
$753.18
|
| Rate for Payer: Frontpath All Commercial |
$1,050.10
|
| Rate for Payer: Frontpath All Commercial |
$1,050.10
|
| Rate for Payer: Humana ChoiceCare |
$803.64
|
| Rate for Payer: Humana ChoiceCare |
$803.64
|
| Rate for Payer: Humana Medicare |
$753.18
|
| Rate for Payer: Humana Medicare |
$753.18
|
| Rate for Payer: Lucent All Commercial |
$1,054.45
|
| Rate for Payer: Lucent All Commercial |
$1,054.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,044.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,044.00
|
| Rate for Payer: Managed Health Services Medicaid |
$728.59
|
| Rate for Payer: Managed Health Services Medicaid |
$728.59
|
| Rate for Payer: MDWise Medicaid |
$728.59
|
| Rate for Payer: MDWise Medicaid |
$728.59
|
| Rate for Payer: PHCS All Commercial |
$753.18
|
| Rate for Payer: PHCS All Commercial |
$753.18
|
| Rate for Payer: PHP All Commercial |
$960.73
|
| Rate for Payer: PHP All Commercial |
$960.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$753.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$753.18
|
| Rate for Payer: Sagamore Health Network All Products |
$753.18
|
| Rate for Payer: Sagamore Health Network All Products |
$753.18
|
| Rate for Payer: Signature Care EPO |
$887.40
|
| Rate for Payer: Signature Care EPO |
$887.40
|
| Rate for Payer: Signature Care PPO |
$887.40
|
| Rate for Payer: Signature Care PPO |
$887.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$97,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$97,000.00
|
| Rate for Payer: United Healthcare Commercial |
$858.04
|
| Rate for Payer: United Healthcare Commercial |
$858.04
|
| Rate for Payer: United Healthcare Medicare |
$727.83
|
| Rate for Payer: United Healthcare Medicare |
$727.83
|
|
|
PR REMOVAL OF FOREIGN BODY
|
Professional
|
Both
|
$405.32
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
z20520
|
| Min. Negotiated Rate |
$90.29 |
| Max. Negotiated Rate |
$20,600.00 |
| Rate for Payer: Aetna Commercial |
$137.99
|
| Rate for Payer: Aetna Commercial |
$137.99
|
| Rate for Payer: Aetna Medicare |
$137.99
|
| Rate for Payer: Aetna Medicare |
$137.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$240.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$240.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$240.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$240.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$240.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$240.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$240.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$240.08
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$90.29
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$90.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$199.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$199.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$158.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$158.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$151.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$151.79
|
| Rate for Payer: Cash Price |
$245.23
|
| Rate for Payer: Cash Price |
$251.30
|
| Rate for Payer: Centivo All Commercial |
$213.88
|
| Rate for Payer: Centivo All Commercial |
$213.88
|
| Rate for Payer: Cigna All Commercial |
$137.99
|
| Rate for Payer: Cigna All Commercial |
$137.99
|
| Rate for Payer: CORVEL All Commercial |
$137.99
|
| Rate for Payer: CORVEL All Commercial |
$137.99
|
| Rate for Payer: Coventry All Commercial |
$165.59
|
| Rate for Payer: Coventry All Commercial |
$165.59
|
| Rate for Payer: Encore All Commercial |
$137.99
|
| Rate for Payer: Encore All Commercial |
$137.99
|
| Rate for Payer: Frontpath All Commercial |
$188.30
|
| Rate for Payer: Frontpath All Commercial |
$188.30
|
| Rate for Payer: Humana ChoiceCare |
$154.77
|
| Rate for Payer: Humana ChoiceCare |
$154.77
|
| Rate for Payer: Humana Medicare |
$137.99
|
| Rate for Payer: Humana Medicare |
$137.99
|
| Rate for Payer: Lucent All Commercial |
$193.19
|
| Rate for Payer: Lucent All Commercial |
$193.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$220.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$220.00
|
| Rate for Payer: Managed Health Services Medicaid |
$199.35
|
| Rate for Payer: Managed Health Services Medicaid |
$199.35
|
| Rate for Payer: MDWise Medicaid |
$199.35
|
| Rate for Payer: MDWise Medicaid |
$199.35
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$90.29
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$90.29
|
| Rate for Payer: PHCS All Commercial |
$137.99
|
| Rate for Payer: PHCS All Commercial |
$137.99
|
| Rate for Payer: PHP All Commercial |
$233.54
|
| Rate for Payer: PHP All Commercial |
$233.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$137.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$137.99
|
| Rate for Payer: Sagamore Health Network All Products |
$137.99
|
| Rate for Payer: Sagamore Health Network All Products |
$137.99
|
| Rate for Payer: Signature Care EPO |
$233.75
|
| Rate for Payer: Signature Care EPO |
$233.75
|
| Rate for Payer: Signature Care PPO |
$233.75
|
| Rate for Payer: Signature Care PPO |
$233.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,600.00
|
| Rate for Payer: United Healthcare Commercial |
$153.30
|
| Rate for Payer: United Healthcare Commercial |
$153.30
|
| Rate for Payer: United Healthcare Medicare |
$197.77
|
| Rate for Payer: United Healthcare Medicare |
$197.77
|
|
|
PR REMOVAL OF FOREIGN BODY DEEP/COMPLIC
|
Professional
|
Both
|
$855.46
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
z20525
|
| Min. Negotiated Rate |
$126.32 |
| Max. Negotiated Rate |
$34,400.00 |
| Rate for Payer: Aetna Commercial |
$229.98
|
| Rate for Payer: Aetna Commercial |
$229.98
|
| Rate for Payer: Aetna Medicare |
$229.98
|
| Rate for Payer: Aetna Medicare |
$229.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$485.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$485.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$485.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$485.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$485.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$485.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$485.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$485.31
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$126.32
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$126.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$420.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$420.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$264.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$264.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$252.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$252.98
|
| Rate for Payer: Cash Price |
$524.52
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Centivo All Commercial |
$356.47
|
| Rate for Payer: Centivo All Commercial |
$356.47
|
| Rate for Payer: Cigna All Commercial |
$229.98
|
| Rate for Payer: Cigna All Commercial |
$229.98
|
| Rate for Payer: CORVEL All Commercial |
$229.98
|
| Rate for Payer: CORVEL All Commercial |
$229.98
|
| Rate for Payer: Coventry All Commercial |
$275.98
|
| Rate for Payer: Coventry All Commercial |
$275.98
|
| Rate for Payer: Encore All Commercial |
$229.98
|
| Rate for Payer: Encore All Commercial |
$229.98
|
| Rate for Payer: Frontpath All Commercial |
$318.90
|
| Rate for Payer: Frontpath All Commercial |
$318.90
|
| Rate for Payer: Humana ChoiceCare |
$266.10
|
| Rate for Payer: Humana ChoiceCare |
$266.10
|
| Rate for Payer: Humana Medicare |
$229.98
|
| Rate for Payer: Humana Medicare |
$229.98
|
| Rate for Payer: Lucent All Commercial |
$321.97
|
| Rate for Payer: Lucent All Commercial |
$321.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$367.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$367.00
|
| Rate for Payer: Managed Health Services Medicaid |
$420.75
|
| Rate for Payer: Managed Health Services Medicaid |
$420.75
|
| Rate for Payer: MDWise Medicaid |
$420.75
|
| Rate for Payer: MDWise Medicaid |
$420.75
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$126.32
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$126.32
|
| Rate for Payer: PHCS All Commercial |
$229.98
|
| Rate for Payer: PHCS All Commercial |
$229.98
|
| Rate for Payer: PHP All Commercial |
$389.10
|
| Rate for Payer: PHP All Commercial |
$389.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$229.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$229.98
|
| Rate for Payer: Sagamore Health Network All Products |
$229.98
|
| Rate for Payer: Sagamore Health Network All Products |
$229.98
|
| Rate for Payer: Signature Care EPO |
$399.50
|
| Rate for Payer: Signature Care EPO |
$399.50
|
| Rate for Payer: Signature Care PPO |
$399.50
|
| Rate for Payer: Signature Care PPO |
$399.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$34,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$34,400.00
|
| Rate for Payer: United Healthcare Commercial |
$269.28
|
| Rate for Payer: United Healthcare Commercial |
$269.28
|
| Rate for Payer: United Healthcare Medicare |
$423.00
|
| Rate for Payer: United Healthcare Medicare |
$423.00
|
|
|
PR REMOVAL OF HEEL BONE
|
Professional
|
Both
|
$1,125.14
|
|
|
Service Code
|
CPT 28118
|
| Hospital Charge Code |
z28118
|
| Min. Negotiated Rate |
$214.91 |
| Max. Negotiated Rate |
$613.10 |
| Rate for Payer: Aetna Commercial |
$395.55
|
| Rate for Payer: Aetna Commercial |
$395.55
|
| Rate for Payer: Aetna Medicare |
$395.55
|
| Rate for Payer: Aetna Medicare |
$395.55
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$214.91
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$214.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$553.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$553.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$454.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$454.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$435.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$435.11
|
| Rate for Payer: Cash Price |
$678.99
|
| Rate for Payer: Cash Price |
$697.59
|
| Rate for Payer: Centivo All Commercial |
$613.10
|
| Rate for Payer: Centivo All Commercial |
$613.10
|
| Rate for Payer: Cigna All Commercial |
$395.55
|
| Rate for Payer: Cigna All Commercial |
$395.55
|
| Rate for Payer: CORVEL All Commercial |
$395.55
|
| Rate for Payer: CORVEL All Commercial |
$395.55
|
| Rate for Payer: Coventry All Commercial |
$474.66
|
| Rate for Payer: Coventry All Commercial |
$474.66
|
| Rate for Payer: Encore All Commercial |
$395.55
|
| Rate for Payer: Encore All Commercial |
$395.55
|
| Rate for Payer: Frontpath All Commercial |
$540.89
|
| Rate for Payer: Frontpath All Commercial |
$540.89
|
| Rate for Payer: Humana ChoiceCare |
$447.82
|
| Rate for Payer: Humana ChoiceCare |
$447.82
|
| Rate for Payer: Humana Medicare |
$395.55
|
| Rate for Payer: Humana Medicare |
$395.55
|
| Rate for Payer: Lucent All Commercial |
$553.77
|
| Rate for Payer: Lucent All Commercial |
$553.77
|
| Rate for Payer: Managed Health Services Medicaid |
$553.38
|
| Rate for Payer: Managed Health Services Medicaid |
$553.38
|
| Rate for Payer: MDWise Medicaid |
$553.38
|
| Rate for Payer: MDWise Medicaid |
$553.38
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$214.91
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$214.91
|
| Rate for Payer: PHCS All Commercial |
$395.55
|
| Rate for Payer: PHCS All Commercial |
$395.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$395.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$395.55
|
| Rate for Payer: Sagamore Health Network All Products |
$395.55
|
| Rate for Payer: Sagamore Health Network All Products |
$395.55
|
| Rate for Payer: United Healthcare Commercial |
$465.84
|
| Rate for Payer: United Healthcare Commercial |
$465.84
|
| Rate for Payer: United Healthcare Medicare |
$547.57
|
| Rate for Payer: United Healthcare Medicare |
$547.57
|
|
|
PR REMOVAL OF HEEL SPUR
|
Professional
|
Both
|
$982.74
|
|
|
Service Code
|
CPT 28119
|
| Hospital Charge Code |
z28119
|
| Min. Negotiated Rate |
$185.15 |
| Max. Negotiated Rate |
$51,500.00 |
| Rate for Payer: Aetna Commercial |
$343.92
|
| Rate for Payer: Aetna Commercial |
$343.92
|
| Rate for Payer: Aetna Medicare |
$343.92
|
| Rate for Payer: Aetna Medicare |
$343.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$499.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$499.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$499.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$499.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$499.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$499.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$499.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$499.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$185.15
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$185.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$483.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$483.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$395.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$395.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$378.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$378.31
|
| Rate for Payer: Cash Price |
$592.51
|
| Rate for Payer: Cash Price |
$609.30
|
| Rate for Payer: Centivo All Commercial |
$533.08
|
| Rate for Payer: Centivo All Commercial |
$533.08
|
| Rate for Payer: Cigna All Commercial |
$343.92
|
| Rate for Payer: Cigna All Commercial |
$343.92
|
| Rate for Payer: CORVEL All Commercial |
$343.92
|
| Rate for Payer: CORVEL All Commercial |
$343.92
|
| Rate for Payer: Coventry All Commercial |
$412.70
|
| Rate for Payer: Coventry All Commercial |
$412.70
|
| Rate for Payer: Encore All Commercial |
$343.92
|
| Rate for Payer: Encore All Commercial |
$343.92
|
| Rate for Payer: Frontpath All Commercial |
$465.89
|
| Rate for Payer: Frontpath All Commercial |
$465.89
|
| Rate for Payer: Humana ChoiceCare |
$395.74
|
| Rate for Payer: Humana ChoiceCare |
$395.74
|
| Rate for Payer: Humana Medicare |
$343.92
|
| Rate for Payer: Humana Medicare |
$343.92
|
| Rate for Payer: Lucent All Commercial |
$481.49
|
| Rate for Payer: Lucent All Commercial |
$481.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$549.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$549.00
|
| Rate for Payer: Managed Health Services Medicaid |
$483.35
|
| Rate for Payer: Managed Health Services Medicaid |
$483.35
|
| Rate for Payer: MDWise Medicaid |
$483.35
|
| Rate for Payer: MDWise Medicaid |
$483.35
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$185.15
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$185.15
|
| Rate for Payer: PHCS All Commercial |
$343.92
|
| Rate for Payer: PHCS All Commercial |
$343.92
|
| Rate for Payer: PHP All Commercial |
$582.50
|
| Rate for Payer: PHP All Commercial |
$582.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$343.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$343.92
|
| Rate for Payer: Sagamore Health Network All Products |
$343.92
|
| Rate for Payer: Sagamore Health Network All Products |
$343.92
|
| Rate for Payer: Signature Care EPO |
$668.95
|
| Rate for Payer: Signature Care EPO |
$668.95
|
| Rate for Payer: Signature Care PPO |
$668.95
|
| Rate for Payer: Signature Care PPO |
$668.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$51,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$51,500.00
|
| Rate for Payer: United Healthcare Commercial |
$412.36
|
| Rate for Payer: United Healthcare Commercial |
$412.36
|
| Rate for Payer: United Healthcare Medicare |
$477.83
|
| Rate for Payer: United Healthcare Medicare |
$477.83
|
|
|
PR REMOVAL OF HIP PROSTHESIS,COMPLEX
|
Professional
|
Both
|
$2,917.22
|
|
|
Service Code
|
CPT 27091
|
| Hospital Charge Code |
z27091
|
| Min. Negotiated Rate |
$1,433.89 |
| Max. Negotiated Rate |
$220,500.00 |
| Rate for Payer: Aetna Commercial |
$1,477.36
|
| Rate for Payer: Aetna Commercial |
$1,477.36
|
| Rate for Payer: Aetna Medicare |
$1,477.36
|
| Rate for Payer: Aetna Medicare |
$1,477.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2,023.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2,023.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,023.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,023.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,023.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,023.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,023.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,023.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,434.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,434.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,698.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,698.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,625.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,625.10
|
| Rate for Payer: Cash Price |
$1,808.68
|
| Rate for Payer: Cash Price |
$1,778.02
|
| Rate for Payer: Centivo All Commercial |
$2,289.91
|
| Rate for Payer: Centivo All Commercial |
$2,289.91
|
| Rate for Payer: Cigna All Commercial |
$1,477.36
|
| Rate for Payer: Cigna All Commercial |
$1,477.36
|
| Rate for Payer: CORVEL All Commercial |
$1,477.36
|
| Rate for Payer: CORVEL All Commercial |
$1,477.36
|
| Rate for Payer: Coventry All Commercial |
$1,772.83
|
| Rate for Payer: Coventry All Commercial |
$1,772.83
|
| Rate for Payer: Encore All Commercial |
$1,477.36
|
| Rate for Payer: Encore All Commercial |
$1,477.36
|
| Rate for Payer: Frontpath All Commercial |
$2,072.75
|
| Rate for Payer: Frontpath All Commercial |
$2,072.75
|
| Rate for Payer: Humana ChoiceCare |
$1,593.32
|
| Rate for Payer: Humana ChoiceCare |
$1,593.32
|
| Rate for Payer: Humana Medicare |
$1,477.36
|
| Rate for Payer: Humana Medicare |
$1,477.36
|
| Rate for Payer: Lucent All Commercial |
$2,068.30
|
| Rate for Payer: Lucent All Commercial |
$2,068.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,352.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,352.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,434.80
|
| Rate for Payer: Managed Health Services Medicaid |
$1,434.80
|
| Rate for Payer: MDWise Medicaid |
$1,434.80
|
| Rate for Payer: MDWise Medicaid |
$1,434.80
|
| Rate for Payer: PHCS All Commercial |
$1,477.36
|
| Rate for Payer: PHCS All Commercial |
$1,477.36
|
| Rate for Payer: PHP All Commercial |
$2,494.97
|
| Rate for Payer: PHP All Commercial |
$2,494.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,477.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,477.36
|
| Rate for Payer: Sagamore Health Network All Products |
$1,477.36
|
| Rate for Payer: Sagamore Health Network All Products |
$1,477.36
|
| Rate for Payer: Signature Care EPO |
$2,125.85
|
| Rate for Payer: Signature Care EPO |
$2,125.85
|
| Rate for Payer: Signature Care PPO |
$2,125.85
|
| Rate for Payer: Signature Care PPO |
$2,125.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$220,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$220,500.00
|
| Rate for Payer: United Healthcare Commercial |
$1,757.24
|
| Rate for Payer: United Healthcare Commercial |
$1,757.24
|
| Rate for Payer: United Healthcare Medicare |
$1,433.89
|
| Rate for Payer: United Healthcare Medicare |
$1,433.89
|
|
|
PR REMOVAL OF HYDROCELE,TUNICA,UNILAT
|
Professional
|
Both
|
$620.56
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
z55040
|
| Min. Negotiated Rate |
$308.46 |
| Max. Negotiated Rate |
$41,100.00 |
| Rate for Payer: Aetna Commercial |
$318.52
|
| Rate for Payer: Aetna Commercial |
$318.52
|
| Rate for Payer: Aetna Medicare |
$318.52
|
| Rate for Payer: Aetna Medicare |
$318.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$424.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$424.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$424.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$424.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$424.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$424.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$424.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$424.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$312.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$312.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.37
|
| Rate for Payer: Cash Price |
$384.75
|
| Rate for Payer: Cash Price |
$382.49
|
| Rate for Payer: Centivo All Commercial |
$493.71
|
| Rate for Payer: Centivo All Commercial |
$493.71
|
| Rate for Payer: Cigna All Commercial |
$318.52
|
| Rate for Payer: Cigna All Commercial |
$318.52
|
| Rate for Payer: CORVEL All Commercial |
$318.52
|
| Rate for Payer: CORVEL All Commercial |
$318.52
|
| Rate for Payer: Coventry All Commercial |
$382.22
|
| Rate for Payer: Coventry All Commercial |
$382.22
|
| Rate for Payer: Encore All Commercial |
$318.52
|
| Rate for Payer: Encore All Commercial |
$318.52
|
| Rate for Payer: Frontpath All Commercial |
$435.55
|
| Rate for Payer: Frontpath All Commercial |
$435.55
|
| Rate for Payer: Humana ChoiceCare |
$392.67
|
| Rate for Payer: Humana ChoiceCare |
$392.67
|
| Rate for Payer: Humana Medicare |
$318.52
|
| Rate for Payer: Humana Medicare |
$318.52
|
| Rate for Payer: Lucent All Commercial |
$445.93
|
| Rate for Payer: Lucent All Commercial |
$445.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$443.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$443.00
|
| Rate for Payer: Managed Health Services Medicaid |
$312.14
|
| Rate for Payer: Managed Health Services Medicaid |
$312.14
|
| Rate for Payer: MDWise Medicaid |
$312.14
|
| Rate for Payer: MDWise Medicaid |
$312.14
|
| Rate for Payer: PHCS All Commercial |
$318.52
|
| Rate for Payer: PHCS All Commercial |
$318.52
|
| Rate for Payer: PHP All Commercial |
$407.17
|
| Rate for Payer: PHP All Commercial |
$407.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$318.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$318.52
|
| Rate for Payer: Sagamore Health Network All Products |
$318.52
|
| Rate for Payer: Sagamore Health Network All Products |
$318.52
|
| Rate for Payer: Signature Care EPO |
$378.25
|
| Rate for Payer: Signature Care EPO |
$378.25
|
| Rate for Payer: Signature Care PPO |
$378.25
|
| Rate for Payer: Signature Care PPO |
$378.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,100.00
|
| Rate for Payer: United Healthcare Commercial |
$411.88
|
| Rate for Payer: United Healthcare Commercial |
$411.88
|
| Rate for Payer: United Healthcare Medicare |
$308.46
|
| Rate for Payer: United Healthcare Medicare |
$308.46
|
|
|
PR REMOVAL OF NAIL BED
|
Professional
|
Both
|
$301.52
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
z11750
|
| Min. Negotiated Rate |
$71.81 |
| Max. Negotiated Rate |
$11,400.00 |
| Rate for Payer: Aetna Commercial |
$96.16
|
| Rate for Payer: Aetna Commercial |
$96.16
|
| Rate for Payer: Aetna Medicare |
$96.16
|
| Rate for Payer: Aetna Medicare |
$96.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$190.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$190.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$190.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$190.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$190.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$190.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$190.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$190.62
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$71.81
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$71.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$148.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$148.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$110.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$110.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$105.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$105.78
|
| Rate for Payer: Cash Price |
$181.76
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Centivo All Commercial |
$149.05
|
| Rate for Payer: Centivo All Commercial |
$149.05
|
| Rate for Payer: Cigna All Commercial |
$96.16
|
| Rate for Payer: Cigna All Commercial |
$96.16
|
| Rate for Payer: CORVEL All Commercial |
$96.16
|
| Rate for Payer: CORVEL All Commercial |
$96.16
|
| Rate for Payer: Coventry All Commercial |
$115.39
|
| Rate for Payer: Coventry All Commercial |
$115.39
|
| Rate for Payer: Encore All Commercial |
$96.16
|
| Rate for Payer: Encore All Commercial |
$96.16
|
| Rate for Payer: Frontpath All Commercial |
$129.16
|
| Rate for Payer: Frontpath All Commercial |
$129.16
|
| Rate for Payer: Humana ChoiceCare |
$134.55
|
| Rate for Payer: Humana ChoiceCare |
$134.55
|
| Rate for Payer: Humana Medicare |
$96.16
|
| Rate for Payer: Humana Medicare |
$96.16
|
| Rate for Payer: Lucent All Commercial |
$134.62
|
| Rate for Payer: Lucent All Commercial |
$134.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$124.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$124.00
|
| Rate for Payer: Managed Health Services Medicaid |
$148.30
|
| Rate for Payer: Managed Health Services Medicaid |
$148.30
|
| Rate for Payer: MDWise Medicaid |
$148.30
|
| Rate for Payer: MDWise Medicaid |
$148.30
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$71.81
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$71.81
|
| Rate for Payer: PHCS All Commercial |
$96.16
|
| Rate for Payer: PHCS All Commercial |
$96.16
|
| Rate for Payer: PHP All Commercial |
$130.16
|
| Rate for Payer: PHP All Commercial |
$130.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$96.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$96.16
|
| Rate for Payer: Sagamore Health Network All Products |
$96.16
|
| Rate for Payer: Sagamore Health Network All Products |
$96.16
|
| Rate for Payer: Signature Care EPO |
$180.87
|
| Rate for Payer: Signature Care EPO |
$180.87
|
| Rate for Payer: Signature Care PPO |
$180.87
|
| Rate for Payer: Signature Care PPO |
$180.87
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,400.00
|
| Rate for Payer: United Healthcare Commercial |
$189.46
|
| Rate for Payer: United Healthcare Commercial |
$189.46
|
| Rate for Payer: United Healthcare Medicare |
$146.58
|
| Rate for Payer: United Healthcare Medicare |
$146.58
|
|
|
PR REMOVAL OF NAIL PLATE
|
Professional
|
Both
|
$215.22
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
z11730
|
| Min. Negotiated Rate |
$27.17 |
| Max. Negotiated Rate |
$6,100.00 |
| Rate for Payer: Aetna Commercial |
$51.18
|
| Rate for Payer: Aetna Commercial |
$51.18
|
| Rate for Payer: Aetna Medicare |
$51.18
|
| Rate for Payer: Aetna Medicare |
$51.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$103.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$103.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$103.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$103.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$103.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$103.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$103.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$103.06
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$27.17
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$27.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$105.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$105.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.30
|
| Rate for Payer: Cash Price |
$130.89
|
| Rate for Payer: Cash Price |
$133.44
|
| Rate for Payer: Centivo All Commercial |
$79.33
|
| Rate for Payer: Centivo All Commercial |
$79.33
|
| Rate for Payer: Cigna All Commercial |
$51.18
|
| Rate for Payer: Cigna All Commercial |
$51.18
|
| Rate for Payer: CORVEL All Commercial |
$51.18
|
| Rate for Payer: CORVEL All Commercial |
$51.18
|
| Rate for Payer: Coventry All Commercial |
$61.42
|
| Rate for Payer: Coventry All Commercial |
$61.42
|
| Rate for Payer: Encore All Commercial |
$51.18
|
| Rate for Payer: Encore All Commercial |
$51.18
|
| Rate for Payer: Frontpath All Commercial |
$69.33
|
| Rate for Payer: Frontpath All Commercial |
$69.33
|
| Rate for Payer: Humana ChoiceCare |
$59.90
|
| Rate for Payer: Humana ChoiceCare |
$59.90
|
| Rate for Payer: Humana Medicare |
$51.18
|
| Rate for Payer: Humana Medicare |
$51.18
|
| Rate for Payer: Lucent All Commercial |
$71.65
|
| Rate for Payer: Lucent All Commercial |
$71.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$66.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$66.00
|
| Rate for Payer: Managed Health Services Medicaid |
$105.85
|
| Rate for Payer: Managed Health Services Medicaid |
$105.85
|
| Rate for Payer: MDWise Medicaid |
$105.85
|
| Rate for Payer: MDWise Medicaid |
$105.85
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$27.17
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$27.17
|
| Rate for Payer: PHCS All Commercial |
$51.18
|
| Rate for Payer: PHCS All Commercial |
$51.18
|
| Rate for Payer: PHP All Commercial |
$69.35
|
| Rate for Payer: PHP All Commercial |
$69.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.18
|
| Rate for Payer: Sagamore Health Network All Products |
$51.18
|
| Rate for Payer: Sagamore Health Network All Products |
$51.18
|
| Rate for Payer: Signature Care EPO |
$92.74
|
| Rate for Payer: Signature Care EPO |
$92.74
|
| Rate for Payer: Signature Care PPO |
$92.74
|
| Rate for Payer: Signature Care PPO |
$92.74
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,100.00
|
| Rate for Payer: United Healthcare Commercial |
$66.61
|
| Rate for Payer: United Healthcare Commercial |
$66.61
|
| Rate for Payer: United Healthcare Medicare |
$105.56
|
| Rate for Payer: United Healthcare Medicare |
$105.56
|
|
|
PR REMOVAL OF OMENTUM
|
Professional
|
Both
|
$1,451.60
|
|
|
Service Code
|
CPT 49255
|
| Hospital Charge Code |
z49255
|
| Min. Negotiated Rate |
$711.83 |
| Max. Negotiated Rate |
$102,100.00 |
| Rate for Payer: Aetna Commercial |
$735.98
|
| Rate for Payer: Aetna Commercial |
$735.98
|
| Rate for Payer: Aetna Medicare |
$735.98
|
| Rate for Payer: Aetna Medicare |
$735.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$850.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$850.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$850.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$850.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$850.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$850.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$850.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$850.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$713.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$713.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$846.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$846.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$809.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$809.58
|
| Rate for Payer: Cash Price |
$899.99
|
| Rate for Payer: Cash Price |
$882.67
|
| Rate for Payer: Centivo All Commercial |
$1,140.77
|
| Rate for Payer: Centivo All Commercial |
$1,140.77
|
| Rate for Payer: Cigna All Commercial |
$735.98
|
| Rate for Payer: Cigna All Commercial |
$735.98
|
| Rate for Payer: CORVEL All Commercial |
$735.98
|
| Rate for Payer: CORVEL All Commercial |
$735.98
|
| Rate for Payer: Coventry All Commercial |
$883.18
|
| Rate for Payer: Coventry All Commercial |
$883.18
|
| Rate for Payer: Encore All Commercial |
$735.98
|
| Rate for Payer: Encore All Commercial |
$735.98
|
| Rate for Payer: Frontpath All Commercial |
$1,037.45
|
| Rate for Payer: Frontpath All Commercial |
$1,037.45
|
| Rate for Payer: Humana ChoiceCare |
$763.70
|
| Rate for Payer: Humana ChoiceCare |
$763.70
|
| Rate for Payer: Humana Medicare |
$735.98
|
| Rate for Payer: Humana Medicare |
$735.98
|
| Rate for Payer: Lucent All Commercial |
$1,030.37
|
| Rate for Payer: Lucent All Commercial |
$1,030.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,094.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,094.00
|
| Rate for Payer: Managed Health Services Medicaid |
$713.96
|
| Rate for Payer: Managed Health Services Medicaid |
$713.96
|
| Rate for Payer: MDWise Medicaid |
$713.96
|
| Rate for Payer: MDWise Medicaid |
$713.96
|
| Rate for Payer: PHCS All Commercial |
$735.98
|
| Rate for Payer: PHCS All Commercial |
$735.98
|
| Rate for Payer: PHP All Commercial |
$1,245.70
|
| Rate for Payer: PHP All Commercial |
$1,245.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$735.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$735.98
|
| Rate for Payer: Sagamore Health Network All Products |
$735.98
|
| Rate for Payer: Sagamore Health Network All Products |
$735.98
|
| 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 |
$102,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$102,100.00
|
| Rate for Payer: United Healthcare Commercial |
$836.49
|
| Rate for Payer: United Healthcare Commercial |
$836.49
|
| Rate for Payer: United Healthcare Medicare |
$711.83
|
| Rate for Payer: United Healthcare Medicare |
$711.83
|
|
|
PR REMOVAL OF OVARIAN CYST(S)
|
Professional
|
Both
|
$1,418.38
|
|
|
Service Code
|
CPT 58925
|
| Hospital Charge Code |
z58925
|
| Min. Negotiated Rate |
$697.61 |
| Max. Negotiated Rate |
$93,100.00 |
| Rate for Payer: Aetna Commercial |
$722.82
|
| Rate for Payer: Aetna Commercial |
$722.82
|
| Rate for Payer: Aetna Medicare |
$722.82
|
| Rate for Payer: Aetna Medicare |
$722.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$903.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$903.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$903.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$903.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$903.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$903.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$903.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$903.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$697.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$697.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$831.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$831.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$795.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$795.10
|
| Rate for Payer: Cash Price |
$879.40
|
| Rate for Payer: Cash Price |
$865.99
|
| Rate for Payer: Centivo All Commercial |
$1,120.37
|
| Rate for Payer: Centivo All Commercial |
$1,120.37
|
| Rate for Payer: Cigna All Commercial |
$722.82
|
| Rate for Payer: Cigna All Commercial |
$722.82
|
| Rate for Payer: CORVEL All Commercial |
$722.82
|
| Rate for Payer: CORVEL All Commercial |
$722.82
|
| Rate for Payer: Coventry All Commercial |
$867.38
|
| Rate for Payer: Coventry All Commercial |
$867.38
|
| Rate for Payer: Encore All Commercial |
$722.82
|
| Rate for Payer: Encore All Commercial |
$722.82
|
| Rate for Payer: Frontpath All Commercial |
$1,006.75
|
| Rate for Payer: Frontpath All Commercial |
$1,006.75
|
| Rate for Payer: Humana ChoiceCare |
$759.06
|
| Rate for Payer: Humana ChoiceCare |
$759.06
|
| Rate for Payer: Humana Medicare |
$722.82
|
| Rate for Payer: Humana Medicare |
$722.82
|
| Rate for Payer: Lucent All Commercial |
$1,011.95
|
| Rate for Payer: Lucent All Commercial |
$1,011.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,002.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,002.00
|
| Rate for Payer: Managed Health Services Medicaid |
$697.61
|
| Rate for Payer: Managed Health Services Medicaid |
$697.61
|
| Rate for Payer: MDWise Medicaid |
$697.61
|
| Rate for Payer: MDWise Medicaid |
$697.61
|
| Rate for Payer: PHCS All Commercial |
$722.82
|
| Rate for Payer: PHCS All Commercial |
$722.82
|
| Rate for Payer: PHP All Commercial |
$921.86
|
| Rate for Payer: PHP All Commercial |
$921.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$722.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$722.82
|
| Rate for Payer: Sagamore Health Network All Products |
$722.82
|
| Rate for Payer: Sagamore Health Network All Products |
$722.82
|
| Rate for Payer: Signature Care EPO |
$853.40
|
| Rate for Payer: Signature Care EPO |
$853.40
|
| Rate for Payer: Signature Care PPO |
$853.40
|
| Rate for Payer: Signature Care PPO |
$853.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$93,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$93,100.00
|
| Rate for Payer: United Healthcare Commercial |
$822.83
|
| Rate for Payer: United Healthcare Commercial |
$822.83
|
| Rate for Payer: United Healthcare Medicare |
$698.38
|
| Rate for Payer: United Healthcare Medicare |
$698.38
|
|
|
PR REMOVAL OF OVARY(S)
|
Professional
|
Both
|
$1,028.52
|
|
|
Service Code
|
CPT 58940
|
| Hospital Charge Code |
z58940
|
| Min. Negotiated Rate |
$505.50 |
| Max. Negotiated Rate |
$67,400.00 |
| Rate for Payer: Aetna Commercial |
$522.74
|
| Rate for Payer: Aetna Commercial |
$522.74
|
| Rate for Payer: Aetna Medicare |
$522.74
|
| Rate for Payer: Aetna Medicare |
$522.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$602.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$602.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$602.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$602.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$602.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$602.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$602.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$602.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$505.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$505.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$601.15
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$601.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$575.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$575.01
|
| Rate for Payer: Cash Price |
$637.68
|
| Rate for Payer: Cash Price |
$627.46
|
| Rate for Payer: Centivo All Commercial |
$810.25
|
| Rate for Payer: Centivo All Commercial |
$810.25
|
| Rate for Payer: Cigna All Commercial |
$522.74
|
| Rate for Payer: Cigna All Commercial |
$522.74
|
| Rate for Payer: CORVEL All Commercial |
$522.74
|
| Rate for Payer: CORVEL All Commercial |
$522.74
|
| Rate for Payer: Coventry All Commercial |
$627.29
|
| Rate for Payer: Coventry All Commercial |
$627.29
|
| Rate for Payer: Encore All Commercial |
$522.74
|
| Rate for Payer: Encore All Commercial |
$522.74
|
| Rate for Payer: Frontpath All Commercial |
$726.87
|
| Rate for Payer: Frontpath All Commercial |
$726.87
|
| Rate for Payer: Humana ChoiceCare |
$505.50
|
| Rate for Payer: Humana ChoiceCare |
$505.50
|
| Rate for Payer: Humana Medicare |
$522.74
|
| Rate for Payer: Humana Medicare |
$522.74
|
| Rate for Payer: Lucent All Commercial |
$731.84
|
| Rate for Payer: Lucent All Commercial |
$731.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$726.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$726.00
|
| Rate for Payer: Managed Health Services Medicaid |
$505.87
|
| Rate for Payer: Managed Health Services Medicaid |
$505.87
|
| Rate for Payer: MDWise Medicaid |
$505.87
|
| Rate for Payer: MDWise Medicaid |
$505.87
|
| Rate for Payer: PHCS All Commercial |
$522.74
|
| Rate for Payer: PHCS All Commercial |
$522.74
|
| Rate for Payer: PHP All Commercial |
$667.95
|
| Rate for Payer: PHP All Commercial |
$667.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$522.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$522.74
|
| Rate for Payer: Sagamore Health Network All Products |
$522.74
|
| Rate for Payer: Sagamore Health Network All Products |
$522.74
|
| Rate for Payer: Signature Care EPO |
$568.65
|
| Rate for Payer: Signature Care EPO |
$568.65
|
| Rate for Payer: Signature Care PPO |
$568.65
|
| Rate for Payer: Signature Care PPO |
$568.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,400.00
|
| Rate for Payer: United Healthcare Commercial |
$562.40
|
| Rate for Payer: United Healthcare Commercial |
$562.40
|
| Rate for Payer: United Healthcare Medicare |
$506.02
|
| Rate for Payer: United Healthcare Medicare |
$506.02
|
|
|
PR REMOVAL OF OVARY/TUBE(S)
|
Professional
|
Both
|
$1,409.92
|
|
|
Service Code
|
CPT 58720
|
| Hospital Charge Code |
z58720
|
| Min. Negotiated Rate |
$690.99 |
| Max. Negotiated Rate |
$92,100.00 |
| Rate for Payer: Aetna Commercial |
$713.57
|
| Rate for Payer: Aetna Commercial |
$713.57
|
| Rate for Payer: Aetna Medicare |
$713.57
|
| Rate for Payer: Aetna Medicare |
$713.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$906.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$906.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$906.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$906.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$906.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$906.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$906.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$906.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$693.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$693.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$820.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$820.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$784.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$784.93
|
| Rate for Payer: Cash Price |
$874.15
|
| Rate for Payer: Cash Price |
$856.83
|
| Rate for Payer: Centivo All Commercial |
$1,106.03
|
| Rate for Payer: Centivo All Commercial |
$1,106.03
|
| Rate for Payer: Cigna All Commercial |
$713.57
|
| Rate for Payer: Cigna All Commercial |
$713.57
|
| Rate for Payer: CORVEL All Commercial |
$713.57
|
| Rate for Payer: CORVEL All Commercial |
$713.57
|
| Rate for Payer: Coventry All Commercial |
$856.28
|
| Rate for Payer: Coventry All Commercial |
$856.28
|
| Rate for Payer: Encore All Commercial |
$713.57
|
| Rate for Payer: Encore All Commercial |
$713.57
|
| Rate for Payer: Frontpath All Commercial |
$991.65
|
| Rate for Payer: Frontpath All Commercial |
$991.65
|
| Rate for Payer: Humana ChoiceCare |
$762.29
|
| Rate for Payer: Humana ChoiceCare |
$762.29
|
| Rate for Payer: Humana Medicare |
$713.57
|
| Rate for Payer: Humana Medicare |
$713.57
|
| Rate for Payer: Lucent All Commercial |
$999.00
|
| Rate for Payer: Lucent All Commercial |
$999.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$992.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$992.00
|
| Rate for Payer: Managed Health Services Medicaid |
$693.46
|
| Rate for Payer: Managed Health Services Medicaid |
$693.46
|
| Rate for Payer: MDWise Medicaid |
$693.46
|
| Rate for Payer: MDWise Medicaid |
$693.46
|
| Rate for Payer: PHCS All Commercial |
$713.57
|
| Rate for Payer: PHCS All Commercial |
$713.57
|
| Rate for Payer: PHP All Commercial |
$912.11
|
| Rate for Payer: PHP All Commercial |
$912.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$713.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$713.57
|
| Rate for Payer: Sagamore Health Network All Products |
$713.57
|
| Rate for Payer: Sagamore Health Network All Products |
$713.57
|
| Rate for Payer: Signature Care EPO |
$914.60
|
| Rate for Payer: Signature Care EPO |
$914.60
|
| Rate for Payer: Signature Care PPO |
$914.60
|
| Rate for Payer: Signature Care PPO |
$914.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92,100.00
|
| Rate for Payer: United Healthcare Commercial |
$806.46
|
| Rate for Payer: United Healthcare Commercial |
$806.46
|
| Rate for Payer: United Healthcare Medicare |
$690.99
|
| Rate for Payer: United Healthcare Medicare |
$690.99
|
|
|
PR REMOVAL OF RECTAL MARKER
|
Professional
|
Both
|
$467.82
|
|
|
Service Code
|
CPT 46030
|
| Hospital Charge Code |
z46030
|
| Min. Negotiated Rate |
$52.12 |
| Max. Negotiated Rate |
$11,300.00 |
| Rate for Payer: Aetna Commercial |
$81.40
|
| Rate for Payer: Aetna Commercial |
$81.40
|
| Rate for Payer: Aetna Medicare |
$81.40
|
| Rate for Payer: Aetna Medicare |
$81.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$137.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$137.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$137.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$137.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$137.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$137.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$137.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$137.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$52.12
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$52.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$230.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$230.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.61
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.54
|
| Rate for Payer: Cash Price |
$289.63
|
| Rate for Payer: Cash Price |
$290.05
|
| Rate for Payer: Centivo All Commercial |
$126.17
|
| Rate for Payer: Centivo All Commercial |
$126.17
|
| Rate for Payer: Cigna All Commercial |
$81.40
|
| Rate for Payer: Cigna All Commercial |
$81.40
|
| Rate for Payer: CORVEL All Commercial |
$81.40
|
| Rate for Payer: CORVEL All Commercial |
$81.40
|
| Rate for Payer: Coventry All Commercial |
$97.68
|
| Rate for Payer: Coventry All Commercial |
$97.68
|
| Rate for Payer: Encore All Commercial |
$81.40
|
| Rate for Payer: Encore All Commercial |
$81.40
|
| Rate for Payer: Frontpath All Commercial |
$113.39
|
| Rate for Payer: Frontpath All Commercial |
$113.39
|
| Rate for Payer: Humana ChoiceCare |
$87.75
|
| Rate for Payer: Humana ChoiceCare |
$87.75
|
| Rate for Payer: Humana Medicare |
$81.40
|
| Rate for Payer: Humana Medicare |
$81.40
|
| Rate for Payer: Lucent All Commercial |
$113.96
|
| Rate for Payer: Lucent All Commercial |
$113.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$121.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$121.00
|
| Rate for Payer: Managed Health Services Medicaid |
$230.09
|
| Rate for Payer: Managed Health Services Medicaid |
$230.09
|
| Rate for Payer: MDWise Medicaid |
$230.09
|
| Rate for Payer: MDWise Medicaid |
$230.09
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$52.12
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$52.12
|
| Rate for Payer: PHCS All Commercial |
$81.40
|
| Rate for Payer: PHCS All Commercial |
$81.40
|
| Rate for Payer: PHP All Commercial |
$137.83
|
| Rate for Payer: PHP All Commercial |
$137.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.40
|
| Rate for Payer: Sagamore Health Network All Products |
$81.40
|
| Rate for Payer: Sagamore Health Network All Products |
$81.40
|
| Rate for Payer: Signature Care EPO |
$208.18
|
| Rate for Payer: Signature Care EPO |
$208.18
|
| Rate for Payer: Signature Care PPO |
$208.18
|
| Rate for Payer: Signature Care PPO |
$208.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,300.00
|
| Rate for Payer: United Healthcare Commercial |
$92.38
|
| Rate for Payer: United Healthcare Commercial |
$92.38
|
| Rate for Payer: United Healthcare Medicare |
$233.57
|
| Rate for Payer: United Healthcare Medicare |
$233.57
|
|
|
PR REMOVAL OF SPERM DUCT(S)
|
Professional
|
Both
|
$611.26
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
z55250
|
| Min. Negotiated Rate |
$162.42 |
| Max. Negotiated Rate |
$27,800.00 |
| Rate for Payer: Aetna Commercial |
$214.32
|
| Rate for Payer: Aetna Commercial |
$214.32
|
| Rate for Payer: Aetna Medicare |
$214.32
|
| Rate for Payer: Aetna Medicare |
$214.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$736.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$736.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$736.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$736.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$736.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$736.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$736.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$736.19
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.42
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$307.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$307.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$246.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$246.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$235.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$235.75
|
| Rate for Payer: Cash Price |
$373.71
|
| Rate for Payer: Cash Price |
$378.98
|
| Rate for Payer: Centivo All Commercial |
$332.20
|
| Rate for Payer: Centivo All Commercial |
$332.20
|
| Rate for Payer: Cigna All Commercial |
$214.32
|
| Rate for Payer: Cigna All Commercial |
$214.32
|
| Rate for Payer: CORVEL All Commercial |
$214.32
|
| Rate for Payer: CORVEL All Commercial |
$214.32
|
| Rate for Payer: Coventry All Commercial |
$257.18
|
| Rate for Payer: Coventry All Commercial |
$257.18
|
| Rate for Payer: Encore All Commercial |
$214.32
|
| Rate for Payer: Encore All Commercial |
$214.32
|
| Rate for Payer: Frontpath All Commercial |
$291.64
|
| Rate for Payer: Frontpath All Commercial |
$291.64
|
| Rate for Payer: Humana ChoiceCare |
$260.20
|
| Rate for Payer: Humana ChoiceCare |
$260.20
|
| Rate for Payer: Humana Medicare |
$214.32
|
| Rate for Payer: Humana Medicare |
$214.32
|
| Rate for Payer: Lucent All Commercial |
$300.05
|
| Rate for Payer: Lucent All Commercial |
$300.05
|
| 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 |
$307.50
|
| Rate for Payer: Managed Health Services Medicaid |
$307.50
|
| Rate for Payer: MDWise Medicaid |
$307.50
|
| Rate for Payer: MDWise Medicaid |
$307.50
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$162.42
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$162.42
|
| Rate for Payer: PHCS All Commercial |
$214.32
|
| Rate for Payer: PHCS All Commercial |
$214.32
|
| Rate for Payer: PHP All Commercial |
$275.82
|
| Rate for Payer: PHP All Commercial |
$275.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$214.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$214.32
|
| Rate for Payer: Sagamore Health Network All Products |
$214.32
|
| Rate for Payer: Sagamore Health Network All Products |
$214.32
|
| Rate for Payer: Signature Care EPO |
$538.05
|
| Rate for Payer: Signature Care EPO |
$538.05
|
| Rate for Payer: Signature Care PPO |
$538.05
|
| Rate for Payer: Signature Care PPO |
$538.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,800.00
|
| Rate for Payer: United Healthcare Commercial |
$276.04
|
| Rate for Payer: United Healthcare Commercial |
$276.04
|
| Rate for Payer: United Healthcare Medicare |
$305.63
|
| Rate for Payer: United Healthcare Medicare |
$305.63
|
|
|
PR REMOVAL OF TONSILS,<12 Y/O
|
Professional
|
Both
|
$505.18
|
|
|
Service Code
|
CPT 42825
|
| Hospital Charge Code |
z42825
|
| Min. Negotiated Rate |
$247.08 |
| Max. Negotiated Rate |
$35,500.00 |
| Rate for Payer: Aetna Commercial |
$251.92
|
| Rate for Payer: Aetna Commercial |
$251.92
|
| Rate for Payer: Aetna Medicare |
$251.92
|
| Rate for Payer: Aetna Medicare |
$251.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$317.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$317.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$317.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$317.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$317.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$317.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$317.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$317.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$248.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$248.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$289.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$289.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$277.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$277.11
|
| Rate for Payer: Cash Price |
$313.21
|
| Rate for Payer: Cash Price |
$306.38
|
| Rate for Payer: Centivo All Commercial |
$390.48
|
| Rate for Payer: Centivo All Commercial |
$390.48
|
| Rate for Payer: Cigna All Commercial |
$251.92
|
| Rate for Payer: Cigna All Commercial |
$251.92
|
| Rate for Payer: CORVEL All Commercial |
$251.92
|
| Rate for Payer: CORVEL All Commercial |
$251.92
|
| Rate for Payer: Coventry All Commercial |
$302.30
|
| Rate for Payer: Coventry All Commercial |
$302.30
|
| Rate for Payer: Encore All Commercial |
$251.92
|
| Rate for Payer: Encore All Commercial |
$251.92
|
| Rate for Payer: Frontpath All Commercial |
$343.94
|
| Rate for Payer: Frontpath All Commercial |
$343.94
|
| Rate for Payer: Humana ChoiceCare |
$290.33
|
| Rate for Payer: Humana ChoiceCare |
$290.33
|
| Rate for Payer: Humana Medicare |
$251.92
|
| Rate for Payer: Humana Medicare |
$251.92
|
| Rate for Payer: Lucent All Commercial |
$352.69
|
| Rate for Payer: Lucent All Commercial |
$352.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$380.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$380.00
|
| Rate for Payer: Managed Health Services Medicaid |
$248.46
|
| Rate for Payer: Managed Health Services Medicaid |
$248.46
|
| Rate for Payer: MDWise Medicaid |
$248.46
|
| Rate for Payer: MDWise Medicaid |
$248.46
|
| Rate for Payer: PHCS All Commercial |
$251.92
|
| Rate for Payer: PHCS All Commercial |
$251.92
|
| Rate for Payer: PHP All Commercial |
$432.39
|
| Rate for Payer: PHP All Commercial |
$432.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$251.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$251.92
|
| Rate for Payer: Sagamore Health Network All Products |
$251.92
|
| Rate for Payer: Sagamore Health Network All Products |
$251.92
|
| Rate for Payer: Signature Care EPO |
$377.40
|
| Rate for Payer: Signature Care EPO |
$377.40
|
| Rate for Payer: Signature Care PPO |
$377.40
|
| Rate for Payer: Signature Care PPO |
$377.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,500.00
|
| Rate for Payer: United Healthcare Commercial |
$286.45
|
| Rate for Payer: United Healthcare Commercial |
$286.45
|
| Rate for Payer: United Healthcare Medicare |
$247.08
|
| Rate for Payer: United Healthcare Medicare |
$247.08
|
|
|
PR REMOVAL OF TONSILS,12+ Y/O
|
Professional
|
Both
|
$480.92
|
|
|
Service Code
|
CPT 42826
|
| Hospital Charge Code |
z42826
|
| Min. Negotiated Rate |
$235.16 |
| Max. Negotiated Rate |
$33,700.00 |
| Rate for Payer: Aetna Commercial |
$239.87
|
| Rate for Payer: Aetna Commercial |
$239.87
|
| Rate for Payer: Aetna Medicare |
$239.87
|
| Rate for Payer: Aetna Medicare |
$239.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$341.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$341.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$341.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$341.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$341.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$341.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$341.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$341.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$236.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$236.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$275.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$275.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$263.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$263.86
|
| Rate for Payer: Cash Price |
$298.17
|
| Rate for Payer: Cash Price |
$291.60
|
| Rate for Payer: Centivo All Commercial |
$371.80
|
| Rate for Payer: Centivo All Commercial |
$371.80
|
| Rate for Payer: Cigna All Commercial |
$239.87
|
| Rate for Payer: Cigna All Commercial |
$239.87
|
| Rate for Payer: CORVEL All Commercial |
$239.87
|
| Rate for Payer: CORVEL All Commercial |
$239.87
|
| Rate for Payer: Coventry All Commercial |
$287.84
|
| Rate for Payer: Coventry All Commercial |
$287.84
|
| Rate for Payer: Encore All Commercial |
$239.87
|
| Rate for Payer: Encore All Commercial |
$239.87
|
| Rate for Payer: Frontpath All Commercial |
$328.09
|
| Rate for Payer: Frontpath All Commercial |
$328.09
|
| Rate for Payer: Humana ChoiceCare |
$283.15
|
| Rate for Payer: Humana ChoiceCare |
$283.15
|
| Rate for Payer: Humana Medicare |
$239.87
|
| Rate for Payer: Humana Medicare |
$239.87
|
| Rate for Payer: Lucent All Commercial |
$335.82
|
| Rate for Payer: Lucent All Commercial |
$335.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$362.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$362.00
|
| Rate for Payer: Managed Health Services Medicaid |
$236.54
|
| Rate for Payer: Managed Health Services Medicaid |
$236.54
|
| Rate for Payer: MDWise Medicaid |
$236.54
|
| Rate for Payer: MDWise Medicaid |
$236.54
|
| Rate for Payer: PHCS All Commercial |
$239.87
|
| Rate for Payer: PHCS All Commercial |
$239.87
|
| Rate for Payer: PHP All Commercial |
$411.52
|
| Rate for Payer: PHP All Commercial |
$411.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$239.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$239.87
|
| Rate for Payer: Sagamore Health Network All Products |
$239.87
|
| Rate for Payer: Sagamore Health Network All Products |
$239.87
|
| Rate for Payer: Signature Care EPO |
$368.90
|
| Rate for Payer: Signature Care EPO |
$368.90
|
| Rate for Payer: Signature Care PPO |
$368.90
|
| Rate for Payer: Signature Care PPO |
$368.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$33,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$33,700.00
|
| Rate for Payer: United Healthcare Commercial |
$276.88
|
| Rate for Payer: United Healthcare Commercial |
$276.88
|
| Rate for Payer: United Healthcare Medicare |
$235.16
|
| Rate for Payer: United Healthcare Medicare |
$235.16
|
|
|
PR REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY
|
Professional
|
Both
|
$420.12
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
z33233
|
| Min. Negotiated Rate |
$206.63 |
| Max. Negotiated Rate |
$365.50 |
| Rate for Payer: Aetna Commercial |
$215.72
|
| Rate for Payer: Aetna Commercial |
$215.72
|
| Rate for Payer: Aetna Medicare |
$215.72
|
| Rate for Payer: Aetna Medicare |
$215.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$206.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$206.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$248.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$248.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$237.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$237.29
|
| Rate for Payer: Cash Price |
$260.47
|
| Rate for Payer: Cash Price |
$257.96
|
| Rate for Payer: Centivo All Commercial |
$334.37
|
| Rate for Payer: Centivo All Commercial |
$334.37
|
| Rate for Payer: Cigna All Commercial |
$215.72
|
| Rate for Payer: Cigna All Commercial |
$215.72
|
| Rate for Payer: CORVEL All Commercial |
$215.72
|
| Rate for Payer: CORVEL All Commercial |
$215.72
|
| Rate for Payer: Coventry All Commercial |
$258.86
|
| Rate for Payer: Coventry All Commercial |
$258.86
|
| Rate for Payer: Encore All Commercial |
$215.72
|
| Rate for Payer: Encore All Commercial |
$215.72
|
| Rate for Payer: Frontpath All Commercial |
$302.87
|
| Rate for Payer: Frontpath All Commercial |
$302.87
|
| Rate for Payer: Humana ChoiceCare |
$314.43
|
| Rate for Payer: Humana ChoiceCare |
$314.43
|
| Rate for Payer: Humana Medicare |
$215.72
|
| Rate for Payer: Humana Medicare |
$215.72
|
| Rate for Payer: Lucent All Commercial |
$302.01
|
| Rate for Payer: Lucent All Commercial |
$302.01
|
| Rate for Payer: Managed Health Services Medicaid |
$206.63
|
| Rate for Payer: Managed Health Services Medicaid |
$206.63
|
| Rate for Payer: MDWise Medicaid |
$206.63
|
| Rate for Payer: MDWise Medicaid |
$206.63
|
| Rate for Payer: PHCS All Commercial |
$215.72
|
| Rate for Payer: PHCS All Commercial |
$215.72
|
| Rate for Payer: PHP All Commercial |
$291.24
|
| Rate for Payer: PHP All Commercial |
$291.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$215.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$215.72
|
| Rate for Payer: Sagamore Health Network All Products |
$215.72
|
| Rate for Payer: Sagamore Health Network All Products |
$215.72
|
| Rate for Payer: Signature Care EPO |
$365.50
|
| Rate for Payer: Signature Care EPO |
$365.50
|
| Rate for Payer: Signature Care PPO |
$365.50
|
| Rate for Payer: Signature Care PPO |
$365.50
|
| Rate for Payer: United Healthcare Commercial |
$289.75
|
| Rate for Payer: United Healthcare Commercial |
$289.75
|
| Rate for Payer: United Healthcare Medicare |
$208.03
|
| Rate for Payer: United Healthcare Medicare |
$208.03
|
|
