|
PR REMV PILONIDAL LESION SIMPLE
|
Professional
|
Both
|
$651.30
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
z11770
|
| Min. Negotiated Rate |
$112.84 |
| Max. Negotiated Rate |
$20,500.00 |
| Rate for Payer: Aetna Commercial |
$172.41
|
| Rate for Payer: Aetna Commercial |
$172.41
|
| Rate for Payer: Aetna Medicare |
$172.41
|
| Rate for Payer: Aetna Medicare |
$172.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$269.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$269.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$269.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$269.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$269.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$269.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$269.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$269.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$112.84
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$112.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$320.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$320.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$198.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$198.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$189.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$189.65
|
| Rate for Payer: Cash Price |
$386.63
|
| Rate for Payer: Cash Price |
$390.78
|
| Rate for Payer: Centivo All Commercial |
$267.24
|
| Rate for Payer: Centivo All Commercial |
$267.24
|
| Rate for Payer: Cigna All Commercial |
$172.41
|
| Rate for Payer: Cigna All Commercial |
$172.41
|
| Rate for Payer: CORVEL All Commercial |
$172.41
|
| Rate for Payer: CORVEL All Commercial |
$172.41
|
| Rate for Payer: Coventry All Commercial |
$206.89
|
| Rate for Payer: Coventry All Commercial |
$206.89
|
| Rate for Payer: Encore All Commercial |
$172.41
|
| Rate for Payer: Encore All Commercial |
$172.41
|
| Rate for Payer: Frontpath All Commercial |
$242.44
|
| Rate for Payer: Frontpath All Commercial |
$242.44
|
| Rate for Payer: Humana ChoiceCare |
$155.87
|
| Rate for Payer: Humana ChoiceCare |
$155.87
|
| Rate for Payer: Humana Medicare |
$172.41
|
| Rate for Payer: Humana Medicare |
$172.41
|
| Rate for Payer: Lucent All Commercial |
$241.37
|
| Rate for Payer: Lucent All Commercial |
$241.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$222.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$222.00
|
| Rate for Payer: Managed Health Services Medicaid |
$320.34
|
| Rate for Payer: Managed Health Services Medicaid |
$320.34
|
| Rate for Payer: MDWise Medicaid |
$320.34
|
| Rate for Payer: MDWise Medicaid |
$320.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$112.84
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$112.84
|
| Rate for Payer: PHCS All Commercial |
$172.41
|
| Rate for Payer: PHCS All Commercial |
$172.41
|
| Rate for Payer: PHP All Commercial |
$233.07
|
| Rate for Payer: PHP All Commercial |
$233.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$172.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$172.41
|
| Rate for Payer: Sagamore Health Network All Products |
$172.41
|
| Rate for Payer: Sagamore Health Network All Products |
$172.41
|
| Rate for Payer: Signature Care EPO |
$289.24
|
| Rate for Payer: Signature Care EPO |
$289.24
|
| Rate for Payer: Signature Care PPO |
$289.24
|
| Rate for Payer: Signature Care PPO |
$289.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20,500.00
|
| Rate for Payer: United Healthcare Commercial |
$190.80
|
| Rate for Payer: United Healthcare Commercial |
$190.80
|
| Rate for Payer: United Healthcare Medicare |
$322.19
|
| Rate for Payer: United Healthcare Medicare |
$322.19
|
|
|
PR REMV RESID OBSTRUC PROSTATE,>1 YR
|
Professional
|
Both
|
$744.68
|
|
|
Service Code
|
CPT 52630
|
| Hospital Charge Code |
z52630
|
| Min. Negotiated Rate |
$369.75 |
| Max. Negotiated Rate |
$589.71 |
| Rate for Payer: Aetna Commercial |
$380.46
|
| Rate for Payer: Aetna Medicare |
$380.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$373.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$437.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$418.51
|
| Rate for Payer: Cash Price |
$446.81
|
| Rate for Payer: Centivo All Commercial |
$589.71
|
| Rate for Payer: Cigna All Commercial |
$380.46
|
| Rate for Payer: CORVEL All Commercial |
$380.46
|
| Rate for Payer: Coventry All Commercial |
$456.55
|
| Rate for Payer: Encore All Commercial |
$380.46
|
| Rate for Payer: Frontpath All Commercial |
$519.05
|
| Rate for Payer: Humana ChoiceCare |
$396.20
|
| Rate for Payer: Humana Medicare |
$380.46
|
| Rate for Payer: Lucent All Commercial |
$532.64
|
| Rate for Payer: Managed Health Services Medicaid |
$373.74
|
| Rate for Payer: MDWise Medicaid |
$373.74
|
| Rate for Payer: PHCS All Commercial |
$380.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$380.46
|
| Rate for Payer: Sagamore Health Network All Products |
$380.46
|
| Rate for Payer: United Healthcare Commercial |
$545.73
|
| Rate for Payer: United Healthcare Medicare |
$369.75
|
|
|
PR REMV TALUS/HEEL BENIGN BONE LESN
|
Professional
|
Both
|
$1,135.84
|
|
|
Service Code
|
CPT 28100
|
| Hospital Charge Code |
z28100
|
| Min. Negotiated Rate |
$214.73 |
| Max. Negotiated Rate |
$610.54 |
| Rate for Payer: Aetna Commercial |
$393.90
|
| Rate for Payer: Aetna Commercial |
$393.90
|
| Rate for Payer: Aetna Medicare |
$393.90
|
| Rate for Payer: Aetna Medicare |
$393.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$214.73
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$214.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$558.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$558.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$452.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$452.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$433.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$433.29
|
| Rate for Payer: Cash Price |
$668.36
|
| Rate for Payer: Cash Price |
$681.50
|
| Rate for Payer: Centivo All Commercial |
$610.54
|
| Rate for Payer: Centivo All Commercial |
$610.54
|
| Rate for Payer: Cigna All Commercial |
$393.90
|
| Rate for Payer: Cigna All Commercial |
$393.90
|
| Rate for Payer: CORVEL All Commercial |
$393.90
|
| Rate for Payer: CORVEL All Commercial |
$393.90
|
| Rate for Payer: Coventry All Commercial |
$472.68
|
| Rate for Payer: Coventry All Commercial |
$472.68
|
| Rate for Payer: Encore All Commercial |
$393.90
|
| Rate for Payer: Encore All Commercial |
$393.90
|
| Rate for Payer: Frontpath All Commercial |
$539.47
|
| Rate for Payer: Frontpath All Commercial |
$539.47
|
| Rate for Payer: Humana ChoiceCare |
$448.19
|
| Rate for Payer: Humana ChoiceCare |
$448.19
|
| Rate for Payer: Humana Medicare |
$393.90
|
| Rate for Payer: Humana Medicare |
$393.90
|
| Rate for Payer: Lucent All Commercial |
$551.46
|
| Rate for Payer: Lucent All Commercial |
$551.46
|
| Rate for Payer: Managed Health Services Medicaid |
$558.66
|
| Rate for Payer: Managed Health Services Medicaid |
$558.66
|
| Rate for Payer: MDWise Medicaid |
$558.66
|
| Rate for Payer: MDWise Medicaid |
$558.66
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$214.73
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$214.73
|
| Rate for Payer: PHCS All Commercial |
$393.90
|
| Rate for Payer: PHCS All Commercial |
$393.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$393.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$393.90
|
| Rate for Payer: Sagamore Health Network All Products |
$393.90
|
| Rate for Payer: Sagamore Health Network All Products |
$393.90
|
| Rate for Payer: United Healthcare Commercial |
$454.68
|
| Rate for Payer: United Healthcare Commercial |
$454.68
|
| Rate for Payer: United Healthcare Medicare |
$556.97
|
| Rate for Payer: United Healthcare Medicare |
$556.97
|
|
|
PR REMV TARSAL/METATARSAL BENIGN BONE LESN
|
Professional
|
Both
|
$977.88
|
|
|
Service Code
|
CPT 28104
|
| Hospital Charge Code |
z28104
|
| Min. Negotiated Rate |
$179.61 |
| Max. Negotiated Rate |
$49,900.00 |
| Rate for Payer: Aetna Commercial |
$332.46
|
| Rate for Payer: Aetna Commercial |
$332.46
|
| Rate for Payer: Aetna Medicare |
$332.46
|
| Rate for Payer: Aetna Medicare |
$332.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$490.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$490.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$490.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$490.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$490.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$490.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$490.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$490.01
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$179.61
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$179.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$480.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$480.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$382.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$382.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$365.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$365.71
|
| Rate for Payer: Cash Price |
$571.82
|
| Rate for Payer: Cash Price |
$586.73
|
| Rate for Payer: Centivo All Commercial |
$515.31
|
| Rate for Payer: Centivo All Commercial |
$515.31
|
| Rate for Payer: Cigna All Commercial |
$332.46
|
| Rate for Payer: Cigna All Commercial |
$332.46
|
| Rate for Payer: CORVEL All Commercial |
$332.46
|
| Rate for Payer: CORVEL All Commercial |
$332.46
|
| Rate for Payer: Coventry All Commercial |
$398.95
|
| Rate for Payer: Coventry All Commercial |
$398.95
|
| Rate for Payer: Encore All Commercial |
$332.46
|
| Rate for Payer: Encore All Commercial |
$332.46
|
| Rate for Payer: Frontpath All Commercial |
$451.83
|
| Rate for Payer: Frontpath All Commercial |
$451.83
|
| Rate for Payer: Humana ChoiceCare |
$391.86
|
| Rate for Payer: Humana ChoiceCare |
$391.86
|
| Rate for Payer: Humana Medicare |
$332.46
|
| Rate for Payer: Humana Medicare |
$332.46
|
| Rate for Payer: Lucent All Commercial |
$465.44
|
| Rate for Payer: Lucent All Commercial |
$465.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$532.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$532.00
|
| Rate for Payer: Managed Health Services Medicaid |
$480.96
|
| Rate for Payer: Managed Health Services Medicaid |
$480.96
|
| Rate for Payer: MDWise Medicaid |
$480.96
|
| Rate for Payer: MDWise Medicaid |
$480.96
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$179.61
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$179.61
|
| Rate for Payer: PHCS All Commercial |
$332.46
|
| Rate for Payer: PHCS All Commercial |
$332.46
|
| Rate for Payer: PHP All Commercial |
$564.49
|
| Rate for Payer: PHP All Commercial |
$564.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$332.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$332.46
|
| Rate for Payer: Sagamore Health Network All Products |
$332.46
|
| Rate for Payer: Sagamore Health Network All Products |
$332.46
|
| Rate for Payer: Signature Care EPO |
$658.75
|
| Rate for Payer: Signature Care EPO |
$658.75
|
| Rate for Payer: Signature Care PPO |
$658.75
|
| Rate for Payer: Signature Care PPO |
$658.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$49,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$49,900.00
|
| Rate for Payer: United Healthcare Commercial |
$398.49
|
| Rate for Payer: United Healthcare Commercial |
$398.49
|
| Rate for Payer: United Healthcare Medicare |
$476.52
|
| Rate for Payer: United Healthcare Medicare |
$476.52
|
|
|
PR REMV TOE BENIGN BONE LESN
|
Professional
|
Both
|
$810.50
|
|
|
Service Code
|
CPT 28108
|
| Hospital Charge Code |
z28108
|
| Min. Negotiated Rate |
$146.21 |
| Max. Negotiated Rate |
$421.66 |
| Rate for Payer: Aetna Commercial |
$272.04
|
| Rate for Payer: Aetna Medicare |
$272.04
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$146.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$398.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$312.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.24
|
| Rate for Payer: Cash Price |
$486.30
|
| Rate for Payer: Centivo All Commercial |
$421.66
|
| Rate for Payer: Cigna All Commercial |
$272.04
|
| Rate for Payer: CORVEL All Commercial |
$272.04
|
| Rate for Payer: Coventry All Commercial |
$326.45
|
| Rate for Payer: Encore All Commercial |
$272.04
|
| Rate for Payer: Frontpath All Commercial |
$367.16
|
| Rate for Payer: Humana ChoiceCare |
$320.21
|
| Rate for Payer: Humana Medicare |
$272.04
|
| Rate for Payer: Lucent All Commercial |
$380.86
|
| Rate for Payer: Managed Health Services Medicaid |
$398.64
|
| Rate for Payer: MDWise Medicaid |
$398.64
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$146.21
|
| Rate for Payer: PHCS All Commercial |
$272.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.04
|
| Rate for Payer: Sagamore Health Network All Products |
$272.04
|
| Rate for Payer: United Healthcare Commercial |
$328.69
|
| Rate for Payer: United Healthcare Medicare |
$395.70
|
|
|
PR RENAL BIOPSY PRQ TROCAR/NEEDLE
|
Professional
|
Both
|
$890.66
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
z50200
|
| Min. Negotiated Rate |
$101.48 |
| Max. Negotiated Rate |
$472.33 |
| Rate for Payer: Aetna Commercial |
$120.16
|
| Rate for Payer: Aetna Medicare |
$120.16
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$101.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$461.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$138.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$132.18
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Centivo All Commercial |
$186.25
|
| Rate for Payer: Cigna All Commercial |
$120.16
|
| Rate for Payer: CORVEL All Commercial |
$120.16
|
| Rate for Payer: Coventry All Commercial |
$144.19
|
| Rate for Payer: Encore All Commercial |
$120.16
|
| Rate for Payer: Frontpath All Commercial |
$163.08
|
| Rate for Payer: Humana ChoiceCare |
$147.78
|
| Rate for Payer: Humana Medicare |
$120.16
|
| Rate for Payer: Lucent All Commercial |
$168.22
|
| Rate for Payer: Managed Health Services Medicaid |
$461.53
|
| Rate for Payer: MDWise Medicaid |
$461.53
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$101.48
|
| Rate for Payer: PHCS All Commercial |
$120.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$120.16
|
| Rate for Payer: Sagamore Health Network All Products |
$120.16
|
| Rate for Payer: United Healthcare Commercial |
$175.45
|
| Rate for Payer: United Healthcare Medicare |
$472.33
|
|
|
PR REOPEN FALLOPIAN TUBE,CHROMOTUBATION
|
Professional
|
Both
|
$285.70
|
|
|
Service Code
|
CPT 58350
|
| Hospital Charge Code |
z58350
|
| Min. Negotiated Rate |
$84.06 |
| Max. Negotiated Rate |
$11,600.00 |
| Rate for Payer: Aetna Commercial |
$90.03
|
| Rate for Payer: Aetna Commercial |
$90.03
|
| Rate for Payer: Aetna Medicare |
$90.03
|
| Rate for Payer: Aetna Medicare |
$90.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$128.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$128.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$128.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$128.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$128.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$128.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$128.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$128.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$140.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$140.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$103.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$103.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$99.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$99.03
|
| Rate for Payer: Cash Price |
$171.42
|
| Rate for Payer: Cash Price |
$169.42
|
| Rate for Payer: Centivo All Commercial |
$139.55
|
| Rate for Payer: Centivo All Commercial |
$139.55
|
| Rate for Payer: Cigna All Commercial |
$90.03
|
| Rate for Payer: Cigna All Commercial |
$90.03
|
| Rate for Payer: CORVEL All Commercial |
$90.03
|
| Rate for Payer: CORVEL All Commercial |
$90.03
|
| Rate for Payer: Coventry All Commercial |
$108.04
|
| Rate for Payer: Coventry All Commercial |
$108.04
|
| Rate for Payer: Encore All Commercial |
$90.03
|
| Rate for Payer: Encore All Commercial |
$90.03
|
| Rate for Payer: Frontpath All Commercial |
$123.08
|
| Rate for Payer: Frontpath All Commercial |
$123.08
|
| Rate for Payer: Humana ChoiceCare |
$84.06
|
| Rate for Payer: Humana ChoiceCare |
$84.06
|
| Rate for Payer: Humana Medicare |
$90.03
|
| Rate for Payer: Humana Medicare |
$90.03
|
| Rate for Payer: Lucent All Commercial |
$126.04
|
| Rate for Payer: Lucent All Commercial |
$126.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.00
|
| Rate for Payer: Managed Health Services Medicaid |
$140.52
|
| Rate for Payer: Managed Health Services Medicaid |
$140.52
|
| Rate for Payer: MDWise Medicaid |
$140.52
|
| Rate for Payer: MDWise Medicaid |
$140.52
|
| Rate for Payer: PHCS All Commercial |
$90.03
|
| Rate for Payer: PHCS All Commercial |
$90.03
|
| Rate for Payer: PHP All Commercial |
$115.19
|
| Rate for Payer: PHP All Commercial |
$115.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$90.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$90.03
|
| Rate for Payer: Sagamore Health Network All Products |
$90.03
|
| Rate for Payer: Sagamore Health Network All Products |
$90.03
|
| Rate for Payer: Signature Care EPO |
$124.98
|
| Rate for Payer: Signature Care EPO |
$124.98
|
| Rate for Payer: Signature Care PPO |
$124.98
|
| Rate for Payer: Signature Care PPO |
$124.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,600.00
|
| Rate for Payer: United Healthcare Commercial |
$86.93
|
| Rate for Payer: United Healthcare Commercial |
$86.93
|
| Rate for Payer: United Healthcare Medicare |
$141.18
|
| Rate for Payer: United Healthcare Medicare |
$141.18
|
|
|
PR REOPEN RECENT ABD EXPLORATORY
|
Professional
|
Both
|
$1,885.78
|
|
|
Service Code
|
CPT 49002
|
| Hospital Charge Code |
z49002
|
| Min. Negotiated Rate |
$708.37 |
| Max. Negotiated Rate |
$133,200.00 |
| Rate for Payer: Aetna Commercial |
$965.77
|
| Rate for Payer: Aetna Commercial |
$965.77
|
| Rate for Payer: Aetna Medicare |
$965.77
|
| Rate for Payer: Aetna Medicare |
$965.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$835.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$835.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$835.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$835.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$835.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$835.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$835.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$835.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$927.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$927.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,110.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,110.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,062.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,062.35
|
| Rate for Payer: Cash Price |
$1,131.47
|
| Rate for Payer: Cash Price |
$1,114.10
|
| Rate for Payer: Centivo All Commercial |
$1,496.94
|
| Rate for Payer: Centivo All Commercial |
$1,496.94
|
| Rate for Payer: Cigna All Commercial |
$965.77
|
| Rate for Payer: Cigna All Commercial |
$965.77
|
| Rate for Payer: CORVEL All Commercial |
$965.77
|
| Rate for Payer: CORVEL All Commercial |
$965.77
|
| Rate for Payer: Coventry All Commercial |
$1,158.92
|
| Rate for Payer: Coventry All Commercial |
$1,158.92
|
| Rate for Payer: Encore All Commercial |
$965.77
|
| Rate for Payer: Encore All Commercial |
$965.77
|
| Rate for Payer: Frontpath All Commercial |
$1,378.64
|
| Rate for Payer: Frontpath All Commercial |
$1,378.64
|
| Rate for Payer: Humana ChoiceCare |
$708.37
|
| Rate for Payer: Humana ChoiceCare |
$708.37
|
| Rate for Payer: Humana Medicare |
$965.77
|
| Rate for Payer: Humana Medicare |
$965.77
|
| Rate for Payer: Lucent All Commercial |
$1,352.08
|
| Rate for Payer: Lucent All Commercial |
$1,352.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,427.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,427.00
|
| Rate for Payer: Managed Health Services Medicaid |
$927.50
|
| Rate for Payer: Managed Health Services Medicaid |
$927.50
|
| Rate for Payer: MDWise Medicaid |
$927.50
|
| Rate for Payer: MDWise Medicaid |
$927.50
|
| Rate for Payer: PHCS All Commercial |
$965.77
|
| Rate for Payer: PHCS All Commercial |
$965.77
|
| Rate for Payer: PHP All Commercial |
$1,624.73
|
| Rate for Payer: PHP All Commercial |
$1,624.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$965.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$965.77
|
| Rate for Payer: Sagamore Health Network All Products |
$965.77
|
| Rate for Payer: Sagamore Health Network All Products |
$965.77
|
| Rate for Payer: Signature Care EPO |
$898.45
|
| Rate for Payer: Signature Care EPO |
$898.45
|
| Rate for Payer: Signature Care PPO |
$898.45
|
| Rate for Payer: Signature Care PPO |
$898.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$133,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$133,200.00
|
| Rate for Payer: United Healthcare Commercial |
$1,087.29
|
| Rate for Payer: United Healthcare Commercial |
$1,087.29
|
| Rate for Payer: United Healthcare Medicare |
$928.42
|
| Rate for Payer: United Healthcare Medicare |
$928.42
|
|
|
PR REPAIR 1 COLLAT ANKLE LIGMNT,PRIMARY
|
Professional
|
Both
|
$911.80
|
|
|
Service Code
|
CPT 27695
|
| Hospital Charge Code |
z27695
|
| Min. Negotiated Rate |
$443.83 |
| Max. Negotiated Rate |
$699.56 |
| Rate for Payer: Aetna Commercial |
$451.33
|
| Rate for Payer: Aetna Commercial |
$451.33
|
| Rate for Payer: Aetna Medicare |
$451.33
|
| Rate for Payer: Aetna Medicare |
$451.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$448.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$448.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$519.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$519.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$496.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$496.46
|
| Rate for Payer: Cash Price |
$532.60
|
| Rate for Payer: Cash Price |
$547.08
|
| Rate for Payer: Centivo All Commercial |
$699.56
|
| Rate for Payer: Centivo All Commercial |
$699.56
|
| Rate for Payer: Cigna All Commercial |
$451.33
|
| Rate for Payer: Cigna All Commercial |
$451.33
|
| Rate for Payer: CORVEL All Commercial |
$451.33
|
| Rate for Payer: CORVEL All Commercial |
$451.33
|
| Rate for Payer: Coventry All Commercial |
$541.60
|
| Rate for Payer: Coventry All Commercial |
$541.60
|
| Rate for Payer: Encore All Commercial |
$451.33
|
| Rate for Payer: Encore All Commercial |
$451.33
|
| Rate for Payer: Frontpath All Commercial |
$618.85
|
| Rate for Payer: Frontpath All Commercial |
$618.85
|
| Rate for Payer: Humana ChoiceCare |
$536.74
|
| Rate for Payer: Humana ChoiceCare |
$536.74
|
| Rate for Payer: Humana Medicare |
$451.33
|
| Rate for Payer: Humana Medicare |
$451.33
|
| Rate for Payer: Lucent All Commercial |
$631.86
|
| Rate for Payer: Lucent All Commercial |
$631.86
|
| Rate for Payer: Managed Health Services Medicaid |
$448.46
|
| Rate for Payer: Managed Health Services Medicaid |
$448.46
|
| Rate for Payer: MDWise Medicaid |
$448.46
|
| Rate for Payer: MDWise Medicaid |
$448.46
|
| Rate for Payer: PHCS All Commercial |
$451.33
|
| Rate for Payer: PHCS All Commercial |
$451.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$451.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$451.33
|
| Rate for Payer: Sagamore Health Network All Products |
$451.33
|
| Rate for Payer: Sagamore Health Network All Products |
$451.33
|
| Rate for Payer: United Healthcare Commercial |
$537.73
|
| Rate for Payer: United Healthcare Commercial |
$537.73
|
| Rate for Payer: United Healthcare Medicare |
$443.83
|
| Rate for Payer: United Healthcare Medicare |
$443.83
|
|
|
PR REPAIR ACHILLES TENDON,PRIMARY
|
Professional
|
Both
|
$1,230.18
|
|
|
Service Code
|
CPT 27650
|
| Hospital Charge Code |
z27650
|
| Min. Negotiated Rate |
$602.50 |
| Max. Negotiated Rate |
$92,600.00 |
| Rate for Payer: Aetna Commercial |
$619.09
|
| Rate for Payer: Aetna Commercial |
$619.09
|
| Rate for Payer: Aetna Medicare |
$619.09
|
| Rate for Payer: Aetna Medicare |
$619.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$926.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$926.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$926.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$926.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$926.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$926.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$926.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$926.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$605.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$605.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$711.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$711.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$681.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$681.00
|
| Rate for Payer: Cash Price |
$738.11
|
| Rate for Payer: Cash Price |
$723.00
|
| Rate for Payer: Centivo All Commercial |
$959.59
|
| Rate for Payer: Centivo All Commercial |
$959.59
|
| Rate for Payer: Cigna All Commercial |
$619.09
|
| Rate for Payer: Cigna All Commercial |
$619.09
|
| Rate for Payer: CORVEL All Commercial |
$619.09
|
| Rate for Payer: CORVEL All Commercial |
$619.09
|
| Rate for Payer: Coventry All Commercial |
$742.91
|
| Rate for Payer: Coventry All Commercial |
$742.91
|
| Rate for Payer: Encore All Commercial |
$619.09
|
| Rate for Payer: Encore All Commercial |
$619.09
|
| Rate for Payer: Frontpath All Commercial |
$850.77
|
| Rate for Payer: Frontpath All Commercial |
$850.77
|
| Rate for Payer: Humana ChoiceCare |
$750.71
|
| Rate for Payer: Humana ChoiceCare |
$750.71
|
| Rate for Payer: Humana Medicare |
$619.09
|
| Rate for Payer: Humana Medicare |
$619.09
|
| Rate for Payer: Lucent All Commercial |
$866.73
|
| Rate for Payer: Lucent All Commercial |
$866.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$988.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$988.00
|
| Rate for Payer: Managed Health Services Medicaid |
$605.05
|
| Rate for Payer: Managed Health Services Medicaid |
$605.05
|
| Rate for Payer: MDWise Medicaid |
$605.05
|
| Rate for Payer: MDWise Medicaid |
$605.05
|
| Rate for Payer: PHCS All Commercial |
$619.09
|
| Rate for Payer: PHCS All Commercial |
$619.09
|
| Rate for Payer: PHP All Commercial |
$1,048.35
|
| Rate for Payer: PHP All Commercial |
$1,048.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$619.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$619.09
|
| Rate for Payer: Sagamore Health Network All Products |
$619.09
|
| Rate for Payer: Sagamore Health Network All Products |
$619.09
|
| Rate for Payer: Signature Care EPO |
$1,008.10
|
| Rate for Payer: Signature Care EPO |
$1,008.10
|
| Rate for Payer: Signature Care PPO |
$1,008.10
|
| Rate for Payer: Signature Care PPO |
$1,008.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92,600.00
|
| Rate for Payer: United Healthcare Commercial |
$734.25
|
| Rate for Payer: United Healthcare Commercial |
$734.25
|
| Rate for Payer: United Healthcare Medicare |
$602.50
|
| Rate for Payer: United Healthcare Medicare |
$602.50
|
|
|
PR REPAIR ACHILLES TENDON,SECONDARY
|
Professional
|
Both
|
$1,340.38
|
|
|
Service Code
|
CPT 27654
|
| Hospital Charge Code |
z27654
|
| Min. Negotiated Rate |
$654.52 |
| Max. Negotiated Rate |
$1,039.91 |
| Rate for Payer: Aetna Commercial |
$670.91
|
| Rate for Payer: Aetna Medicare |
$670.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$659.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$771.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$738.00
|
| Rate for Payer: Cash Price |
$804.23
|
| Rate for Payer: Centivo All Commercial |
$1,039.91
|
| Rate for Payer: Cigna All Commercial |
$670.91
|
| Rate for Payer: CORVEL All Commercial |
$670.91
|
| Rate for Payer: Coventry All Commercial |
$805.09
|
| Rate for Payer: Encore All Commercial |
$670.91
|
| Rate for Payer: Frontpath All Commercial |
$921.90
|
| Rate for Payer: Humana ChoiceCare |
$749.86
|
| Rate for Payer: Humana Medicare |
$670.91
|
| Rate for Payer: Lucent All Commercial |
$939.27
|
| Rate for Payer: Managed Health Services Medicaid |
$659.25
|
| Rate for Payer: MDWise Medicaid |
$659.25
|
| Rate for Payer: PHCS All Commercial |
$670.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$670.91
|
| Rate for Payer: Sagamore Health Network All Products |
$670.91
|
| Rate for Payer: United Healthcare Commercial |
$791.84
|
| Rate for Payer: United Healthcare Medicare |
$654.52
|
|
|
PR REPAIR BICEPS LONG TENDON
|
Professional
|
Both
|
$1,383.42
|
|
|
Service Code
|
CPT 23430
|
| Hospital Charge Code |
z23430
|
| Min. Negotiated Rate |
$677.23 |
| Max. Negotiated Rate |
$104,100.00 |
| Rate for Payer: Aetna Commercial |
$695.12
|
| Rate for Payer: Aetna Commercial |
$695.12
|
| Rate for Payer: Aetna Medicare |
$695.12
|
| Rate for Payer: Aetna Medicare |
$695.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$942.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$942.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$942.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$942.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$942.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$942.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$942.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$942.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$680.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$680.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$799.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$799.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$764.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$764.63
|
| Rate for Payer: Cash Price |
$830.05
|
| Rate for Payer: Cash Price |
$812.68
|
| Rate for Payer: Centivo All Commercial |
$1,077.44
|
| Rate for Payer: Centivo All Commercial |
$1,077.44
|
| Rate for Payer: Cigna All Commercial |
$695.12
|
| Rate for Payer: Cigna All Commercial |
$695.12
|
| Rate for Payer: CORVEL All Commercial |
$695.12
|
| Rate for Payer: CORVEL All Commercial |
$695.12
|
| Rate for Payer: Coventry All Commercial |
$834.14
|
| Rate for Payer: Coventry All Commercial |
$834.14
|
| Rate for Payer: Encore All Commercial |
$695.12
|
| Rate for Payer: Encore All Commercial |
$695.12
|
| Rate for Payer: Frontpath All Commercial |
$966.37
|
| Rate for Payer: Frontpath All Commercial |
$966.37
|
| Rate for Payer: Humana ChoiceCare |
$789.37
|
| Rate for Payer: Humana ChoiceCare |
$789.37
|
| Rate for Payer: Humana Medicare |
$695.12
|
| Rate for Payer: Humana Medicare |
$695.12
|
| Rate for Payer: Lucent All Commercial |
$973.17
|
| Rate for Payer: Lucent All Commercial |
$973.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,111.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,111.00
|
| Rate for Payer: Managed Health Services Medicaid |
$680.42
|
| Rate for Payer: Managed Health Services Medicaid |
$680.42
|
| Rate for Payer: MDWise Medicaid |
$680.42
|
| Rate for Payer: MDWise Medicaid |
$680.42
|
| Rate for Payer: PHCS All Commercial |
$695.12
|
| Rate for Payer: PHCS All Commercial |
$695.12
|
| Rate for Payer: PHP All Commercial |
$1,178.37
|
| Rate for Payer: PHP All Commercial |
$1,178.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$695.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$695.12
|
| Rate for Payer: Sagamore Health Network All Products |
$695.12
|
| Rate for Payer: Sagamore Health Network All Products |
$695.12
|
| Rate for Payer: Signature Care EPO |
$1,058.25
|
| Rate for Payer: Signature Care EPO |
$1,058.25
|
| Rate for Payer: Signature Care PPO |
$1,058.25
|
| Rate for Payer: Signature Care PPO |
$1,058.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$104,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$104,100.00
|
| Rate for Payer: United Healthcare Commercial |
$800.95
|
| Rate for Payer: United Healthcare Commercial |
$800.95
|
| Rate for Payer: United Healthcare Medicare |
$677.23
|
| Rate for Payer: United Healthcare Medicare |
$677.23
|
|
|
PR REPAIR BLEED LIVER/SUTURE WOUND
|
Professional
|
Both
|
$2,469.50
|
|
|
Service Code
|
CPT 47350
|
| Hospital Charge Code |
z47350
|
| Min. Negotiated Rate |
$1,004.60 |
| Max. Negotiated Rate |
$174,900.00 |
| Rate for Payer: Aetna Commercial |
$1,268.64
|
| Rate for Payer: Aetna Commercial |
$1,268.64
|
| Rate for Payer: Aetna Medicare |
$1,268.64
|
| Rate for Payer: Aetna Medicare |
$1,268.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,004.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,004.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,004.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,004.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,004.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,004.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,004.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,004.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,214.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,214.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,458.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,458.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,395.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,395.50
|
| Rate for Payer: Cash Price |
$1,481.70
|
| Rate for Payer: Cash Price |
$1,462.87
|
| Rate for Payer: Centivo All Commercial |
$1,966.39
|
| Rate for Payer: Centivo All Commercial |
$1,966.39
|
| Rate for Payer: Cigna All Commercial |
$1,268.64
|
| Rate for Payer: Cigna All Commercial |
$1,268.64
|
| Rate for Payer: CORVEL All Commercial |
$1,268.64
|
| Rate for Payer: CORVEL All Commercial |
$1,268.64
|
| Rate for Payer: Coventry All Commercial |
$1,522.37
|
| Rate for Payer: Coventry All Commercial |
$1,522.37
|
| Rate for Payer: Encore All Commercial |
$1,268.64
|
| Rate for Payer: Encore All Commercial |
$1,268.64
|
| Rate for Payer: Frontpath All Commercial |
$1,807.66
|
| Rate for Payer: Frontpath All Commercial |
$1,807.66
|
| Rate for Payer: Humana ChoiceCare |
$1,302.35
|
| Rate for Payer: Humana ChoiceCare |
$1,302.35
|
| Rate for Payer: Humana Medicare |
$1,268.64
|
| Rate for Payer: Humana Medicare |
$1,268.64
|
| Rate for Payer: Lucent All Commercial |
$1,776.10
|
| Rate for Payer: Lucent All Commercial |
$1,776.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,874.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,874.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,214.60
|
| Rate for Payer: Managed Health Services Medicaid |
$1,214.60
|
| Rate for Payer: MDWise Medicaid |
$1,214.60
|
| Rate for Payer: MDWise Medicaid |
$1,214.60
|
| Rate for Payer: PHCS All Commercial |
$1,268.64
|
| Rate for Payer: PHCS All Commercial |
$1,268.64
|
| Rate for Payer: PHP All Commercial |
$2,133.36
|
| Rate for Payer: PHP All Commercial |
$2,133.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,268.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,268.64
|
| Rate for Payer: Sagamore Health Network All Products |
$1,268.64
|
| Rate for Payer: Sagamore Health Network All Products |
$1,268.64
|
| Rate for Payer: Signature Care EPO |
$1,625.20
|
| Rate for Payer: Signature Care EPO |
$1,625.20
|
| Rate for Payer: Signature Care PPO |
$1,625.20
|
| Rate for Payer: Signature Care PPO |
$1,625.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$174,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$174,900.00
|
| Rate for Payer: United Healthcare Commercial |
$1,456.69
|
| Rate for Payer: United Healthcare Commercial |
$1,456.69
|
| Rate for Payer: United Healthcare Medicare |
$1,219.06
|
| Rate for Payer: United Healthcare Medicare |
$1,219.06
|
|
|
PR REPAIR COLLAT LIGAMT/CAPSULE,KNEE
|
Professional
|
Both
|
$1,259.28
|
|
|
Service Code
|
CPT 27405
|
| Hospital Charge Code |
z27405
|
| Min. Negotiated Rate |
$615.47 |
| Max. Negotiated Rate |
$980.20 |
| Rate for Payer: Aetna Commercial |
$632.39
|
| Rate for Payer: Aetna Commercial |
$632.39
|
| Rate for Payer: Aetna Medicare |
$632.39
|
| Rate for Payer: Aetna Medicare |
$632.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$619.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$619.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$727.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$727.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$695.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$695.63
|
| Rate for Payer: Cash Price |
$738.56
|
| Rate for Payer: Cash Price |
$755.57
|
| Rate for Payer: Centivo All Commercial |
$980.20
|
| Rate for Payer: Centivo All Commercial |
$980.20
|
| Rate for Payer: Cigna All Commercial |
$632.39
|
| Rate for Payer: Cigna All Commercial |
$632.39
|
| Rate for Payer: CORVEL All Commercial |
$632.39
|
| Rate for Payer: CORVEL All Commercial |
$632.39
|
| Rate for Payer: Coventry All Commercial |
$758.87
|
| Rate for Payer: Coventry All Commercial |
$758.87
|
| Rate for Payer: Encore All Commercial |
$632.39
|
| Rate for Payer: Encore All Commercial |
$632.39
|
| Rate for Payer: Frontpath All Commercial |
$879.32
|
| Rate for Payer: Frontpath All Commercial |
$879.32
|
| Rate for Payer: Humana ChoiceCare |
$703.00
|
| Rate for Payer: Humana ChoiceCare |
$703.00
|
| Rate for Payer: Humana Medicare |
$632.39
|
| Rate for Payer: Humana Medicare |
$632.39
|
| Rate for Payer: Lucent All Commercial |
$885.35
|
| Rate for Payer: Lucent All Commercial |
$885.35
|
| Rate for Payer: Managed Health Services Medicaid |
$619.37
|
| Rate for Payer: Managed Health Services Medicaid |
$619.37
|
| Rate for Payer: MDWise Medicaid |
$619.37
|
| Rate for Payer: MDWise Medicaid |
$619.37
|
| Rate for Payer: PHCS All Commercial |
$632.39
|
| Rate for Payer: PHCS All Commercial |
$632.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$632.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$632.39
|
| Rate for Payer: Sagamore Health Network All Products |
$632.39
|
| Rate for Payer: Sagamore Health Network All Products |
$632.39
|
| Rate for Payer: United Healthcare Commercial |
$727.81
|
| Rate for Payer: United Healthcare Commercial |
$727.81
|
| Rate for Payer: United Healthcare Medicare |
$615.47
|
| Rate for Payer: United Healthcare Medicare |
$615.47
|
|
|
PR REPAIR EXTEN LEG TENDON,PRIM,EA
|
Professional
|
Both
|
$902.04
|
|
|
Service Code
|
CPT 28208
|
| Hospital Charge Code |
z28208
|
| Min. Negotiated Rate |
$162.82 |
| Max. Negotiated Rate |
$45,500.00 |
| Rate for Payer: Aetna Commercial |
$300.26
|
| Rate for Payer: Aetna Commercial |
$300.26
|
| Rate for Payer: Aetna Medicare |
$300.26
|
| Rate for Payer: Aetna Medicare |
$300.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$427.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$427.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$427.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$427.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$427.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$427.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$427.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$427.87
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.82
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$443.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$443.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$345.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$345.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$330.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$330.29
|
| Rate for Payer: Cash Price |
$531.19
|
| Rate for Payer: Cash Price |
$541.22
|
| Rate for Payer: Centivo All Commercial |
$465.40
|
| Rate for Payer: Centivo All Commercial |
$465.40
|
| Rate for Payer: Cigna All Commercial |
$300.26
|
| Rate for Payer: Cigna All Commercial |
$300.26
|
| Rate for Payer: CORVEL All Commercial |
$300.26
|
| Rate for Payer: CORVEL All Commercial |
$300.26
|
| Rate for Payer: Coventry All Commercial |
$360.31
|
| Rate for Payer: Coventry All Commercial |
$360.31
|
| Rate for Payer: Encore All Commercial |
$300.26
|
| Rate for Payer: Encore All Commercial |
$300.26
|
| Rate for Payer: Frontpath All Commercial |
$408.72
|
| Rate for Payer: Frontpath All Commercial |
$408.72
|
| Rate for Payer: Humana ChoiceCare |
$332.32
|
| Rate for Payer: Humana ChoiceCare |
$332.32
|
| Rate for Payer: Humana Medicare |
$300.26
|
| Rate for Payer: Humana Medicare |
$300.26
|
| Rate for Payer: Lucent All Commercial |
$420.36
|
| Rate for Payer: Lucent All Commercial |
$420.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$485.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$485.00
|
| Rate for Payer: Managed Health Services Medicaid |
$443.66
|
| Rate for Payer: Managed Health Services Medicaid |
$443.66
|
| Rate for Payer: MDWise Medicaid |
$443.66
|
| Rate for Payer: MDWise Medicaid |
$443.66
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$162.82
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$162.82
|
| Rate for Payer: PHCS All Commercial |
$300.26
|
| Rate for Payer: PHCS All Commercial |
$300.26
|
| Rate for Payer: PHP All Commercial |
$514.49
|
| Rate for Payer: PHP All Commercial |
$514.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$300.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$300.26
|
| Rate for Payer: Sagamore Health Network All Products |
$300.26
|
| Rate for Payer: Sagamore Health Network All Products |
$300.26
|
| Rate for Payer: Signature Care EPO |
$578.85
|
| Rate for Payer: Signature Care EPO |
$578.85
|
| Rate for Payer: Signature Care PPO |
$578.85
|
| Rate for Payer: Signature Care PPO |
$578.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$45,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$45,500.00
|
| Rate for Payer: United Healthcare Commercial |
$347.36
|
| Rate for Payer: United Healthcare Commercial |
$347.36
|
| Rate for Payer: United Healthcare Medicare |
$442.66
|
| Rate for Payer: United Healthcare Medicare |
$442.66
|
|
|
PR REPAIR EXTEN TENDON,DISTAL INSERT,OPEN
|
Professional
|
Both
|
$1,067.18
|
|
|
Service Code
|
CPT 26433
|
| Hospital Charge Code |
z26433
|
| Min. Negotiated Rate |
$524.88 |
| Max. Negotiated Rate |
$81,200.00 |
| Rate for Payer: Aetna Commercial |
$545.11
|
| Rate for Payer: Aetna Commercial |
$545.11
|
| Rate for Payer: Aetna Medicare |
$545.11
|
| Rate for Payer: Aetna Medicare |
$545.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$589.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$589.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$589.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$589.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$589.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$589.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$589.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$589.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$524.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$524.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$626.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$626.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$599.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$599.62
|
| Rate for Payer: Cash Price |
$640.31
|
| Rate for Payer: Cash Price |
$633.49
|
| Rate for Payer: Centivo All Commercial |
$844.92
|
| Rate for Payer: Centivo All Commercial |
$844.92
|
| Rate for Payer: Cigna All Commercial |
$545.11
|
| Rate for Payer: Cigna All Commercial |
$545.11
|
| Rate for Payer: CORVEL All Commercial |
$545.11
|
| Rate for Payer: CORVEL All Commercial |
$545.11
|
| Rate for Payer: Coventry All Commercial |
$654.13
|
| Rate for Payer: Coventry All Commercial |
$654.13
|
| Rate for Payer: Encore All Commercial |
$545.11
|
| Rate for Payer: Encore All Commercial |
$545.11
|
| Rate for Payer: Frontpath All Commercial |
$740.74
|
| Rate for Payer: Frontpath All Commercial |
$740.74
|
| Rate for Payer: Humana ChoiceCare |
$640.33
|
| Rate for Payer: Humana ChoiceCare |
$640.33
|
| Rate for Payer: Humana Medicare |
$545.11
|
| Rate for Payer: Humana Medicare |
$545.11
|
| Rate for Payer: Lucent All Commercial |
$763.15
|
| Rate for Payer: Lucent All Commercial |
$763.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$866.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$866.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.88
|
| Rate for Payer: MDWise Medicaid |
$524.88
|
| Rate for Payer: MDWise Medicaid |
$524.88
|
| Rate for Payer: PHCS All Commercial |
$545.11
|
| Rate for Payer: PHCS All Commercial |
$545.11
|
| Rate for Payer: PHP All Commercial |
$918.57
|
| Rate for Payer: PHP All Commercial |
$918.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$545.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$545.11
|
| Rate for Payer: Sagamore Health Network All Products |
$545.11
|
| Rate for Payer: Sagamore Health Network All Products |
$545.11
|
| Rate for Payer: Signature Care EPO |
$842.47
|
| Rate for Payer: Signature Care EPO |
$842.47
|
| Rate for Payer: Signature Care PPO |
$842.47
|
| Rate for Payer: Signature Care PPO |
$842.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$81,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$81,200.00
|
| Rate for Payer: United Healthcare Commercial |
$555.48
|
| Rate for Payer: United Healthcare Commercial |
$555.48
|
| Rate for Payer: United Healthcare Medicare |
$527.91
|
| Rate for Payer: United Healthcare Medicare |
$527.91
|
|
|
PR REPAIR EXTEN TENDON,DORSUM FINGR,EA
|
Professional
|
Both
|
$1,166.90
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
z26418
|
| Min. Negotiated Rate |
$573.93 |
| Max. Negotiated Rate |
$88,400.00 |
| Rate for Payer: Aetna Commercial |
$593.50
|
| Rate for Payer: Aetna Commercial |
$593.50
|
| Rate for Payer: Aetna Medicare |
$593.50
|
| Rate for Payer: Aetna Medicare |
$593.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$767.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$767.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$767.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$767.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$767.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$767.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$767.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$767.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$573.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$573.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$682.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$682.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$652.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$652.85
|
| Rate for Payer: Cash Price |
$700.14
|
| Rate for Payer: Cash Price |
$690.11
|
| Rate for Payer: Centivo All Commercial |
$919.92
|
| Rate for Payer: Centivo All Commercial |
$919.92
|
| Rate for Payer: Cigna All Commercial |
$593.50
|
| Rate for Payer: Cigna All Commercial |
$593.50
|
| Rate for Payer: CORVEL All Commercial |
$593.50
|
| Rate for Payer: CORVEL All Commercial |
$593.50
|
| Rate for Payer: Coventry All Commercial |
$712.20
|
| Rate for Payer: Coventry All Commercial |
$712.20
|
| Rate for Payer: Encore All Commercial |
$593.50
|
| Rate for Payer: Encore All Commercial |
$593.50
|
| Rate for Payer: Frontpath All Commercial |
$803.60
|
| Rate for Payer: Frontpath All Commercial |
$803.60
|
| Rate for Payer: Humana ChoiceCare |
$686.75
|
| Rate for Payer: Humana ChoiceCare |
$686.75
|
| Rate for Payer: Humana Medicare |
$593.50
|
| Rate for Payer: Humana Medicare |
$593.50
|
| Rate for Payer: Lucent All Commercial |
$830.90
|
| Rate for Payer: Lucent All Commercial |
$830.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$943.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$943.00
|
| Rate for Payer: Managed Health Services Medicaid |
$573.93
|
| Rate for Payer: Managed Health Services Medicaid |
$573.93
|
| Rate for Payer: MDWise Medicaid |
$573.93
|
| Rate for Payer: MDWise Medicaid |
$573.93
|
| Rate for Payer: PHCS All Commercial |
$593.50
|
| Rate for Payer: PHCS All Commercial |
$593.50
|
| Rate for Payer: PHP All Commercial |
$1,000.65
|
| Rate for Payer: PHP All Commercial |
$1,000.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$593.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$593.50
|
| Rate for Payer: Sagamore Health Network All Products |
$593.50
|
| Rate for Payer: Sagamore Health Network All Products |
$593.50
|
| Rate for Payer: Signature Care EPO |
$914.14
|
| Rate for Payer: Signature Care EPO |
$914.14
|
| Rate for Payer: Signature Care PPO |
$914.14
|
| Rate for Payer: Signature Care PPO |
$914.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$88,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$88,400.00
|
| Rate for Payer: United Healthcare Commercial |
$592.40
|
| Rate for Payer: United Healthcare Commercial |
$592.40
|
| Rate for Payer: United Healthcare Medicare |
$575.09
|
| Rate for Payer: United Healthcare Medicare |
$575.09
|
|
|
PR REPAIR EXTEN TENDON,DORSUM HAND,EA
|
Professional
|
Both
|
$1,121.92
|
|
|
Service Code
|
CPT 26410
|
| Hospital Charge Code |
z26410
|
| Min. Negotiated Rate |
$551.80 |
| Max. Negotiated Rate |
$85,200.00 |
| Rate for Payer: Aetna Commercial |
$572.92
|
| Rate for Payer: Aetna Commercial |
$572.92
|
| Rate for Payer: Aetna Medicare |
$572.92
|
| Rate for Payer: Aetna Medicare |
$572.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$931.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$931.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$931.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$931.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$931.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$931.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$931.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$931.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$551.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$551.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$658.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$658.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$630.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$630.21
|
| Rate for Payer: Cash Price |
$673.15
|
| Rate for Payer: Cash Price |
$665.02
|
| Rate for Payer: Centivo All Commercial |
$888.03
|
| Rate for Payer: Centivo All Commercial |
$888.03
|
| Rate for Payer: Cigna All Commercial |
$572.92
|
| Rate for Payer: Cigna All Commercial |
$572.92
|
| Rate for Payer: CORVEL All Commercial |
$572.92
|
| Rate for Payer: CORVEL All Commercial |
$572.92
|
| Rate for Payer: Coventry All Commercial |
$687.50
|
| Rate for Payer: Coventry All Commercial |
$687.50
|
| Rate for Payer: Encore All Commercial |
$572.92
|
| Rate for Payer: Encore All Commercial |
$572.92
|
| Rate for Payer: Frontpath All Commercial |
$777.66
|
| Rate for Payer: Frontpath All Commercial |
$777.66
|
| Rate for Payer: Humana ChoiceCare |
$689.06
|
| Rate for Payer: Humana ChoiceCare |
$689.06
|
| Rate for Payer: Humana Medicare |
$572.92
|
| Rate for Payer: Humana Medicare |
$572.92
|
| Rate for Payer: Lucent All Commercial |
$802.09
|
| Rate for Payer: Lucent All Commercial |
$802.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$909.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$909.00
|
| Rate for Payer: Managed Health Services Medicaid |
$551.80
|
| Rate for Payer: Managed Health Services Medicaid |
$551.80
|
| Rate for Payer: MDWise Medicaid |
$551.80
|
| Rate for Payer: MDWise Medicaid |
$551.80
|
| Rate for Payer: PHCS All Commercial |
$572.92
|
| Rate for Payer: PHCS All Commercial |
$572.92
|
| Rate for Payer: PHP All Commercial |
$964.27
|
| Rate for Payer: PHP All Commercial |
$964.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$572.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$572.92
|
| Rate for Payer: Sagamore Health Network All Products |
$572.92
|
| Rate for Payer: Sagamore Health Network All Products |
$572.92
|
| Rate for Payer: Signature Care EPO |
$894.32
|
| Rate for Payer: Signature Care EPO |
$894.32
|
| Rate for Payer: Signature Care PPO |
$894.32
|
| Rate for Payer: Signature Care PPO |
$894.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$85,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$85,200.00
|
| Rate for Payer: United Healthcare Commercial |
$591.18
|
| Rate for Payer: United Healthcare Commercial |
$591.18
|
| Rate for Payer: United Healthcare Medicare |
$554.18
|
| Rate for Payer: United Healthcare Medicare |
$554.18
|
|
|
PR REPAIR FLEX FOOT TENDON,EA
|
Professional
|
Both
|
$919.82
|
|
|
Service Code
|
CPT 28200
|
| Hospital Charge Code |
z28200
|
| Min. Negotiated Rate |
$166.98 |
| Max. Negotiated Rate |
$46,200.00 |
| Rate for Payer: Aetna Commercial |
$308.53
|
| Rate for Payer: Aetna Commercial |
$308.53
|
| Rate for Payer: Aetna Medicare |
$308.53
|
| Rate for Payer: Aetna Medicare |
$308.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$449.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$449.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$449.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$449.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$449.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$449.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$449.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$449.57
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$166.98
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$166.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$452.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$452.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$354.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$354.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$339.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$339.38
|
| Rate for Payer: Cash Price |
$539.77
|
| Rate for Payer: Cash Price |
$551.89
|
| Rate for Payer: Centivo All Commercial |
$478.22
|
| Rate for Payer: Centivo All Commercial |
$478.22
|
| Rate for Payer: Cigna All Commercial |
$308.53
|
| Rate for Payer: Cigna All Commercial |
$308.53
|
| Rate for Payer: CORVEL All Commercial |
$308.53
|
| Rate for Payer: CORVEL All Commercial |
$308.53
|
| Rate for Payer: Coventry All Commercial |
$370.24
|
| Rate for Payer: Coventry All Commercial |
$370.24
|
| Rate for Payer: Encore All Commercial |
$308.53
|
| Rate for Payer: Encore All Commercial |
$308.53
|
| Rate for Payer: Frontpath All Commercial |
$419.47
|
| Rate for Payer: Frontpath All Commercial |
$419.47
|
| Rate for Payer: Humana ChoiceCare |
$352.81
|
| Rate for Payer: Humana ChoiceCare |
$352.81
|
| Rate for Payer: Humana Medicare |
$308.53
|
| Rate for Payer: Humana Medicare |
$308.53
|
| Rate for Payer: Lucent All Commercial |
$431.94
|
| Rate for Payer: Lucent All Commercial |
$431.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$493.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$493.00
|
| Rate for Payer: Managed Health Services Medicaid |
$452.40
|
| Rate for Payer: Managed Health Services Medicaid |
$452.40
|
| Rate for Payer: MDWise Medicaid |
$452.40
|
| Rate for Payer: MDWise Medicaid |
$452.40
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$166.98
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$166.98
|
| Rate for Payer: PHCS All Commercial |
$308.53
|
| Rate for Payer: PHCS All Commercial |
$308.53
|
| Rate for Payer: PHP All Commercial |
$522.73
|
| Rate for Payer: PHP All Commercial |
$522.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$308.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$308.53
|
| Rate for Payer: Sagamore Health Network All Products |
$308.53
|
| Rate for Payer: Sagamore Health Network All Products |
$308.53
|
| Rate for Payer: Signature Care EPO |
$603.50
|
| Rate for Payer: Signature Care EPO |
$603.50
|
| Rate for Payer: Signature Care PPO |
$603.50
|
| Rate for Payer: Signature Care PPO |
$603.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,200.00
|
| Rate for Payer: United Healthcare Commercial |
$361.86
|
| Rate for Payer: United Healthcare Commercial |
$361.86
|
| Rate for Payer: United Healthcare Medicare |
$449.81
|
| Rate for Payer: United Healthcare Medicare |
$449.81
|
|
|
PR REPAIR FLEX LEG TENDON,PRIM,EA
|
Professional
|
Both
|
$678.32
|
|
|
Service Code
|
CPT 27658
|
| Hospital Charge Code |
z27658
|
| Min. Negotiated Rate |
$339.16 |
| Max. Negotiated Rate |
$538.08 |
| Rate for Payer: Aetna Commercial |
$347.15
|
| Rate for Payer: Aetna Commercial |
$347.15
|
| Rate for Payer: Aetna Medicare |
$347.15
|
| Rate for Payer: Aetna Medicare |
$347.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$341.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$341.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$399.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$399.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$381.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$381.87
|
| Rate for Payer: Cash Price |
$417.17
|
| Rate for Payer: Cash Price |
$406.99
|
| Rate for Payer: Centivo All Commercial |
$538.08
|
| Rate for Payer: Centivo All Commercial |
$538.08
|
| Rate for Payer: Cigna All Commercial |
$347.15
|
| Rate for Payer: Cigna All Commercial |
$347.15
|
| Rate for Payer: CORVEL All Commercial |
$347.15
|
| Rate for Payer: CORVEL All Commercial |
$347.15
|
| Rate for Payer: Coventry All Commercial |
$416.58
|
| Rate for Payer: Coventry All Commercial |
$416.58
|
| Rate for Payer: Encore All Commercial |
$347.15
|
| Rate for Payer: Encore All Commercial |
$347.15
|
| Rate for Payer: Frontpath All Commercial |
$474.93
|
| Rate for Payer: Frontpath All Commercial |
$474.93
|
| Rate for Payer: Humana ChoiceCare |
$412.78
|
| Rate for Payer: Humana ChoiceCare |
$412.78
|
| Rate for Payer: Humana Medicare |
$347.15
|
| Rate for Payer: Humana Medicare |
$347.15
|
| Rate for Payer: Lucent All Commercial |
$486.01
|
| Rate for Payer: Lucent All Commercial |
$486.01
|
| Rate for Payer: Managed Health Services Medicaid |
$341.97
|
| Rate for Payer: Managed Health Services Medicaid |
$341.97
|
| Rate for Payer: MDWise Medicaid |
$341.97
|
| Rate for Payer: MDWise Medicaid |
$341.97
|
| Rate for Payer: PHCS All Commercial |
$347.15
|
| Rate for Payer: PHCS All Commercial |
$347.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$347.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$347.15
|
| Rate for Payer: Sagamore Health Network All Products |
$347.15
|
| Rate for Payer: Sagamore Health Network All Products |
$347.15
|
| Rate for Payer: United Healthcare Commercial |
$416.14
|
| Rate for Payer: United Healthcare Commercial |
$416.14
|
| Rate for Payer: United Healthcare Medicare |
$339.16
|
| Rate for Payer: United Healthcare Medicare |
$339.16
|
|
|
PR REPAIR FLEX TENDON,ZONE 2,HAND
|
Professional
|
Both
|
$1,486.08
|
|
|
Service Code
|
CPT 26356
|
| Hospital Charge Code |
z26356
|
| Min. Negotiated Rate |
$727.85 |
| Max. Negotiated Rate |
$111,900.00 |
| Rate for Payer: Aetna Commercial |
$744.13
|
| Rate for Payer: Aetna Commercial |
$744.13
|
| Rate for Payer: Aetna Medicare |
$744.13
|
| Rate for Payer: Aetna Medicare |
$744.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,168.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,168.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,168.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,168.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,168.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,168.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,168.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,168.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$730.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$730.91
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$855.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$855.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$818.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$818.54
|
| Rate for Payer: Cash Price |
$891.65
|
| Rate for Payer: Cash Price |
$873.42
|
| Rate for Payer: Centivo All Commercial |
$1,153.40
|
| Rate for Payer: Centivo All Commercial |
$1,153.40
|
| Rate for Payer: Cigna All Commercial |
$744.13
|
| Rate for Payer: Cigna All Commercial |
$744.13
|
| Rate for Payer: CORVEL All Commercial |
$744.13
|
| Rate for Payer: CORVEL All Commercial |
$744.13
|
| Rate for Payer: Coventry All Commercial |
$892.96
|
| Rate for Payer: Coventry All Commercial |
$892.96
|
| Rate for Payer: Encore All Commercial |
$744.13
|
| Rate for Payer: Encore All Commercial |
$744.13
|
| Rate for Payer: Frontpath All Commercial |
$1,024.96
|
| Rate for Payer: Frontpath All Commercial |
$1,024.96
|
| Rate for Payer: Humana ChoiceCare |
$1,103.50
|
| Rate for Payer: Humana ChoiceCare |
$1,103.50
|
| Rate for Payer: Humana Medicare |
$744.13
|
| Rate for Payer: Humana Medicare |
$744.13
|
| Rate for Payer: Lucent All Commercial |
$1,041.78
|
| Rate for Payer: Lucent All Commercial |
$1,041.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,194.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,194.00
|
| Rate for Payer: Managed Health Services Medicaid |
$730.91
|
| Rate for Payer: Managed Health Services Medicaid |
$730.91
|
| Rate for Payer: MDWise Medicaid |
$730.91
|
| Rate for Payer: MDWise Medicaid |
$730.91
|
| Rate for Payer: PHCS All Commercial |
$744.13
|
| Rate for Payer: PHCS All Commercial |
$744.13
|
| Rate for Payer: PHP All Commercial |
$1,266.46
|
| Rate for Payer: PHP All Commercial |
$1,266.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$744.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$744.13
|
| Rate for Payer: Sagamore Health Network All Products |
$744.13
|
| Rate for Payer: Sagamore Health Network All Products |
$744.13
|
| Rate for Payer: Signature Care EPO |
$1,265.02
|
| Rate for Payer: Signature Care EPO |
$1,265.02
|
| Rate for Payer: Signature Care PPO |
$1,265.02
|
| Rate for Payer: Signature Care PPO |
$1,265.02
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$111,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$111,900.00
|
| Rate for Payer: United Healthcare Commercial |
$1,109.68
|
| Rate for Payer: United Healthcare Commercial |
$1,109.68
|
| Rate for Payer: United Healthcare Medicare |
$727.85
|
| Rate for Payer: United Healthcare Medicare |
$727.85
|
|
|
PR REPAIR/GRAFT ACHILLES TENDON
|
Professional
|
Both
|
$1,262.82
|
|
|
Service Code
|
CPT 27652
|
| Hospital Charge Code |
z27652
|
| Min. Negotiated Rate |
$610.38 |
| Max. Negotiated Rate |
$93,800.00 |
| Rate for Payer: Aetna Commercial |
$625.39
|
| Rate for Payer: Aetna Commercial |
$625.39
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$996.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$996.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$996.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$996.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$996.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$996.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$996.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$996.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$621.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$621.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$719.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$719.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$687.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$687.93
|
| Rate for Payer: Cash Price |
$757.69
|
| Rate for Payer: Cash Price |
$732.46
|
| Rate for Payer: Centivo All Commercial |
$969.35
|
| Rate for Payer: Centivo All Commercial |
$969.35
|
| Rate for Payer: Cigna All Commercial |
$625.39
|
| Rate for Payer: Cigna All Commercial |
$625.39
|
| Rate for Payer: CORVEL All Commercial |
$625.39
|
| Rate for Payer: CORVEL All Commercial |
$625.39
|
| Rate for Payer: Coventry All Commercial |
$750.47
|
| Rate for Payer: Coventry All Commercial |
$750.47
|
| Rate for Payer: Encore All Commercial |
$625.39
|
| Rate for Payer: Encore All Commercial |
$625.39
|
| Rate for Payer: Frontpath All Commercial |
$854.14
|
| Rate for Payer: Frontpath All Commercial |
$854.14
|
| Rate for Payer: Humana ChoiceCare |
$801.08
|
| Rate for Payer: Humana ChoiceCare |
$801.08
|
| Rate for Payer: Humana Medicare |
$625.39
|
| Rate for Payer: Humana Medicare |
$625.39
|
| Rate for Payer: Lucent All Commercial |
$875.55
|
| Rate for Payer: Lucent All Commercial |
$875.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,001.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,001.00
|
| Rate for Payer: Managed Health Services Medicaid |
$621.11
|
| Rate for Payer: Managed Health Services Medicaid |
$621.11
|
| Rate for Payer: MDWise Medicaid |
$621.11
|
| Rate for Payer: MDWise Medicaid |
$621.11
|
| Rate for Payer: PHCS All Commercial |
$625.39
|
| Rate for Payer: PHCS All Commercial |
$625.39
|
| Rate for Payer: PHP All Commercial |
$1,062.07
|
| Rate for Payer: PHP All Commercial |
$1,062.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$625.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$625.39
|
| Rate for Payer: Sagamore Health Network All Products |
$625.39
|
| Rate for Payer: Sagamore Health Network All Products |
$625.39
|
| Rate for Payer: Signature Care EPO |
$1,063.16
|
| Rate for Payer: Signature Care EPO |
$1,063.16
|
| Rate for Payer: Signature Care PPO |
$1,063.16
|
| Rate for Payer: Signature Care PPO |
$1,063.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$93,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$93,800.00
|
| Rate for Payer: United Healthcare Commercial |
$811.29
|
| Rate for Payer: United Healthcare Commercial |
$811.29
|
| Rate for Payer: United Healthcare Medicare |
$610.38
|
| Rate for Payer: United Healthcare Medicare |
$610.38
|
|
|
PR REPAIR ING HERNIA,5+Y/O,REDUCIBL
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
z49505
|
| Min. Negotiated Rate |
$468.03 |
| Max. Negotiated Rate |
$752.49 |
| Rate for Payer: Aetna Commercial |
$485.48
|
| Rate for Payer: Aetna Medicare |
$485.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$469.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$558.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$534.03
|
| Rate for Payer: Cash Price |
$572.40
|
| Rate for Payer: Centivo All Commercial |
$752.49
|
| Rate for Payer: Cigna All Commercial |
$485.48
|
| Rate for Payer: CORVEL All Commercial |
$485.48
|
| Rate for Payer: Coventry All Commercial |
$582.58
|
| Rate for Payer: Encore All Commercial |
$485.48
|
| Rate for Payer: Frontpath All Commercial |
$690.50
|
| Rate for Payer: Humana ChoiceCare |
$518.80
|
| Rate for Payer: Humana Medicare |
$485.48
|
| Rate for Payer: Lucent All Commercial |
$679.67
|
| Rate for Payer: Managed Health Services Medicaid |
$469.18
|
| Rate for Payer: MDWise Medicaid |
$469.18
|
| Rate for Payer: PHCS All Commercial |
$485.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$485.48
|
| Rate for Payer: Sagamore Health Network All Products |
$485.48
|
| Rate for Payer: United Healthcare Commercial |
$545.73
|
| Rate for Payer: United Healthcare Medicare |
$468.03
|
|
|
PR REPAIR ING HERNIA,5+Y/O,STRANG
|
Professional
|
Both
|
$1,071.64
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
z49507
|
| Min. Negotiated Rate |
$526.35 |
| Max. Negotiated Rate |
$75,500.00 |
| Rate for Payer: Aetna Commercial |
$545.43
|
| Rate for Payer: Aetna Commercial |
$545.43
|
| Rate for Payer: Aetna Medicare |
$545.43
|
| Rate for Payer: Aetna Medicare |
$545.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$677.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$677.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$677.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$677.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$677.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$677.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$677.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$677.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$527.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$527.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$627.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$627.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$599.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$599.97
|
| Rate for Payer: Cash Price |
$642.98
|
| Rate for Payer: Cash Price |
$631.62
|
| Rate for Payer: Centivo All Commercial |
$845.42
|
| Rate for Payer: Centivo All Commercial |
$845.42
|
| Rate for Payer: Cigna All Commercial |
$545.43
|
| Rate for Payer: Cigna All Commercial |
$545.43
|
| Rate for Payer: CORVEL All Commercial |
$545.43
|
| Rate for Payer: CORVEL All Commercial |
$545.43
|
| Rate for Payer: Coventry All Commercial |
$654.52
|
| Rate for Payer: Coventry All Commercial |
$654.52
|
| Rate for Payer: Encore All Commercial |
$545.43
|
| Rate for Payer: Encore All Commercial |
$545.43
|
| Rate for Payer: Frontpath All Commercial |
$775.81
|
| Rate for Payer: Frontpath All Commercial |
$775.81
|
| Rate for Payer: Humana ChoiceCare |
$642.09
|
| Rate for Payer: Humana ChoiceCare |
$642.09
|
| Rate for Payer: Humana Medicare |
$545.43
|
| Rate for Payer: Humana Medicare |
$545.43
|
| Rate for Payer: Lucent All Commercial |
$763.60
|
| Rate for Payer: Lucent All Commercial |
$763.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$809.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$809.00
|
| Rate for Payer: Managed Health Services Medicaid |
$527.07
|
| Rate for Payer: Managed Health Services Medicaid |
$527.07
|
| Rate for Payer: MDWise Medicaid |
$527.07
|
| Rate for Payer: MDWise Medicaid |
$527.07
|
| Rate for Payer: PHCS All Commercial |
$545.43
|
| Rate for Payer: PHCS All Commercial |
$545.43
|
| Rate for Payer: PHP All Commercial |
$921.11
|
| Rate for Payer: PHP All Commercial |
$921.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$545.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$545.43
|
| Rate for Payer: Sagamore Health Network All Products |
$545.43
|
| Rate for Payer: Sagamore Health Network All Products |
$545.43
|
| Rate for Payer: Signature Care EPO |
$811.75
|
| Rate for Payer: Signature Care EPO |
$811.75
|
| Rate for Payer: Signature Care PPO |
$811.75
|
| Rate for Payer: Signature Care PPO |
$811.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$75,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$75,500.00
|
| Rate for Payer: United Healthcare Commercial |
$672.50
|
| Rate for Payer: United Healthcare Commercial |
$672.50
|
| Rate for Payer: United Healthcare Medicare |
$526.35
|
| Rate for Payer: United Healthcare Medicare |
$526.35
|
|
|
PR REPAIR INTERCARP/CARP-METACARP JT
|
Professional
|
Both
|
$1,550.66
|
|
|
Service Code
|
CPT 25447
|
| Hospital Charge Code |
z25447
|
| Min. Negotiated Rate |
$758.61 |
| Max. Negotiated Rate |
$116,600.00 |
| Rate for Payer: Aetna Commercial |
$776.21
|
| Rate for Payer: Aetna Commercial |
$776.21
|
| Rate for Payer: Aetna Medicare |
$776.21
|
| Rate for Payer: Aetna Medicare |
$776.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,014.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,014.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,014.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,014.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,014.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,014.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,014.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,014.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$762.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$762.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$892.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$892.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$853.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$853.83
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$910.33
|
| Rate for Payer: Centivo All Commercial |
$1,203.13
|
| Rate for Payer: Centivo All Commercial |
$1,203.13
|
| Rate for Payer: Cigna All Commercial |
$776.21
|
| Rate for Payer: Cigna All Commercial |
$776.21
|
| Rate for Payer: CORVEL All Commercial |
$776.21
|
| Rate for Payer: CORVEL All Commercial |
$776.21
|
| Rate for Payer: Coventry All Commercial |
$931.45
|
| Rate for Payer: Coventry All Commercial |
$931.45
|
| Rate for Payer: Encore All Commercial |
$776.21
|
| Rate for Payer: Encore All Commercial |
$776.21
|
| Rate for Payer: Frontpath All Commercial |
$1,074.09
|
| Rate for Payer: Frontpath All Commercial |
$1,074.09
|
| Rate for Payer: Humana ChoiceCare |
$825.83
|
| Rate for Payer: Humana ChoiceCare |
$825.83
|
| Rate for Payer: Humana Medicare |
$776.21
|
| Rate for Payer: Humana Medicare |
$776.21
|
| Rate for Payer: Lucent All Commercial |
$1,086.69
|
| Rate for Payer: Lucent All Commercial |
$1,086.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,244.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,244.00
|
| Rate for Payer: Managed Health Services Medicaid |
$762.67
|
| Rate for Payer: Managed Health Services Medicaid |
$762.67
|
| Rate for Payer: MDWise Medicaid |
$762.67
|
| Rate for Payer: MDWise Medicaid |
$762.67
|
| Rate for Payer: PHCS All Commercial |
$776.21
|
| Rate for Payer: PHCS All Commercial |
$776.21
|
| Rate for Payer: PHP All Commercial |
$1,319.98
|
| Rate for Payer: PHP All Commercial |
$1,319.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$776.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$776.21
|
| Rate for Payer: Sagamore Health Network All Products |
$776.21
|
| Rate for Payer: Sagamore Health Network All Products |
$776.21
|
| Rate for Payer: Signature Care EPO |
$1,101.60
|
| Rate for Payer: Signature Care EPO |
$1,101.60
|
| Rate for Payer: Signature Care PPO |
$1,101.60
|
| Rate for Payer: Signature Care PPO |
$1,101.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$116,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$116,600.00
|
| Rate for Payer: United Healthcare Commercial |
$878.58
|
| Rate for Payer: United Healthcare Commercial |
$878.58
|
| Rate for Payer: United Healthcare Medicare |
$758.61
|
| Rate for Payer: United Healthcare Medicare |
$758.61
|
|
