|
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 |
$177.13
|
| Rate for Payer: Cash Price |
$175.06
|
| 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 |
$1,169.18
|
| Rate for Payer: Cash Price |
$1,151.24
|
| 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 |
$550.35
|
| Rate for Payer: Cash Price |
$565.32
|
| 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 |
$762.71
|
| Rate for Payer: Cash Price |
$747.10
|
| 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 |
$831.04
|
| 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 |
$857.72
|
| Rate for Payer: Cash Price |
$839.77
|
| 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 |
$1,531.09
|
| Rate for Payer: Cash Price |
$1,511.63
|
| 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 |
$763.18
|
| Rate for Payer: Cash Price |
$780.75
|
| 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 |
$548.90
|
| Rate for Payer: Cash Price |
$559.26
|
| 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 Medicare |
$162.82
|
| Rate for Payer: Molina Healthcare of OH 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 |
$661.65
|
| Rate for Payer: Cash Price |
$654.61
|
| 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 |
$723.48
|
| Rate for Payer: Cash Price |
$713.11
|
| 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 |
$695.59
|
| Rate for Payer: Cash Price |
$687.18
|
| 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 |
$557.76
|
| Rate for Payer: Cash Price |
$570.29
|
| 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 Medicare |
$166.98
|
| Rate for Payer: Molina Healthcare of OH 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 |
$431.07
|
| Rate for Payer: Cash Price |
$420.56
|
| 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 |
$921.37
|
| Rate for Payer: Cash Price |
$902.53
|
| 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 |
$782.95
|
| Rate for Payer: Cash Price |
$756.87
|
| 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 |
$591.48
|
| 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 |
$664.42
|
| Rate for Payer: Cash Price |
$652.67
|
| 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 |
$961.41
|
| Rate for Payer: Cash Price |
$940.68
|
| 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
|
|
|
PR REPAIR NON/MALUNION METATARSAL
|
Professional
|
Both
|
$1,460.32
|
|
|
Service Code
|
CPT 28322
|
| Hospital Charge Code |
z28322
|
| Min. Negotiated Rate |
$294.85 |
| Max. Negotiated Rate |
$81,300.00 |
| Rate for Payer: Aetna Commercial |
$540.82
|
| Rate for Payer: Aetna Commercial |
$540.82
|
| Rate for Payer: Aetna Medicare |
$540.82
|
| Rate for Payer: Aetna Medicare |
$540.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$711.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$711.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$711.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$711.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$711.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$711.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$711.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$711.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$294.85
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$294.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$718.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$718.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$621.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$621.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$594.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$594.90
|
| Rate for Payer: Cash Price |
$887.75
|
| Rate for Payer: Cash Price |
$905.40
|
| Rate for Payer: Centivo All Commercial |
$838.27
|
| Rate for Payer: Centivo All Commercial |
$838.27
|
| Rate for Payer: Cigna All Commercial |
$540.82
|
| Rate for Payer: Cigna All Commercial |
$540.82
|
| Rate for Payer: CORVEL All Commercial |
$540.82
|
| Rate for Payer: CORVEL All Commercial |
$540.82
|
| Rate for Payer: Coventry All Commercial |
$648.98
|
| Rate for Payer: Coventry All Commercial |
$648.98
|
| Rate for Payer: Encore All Commercial |
$540.82
|
| Rate for Payer: Encore All Commercial |
$540.82
|
| Rate for Payer: Frontpath All Commercial |
$743.80
|
| Rate for Payer: Frontpath All Commercial |
$743.80
|
| Rate for Payer: Humana ChoiceCare |
$639.01
|
| Rate for Payer: Humana ChoiceCare |
$639.01
|
| Rate for Payer: Humana Medicare |
$540.82
|
| Rate for Payer: Humana Medicare |
$540.82
|
| Rate for Payer: Lucent All Commercial |
$757.15
|
| Rate for Payer: Lucent All Commercial |
$757.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$867.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$867.00
|
| Rate for Payer: Managed Health Services Medicaid |
$718.25
|
| Rate for Payer: Managed Health Services Medicaid |
$718.25
|
| Rate for Payer: MDWise Medicaid |
$718.25
|
| Rate for Payer: MDWise Medicaid |
$718.25
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$294.85
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$294.85
|
| Rate for Payer: PHCS All Commercial |
$540.82
|
| Rate for Payer: PHCS All Commercial |
$540.82
|
| Rate for Payer: PHP All Commercial |
$920.29
|
| Rate for Payer: PHP All Commercial |
$920.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$540.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$540.82
|
| Rate for Payer: Sagamore Health Network All Products |
$540.82
|
| Rate for Payer: Sagamore Health Network All Products |
$540.82
|
| Rate for Payer: Signature Care EPO |
$1,064.20
|
| Rate for Payer: Signature Care EPO |
$1,064.20
|
| Rate for Payer: Signature Care PPO |
$1,064.20
|
| Rate for Payer: Signature Care PPO |
$1,064.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$81,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$81,300.00
|
| Rate for Payer: United Healthcare Commercial |
$645.21
|
| Rate for Payer: United Healthcare Commercial |
$645.21
|
| Rate for Payer: United Healthcare Medicare |
$715.93
|
| Rate for Payer: United Healthcare Medicare |
$715.93
|
|
|
PR REPAIR NONUNION RADIUS OR ULNA
|
Professional
|
Both
|
$1,489.80
|
|
|
Service Code
|
CPT 25400
|
| Hospital Charge Code |
z25400
|
| Min. Negotiated Rate |
$731.06 |
| Max. Negotiated Rate |
$112,400.00 |
| Rate for Payer: Aetna Commercial |
$749.50
|
| Rate for Payer: Aetna Commercial |
$749.50
|
| Rate for Payer: Aetna Medicare |
$749.50
|
| Rate for Payer: Aetna Medicare |
$749.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,185.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,185.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,185.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,185.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,185.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,185.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,185.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,185.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$732.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$732.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$861.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$861.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$824.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$824.45
|
| Rate for Payer: Cash Price |
$923.68
|
| Rate for Payer: Cash Price |
$906.51
|
| Rate for Payer: Centivo All Commercial |
$1,161.72
|
| Rate for Payer: Centivo All Commercial |
$1,161.72
|
| Rate for Payer: Cigna All Commercial |
$749.50
|
| Rate for Payer: Cigna All Commercial |
$749.50
|
| Rate for Payer: CORVEL All Commercial |
$749.50
|
| Rate for Payer: CORVEL All Commercial |
$749.50
|
| Rate for Payer: Coventry All Commercial |
$899.40
|
| Rate for Payer: Coventry All Commercial |
$899.40
|
| Rate for Payer: Encore All Commercial |
$749.50
|
| Rate for Payer: Encore All Commercial |
$749.50
|
| Rate for Payer: Frontpath All Commercial |
$1,041.85
|
| Rate for Payer: Frontpath All Commercial |
$1,041.85
|
| Rate for Payer: Humana ChoiceCare |
$1,112.92
|
| Rate for Payer: Humana ChoiceCare |
$1,112.92
|
| Rate for Payer: Humana Medicare |
$749.50
|
| Rate for Payer: Humana Medicare |
$749.50
|
| Rate for Payer: Lucent All Commercial |
$1,049.30
|
| Rate for Payer: Lucent All Commercial |
$1,049.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,199.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,199.00
|
| Rate for Payer: Managed Health Services Medicaid |
$732.75
|
| Rate for Payer: Managed Health Services Medicaid |
$732.75
|
| Rate for Payer: MDWise Medicaid |
$732.75
|
| Rate for Payer: MDWise Medicaid |
$732.75
|
| Rate for Payer: PHCS All Commercial |
$749.50
|
| Rate for Payer: PHCS All Commercial |
$749.50
|
| Rate for Payer: PHP All Commercial |
$1,272.05
|
| Rate for Payer: PHP All Commercial |
$1,272.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$749.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$749.50
|
| Rate for Payer: Sagamore Health Network All Products |
$749.50
|
| Rate for Payer: Sagamore Health Network All Products |
$749.50
|
| Rate for Payer: Signature Care EPO |
$1,274.15
|
| Rate for Payer: Signature Care EPO |
$1,274.15
|
| Rate for Payer: Signature Care PPO |
$1,274.15
|
| Rate for Payer: Signature Care PPO |
$1,274.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$112,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$112,400.00
|
| Rate for Payer: United Healthcare Commercial |
$943.65
|
| Rate for Payer: United Healthcare Commercial |
$943.65
|
| Rate for Payer: United Healthcare Medicare |
$731.06
|
| Rate for Payer: United Healthcare Medicare |
$731.06
|
|
|
PR REPAIR OF BICEPS TENDON AT ELBOW
|
Professional
|
Both
|
$1,118.18
|
|
|
Service Code
|
CPT 24340
|
| Hospital Charge Code |
z24340
|
| Min. Negotiated Rate |
$549.22 |
| Max. Negotiated Rate |
$84,400.00 |
| Rate for Payer: Aetna Commercial |
$577.91
|
| Rate for Payer: Aetna Commercial |
$577.91
|
| Rate for Payer: Aetna Medicare |
$577.91
|
| Rate for Payer: Aetna Medicare |
$577.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$743.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$743.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$743.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$743.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$743.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$743.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$743.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$743.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$549.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$549.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$664.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$664.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$635.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$635.70
|
| Rate for Payer: Cash Price |
$693.27
|
| Rate for Payer: Cash Price |
$681.03
|
| Rate for Payer: Centivo All Commercial |
$895.76
|
| Rate for Payer: Centivo All Commercial |
$895.76
|
| Rate for Payer: Cigna All Commercial |
$577.91
|
| Rate for Payer: Cigna All Commercial |
$577.91
|
| Rate for Payer: CORVEL All Commercial |
$577.91
|
| Rate for Payer: CORVEL All Commercial |
$577.91
|
| Rate for Payer: Coventry All Commercial |
$693.49
|
| Rate for Payer: Coventry All Commercial |
$693.49
|
| Rate for Payer: Encore All Commercial |
$577.91
|
| Rate for Payer: Encore All Commercial |
$577.91
|
| Rate for Payer: Frontpath All Commercial |
$802.80
|
| Rate for Payer: Frontpath All Commercial |
$802.80
|
| Rate for Payer: Humana ChoiceCare |
$646.79
|
| Rate for Payer: Humana ChoiceCare |
$646.79
|
| Rate for Payer: Humana Medicare |
$577.91
|
| Rate for Payer: Humana Medicare |
$577.91
|
| Rate for Payer: Lucent All Commercial |
$809.07
|
| Rate for Payer: Lucent All Commercial |
$809.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$901.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$901.00
|
| Rate for Payer: Managed Health Services Medicaid |
$549.97
|
| Rate for Payer: Managed Health Services Medicaid |
$549.97
|
| Rate for Payer: MDWise Medicaid |
$549.97
|
| Rate for Payer: MDWise Medicaid |
$549.97
|
| Rate for Payer: PHCS All Commercial |
$577.91
|
| Rate for Payer: PHCS All Commercial |
$577.91
|
| Rate for Payer: PHP All Commercial |
$955.64
|
| Rate for Payer: PHP All Commercial |
$955.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$577.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$577.91
|
| Rate for Payer: Sagamore Health Network All Products |
$577.91
|
| Rate for Payer: Sagamore Health Network All Products |
$577.91
|
| Rate for Payer: Signature Care EPO |
$862.75
|
| Rate for Payer: Signature Care EPO |
$862.75
|
| Rate for Payer: Signature Care PPO |
$862.75
|
| Rate for Payer: Signature Care PPO |
$862.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$84,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$84,400.00
|
| Rate for Payer: United Healthcare Commercial |
$657.15
|
| Rate for Payer: United Healthcare Commercial |
$657.15
|
| Rate for Payer: United Healthcare Medicare |
$549.22
|
| Rate for Payer: United Healthcare Medicare |
$549.22
|
|
|
PR REPAIR OF PERINEUM,NON OBSTETRICAL
|
Professional
|
Both
|
$508.64
|
|
|
Service Code
|
CPT 56810
|
| Hospital Charge Code |
z56810
|
| Min. Negotiated Rate |
$248.74 |
| Max. Negotiated Rate |
$33,100.00 |
| Rate for Payer: Aetna Commercial |
$256.89
|
| Rate for Payer: Aetna Commercial |
$256.89
|
| Rate for Payer: Aetna Medicare |
$256.89
|
| Rate for Payer: Aetna Medicare |
$256.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$338.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$338.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$250.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$250.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$295.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$295.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$282.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$282.58
|
| Rate for Payer: Cash Price |
$315.36
|
| Rate for Payer: Cash Price |
$308.44
|
| Rate for Payer: Centivo All Commercial |
$398.18
|
| Rate for Payer: Centivo All Commercial |
$398.18
|
| Rate for Payer: Cigna All Commercial |
$256.89
|
| Rate for Payer: Cigna All Commercial |
$256.89
|
| Rate for Payer: CORVEL All Commercial |
$256.89
|
| Rate for Payer: CORVEL All Commercial |
$256.89
|
| Rate for Payer: Coventry All Commercial |
$308.27
|
| Rate for Payer: Coventry All Commercial |
$308.27
|
| Rate for Payer: Encore All Commercial |
$256.89
|
| Rate for Payer: Encore All Commercial |
$256.89
|
| Rate for Payer: Frontpath All Commercial |
$355.03
|
| Rate for Payer: Frontpath All Commercial |
$355.03
|
| Rate for Payer: Humana ChoiceCare |
$284.54
|
| Rate for Payer: Humana ChoiceCare |
$284.54
|
| Rate for Payer: Humana Medicare |
$256.89
|
| Rate for Payer: Humana Medicare |
$256.89
|
| Rate for Payer: Lucent All Commercial |
$359.65
|
| Rate for Payer: Lucent All Commercial |
$359.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$357.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$357.00
|
| Rate for Payer: Managed Health Services Medicaid |
$250.17
|
| Rate for Payer: Managed Health Services Medicaid |
$250.17
|
| Rate for Payer: MDWise Medicaid |
$250.17
|
| Rate for Payer: MDWise Medicaid |
$250.17
|
| Rate for Payer: PHCS All Commercial |
$256.89
|
| Rate for Payer: PHCS All Commercial |
$256.89
|
| Rate for Payer: PHP All Commercial |
$328.34
|
| Rate for Payer: PHP All Commercial |
$328.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$256.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$256.89
|
| Rate for Payer: Sagamore Health Network All Products |
$256.89
|
| Rate for Payer: Sagamore Health Network All Products |
$256.89
|
| Rate for Payer: Signature Care EPO |
$320.45
|
| Rate for Payer: Signature Care EPO |
$320.45
|
| Rate for Payer: Signature Care PPO |
$320.45
|
| Rate for Payer: Signature Care PPO |
$320.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$33,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$33,100.00
|
| Rate for Payer: United Healthcare Commercial |
$294.69
|
| Rate for Payer: United Healthcare Commercial |
$294.69
|
| Rate for Payer: United Healthcare Medicare |
$248.74
|
| Rate for Payer: United Healthcare Medicare |
$248.74
|
|
|
PR REPAIR OF RUPTURED UTERUS
|
Professional
|
Both
|
$494.58
|
|
|
Service Code
|
CPT 59350
|
| Hospital Charge Code |
z59350
|
| Min. Negotiated Rate |
$243.26 |
| Max. Negotiated Rate |
$32,500.00 |
| Rate for Payer: Aetna Commercial |
$251.57
|
| Rate for Payer: Aetna Commercial |
$251.57
|
| Rate for Payer: Aetna Medicare |
$251.57
|
| Rate for Payer: Aetna Medicare |
$251.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$391.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$391.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$391.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$391.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$391.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$391.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$391.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$391.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$243.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$243.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$289.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$289.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$276.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$276.73
|
| Rate for Payer: Cash Price |
$306.64
|
| Rate for Payer: Cash Price |
$302.86
|
| Rate for Payer: Centivo All Commercial |
$389.93
|
| Rate for Payer: Centivo All Commercial |
$389.93
|
| Rate for Payer: Cigna All Commercial |
$251.57
|
| Rate for Payer: Cigna All Commercial |
$251.57
|
| Rate for Payer: CORVEL All Commercial |
$251.57
|
| Rate for Payer: CORVEL All Commercial |
$251.57
|
| Rate for Payer: Coventry All Commercial |
$301.88
|
| Rate for Payer: Coventry All Commercial |
$301.88
|
| Rate for Payer: Encore All Commercial |
$251.57
|
| Rate for Payer: Encore All Commercial |
$251.57
|
| Rate for Payer: Frontpath All Commercial |
$362.37
|
| Rate for Payer: Frontpath All Commercial |
$362.37
|
| Rate for Payer: Humana ChoiceCare |
$271.10
|
| Rate for Payer: Humana ChoiceCare |
$271.10
|
| Rate for Payer: Humana Medicare |
$251.57
|
| Rate for Payer: Humana Medicare |
$251.57
|
| Rate for Payer: Lucent All Commercial |
$352.20
|
| Rate for Payer: Lucent All Commercial |
$352.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$350.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$350.00
|
| Rate for Payer: Managed Health Services Medicaid |
$243.26
|
| Rate for Payer: Managed Health Services Medicaid |
$243.26
|
| Rate for Payer: MDWise Medicaid |
$243.26
|
| Rate for Payer: MDWise Medicaid |
$243.26
|
| Rate for Payer: PHCS All Commercial |
$251.57
|
| Rate for Payer: PHCS All Commercial |
$251.57
|
| Rate for Payer: PHP All Commercial |
$322.40
|
| Rate for Payer: PHP All Commercial |
$322.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$251.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$251.57
|
| Rate for Payer: Sagamore Health Network All Products |
$251.57
|
| Rate for Payer: Sagamore Health Network All Products |
$251.57
|
| Rate for Payer: Signature Care EPO |
$351.05
|
| Rate for Payer: Signature Care EPO |
$351.05
|
| Rate for Payer: Signature Care PPO |
$351.05
|
| Rate for Payer: Signature Care PPO |
$351.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,500.00
|
| Rate for Payer: United Healthcare Commercial |
$314.73
|
| Rate for Payer: United Healthcare Commercial |
$314.73
|
| Rate for Payer: United Healthcare Medicare |
$244.24
|
| Rate for Payer: United Healthcare Medicare |
$244.24
|
|
|
PR REPAIR RECURR INGUIN HERN,REDUCIBL
|
Professional
|
Both
|
$1,153.12
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
z49520
|
| Min. Negotiated Rate |
$566.34 |
| Max. Negotiated Rate |
$81,200.00 |
| Rate for Payer: Aetna Commercial |
$587.92
|
| Rate for Payer: Aetna Commercial |
$587.92
|
| Rate for Payer: Aetna Medicare |
$587.92
|
| Rate for Payer: Aetna Medicare |
$587.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$672.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$672.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$567.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$567.15
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$676.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$676.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$646.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$646.71
|
| Rate for Payer: Cash Price |
$714.93
|
| Rate for Payer: Cash Price |
$702.26
|
| Rate for Payer: Centivo All Commercial |
$911.28
|
| Rate for Payer: Centivo All Commercial |
$911.28
|
| Rate for Payer: Cigna All Commercial |
$587.92
|
| Rate for Payer: Cigna All Commercial |
$587.92
|
| Rate for Payer: CORVEL All Commercial |
$587.92
|
| Rate for Payer: CORVEL All Commercial |
$587.92
|
| Rate for Payer: Coventry All Commercial |
$705.50
|
| Rate for Payer: Coventry All Commercial |
$705.50
|
| Rate for Payer: Encore All Commercial |
$587.92
|
| Rate for Payer: Encore All Commercial |
$587.92
|
| Rate for Payer: Frontpath All Commercial |
$838.55
|
| Rate for Payer: Frontpath All Commercial |
$838.55
|
| Rate for Payer: Humana ChoiceCare |
$644.19
|
| Rate for Payer: Humana ChoiceCare |
$644.19
|
| Rate for Payer: Humana Medicare |
$587.92
|
| Rate for Payer: Humana Medicare |
$587.92
|
| Rate for Payer: Lucent All Commercial |
$823.09
|
| Rate for Payer: Lucent All Commercial |
$823.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$871.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$871.00
|
| Rate for Payer: Managed Health Services Medicaid |
$567.15
|
| Rate for Payer: Managed Health Services Medicaid |
$567.15
|
| Rate for Payer: MDWise Medicaid |
$567.15
|
| Rate for Payer: MDWise Medicaid |
$567.15
|
| Rate for Payer: PHCS All Commercial |
$587.92
|
| Rate for Payer: PHCS All Commercial |
$587.92
|
| Rate for Payer: PHP All Commercial |
$991.09
|
| Rate for Payer: PHP All Commercial |
$991.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$587.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$587.92
|
| Rate for Payer: Sagamore Health Network All Products |
$587.92
|
| Rate for Payer: Sagamore Health Network All Products |
$587.92
|
| Rate for Payer: Signature Care EPO |
$812.60
|
| Rate for Payer: Signature Care EPO |
$812.60
|
| Rate for Payer: Signature Care PPO |
$812.60
|
| Rate for Payer: Signature Care PPO |
$812.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$81,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$81,200.00
|
| Rate for Payer: United Healthcare Commercial |
$667.58
|
| Rate for Payer: United Healthcare Commercial |
$667.58
|
| Rate for Payer: United Healthcare Medicare |
$566.34
|
| Rate for Payer: United Healthcare Medicare |
$566.34
|
|
