|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Professional
|
Both
|
$1,103.10
|
|
|
Service Code
|
CPT 29823
|
| Hospital Charge Code |
z29823
|
| Min. Negotiated Rate |
$539.80 |
| Max. Negotiated Rate |
$83,000.00 |
| Rate for Payer: Aetna Commercial |
$553.39
|
| Rate for Payer: Aetna Commercial |
$553.39
|
| Rate for Payer: Aetna Medicare |
$553.39
|
| Rate for Payer: Aetna Medicare |
$553.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$862.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$862.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$862.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$862.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$862.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$862.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$862.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$862.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$542.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$542.55
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$636.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$636.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$608.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$608.73
|
| Rate for Payer: Cash Price |
$683.92
|
| Rate for Payer: Cash Price |
$669.35
|
| Rate for Payer: Centivo All Commercial |
$857.75
|
| Rate for Payer: Centivo All Commercial |
$857.75
|
| Rate for Payer: Cigna All Commercial |
$553.39
|
| Rate for Payer: Cigna All Commercial |
$553.39
|
| Rate for Payer: CORVEL All Commercial |
$553.39
|
| Rate for Payer: CORVEL All Commercial |
$553.39
|
| Rate for Payer: Coventry All Commercial |
$664.07
|
| Rate for Payer: Coventry All Commercial |
$664.07
|
| Rate for Payer: Encore All Commercial |
$553.39
|
| Rate for Payer: Encore All Commercial |
$553.39
|
| Rate for Payer: Frontpath All Commercial |
$768.56
|
| Rate for Payer: Frontpath All Commercial |
$768.56
|
| Rate for Payer: Humana ChoiceCare |
$669.46
|
| Rate for Payer: Humana ChoiceCare |
$669.46
|
| Rate for Payer: Humana Medicare |
$553.39
|
| Rate for Payer: Humana Medicare |
$553.39
|
| Rate for Payer: Lucent All Commercial |
$774.75
|
| Rate for Payer: Lucent All Commercial |
$774.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$885.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$885.00
|
| Rate for Payer: Managed Health Services Medicaid |
$542.55
|
| Rate for Payer: Managed Health Services Medicaid |
$542.55
|
| Rate for Payer: MDWise Medicaid |
$542.55
|
| Rate for Payer: MDWise Medicaid |
$542.55
|
| Rate for Payer: PHCS All Commercial |
$553.39
|
| Rate for Payer: PHCS All Commercial |
$553.39
|
| Rate for Payer: PHP All Commercial |
$939.25
|
| Rate for Payer: PHP All Commercial |
$939.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$553.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$553.39
|
| Rate for Payer: Sagamore Health Network All Products |
$553.39
|
| Rate for Payer: Sagamore Health Network All Products |
$553.39
|
| Rate for Payer: Signature Care EPO |
$926.50
|
| Rate for Payer: Signature Care EPO |
$926.50
|
| Rate for Payer: Signature Care PPO |
$926.50
|
| Rate for Payer: Signature Care PPO |
$926.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$83,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$83,000.00
|
| Rate for Payer: United Healthcare Commercial |
$677.75
|
| Rate for Payer: United Healthcare Commercial |
$677.75
|
| Rate for Payer: United Healthcare Medicare |
$539.80
|
| Rate for Payer: United Healthcare Medicare |
$539.80
|
|
|
PR SURG RX INCOMPLETE ABORTN
|
Professional
|
Both
|
$660.22
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
z59812
|
| Min. Negotiated Rate |
$169.93 |
| Max. Negotiated Rate |
$36,400.00 |
| Rate for Payer: Aetna Commercial |
$282.16
|
| Rate for Payer: Aetna Commercial |
$282.16
|
| Rate for Payer: Aetna Medicare |
$282.16
|
| Rate for Payer: Aetna Medicare |
$282.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$367.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$367.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$367.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$367.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$367.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$367.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$367.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$367.12
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$169.93
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$169.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$324.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$324.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$324.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$324.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$310.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$310.38
|
| Rate for Payer: Cash Price |
$403.02
|
| Rate for Payer: Cash Price |
$409.34
|
| Rate for Payer: Centivo All Commercial |
$437.35
|
| Rate for Payer: Centivo All Commercial |
$437.35
|
| Rate for Payer: Cigna All Commercial |
$282.16
|
| Rate for Payer: Cigna All Commercial |
$282.16
|
| Rate for Payer: CORVEL All Commercial |
$282.16
|
| Rate for Payer: CORVEL All Commercial |
$282.16
|
| Rate for Payer: Coventry All Commercial |
$338.59
|
| Rate for Payer: Coventry All Commercial |
$338.59
|
| Rate for Payer: Encore All Commercial |
$282.16
|
| Rate for Payer: Encore All Commercial |
$282.16
|
| Rate for Payer: Frontpath All Commercial |
$398.55
|
| Rate for Payer: Frontpath All Commercial |
$398.55
|
| Rate for Payer: Humana ChoiceCare |
$254.84
|
| Rate for Payer: Humana ChoiceCare |
$254.84
|
| Rate for Payer: Humana Medicare |
$282.16
|
| Rate for Payer: Humana Medicare |
$282.16
|
| Rate for Payer: Lucent All Commercial |
$395.02
|
| Rate for Payer: Lucent All Commercial |
$395.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$393.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$393.00
|
| Rate for Payer: Managed Health Services Medicaid |
$324.72
|
| Rate for Payer: Managed Health Services Medicaid |
$324.72
|
| Rate for Payer: MDWise Medicaid |
$324.72
|
| Rate for Payer: MDWise Medicaid |
$324.72
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$169.93
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$169.93
|
| Rate for Payer: PHCS All Commercial |
$282.16
|
| Rate for Payer: PHCS All Commercial |
$282.16
|
| Rate for Payer: PHP All Commercial |
$361.05
|
| Rate for Payer: PHP All Commercial |
$361.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$282.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$282.16
|
| Rate for Payer: Sagamore Health Network All Products |
$282.16
|
| Rate for Payer: Sagamore Health Network All Products |
$282.16
|
| Rate for Payer: Signature Care EPO |
$324.70
|
| Rate for Payer: Signature Care EPO |
$324.70
|
| Rate for Payer: Signature Care PPO |
$324.70
|
| Rate for Payer: Signature Care PPO |
$324.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$36,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$36,400.00
|
| Rate for Payer: United Healthcare Commercial |
$324.96
|
| Rate for Payer: United Healthcare Commercial |
$324.96
|
| Rate for Payer: United Healthcare Medicare |
$325.02
|
| Rate for Payer: United Healthcare Medicare |
$325.02
|
|
|
PR SURG RX MISSED ABORTN,1ST TRI
|
Professional
|
Both
|
$803.04
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
z59820
|
| Min. Negotiated Rate |
$200.62 |
| Max. Negotiated Rate |
$46,000.00 |
| Rate for Payer: Aetna Commercial |
$354.15
|
| Rate for Payer: Aetna Commercial |
$354.15
|
| Rate for Payer: Aetna Medicare |
$354.15
|
| Rate for Payer: Aetna Medicare |
$354.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$459.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$459.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$459.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$459.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$459.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$459.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$459.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$459.14
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$200.62
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$200.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$394.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$394.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$407.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$407.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$389.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$389.56
|
| Rate for Payer: Cash Price |
$489.01
|
| Rate for Payer: Cash Price |
$497.88
|
| Rate for Payer: Centivo All Commercial |
$548.93
|
| Rate for Payer: Centivo All Commercial |
$548.93
|
| Rate for Payer: Cigna All Commercial |
$354.15
|
| Rate for Payer: Cigna All Commercial |
$354.15
|
| Rate for Payer: CORVEL All Commercial |
$354.15
|
| Rate for Payer: CORVEL All Commercial |
$354.15
|
| Rate for Payer: Coventry All Commercial |
$424.98
|
| Rate for Payer: Coventry All Commercial |
$424.98
|
| Rate for Payer: Encore All Commercial |
$354.15
|
| Rate for Payer: Encore All Commercial |
$354.15
|
| Rate for Payer: Frontpath All Commercial |
$494.80
|
| Rate for Payer: Frontpath All Commercial |
$494.80
|
| Rate for Payer: Humana ChoiceCare |
$289.86
|
| Rate for Payer: Humana ChoiceCare |
$289.86
|
| Rate for Payer: Humana Medicare |
$354.15
|
| Rate for Payer: Humana Medicare |
$354.15
|
| Rate for Payer: Lucent All Commercial |
$495.81
|
| Rate for Payer: Lucent All Commercial |
$495.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$495.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$495.00
|
| Rate for Payer: Managed Health Services Medicaid |
$394.97
|
| Rate for Payer: Managed Health Services Medicaid |
$394.97
|
| Rate for Payer: MDWise Medicaid |
$394.97
|
| Rate for Payer: MDWise Medicaid |
$394.97
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$200.62
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$200.62
|
| Rate for Payer: PHCS All Commercial |
$354.15
|
| Rate for Payer: PHCS All Commercial |
$354.15
|
| Rate for Payer: PHP All Commercial |
$455.35
|
| Rate for Payer: PHP All Commercial |
$455.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$354.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$354.15
|
| Rate for Payer: Sagamore Health Network All Products |
$354.15
|
| Rate for Payer: Sagamore Health Network All Products |
$354.15
|
| Rate for Payer: Signature Care EPO |
$371.45
|
| Rate for Payer: Signature Care EPO |
$371.45
|
| Rate for Payer: Signature Care PPO |
$371.45
|
| Rate for Payer: Signature Care PPO |
$371.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,000.00
|
| Rate for Payer: United Healthcare Commercial |
$382.33
|
| Rate for Payer: United Healthcare Commercial |
$382.33
|
| Rate for Payer: United Healthcare Medicare |
$394.36
|
| Rate for Payer: United Healthcare Medicare |
$394.36
|
|
|
PR SURG RX MISSED ABORTN,2ND TRI
|
Professional
|
Both
|
$789.44
|
|
|
Service Code
|
CPT 59821
|
| Hospital Charge Code |
z59821
|
| Min. Negotiated Rate |
$194.66 |
| Max. Negotiated Rate |
$44,800.00 |
| Rate for Payer: Aetna Commercial |
$345.87
|
| Rate for Payer: Aetna Commercial |
$345.87
|
| Rate for Payer: Aetna Medicare |
$345.87
|
| Rate for Payer: Aetna Medicare |
$345.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$479.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$479.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$479.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$479.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$479.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$479.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$479.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$479.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$194.66
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$194.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$388.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$388.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$397.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$397.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$380.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$380.46
|
| Rate for Payer: Cash Price |
$481.41
|
| Rate for Payer: Cash Price |
$489.45
|
| Rate for Payer: Centivo All Commercial |
$536.10
|
| Rate for Payer: Centivo All Commercial |
$536.10
|
| Rate for Payer: Cigna All Commercial |
$345.87
|
| Rate for Payer: Cigna All Commercial |
$345.87
|
| Rate for Payer: CORVEL All Commercial |
$345.87
|
| Rate for Payer: CORVEL All Commercial |
$345.87
|
| Rate for Payer: Coventry All Commercial |
$415.04
|
| Rate for Payer: Coventry All Commercial |
$415.04
|
| Rate for Payer: Encore All Commercial |
$345.87
|
| Rate for Payer: Encore All Commercial |
$345.87
|
| Rate for Payer: Frontpath All Commercial |
$486.37
|
| Rate for Payer: Frontpath All Commercial |
$486.37
|
| Rate for Payer: Humana ChoiceCare |
$303.62
|
| Rate for Payer: Humana ChoiceCare |
$303.62
|
| Rate for Payer: Humana Medicare |
$345.87
|
| Rate for Payer: Humana Medicare |
$345.87
|
| Rate for Payer: Lucent All Commercial |
$484.22
|
| Rate for Payer: Lucent All Commercial |
$484.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$483.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$483.00
|
| Rate for Payer: Managed Health Services Medicaid |
$388.28
|
| Rate for Payer: Managed Health Services Medicaid |
$388.28
|
| Rate for Payer: MDWise Medicaid |
$388.28
|
| Rate for Payer: MDWise Medicaid |
$388.28
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$194.66
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$194.66
|
| Rate for Payer: PHCS All Commercial |
$345.87
|
| Rate for Payer: PHCS All Commercial |
$345.87
|
| Rate for Payer: PHP All Commercial |
$444.48
|
| Rate for Payer: PHP All Commercial |
$444.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$345.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$345.87
|
| Rate for Payer: Sagamore Health Network All Products |
$345.87
|
| Rate for Payer: Sagamore Health Network All Products |
$345.87
|
| Rate for Payer: Signature Care EPO |
$392.70
|
| Rate for Payer: Signature Care EPO |
$392.70
|
| Rate for Payer: Signature Care PPO |
$392.70
|
| Rate for Payer: Signature Care PPO |
$392.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,800.00
|
| Rate for Payer: United Healthcare Commercial |
$388.44
|
| Rate for Payer: United Healthcare Commercial |
$388.44
|
| Rate for Payer: United Healthcare Medicare |
$388.23
|
| Rate for Payer: United Healthcare Medicare |
$388.23
|
|
|
PR SUSPENSION OF VAGINA,ABD APPRCH
|
Professional
|
Both
|
$1,792.84
|
|
|
Service Code
|
CPT 57280
|
| Hospital Charge Code |
z57280
|
| Min. Negotiated Rate |
$881.79 |
| Max. Negotiated Rate |
$117,600.00 |
| Rate for Payer: Aetna Commercial |
$914.14
|
| Rate for Payer: Aetna Commercial |
$914.14
|
| Rate for Payer: Aetna Medicare |
$914.14
|
| Rate for Payer: Aetna Medicare |
$914.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,178.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,178.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,178.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,178.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,178.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,178.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,178.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,178.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$881.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$881.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,051.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,051.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,005.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,005.55
|
| Rate for Payer: Cash Price |
$1,111.56
|
| Rate for Payer: Cash Price |
$1,094.56
|
| Rate for Payer: Centivo All Commercial |
$1,416.92
|
| Rate for Payer: Centivo All Commercial |
$1,416.92
|
| Rate for Payer: Cigna All Commercial |
$914.14
|
| Rate for Payer: Cigna All Commercial |
$914.14
|
| Rate for Payer: CORVEL All Commercial |
$914.14
|
| Rate for Payer: CORVEL All Commercial |
$914.14
|
| Rate for Payer: Coventry All Commercial |
$1,096.97
|
| Rate for Payer: Coventry All Commercial |
$1,096.97
|
| Rate for Payer: Encore All Commercial |
$914.14
|
| Rate for Payer: Encore All Commercial |
$914.14
|
| Rate for Payer: Frontpath All Commercial |
$1,266.34
|
| Rate for Payer: Frontpath All Commercial |
$1,266.34
|
| Rate for Payer: Humana ChoiceCare |
$994.75
|
| Rate for Payer: Humana ChoiceCare |
$994.75
|
| Rate for Payer: Humana Medicare |
$914.14
|
| Rate for Payer: Humana Medicare |
$914.14
|
| Rate for Payer: Lucent All Commercial |
$1,279.80
|
| Rate for Payer: Lucent All Commercial |
$1,279.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,267.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,267.00
|
| Rate for Payer: Managed Health Services Medicaid |
$881.79
|
| Rate for Payer: Managed Health Services Medicaid |
$881.79
|
| Rate for Payer: MDWise Medicaid |
$881.79
|
| Rate for Payer: MDWise Medicaid |
$881.79
|
| Rate for Payer: PHCS All Commercial |
$914.14
|
| Rate for Payer: PHCS All Commercial |
$914.14
|
| Rate for Payer: PHP All Commercial |
$1,165.18
|
| Rate for Payer: PHP All Commercial |
$1,165.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$914.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$914.14
|
| Rate for Payer: Sagamore Health Network All Products |
$914.14
|
| Rate for Payer: Sagamore Health Network All Products |
$914.14
|
| Rate for Payer: Signature Care EPO |
$1,120.30
|
| Rate for Payer: Signature Care EPO |
$1,120.30
|
| Rate for Payer: Signature Care PPO |
$1,120.30
|
| Rate for Payer: Signature Care PPO |
$1,120.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117,600.00
|
| Rate for Payer: United Healthcare Commercial |
$1,095.11
|
| Rate for Payer: United Healthcare Commercial |
$1,095.11
|
| Rate for Payer: United Healthcare Medicare |
$882.71
|
| Rate for Payer: United Healthcare Medicare |
$882.71
|
|
|
PR SUTURE LRG INTEST
|
Professional
|
Both
|
$1,907.48
|
|
|
Service Code
|
CPT 44604
|
| Hospital Charge Code |
z44604
|
| Min. Negotiated Rate |
$938.18 |
| Max. Negotiated Rate |
$134,900.00 |
| Rate for Payer: Aetna Commercial |
$976.45
|
| Rate for Payer: Aetna Commercial |
$976.45
|
| Rate for Payer: Aetna Medicare |
$976.45
|
| Rate for Payer: Aetna Medicare |
$976.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,094.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,094.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,094.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,094.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,094.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,094.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,094.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,094.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$938.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$938.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,122.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,122.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,074.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,074.10
|
| Rate for Payer: Cash Price |
$1,182.64
|
| Rate for Payer: Cash Price |
$1,165.50
|
| Rate for Payer: Centivo All Commercial |
$1,513.50
|
| Rate for Payer: Centivo All Commercial |
$1,513.50
|
| Rate for Payer: Cigna All Commercial |
$976.45
|
| Rate for Payer: Cigna All Commercial |
$976.45
|
| Rate for Payer: CORVEL All Commercial |
$976.45
|
| Rate for Payer: CORVEL All Commercial |
$976.45
|
| Rate for Payer: Coventry All Commercial |
$1,171.74
|
| Rate for Payer: Coventry All Commercial |
$1,171.74
|
| Rate for Payer: Encore All Commercial |
$976.45
|
| Rate for Payer: Encore All Commercial |
$976.45
|
| Rate for Payer: Frontpath All Commercial |
$1,390.99
|
| Rate for Payer: Frontpath All Commercial |
$1,390.99
|
| Rate for Payer: Humana ChoiceCare |
$1,033.91
|
| Rate for Payer: Humana ChoiceCare |
$1,033.91
|
| Rate for Payer: Humana Medicare |
$976.45
|
| Rate for Payer: Humana Medicare |
$976.45
|
| Rate for Payer: Lucent All Commercial |
$1,367.03
|
| Rate for Payer: Lucent All Commercial |
$1,367.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,445.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,445.00
|
| Rate for Payer: Managed Health Services Medicaid |
$938.18
|
| Rate for Payer: Managed Health Services Medicaid |
$938.18
|
| Rate for Payer: MDWise Medicaid |
$938.18
|
| Rate for Payer: MDWise Medicaid |
$938.18
|
| Rate for Payer: PHCS All Commercial |
$976.45
|
| Rate for Payer: PHCS All Commercial |
$976.45
|
| Rate for Payer: PHP All Commercial |
$1,644.86
|
| Rate for Payer: PHP All Commercial |
$1,644.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$976.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$976.45
|
| Rate for Payer: Sagamore Health Network All Products |
$976.45
|
| Rate for Payer: Sagamore Health Network All Products |
$976.45
|
| Rate for Payer: Signature Care EPO |
$1,301.35
|
| Rate for Payer: Signature Care EPO |
$1,301.35
|
| Rate for Payer: Signature Care PPO |
$1,301.35
|
| Rate for Payer: Signature Care PPO |
$1,301.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$134,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$134,900.00
|
| Rate for Payer: United Healthcare Commercial |
$1,135.91
|
| Rate for Payer: United Healthcare Commercial |
$1,135.91
|
| Rate for Payer: United Healthcare Medicare |
$939.92
|
| Rate for Payer: United Healthcare Medicare |
$939.92
|
|
|
PR SUTURE OF MESENTERY
|
Professional
|
Both
|
$1,361.40
|
|
|
Service Code
|
CPT 44850
|
| Hospital Charge Code |
z44850
|
| Min. Negotiated Rate |
$667.22 |
| Max. Negotiated Rate |
$95,700.00 |
| Rate for Payer: Aetna Commercial |
$696.67
|
| Rate for Payer: Aetna Commercial |
$696.67
|
| Rate for Payer: Aetna Medicare |
$696.67
|
| Rate for Payer: Aetna Medicare |
$696.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$754.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$754.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$754.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$754.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$754.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$754.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$754.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$754.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$669.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$669.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$801.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$801.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$766.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$766.34
|
| Rate for Payer: Cash Price |
$844.07
|
| Rate for Payer: Cash Price |
$827.35
|
| Rate for Payer: Centivo All Commercial |
$1,079.84
|
| Rate for Payer: Centivo All Commercial |
$1,079.84
|
| Rate for Payer: Cigna All Commercial |
$696.67
|
| Rate for Payer: Cigna All Commercial |
$696.67
|
| Rate for Payer: CORVEL All Commercial |
$696.67
|
| Rate for Payer: CORVEL All Commercial |
$696.67
|
| Rate for Payer: Coventry All Commercial |
$836.00
|
| Rate for Payer: Coventry All Commercial |
$836.00
|
| Rate for Payer: Encore All Commercial |
$696.67
|
| Rate for Payer: Encore All Commercial |
$696.67
|
| Rate for Payer: Frontpath All Commercial |
$990.66
|
| Rate for Payer: Frontpath All Commercial |
$990.66
|
| Rate for Payer: Humana ChoiceCare |
$719.70
|
| Rate for Payer: Humana ChoiceCare |
$719.70
|
| Rate for Payer: Humana Medicare |
$696.67
|
| Rate for Payer: Humana Medicare |
$696.67
|
| Rate for Payer: Lucent All Commercial |
$975.34
|
| Rate for Payer: Lucent All Commercial |
$975.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$669.59
|
| Rate for Payer: Managed Health Services Medicaid |
$669.59
|
| Rate for Payer: MDWise Medicaid |
$669.59
|
| Rate for Payer: MDWise Medicaid |
$669.59
|
| Rate for Payer: PHCS All Commercial |
$696.67
|
| Rate for Payer: PHCS All Commercial |
$696.67
|
| Rate for Payer: PHP All Commercial |
$1,167.64
|
| Rate for Payer: PHP All Commercial |
$1,167.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$696.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$696.67
|
| Rate for Payer: Sagamore Health Network All Products |
$696.67
|
| Rate for Payer: Sagamore Health Network All Products |
$696.67
|
| Rate for Payer: Signature Care EPO |
$908.65
|
| Rate for Payer: Signature Care EPO |
$908.65
|
| Rate for Payer: Signature Care PPO |
$908.65
|
| Rate for Payer: Signature Care PPO |
$908.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$95,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$95,700.00
|
| Rate for Payer: United Healthcare Commercial |
$789.30
|
| Rate for Payer: United Healthcare Commercial |
$789.30
|
| Rate for Payer: United Healthcare Medicare |
$667.22
|
| Rate for Payer: United Healthcare Medicare |
$667.22
|
|
|
PR SUTURE SM INTEST,SINGLE PERF
|
Professional
|
Both
|
$2,533.64
|
|
|
Service Code
|
CPT 44602
|
| Hospital Charge Code |
z44602
|
| Min. Negotiated Rate |
$868.60 |
| Max. Negotiated Rate |
$179,400.00 |
| Rate for Payer: Aetna Commercial |
$1,301.38
|
| Rate for Payer: Aetna Commercial |
$1,301.38
|
| Rate for Payer: Aetna Medicare |
$1,301.38
|
| Rate for Payer: Aetna Medicare |
$1,301.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$868.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$868.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$868.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$868.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$868.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$868.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$868.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$868.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,246.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,246.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,496.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,496.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,431.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,431.52
|
| Rate for Payer: Cash Price |
$1,570.86
|
| Rate for Payer: Cash Price |
$1,550.05
|
| Rate for Payer: Centivo All Commercial |
$2,017.14
|
| Rate for Payer: Centivo All Commercial |
$2,017.14
|
| Rate for Payer: Cigna All Commercial |
$1,301.38
|
| Rate for Payer: Cigna All Commercial |
$1,301.38
|
| Rate for Payer: CORVEL All Commercial |
$1,301.38
|
| Rate for Payer: CORVEL All Commercial |
$1,301.38
|
| Rate for Payer: Coventry All Commercial |
$1,561.66
|
| Rate for Payer: Coventry All Commercial |
$1,561.66
|
| Rate for Payer: Encore All Commercial |
$1,301.38
|
| Rate for Payer: Encore All Commercial |
$1,301.38
|
| Rate for Payer: Frontpath All Commercial |
$1,863.10
|
| Rate for Payer: Frontpath All Commercial |
$1,863.10
|
| Rate for Payer: Humana ChoiceCare |
$1,031.44
|
| Rate for Payer: Humana ChoiceCare |
$1,031.44
|
| Rate for Payer: Humana Medicare |
$1,301.38
|
| Rate for Payer: Humana Medicare |
$1,301.38
|
| Rate for Payer: Lucent All Commercial |
$1,821.93
|
| Rate for Payer: Lucent All Commercial |
$1,821.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,922.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,922.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,246.14
|
| Rate for Payer: Managed Health Services Medicaid |
$1,246.14
|
| Rate for Payer: MDWise Medicaid |
$1,246.14
|
| Rate for Payer: MDWise Medicaid |
$1,246.14
|
| Rate for Payer: PHCS All Commercial |
$1,301.38
|
| Rate for Payer: PHCS All Commercial |
$1,301.38
|
| Rate for Payer: PHP All Commercial |
$2,187.57
|
| Rate for Payer: PHP All Commercial |
$2,187.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,301.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,301.38
|
| Rate for Payer: Sagamore Health Network All Products |
$1,301.38
|
| Rate for Payer: Sagamore Health Network All Products |
$1,301.38
|
| Rate for Payer: Signature Care EPO |
$1,286.90
|
| Rate for Payer: Signature Care EPO |
$1,286.90
|
| Rate for Payer: Signature Care PPO |
$1,286.90
|
| Rate for Payer: Signature Care PPO |
$1,286.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$179,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$179,400.00
|
| Rate for Payer: United Healthcare Commercial |
$1,480.99
|
| Rate for Payer: United Healthcare Commercial |
$1,480.99
|
| Rate for Payer: United Healthcare Medicare |
$1,250.04
|
| Rate for Payer: United Healthcare Medicare |
$1,250.04
|
|
|
PR SYNTHETIC SENTENCE TEST
|
Professional
|
Both
|
$78.28
|
|
|
Service Code
|
CPT 92576
|
| Hospital Charge Code |
z92576
|
| Min. Negotiated Rate |
$17.90 |
| Max. Negotiated Rate |
$4,400.00 |
| Rate for Payer: Aetna Commercial |
$34.73
|
| Rate for Payer: Aetna Commercial |
$34.73
|
| Rate for Payer: Aetna Medicare |
$34.73
|
| Rate for Payer: Aetna Medicare |
$34.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$17.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$17.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$17.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$17.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$38.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$38.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.20
|
| Rate for Payer: Cash Price |
$48.53
|
| Rate for Payer: Cash Price |
$44.27
|
| Rate for Payer: Centivo All Commercial |
$53.83
|
| Rate for Payer: Centivo All Commercial |
$53.83
|
| Rate for Payer: Cigna All Commercial |
$34.73
|
| Rate for Payer: Cigna All Commercial |
$34.73
|
| Rate for Payer: CORVEL All Commercial |
$34.73
|
| Rate for Payer: CORVEL All Commercial |
$34.73
|
| Rate for Payer: Coventry All Commercial |
$41.68
|
| Rate for Payer: Coventry All Commercial |
$41.68
|
| Rate for Payer: Encore All Commercial |
$34.73
|
| Rate for Payer: Encore All Commercial |
$34.73
|
| Rate for Payer: Frontpath All Commercial |
$39.00
|
| Rate for Payer: Frontpath All Commercial |
$39.00
|
| Rate for Payer: Humana ChoiceCare |
$18.64
|
| Rate for Payer: Humana ChoiceCare |
$18.64
|
| Rate for Payer: Humana Medicare |
$34.73
|
| Rate for Payer: Humana Medicare |
$34.73
|
| Rate for Payer: Lucent All Commercial |
$48.62
|
| Rate for Payer: Lucent All Commercial |
$48.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$48.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$48.00
|
| Rate for Payer: Managed Health Services Medicaid |
$38.50
|
| Rate for Payer: Managed Health Services Medicaid |
$38.50
|
| Rate for Payer: MDWise Medicaid |
$38.50
|
| Rate for Payer: MDWise Medicaid |
$38.50
|
| Rate for Payer: PHCS All Commercial |
$34.73
|
| Rate for Payer: PHCS All Commercial |
$34.73
|
| Rate for Payer: PHP All Commercial |
$51.76
|
| Rate for Payer: PHP All Commercial |
$51.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.73
|
| Rate for Payer: Sagamore Health Network All Products |
$34.73
|
| Rate for Payer: Sagamore Health Network All Products |
$34.73
|
| Rate for Payer: Signature Care EPO |
$29.52
|
| Rate for Payer: Signature Care EPO |
$29.52
|
| Rate for Payer: Signature Care PPO |
$29.52
|
| Rate for Payer: Signature Care PPO |
$29.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,400.00
|
| Rate for Payer: United Healthcare Commercial |
$23.29
|
| Rate for Payer: United Healthcare Commercial |
$23.29
|
| Rate for Payer: United Healthcare Medicare |
$35.70
|
| Rate for Payer: United Healthcare Medicare |
$35.70
|
|
|
PR TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$93.50
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
z11103
|
| Min. Negotiated Rate |
$15.31 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$20.65
|
| Rate for Payer: Aetna Commercial |
$20.65
|
| Rate for Payer: Aetna Medicare |
$20.65
|
| Rate for Payer: Aetna Medicare |
$20.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$50.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$50.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$50.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$50.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$50.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$50.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$50.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$50.15
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$15.31
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$15.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$45.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$45.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$23.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$23.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22.71
|
| Rate for Payer: Cash Price |
$57.06
|
| Rate for Payer: Cash Price |
$57.97
|
| Rate for Payer: Centivo All Commercial |
$32.01
|
| Rate for Payer: Centivo All Commercial |
$32.01
|
| Rate for Payer: Cigna All Commercial |
$20.65
|
| Rate for Payer: Cigna All Commercial |
$20.65
|
| Rate for Payer: CORVEL All Commercial |
$20.65
|
| Rate for Payer: CORVEL All Commercial |
$20.65
|
| Rate for Payer: Coventry All Commercial |
$24.78
|
| Rate for Payer: Coventry All Commercial |
$24.78
|
| Rate for Payer: Encore All Commercial |
$20.65
|
| Rate for Payer: Encore All Commercial |
$20.65
|
| Rate for Payer: Frontpath All Commercial |
$28.11
|
| Rate for Payer: Frontpath All Commercial |
$28.11
|
| Rate for Payer: Humana ChoiceCare |
$22.00
|
| Rate for Payer: Humana ChoiceCare |
$22.00
|
| Rate for Payer: Humana Medicare |
$20.65
|
| Rate for Payer: Humana Medicare |
$20.65
|
| Rate for Payer: Lucent All Commercial |
$28.91
|
| Rate for Payer: Lucent All Commercial |
$28.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$26.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$26.00
|
| Rate for Payer: Managed Health Services Medicaid |
$45.99
|
| Rate for Payer: Managed Health Services Medicaid |
$45.99
|
| Rate for Payer: MDWise Medicaid |
$45.99
|
| Rate for Payer: MDWise Medicaid |
$45.99
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$15.31
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$15.31
|
| Rate for Payer: PHCS All Commercial |
$20.65
|
| Rate for Payer: PHCS All Commercial |
$20.65
|
| Rate for Payer: PHP All Commercial |
$27.74
|
| Rate for Payer: PHP All Commercial |
$27.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20.65
|
| Rate for Payer: Sagamore Health Network All Products |
$20.65
|
| Rate for Payer: Sagamore Health Network All Products |
$20.65
|
| Rate for Payer: Signature Care EPO |
$50.30
|
| Rate for Payer: Signature Care EPO |
$50.30
|
| Rate for Payer: Signature Care PPO |
$50.30
|
| Rate for Payer: Signature Care PPO |
$50.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,400.00
|
| Rate for Payer: United Healthcare Commercial |
$28.00
|
| Rate for Payer: United Healthcare Commercial |
$28.00
|
| Rate for Payer: United Healthcare Medicare |
$46.02
|
| Rate for Payer: United Healthcare Medicare |
$46.02
|
|
|
PR TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$186.76
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
z11102
|
| Min. Negotiated Rate |
$25.52 |
| Max. Negotiated Rate |
$4,300.00 |
| Rate for Payer: Aetna Commercial |
$35.49
|
| Rate for Payer: Aetna Commercial |
$35.49
|
| Rate for Payer: Aetna Medicare |
$35.49
|
| Rate for Payer: Aetna Medicare |
$35.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$92.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$92.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$92.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$92.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$92.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$92.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$92.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$92.91
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.52
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$25.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$91.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$91.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$40.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$40.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.04
|
| Rate for Payer: Cash Price |
$115.06
|
| Rate for Payer: Cash Price |
$115.79
|
| Rate for Payer: Centivo All Commercial |
$55.01
|
| Rate for Payer: Centivo All Commercial |
$55.01
|
| Rate for Payer: Cigna All Commercial |
$35.49
|
| Rate for Payer: Cigna All Commercial |
$35.49
|
| Rate for Payer: CORVEL All Commercial |
$35.49
|
| Rate for Payer: CORVEL All Commercial |
$35.49
|
| Rate for Payer: Coventry All Commercial |
$42.59
|
| Rate for Payer: Coventry All Commercial |
$42.59
|
| Rate for Payer: Encore All Commercial |
$35.49
|
| Rate for Payer: Encore All Commercial |
$35.49
|
| Rate for Payer: Frontpath All Commercial |
$48.33
|
| Rate for Payer: Frontpath All Commercial |
$48.33
|
| Rate for Payer: Humana ChoiceCare |
$37.93
|
| Rate for Payer: Humana ChoiceCare |
$37.93
|
| Rate for Payer: Humana Medicare |
$35.49
|
| Rate for Payer: Humana Medicare |
$35.49
|
| Rate for Payer: Lucent All Commercial |
$49.69
|
| Rate for Payer: Lucent All Commercial |
$49.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46.00
|
| Rate for Payer: Managed Health Services Medicaid |
$91.86
|
| Rate for Payer: Managed Health Services Medicaid |
$91.86
|
| Rate for Payer: MDWise Medicaid |
$91.86
|
| Rate for Payer: MDWise Medicaid |
$91.86
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$25.52
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$25.52
|
| Rate for Payer: PHCS All Commercial |
$35.49
|
| Rate for Payer: PHCS All Commercial |
$35.49
|
| Rate for Payer: PHP All Commercial |
$48.53
|
| Rate for Payer: PHP All Commercial |
$48.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$35.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$35.49
|
| Rate for Payer: Sagamore Health Network All Products |
$35.49
|
| Rate for Payer: Sagamore Health Network All Products |
$35.49
|
| Rate for Payer: Signature Care EPO |
$93.19
|
| Rate for Payer: Signature Care EPO |
$93.19
|
| Rate for Payer: Signature Care PPO |
$93.19
|
| Rate for Payer: Signature Care PPO |
$93.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,300.00
|
| Rate for Payer: United Healthcare Commercial |
$48.33
|
| Rate for Payer: United Healthcare Commercial |
$48.33
|
| Rate for Payer: United Healthcare Medicare |
$92.79
|
| Rate for Payer: United Healthcare Medicare |
$92.79
|
|
|
PR TARSAL TUNNEL RELEASE
|
Professional
|
Both
|
$982.68
|
|
|
Service Code
|
CPT 28035
|
| Hospital Charge Code |
z28035
|
| Min. Negotiated Rate |
$200.67 |
| Max. Negotiated Rate |
$50,600.00 |
| Rate for Payer: Aetna Commercial |
$334.56
|
| Rate for Payer: Aetna Commercial |
$334.56
|
| Rate for Payer: Aetna Medicare |
$334.56
|
| Rate for Payer: Aetna Medicare |
$334.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$502.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$502.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$502.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$502.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$502.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$502.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$502.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$502.78
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$200.67
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$200.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$483.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$483.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$384.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$384.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$368.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$368.02
|
| Rate for Payer: Cash Price |
$597.17
|
| Rate for Payer: Cash Price |
$609.26
|
| Rate for Payer: Centivo All Commercial |
$518.57
|
| Rate for Payer: Centivo All Commercial |
$518.57
|
| Rate for Payer: Cigna All Commercial |
$334.56
|
| Rate for Payer: Cigna All Commercial |
$334.56
|
| Rate for Payer: CORVEL All Commercial |
$334.56
|
| Rate for Payer: CORVEL All Commercial |
$334.56
|
| Rate for Payer: Coventry All Commercial |
$401.47
|
| Rate for Payer: Coventry All Commercial |
$401.47
|
| Rate for Payer: Encore All Commercial |
$334.56
|
| Rate for Payer: Encore All Commercial |
$334.56
|
| Rate for Payer: Frontpath All Commercial |
$455.73
|
| Rate for Payer: Frontpath All Commercial |
$455.73
|
| Rate for Payer: Humana ChoiceCare |
$397.28
|
| Rate for Payer: Humana ChoiceCare |
$397.28
|
| Rate for Payer: Humana Medicare |
$334.56
|
| Rate for Payer: Humana Medicare |
$334.56
|
| Rate for Payer: Lucent All Commercial |
$468.38
|
| Rate for Payer: Lucent All Commercial |
$468.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$540.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$540.00
|
| Rate for Payer: Managed Health Services Medicaid |
$483.32
|
| Rate for Payer: Managed Health Services Medicaid |
$483.32
|
| Rate for Payer: MDWise Medicaid |
$483.32
|
| Rate for Payer: MDWise Medicaid |
$483.32
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$200.67
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$200.67
|
| Rate for Payer: PHCS All Commercial |
$334.56
|
| Rate for Payer: PHCS All Commercial |
$334.56
|
| Rate for Payer: PHP All Commercial |
$572.79
|
| Rate for Payer: PHP All Commercial |
$572.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$334.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$334.56
|
| Rate for Payer: Sagamore Health Network All Products |
$334.56
|
| Rate for Payer: Sagamore Health Network All Products |
$334.56
|
| Rate for Payer: Signature Care EPO |
$614.55
|
| Rate for Payer: Signature Care EPO |
$614.55
|
| Rate for Payer: Signature Care PPO |
$614.55
|
| Rate for Payer: Signature Care PPO |
$614.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50,600.00
|
| Rate for Payer: United Healthcare Commercial |
$404.59
|
| Rate for Payer: United Healthcare Commercial |
$404.59
|
| Rate for Payer: United Healthcare Medicare |
$481.59
|
| Rate for Payer: United Healthcare Medicare |
$481.59
|
|
|
PR TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG
|
Professional
|
Both
|
$853.26
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
z33274
|
| Min. Negotiated Rate |
$419.67 |
| Max. Negotiated Rate |
$65,400.00 |
| Rate for Payer: Aetna Commercial |
$444.03
|
| Rate for Payer: Aetna Commercial |
$444.03
|
| Rate for Payer: Aetna Medicare |
$444.03
|
| Rate for Payer: Aetna Medicare |
$444.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$458.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$458.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$458.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$458.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$458.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$458.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$458.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$458.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$419.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$419.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$510.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$510.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$488.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$488.43
|
| Rate for Payer: Cash Price |
$529.02
|
| Rate for Payer: Cash Price |
$527.11
|
| Rate for Payer: Centivo All Commercial |
$688.25
|
| Rate for Payer: Centivo All Commercial |
$688.25
|
| Rate for Payer: Cigna All Commercial |
$444.03
|
| Rate for Payer: Cigna All Commercial |
$444.03
|
| Rate for Payer: CORVEL All Commercial |
$444.03
|
| Rate for Payer: CORVEL All Commercial |
$444.03
|
| Rate for Payer: Coventry All Commercial |
$532.84
|
| Rate for Payer: Coventry All Commercial |
$532.84
|
| Rate for Payer: Encore All Commercial |
$444.03
|
| Rate for Payer: Encore All Commercial |
$444.03
|
| Rate for Payer: Frontpath All Commercial |
$630.90
|
| Rate for Payer: Frontpath All Commercial |
$630.90
|
| Rate for Payer: Humana ChoiceCare |
$597.92
|
| Rate for Payer: Humana ChoiceCare |
$597.92
|
| Rate for Payer: Humana Medicare |
$444.03
|
| Rate for Payer: Humana Medicare |
$444.03
|
| Rate for Payer: Lucent All Commercial |
$621.64
|
| Rate for Payer: Lucent All Commercial |
$621.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$697.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$697.00
|
| Rate for Payer: Managed Health Services Medicaid |
$419.67
|
| Rate for Payer: Managed Health Services Medicaid |
$419.67
|
| Rate for Payer: MDWise Medicaid |
$419.67
|
| Rate for Payer: MDWise Medicaid |
$419.67
|
| Rate for Payer: PHCS All Commercial |
$444.03
|
| Rate for Payer: PHCS All Commercial |
$444.03
|
| Rate for Payer: PHP All Commercial |
$595.13
|
| Rate for Payer: PHP All Commercial |
$595.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.03
|
| Rate for Payer: Sagamore Health Network All Products |
$444.03
|
| Rate for Payer: Sagamore Health Network All Products |
$444.03
|
| Rate for Payer: Signature Care EPO |
$646.49
|
| Rate for Payer: Signature Care EPO |
$646.49
|
| Rate for Payer: Signature Care PPO |
$646.49
|
| Rate for Payer: Signature Care PPO |
$646.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$65,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$65,400.00
|
| Rate for Payer: United Healthcare Commercial |
$590.90
|
| Rate for Payer: United Healthcare Commercial |
$590.90
|
| Rate for Payer: United Healthcare Medicare |
$425.09
|
| Rate for Payer: United Healthcare Medicare |
$425.09
|
|
|
PR TELEHEALTH FACILITY FEE
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
CPT Q3014
|
| Hospital Charge Code |
zQ3014
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$29.65 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.42
|
| Rate for Payer: Cash Price |
$35.34
|
| Rate for Payer: Humana ChoiceCare |
$24.34
|
| Rate for Payer: Managed Health Services Medicaid |
$21.42
|
| Rate for Payer: MDWise Medicaid |
$21.42
|
| Rate for Payer: United Healthcare Commercial |
$29.65
|
|
|
PR TEMPORAL ARTERY LIGATN OR BX
|
Professional
|
Both
|
$564.84
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
z37609
|
| Min. Negotiated Rate |
$104.69 |
| Max. Negotiated Rate |
$28,200.00 |
| Rate for Payer: Aetna Commercial |
$189.35
|
| Rate for Payer: Aetna Commercial |
$189.35
|
| Rate for Payer: Aetna Medicare |
$189.35
|
| Rate for Payer: Aetna Medicare |
$189.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$320.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$320.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$104.69
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$104.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$280.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$280.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$217.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$217.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$208.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$208.28
|
| Rate for Payer: Cash Price |
$353.35
|
| Rate for Payer: Cash Price |
$350.20
|
| Rate for Payer: Centivo All Commercial |
$293.49
|
| Rate for Payer: Centivo All Commercial |
$293.49
|
| Rate for Payer: Cigna All Commercial |
$189.35
|
| Rate for Payer: Cigna All Commercial |
$189.35
|
| Rate for Payer: CORVEL All Commercial |
$189.35
|
| Rate for Payer: CORVEL All Commercial |
$189.35
|
| Rate for Payer: Coventry All Commercial |
$227.22
|
| Rate for Payer: Coventry All Commercial |
$227.22
|
| Rate for Payer: Encore All Commercial |
$189.35
|
| Rate for Payer: Encore All Commercial |
$189.35
|
| Rate for Payer: Frontpath All Commercial |
$265.64
|
| Rate for Payer: Frontpath All Commercial |
$265.64
|
| Rate for Payer: Humana ChoiceCare |
$244.40
|
| Rate for Payer: Humana ChoiceCare |
$244.40
|
| Rate for Payer: Humana Medicare |
$189.35
|
| Rate for Payer: Humana Medicare |
$189.35
|
| Rate for Payer: Lucent All Commercial |
$265.09
|
| Rate for Payer: Lucent All Commercial |
$265.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$301.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$301.00
|
| Rate for Payer: Managed Health Services Medicaid |
$280.31
|
| Rate for Payer: Managed Health Services Medicaid |
$280.31
|
| Rate for Payer: MDWise Medicaid |
$280.31
|
| Rate for Payer: MDWise Medicaid |
$280.31
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$104.69
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$104.69
|
| Rate for Payer: PHCS All Commercial |
$189.35
|
| Rate for Payer: PHCS All Commercial |
$189.35
|
| Rate for Payer: PHP All Commercial |
$256.66
|
| Rate for Payer: PHP All Commercial |
$256.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$189.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$189.35
|
| Rate for Payer: Sagamore Health Network All Products |
$189.35
|
| Rate for Payer: Sagamore Health Network All Products |
$189.35
|
| Rate for Payer: Signature Care EPO |
$420.75
|
| Rate for Payer: Signature Care EPO |
$420.75
|
| Rate for Payer: Signature Care PPO |
$420.75
|
| Rate for Payer: Signature Care PPO |
$420.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28,200.00
|
| Rate for Payer: United Healthcare Commercial |
$224.09
|
| Rate for Payer: United Healthcare Commercial |
$224.09
|
| Rate for Payer: United Healthcare Medicare |
$282.42
|
| Rate for Payer: United Healthcare Medicare |
$282.42
|
|
|
PR TENOTOMY ELBOW LATERAL/MEDIAL DEBRIDE OPEN
|
Professional
|
Both
|
$993.28
|
|
|
Service Code
|
CPT 24358
|
| Hospital Charge Code |
z24358
|
| Min. Negotiated Rate |
$484.23 |
| Max. Negotiated Rate |
$74,500.00 |
| Rate for Payer: Aetna Commercial |
$495.57
|
| Rate for Payer: Aetna Commercial |
$495.57
|
| Rate for Payer: Aetna Medicare |
$495.57
|
| Rate for Payer: Aetna Medicare |
$495.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$720.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$720.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$720.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$720.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$720.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$720.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$720.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$720.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$488.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$488.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$569.91
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$569.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$545.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$545.13
|
| Rate for Payer: Cash Price |
$615.83
|
| Rate for Payer: Cash Price |
$600.45
|
| Rate for Payer: Centivo All Commercial |
$768.13
|
| Rate for Payer: Centivo All Commercial |
$768.13
|
| Rate for Payer: Cigna All Commercial |
$495.57
|
| Rate for Payer: Cigna All Commercial |
$495.57
|
| Rate for Payer: CORVEL All Commercial |
$495.57
|
| Rate for Payer: CORVEL All Commercial |
$495.57
|
| Rate for Payer: Coventry All Commercial |
$594.68
|
| Rate for Payer: Coventry All Commercial |
$594.68
|
| Rate for Payer: Encore All Commercial |
$495.57
|
| Rate for Payer: Encore All Commercial |
$495.57
|
| Rate for Payer: Frontpath All Commercial |
$685.05
|
| Rate for Payer: Frontpath All Commercial |
$685.05
|
| Rate for Payer: Humana ChoiceCare |
$506.14
|
| Rate for Payer: Humana ChoiceCare |
$506.14
|
| Rate for Payer: Humana Medicare |
$495.57
|
| Rate for Payer: Humana Medicare |
$495.57
|
| Rate for Payer: Lucent All Commercial |
$693.80
|
| Rate for Payer: Lucent All Commercial |
$693.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$794.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$794.00
|
| Rate for Payer: Managed Health Services Medicaid |
$488.54
|
| Rate for Payer: Managed Health Services Medicaid |
$488.54
|
| Rate for Payer: MDWise Medicaid |
$488.54
|
| Rate for Payer: MDWise Medicaid |
$488.54
|
| Rate for Payer: PHCS All Commercial |
$495.57
|
| Rate for Payer: PHCS All Commercial |
$495.57
|
| Rate for Payer: PHP All Commercial |
$842.56
|
| Rate for Payer: PHP All Commercial |
$842.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$495.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$495.57
|
| Rate for Payer: Sagamore Health Network All Products |
$495.57
|
| Rate for Payer: Sagamore Health Network All Products |
$495.57
|
| Rate for Payer: Signature Care EPO |
$687.17
|
| Rate for Payer: Signature Care EPO |
$687.17
|
| Rate for Payer: Signature Care PPO |
$687.17
|
| Rate for Payer: Signature Care PPO |
$687.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$74,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$74,500.00
|
| Rate for Payer: United Healthcare Commercial |
$555.09
|
| Rate for Payer: United Healthcare Commercial |
$555.09
|
| Rate for Payer: United Healthcare Medicare |
$484.23
|
| Rate for Payer: United Healthcare Medicare |
$484.23
|
|
|
PR TENOTOMY ELBOW LATERAL/MEDIAL DEBRIDE REPAIR
|
Professional
|
Both
|
$1,238.10
|
|
|
Service Code
|
CPT 24359
|
| Hospital Charge Code |
z24359
|
| Min. Negotiated Rate |
$605.04 |
| Max. Negotiated Rate |
$93,000.00 |
| Rate for Payer: Aetna Commercial |
$619.69
|
| Rate for Payer: Aetna Commercial |
$619.69
|
| Rate for Payer: Aetna Medicare |
$619.69
|
| Rate for Payer: Aetna Medicare |
$619.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$884.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$884.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$884.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$884.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$884.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$884.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$884.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$884.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$608.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$608.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$712.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$712.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$681.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$681.66
|
| Rate for Payer: Cash Price |
$767.62
|
| Rate for Payer: Cash Price |
$750.25
|
| Rate for Payer: Centivo All Commercial |
$960.52
|
| Rate for Payer: Centivo All Commercial |
$960.52
|
| Rate for Payer: Cigna All Commercial |
$619.69
|
| Rate for Payer: Cigna All Commercial |
$619.69
|
| Rate for Payer: CORVEL All Commercial |
$619.69
|
| Rate for Payer: CORVEL All Commercial |
$619.69
|
| Rate for Payer: Coventry All Commercial |
$743.63
|
| Rate for Payer: Coventry All Commercial |
$743.63
|
| Rate for Payer: Encore All Commercial |
$619.69
|
| Rate for Payer: Encore All Commercial |
$619.69
|
| Rate for Payer: Frontpath All Commercial |
$859.55
|
| Rate for Payer: Frontpath All Commercial |
$859.55
|
| Rate for Payer: Humana ChoiceCare |
$622.13
|
| Rate for Payer: Humana ChoiceCare |
$622.13
|
| Rate for Payer: Humana Medicare |
$619.69
|
| Rate for Payer: Humana Medicare |
$619.69
|
| Rate for Payer: Lucent All Commercial |
$867.57
|
| Rate for Payer: Lucent All Commercial |
$867.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$992.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$992.00
|
| Rate for Payer: Managed Health Services Medicaid |
$608.94
|
| Rate for Payer: Managed Health Services Medicaid |
$608.94
|
| Rate for Payer: MDWise Medicaid |
$608.94
|
| Rate for Payer: MDWise Medicaid |
$608.94
|
| Rate for Payer: PHCS All Commercial |
$619.69
|
| Rate for Payer: PHCS All Commercial |
$619.69
|
| Rate for Payer: PHP All Commercial |
$1,052.78
|
| Rate for Payer: PHP All Commercial |
$1,052.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$619.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$619.69
|
| Rate for Payer: Sagamore Health Network All Products |
$619.69
|
| Rate for Payer: Sagamore Health Network All Products |
$619.69
|
| Rate for Payer: Signature Care EPO |
$844.63
|
| Rate for Payer: Signature Care EPO |
$844.63
|
| Rate for Payer: Signature Care PPO |
$844.63
|
| Rate for Payer: Signature Care PPO |
$844.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$93,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$93,000.00
|
| Rate for Payer: United Healthcare Commercial |
$701.15
|
| Rate for Payer: United Healthcare Commercial |
$701.15
|
| Rate for Payer: United Healthcare Medicare |
$605.04
|
| Rate for Payer: United Healthcare Medicare |
$605.04
|
|
|
PR TENOTOMY FINGR FLEX,SINGLE,OPEN,EACH
|
Professional
|
Both
|
$835.74
|
|
|
Service Code
|
CPT 26455
|
| Hospital Charge Code |
z26455
|
| Min. Negotiated Rate |
$417.06 |
| Max. Negotiated Rate |
$676.78 |
| Rate for Payer: Aetna Commercial |
$436.63
|
| Rate for Payer: Aetna Medicare |
$436.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$424.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$502.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$480.29
|
| Rate for Payer: Cash Price |
$518.16
|
| Rate for Payer: Centivo All Commercial |
$676.78
|
| Rate for Payer: Cigna All Commercial |
$436.63
|
| Rate for Payer: CORVEL All Commercial |
$436.63
|
| Rate for Payer: Coventry All Commercial |
$523.96
|
| Rate for Payer: Encore All Commercial |
$436.63
|
| Rate for Payer: Frontpath All Commercial |
$592.41
|
| Rate for Payer: Humana ChoiceCare |
$458.27
|
| Rate for Payer: Humana Medicare |
$436.63
|
| Rate for Payer: Lucent All Commercial |
$611.28
|
| Rate for Payer: Managed Health Services Medicaid |
$424.38
|
| Rate for Payer: MDWise Medicaid |
$424.38
|
| Rate for Payer: PHCS All Commercial |
$436.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$436.63
|
| Rate for Payer: Sagamore Health Network All Products |
$436.63
|
| Rate for Payer: United Healthcare Commercial |
$417.06
|
| Rate for Payer: United Healthcare Medicare |
$426.10
|
|
|
PR THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF
|
Professional
|
Both
|
$336.10
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
z62272
|
| Min. Negotiated Rate |
$56.01 |
| Max. Negotiated Rate |
$12,300.00 |
| Rate for Payer: Aetna Commercial |
$81.51
|
| Rate for Payer: Aetna Commercial |
$81.51
|
| Rate for Payer: Aetna Medicare |
$81.51
|
| Rate for Payer: Aetna Medicare |
$81.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$174.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$174.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$174.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$174.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$174.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$174.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$174.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$174.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.01
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$165.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$165.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.66
|
| Rate for Payer: Cash Price |
$197.88
|
| Rate for Payer: Cash Price |
$208.38
|
| Rate for Payer: Centivo All Commercial |
$126.34
|
| Rate for Payer: Centivo All Commercial |
$126.34
|
| Rate for Payer: Cigna All Commercial |
$81.51
|
| Rate for Payer: Cigna All Commercial |
$81.51
|
| Rate for Payer: CORVEL All Commercial |
$81.51
|
| Rate for Payer: CORVEL All Commercial |
$81.51
|
| Rate for Payer: Coventry All Commercial |
$97.81
|
| Rate for Payer: Coventry All Commercial |
$97.81
|
| Rate for Payer: Encore All Commercial |
$81.51
|
| Rate for Payer: Encore All Commercial |
$81.51
|
| Rate for Payer: Frontpath All Commercial |
$117.39
|
| Rate for Payer: Frontpath All Commercial |
$117.39
|
| Rate for Payer: Humana ChoiceCare |
$105.99
|
| Rate for Payer: Humana ChoiceCare |
$105.99
|
| Rate for Payer: Humana Medicare |
$81.51
|
| Rate for Payer: Humana Medicare |
$81.51
|
| Rate for Payer: Lucent All Commercial |
$114.11
|
| Rate for Payer: Lucent All Commercial |
$114.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$131.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$131.00
|
| Rate for Payer: Managed Health Services Medicaid |
$165.31
|
| Rate for Payer: Managed Health Services Medicaid |
$165.31
|
| Rate for Payer: MDWise Medicaid |
$165.31
|
| Rate for Payer: MDWise Medicaid |
$165.31
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$56.01
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$56.01
|
| Rate for Payer: PHCS All Commercial |
$81.51
|
| Rate for Payer: PHCS All Commercial |
$81.51
|
| Rate for Payer: PHP All Commercial |
$139.60
|
| Rate for Payer: PHP All Commercial |
$139.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.51
|
| Rate for Payer: Sagamore Health Network All Products |
$81.51
|
| Rate for Payer: Sagamore Health Network All Products |
$81.51
|
| Rate for Payer: Signature Care EPO |
$271.47
|
| Rate for Payer: Signature Care EPO |
$271.47
|
| Rate for Payer: Signature Care PPO |
$271.47
|
| Rate for Payer: Signature Care PPO |
$271.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,300.00
|
| Rate for Payer: United Healthcare Commercial |
$93.04
|
| Rate for Payer: United Healthcare Commercial |
$93.04
|
| Rate for Payer: United Healthcare Medicare |
$159.58
|
| Rate for Payer: United Healthcare Medicare |
$159.58
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING
|
Professional
|
Both
|
$579.32
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
z32555
|
| Min. Negotiated Rate |
$64.77 |
| Max. Negotiated Rate |
$15,400.00 |
| Rate for Payer: Aetna Commercial |
$104.82
|
| Rate for Payer: Aetna Commercial |
$104.82
|
| Rate for Payer: Aetna Medicare |
$104.82
|
| Rate for Payer: Aetna Medicare |
$104.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$825.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$825.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$825.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$825.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$825.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$825.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$825.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$825.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$64.77
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$64.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$284.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$284.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$120.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$120.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$115.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$115.30
|
| Rate for Payer: Cash Price |
$359.13
|
| Rate for Payer: Cash Price |
$359.18
|
| Rate for Payer: Centivo All Commercial |
$162.47
|
| Rate for Payer: Centivo All Commercial |
$162.47
|
| Rate for Payer: Cigna All Commercial |
$104.82
|
| Rate for Payer: Cigna All Commercial |
$104.82
|
| Rate for Payer: CORVEL All Commercial |
$104.82
|
| Rate for Payer: CORVEL All Commercial |
$104.82
|
| Rate for Payer: Coventry All Commercial |
$125.78
|
| Rate for Payer: Coventry All Commercial |
$125.78
|
| Rate for Payer: Encore All Commercial |
$104.82
|
| Rate for Payer: Encore All Commercial |
$104.82
|
| Rate for Payer: Frontpath All Commercial |
$142.36
|
| Rate for Payer: Frontpath All Commercial |
$142.36
|
| Rate for Payer: Humana ChoiceCare |
$130.19
|
| Rate for Payer: Humana ChoiceCare |
$130.19
|
| Rate for Payer: Humana Medicare |
$104.82
|
| Rate for Payer: Humana Medicare |
$104.82
|
| Rate for Payer: Lucent All Commercial |
$146.75
|
| Rate for Payer: Lucent All Commercial |
$146.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$165.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$165.00
|
| Rate for Payer: Managed Health Services Medicaid |
$284.93
|
| Rate for Payer: Managed Health Services Medicaid |
$284.93
|
| Rate for Payer: MDWise Medicaid |
$284.93
|
| Rate for Payer: MDWise Medicaid |
$284.93
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$64.77
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$64.77
|
| Rate for Payer: PHCS All Commercial |
$104.82
|
| Rate for Payer: PHCS All Commercial |
$104.82
|
| Rate for Payer: PHP All Commercial |
$140.67
|
| Rate for Payer: PHP All Commercial |
$140.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$104.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$104.82
|
| Rate for Payer: Sagamore Health Network All Products |
$104.82
|
| Rate for Payer: Sagamore Health Network All Products |
$104.82
|
| Rate for Payer: Signature Care EPO |
$259.85
|
| Rate for Payer: Signature Care EPO |
$259.85
|
| Rate for Payer: Signature Care PPO |
$259.85
|
| Rate for Payer: Signature Care PPO |
$259.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,400.00
|
| Rate for Payer: United Healthcare Commercial |
$141.66
|
| Rate for Payer: United Healthcare Commercial |
$141.66
|
| Rate for Payer: United Healthcare Medicare |
$289.62
|
| Rate for Payer: United Healthcare Medicare |
$289.62
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$433.64
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
z32554
|
| Min. Negotiated Rate |
$51.73 |
| Max. Negotiated Rate |
$12,400.00 |
| Rate for Payer: Aetna Commercial |
$84.89
|
| Rate for Payer: Aetna Commercial |
$84.89
|
| Rate for Payer: Aetna Medicare |
$84.89
|
| Rate for Payer: Aetna Medicare |
$84.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$715.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$715.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$715.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$715.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$715.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$715.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$715.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$715.42
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$51.73
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$51.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$213.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$213.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$97.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$97.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$93.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$93.38
|
| Rate for Payer: Cash Price |
$265.61
|
| Rate for Payer: Cash Price |
$268.86
|
| Rate for Payer: Centivo All Commercial |
$131.58
|
| Rate for Payer: Centivo All Commercial |
$131.58
|
| Rate for Payer: Cigna All Commercial |
$84.89
|
| Rate for Payer: Cigna All Commercial |
$84.89
|
| Rate for Payer: CORVEL All Commercial |
$84.89
|
| Rate for Payer: CORVEL All Commercial |
$84.89
|
| Rate for Payer: Coventry All Commercial |
$101.87
|
| Rate for Payer: Coventry All Commercial |
$101.87
|
| Rate for Payer: Encore All Commercial |
$84.89
|
| Rate for Payer: Encore All Commercial |
$84.89
|
| Rate for Payer: Frontpath All Commercial |
$116.36
|
| Rate for Payer: Frontpath All Commercial |
$116.36
|
| Rate for Payer: Humana ChoiceCare |
$104.34
|
| Rate for Payer: Humana ChoiceCare |
$104.34
|
| Rate for Payer: Humana Medicare |
$84.89
|
| Rate for Payer: Humana Medicare |
$84.89
|
| Rate for Payer: Lucent All Commercial |
$118.85
|
| Rate for Payer: Lucent All Commercial |
$118.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$132.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$132.00
|
| Rate for Payer: Managed Health Services Medicaid |
$213.28
|
| Rate for Payer: Managed Health Services Medicaid |
$213.28
|
| Rate for Payer: MDWise Medicaid |
$213.28
|
| Rate for Payer: MDWise Medicaid |
$213.28
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$51.73
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$51.73
|
| Rate for Payer: PHCS All Commercial |
$84.89
|
| Rate for Payer: PHCS All Commercial |
$84.89
|
| Rate for Payer: PHP All Commercial |
$113.09
|
| Rate for Payer: PHP All Commercial |
$113.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$84.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$84.89
|
| Rate for Payer: Sagamore Health Network All Products |
$84.89
|
| Rate for Payer: Sagamore Health Network All Products |
$84.89
|
| Rate for Payer: Signature Care EPO |
$324.89
|
| Rate for Payer: Signature Care EPO |
$324.89
|
| Rate for Payer: Signature Care PPO |
$324.89
|
| Rate for Payer: Signature Care PPO |
$324.89
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,400.00
|
| Rate for Payer: United Healthcare Commercial |
$113.54
|
| Rate for Payer: United Healthcare Commercial |
$113.54
|
| Rate for Payer: United Healthcare Medicare |
$214.20
|
| Rate for Payer: United Healthcare Medicare |
$214.20
|
|
|
PR TIBIAL SCOPE/SURG/FX AID,UNICONDYLR
|
Professional
|
Both
|
$1,445.62
|
|
|
Service Code
|
CPT 29855
|
| Hospital Charge Code |
z29855
|
| Min. Negotiated Rate |
$709.01 |
| Max. Negotiated Rate |
$109,000.00 |
| Rate for Payer: Aetna Commercial |
$727.77
|
| Rate for Payer: Aetna Commercial |
$727.77
|
| Rate for Payer: Aetna Medicare |
$727.77
|
| Rate for Payer: Aetna Medicare |
$727.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,073.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,073.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,073.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,073.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,073.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,073.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,073.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,073.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$711.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$711.02
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$836.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$836.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$800.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$800.55
|
| Rate for Payer: Cash Price |
$896.28
|
| Rate for Payer: Cash Price |
$879.17
|
| Rate for Payer: Centivo All Commercial |
$1,128.04
|
| Rate for Payer: Centivo All Commercial |
$1,128.04
|
| Rate for Payer: Cigna All Commercial |
$727.77
|
| Rate for Payer: Cigna All Commercial |
$727.77
|
| Rate for Payer: CORVEL All Commercial |
$727.77
|
| Rate for Payer: CORVEL All Commercial |
$727.77
|
| Rate for Payer: Coventry All Commercial |
$873.32
|
| Rate for Payer: Coventry All Commercial |
$873.32
|
| Rate for Payer: Encore All Commercial |
$727.77
|
| Rate for Payer: Encore All Commercial |
$727.77
|
| Rate for Payer: Frontpath All Commercial |
$1,013.52
|
| Rate for Payer: Frontpath All Commercial |
$1,013.52
|
| Rate for Payer: Humana ChoiceCare |
$845.48
|
| Rate for Payer: Humana ChoiceCare |
$845.48
|
| Rate for Payer: Humana Medicare |
$727.77
|
| Rate for Payer: Humana Medicare |
$727.77
|
| Rate for Payer: Lucent All Commercial |
$1,018.88
|
| Rate for Payer: Lucent All Commercial |
$1,018.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,163.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,163.00
|
| Rate for Payer: Managed Health Services Medicaid |
$711.02
|
| Rate for Payer: Managed Health Services Medicaid |
$711.02
|
| Rate for Payer: MDWise Medicaid |
$711.02
|
| Rate for Payer: MDWise Medicaid |
$711.02
|
| Rate for Payer: PHCS All Commercial |
$727.77
|
| Rate for Payer: PHCS All Commercial |
$727.77
|
| Rate for Payer: PHP All Commercial |
$1,233.68
|
| Rate for Payer: PHP All Commercial |
$1,233.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$727.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$727.77
|
| Rate for Payer: Sagamore Health Network All Products |
$727.77
|
| Rate for Payer: Sagamore Health Network All Products |
$727.77
|
| Rate for Payer: Signature Care EPO |
$1,124.55
|
| Rate for Payer: Signature Care EPO |
$1,124.55
|
| Rate for Payer: Signature Care PPO |
$1,124.55
|
| Rate for Payer: Signature Care PPO |
$1,124.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$109,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$109,000.00
|
| Rate for Payer: United Healthcare Commercial |
$852.31
|
| Rate for Payer: United Healthcare Commercial |
$852.31
|
| Rate for Payer: United Healthcare Medicare |
$709.01
|
| Rate for Payer: United Healthcare Medicare |
$709.01
|
|
|
PR TILT TABLE EVALUATION
|
Professional
|
Both
|
$170.82
|
|
|
Service Code
|
CPT 93660
|
| Hospital Charge Code |
z93660
|
| Min. Negotiated Rate |
$150.26 |
| Max. Negotiated Rate |
$18,200.00 |
| Rate for Payer: Aetna Commercial |
$150.96
|
| Rate for Payer: Aetna Commercial |
$150.96
|
| Rate for Payer: Aetna Medicare |
$150.96
|
| Rate for Payer: Aetna Medicare |
$150.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$162.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$162.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$162.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$162.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$162.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$162.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$162.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$162.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$150.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$150.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$173.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$173.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$166.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$166.06
|
| Rate for Payer: Cash Price |
$105.91
|
| Rate for Payer: Cash Price |
$189.42
|
| Rate for Payer: Centivo All Commercial |
$233.99
|
| Rate for Payer: Centivo All Commercial |
$233.99
|
| Rate for Payer: Cigna All Commercial |
$150.96
|
| Rate for Payer: Cigna All Commercial |
$150.96
|
| Rate for Payer: CORVEL All Commercial |
$150.96
|
| Rate for Payer: CORVEL All Commercial |
$150.96
|
| Rate for Payer: Coventry All Commercial |
$181.15
|
| Rate for Payer: Coventry All Commercial |
$181.15
|
| Rate for Payer: Encore All Commercial |
$150.96
|
| Rate for Payer: Encore All Commercial |
$150.96
|
| Rate for Payer: Frontpath All Commercial |
$170.02
|
| Rate for Payer: Frontpath All Commercial |
$170.02
|
| Rate for Payer: Humana ChoiceCare |
$212.06
|
| Rate for Payer: Humana ChoiceCare |
$212.06
|
| Rate for Payer: Humana Medicare |
$150.96
|
| Rate for Payer: Humana Medicare |
$150.96
|
| Rate for Payer: Lucent All Commercial |
$211.34
|
| Rate for Payer: Lucent All Commercial |
$211.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$197.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$197.00
|
| Rate for Payer: Managed Health Services Medicaid |
$150.26
|
| Rate for Payer: Managed Health Services Medicaid |
$150.26
|
| Rate for Payer: MDWise Medicaid |
$150.26
|
| Rate for Payer: MDWise Medicaid |
$150.26
|
| Rate for Payer: PHCS All Commercial |
$150.96
|
| Rate for Payer: PHCS All Commercial |
$150.96
|
| Rate for Payer: PHP All Commercial |
$217.69
|
| Rate for Payer: PHP All Commercial |
$217.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$150.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$150.96
|
| Rate for Payer: Sagamore Health Network All Products |
$150.96
|
| Rate for Payer: Sagamore Health Network All Products |
$150.96
|
| Rate for Payer: Signature Care EPO |
$178.54
|
| Rate for Payer: Signature Care EPO |
$178.54
|
| Rate for Payer: Signature Care PPO |
$178.54
|
| Rate for Payer: Signature Care PPO |
$178.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18,200.00
|
| Rate for Payer: United Healthcare Commercial |
$202.43
|
| Rate for Payer: United Healthcare Commercial |
$202.43
|
|
|
PR TINNITUS ASSESSMENT
|
Professional
|
Both
|
$127.90
|
|
|
Service Code
|
CPT 92625
|
| Hospital Charge Code |
z92625
|
| Min. Negotiated Rate |
$26.98 |
| Max. Negotiated Rate |
$7,100.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$42.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$42.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$42.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$42.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$42.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$42.13
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$26.98
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$26.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$63.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$63.05
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Cash Price |
$79.47
|
| Rate for Payer: Frontpath All Commercial |
$66.72
|
| Rate for Payer: Frontpath All Commercial |
$66.72
|
| Rate for Payer: Humana ChoiceCare |
$46.16
|
| Rate for Payer: Humana ChoiceCare |
$46.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$76.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$76.00
|
| Rate for Payer: Managed Health Services Medicaid |
$63.05
|
| Rate for Payer: Managed Health Services Medicaid |
$63.05
|
| Rate for Payer: MDWise Medicaid |
$63.05
|
| Rate for Payer: MDWise Medicaid |
$63.05
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$26.98
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$26.98
|
| Rate for Payer: PHP All Commercial |
$83.12
|
| Rate for Payer: PHP All Commercial |
$83.12
|
| Rate for Payer: Signature Care EPO |
$57.54
|
| Rate for Payer: Signature Care EPO |
$57.54
|
| Rate for Payer: Signature Care PPO |
$57.54
|
| Rate for Payer: Signature Care PPO |
$57.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,100.00
|
| Rate for Payer: United Healthcare Commercial |
$68.80
|
| Rate for Payer: United Healthcare Commercial |
$68.80
|
| Rate for Payer: United Healthcare Medicare |
$63.95
|
| Rate for Payer: United Healthcare Medicare |
$63.95
|
|
|
PR TOBACCO USE CESSATION INTENSIVE >10 MINUTES
|
Professional
|
Both
|
$51.76
|
|
|
Service Code
|
CPT 99407
|
| Hospital Charge Code |
z99407
|
| Min. Negotiated Rate |
$22.16 |
| Max. Negotiated Rate |
$37.48 |
| Rate for Payer: Aetna Commercial |
$24.18
|
| Rate for Payer: Aetna Commercial |
$24.18
|
| Rate for Payer: Aetna Medicare |
$24.18
|
| Rate for Payer: Aetna Medicare |
$24.18
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$29.48
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$29.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$25.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$25.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.60
|
| Rate for Payer: Cash Price |
$31.73
|
| Rate for Payer: Cash Price |
$32.09
|
| Rate for Payer: Centivo All Commercial |
$37.48
|
| Rate for Payer: Centivo All Commercial |
$37.48
|
| Rate for Payer: Cigna All Commercial |
$24.18
|
| Rate for Payer: Cigna All Commercial |
$24.18
|
| Rate for Payer: CORVEL All Commercial |
$24.18
|
| Rate for Payer: CORVEL All Commercial |
$24.18
|
| Rate for Payer: Coventry All Commercial |
$29.02
|
| Rate for Payer: Coventry All Commercial |
$29.02
|
| Rate for Payer: Encore All Commercial |
$24.18
|
| Rate for Payer: Encore All Commercial |
$24.18
|
| Rate for Payer: Frontpath All Commercial |
$26.40
|
| Rate for Payer: Frontpath All Commercial |
$26.40
|
| Rate for Payer: Humana ChoiceCare |
$22.16
|
| Rate for Payer: Humana ChoiceCare |
$22.16
|
| Rate for Payer: Humana Medicare |
$24.18
|
| Rate for Payer: Humana Medicare |
$24.18
|
| Rate for Payer: Lucent All Commercial |
$33.85
|
| Rate for Payer: Lucent All Commercial |
$33.85
|
| Rate for Payer: Managed Health Services Medicaid |
$25.46
|
| Rate for Payer: Managed Health Services Medicaid |
$25.46
|
| Rate for Payer: MDWise Medicaid |
$25.46
|
| Rate for Payer: MDWise Medicaid |
$25.46
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$29.48
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$29.48
|
| Rate for Payer: PHCS All Commercial |
$24.18
|
| Rate for Payer: PHCS All Commercial |
$24.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.18
|
| Rate for Payer: Sagamore Health Network All Products |
$24.18
|
| Rate for Payer: Sagamore Health Network All Products |
$24.18
|
| Rate for Payer: United Healthcare Commercial |
$24.38
|
| Rate for Payer: United Healthcare Commercial |
$24.38
|
| Rate for Payer: United Healthcare Medicare |
$25.59
|
| Rate for Payer: United Healthcare Medicare |
$25.59
|
|
