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Service Code CPT 73070 RT
Hospital Charge Code 11619070
Hospital Revenue Code 320
Min. Negotiated Rate $351.61
Max. Negotiated Rate $436.00
Rate for Payer: Aetna Commercial $405.05
Rate for Payer: Cash Price $290.66
Rate for Payer: Cigna All Commercial $404.59
Rate for Payer: CORVEL All Commercial $436.00
Rate for Payer: Coventry All Commercial $412.55
Rate for Payer: Encore All Commercial $431.54
Rate for Payer: Frontpath All Commercial $431.31
Rate for Payer: Humana ChoiceCare $404.91
Rate for Payer: Lutheran Preferred All Commercial $421.93
Rate for Payer: PHCS All Commercial $351.61
Rate for Payer: PHP All Commercial $355.55
Rate for Payer: Sagamore Health Network All Products $361.92
Rate for Payer: Signature Care EPO $389.11
Rate for Payer: Signature Care PPO $412.55
Rate for Payer: United Healthcare Commercial $369.42
Service Code CPT 73070 RT
Hospital Charge Code 11619070
Hospital Revenue Code 320
Min. Negotiated Rate $154.71
Max. Negotiated Rate $436.00
Rate for Payer: Aetna Commercial $395.68
Rate for Payer: Aetna Medicare $154.71
Rate for Payer: Anthem Blue Cross of IN Medicare $154.71
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $269.24
Rate for Payer: Anthem Blue Cross of IN Traditional $293.05
Rate for Payer: CareSource Indiana of IN Just 4 Me $177.91
Rate for Payer: CareSource Indiana of IN Medicare $170.18
Rate for Payer: Cash Price $290.66
Rate for Payer: Centivo All Commercial $239.09
Rate for Payer: Cigna All Commercial $404.59
Rate for Payer: CORVEL All Commercial $436.00
Rate for Payer: Coventry All Commercial $412.55
Rate for Payer: Encore All Commercial $431.54
Rate for Payer: Frontpath All Commercial $431.31
Rate for Payer: Humana ChoiceCare $404.91
Rate for Payer: Humana Medicare $239.09
Rate for Payer: Lucent All Commercial $239.09
Rate for Payer: Lutheran Preferred All Commercial $421.93
Rate for Payer: PHCS All Commercial $351.61
Rate for Payer: PHP All Commercial $355.55
Rate for Payer: Plain Church Group Ministry All Commercial $182.84
Rate for Payer: Sagamore Health Network All Products $361.92
Rate for Payer: Signature Care EPO $389.11
Rate for Payer: Signature Care PPO $412.55
Rate for Payer: Three Rivers Preferred All Commercial $398.49
Rate for Payer: United Healthcare Commercial $369.42
Rate for Payer: United Healthcare Medicare $154.71
Service Code CPT 73080 50
Hospital Charge Code 21613070
Hospital Revenue Code 320
Min. Negotiated Rate $251.35
Max. Negotiated Rate $708.34
Rate for Payer: Aetna Commercial $642.84
Rate for Payer: Aetna Medicare $251.35
Rate for Payer: Anthem Blue Cross of IN Medicare $251.35
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $437.42
Rate for Payer: Anthem Blue Cross of IN Traditional $476.11
Rate for Payer: CareSource Indiana of IN Just 4 Me $289.05
Rate for Payer: CareSource Indiana of IN Medicare $276.48
Rate for Payer: Cash Price $472.23
Rate for Payer: Centivo All Commercial $388.44
Rate for Payer: Cigna All Commercial $657.31
Rate for Payer: CORVEL All Commercial $708.34
Rate for Payer: Coventry All Commercial $670.26
Rate for Payer: Encore All Commercial $701.10
Rate for Payer: Frontpath All Commercial $700.72
Rate for Payer: Humana ChoiceCare $657.84
Rate for Payer: Humana Medicare $388.44
Rate for Payer: Lucent All Commercial $388.44
Rate for Payer: Lutheran Preferred All Commercial $685.49
Rate for Payer: PHCS All Commercial $571.24
Rate for Payer: PHP All Commercial $577.64
Rate for Payer: Plain Church Group Ministry All Commercial $297.05
Rate for Payer: Sagamore Health Network All Products $588.00
Rate for Payer: Signature Care EPO $632.17
Rate for Payer: Signature Care PPO $670.26
Rate for Payer: Three Rivers Preferred All Commercial $647.41
Rate for Payer: United Healthcare Commercial $600.18
Rate for Payer: United Healthcare Medicare $251.35
Service Code CPT 73080 50
Hospital Charge Code 21613070
Hospital Revenue Code 320
Min. Negotiated Rate $571.24
Max. Negotiated Rate $708.34
Rate for Payer: Aetna Commercial $658.07
Rate for Payer: Cash Price $472.23
Rate for Payer: Cigna All Commercial $657.31
Rate for Payer: CORVEL All Commercial $708.34
Rate for Payer: Coventry All Commercial $670.26
Rate for Payer: Encore All Commercial $701.10
Rate for Payer: Frontpath All Commercial $700.72
Rate for Payer: Humana ChoiceCare $657.84
Rate for Payer: Lutheran Preferred All Commercial $685.49
Rate for Payer: PHCS All Commercial $571.24
Rate for Payer: PHP All Commercial $577.64
Rate for Payer: Sagamore Health Network All Products $588.00
Rate for Payer: Signature Care EPO $632.17
Rate for Payer: Signature Care PPO $670.26
Rate for Payer: United Healthcare Commercial $600.18
Service Code CPT 73080 LT
Hospital Charge Code 01613070
Hospital Revenue Code 320
Min. Negotiated Rate $380.82
Max. Negotiated Rate $472.22
Rate for Payer: Aetna Commercial $438.71
Rate for Payer: Cash Price $314.82
Rate for Payer: Cigna All Commercial $438.20
Rate for Payer: CORVEL All Commercial $472.22
Rate for Payer: Coventry All Commercial $446.83
Rate for Payer: Encore All Commercial $467.40
Rate for Payer: Frontpath All Commercial $467.14
Rate for Payer: Humana ChoiceCare $438.56
Rate for Payer: Lutheran Preferred All Commercial $456.99
Rate for Payer: PHCS All Commercial $380.82
Rate for Payer: PHP All Commercial $385.09
Rate for Payer: Sagamore Health Network All Products $392.00
Rate for Payer: Signature Care EPO $421.45
Rate for Payer: Signature Care PPO $446.83
Rate for Payer: United Healthcare Commercial $400.12
Service Code CPT 73080 LT
Hospital Charge Code 01613070
Hospital Revenue Code 320
Min. Negotiated Rate $167.56
Max. Negotiated Rate $472.22
Rate for Payer: Aetna Commercial $428.55
Rate for Payer: Aetna Medicare $167.56
Rate for Payer: Anthem Blue Cross of IN Medicare $167.56
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $291.61
Rate for Payer: Anthem Blue Cross of IN Traditional $317.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $192.70
Rate for Payer: CareSource Indiana of IN Medicare $184.32
Rate for Payer: Cash Price $314.82
Rate for Payer: Centivo All Commercial $258.96
Rate for Payer: Cigna All Commercial $438.20
Rate for Payer: CORVEL All Commercial $472.22
Rate for Payer: Coventry All Commercial $446.83
Rate for Payer: Encore All Commercial $467.40
Rate for Payer: Frontpath All Commercial $467.14
Rate for Payer: Humana ChoiceCare $438.56
Rate for Payer: Humana Medicare $258.96
Rate for Payer: Lucent All Commercial $258.96
Rate for Payer: Lutheran Preferred All Commercial $456.99
Rate for Payer: PHCS All Commercial $380.82
Rate for Payer: PHP All Commercial $385.09
Rate for Payer: Plain Church Group Ministry All Commercial $198.03
Rate for Payer: Sagamore Health Network All Products $392.00
Rate for Payer: Signature Care EPO $421.45
Rate for Payer: Signature Care PPO $446.83
Rate for Payer: Three Rivers Preferred All Commercial $431.60
Rate for Payer: United Healthcare Commercial $400.12
Rate for Payer: United Healthcare Medicare $167.56
Service Code CPT 73080 RT
Hospital Charge Code 11613070
Hospital Revenue Code 320
Min. Negotiated Rate $167.56
Max. Negotiated Rate $472.22
Rate for Payer: Aetna Commercial $428.55
Rate for Payer: Aetna Medicare $167.56
Rate for Payer: Anthem Blue Cross of IN Medicare $167.56
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $291.61
Rate for Payer: Anthem Blue Cross of IN Traditional $317.40
Rate for Payer: CareSource Indiana of IN Just 4 Me $192.70
Rate for Payer: CareSource Indiana of IN Medicare $184.32
Rate for Payer: Cash Price $314.82
Rate for Payer: Centivo All Commercial $258.96
Rate for Payer: Cigna All Commercial $438.20
Rate for Payer: CORVEL All Commercial $472.22
Rate for Payer: Coventry All Commercial $446.83
Rate for Payer: Encore All Commercial $467.40
Rate for Payer: Frontpath All Commercial $467.14
Rate for Payer: Humana ChoiceCare $438.56
Rate for Payer: Humana Medicare $258.96
Rate for Payer: Lucent All Commercial $258.96
Rate for Payer: Lutheran Preferred All Commercial $456.99
Rate for Payer: PHCS All Commercial $380.82
Rate for Payer: PHP All Commercial $385.09
Rate for Payer: Plain Church Group Ministry All Commercial $198.03
Rate for Payer: Sagamore Health Network All Products $392.00
Rate for Payer: Signature Care EPO $421.45
Rate for Payer: Signature Care PPO $446.83
Rate for Payer: Three Rivers Preferred All Commercial $431.60
Rate for Payer: United Healthcare Commercial $400.12
Rate for Payer: United Healthcare Medicare $167.56
Service Code CPT 73080 RT
Hospital Charge Code 11613070
Hospital Revenue Code 320
Min. Negotiated Rate $380.82
Max. Negotiated Rate $472.22
Rate for Payer: Aetna Commercial $438.71
Rate for Payer: Cash Price $314.82
Rate for Payer: Cigna All Commercial $438.20
Rate for Payer: CORVEL All Commercial $472.22
Rate for Payer: Coventry All Commercial $446.83
Rate for Payer: Encore All Commercial $467.40
Rate for Payer: Frontpath All Commercial $467.14
Rate for Payer: Humana ChoiceCare $438.56
Rate for Payer: Lutheran Preferred All Commercial $456.99
Rate for Payer: PHCS All Commercial $380.82
Rate for Payer: PHP All Commercial $385.09
Rate for Payer: Sagamore Health Network All Products $392.00
Rate for Payer: Signature Care EPO $421.45
Rate for Payer: Signature Care PPO $446.83
Rate for Payer: United Healthcare Commercial $400.12
Service Code CPT 74018
Hospital Charge Code 01614018
Hospital Revenue Code 320
Min. Negotiated Rate $379.67
Max. Negotiated Rate $470.79
Rate for Payer: Aetna Commercial $437.38
Rate for Payer: Cash Price $313.86
Rate for Payer: Cigna All Commercial $436.87
Rate for Payer: CORVEL All Commercial $470.79
Rate for Payer: Coventry All Commercial $445.48
Rate for Payer: Encore All Commercial $465.98
Rate for Payer: Frontpath All Commercial $465.73
Rate for Payer: Humana ChoiceCare $437.23
Rate for Payer: Lutheran Preferred All Commercial $455.60
Rate for Payer: PHCS All Commercial $379.67
Rate for Payer: PHP All Commercial $383.92
Rate for Payer: Sagamore Health Network All Products $390.81
Rate for Payer: Signature Care EPO $420.17
Rate for Payer: Signature Care PPO $445.48
Rate for Payer: United Healthcare Commercial $398.91
Service Code CPT 74018
Hospital Charge Code 01614018
Hospital Revenue Code 320
Min. Negotiated Rate $167.05
Max. Negotiated Rate $470.79
Rate for Payer: Aetna Commercial $427.25
Rate for Payer: Aetna Medicare $167.05
Rate for Payer: Anthem Blue Cross of IN Medicare $167.05
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $290.73
Rate for Payer: Anthem Blue Cross of IN Traditional $316.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $242.27
Rate for Payer: CareSource Indiana of IN Just 4 Me $192.11
Rate for Payer: CareSource Indiana of IN Medicare $183.76
Rate for Payer: Cash Price $313.86
Rate for Payer: Cash Price $313.86
Rate for Payer: Centivo All Commercial $258.18
Rate for Payer: Cigna All Commercial $436.87
Rate for Payer: CORVEL All Commercial $470.79
Rate for Payer: Coventry All Commercial $445.48
Rate for Payer: Encore All Commercial $465.98
Rate for Payer: Frontpath All Commercial $465.73
Rate for Payer: Humana ChoiceCare $437.23
Rate for Payer: Humana Medicare $258.18
Rate for Payer: Lucent All Commercial $258.18
Rate for Payer: Lutheran Preferred All Commercial $455.60
Rate for Payer: Managed Health Services Medicaid $242.27
Rate for Payer: MDWise Medicaid $242.27
Rate for Payer: PHCS All Commercial $379.67
Rate for Payer: PHP All Commercial $383.92
Rate for Payer: Plain Church Group Ministry All Commercial $197.43
Rate for Payer: Sagamore Health Network All Products $390.81
Rate for Payer: Signature Care EPO $420.17
Rate for Payer: Signature Care PPO $445.48
Rate for Payer: Three Rivers Preferred All Commercial $430.29
Rate for Payer: United Healthcare Commercial $398.91
Rate for Payer: United Healthcare Medicare $167.05
Service Code CPT 74019
Hospital Charge Code 01614010
Hospital Revenue Code 320
Min. Negotiated Rate $192.12
Max. Negotiated Rate $541.42
Rate for Payer: Aetna Commercial $491.36
Rate for Payer: Aetna Medicare $192.12
Rate for Payer: Anthem Blue Cross of IN Medicare $192.12
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $334.34
Rate for Payer: Anthem Blue Cross of IN Traditional $363.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $446.39
Rate for Payer: CareSource Indiana of IN Just 4 Me $220.94
Rate for Payer: CareSource Indiana of IN Medicare $211.33
Rate for Payer: Cash Price $360.95
Rate for Payer: Cash Price $360.95
Rate for Payer: Centivo All Commercial $296.91
Rate for Payer: Cigna All Commercial $502.42
Rate for Payer: CORVEL All Commercial $541.42
Rate for Payer: Coventry All Commercial $512.31
Rate for Payer: Encore All Commercial $535.89
Rate for Payer: Frontpath All Commercial $535.60
Rate for Payer: Humana ChoiceCare $502.82
Rate for Payer: Humana Medicare $296.91
Rate for Payer: Lucent All Commercial $296.91
Rate for Payer: Lutheran Preferred All Commercial $523.96
Rate for Payer: Managed Health Services Medicaid $446.39
Rate for Payer: MDWise Medicaid $446.39
Rate for Payer: PHCS All Commercial $436.63
Rate for Payer: PHP All Commercial $441.52
Rate for Payer: Plain Church Group Ministry All Commercial $227.05
Rate for Payer: Sagamore Health Network All Products $449.44
Rate for Payer: Signature Care EPO $483.21
Rate for Payer: Signature Care PPO $512.31
Rate for Payer: Three Rivers Preferred All Commercial $494.85
Rate for Payer: United Healthcare Commercial $458.75
Rate for Payer: United Healthcare Medicare $192.12
Service Code CPT 74019
Hospital Charge Code 01614010
Hospital Revenue Code 320
Min. Negotiated Rate $436.63
Max. Negotiated Rate $541.42
Rate for Payer: Aetna Commercial $503.00
Rate for Payer: Cash Price $360.95
Rate for Payer: Cigna All Commercial $502.42
Rate for Payer: CORVEL All Commercial $541.42
Rate for Payer: Coventry All Commercial $512.31
Rate for Payer: Encore All Commercial $535.89
Rate for Payer: Frontpath All Commercial $535.60
Rate for Payer: Humana ChoiceCare $502.82
Rate for Payer: Lutheran Preferred All Commercial $523.96
Rate for Payer: PHCS All Commercial $436.63
Rate for Payer: PHP All Commercial $441.52
Rate for Payer: Sagamore Health Network All Products $449.44
Rate for Payer: Signature Care EPO $483.21
Rate for Payer: Signature Care PPO $512.31
Rate for Payer: United Healthcare Commercial $458.75
Service Code CPT 74021
Hospital Charge Code 01614021
Hospital Revenue Code 320
Min. Negotiated Rate $220.93
Max. Negotiated Rate $622.63
Rate for Payer: Aetna Commercial $565.06
Rate for Payer: Aetna Medicare $220.93
Rate for Payer: Anthem Blue Cross of IN Medicare $220.93
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $384.49
Rate for Payer: Anthem Blue Cross of IN Traditional $418.50
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $446.39
Rate for Payer: CareSource Indiana of IN Just 4 Me $254.07
Rate for Payer: CareSource Indiana of IN Medicare $243.03
Rate for Payer: Cash Price $415.09
Rate for Payer: Cash Price $415.09
Rate for Payer: Centivo All Commercial $341.44
Rate for Payer: Cigna All Commercial $577.78
Rate for Payer: CORVEL All Commercial $622.63
Rate for Payer: Coventry All Commercial $589.16
Rate for Payer: Encore All Commercial $616.27
Rate for Payer: Frontpath All Commercial $615.94
Rate for Payer: Humana ChoiceCare $578.24
Rate for Payer: Humana Medicare $341.44
Rate for Payer: Lucent All Commercial $341.44
Rate for Payer: Lutheran Preferred All Commercial $602.55
Rate for Payer: Managed Health Services Medicaid $446.39
Rate for Payer: MDWise Medicaid $446.39
Rate for Payer: PHCS All Commercial $502.12
Rate for Payer: PHP All Commercial $507.75
Rate for Payer: Plain Church Group Ministry All Commercial $261.10
Rate for Payer: Sagamore Health Network All Products $516.85
Rate for Payer: Signature Care EPO $555.68
Rate for Payer: Signature Care PPO $589.16
Rate for Payer: Three Rivers Preferred All Commercial $569.07
Rate for Payer: United Healthcare Commercial $527.56
Rate for Payer: United Healthcare Medicare $220.93
Service Code CPT 74021
Hospital Charge Code 01614021
Hospital Revenue Code 320
Min. Negotiated Rate $502.12
Max. Negotiated Rate $622.63
Rate for Payer: Aetna Commercial $578.45
Rate for Payer: Cash Price $415.09
Rate for Payer: Cigna All Commercial $577.78
Rate for Payer: CORVEL All Commercial $622.63
Rate for Payer: Coventry All Commercial $589.16
Rate for Payer: Encore All Commercial $616.27
Rate for Payer: Frontpath All Commercial $615.94
Rate for Payer: Humana ChoiceCare $578.24
Rate for Payer: Lutheran Preferred All Commercial $602.55
Rate for Payer: PHCS All Commercial $502.12
Rate for Payer: PHP All Commercial $507.75
Rate for Payer: Sagamore Health Network All Products $516.85
Rate for Payer: Signature Care EPO $555.68
Rate for Payer: Signature Care PPO $589.16
Rate for Payer: United Healthcare Commercial $527.56
Service Code CPT 71045
Hospital Charge Code 01611010
Hospital Revenue Code 324
Min. Negotiated Rate $270.24
Max. Negotiated Rate $335.10
Rate for Payer: Aetna Commercial $311.32
Rate for Payer: Cash Price $223.40
Rate for Payer: Cigna All Commercial $310.96
Rate for Payer: CORVEL All Commercial $335.10
Rate for Payer: Coventry All Commercial $317.09
Rate for Payer: Encore All Commercial $331.68
Rate for Payer: Frontpath All Commercial $331.50
Rate for Payer: Humana ChoiceCare $311.21
Rate for Payer: Lutheran Preferred All Commercial $324.29
Rate for Payer: PHCS All Commercial $270.24
Rate for Payer: PHP All Commercial $273.27
Rate for Payer: Sagamore Health Network All Products $278.17
Rate for Payer: Signature Care EPO $299.07
Rate for Payer: Signature Care PPO $317.09
Rate for Payer: United Healthcare Commercial $283.94
Service Code CPT 71045
Hospital Charge Code 01611010
Hospital Revenue Code 324
Min. Negotiated Rate $118.91
Max. Negotiated Rate $335.10
Rate for Payer: Aetna Commercial $304.11
Rate for Payer: Aetna Medicare $118.91
Rate for Payer: Anthem Blue Cross of IN Medicare $118.91
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $206.93
Rate for Payer: Anthem Blue Cross of IN Traditional $225.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $242.27
Rate for Payer: CareSource Indiana of IN Just 4 Me $136.74
Rate for Payer: CareSource Indiana of IN Medicare $130.80
Rate for Payer: Cash Price $223.40
Rate for Payer: Cash Price $223.40
Rate for Payer: Centivo All Commercial $183.77
Rate for Payer: Cigna All Commercial $310.96
Rate for Payer: CORVEL All Commercial $335.10
Rate for Payer: Coventry All Commercial $317.09
Rate for Payer: Encore All Commercial $331.68
Rate for Payer: Frontpath All Commercial $331.50
Rate for Payer: Humana ChoiceCare $311.21
Rate for Payer: Humana Medicare $183.77
Rate for Payer: Lucent All Commercial $183.77
Rate for Payer: Lutheran Preferred All Commercial $324.29
Rate for Payer: Managed Health Services Medicaid $242.27
Rate for Payer: MDWise Medicaid $242.27
Rate for Payer: PHCS All Commercial $270.24
Rate for Payer: PHP All Commercial $273.27
Rate for Payer: Plain Church Group Ministry All Commercial $140.53
Rate for Payer: Sagamore Health Network All Products $278.17
Rate for Payer: Signature Care EPO $299.07
Rate for Payer: Signature Care PPO $317.09
Rate for Payer: Three Rivers Preferred All Commercial $306.28
Rate for Payer: United Healthcare Commercial $283.94
Rate for Payer: United Healthcare Medicare $118.91
Service Code CPT 71046
Hospital Charge Code 01611046
Hospital Revenue Code 324
Min. Negotiated Rate $310.78
Max. Negotiated Rate $385.37
Rate for Payer: Aetna Commercial $358.02
Rate for Payer: Cash Price $256.91
Rate for Payer: Cigna All Commercial $357.61
Rate for Payer: CORVEL All Commercial $385.37
Rate for Payer: Coventry All Commercial $364.65
Rate for Payer: Encore All Commercial $381.43
Rate for Payer: Frontpath All Commercial $381.22
Rate for Payer: Humana ChoiceCare $357.90
Rate for Payer: Lutheran Preferred All Commercial $372.94
Rate for Payer: PHCS All Commercial $310.78
Rate for Payer: PHP All Commercial $314.26
Rate for Payer: Sagamore Health Network All Products $319.90
Rate for Payer: Signature Care EPO $343.93
Rate for Payer: Signature Care PPO $364.65
Rate for Payer: United Healthcare Commercial $326.53
Service Code CPT 71046
Hospital Charge Code 01611046
Hospital Revenue Code 324
Min. Negotiated Rate $136.74
Max. Negotiated Rate $385.37
Rate for Payer: Aetna Commercial $349.73
Rate for Payer: Aetna Medicare $136.74
Rate for Payer: Anthem Blue Cross of IN Medicare $136.74
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $237.98
Rate for Payer: Anthem Blue Cross of IN Traditional $259.03
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $242.27
Rate for Payer: CareSource Indiana of IN Just 4 Me $157.26
Rate for Payer: CareSource Indiana of IN Medicare $150.42
Rate for Payer: Cash Price $256.91
Rate for Payer: Cash Price $256.91
Rate for Payer: Centivo All Commercial $211.33
Rate for Payer: Cigna All Commercial $357.61
Rate for Payer: CORVEL All Commercial $385.37
Rate for Payer: Coventry All Commercial $364.65
Rate for Payer: Encore All Commercial $381.43
Rate for Payer: Frontpath All Commercial $381.22
Rate for Payer: Humana ChoiceCare $357.90
Rate for Payer: Humana Medicare $211.33
Rate for Payer: Lucent All Commercial $211.33
Rate for Payer: Lutheran Preferred All Commercial $372.94
Rate for Payer: Managed Health Services Medicaid $242.27
Rate for Payer: MDWise Medicaid $242.27
Rate for Payer: PHCS All Commercial $310.78
Rate for Payer: PHP All Commercial $314.26
Rate for Payer: Plain Church Group Ministry All Commercial $161.61
Rate for Payer: Sagamore Health Network All Products $319.90
Rate for Payer: Signature Care EPO $343.93
Rate for Payer: Signature Care PPO $364.65
Rate for Payer: Three Rivers Preferred All Commercial $352.22
Rate for Payer: United Healthcare Commercial $326.53
Rate for Payer: United Healthcare Medicare $136.74
Service Code CPT 71047
Hospital Charge Code 01611047
Hospital Revenue Code 324
Min. Negotiated Rate $157.25
Max. Negotiated Rate $443.17
Rate for Payer: Aetna Commercial $402.19
Rate for Payer: Aetna Medicare $157.25
Rate for Payer: Anthem Blue Cross of IN Medicare $157.25
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $273.67
Rate for Payer: Anthem Blue Cross of IN Traditional $297.87
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $242.27
Rate for Payer: CareSource Indiana of IN Just 4 Me $180.84
Rate for Payer: CareSource Indiana of IN Medicare $172.98
Rate for Payer: Cash Price $295.45
Rate for Payer: Cash Price $295.45
Rate for Payer: Centivo All Commercial $243.03
Rate for Payer: Cigna All Commercial $411.24
Rate for Payer: CORVEL All Commercial $443.17
Rate for Payer: Coventry All Commercial $419.34
Rate for Payer: Encore All Commercial $438.64
Rate for Payer: Frontpath All Commercial $438.40
Rate for Payer: Humana ChoiceCare $411.57
Rate for Payer: Humana Medicare $243.03
Rate for Payer: Lucent All Commercial $243.03
Rate for Payer: Lutheran Preferred All Commercial $428.87
Rate for Payer: Managed Health Services Medicaid $242.27
Rate for Payer: MDWise Medicaid $242.27
Rate for Payer: PHCS All Commercial $357.39
Rate for Payer: PHP All Commercial $361.40
Rate for Payer: Plain Church Group Ministry All Commercial $185.84
Rate for Payer: Sagamore Health Network All Products $367.88
Rate for Payer: Signature Care EPO $395.51
Rate for Payer: Signature Care PPO $419.34
Rate for Payer: Three Rivers Preferred All Commercial $405.05
Rate for Payer: United Healthcare Commercial $375.50
Rate for Payer: United Healthcare Medicare $157.25
Service Code CPT 71047
Hospital Charge Code 01611047
Hospital Revenue Code 324
Min. Negotiated Rate $357.39
Max. Negotiated Rate $443.17
Rate for Payer: Aetna Commercial $411.72
Rate for Payer: Cash Price $295.45
Rate for Payer: Cigna All Commercial $411.24
Rate for Payer: CORVEL All Commercial $443.17
Rate for Payer: Coventry All Commercial $419.34
Rate for Payer: Encore All Commercial $438.64
Rate for Payer: Frontpath All Commercial $438.40
Rate for Payer: Humana ChoiceCare $411.57
Rate for Payer: Lutheran Preferred All Commercial $428.87
Rate for Payer: PHCS All Commercial $357.39
Rate for Payer: PHP All Commercial $361.40
Rate for Payer: Sagamore Health Network All Products $367.88
Rate for Payer: Signature Care EPO $395.51
Rate for Payer: Signature Care PPO $419.34
Rate for Payer: United Healthcare Commercial $375.50
Service Code CPT 71048
Hospital Charge Code 01611039
Hospital Revenue Code 324
Min. Negotiated Rate $296.24
Max. Negotiated Rate $834.85
Rate for Payer: Aetna Commercial $757.65
Rate for Payer: Aetna Medicare $296.24
Rate for Payer: Anthem Blue Cross of IN Medicare $296.24
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $515.54
Rate for Payer: Anthem Blue Cross of IN Traditional $561.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $446.39
Rate for Payer: CareSource Indiana of IN Just 4 Me $340.67
Rate for Payer: CareSource Indiana of IN Medicare $325.86
Rate for Payer: Cash Price $556.57
Rate for Payer: Cash Price $556.57
Rate for Payer: Centivo All Commercial $457.82
Rate for Payer: Cigna All Commercial $774.71
Rate for Payer: CORVEL All Commercial $834.85
Rate for Payer: Coventry All Commercial $789.97
Rate for Payer: Encore All Commercial $826.33
Rate for Payer: Frontpath All Commercial $825.88
Rate for Payer: Humana ChoiceCare $775.34
Rate for Payer: Humana Medicare $457.82
Rate for Payer: Lucent All Commercial $457.82
Rate for Payer: Lutheran Preferred All Commercial $807.92
Rate for Payer: Managed Health Services Medicaid $446.39
Rate for Payer: MDWise Medicaid $446.39
Rate for Payer: PHCS All Commercial $673.27
Rate for Payer: PHP All Commercial $680.81
Rate for Payer: Plain Church Group Ministry All Commercial $350.10
Rate for Payer: Sagamore Health Network All Products $693.02
Rate for Payer: Signature Care EPO $745.08
Rate for Payer: Signature Care PPO $789.97
Rate for Payer: Three Rivers Preferred All Commercial $763.04
Rate for Payer: United Healthcare Commercial $707.38
Rate for Payer: United Healthcare Medicare $296.24
Service Code CPT 71048
Hospital Charge Code 01611039
Hospital Revenue Code 324
Min. Negotiated Rate $673.27
Max. Negotiated Rate $834.85
Rate for Payer: Aetna Commercial $775.61
Rate for Payer: Cash Price $556.57
Rate for Payer: Cigna All Commercial $774.71
Rate for Payer: CORVEL All Commercial $834.85
Rate for Payer: Coventry All Commercial $789.97
Rate for Payer: Encore All Commercial $826.33
Rate for Payer: Frontpath All Commercial $825.88
Rate for Payer: Humana ChoiceCare $775.34
Rate for Payer: Lutheran Preferred All Commercial $807.92
Rate for Payer: PHCS All Commercial $673.27
Rate for Payer: PHP All Commercial $680.81
Rate for Payer: Sagamore Health Network All Products $693.02
Rate for Payer: Signature Care EPO $745.08
Rate for Payer: Signature Care PPO $789.97
Rate for Payer: United Healthcare Commercial $707.38
Service Code CPT 72084
Hospital Charge Code 01612084
Hospital Revenue Code 320
Min. Negotiated Rate $185.17
Max. Negotiated Rate $1,060.53
Rate for Payer: Aetna Commercial $962.46
Rate for Payer: Aetna Medicare $376.32
Rate for Payer: Anthem Blue Cross of IN Medicare $376.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $654.91
Rate for Payer: Anthem Blue Cross of IN Traditional $712.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $185.17
Rate for Payer: CareSource Indiana of IN Just 4 Me $432.77
Rate for Payer: CareSource Indiana of IN Medicare $413.95
Rate for Payer: Cash Price $707.02
Rate for Payer: Cash Price $707.02
Rate for Payer: Centivo All Commercial $581.58
Rate for Payer: Cigna All Commercial $984.13
Rate for Payer: CORVEL All Commercial $1,060.53
Rate for Payer: Coventry All Commercial $1,003.52
Rate for Payer: Encore All Commercial $1,049.70
Rate for Payer: Frontpath All Commercial $1,049.13
Rate for Payer: Humana ChoiceCare $984.93
Rate for Payer: Humana Medicare $581.58
Rate for Payer: Lucent All Commercial $581.58
Rate for Payer: Lutheran Preferred All Commercial $1,026.32
Rate for Payer: Managed Health Services Medicaid $185.17
Rate for Payer: MDWise Medicaid $185.17
Rate for Payer: PHCS All Commercial $855.27
Rate for Payer: PHP All Commercial $864.85
Rate for Payer: Plain Church Group Ministry All Commercial $444.74
Rate for Payer: Sagamore Health Network All Products $880.36
Rate for Payer: Signature Care EPO $946.50
Rate for Payer: Signature Care PPO $1,003.52
Rate for Payer: Three Rivers Preferred All Commercial $969.31
Rate for Payer: United Healthcare Commercial $898.60
Rate for Payer: United Healthcare Medicare $376.32
Service Code CPT 72084
Hospital Charge Code 01612084
Hospital Revenue Code 320
Min. Negotiated Rate $855.27
Max. Negotiated Rate $1,060.53
Rate for Payer: Aetna Commercial $985.27
Rate for Payer: Cash Price $707.02
Rate for Payer: Cigna All Commercial $984.13
Rate for Payer: CORVEL All Commercial $1,060.53
Rate for Payer: Coventry All Commercial $1,003.52
Rate for Payer: Encore All Commercial $1,049.70
Rate for Payer: Frontpath All Commercial $1,049.13
Rate for Payer: Humana ChoiceCare $984.93
Rate for Payer: Lutheran Preferred All Commercial $1,026.32
Rate for Payer: PHCS All Commercial $855.27
Rate for Payer: PHP All Commercial $864.85
Rate for Payer: Sagamore Health Network All Products $880.36
Rate for Payer: Signature Care EPO $946.50
Rate for Payer: Signature Care PPO $1,003.52
Rate for Payer: United Healthcare Commercial $898.60
Service Code CPT 74220
Hospital Charge Code 01614220
Hospital Revenue Code 320
Min. Negotiated Rate $189.03
Max. Negotiated Rate $873.75
Rate for Payer: Aetna Commercial $792.95
Rate for Payer: Aetna Medicare $310.04
Rate for Payer: Anthem Blue Cross of IN Medicare $310.04
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $539.56
Rate for Payer: Anthem Blue Cross of IN Traditional $587.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $189.03
Rate for Payer: CareSource Indiana of IN Just 4 Me $356.54
Rate for Payer: CareSource Indiana of IN Medicare $341.04
Rate for Payer: Cash Price $582.50
Rate for Payer: Cash Price $582.50
Rate for Payer: Centivo All Commercial $479.15
Rate for Payer: Cigna All Commercial $810.80
Rate for Payer: CORVEL All Commercial $873.75
Rate for Payer: Coventry All Commercial $826.77
Rate for Payer: Encore All Commercial $864.82
Rate for Payer: Frontpath All Commercial $864.35
Rate for Payer: Humana ChoiceCare $811.46
Rate for Payer: Humana Medicare $479.15
Rate for Payer: Lucent All Commercial $479.15
Rate for Payer: Lutheran Preferred All Commercial $845.56
Rate for Payer: Managed Health Services Medicaid $189.03
Rate for Payer: MDWise Medicaid $189.03
Rate for Payer: PHCS All Commercial $704.63
Rate for Payer: PHP All Commercial $712.53
Rate for Payer: Plain Church Group Ministry All Commercial $366.41
Rate for Payer: Sagamore Health Network All Products $725.30
Rate for Payer: Signature Care EPO $779.79
Rate for Payer: Signature Care PPO $826.77
Rate for Payer: Three Rivers Preferred All Commercial $798.59
Rate for Payer: United Healthcare Commercial $740.34
Rate for Payer: United Healthcare Medicare $310.04