|
HC ACU 1.1MMX3.5 SURGIBIT DRILL
|
Facility
OP
|
$889.00
|
|
| Hospital Charge Code |
41603240
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$826.77 |
| Rate for Payer: Aetna Commercial |
$750.32
|
| Rate for Payer: Aetna Medicare |
$293.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$293.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$510.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$555.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$337.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$322.71
|
| Rate for Payer: Cash Price |
$551.18
|
| Rate for Payer: Cash Price |
$551.18
|
| Rate for Payer: Centivo All Commercial |
$453.39
|
| Rate for Payer: Cigna All Commercial |
$767.21
|
| Rate for Payer: CORVEL All Commercial |
$826.77
|
| Rate for Payer: Coventry All Commercial |
$782.32
|
| Rate for Payer: Encore All Commercial |
$818.32
|
| Rate for Payer: Frontpath All Commercial |
$817.88
|
| Rate for Payer: Humana ChoiceCare |
$767.83
|
| Rate for Payer: Humana Medicare |
$453.39
|
| Rate for Payer: Lucent All Commercial |
$453.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$800.10
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$666.75
|
| Rate for Payer: PHP All Commercial |
$674.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$346.71
|
| Rate for Payer: Sagamore Health Network All Products |
$686.31
|
| Rate for Payer: Signature Care EPO |
$737.87
|
| Rate for Payer: Signature Care PPO |
$782.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$755.65
|
| Rate for Payer: United Healthcare Commercial |
$700.53
|
| Rate for Payer: United Healthcare Medicare |
$293.37
|
|
|
HC ACU 1.3MM COMP PLATE 6 HOLE
|
Facility
IP
|
$2,664.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603183
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,998.00 |
| Max. Negotiated Rate |
$2,477.52 |
| Rate for Payer: Aetna Commercial |
$2,301.70
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Cigna All Commercial |
$2,299.03
|
| Rate for Payer: CORVEL All Commercial |
$2,477.52
|
| Rate for Payer: Coventry All Commercial |
$2,344.32
|
| Rate for Payer: Encore All Commercial |
$2,452.21
|
| Rate for Payer: Frontpath All Commercial |
$2,450.88
|
| Rate for Payer: Humana ChoiceCare |
$2,300.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,397.60
|
| Rate for Payer: PHCS All Commercial |
$1,998.00
|
| Rate for Payer: PHP All Commercial |
$2,020.38
|
| Rate for Payer: Sagamore Health Network All Products |
$2,056.61
|
| Rate for Payer: Signature Care EPO |
$2,211.12
|
| Rate for Payer: Signature Care PPO |
$2,344.32
|
| Rate for Payer: United Healthcare Commercial |
$2,099.23
|
|
|
HC ACU 1.3MM COMP PLATE 6 HOLE
|
Facility
OP
|
$2,664.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603183
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,477.52 |
| Rate for Payer: Aetna Commercial |
$2,248.42
|
| Rate for Payer: Aetna Medicare |
$879.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$879.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,529.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,665.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,010.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$967.03
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Centivo All Commercial |
$1,358.64
|
| Rate for Payer: Cigna All Commercial |
$2,299.03
|
| Rate for Payer: CORVEL All Commercial |
$2,477.52
|
| Rate for Payer: Coventry All Commercial |
$2,344.32
|
| Rate for Payer: Encore All Commercial |
$2,452.21
|
| Rate for Payer: Frontpath All Commercial |
$2,450.88
|
| Rate for Payer: Humana ChoiceCare |
$2,300.90
|
| Rate for Payer: Humana Medicare |
$1,358.64
|
| Rate for Payer: Lucent All Commercial |
$1,358.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,397.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,998.00
|
| Rate for Payer: PHP All Commercial |
$2,020.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,038.96
|
| Rate for Payer: Sagamore Health Network All Products |
$2,056.61
|
| Rate for Payer: Signature Care EPO |
$2,211.12
|
| Rate for Payer: Signature Care PPO |
$2,344.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,264.40
|
| Rate for Payer: United Healthcare Commercial |
$2,099.23
|
| Rate for Payer: United Healthcare Medicare |
$879.12
|
|
|
HC ACU 1.3MM MC NECK PLATE LT
|
Facility
OP
|
$3,067.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,852.50 |
| Rate for Payer: Aetna Commercial |
$2,588.72
|
| Rate for Payer: Aetna Medicare |
$1,012.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,012.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,761.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,917.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,164.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,113.39
|
| Rate for Payer: Cash Price |
$1,901.66
|
| Rate for Payer: Cash Price |
$1,901.66
|
| Rate for Payer: Centivo All Commercial |
$1,564.27
|
| Rate for Payer: Cigna All Commercial |
$2,646.99
|
| Rate for Payer: CORVEL All Commercial |
$2,852.50
|
| Rate for Payer: Coventry All Commercial |
$2,699.14
|
| Rate for Payer: Encore All Commercial |
$2,823.36
|
| Rate for Payer: Frontpath All Commercial |
$2,821.82
|
| Rate for Payer: Humana ChoiceCare |
$2,649.14
|
| Rate for Payer: Humana Medicare |
$1,564.27
|
| Rate for Payer: Lucent All Commercial |
$1,564.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,760.48
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,300.40
|
| Rate for Payer: PHP All Commercial |
$2,326.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,196.21
|
| Rate for Payer: Sagamore Health Network All Products |
$2,367.88
|
| Rate for Payer: Signature Care EPO |
$2,545.78
|
| Rate for Payer: Signature Care PPO |
$2,699.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,607.12
|
| Rate for Payer: United Healthcare Commercial |
$2,416.95
|
| Rate for Payer: United Healthcare Medicare |
$1,012.18
|
|
|
HC ACU 1.3MM MC NECK PLATE LT
|
Facility
IP
|
$3,067.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,300.40 |
| Max. Negotiated Rate |
$2,852.50 |
| Rate for Payer: Aetna Commercial |
$2,650.06
|
| Rate for Payer: Cash Price |
$1,901.66
|
| Rate for Payer: Cigna All Commercial |
$2,646.99
|
| Rate for Payer: CORVEL All Commercial |
$2,852.50
|
| Rate for Payer: Coventry All Commercial |
$2,699.14
|
| Rate for Payer: Encore All Commercial |
$2,823.36
|
| Rate for Payer: Frontpath All Commercial |
$2,821.82
|
| Rate for Payer: Humana ChoiceCare |
$2,649.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,760.48
|
| Rate for Payer: PHCS All Commercial |
$2,300.40
|
| Rate for Payer: PHP All Commercial |
$2,326.16
|
| Rate for Payer: Sagamore Health Network All Products |
$2,367.88
|
| Rate for Payer: Signature Care EPO |
$2,545.78
|
| Rate for Payer: Signature Care PPO |
$2,699.14
|
| Rate for Payer: United Healthcare Commercial |
$2,416.95
|
|
|
HC ACU 1.3MM MC NECK PLATE RT
|
Facility
IP
|
$3,067.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,300.40 |
| Max. Negotiated Rate |
$2,852.50 |
| Rate for Payer: Aetna Commercial |
$2,650.06
|
| Rate for Payer: Cash Price |
$1,901.66
|
| Rate for Payer: Cigna All Commercial |
$2,646.99
|
| Rate for Payer: CORVEL All Commercial |
$2,852.50
|
| Rate for Payer: Coventry All Commercial |
$2,699.14
|
| Rate for Payer: Encore All Commercial |
$2,823.36
|
| Rate for Payer: Frontpath All Commercial |
$2,821.82
|
| Rate for Payer: Humana ChoiceCare |
$2,649.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,760.48
|
| Rate for Payer: PHCS All Commercial |
$2,300.40
|
| Rate for Payer: PHP All Commercial |
$2,326.16
|
| Rate for Payer: Sagamore Health Network All Products |
$2,367.88
|
| Rate for Payer: Signature Care EPO |
$2,545.78
|
| Rate for Payer: Signature Care PPO |
$2,699.14
|
| Rate for Payer: United Healthcare Commercial |
$2,416.95
|
|
|
HC ACU 1.3MM MC NECK PLATE RT
|
Facility
OP
|
$3,067.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,852.50 |
| Rate for Payer: Aetna Commercial |
$2,588.72
|
| Rate for Payer: Aetna Medicare |
$1,012.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,012.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,761.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,917.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,164.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,113.39
|
| Rate for Payer: Cash Price |
$1,901.66
|
| Rate for Payer: Cash Price |
$1,901.66
|
| Rate for Payer: Centivo All Commercial |
$1,564.27
|
| Rate for Payer: Cigna All Commercial |
$2,646.99
|
| Rate for Payer: CORVEL All Commercial |
$2,852.50
|
| Rate for Payer: Coventry All Commercial |
$2,699.14
|
| Rate for Payer: Encore All Commercial |
$2,823.36
|
| Rate for Payer: Frontpath All Commercial |
$2,821.82
|
| Rate for Payer: Humana ChoiceCare |
$2,649.14
|
| Rate for Payer: Humana Medicare |
$1,564.27
|
| Rate for Payer: Lucent All Commercial |
$1,564.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,760.48
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,300.40
|
| Rate for Payer: PHP All Commercial |
$2,326.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,196.21
|
| Rate for Payer: Sagamore Health Network All Products |
$2,367.88
|
| Rate for Payer: Signature Care EPO |
$2,545.78
|
| Rate for Payer: Signature Care PPO |
$2,699.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,607.12
|
| Rate for Payer: United Healthcare Commercial |
$2,416.95
|
| Rate for Payer: United Healthcare Medicare |
$1,012.18
|
|
|
HC ACU 1.3MM ROL FX HOOK PLATE
|
Facility
OP
|
$2,664.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,477.52 |
| Rate for Payer: Aetna Commercial |
$2,248.42
|
| Rate for Payer: Aetna Medicare |
$879.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$879.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,529.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,665.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,010.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$967.03
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Centivo All Commercial |
$1,358.64
|
| Rate for Payer: Cigna All Commercial |
$2,299.03
|
| Rate for Payer: CORVEL All Commercial |
$2,477.52
|
| Rate for Payer: Coventry All Commercial |
$2,344.32
|
| Rate for Payer: Encore All Commercial |
$2,452.21
|
| Rate for Payer: Frontpath All Commercial |
$2,450.88
|
| Rate for Payer: Humana ChoiceCare |
$2,300.90
|
| Rate for Payer: Humana Medicare |
$1,358.64
|
| Rate for Payer: Lucent All Commercial |
$1,358.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,397.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,998.00
|
| Rate for Payer: PHP All Commercial |
$2,020.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,038.96
|
| Rate for Payer: Sagamore Health Network All Products |
$2,056.61
|
| Rate for Payer: Signature Care EPO |
$2,211.12
|
| Rate for Payer: Signature Care PPO |
$2,344.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,264.40
|
| Rate for Payer: United Healthcare Commercial |
$2,099.23
|
| Rate for Payer: United Healthcare Medicare |
$879.12
|
|
|
HC ACU 1.3MM ROL FX HOOK PLATE
|
Facility
IP
|
$2,664.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,998.00 |
| Max. Negotiated Rate |
$2,477.52 |
| Rate for Payer: Aetna Commercial |
$2,301.70
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Cigna All Commercial |
$2,299.03
|
| Rate for Payer: CORVEL All Commercial |
$2,477.52
|
| Rate for Payer: Coventry All Commercial |
$2,344.32
|
| Rate for Payer: Encore All Commercial |
$2,452.21
|
| Rate for Payer: Frontpath All Commercial |
$2,450.88
|
| Rate for Payer: Humana ChoiceCare |
$2,300.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,397.60
|
| Rate for Payer: PHCS All Commercial |
$1,998.00
|
| Rate for Payer: PHP All Commercial |
$2,020.38
|
| Rate for Payer: Sagamore Health Network All Products |
$2,056.61
|
| Rate for Payer: Signature Care EPO |
$2,211.12
|
| Rate for Payer: Signature Care PPO |
$2,344.32
|
| Rate for Payer: United Healthcare Commercial |
$2,099.23
|
|
|
HC ACU 1.3MM ROT CORRECT PLATE
|
Facility
IP
|
$3,067.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,300.40 |
| Max. Negotiated Rate |
$2,852.50 |
| Rate for Payer: Aetna Commercial |
$2,650.06
|
| Rate for Payer: Cash Price |
$1,901.66
|
| Rate for Payer: Cigna All Commercial |
$2,646.99
|
| Rate for Payer: CORVEL All Commercial |
$2,852.50
|
| Rate for Payer: Coventry All Commercial |
$2,699.14
|
| Rate for Payer: Encore All Commercial |
$2,823.36
|
| Rate for Payer: Frontpath All Commercial |
$2,821.82
|
| Rate for Payer: Humana ChoiceCare |
$2,649.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,760.48
|
| Rate for Payer: PHCS All Commercial |
$2,300.40
|
| Rate for Payer: PHP All Commercial |
$2,326.16
|
| Rate for Payer: Sagamore Health Network All Products |
$2,367.88
|
| Rate for Payer: Signature Care EPO |
$2,545.78
|
| Rate for Payer: Signature Care PPO |
$2,699.14
|
| Rate for Payer: United Healthcare Commercial |
$2,416.95
|
|
|
HC ACU 1.3MM ROT CORRECT PLATE
|
Facility
OP
|
$3,067.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,852.50 |
| Rate for Payer: Aetna Commercial |
$2,588.72
|
| Rate for Payer: Aetna Medicare |
$1,012.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,012.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,761.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,917.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,164.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,113.39
|
| Rate for Payer: Cash Price |
$1,901.66
|
| Rate for Payer: Cash Price |
$1,901.66
|
| Rate for Payer: Centivo All Commercial |
$1,564.27
|
| Rate for Payer: Cigna All Commercial |
$2,646.99
|
| Rate for Payer: CORVEL All Commercial |
$2,852.50
|
| Rate for Payer: Coventry All Commercial |
$2,699.14
|
| Rate for Payer: Encore All Commercial |
$2,823.36
|
| Rate for Payer: Frontpath All Commercial |
$2,821.82
|
| Rate for Payer: Humana ChoiceCare |
$2,649.14
|
| Rate for Payer: Humana Medicare |
$1,564.27
|
| Rate for Payer: Lucent All Commercial |
$1,564.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,760.48
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,300.40
|
| Rate for Payer: PHP All Commercial |
$2,326.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,196.21
|
| Rate for Payer: Sagamore Health Network All Products |
$2,367.88
|
| Rate for Payer: Signature Care EPO |
$2,545.78
|
| Rate for Payer: Signature Care PPO |
$2,699.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,607.12
|
| Rate for Payer: United Healthcare Commercial |
$2,416.95
|
| Rate for Payer: United Healthcare Medicare |
$1,012.18
|
|
|
HC ACU 1.3MM ST PLATE 10 HOLE
|
Facility
IP
|
$2,664.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603184
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,998.00 |
| Max. Negotiated Rate |
$2,477.52 |
| Rate for Payer: Aetna Commercial |
$2,301.70
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Cigna All Commercial |
$2,299.03
|
| Rate for Payer: CORVEL All Commercial |
$2,477.52
|
| Rate for Payer: Coventry All Commercial |
$2,344.32
|
| Rate for Payer: Encore All Commercial |
$2,452.21
|
| Rate for Payer: Frontpath All Commercial |
$2,450.88
|
| Rate for Payer: Humana ChoiceCare |
$2,300.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,397.60
|
| Rate for Payer: PHCS All Commercial |
$1,998.00
|
| Rate for Payer: PHP All Commercial |
$2,020.38
|
| Rate for Payer: Sagamore Health Network All Products |
$2,056.61
|
| Rate for Payer: Signature Care EPO |
$2,211.12
|
| Rate for Payer: Signature Care PPO |
$2,344.32
|
| Rate for Payer: United Healthcare Commercial |
$2,099.23
|
|
|
HC ACU 1.3MM ST PLATE 10 HOLE
|
Facility
OP
|
$2,664.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603184
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,477.52 |
| Rate for Payer: Aetna Commercial |
$2,248.42
|
| Rate for Payer: Aetna Medicare |
$879.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$879.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,529.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,665.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,010.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$967.03
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Centivo All Commercial |
$1,358.64
|
| Rate for Payer: Cigna All Commercial |
$2,299.03
|
| Rate for Payer: CORVEL All Commercial |
$2,477.52
|
| Rate for Payer: Coventry All Commercial |
$2,344.32
|
| Rate for Payer: Encore All Commercial |
$2,452.21
|
| Rate for Payer: Frontpath All Commercial |
$2,450.88
|
| Rate for Payer: Humana ChoiceCare |
$2,300.90
|
| Rate for Payer: Humana Medicare |
$1,358.64
|
| Rate for Payer: Lucent All Commercial |
$1,358.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,397.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,998.00
|
| Rate for Payer: PHP All Commercial |
$2,020.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,038.96
|
| Rate for Payer: Sagamore Health Network All Products |
$2,056.61
|
| Rate for Payer: Signature Care EPO |
$2,211.12
|
| Rate for Payer: Signature Care PPO |
$2,344.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,264.40
|
| Rate for Payer: United Healthcare Commercial |
$2,099.23
|
| Rate for Payer: United Healthcare Medicare |
$879.12
|
|
|
HC ACU 1.3MM T-PLATE
|
Facility
IP
|
$2,664.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,998.00 |
| Max. Negotiated Rate |
$2,477.52 |
| Rate for Payer: Aetna Commercial |
$2,301.70
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Cigna All Commercial |
$2,299.03
|
| Rate for Payer: CORVEL All Commercial |
$2,477.52
|
| Rate for Payer: Coventry All Commercial |
$2,344.32
|
| Rate for Payer: Encore All Commercial |
$2,452.21
|
| Rate for Payer: Frontpath All Commercial |
$2,450.88
|
| Rate for Payer: Humana ChoiceCare |
$2,300.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,397.60
|
| Rate for Payer: PHCS All Commercial |
$1,998.00
|
| Rate for Payer: PHP All Commercial |
$2,020.38
|
| Rate for Payer: Sagamore Health Network All Products |
$2,056.61
|
| Rate for Payer: Signature Care EPO |
$2,211.12
|
| Rate for Payer: Signature Care PPO |
$2,344.32
|
| Rate for Payer: United Healthcare Commercial |
$2,099.23
|
|
|
HC ACU 1.3MM T-PLATE
|
Facility
OP
|
$2,664.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,477.52 |
| Rate for Payer: Aetna Commercial |
$2,248.42
|
| Rate for Payer: Aetna Medicare |
$879.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$879.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,529.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,665.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,010.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$967.03
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Cash Price |
$1,651.68
|
| Rate for Payer: Centivo All Commercial |
$1,358.64
|
| Rate for Payer: Cigna All Commercial |
$2,299.03
|
| Rate for Payer: CORVEL All Commercial |
$2,477.52
|
| Rate for Payer: Coventry All Commercial |
$2,344.32
|
| Rate for Payer: Encore All Commercial |
$2,452.21
|
| Rate for Payer: Frontpath All Commercial |
$2,450.88
|
| Rate for Payer: Humana ChoiceCare |
$2,300.90
|
| Rate for Payer: Humana Medicare |
$1,358.64
|
| Rate for Payer: Lucent All Commercial |
$1,358.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,397.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,998.00
|
| Rate for Payer: PHP All Commercial |
$2,020.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,038.96
|
| Rate for Payer: Sagamore Health Network All Products |
$2,056.61
|
| Rate for Payer: Signature Care EPO |
$2,211.12
|
| Rate for Payer: Signature Care PPO |
$2,344.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,264.40
|
| Rate for Payer: United Healthcare Commercial |
$2,099.23
|
| Rate for Payer: United Healthcare Medicare |
$879.12
|
|
|
HC ACU 1.3 NON-TD GUIDE WIRE 150
|
Facility
IP
|
$105.00
|
|
| Hospital Charge Code |
41602813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$97.65 |
| Rate for Payer: Aetna Commercial |
$90.72
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cigna All Commercial |
$90.62
|
| Rate for Payer: CORVEL All Commercial |
$97.65
|
| Rate for Payer: Coventry All Commercial |
$92.40
|
| Rate for Payer: Encore All Commercial |
$96.65
|
| Rate for Payer: Frontpath All Commercial |
$96.60
|
| Rate for Payer: Humana ChoiceCare |
$90.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$94.50
|
| Rate for Payer: PHCS All Commercial |
$78.75
|
| Rate for Payer: PHP All Commercial |
$79.63
|
| Rate for Payer: Sagamore Health Network All Products |
$81.06
|
| Rate for Payer: Signature Care EPO |
$87.15
|
| Rate for Payer: Signature Care PPO |
$92.40
|
| Rate for Payer: United Healthcare Commercial |
$82.74
|
|
|
HC ACU 1.3 NON-TD GUIDE WIRE 150
|
Facility
OP
|
$105.00
|
|
| Hospital Charge Code |
41602813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: Aetna Commercial |
$88.62
|
| Rate for Payer: Aetna Medicare |
$34.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$34.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$60.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$65.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.12
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Centivo All Commercial |
$53.55
|
| Rate for Payer: Cigna All Commercial |
$90.62
|
| Rate for Payer: CORVEL All Commercial |
$97.65
|
| Rate for Payer: Coventry All Commercial |
$92.40
|
| Rate for Payer: Encore All Commercial |
$96.65
|
| Rate for Payer: Frontpath All Commercial |
$96.60
|
| Rate for Payer: Humana ChoiceCare |
$90.69
|
| Rate for Payer: Humana Medicare |
$53.55
|
| Rate for Payer: Lucent All Commercial |
$53.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$94.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$78.75
|
| Rate for Payer: PHP All Commercial |
$79.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.95
|
| Rate for Payer: Sagamore Health Network All Products |
$81.06
|
| Rate for Payer: Signature Care EPO |
$87.15
|
| Rate for Payer: Signature Care PPO |
$92.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$89.25
|
| Rate for Payer: United Healthcare Commercial |
$82.74
|
| Rate for Payer: United Healthcare Medicare |
$34.65
|
|
|
HC ACU 1.5MM X 10MM HEX LAG SCREW
|
Facility
OP
|
$820.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603218
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.60 |
| Max. Negotiated Rate |
$762.60 |
| Rate for Payer: Aetna Commercial |
$692.08
|
| Rate for Payer: Aetna Medicare |
$270.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$270.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$470.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$512.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$311.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$297.66
|
| Rate for Payer: Cash Price |
$508.40
|
| Rate for Payer: Cash Price |
$508.40
|
| Rate for Payer: Centivo All Commercial |
$418.20
|
| Rate for Payer: Cigna All Commercial |
$707.66
|
| Rate for Payer: CORVEL All Commercial |
$762.60
|
| Rate for Payer: Coventry All Commercial |
$721.60
|
| Rate for Payer: Encore All Commercial |
$754.81
|
| Rate for Payer: Frontpath All Commercial |
$754.40
|
| Rate for Payer: Humana ChoiceCare |
$708.23
|
| Rate for Payer: Humana Medicare |
$418.20
|
| Rate for Payer: Lucent All Commercial |
$418.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$738.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$615.00
|
| Rate for Payer: PHP All Commercial |
$621.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.80
|
| Rate for Payer: Sagamore Health Network All Products |
$633.04
|
| Rate for Payer: Signature Care EPO |
$680.60
|
| Rate for Payer: Signature Care PPO |
$721.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$697.00
|
| Rate for Payer: United Healthcare Commercial |
$646.16
|
| Rate for Payer: United Healthcare Medicare |
$270.60
|
|
|
HC ACU 1.5MM X 10MM HEX LAG SCREW
|
Facility
IP
|
$820.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603218
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$615.00 |
| Max. Negotiated Rate |
$762.60 |
| Rate for Payer: Aetna Commercial |
$708.48
|
| Rate for Payer: Cash Price |
$508.40
|
| Rate for Payer: Cigna All Commercial |
$707.66
|
| Rate for Payer: CORVEL All Commercial |
$762.60
|
| Rate for Payer: Coventry All Commercial |
$721.60
|
| Rate for Payer: Encore All Commercial |
$754.81
|
| Rate for Payer: Frontpath All Commercial |
$754.40
|
| Rate for Payer: Humana ChoiceCare |
$708.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$738.00
|
| Rate for Payer: PHCS All Commercial |
$615.00
|
| Rate for Payer: PHP All Commercial |
$621.89
|
| Rate for Payer: Sagamore Health Network All Products |
$633.04
|
| Rate for Payer: Signature Care EPO |
$680.60
|
| Rate for Payer: Signature Care PPO |
$721.60
|
| Rate for Payer: United Healthcare Commercial |
$646.16
|
|
|
HC ACU 1.5MM X 10MM HEX MLT SCREW
|
Facility
IP
|
$820.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603192
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$615.00 |
| Max. Negotiated Rate |
$762.60 |
| Rate for Payer: Aetna Commercial |
$708.48
|
| Rate for Payer: Cash Price |
$508.40
|
| Rate for Payer: Cigna All Commercial |
$707.66
|
| Rate for Payer: CORVEL All Commercial |
$762.60
|
| Rate for Payer: Coventry All Commercial |
$721.60
|
| Rate for Payer: Encore All Commercial |
$754.81
|
| Rate for Payer: Frontpath All Commercial |
$754.40
|
| Rate for Payer: Humana ChoiceCare |
$708.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$738.00
|
| Rate for Payer: PHCS All Commercial |
$615.00
|
| Rate for Payer: PHP All Commercial |
$621.89
|
| Rate for Payer: Sagamore Health Network All Products |
$633.04
|
| Rate for Payer: Signature Care EPO |
$680.60
|
| Rate for Payer: Signature Care PPO |
$721.60
|
| Rate for Payer: United Healthcare Commercial |
$646.16
|
|
|
HC ACU 1.5MM X 10MM HEX MLT SCREW
|
Facility
OP
|
$820.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603192
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.60 |
| Max. Negotiated Rate |
$762.60 |
| Rate for Payer: Aetna Commercial |
$692.08
|
| Rate for Payer: Aetna Medicare |
$270.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$270.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$470.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$512.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$311.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$297.66
|
| Rate for Payer: Cash Price |
$508.40
|
| Rate for Payer: Cash Price |
$508.40
|
| Rate for Payer: Centivo All Commercial |
$418.20
|
| Rate for Payer: Cigna All Commercial |
$707.66
|
| Rate for Payer: CORVEL All Commercial |
$762.60
|
| Rate for Payer: Coventry All Commercial |
$721.60
|
| Rate for Payer: Encore All Commercial |
$754.81
|
| Rate for Payer: Frontpath All Commercial |
$754.40
|
| Rate for Payer: Humana ChoiceCare |
$708.23
|
| Rate for Payer: Humana Medicare |
$418.20
|
| Rate for Payer: Lucent All Commercial |
$418.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$738.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$615.00
|
| Rate for Payer: PHP All Commercial |
$621.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.80
|
| Rate for Payer: Sagamore Health Network All Products |
$633.04
|
| Rate for Payer: Signature Care EPO |
$680.60
|
| Rate for Payer: Signature Care PPO |
$721.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$697.00
|
| Rate for Payer: United Healthcare Commercial |
$646.16
|
| Rate for Payer: United Healthcare Medicare |
$270.60
|
|
|
HC ACU 1.5MM X 11MM HEX LAG SCREW
|
Facility
IP
|
$735.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603219
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$551.25 |
| Max. Negotiated Rate |
$683.55 |
| Rate for Payer: Aetna Commercial |
$635.04
|
| Rate for Payer: Cash Price |
$455.70
|
| Rate for Payer: Cigna All Commercial |
$634.30
|
| Rate for Payer: CORVEL All Commercial |
$683.55
|
| Rate for Payer: Coventry All Commercial |
$646.80
|
| Rate for Payer: Encore All Commercial |
$676.57
|
| Rate for Payer: Frontpath All Commercial |
$676.20
|
| Rate for Payer: Humana ChoiceCare |
$634.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$661.50
|
| Rate for Payer: PHCS All Commercial |
$551.25
|
| Rate for Payer: PHP All Commercial |
$557.42
|
| Rate for Payer: Sagamore Health Network All Products |
$567.42
|
| Rate for Payer: Signature Care EPO |
$610.05
|
| Rate for Payer: Signature Care PPO |
$646.80
|
| Rate for Payer: United Healthcare Commercial |
$579.18
|
|
|
HC ACU 1.5MM X 11MM HEX LAG SCREW
|
Facility
OP
|
$735.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603219
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$242.55 |
| Max. Negotiated Rate |
$683.55 |
| Rate for Payer: Aetna Commercial |
$620.34
|
| Rate for Payer: Aetna Medicare |
$242.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$242.55
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$422.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$459.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$278.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$266.80
|
| Rate for Payer: Cash Price |
$455.70
|
| Rate for Payer: Cash Price |
$455.70
|
| Rate for Payer: Centivo All Commercial |
$374.85
|
| Rate for Payer: Cigna All Commercial |
$634.30
|
| Rate for Payer: CORVEL All Commercial |
$683.55
|
| Rate for Payer: Coventry All Commercial |
$646.80
|
| Rate for Payer: Encore All Commercial |
$676.57
|
| Rate for Payer: Frontpath All Commercial |
$676.20
|
| Rate for Payer: Humana ChoiceCare |
$634.82
|
| Rate for Payer: Humana Medicare |
$374.85
|
| Rate for Payer: Lucent All Commercial |
$374.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$661.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$551.25
|
| Rate for Payer: PHP All Commercial |
$557.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$286.65
|
| Rate for Payer: Sagamore Health Network All Products |
$567.42
|
| Rate for Payer: Signature Care EPO |
$610.05
|
| Rate for Payer: Signature Care PPO |
$646.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$624.75
|
| Rate for Payer: United Healthcare Commercial |
$579.18
|
| Rate for Payer: United Healthcare Medicare |
$242.55
|
|
|
HC ACU 1.5MM X 11MM HEX MLT SCREW
|
Facility
OP
|
$820.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.60 |
| Max. Negotiated Rate |
$762.60 |
| Rate for Payer: Aetna Commercial |
$692.08
|
| Rate for Payer: Aetna Medicare |
$270.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$270.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$470.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$512.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$311.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$297.66
|
| Rate for Payer: Cash Price |
$508.40
|
| Rate for Payer: Cash Price |
$508.40
|
| Rate for Payer: Centivo All Commercial |
$418.20
|
| Rate for Payer: Cigna All Commercial |
$707.66
|
| Rate for Payer: CORVEL All Commercial |
$762.60
|
| Rate for Payer: Coventry All Commercial |
$721.60
|
| Rate for Payer: Encore All Commercial |
$754.81
|
| Rate for Payer: Frontpath All Commercial |
$754.40
|
| Rate for Payer: Humana ChoiceCare |
$708.23
|
| Rate for Payer: Humana Medicare |
$418.20
|
| Rate for Payer: Lucent All Commercial |
$418.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$738.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$615.00
|
| Rate for Payer: PHP All Commercial |
$621.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.80
|
| Rate for Payer: Sagamore Health Network All Products |
$633.04
|
| Rate for Payer: Signature Care EPO |
$680.60
|
| Rate for Payer: Signature Care PPO |
$721.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$697.00
|
| Rate for Payer: United Healthcare Commercial |
$646.16
|
| Rate for Payer: United Healthcare Medicare |
$270.60
|
|
|
HC ACU 1.5MM X 11MM HEX MLT SCREW
|
Facility
IP
|
$820.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$615.00 |
| Max. Negotiated Rate |
$762.60 |
| Rate for Payer: Aetna Commercial |
$708.48
|
| Rate for Payer: Cash Price |
$508.40
|
| Rate for Payer: Cigna All Commercial |
$707.66
|
| Rate for Payer: CORVEL All Commercial |
$762.60
|
| Rate for Payer: Coventry All Commercial |
$721.60
|
| Rate for Payer: Encore All Commercial |
$754.81
|
| Rate for Payer: Frontpath All Commercial |
$754.40
|
| Rate for Payer: Humana ChoiceCare |
$708.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$738.00
|
| Rate for Payer: PHCS All Commercial |
$615.00
|
| Rate for Payer: PHP All Commercial |
$621.89
|
| Rate for Payer: Sagamore Health Network All Products |
$633.04
|
| Rate for Payer: Signature Care EPO |
$680.60
|
| Rate for Payer: Signature Care PPO |
$721.60
|
| Rate for Payer: United Healthcare Commercial |
$646.16
|
|
