|
HC Z ALL POLY PAT PRLG 26MM
|
Facility
IP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605229
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,987.20 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,289.25
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
|
|
HC Z ALL POLY PAT PRLG 29MM
|
Facility
IP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605230
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,987.20 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,289.25
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
|
|
HC Z ALL POLY PAT PRLG 29MM
|
Facility
OP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605230
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,236.26
|
| Rate for Payer: Aetna Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,521.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,656.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,005.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$961.80
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Centivo All Commercial |
$1,351.30
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Humana Medicare |
$1,351.30
|
| Rate for Payer: Lucent All Commercial |
$1,351.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,033.34
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,252.16
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
| Rate for Payer: United Healthcare Medicare |
$874.37
|
|
|
HC Z ALL POLY PAT PRLG 32MM
|
Facility
IP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605231
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,987.20 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,289.25
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
|
|
HC Z ALL POLY PAT PRLG 32MM
|
Facility
OP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605231
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,236.26
|
| Rate for Payer: Aetna Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,521.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,656.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,005.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$961.80
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Centivo All Commercial |
$1,351.30
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Humana Medicare |
$1,351.30
|
| Rate for Payer: Lucent All Commercial |
$1,351.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,033.34
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,252.16
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
| Rate for Payer: United Healthcare Medicare |
$874.37
|
|
|
HC Z ALL POLY PAT PRLG 35MM
|
Facility
IP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605232
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,987.20 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,289.25
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
|
|
HC Z ALL POLY PAT PRLG 35MM
|
Facility
OP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605232
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,236.26
|
| Rate for Payer: Aetna Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,521.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,656.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,005.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$961.80
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Centivo All Commercial |
$1,351.30
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Humana Medicare |
$1,351.30
|
| Rate for Payer: Lucent All Commercial |
$1,351.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,033.34
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,252.16
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
| Rate for Payer: United Healthcare Medicare |
$874.37
|
|
|
HC Z ALL POLY PAT PRLG 38MM
|
Facility
OP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605233
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,236.26
|
| Rate for Payer: Aetna Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,521.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,656.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,005.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$961.80
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Centivo All Commercial |
$1,351.30
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Humana Medicare |
$1,351.30
|
| Rate for Payer: Lucent All Commercial |
$1,351.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,033.34
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,252.16
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
| Rate for Payer: United Healthcare Medicare |
$874.37
|
|
|
HC Z ALL POLY PAT PRLG 38MM
|
Facility
IP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605233
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,987.20 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,289.25
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
|
|
HC Z ALL POLY PAT PRLG 41MM
|
Facility
OP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605234
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,236.26
|
| Rate for Payer: Aetna Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,521.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,656.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,005.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$961.80
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Centivo All Commercial |
$1,351.30
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Humana Medicare |
$1,351.30
|
| Rate for Payer: Lucent All Commercial |
$1,351.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,033.34
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,252.16
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
| Rate for Payer: United Healthcare Medicare |
$874.37
|
|
|
HC Z ALL POLY PAT PRLG 41MM
|
Facility
IP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605234
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,987.20 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,289.25
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
|
|
HC Z ANAT MNSC BEARING 7MM
|
Facility
OP
|
$3,312.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606624
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,080.16 |
| Rate for Payer: Aetna Commercial |
$2,795.33
|
| Rate for Payer: Aetna Medicare |
$1,092.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,092.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,902.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,070.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,256.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,202.26
|
| Rate for Payer: Cash Price |
$2,053.44
|
| Rate for Payer: Cash Price |
$2,053.44
|
| Rate for Payer: Centivo All Commercial |
$1,689.12
|
| Rate for Payer: Cigna All Commercial |
$2,858.26
|
| Rate for Payer: CORVEL All Commercial |
$3,080.16
|
| Rate for Payer: Coventry All Commercial |
$2,914.56
|
| Rate for Payer: Encore All Commercial |
$3,048.70
|
| Rate for Payer: Frontpath All Commercial |
$3,047.04
|
| Rate for Payer: Humana ChoiceCare |
$2,860.57
|
| Rate for Payer: Humana Medicare |
$1,689.12
|
| Rate for Payer: Lucent All Commercial |
$1,689.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,980.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,484.00
|
| Rate for Payer: PHP All Commercial |
$2,511.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,291.68
|
| Rate for Payer: Sagamore Health Network All Products |
$2,556.86
|
| Rate for Payer: Signature Care EPO |
$2,748.96
|
| Rate for Payer: Signature Care PPO |
$2,914.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,815.20
|
| Rate for Payer: United Healthcare Commercial |
$2,609.86
|
| Rate for Payer: United Healthcare Medicare |
$1,092.96
|
|
|
HC Z ANAT MNSC BEARING 7MM
|
Facility
IP
|
$3,312.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606624
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,484.00 |
| Max. Negotiated Rate |
$3,080.16 |
| Rate for Payer: Aetna Commercial |
$2,861.57
|
| Rate for Payer: Cash Price |
$2,053.44
|
| Rate for Payer: Cigna All Commercial |
$2,858.26
|
| Rate for Payer: CORVEL All Commercial |
$3,080.16
|
| Rate for Payer: Coventry All Commercial |
$2,914.56
|
| Rate for Payer: Encore All Commercial |
$3,048.70
|
| Rate for Payer: Frontpath All Commercial |
$3,047.04
|
| Rate for Payer: Humana ChoiceCare |
$2,860.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,980.80
|
| Rate for Payer: PHCS All Commercial |
$2,484.00
|
| Rate for Payer: PHP All Commercial |
$2,511.82
|
| Rate for Payer: Sagamore Health Network All Products |
$2,556.86
|
| Rate for Payer: Signature Care EPO |
$2,748.96
|
| Rate for Payer: Signature Care PPO |
$2,914.56
|
| Rate for Payer: United Healthcare Commercial |
$2,609.86
|
|
|
HC Z ANCHOR JGRKNT 2.9
|
Facility
OP
|
$1,855.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607787
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,725.15 |
| Rate for Payer: Aetna Commercial |
$1,565.62
|
| Rate for Payer: Aetna Medicare |
$612.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,065.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,159.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$703.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.36
|
| Rate for Payer: Cash Price |
$1,150.10
|
| Rate for Payer: Cash Price |
$1,150.10
|
| Rate for Payer: Centivo All Commercial |
$946.05
|
| Rate for Payer: Cigna All Commercial |
$1,600.86
|
| Rate for Payer: CORVEL All Commercial |
$1,725.15
|
| Rate for Payer: Coventry All Commercial |
$1,632.40
|
| Rate for Payer: Encore All Commercial |
$1,707.53
|
| Rate for Payer: Frontpath All Commercial |
$1,706.60
|
| Rate for Payer: Humana ChoiceCare |
$1,602.16
|
| Rate for Payer: Humana Medicare |
$946.05
|
| Rate for Payer: Lucent All Commercial |
$946.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,669.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,391.25
|
| Rate for Payer: PHP All Commercial |
$1,406.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.45
|
| Rate for Payer: Sagamore Health Network All Products |
$1,432.06
|
| Rate for Payer: Signature Care EPO |
$1,539.65
|
| Rate for Payer: Signature Care PPO |
$1,632.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,576.75
|
| Rate for Payer: United Healthcare Commercial |
$1,461.74
|
| Rate for Payer: United Healthcare Medicare |
$612.15
|
|
|
HC Z ANCHOR JGRKNT 2.9
|
Facility
IP
|
$1,855.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607787
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,391.25 |
| Max. Negotiated Rate |
$1,725.15 |
| Rate for Payer: Aetna Commercial |
$1,602.72
|
| Rate for Payer: Cash Price |
$1,150.10
|
| Rate for Payer: Cigna All Commercial |
$1,600.86
|
| Rate for Payer: CORVEL All Commercial |
$1,725.15
|
| Rate for Payer: Coventry All Commercial |
$1,632.40
|
| Rate for Payer: Encore All Commercial |
$1,707.53
|
| Rate for Payer: Frontpath All Commercial |
$1,706.60
|
| Rate for Payer: Humana ChoiceCare |
$1,602.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,669.50
|
| Rate for Payer: PHCS All Commercial |
$1,391.25
|
| Rate for Payer: PHP All Commercial |
$1,406.83
|
| Rate for Payer: Sagamore Health Network All Products |
$1,432.06
|
| Rate for Payer: Signature Care EPO |
$1,539.65
|
| Rate for Payer: Signature Care PPO |
$1,632.40
|
| Rate for Payer: United Healthcare Commercial |
$1,461.74
|
|
|
HC Z ANCHOR JGRKNT 2.9 SHRT BL/BK
|
Facility
OP
|
$2,275.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,115.75 |
| Rate for Payer: Aetna Commercial |
$1,920.10
|
| Rate for Payer: Aetna Medicare |
$750.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$750.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,306.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,422.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$863.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$825.82
|
| Rate for Payer: Cash Price |
$1,410.50
|
| Rate for Payer: Cash Price |
$1,410.50
|
| Rate for Payer: Centivo All Commercial |
$1,160.25
|
| Rate for Payer: Cigna All Commercial |
$1,963.32
|
| Rate for Payer: CORVEL All Commercial |
$2,115.75
|
| Rate for Payer: Coventry All Commercial |
$2,002.00
|
| Rate for Payer: Encore All Commercial |
$2,094.14
|
| Rate for Payer: Frontpath All Commercial |
$2,093.00
|
| Rate for Payer: Humana ChoiceCare |
$1,964.92
|
| Rate for Payer: Humana Medicare |
$1,160.25
|
| Rate for Payer: Lucent All Commercial |
$1,160.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,047.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,706.25
|
| Rate for Payer: PHP All Commercial |
$1,725.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$887.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,756.30
|
| Rate for Payer: Signature Care EPO |
$1,888.25
|
| Rate for Payer: Signature Care PPO |
$2,002.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,933.75
|
| Rate for Payer: United Healthcare Commercial |
$1,792.70
|
| Rate for Payer: United Healthcare Medicare |
$750.75
|
|
|
HC Z ANCHOR JGRKNT 2.9 SHRT BL/BK
|
Facility
IP
|
$2,275.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,706.25 |
| Max. Negotiated Rate |
$2,115.75 |
| Rate for Payer: Aetna Commercial |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,410.50
|
| Rate for Payer: Cigna All Commercial |
$1,963.32
|
| Rate for Payer: CORVEL All Commercial |
$2,115.75
|
| Rate for Payer: Coventry All Commercial |
$2,002.00
|
| Rate for Payer: Encore All Commercial |
$2,094.14
|
| Rate for Payer: Frontpath All Commercial |
$2,093.00
|
| Rate for Payer: Humana ChoiceCare |
$1,964.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,047.50
|
| Rate for Payer: PHCS All Commercial |
$1,706.25
|
| Rate for Payer: PHP All Commercial |
$1,725.36
|
| Rate for Payer: Sagamore Health Network All Products |
$1,756.30
|
| Rate for Payer: Signature Care EPO |
$1,888.25
|
| Rate for Payer: Signature Care PPO |
$2,002.00
|
| Rate for Payer: United Healthcare Commercial |
$1,792.70
|
|
|
HC Z ARCOM XL 44-36 STD
|
Facility
OP
|
$3,745.87
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,483.66 |
| Rate for Payer: Aetna Commercial |
$3,161.51
|
| Rate for Payer: Aetna Medicare |
$1,236.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,236.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,151.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,341.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,421.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,359.75
|
| Rate for Payer: Cash Price |
$2,322.44
|
| Rate for Payer: Cash Price |
$2,322.44
|
| Rate for Payer: Centivo All Commercial |
$1,910.39
|
| Rate for Payer: Cigna All Commercial |
$3,232.69
|
| Rate for Payer: CORVEL All Commercial |
$3,483.66
|
| Rate for Payer: Coventry All Commercial |
$3,296.37
|
| Rate for Payer: Encore All Commercial |
$3,448.07
|
| Rate for Payer: Frontpath All Commercial |
$3,446.20
|
| Rate for Payer: Humana ChoiceCare |
$3,235.31
|
| Rate for Payer: Humana Medicare |
$1,910.39
|
| Rate for Payer: Lucent All Commercial |
$1,910.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,371.28
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,809.40
|
| Rate for Payer: PHP All Commercial |
$2,840.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,460.89
|
| Rate for Payer: Sagamore Health Network All Products |
$2,891.81
|
| Rate for Payer: Signature Care EPO |
$3,109.07
|
| Rate for Payer: Signature Care PPO |
$3,296.37
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,183.99
|
| Rate for Payer: United Healthcare Commercial |
$2,951.75
|
| Rate for Payer: United Healthcare Medicare |
$1,236.14
|
|
|
HC Z ARCOM XL 44-36 STD
|
Facility
IP
|
$3,745.87
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,809.40 |
| Max. Negotiated Rate |
$3,483.66 |
| Rate for Payer: Aetna Commercial |
$3,236.43
|
| Rate for Payer: Cash Price |
$2,322.44
|
| Rate for Payer: Cigna All Commercial |
$3,232.69
|
| Rate for Payer: CORVEL All Commercial |
$3,483.66
|
| Rate for Payer: Coventry All Commercial |
$3,296.37
|
| Rate for Payer: Encore All Commercial |
$3,448.07
|
| Rate for Payer: Frontpath All Commercial |
$3,446.20
|
| Rate for Payer: Humana ChoiceCare |
$3,235.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,371.28
|
| Rate for Payer: PHCS All Commercial |
$2,809.40
|
| Rate for Payer: PHP All Commercial |
$2,840.87
|
| Rate for Payer: Sagamore Health Network All Products |
$2,891.81
|
| Rate for Payer: Signature Care EPO |
$3,109.07
|
| Rate for Payer: Signature Care PPO |
$3,296.37
|
| Rate for Payer: United Healthcare Commercial |
$2,951.75
|
|
|
HC Z ARCOS 14X210MM BRCH STD BODY
|
Facility
OP
|
$25,740.86
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$23,939.00 |
| Rate for Payer: Aetna Commercial |
$21,725.29
|
| Rate for Payer: Aetna Medicare |
$8,494.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$8,494.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$14,782.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16,090.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9,768.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$9,343.93
|
| Rate for Payer: Cash Price |
$15,959.33
|
| Rate for Payer: Cash Price |
$15,959.33
|
| Rate for Payer: Centivo All Commercial |
$13,127.84
|
| Rate for Payer: Cigna All Commercial |
$22,214.36
|
| Rate for Payer: CORVEL All Commercial |
$23,939.00
|
| Rate for Payer: Coventry All Commercial |
$22,651.96
|
| Rate for Payer: Encore All Commercial |
$23,694.46
|
| Rate for Payer: Frontpath All Commercial |
$23,681.59
|
| Rate for Payer: Humana ChoiceCare |
$22,232.38
|
| Rate for Payer: Humana Medicare |
$13,127.84
|
| Rate for Payer: Lucent All Commercial |
$13,127.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$23,166.77
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$19,305.64
|
| Rate for Payer: PHP All Commercial |
$19,521.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$10,038.94
|
| Rate for Payer: Sagamore Health Network All Products |
$19,871.94
|
| Rate for Payer: Signature Care EPO |
$21,364.91
|
| Rate for Payer: Signature Care PPO |
$22,651.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21,879.73
|
| Rate for Payer: United Healthcare Commercial |
$20,283.80
|
| Rate for Payer: United Healthcare Medicare |
$8,494.48
|
|
|
HC Z ARCOS 14X210MM BRCH STD BODY
|
Facility
IP
|
$25,740.86
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19,305.64 |
| Max. Negotiated Rate |
$23,939.00 |
| Rate for Payer: Aetna Commercial |
$22,240.10
|
| Rate for Payer: Cash Price |
$15,959.33
|
| Rate for Payer: Cigna All Commercial |
$22,214.36
|
| Rate for Payer: CORVEL All Commercial |
$23,939.00
|
| Rate for Payer: Coventry All Commercial |
$22,651.96
|
| Rate for Payer: Encore All Commercial |
$23,694.46
|
| Rate for Payer: Frontpath All Commercial |
$23,681.59
|
| Rate for Payer: Humana ChoiceCare |
$22,232.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$23,166.77
|
| Rate for Payer: PHCS All Commercial |
$19,305.64
|
| Rate for Payer: PHP All Commercial |
$19,521.87
|
| Rate for Payer: Sagamore Health Network All Products |
$19,871.94
|
| Rate for Payer: Signature Care EPO |
$21,364.91
|
| Rate for Payer: Signature Care PPO |
$22,651.96
|
| Rate for Payer: United Healthcare Commercial |
$20,283.80
|
|
|
HC Z ARCOS 15X175 BRCH STD BODY
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,210.00 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$7,153.92
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
|
|
HC Z ARCOS 15X175 BRCH STD BODY
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$6,988.32
|
| Rate for Payer: Aetna Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,755.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,175.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,142.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,005.64
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Centivo All Commercial |
$4,222.80
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Humana Medicare |
$4,222.80
|
| Rate for Payer: Lucent All Commercial |
$4,222.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,229.20
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,038.00
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
| Rate for Payer: United Healthcare Medicare |
$2,732.40
|
|
|
HC Z ARCOS 16X175MM BRCH STD BODY
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$6,988.32
|
| Rate for Payer: Aetna Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,755.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,175.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,142.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,005.64
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Centivo All Commercial |
$4,222.80
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Humana Medicare |
$4,222.80
|
| Rate for Payer: Lucent All Commercial |
$4,222.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,229.20
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,038.00
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
| Rate for Payer: United Healthcare Medicare |
$2,732.40
|
|
|
HC Z ARCOS 16X175MM BRCH STD BODY
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,210.00 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$7,153.92
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
|
