|
HC Z COMP STEM 13MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605591
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,633.43
|
| Rate for Payer: Aetna Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,235.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,875.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,781.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,573.38
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Centivo All Commercial |
$6,425.41
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Humana Medicare |
$6,425.41
|
| Rate for Payer: Lucent All Commercial |
$6,425.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,913.55
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,709.02
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
| Rate for Payer: United Healthcare Medicare |
$4,157.62
|
|
|
HC Z COMP STEM 14MM MINI
|
Facility
OP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605606
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$11,874.56
|
| Rate for Payer: Aetna Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,080.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,794.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,339.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,107.18
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Centivo All Commercial |
$7,175.38
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Humana Medicare |
$7,175.38
|
| Rate for Payer: Lucent All Commercial |
$7,175.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,487.06
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,958.97
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
| Rate for Payer: United Healthcare Medicare |
$4,642.90
|
|
|
HC Z COMP STEM 14MM MINI
|
Facility
IP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605606
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,552.04 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$12,155.94
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
|
|
HC Z COMP STEM 14MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605592
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,633.43
|
| Rate for Payer: Aetna Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,235.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,875.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,781.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,573.38
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Centivo All Commercial |
$6,425.41
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Humana Medicare |
$6,425.41
|
| Rate for Payer: Lucent All Commercial |
$6,425.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,913.55
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,709.02
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
| Rate for Payer: United Healthcare Medicare |
$4,157.62
|
|
|
HC Z COMP STEM 14MM STD
|
Facility
IP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605592
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,449.14 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,885.41
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
|
|
HC Z COMP STEM 15MM MINI
|
Facility
OP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$11,874.56
|
| Rate for Payer: Aetna Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,080.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,794.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,339.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,107.18
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Centivo All Commercial |
$7,175.38
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Humana Medicare |
$7,175.38
|
| Rate for Payer: Lucent All Commercial |
$7,175.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,487.06
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,958.97
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
| Rate for Payer: United Healthcare Medicare |
$4,642.90
|
|
|
HC Z COMP STEM 15MM MINI
|
Facility
IP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,552.04 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$12,155.94
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
|
|
HC Z COMP STEM 15MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605593
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,633.43
|
| Rate for Payer: Aetna Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,235.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,875.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,781.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,573.38
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Centivo All Commercial |
$6,425.41
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Humana Medicare |
$6,425.41
|
| Rate for Payer: Lucent All Commercial |
$6,425.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,913.55
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,709.02
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
| Rate for Payer: United Healthcare Medicare |
$4,157.62
|
|
|
HC Z COMP STEM 15MM STD
|
Facility
IP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605593
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,449.14 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,885.41
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
|
|
HC Z COMP STEM 16MM MINI
|
Facility
IP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,552.04 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$12,155.94
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
|
|
HC Z COMP STEM 16MM MINI
|
Facility
OP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$11,874.56
|
| Rate for Payer: Aetna Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,080.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,794.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,339.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,107.18
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Centivo All Commercial |
$7,175.38
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Humana Medicare |
$7,175.38
|
| Rate for Payer: Lucent All Commercial |
$7,175.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,487.06
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,958.97
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
| Rate for Payer: United Healthcare Medicare |
$4,642.90
|
|
|
HC Z COMP STEM 16MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605594
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,633.43
|
| Rate for Payer: Aetna Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,235.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,875.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,781.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,573.38
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Centivo All Commercial |
$6,425.41
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Humana Medicare |
$6,425.41
|
| Rate for Payer: Lucent All Commercial |
$6,425.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,913.55
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,709.02
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
| Rate for Payer: United Healthcare Medicare |
$4,157.62
|
|
|
HC Z COMP STEM 16MM STD
|
Facility
IP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605594
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,449.14 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,885.41
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
|
|
HC Z COMP STEM 17MM MINI
|
Facility
IP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605609
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,552.04 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$12,155.94
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
|
|
HC Z COMP STEM 17MM MINI
|
Facility
OP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605609
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$11,874.56
|
| Rate for Payer: Aetna Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,080.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,794.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,339.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,107.18
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Centivo All Commercial |
$7,175.38
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Humana Medicare |
$7,175.38
|
| Rate for Payer: Lucent All Commercial |
$7,175.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,487.06
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,958.97
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
| Rate for Payer: United Healthcare Medicare |
$4,642.90
|
|
|
HC Z COMP STEM 17MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605595
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,633.43
|
| Rate for Payer: Aetna Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,235.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,875.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,781.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,573.38
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Centivo All Commercial |
$6,425.41
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Humana Medicare |
$6,425.41
|
| Rate for Payer: Lucent All Commercial |
$6,425.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,913.55
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,709.02
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
| Rate for Payer: United Healthcare Medicare |
$4,157.62
|
|
|
HC Z COMP STEM 17MM STD
|
Facility
IP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605595
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,449.14 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,885.41
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
|
|
HC Z COMP STEM 4MM MINI
|
Facility
IP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605596
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,552.04 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$12,155.94
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
|
|
HC Z COMP STEM 4MM MINI
|
Facility
OP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605596
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$11,874.56
|
| Rate for Payer: Aetna Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,080.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,794.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,339.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,107.18
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Centivo All Commercial |
$7,175.38
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Humana Medicare |
$7,175.38
|
| Rate for Payer: Lucent All Commercial |
$7,175.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,487.06
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,958.97
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
| Rate for Payer: United Healthcare Medicare |
$4,642.90
|
|
|
HC Z COMP STEM 4MM STD
|
Facility
IP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605582
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,449.14 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,885.41
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
|
|
HC Z COMP STEM 4MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605582
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,633.43
|
| Rate for Payer: Aetna Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,235.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,875.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,781.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,573.38
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Centivo All Commercial |
$6,425.41
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Humana Medicare |
$6,425.41
|
| Rate for Payer: Lucent All Commercial |
$6,425.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,913.55
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,709.02
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
| Rate for Payer: United Healthcare Medicare |
$4,157.62
|
|
|
HC Z COMP STEM 5MM MINI
|
Facility
OP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605597
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$11,874.56
|
| Rate for Payer: Aetna Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,642.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,080.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,794.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,339.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,107.18
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Centivo All Commercial |
$7,175.38
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Humana Medicare |
$7,175.38
|
| Rate for Payer: Lucent All Commercial |
$7,175.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,487.06
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,958.97
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
| Rate for Payer: United Healthcare Medicare |
$4,642.90
|
|
|
HC Z COMP STEM 5MM MINI
|
Facility
IP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605597
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,552.04 |
| Max. Negotiated Rate |
$13,084.52 |
| Rate for Payer: Aetna Commercial |
$12,155.94
|
| Rate for Payer: Cash Price |
$8,723.02
|
| Rate for Payer: Cigna All Commercial |
$12,141.87
|
| Rate for Payer: CORVEL All Commercial |
$13,084.52
|
| Rate for Payer: Coventry All Commercial |
$12,381.05
|
| Rate for Payer: Encore All Commercial |
$12,950.86
|
| Rate for Payer: Frontpath All Commercial |
$12,943.83
|
| Rate for Payer: Humana ChoiceCare |
$12,151.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,662.44
|
| Rate for Payer: PHCS All Commercial |
$10,552.04
|
| Rate for Payer: PHP All Commercial |
$10,670.22
|
| Rate for Payer: Sagamore Health Network All Products |
$10,861.56
|
| Rate for Payer: Signature Care EPO |
$11,677.59
|
| Rate for Payer: Signature Care PPO |
$12,381.05
|
| Rate for Payer: United Healthcare Commercial |
$11,086.67
|
|
|
HC Z COMP STEM 5MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605583
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,633.43
|
| Rate for Payer: Aetna Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,157.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,235.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,875.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,781.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,573.38
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Centivo All Commercial |
$6,425.41
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Humana Medicare |
$6,425.41
|
| Rate for Payer: Lucent All Commercial |
$6,425.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,913.55
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,709.02
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
| Rate for Payer: United Healthcare Medicare |
$4,157.62
|
|
|
HC Z COMP STEM 5MM STD
|
Facility
IP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605583
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,449.14 |
| Max. Negotiated Rate |
$11,716.93 |
| Rate for Payer: Aetna Commercial |
$10,885.41
|
| Rate for Payer: Cash Price |
$7,811.29
|
| Rate for Payer: Cigna All Commercial |
$10,872.81
|
| Rate for Payer: CORVEL All Commercial |
$11,716.93
|
| Rate for Payer: Coventry All Commercial |
$11,086.99
|
| Rate for Payer: Encore All Commercial |
$11,597.24
|
| Rate for Payer: Frontpath All Commercial |
$11,590.94
|
| Rate for Payer: Humana ChoiceCare |
$10,881.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,338.96
|
| Rate for Payer: PHCS All Commercial |
$9,449.14
|
| Rate for Payer: PHP All Commercial |
$9,554.97
|
| Rate for Payer: Sagamore Health Network All Products |
$9,726.31
|
| Rate for Payer: Signature Care EPO |
$10,457.05
|
| Rate for Payer: Signature Care PPO |
$11,086.99
|
| Rate for Payer: United Healthcare Commercial |
$9,927.89
|
|
