|
HC Z COMP STEM 6MM MINI
|
Facility
OP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605598
|
|
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 6MM MINI
|
Facility
IP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605598
|
|
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 6MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605584
|
|
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 6MM STD
|
Facility
IP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605584
|
|
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 7MM MINI
|
Facility
IP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605599
|
|
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 7MM MINI
|
Facility
OP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605599
|
|
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 7MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605585
|
|
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 7MM STD
|
Facility
IP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605585
|
|
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 8MM MINI
|
Facility
IP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605600
|
|
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 8MM MINI
|
Facility
OP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605600
|
|
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 8MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605586
|
|
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 8MM STD
|
Facility
IP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605586
|
|
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 9MM MINI
|
Facility
OP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605601
|
|
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 9MM MINI
|
Facility
IP
|
$14,069.38
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605601
|
|
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 9MM STD
|
Facility
IP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605587
|
|
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 9MM STD
|
Facility
OP
|
$12,598.85
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605587
|
|
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 CONSTR MOD HD 36 MM STD
|
Facility
OP
|
$5,153.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606093
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$4,792.73 |
| Rate for Payer: Aetna Commercial |
$4,349.53
|
| Rate for Payer: Aetna Medicare |
$1,700.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,700.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,959.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,221.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,955.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,870.71
|
| Rate for Payer: Cash Price |
$3,195.15
|
| Rate for Payer: Cash Price |
$3,195.15
|
| Rate for Payer: Centivo All Commercial |
$2,628.27
|
| Rate for Payer: Cigna All Commercial |
$4,447.44
|
| Rate for Payer: CORVEL All Commercial |
$4,792.73
|
| Rate for Payer: Coventry All Commercial |
$4,535.05
|
| Rate for Payer: Encore All Commercial |
$4,743.77
|
| Rate for Payer: Frontpath All Commercial |
$4,741.19
|
| Rate for Payer: Humana ChoiceCare |
$4,451.05
|
| Rate for Payer: Humana Medicare |
$2,628.27
|
| Rate for Payer: Lucent All Commercial |
$2,628.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,638.12
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$3,865.10
|
| Rate for Payer: PHP All Commercial |
$3,908.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,009.85
|
| Rate for Payer: Sagamore Health Network All Products |
$3,978.48
|
| Rate for Payer: Signature Care EPO |
$4,277.38
|
| Rate for Payer: Signature Care PPO |
$4,535.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,380.45
|
| Rate for Payer: United Healthcare Commercial |
$4,060.93
|
| Rate for Payer: United Healthcare Medicare |
$1,700.65
|
|
|
HC Z CONSTR MOD HD 36 MM STD
|
Facility
IP
|
$5,153.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606093
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,865.10 |
| Max. Negotiated Rate |
$4,792.73 |
| Rate for Payer: Aetna Commercial |
$4,452.60
|
| Rate for Payer: Cash Price |
$3,195.15
|
| Rate for Payer: Cigna All Commercial |
$4,447.44
|
| Rate for Payer: CORVEL All Commercial |
$4,792.73
|
| Rate for Payer: Coventry All Commercial |
$4,535.05
|
| Rate for Payer: Encore All Commercial |
$4,743.77
|
| Rate for Payer: Frontpath All Commercial |
$4,741.19
|
| Rate for Payer: Humana ChoiceCare |
$4,451.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,638.12
|
| Rate for Payer: PHCS All Commercial |
$3,865.10
|
| Rate for Payer: PHP All Commercial |
$3,908.39
|
| Rate for Payer: Sagamore Health Network All Products |
$3,978.48
|
| Rate for Payer: Signature Care EPO |
$4,277.38
|
| Rate for Payer: Signature Care PPO |
$4,535.05
|
| Rate for Payer: United Healthcare Commercial |
$4,060.93
|
|
|
HC Z CONT 32X68 QU ELV LINER
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605544
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,222.80 |
| Max. Negotiated Rate |
$5,236.27 |
| Rate for Payer: Aetna Commercial |
$4,864.67
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Cigna All Commercial |
$4,859.04
|
| Rate for Payer: CORVEL All Commercial |
$5,236.27
|
| Rate for Payer: Coventry All Commercial |
$4,954.75
|
| Rate for Payer: Encore All Commercial |
$5,182.78
|
| Rate for Payer: Frontpath All Commercial |
$5,179.97
|
| Rate for Payer: Humana ChoiceCare |
$4,862.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,067.36
|
| Rate for Payer: PHCS All Commercial |
$4,222.80
|
| Rate for Payer: PHP All Commercial |
$4,270.10
|
| Rate for Payer: Sagamore Health Network All Products |
$4,346.67
|
| Rate for Payer: Signature Care EPO |
$4,673.23
|
| Rate for Payer: Signature Care PPO |
$4,954.75
|
| Rate for Payer: United Healthcare Commercial |
$4,436.76
|
|
|
HC Z CONT 32X68 QU ELV LINER
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605544
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,236.27 |
| Rate for Payer: Aetna Commercial |
$4,752.06
|
| Rate for Payer: Aetna Medicare |
$1,858.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,858.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,233.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,519.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,136.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,043.84
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Centivo All Commercial |
$2,871.50
|
| Rate for Payer: Cigna All Commercial |
$4,859.04
|
| Rate for Payer: CORVEL All Commercial |
$5,236.27
|
| Rate for Payer: Coventry All Commercial |
$4,954.75
|
| Rate for Payer: Encore All Commercial |
$5,182.78
|
| Rate for Payer: Frontpath All Commercial |
$5,179.97
|
| Rate for Payer: Humana ChoiceCare |
$4,862.98
|
| Rate for Payer: Humana Medicare |
$2,871.50
|
| Rate for Payer: Lucent All Commercial |
$2,871.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,067.36
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,222.80
|
| Rate for Payer: PHP All Commercial |
$4,270.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,195.86
|
| Rate for Payer: Sagamore Health Network All Products |
$4,346.67
|
| Rate for Payer: Signature Care EPO |
$4,673.23
|
| Rate for Payer: Signature Care PPO |
$4,954.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,785.84
|
| Rate for Payer: United Healthcare Commercial |
$4,436.76
|
| Rate for Payer: United Healthcare Medicare |
$1,858.03
|
|
|
HC Z CONT 32X70 RR ELV LINER
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605545
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,236.27 |
| Rate for Payer: Aetna Commercial |
$4,752.06
|
| Rate for Payer: Aetna Medicare |
$1,858.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,858.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,233.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,519.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,136.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,043.84
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Centivo All Commercial |
$2,871.50
|
| Rate for Payer: Cigna All Commercial |
$4,859.04
|
| Rate for Payer: CORVEL All Commercial |
$5,236.27
|
| Rate for Payer: Coventry All Commercial |
$4,954.75
|
| Rate for Payer: Encore All Commercial |
$5,182.78
|
| Rate for Payer: Frontpath All Commercial |
$5,179.97
|
| Rate for Payer: Humana ChoiceCare |
$4,862.98
|
| Rate for Payer: Humana Medicare |
$2,871.50
|
| Rate for Payer: Lucent All Commercial |
$2,871.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,067.36
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,222.80
|
| Rate for Payer: PHP All Commercial |
$4,270.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,195.86
|
| Rate for Payer: Sagamore Health Network All Products |
$4,346.67
|
| Rate for Payer: Signature Care EPO |
$4,673.23
|
| Rate for Payer: Signature Care PPO |
$4,954.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,785.84
|
| Rate for Payer: United Healthcare Commercial |
$4,436.76
|
| Rate for Payer: United Healthcare Medicare |
$1,858.03
|
|
|
HC Z CONT 32X70 RR ELV LINER
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605545
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,222.80 |
| Max. Negotiated Rate |
$5,236.27 |
| Rate for Payer: Aetna Commercial |
$4,864.67
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Cigna All Commercial |
$4,859.04
|
| Rate for Payer: CORVEL All Commercial |
$5,236.27
|
| Rate for Payer: Coventry All Commercial |
$4,954.75
|
| Rate for Payer: Encore All Commercial |
$5,182.78
|
| Rate for Payer: Frontpath All Commercial |
$5,179.97
|
| Rate for Payer: Humana ChoiceCare |
$4,862.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,067.36
|
| Rate for Payer: PHCS All Commercial |
$4,222.80
|
| Rate for Payer: PHP All Commercial |
$4,270.10
|
| Rate for Payer: Sagamore Health Network All Products |
$4,346.67
|
| Rate for Payer: Signature Care EPO |
$4,673.23
|
| Rate for Payer: Signature Care PPO |
$4,954.75
|
| Rate for Payer: United Healthcare Commercial |
$4,436.76
|
|
|
HC Z CONT 32X72 SS ELV LINER
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605546
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,222.80 |
| Max. Negotiated Rate |
$5,236.27 |
| Rate for Payer: Aetna Commercial |
$4,864.67
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Cigna All Commercial |
$4,859.04
|
| Rate for Payer: CORVEL All Commercial |
$5,236.27
|
| Rate for Payer: Coventry All Commercial |
$4,954.75
|
| Rate for Payer: Encore All Commercial |
$5,182.78
|
| Rate for Payer: Frontpath All Commercial |
$5,179.97
|
| Rate for Payer: Humana ChoiceCare |
$4,862.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,067.36
|
| Rate for Payer: PHCS All Commercial |
$4,222.80
|
| Rate for Payer: PHP All Commercial |
$4,270.10
|
| Rate for Payer: Sagamore Health Network All Products |
$4,346.67
|
| Rate for Payer: Signature Care EPO |
$4,673.23
|
| Rate for Payer: Signature Care PPO |
$4,954.75
|
| Rate for Payer: United Healthcare Commercial |
$4,436.76
|
|
|
HC Z CONT 32X72 SS ELV LINER
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605546
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,236.27 |
| Rate for Payer: Aetna Commercial |
$4,752.06
|
| Rate for Payer: Aetna Medicare |
$1,858.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,858.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,233.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,519.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,136.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,043.84
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Centivo All Commercial |
$2,871.50
|
| Rate for Payer: Cigna All Commercial |
$4,859.04
|
| Rate for Payer: CORVEL All Commercial |
$5,236.27
|
| Rate for Payer: Coventry All Commercial |
$4,954.75
|
| Rate for Payer: Encore All Commercial |
$5,182.78
|
| Rate for Payer: Frontpath All Commercial |
$5,179.97
|
| Rate for Payer: Humana ChoiceCare |
$4,862.98
|
| Rate for Payer: Humana Medicare |
$2,871.50
|
| Rate for Payer: Lucent All Commercial |
$2,871.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,067.36
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,222.80
|
| Rate for Payer: PHP All Commercial |
$4,270.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,195.86
|
| Rate for Payer: Sagamore Health Network All Products |
$4,346.67
|
| Rate for Payer: Signature Care EPO |
$4,673.23
|
| Rate for Payer: Signature Care PPO |
$4,954.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,785.84
|
| Rate for Payer: United Healthcare Commercial |
$4,436.76
|
| Rate for Payer: United Healthcare Medicare |
$1,858.03
|
|
|
HC Z CONT 32X74 TT ELV LINER
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605547
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,236.27 |
| Rate for Payer: Aetna Commercial |
$4,752.06
|
| Rate for Payer: Aetna Medicare |
$1,858.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,858.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,233.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,519.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,136.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,043.84
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Centivo All Commercial |
$2,871.50
|
| Rate for Payer: Cigna All Commercial |
$4,859.04
|
| Rate for Payer: CORVEL All Commercial |
$5,236.27
|
| Rate for Payer: Coventry All Commercial |
$4,954.75
|
| Rate for Payer: Encore All Commercial |
$5,182.78
|
| Rate for Payer: Frontpath All Commercial |
$5,179.97
|
| Rate for Payer: Humana ChoiceCare |
$4,862.98
|
| Rate for Payer: Humana Medicare |
$2,871.50
|
| Rate for Payer: Lucent All Commercial |
$2,871.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,067.36
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,222.80
|
| Rate for Payer: PHP All Commercial |
$4,270.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,195.86
|
| Rate for Payer: Sagamore Health Network All Products |
$4,346.67
|
| Rate for Payer: Signature Care EPO |
$4,673.23
|
| Rate for Payer: Signature Care PPO |
$4,954.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,785.84
|
| Rate for Payer: United Healthcare Commercial |
$4,436.76
|
| Rate for Payer: United Healthcare Medicare |
$1,858.03
|
|
