|
HC Z CR 18MM PLY 7-12 GH L
|
Facility
IP
|
$4,305.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,229.20 |
| Max. Negotiated Rate |
$4,004.21 |
| Rate for Payer: Aetna Commercial |
$3,720.04
|
| Rate for Payer: Cash Price |
$2,669.47
|
| Rate for Payer: Cigna All Commercial |
$3,715.73
|
| Rate for Payer: CORVEL All Commercial |
$4,004.21
|
| Rate for Payer: Coventry All Commercial |
$3,788.93
|
| Rate for Payer: Encore All Commercial |
$3,963.30
|
| Rate for Payer: Frontpath All Commercial |
$3,961.15
|
| Rate for Payer: Humana ChoiceCare |
$3,718.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,875.04
|
| Rate for Payer: PHCS All Commercial |
$3,229.20
|
| Rate for Payer: PHP All Commercial |
$3,265.37
|
| Rate for Payer: Sagamore Health Network All Products |
$3,323.92
|
| Rate for Payer: Signature Care EPO |
$3,573.65
|
| Rate for Payer: Signature Care PPO |
$3,788.93
|
| Rate for Payer: United Healthcare Commercial |
$3,392.81
|
|
|
HC Z CR 18MM PLY 7-12 GH R
|
Facility
OP
|
$4,305.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,004.21 |
| Rate for Payer: Aetna Commercial |
$3,633.93
|
| Rate for Payer: Aetna Medicare |
$1,420.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,420.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,472.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,691.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,633.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,562.93
|
| Rate for Payer: Cash Price |
$2,669.47
|
| Rate for Payer: Cash Price |
$2,669.47
|
| Rate for Payer: Centivo All Commercial |
$2,195.86
|
| Rate for Payer: Cigna All Commercial |
$3,715.73
|
| Rate for Payer: CORVEL All Commercial |
$4,004.21
|
| Rate for Payer: Coventry All Commercial |
$3,788.93
|
| Rate for Payer: Encore All Commercial |
$3,963.30
|
| Rate for Payer: Frontpath All Commercial |
$3,961.15
|
| Rate for Payer: Humana ChoiceCare |
$3,718.75
|
| Rate for Payer: Humana Medicare |
$2,195.86
|
| Rate for Payer: Lucent All Commercial |
$2,195.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,875.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,229.20
|
| Rate for Payer: PHP All Commercial |
$3,265.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,679.18
|
| Rate for Payer: Sagamore Health Network All Products |
$3,323.92
|
| Rate for Payer: Signature Care EPO |
$3,573.65
|
| Rate for Payer: Signature Care PPO |
$3,788.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,659.76
|
| Rate for Payer: United Healthcare Commercial |
$3,392.81
|
| Rate for Payer: United Healthcare Medicare |
$1,420.85
|
|
|
HC Z CR 18MM PLY 7-12 GH R
|
Facility
IP
|
$4,305.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,229.20 |
| Max. Negotiated Rate |
$4,004.21 |
| Rate for Payer: Aetna Commercial |
$3,720.04
|
| Rate for Payer: Cash Price |
$2,669.47
|
| Rate for Payer: Cigna All Commercial |
$3,715.73
|
| Rate for Payer: CORVEL All Commercial |
$4,004.21
|
| Rate for Payer: Coventry All Commercial |
$3,788.93
|
| Rate for Payer: Encore All Commercial |
$3,963.30
|
| Rate for Payer: Frontpath All Commercial |
$3,961.15
|
| Rate for Payer: Humana ChoiceCare |
$3,718.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,875.04
|
| Rate for Payer: PHCS All Commercial |
$3,229.20
|
| Rate for Payer: PHP All Commercial |
$3,265.37
|
| Rate for Payer: Sagamore Health Network All Products |
$3,323.92
|
| Rate for Payer: Signature Care EPO |
$3,573.65
|
| Rate for Payer: Signature Care PPO |
$3,788.93
|
| Rate for Payer: United Healthcare Commercial |
$3,392.81
|
|
|
HC Z CR 18MM VE 3-11 EF L
|
Facility
IP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,968.00 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,723.14
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
|
|
HC Z CR 18MM VE 3-11 EF L
|
Facility
OP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,590.66
|
| Rate for Payer: Aetna Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,804.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,140.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,513.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,404.51
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Centivo All Commercial |
$3,378.24
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Humana Medicare |
$3,378.24
|
| Rate for Payer: Lucent All Commercial |
$3,378.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,583.36
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,630.40
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
| Rate for Payer: United Healthcare Medicare |
$2,185.92
|
|
|
HC Z CR 18MM VE 3-11 EF R
|
Facility
OP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605209
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,590.66
|
| Rate for Payer: Aetna Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,804.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,140.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,513.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,404.51
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Centivo All Commercial |
$3,378.24
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Humana Medicare |
$3,378.24
|
| Rate for Payer: Lucent All Commercial |
$3,378.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,583.36
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,630.40
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
| Rate for Payer: United Healthcare Medicare |
$2,185.92
|
|
|
HC Z CR 18MM VE 3-11 EF R
|
Facility
IP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605209
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,968.00 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,723.14
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
|
|
HC Z CR 18MM VE 3-9 CD L
|
Facility
OP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605535
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,590.66
|
| Rate for Payer: Aetna Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,804.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,140.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,513.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,404.51
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Centivo All Commercial |
$3,378.24
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Humana Medicare |
$3,378.24
|
| Rate for Payer: Lucent All Commercial |
$3,378.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,583.36
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,630.40
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
| Rate for Payer: United Healthcare Medicare |
$2,185.92
|
|
|
HC Z CR 18MM VE 3-9 CD L
|
Facility
IP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605535
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,968.00 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,723.14
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
|
|
HC Z CR 18MM VE 3-9 CD R
|
Facility
IP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,968.00 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,723.14
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
|
|
HC Z CR 18MM VE 3-9 CD R
|
Facility
OP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,590.66
|
| Rate for Payer: Aetna Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,804.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,140.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,513.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,404.51
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Centivo All Commercial |
$3,378.24
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Humana Medicare |
$3,378.24
|
| Rate for Payer: Lucent All Commercial |
$3,378.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,583.36
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,630.40
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
| Rate for Payer: United Healthcare Medicare |
$2,185.92
|
|
|
HC Z CR 18MM VE 7-12 GH L
|
Facility
IP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605202
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,968.00 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,723.14
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
|
|
HC Z CR 18MM VE 7-12 GH L
|
Facility
OP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605202
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,590.66
|
| Rate for Payer: Aetna Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,804.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,140.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,513.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,404.51
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Centivo All Commercial |
$3,378.24
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Humana Medicare |
$3,378.24
|
| Rate for Payer: Lucent All Commercial |
$3,378.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,583.36
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,630.40
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
| Rate for Payer: United Healthcare Medicare |
$2,185.92
|
|
|
HC Z CR 18MM VE 7-12 GH R
|
Facility
IP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605216
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,968.00 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,723.14
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
|
|
HC Z CR 18MM VE 7-12 GH R
|
Facility
OP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605216
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,590.66
|
| Rate for Payer: Aetna Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,804.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,140.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,513.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,404.51
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Centivo All Commercial |
$3,378.24
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Humana Medicare |
$3,378.24
|
| Rate for Payer: Lucent All Commercial |
$3,378.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,583.36
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,630.40
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
| Rate for Payer: United Healthcare Medicare |
$2,185.92
|
|
|
HC Z DELTA 28 FEM HD T1
|
Facility
OP
|
$7,452.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,930.36 |
| Rate for Payer: Aetna Commercial |
$6,289.49
|
| Rate for Payer: Aetna Medicare |
$2,459.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,459.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,279.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,658.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,828.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,705.08
|
| Rate for Payer: Cash Price |
$4,620.24
|
| Rate for Payer: Cash Price |
$4,620.24
|
| Rate for Payer: Centivo All Commercial |
$3,800.52
|
| Rate for Payer: Cigna All Commercial |
$6,431.08
|
| Rate for Payer: CORVEL All Commercial |
$6,930.36
|
| Rate for Payer: Coventry All Commercial |
$6,557.76
|
| Rate for Payer: Encore All Commercial |
$6,859.57
|
| Rate for Payer: Frontpath All Commercial |
$6,855.84
|
| Rate for Payer: Humana ChoiceCare |
$6,436.29
|
| Rate for Payer: Humana Medicare |
$3,800.52
|
| Rate for Payer: Lucent All Commercial |
$3,800.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,706.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,589.00
|
| Rate for Payer: PHP All Commercial |
$5,651.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,906.28
|
| Rate for Payer: Sagamore Health Network All Products |
$5,752.94
|
| Rate for Payer: Signature Care EPO |
$6,185.16
|
| Rate for Payer: Signature Care PPO |
$6,557.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,334.20
|
| Rate for Payer: United Healthcare Commercial |
$5,872.18
|
| Rate for Payer: United Healthcare Medicare |
$2,459.16
|
|
|
HC Z DELTA 28 FEM HD T1
|
Facility
IP
|
$7,452.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,589.00 |
| Max. Negotiated Rate |
$6,930.36 |
| Rate for Payer: Aetna Commercial |
$6,438.53
|
| Rate for Payer: Cash Price |
$4,620.24
|
| Rate for Payer: Cigna All Commercial |
$6,431.08
|
| Rate for Payer: CORVEL All Commercial |
$6,930.36
|
| Rate for Payer: Coventry All Commercial |
$6,557.76
|
| Rate for Payer: Encore All Commercial |
$6,859.57
|
| Rate for Payer: Frontpath All Commercial |
$6,855.84
|
| Rate for Payer: Humana ChoiceCare |
$6,436.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,706.80
|
| Rate for Payer: PHCS All Commercial |
$5,589.00
|
| Rate for Payer: PHP All Commercial |
$5,651.60
|
| Rate for Payer: Sagamore Health Network All Products |
$5,752.94
|
| Rate for Payer: Signature Care EPO |
$6,185.16
|
| Rate for Payer: Signature Care PPO |
$6,557.76
|
| Rate for Payer: United Healthcare Commercial |
$5,872.18
|
|
|
HC Z DEPTH GAUGE DVR
|
Facility
OP
|
$760.00
|
|
| Hospital Charge Code |
41606484
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$706.80 |
| Rate for Payer: Aetna Commercial |
$641.44
|
| Rate for Payer: Aetna Medicare |
$250.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$250.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$436.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$475.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$288.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$275.88
|
| Rate for Payer: Cash Price |
$471.20
|
| Rate for Payer: Cash Price |
$471.20
|
| Rate for Payer: Centivo All Commercial |
$387.60
|
| Rate for Payer: Cigna All Commercial |
$655.88
|
| Rate for Payer: CORVEL All Commercial |
$706.80
|
| Rate for Payer: Coventry All Commercial |
$668.80
|
| Rate for Payer: Encore All Commercial |
$699.58
|
| Rate for Payer: Frontpath All Commercial |
$699.20
|
| Rate for Payer: Humana ChoiceCare |
$656.41
|
| Rate for Payer: Humana Medicare |
$387.60
|
| Rate for Payer: Lucent All Commercial |
$387.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$684.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$570.00
|
| Rate for Payer: PHP All Commercial |
$576.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$296.40
|
| Rate for Payer: Sagamore Health Network All Products |
$586.72
|
| Rate for Payer: Signature Care EPO |
$630.80
|
| Rate for Payer: Signature Care PPO |
$668.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$646.00
|
| Rate for Payer: United Healthcare Commercial |
$598.88
|
| Rate for Payer: United Healthcare Medicare |
$250.80
|
|
|
HC Z DEPTH GAUGE DVR
|
Facility
IP
|
$760.00
|
|
| Hospital Charge Code |
41606484
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$570.00 |
| Max. Negotiated Rate |
$706.80 |
| Rate for Payer: Aetna Commercial |
$656.64
|
| Rate for Payer: Cash Price |
$471.20
|
| Rate for Payer: Cigna All Commercial |
$655.88
|
| Rate for Payer: CORVEL All Commercial |
$706.80
|
| Rate for Payer: Coventry All Commercial |
$668.80
|
| Rate for Payer: Encore All Commercial |
$699.58
|
| Rate for Payer: Frontpath All Commercial |
$699.20
|
| Rate for Payer: Humana ChoiceCare |
$656.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$684.00
|
| Rate for Payer: PHCS All Commercial |
$570.00
|
| Rate for Payer: PHP All Commercial |
$576.38
|
| Rate for Payer: Sagamore Health Network All Products |
$586.72
|
| Rate for Payer: Signature Care EPO |
$630.80
|
| Rate for Payer: Signature Care PPO |
$668.80
|
| Rate for Payer: United Healthcare Commercial |
$598.88
|
|
|
HC Z DIA COCR MOD HD 28 +3 NECK
|
Facility
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603451
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,139.00 |
| Rate for Payer: Aetna Commercial |
$1,941.20
|
| Rate for Payer: Aetna Medicare |
$759.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$759.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,320.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,437.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$872.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$834.90
|
| Rate for Payer: Cash Price |
$1,426.00
|
| Rate for Payer: Cash Price |
$1,426.00
|
| Rate for Payer: Centivo All Commercial |
$1,173.00
|
| Rate for Payer: Cigna All Commercial |
$1,984.90
|
| Rate for Payer: CORVEL All Commercial |
$2,139.00
|
| Rate for Payer: Coventry All Commercial |
$2,024.00
|
| Rate for Payer: Encore All Commercial |
$2,117.15
|
| Rate for Payer: Frontpath All Commercial |
$2,116.00
|
| Rate for Payer: Humana ChoiceCare |
$1,986.51
|
| Rate for Payer: Humana Medicare |
$1,173.00
|
| Rate for Payer: Lucent All Commercial |
$1,173.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,070.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,725.00
|
| Rate for Payer: PHP All Commercial |
$1,744.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$897.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,775.60
|
| Rate for Payer: Signature Care EPO |
$1,909.00
|
| Rate for Payer: Signature Care PPO |
$2,024.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare Commercial |
$1,812.40
|
| Rate for Payer: United Healthcare Medicare |
$759.00
|
|
|
HC Z DIA COCR MOD HD 28 +3 NECK
|
Facility
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603451
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,725.00 |
| Max. Negotiated Rate |
$2,139.00 |
| Rate for Payer: Aetna Commercial |
$1,987.20
|
| Rate for Payer: Cash Price |
$1,426.00
|
| Rate for Payer: Cigna All Commercial |
$1,984.90
|
| Rate for Payer: CORVEL All Commercial |
$2,139.00
|
| Rate for Payer: Coventry All Commercial |
$2,024.00
|
| Rate for Payer: Encore All Commercial |
$2,117.15
|
| Rate for Payer: Frontpath All Commercial |
$2,116.00
|
| Rate for Payer: Humana ChoiceCare |
$1,986.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,070.00
|
| Rate for Payer: PHCS All Commercial |
$1,725.00
|
| Rate for Payer: PHP All Commercial |
$1,744.32
|
| Rate for Payer: Sagamore Health Network All Products |
$1,775.60
|
| Rate for Payer: Signature Care EPO |
$1,909.00
|
| Rate for Payer: Signature Care PPO |
$2,024.00
|
| Rate for Payer: United Healthcare Commercial |
$1,812.40
|
|
|
HC Z DM BRG 28X38 VIV-E
|
Facility
OP
|
$7,452.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,930.36 |
| Rate for Payer: Aetna Commercial |
$6,289.49
|
| Rate for Payer: Aetna Medicare |
$2,459.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,459.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,279.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,658.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,828.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,705.08
|
| Rate for Payer: Cash Price |
$4,620.24
|
| Rate for Payer: Cash Price |
$4,620.24
|
| Rate for Payer: Centivo All Commercial |
$3,800.52
|
| Rate for Payer: Cigna All Commercial |
$6,431.08
|
| Rate for Payer: CORVEL All Commercial |
$6,930.36
|
| Rate for Payer: Coventry All Commercial |
$6,557.76
|
| Rate for Payer: Encore All Commercial |
$6,859.57
|
| Rate for Payer: Frontpath All Commercial |
$6,855.84
|
| Rate for Payer: Humana ChoiceCare |
$6,436.29
|
| Rate for Payer: Humana Medicare |
$3,800.52
|
| Rate for Payer: Lucent All Commercial |
$3,800.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,706.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,589.00
|
| Rate for Payer: PHP All Commercial |
$5,651.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,906.28
|
| Rate for Payer: Sagamore Health Network All Products |
$5,752.94
|
| Rate for Payer: Signature Care EPO |
$6,185.16
|
| Rate for Payer: Signature Care PPO |
$6,557.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,334.20
|
| Rate for Payer: United Healthcare Commercial |
$5,872.18
|
| Rate for Payer: United Healthcare Medicare |
$2,459.16
|
|
|
HC Z DM BRG 28X38 VIV-E
|
Facility
IP
|
$7,452.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,589.00 |
| Max. Negotiated Rate |
$6,930.36 |
| Rate for Payer: Aetna Commercial |
$6,438.53
|
| Rate for Payer: Cash Price |
$4,620.24
|
| Rate for Payer: Cigna All Commercial |
$6,431.08
|
| Rate for Payer: CORVEL All Commercial |
$6,930.36
|
| Rate for Payer: Coventry All Commercial |
$6,557.76
|
| Rate for Payer: Encore All Commercial |
$6,859.57
|
| Rate for Payer: Frontpath All Commercial |
$6,855.84
|
| Rate for Payer: Humana ChoiceCare |
$6,436.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,706.80
|
| Rate for Payer: PHCS All Commercial |
$5,589.00
|
| Rate for Payer: PHP All Commercial |
$5,651.60
|
| Rate for Payer: Sagamore Health Network All Products |
$5,752.94
|
| Rate for Payer: Signature Care EPO |
$6,185.16
|
| Rate for Payer: Signature Care PPO |
$6,557.76
|
| Rate for Payer: United Healthcare Commercial |
$5,872.18
|
|
|
HC Z DM BRG 28X42 VIV-E L
|
Facility
OP
|
$7,452.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608080
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,930.36 |
| Rate for Payer: Aetna Commercial |
$6,289.49
|
| Rate for Payer: Aetna Medicare |
$2,459.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,459.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,279.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,658.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,828.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,705.08
|
| Rate for Payer: Cash Price |
$4,620.24
|
| Rate for Payer: Cash Price |
$4,620.24
|
| Rate for Payer: Centivo All Commercial |
$3,800.52
|
| Rate for Payer: Cigna All Commercial |
$6,431.08
|
| Rate for Payer: CORVEL All Commercial |
$6,930.36
|
| Rate for Payer: Coventry All Commercial |
$6,557.76
|
| Rate for Payer: Encore All Commercial |
$6,859.57
|
| Rate for Payer: Frontpath All Commercial |
$6,855.84
|
| Rate for Payer: Humana ChoiceCare |
$6,436.29
|
| Rate for Payer: Humana Medicare |
$3,800.52
|
| Rate for Payer: Lucent All Commercial |
$3,800.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,706.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,589.00
|
| Rate for Payer: PHP All Commercial |
$5,651.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,906.28
|
| Rate for Payer: Sagamore Health Network All Products |
$5,752.94
|
| Rate for Payer: Signature Care EPO |
$6,185.16
|
| Rate for Payer: Signature Care PPO |
$6,557.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,334.20
|
| Rate for Payer: United Healthcare Commercial |
$5,872.18
|
| Rate for Payer: United Healthcare Medicare |
$2,459.16
|
|
|
HC Z DM BRG 28X42 VIV-E L
|
Facility
IP
|
$7,452.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608080
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,589.00 |
| Max. Negotiated Rate |
$6,930.36 |
| Rate for Payer: Aetna Commercial |
$6,438.53
|
| Rate for Payer: Cash Price |
$4,620.24
|
| Rate for Payer: Cigna All Commercial |
$6,431.08
|
| Rate for Payer: CORVEL All Commercial |
$6,930.36
|
| Rate for Payer: Coventry All Commercial |
$6,557.76
|
| Rate for Payer: Encore All Commercial |
$6,859.57
|
| Rate for Payer: Frontpath All Commercial |
$6,855.84
|
| Rate for Payer: Humana ChoiceCare |
$6,436.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,706.80
|
| Rate for Payer: PHCS All Commercial |
$5,589.00
|
| Rate for Payer: PHP All Commercial |
$5,651.60
|
| Rate for Payer: Sagamore Health Network All Products |
$5,752.94
|
| Rate for Payer: Signature Care EPO |
$6,185.16
|
| Rate for Payer: Signature Care PPO |
$6,557.76
|
| Rate for Payer: United Healthcare Commercial |
$5,872.18
|
|
