|
HC Z ENDO II MOD HD 53
|
Facility
IP
|
$1,610.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603992
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,207.50 |
| Max. Negotiated Rate |
$1,497.30 |
| Rate for Payer: Aetna Commercial |
$1,391.04
|
| Rate for Payer: Cash Price |
$998.20
|
| Rate for Payer: Cigna All Commercial |
$1,389.43
|
| Rate for Payer: CORVEL All Commercial |
$1,497.30
|
| Rate for Payer: Coventry All Commercial |
$1,416.80
|
| Rate for Payer: Encore All Commercial |
$1,482.00
|
| Rate for Payer: Frontpath All Commercial |
$1,481.20
|
| Rate for Payer: Humana ChoiceCare |
$1,390.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,449.00
|
| Rate for Payer: PHCS All Commercial |
$1,207.50
|
| Rate for Payer: PHP All Commercial |
$1,221.02
|
| Rate for Payer: Sagamore Health Network All Products |
$1,242.92
|
| Rate for Payer: Signature Care EPO |
$1,336.30
|
| Rate for Payer: Signature Care PPO |
$1,416.80
|
| Rate for Payer: United Healthcare Commercial |
$1,268.68
|
|
|
HC Z ENDO II MOD HD 53
|
Facility
OP
|
$1,610.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603992
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,497.30 |
| Rate for Payer: Aetna Commercial |
$1,358.84
|
| Rate for Payer: Aetna Medicare |
$531.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$531.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$924.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,006.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$611.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$584.43
|
| Rate for Payer: Cash Price |
$998.20
|
| Rate for Payer: Cash Price |
$998.20
|
| Rate for Payer: Centivo All Commercial |
$821.10
|
| Rate for Payer: Cigna All Commercial |
$1,389.43
|
| Rate for Payer: CORVEL All Commercial |
$1,497.30
|
| Rate for Payer: Coventry All Commercial |
$1,416.80
|
| Rate for Payer: Encore All Commercial |
$1,482.00
|
| Rate for Payer: Frontpath All Commercial |
$1,481.20
|
| Rate for Payer: Humana ChoiceCare |
$1,390.56
|
| Rate for Payer: Humana Medicare |
$821.10
|
| Rate for Payer: Lucent All Commercial |
$821.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,449.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,207.50
|
| Rate for Payer: PHP All Commercial |
$1,221.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$627.90
|
| Rate for Payer: Sagamore Health Network All Products |
$1,242.92
|
| Rate for Payer: Signature Care EPO |
$1,336.30
|
| Rate for Payer: Signature Care PPO |
$1,416.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,368.50
|
| Rate for Payer: United Healthcare Commercial |
$1,268.68
|
| Rate for Payer: United Healthcare Medicare |
$531.30
|
|
|
HC Z ENDO II TPR ADAPTER -3NK T1
|
Facility
OP
|
$966.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603989
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.78 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$815.30
|
| Rate for Payer: Aetna Medicare |
$318.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.66
|
| Rate for Payer: Cash Price |
$598.92
|
| Rate for Payer: Cash Price |
$598.92
|
| Rate for Payer: Centivo All Commercial |
$492.66
|
| Rate for Payer: Cigna All Commercial |
$833.66
|
| Rate for Payer: CORVEL All Commercial |
$898.38
|
| Rate for Payer: Coventry All Commercial |
$850.08
|
| Rate for Payer: Encore All Commercial |
$889.20
|
| Rate for Payer: Frontpath All Commercial |
$888.72
|
| Rate for Payer: Humana ChoiceCare |
$834.33
|
| Rate for Payer: Humana Medicare |
$492.66
|
| Rate for Payer: Lucent All Commercial |
$492.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$869.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$724.50
|
| Rate for Payer: PHP All Commercial |
$732.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.74
|
| Rate for Payer: Sagamore Health Network All Products |
$745.75
|
| Rate for Payer: Signature Care EPO |
$801.78
|
| Rate for Payer: Signature Care PPO |
$850.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$821.10
|
| Rate for Payer: United Healthcare Commercial |
$761.21
|
| Rate for Payer: United Healthcare Medicare |
$318.78
|
|
|
HC Z ENDO II TPR ADAPTER -3NK T1
|
Facility
IP
|
$966.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603989
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$724.50 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$834.62
|
| Rate for Payer: Cash Price |
$598.92
|
| Rate for Payer: Cigna All Commercial |
$833.66
|
| Rate for Payer: CORVEL All Commercial |
$898.38
|
| Rate for Payer: Coventry All Commercial |
$850.08
|
| Rate for Payer: Encore All Commercial |
$889.20
|
| Rate for Payer: Frontpath All Commercial |
$888.72
|
| Rate for Payer: Humana ChoiceCare |
$834.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$869.40
|
| Rate for Payer: PHCS All Commercial |
$724.50
|
| Rate for Payer: PHP All Commercial |
$732.61
|
| Rate for Payer: Sagamore Health Network All Products |
$745.75
|
| Rate for Payer: Signature Care EPO |
$801.78
|
| Rate for Payer: Signature Care PPO |
$850.08
|
| Rate for Payer: United Healthcare Commercial |
$761.21
|
|
|
HC Z ENDO II TPR ADAPTER +6NK T1
|
Facility
OP
|
$966.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603710
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.78 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$815.30
|
| Rate for Payer: Aetna Medicare |
$318.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.66
|
| Rate for Payer: Cash Price |
$598.92
|
| Rate for Payer: Cash Price |
$598.92
|
| Rate for Payer: Centivo All Commercial |
$492.66
|
| Rate for Payer: Cigna All Commercial |
$833.66
|
| Rate for Payer: CORVEL All Commercial |
$898.38
|
| Rate for Payer: Coventry All Commercial |
$850.08
|
| Rate for Payer: Encore All Commercial |
$889.20
|
| Rate for Payer: Frontpath All Commercial |
$888.72
|
| Rate for Payer: Humana ChoiceCare |
$834.33
|
| Rate for Payer: Humana Medicare |
$492.66
|
| Rate for Payer: Lucent All Commercial |
$492.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$869.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$724.50
|
| Rate for Payer: PHP All Commercial |
$732.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.74
|
| Rate for Payer: Sagamore Health Network All Products |
$745.75
|
| Rate for Payer: Signature Care EPO |
$801.78
|
| Rate for Payer: Signature Care PPO |
$850.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$821.10
|
| Rate for Payer: United Healthcare Commercial |
$761.21
|
| Rate for Payer: United Healthcare Medicare |
$318.78
|
|
|
HC Z ENDO II TPR ADAPTER +6NK T1
|
Facility
IP
|
$966.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603710
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$724.50 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$834.62
|
| Rate for Payer: Cash Price |
$598.92
|
| Rate for Payer: Cigna All Commercial |
$833.66
|
| Rate for Payer: CORVEL All Commercial |
$898.38
|
| Rate for Payer: Coventry All Commercial |
$850.08
|
| Rate for Payer: Encore All Commercial |
$889.20
|
| Rate for Payer: Frontpath All Commercial |
$888.72
|
| Rate for Payer: Humana ChoiceCare |
$834.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$869.40
|
| Rate for Payer: PHCS All Commercial |
$724.50
|
| Rate for Payer: PHP All Commercial |
$732.61
|
| Rate for Payer: Sagamore Health Network All Products |
$745.75
|
| Rate for Payer: Signature Care EPO |
$801.78
|
| Rate for Payer: Signature Care PPO |
$850.08
|
| Rate for Payer: United Healthcare Commercial |
$761.21
|
|
|
HC Z ENDO II TPR ADAPTER -6NK T1
|
Facility
OP
|
$966.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41604385
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.78 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$815.30
|
| Rate for Payer: Aetna Medicare |
$318.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.66
|
| Rate for Payer: Cash Price |
$598.92
|
| Rate for Payer: Cash Price |
$598.92
|
| Rate for Payer: Centivo All Commercial |
$492.66
|
| Rate for Payer: Cigna All Commercial |
$833.66
|
| Rate for Payer: CORVEL All Commercial |
$898.38
|
| Rate for Payer: Coventry All Commercial |
$850.08
|
| Rate for Payer: Encore All Commercial |
$889.20
|
| Rate for Payer: Frontpath All Commercial |
$888.72
|
| Rate for Payer: Humana ChoiceCare |
$834.33
|
| Rate for Payer: Humana Medicare |
$492.66
|
| Rate for Payer: Lucent All Commercial |
$492.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$869.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$724.50
|
| Rate for Payer: PHP All Commercial |
$732.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.74
|
| Rate for Payer: Sagamore Health Network All Products |
$745.75
|
| Rate for Payer: Signature Care EPO |
$801.78
|
| Rate for Payer: Signature Care PPO |
$850.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$821.10
|
| Rate for Payer: United Healthcare Commercial |
$761.21
|
| Rate for Payer: United Healthcare Medicare |
$318.78
|
|
|
HC Z ENDO II TPR ADAPTER -6NK T1
|
Facility
IP
|
$966.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41604385
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$724.50 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$834.62
|
| Rate for Payer: Cash Price |
$598.92
|
| Rate for Payer: Cigna All Commercial |
$833.66
|
| Rate for Payer: CORVEL All Commercial |
$898.38
|
| Rate for Payer: Coventry All Commercial |
$850.08
|
| Rate for Payer: Encore All Commercial |
$889.20
|
| Rate for Payer: Frontpath All Commercial |
$888.72
|
| Rate for Payer: Humana ChoiceCare |
$834.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$869.40
|
| Rate for Payer: PHCS All Commercial |
$724.50
|
| Rate for Payer: PHP All Commercial |
$732.61
|
| Rate for Payer: Sagamore Health Network All Products |
$745.75
|
| Rate for Payer: Signature Care EPO |
$801.78
|
| Rate for Payer: Signature Care PPO |
$850.08
|
| Rate for Payer: United Healthcare Commercial |
$761.21
|
|
|
HC Z EPAK STORAGE TOTE
|
Facility
OP
|
$4,500.00
|
|
| Hospital Charge Code |
41606482
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$4,185.00 |
| Rate for Payer: Aetna Commercial |
$3,798.00
|
| Rate for Payer: Aetna Medicare |
$1,485.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,485.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,584.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,812.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,707.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,633.50
|
| Rate for Payer: Cash Price |
$2,790.00
|
| Rate for Payer: Cash Price |
$2,790.00
|
| Rate for Payer: Centivo All Commercial |
$2,295.00
|
| Rate for Payer: Cigna All Commercial |
$3,883.50
|
| Rate for Payer: CORVEL All Commercial |
$4,185.00
|
| Rate for Payer: Coventry All Commercial |
$3,960.00
|
| Rate for Payer: Encore All Commercial |
$4,142.25
|
| Rate for Payer: Frontpath All Commercial |
$4,140.00
|
| Rate for Payer: Humana ChoiceCare |
$3,886.65
|
| Rate for Payer: Humana Medicare |
$2,295.00
|
| Rate for Payer: Lucent All Commercial |
$2,295.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,050.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$3,375.00
|
| Rate for Payer: PHP All Commercial |
$3,412.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,755.00
|
| Rate for Payer: Sagamore Health Network All Products |
$3,474.00
|
| Rate for Payer: Signature Care EPO |
$3,735.00
|
| Rate for Payer: Signature Care PPO |
$3,960.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,825.00
|
| Rate for Payer: United Healthcare Commercial |
$3,546.00
|
| Rate for Payer: United Healthcare Medicare |
$1,485.00
|
|
|
HC Z EPAK STORAGE TOTE
|
Facility
IP
|
$4,500.00
|
|
| Hospital Charge Code |
41606482
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,375.00 |
| Max. Negotiated Rate |
$4,185.00 |
| Rate for Payer: Aetna Commercial |
$3,888.00
|
| Rate for Payer: Cash Price |
$2,790.00
|
| Rate for Payer: Cigna All Commercial |
$3,883.50
|
| Rate for Payer: CORVEL All Commercial |
$4,185.00
|
| Rate for Payer: Coventry All Commercial |
$3,960.00
|
| Rate for Payer: Encore All Commercial |
$4,142.25
|
| Rate for Payer: Frontpath All Commercial |
$4,140.00
|
| Rate for Payer: Humana ChoiceCare |
$3,886.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,050.00
|
| Rate for Payer: PHCS All Commercial |
$3,375.00
|
| Rate for Payer: PHP All Commercial |
$3,412.80
|
| Rate for Payer: Sagamore Health Network All Products |
$3,474.00
|
| Rate for Payer: Signature Care EPO |
$3,735.00
|
| Rate for Payer: Signature Care PPO |
$3,960.00
|
| Rate for Payer: United Healthcare Commercial |
$3,546.00
|
|
|
HC Z EQUIVABONE 10 CC
|
Facility
OP
|
$15,699.60
|
|
|
Service Code
|
CPT C1762
|
| Hospital Charge Code |
41607092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$14,600.63 |
| Rate for Payer: Aetna Commercial |
$13,250.46
|
| Rate for Payer: Aetna Medicare |
$5,180.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,180.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,016.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,813.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,958.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,698.95
|
| Rate for Payer: Cash Price |
$9,733.75
|
| Rate for Payer: Cash Price |
$9,733.75
|
| Rate for Payer: Centivo All Commercial |
$8,006.80
|
| Rate for Payer: Cigna All Commercial |
$13,548.75
|
| Rate for Payer: CORVEL All Commercial |
$14,600.63
|
| Rate for Payer: Coventry All Commercial |
$13,815.65
|
| Rate for Payer: Encore All Commercial |
$14,451.48
|
| Rate for Payer: Frontpath All Commercial |
$14,443.63
|
| Rate for Payer: Humana ChoiceCare |
$13,559.74
|
| Rate for Payer: Humana Medicare |
$8,006.80
|
| Rate for Payer: Lucent All Commercial |
$8,006.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,129.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,774.70
|
| Rate for Payer: PHP All Commercial |
$11,906.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,122.84
|
| Rate for Payer: Sagamore Health Network All Products |
$12,120.09
|
| Rate for Payer: Signature Care EPO |
$13,030.67
|
| Rate for Payer: Signature Care PPO |
$13,815.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,344.66
|
| Rate for Payer: United Healthcare Commercial |
$12,371.28
|
| Rate for Payer: United Healthcare Medicare |
$5,180.87
|
|
|
HC Z EQUIVABONE 10 CC
|
Facility
IP
|
$15,699.60
|
|
|
Service Code
|
CPT C1762
|
| Hospital Charge Code |
41607092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,774.70 |
| Max. Negotiated Rate |
$14,600.63 |
| Rate for Payer: Aetna Commercial |
$13,564.45
|
| Rate for Payer: Cash Price |
$9,733.75
|
| Rate for Payer: Cigna All Commercial |
$13,548.75
|
| Rate for Payer: CORVEL All Commercial |
$14,600.63
|
| Rate for Payer: Coventry All Commercial |
$13,815.65
|
| Rate for Payer: Encore All Commercial |
$14,451.48
|
| Rate for Payer: Frontpath All Commercial |
$14,443.63
|
| Rate for Payer: Humana ChoiceCare |
$13,559.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,129.64
|
| Rate for Payer: PHCS All Commercial |
$11,774.70
|
| Rate for Payer: PHP All Commercial |
$11,906.58
|
| Rate for Payer: Sagamore Health Network All Products |
$12,120.09
|
| Rate for Payer: Signature Care EPO |
$13,030.67
|
| Rate for Payer: Signature Care PPO |
$13,815.65
|
| Rate for Payer: United Healthcare Commercial |
$12,371.28
|
|
|
HC Z EXCHANGE TUBE
|
Facility
OP
|
$888.80
|
|
| Hospital Charge Code |
41606163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$826.58 |
| Rate for Payer: Aetna Commercial |
$750.15
|
| Rate for Payer: Aetna Medicare |
$293.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$293.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$510.44
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$555.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$337.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$322.63
|
| Rate for Payer: Cash Price |
$551.06
|
| Rate for Payer: Cash Price |
$551.06
|
| Rate for Payer: Centivo All Commercial |
$453.29
|
| Rate for Payer: Cigna All Commercial |
$767.03
|
| Rate for Payer: CORVEL All Commercial |
$826.58
|
| Rate for Payer: Coventry All Commercial |
$782.14
|
| Rate for Payer: Encore All Commercial |
$818.14
|
| Rate for Payer: Frontpath All Commercial |
$817.70
|
| Rate for Payer: Humana ChoiceCare |
$767.66
|
| Rate for Payer: Humana Medicare |
$453.29
|
| Rate for Payer: Lucent All Commercial |
$453.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$799.92
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$666.60
|
| Rate for Payer: PHP All Commercial |
$674.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$346.63
|
| Rate for Payer: Sagamore Health Network All Products |
$686.15
|
| Rate for Payer: Signature Care EPO |
$737.70
|
| Rate for Payer: Signature Care PPO |
$782.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$755.48
|
| Rate for Payer: United Healthcare Commercial |
$700.37
|
| Rate for Payer: United Healthcare Medicare |
$293.30
|
|
|
HC Z EXCHANGE TUBE
|
Facility
IP
|
$888.80
|
|
| Hospital Charge Code |
41606163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$666.60 |
| Max. Negotiated Rate |
$826.58 |
| Rate for Payer: Aetna Commercial |
$767.92
|
| Rate for Payer: Cash Price |
$551.06
|
| Rate for Payer: Cigna All Commercial |
$767.03
|
| Rate for Payer: CORVEL All Commercial |
$826.58
|
| Rate for Payer: Coventry All Commercial |
$782.14
|
| Rate for Payer: Encore All Commercial |
$818.14
|
| Rate for Payer: Frontpath All Commercial |
$817.70
|
| Rate for Payer: Humana ChoiceCare |
$767.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$799.92
|
| Rate for Payer: PHCS All Commercial |
$666.60
|
| Rate for Payer: PHP All Commercial |
$674.07
|
| Rate for Payer: Sagamore Health Network All Products |
$686.15
|
| Rate for Payer: Signature Care EPO |
$737.70
|
| Rate for Payer: Signature Care PPO |
$782.14
|
| Rate for Payer: United Healthcare Commercial |
$700.37
|
|
|
HC Z EXPLOR IMP HEAD 10X22
|
Facility
OP
|
$7,704.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,164.72 |
| Rate for Payer: Aetna Commercial |
$6,502.18
|
| Rate for Payer: Aetna Medicare |
$2,542.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,542.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,424.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,815.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,923.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,796.55
|
| Rate for Payer: Cash Price |
$4,776.48
|
| Rate for Payer: Cash Price |
$4,776.48
|
| Rate for Payer: Centivo All Commercial |
$3,929.04
|
| Rate for Payer: Cigna All Commercial |
$6,648.55
|
| Rate for Payer: CORVEL All Commercial |
$7,164.72
|
| Rate for Payer: Coventry All Commercial |
$6,779.52
|
| Rate for Payer: Encore All Commercial |
$7,091.53
|
| Rate for Payer: Frontpath All Commercial |
$7,087.68
|
| Rate for Payer: Humana ChoiceCare |
$6,653.94
|
| Rate for Payer: Humana Medicare |
$3,929.04
|
| Rate for Payer: Lucent All Commercial |
$3,929.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,933.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,778.00
|
| Rate for Payer: PHP All Commercial |
$5,842.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,004.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,947.49
|
| Rate for Payer: Signature Care EPO |
$6,394.32
|
| Rate for Payer: Signature Care PPO |
$6,779.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,548.40
|
| Rate for Payer: United Healthcare Commercial |
$6,070.75
|
| Rate for Payer: United Healthcare Medicare |
$2,542.32
|
|
|
HC Z EXPLOR IMP HEAD 10X22
|
Facility
IP
|
$7,704.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,778.00 |
| Max. Negotiated Rate |
$7,164.72 |
| Rate for Payer: Aetna Commercial |
$6,656.26
|
| Rate for Payer: Cash Price |
$4,776.48
|
| Rate for Payer: Cigna All Commercial |
$6,648.55
|
| Rate for Payer: CORVEL All Commercial |
$7,164.72
|
| Rate for Payer: Coventry All Commercial |
$6,779.52
|
| Rate for Payer: Encore All Commercial |
$7,091.53
|
| Rate for Payer: Frontpath All Commercial |
$7,087.68
|
| Rate for Payer: Humana ChoiceCare |
$6,653.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,933.60
|
| Rate for Payer: PHCS All Commercial |
$5,778.00
|
| Rate for Payer: PHP All Commercial |
$5,842.71
|
| Rate for Payer: Sagamore Health Network All Products |
$5,947.49
|
| Rate for Payer: Signature Care EPO |
$6,394.32
|
| Rate for Payer: Signature Care PPO |
$6,779.52
|
| Rate for Payer: United Healthcare Commercial |
$6,070.75
|
|
|
HC Z EXPLOR IMP HEAD 14X20
|
Facility
IP
|
$7,704.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,778.00 |
| Max. Negotiated Rate |
$7,164.72 |
| Rate for Payer: Aetna Commercial |
$6,656.26
|
| Rate for Payer: Cash Price |
$4,776.48
|
| Rate for Payer: Cigna All Commercial |
$6,648.55
|
| Rate for Payer: CORVEL All Commercial |
$7,164.72
|
| Rate for Payer: Coventry All Commercial |
$6,779.52
|
| Rate for Payer: Encore All Commercial |
$7,091.53
|
| Rate for Payer: Frontpath All Commercial |
$7,087.68
|
| Rate for Payer: Humana ChoiceCare |
$6,653.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,933.60
|
| Rate for Payer: PHCS All Commercial |
$5,778.00
|
| Rate for Payer: PHP All Commercial |
$5,842.71
|
| Rate for Payer: Sagamore Health Network All Products |
$5,947.49
|
| Rate for Payer: Signature Care EPO |
$6,394.32
|
| Rate for Payer: Signature Care PPO |
$6,779.52
|
| Rate for Payer: United Healthcare Commercial |
$6,070.75
|
|
|
HC Z EXPLOR IMP HEAD 14X20
|
Facility
OP
|
$7,704.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,164.72 |
| Rate for Payer: Aetna Commercial |
$6,502.18
|
| Rate for Payer: Aetna Medicare |
$2,542.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,542.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,424.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,815.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,923.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,796.55
|
| Rate for Payer: Cash Price |
$4,776.48
|
| Rate for Payer: Cash Price |
$4,776.48
|
| Rate for Payer: Centivo All Commercial |
$3,929.04
|
| Rate for Payer: Cigna All Commercial |
$6,648.55
|
| Rate for Payer: CORVEL All Commercial |
$7,164.72
|
| Rate for Payer: Coventry All Commercial |
$6,779.52
|
| Rate for Payer: Encore All Commercial |
$7,091.53
|
| Rate for Payer: Frontpath All Commercial |
$7,087.68
|
| Rate for Payer: Humana ChoiceCare |
$6,653.94
|
| Rate for Payer: Humana Medicare |
$3,929.04
|
| Rate for Payer: Lucent All Commercial |
$3,929.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,933.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,778.00
|
| Rate for Payer: PHP All Commercial |
$5,842.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,004.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,947.49
|
| Rate for Payer: Signature Care EPO |
$6,394.32
|
| Rate for Payer: Signature Care PPO |
$6,779.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,548.40
|
| Rate for Payer: United Healthcare Commercial |
$6,070.75
|
| Rate for Payer: United Healthcare Medicare |
$2,542.32
|
|
|
HC Z EXPLOR IMP STEM W SCREW 6X24
|
Facility
IP
|
$7,704.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603461
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,778.00 |
| Max. Negotiated Rate |
$7,164.72 |
| Rate for Payer: Aetna Commercial |
$6,656.26
|
| Rate for Payer: Cash Price |
$4,776.48
|
| Rate for Payer: Cigna All Commercial |
$6,648.55
|
| Rate for Payer: CORVEL All Commercial |
$7,164.72
|
| Rate for Payer: Coventry All Commercial |
$6,779.52
|
| Rate for Payer: Encore All Commercial |
$7,091.53
|
| Rate for Payer: Frontpath All Commercial |
$7,087.68
|
| Rate for Payer: Humana ChoiceCare |
$6,653.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,933.60
|
| Rate for Payer: PHCS All Commercial |
$5,778.00
|
| Rate for Payer: PHP All Commercial |
$5,842.71
|
| Rate for Payer: Sagamore Health Network All Products |
$5,947.49
|
| Rate for Payer: Signature Care EPO |
$6,394.32
|
| Rate for Payer: Signature Care PPO |
$6,779.52
|
| Rate for Payer: United Healthcare Commercial |
$6,070.75
|
|
|
HC Z EXPLOR IMP STEM W SCREW 6X24
|
Facility
OP
|
$7,704.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603461
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,164.72 |
| Rate for Payer: Aetna Commercial |
$6,502.18
|
| Rate for Payer: Aetna Medicare |
$2,542.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,542.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,424.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,815.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,923.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,796.55
|
| Rate for Payer: Cash Price |
$4,776.48
|
| Rate for Payer: Cash Price |
$4,776.48
|
| Rate for Payer: Centivo All Commercial |
$3,929.04
|
| Rate for Payer: Cigna All Commercial |
$6,648.55
|
| Rate for Payer: CORVEL All Commercial |
$7,164.72
|
| Rate for Payer: Coventry All Commercial |
$6,779.52
|
| Rate for Payer: Encore All Commercial |
$7,091.53
|
| Rate for Payer: Frontpath All Commercial |
$7,087.68
|
| Rate for Payer: Humana ChoiceCare |
$6,653.94
|
| Rate for Payer: Humana Medicare |
$3,929.04
|
| Rate for Payer: Lucent All Commercial |
$3,929.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,933.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,778.00
|
| Rate for Payer: PHP All Commercial |
$5,842.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,004.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,947.49
|
| Rate for Payer: Signature Care EPO |
$6,394.32
|
| Rate for Payer: Signature Care PPO |
$6,779.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,548.40
|
| Rate for Payer: United Healthcare Commercial |
$6,070.75
|
| Rate for Payer: United Healthcare Medicare |
$2,542.32
|
|
|
HC Z EZ PASS 30 DEG L
|
Facility
OP
|
$1,435.00
|
|
| Hospital Charge Code |
41608165
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,334.55 |
| Rate for Payer: Aetna Commercial |
$1,211.14
|
| Rate for Payer: Aetna Medicare |
$473.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$473.55
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$824.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$897.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$544.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$520.90
|
| Rate for Payer: Cash Price |
$889.70
|
| Rate for Payer: Cash Price |
$889.70
|
| Rate for Payer: Centivo All Commercial |
$731.85
|
| Rate for Payer: Cigna All Commercial |
$1,238.40
|
| Rate for Payer: CORVEL All Commercial |
$1,334.55
|
| Rate for Payer: Coventry All Commercial |
$1,262.80
|
| Rate for Payer: Encore All Commercial |
$1,320.92
|
| Rate for Payer: Frontpath All Commercial |
$1,320.20
|
| Rate for Payer: Humana ChoiceCare |
$1,239.41
|
| Rate for Payer: Humana Medicare |
$731.85
|
| Rate for Payer: Lucent All Commercial |
$731.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,291.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,076.25
|
| Rate for Payer: PHP All Commercial |
$1,088.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$559.65
|
| Rate for Payer: Sagamore Health Network All Products |
$1,107.82
|
| Rate for Payer: Signature Care EPO |
$1,191.05
|
| Rate for Payer: Signature Care PPO |
$1,262.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,219.75
|
| Rate for Payer: United Healthcare Commercial |
$1,130.78
|
| Rate for Payer: United Healthcare Medicare |
$473.55
|
|
|
HC Z EZ PASS 30 DEG L
|
Facility
IP
|
$1,435.00
|
|
| Hospital Charge Code |
41608165
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,076.25 |
| Max. Negotiated Rate |
$1,334.55 |
| Rate for Payer: Aetna Commercial |
$1,239.84
|
| Rate for Payer: Cash Price |
$889.70
|
| Rate for Payer: Cigna All Commercial |
$1,238.40
|
| Rate for Payer: CORVEL All Commercial |
$1,334.55
|
| Rate for Payer: Coventry All Commercial |
$1,262.80
|
| Rate for Payer: Encore All Commercial |
$1,320.92
|
| Rate for Payer: Frontpath All Commercial |
$1,320.20
|
| Rate for Payer: Humana ChoiceCare |
$1,239.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,291.50
|
| Rate for Payer: PHCS All Commercial |
$1,076.25
|
| Rate for Payer: PHP All Commercial |
$1,088.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,107.82
|
| Rate for Payer: Signature Care EPO |
$1,191.05
|
| Rate for Payer: Signature Care PPO |
$1,262.80
|
| Rate for Payer: United Healthcare Commercial |
$1,130.78
|
|
|
HC Z EZ PASS 30 DEG R
|
Facility
OP
|
$1,435.00
|
|
| Hospital Charge Code |
41608166
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,334.55 |
| Rate for Payer: Aetna Commercial |
$1,211.14
|
| Rate for Payer: Aetna Medicare |
$473.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$473.55
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$824.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$897.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$544.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$520.90
|
| Rate for Payer: Cash Price |
$889.70
|
| Rate for Payer: Cash Price |
$889.70
|
| Rate for Payer: Centivo All Commercial |
$731.85
|
| Rate for Payer: Cigna All Commercial |
$1,238.40
|
| Rate for Payer: CORVEL All Commercial |
$1,334.55
|
| Rate for Payer: Coventry All Commercial |
$1,262.80
|
| Rate for Payer: Encore All Commercial |
$1,320.92
|
| Rate for Payer: Frontpath All Commercial |
$1,320.20
|
| Rate for Payer: Humana ChoiceCare |
$1,239.41
|
| Rate for Payer: Humana Medicare |
$731.85
|
| Rate for Payer: Lucent All Commercial |
$731.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,291.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,076.25
|
| Rate for Payer: PHP All Commercial |
$1,088.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$559.65
|
| Rate for Payer: Sagamore Health Network All Products |
$1,107.82
|
| Rate for Payer: Signature Care EPO |
$1,191.05
|
| Rate for Payer: Signature Care PPO |
$1,262.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,219.75
|
| Rate for Payer: United Healthcare Commercial |
$1,130.78
|
| Rate for Payer: United Healthcare Medicare |
$473.55
|
|
|
HC Z EZ PASS 30 DEG R
|
Facility
IP
|
$1,435.00
|
|
| Hospital Charge Code |
41608166
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,076.25 |
| Max. Negotiated Rate |
$1,334.55 |
| Rate for Payer: Aetna Commercial |
$1,239.84
|
| Rate for Payer: Cash Price |
$889.70
|
| Rate for Payer: Cigna All Commercial |
$1,238.40
|
| Rate for Payer: CORVEL All Commercial |
$1,334.55
|
| Rate for Payer: Coventry All Commercial |
$1,262.80
|
| Rate for Payer: Encore All Commercial |
$1,320.92
|
| Rate for Payer: Frontpath All Commercial |
$1,320.20
|
| Rate for Payer: Humana ChoiceCare |
$1,239.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,291.50
|
| Rate for Payer: PHCS All Commercial |
$1,076.25
|
| Rate for Payer: PHP All Commercial |
$1,088.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,107.82
|
| Rate for Payer: Signature Care EPO |
$1,191.05
|
| Rate for Payer: Signature Care PPO |
$1,262.80
|
| Rate for Payer: United Healthcare Commercial |
$1,130.78
|
|
|
HC Z FEM 10 CR STD L
|
Facility
OP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605500
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$12,215.91 |
| Rate for Payer: Aetna Commercial |
$11,086.27
|
| Rate for Payer: Aetna Medicare |
$4,334.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,334.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,543.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,210.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,984.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,768.15
|
| Rate for Payer: Cash Price |
$8,143.94
|
| Rate for Payer: Cash Price |
$8,143.94
|
| Rate for Payer: Centivo All Commercial |
$6,699.05
|
| Rate for Payer: Cigna All Commercial |
$11,335.84
|
| Rate for Payer: CORVEL All Commercial |
$12,215.91
|
| Rate for Payer: Coventry All Commercial |
$11,559.14
|
| Rate for Payer: Encore All Commercial |
$12,091.13
|
| Rate for Payer: Frontpath All Commercial |
$12,084.56
|
| Rate for Payer: Humana ChoiceCare |
$11,345.04
|
| Rate for Payer: Humana Medicare |
$6,699.05
|
| Rate for Payer: Lucent All Commercial |
$6,699.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,821.85
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,851.54
|
| Rate for Payer: PHP All Commercial |
$9,961.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,122.80
|
| Rate for Payer: Sagamore Health Network All Products |
$10,140.52
|
| Rate for Payer: Signature Care EPO |
$10,902.37
|
| Rate for Payer: Signature Care PPO |
$11,559.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,165.08
|
| Rate for Payer: United Healthcare Commercial |
$10,350.69
|
| Rate for Payer: United Healthcare Medicare |
$4,334.68
|
|
