|
HC Z FEMORAL COMP 3-LT
|
Facility
OP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605833
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$14,742.56
|
| Rate for Payer: Aetna Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10,031.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,918.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,628.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,340.70
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Centivo All Commercial |
$8,908.42
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Humana Medicare |
$8,908.42
|
| Rate for Payer: Lucent All Commercial |
$8,908.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,812.32
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,847.37
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
| Rate for Payer: United Healthcare Medicare |
$5,764.27
|
|
|
HC Z FEMORAL COMP 3-RT
|
Facility
OP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605834
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$14,742.56
|
| Rate for Payer: Aetna Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10,031.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,918.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,628.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,340.70
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Centivo All Commercial |
$8,908.42
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Humana Medicare |
$8,908.42
|
| Rate for Payer: Lucent All Commercial |
$8,908.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,812.32
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,847.37
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
| Rate for Payer: United Healthcare Medicare |
$5,764.27
|
|
|
HC Z FEMORAL COMP 3-RT
|
Facility
IP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605834
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,100.62 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$15,091.91
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
|
|
HC Z FEMORAL COMP 4-LT
|
Facility
OP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605835
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$14,742.56
|
| Rate for Payer: Aetna Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10,031.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,918.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,628.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,340.70
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Centivo All Commercial |
$8,908.42
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Humana Medicare |
$8,908.42
|
| Rate for Payer: Lucent All Commercial |
$8,908.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,812.32
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,847.37
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
| Rate for Payer: United Healthcare Medicare |
$5,764.27
|
|
|
HC Z FEMORAL COMP 4-LT
|
Facility
IP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605835
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,100.62 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$15,091.91
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
|
|
HC Z FEMORAL COMP 4-RT
|
Facility
IP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,100.62 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$15,091.91
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
|
|
HC Z FEMORAL COMP 4-RT
|
Facility
OP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$14,742.56
|
| Rate for Payer: Aetna Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10,031.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,918.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,628.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,340.70
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Centivo All Commercial |
$8,908.42
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Humana Medicare |
$8,908.42
|
| Rate for Payer: Lucent All Commercial |
$8,908.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,812.32
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,847.37
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
| Rate for Payer: United Healthcare Medicare |
$5,764.27
|
|
|
HC Z FEMORAL COMP 5-LT
|
Facility
OP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605837
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$14,742.56
|
| Rate for Payer: Aetna Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10,031.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,918.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,628.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,340.70
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Centivo All Commercial |
$8,908.42
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Humana Medicare |
$8,908.42
|
| Rate for Payer: Lucent All Commercial |
$8,908.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,812.32
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,847.37
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
| Rate for Payer: United Healthcare Medicare |
$5,764.27
|
|
|
HC Z FEMORAL COMP 5-LT
|
Facility
IP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605837
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,100.62 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$15,091.91
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
|
|
HC Z FEMORAL COMP 5-RT
|
Facility
IP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605838
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,100.62 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$15,091.91
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
|
|
HC Z FEMORAL COMP 5-RT
|
Facility
OP
|
$17,467.49
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605838
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$16,244.77 |
| Rate for Payer: Aetna Commercial |
$14,742.56
|
| Rate for Payer: Aetna Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,764.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10,031.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,918.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,628.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,340.70
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Cash Price |
$10,829.84
|
| Rate for Payer: Centivo All Commercial |
$8,908.42
|
| Rate for Payer: Cigna All Commercial |
$15,074.44
|
| Rate for Payer: CORVEL All Commercial |
$16,244.77
|
| Rate for Payer: Coventry All Commercial |
$15,371.39
|
| Rate for Payer: Encore All Commercial |
$16,078.82
|
| Rate for Payer: Frontpath All Commercial |
$16,070.09
|
| Rate for Payer: Humana ChoiceCare |
$15,086.67
|
| Rate for Payer: Humana Medicare |
$8,908.42
|
| Rate for Payer: Lucent All Commercial |
$8,908.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,720.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$13,100.62
|
| Rate for Payer: PHP All Commercial |
$13,247.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,812.32
|
| Rate for Payer: Sagamore Health Network All Products |
$13,484.90
|
| Rate for Payer: Signature Care EPO |
$14,498.02
|
| Rate for Payer: Signature Care PPO |
$15,371.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,847.37
|
| Rate for Payer: United Healthcare Commercial |
$13,764.38
|
| Rate for Payer: United Healthcare Medicare |
$5,764.27
|
|
|
HC Z FEM STEM TAPER 12.5
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$6,988.32
|
| Rate for Payer: Aetna Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,755.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,175.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,142.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,005.64
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Centivo All Commercial |
$4,222.80
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Humana Medicare |
$4,222.80
|
| Rate for Payer: Lucent All Commercial |
$4,222.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,229.20
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,038.00
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
| Rate for Payer: United Healthcare Medicare |
$2,732.40
|
|
|
HC Z FEM STEM TAPER 12.5
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,210.00 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$7,153.92
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
|
|
HC Z FEM STEM TAPER 9
|
Facility
OP
|
$9,000.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,370.00 |
| Rate for Payer: Aetna Commercial |
$7,596.00
|
| Rate for Payer: Aetna Medicare |
$2,970.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,970.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,168.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,625.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,415.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,267.00
|
| Rate for Payer: Cash Price |
$5,580.00
|
| Rate for Payer: Cash Price |
$5,580.00
|
| Rate for Payer: Centivo All Commercial |
$4,590.00
|
| Rate for Payer: Cigna All Commercial |
$7,767.00
|
| Rate for Payer: CORVEL All Commercial |
$8,370.00
|
| Rate for Payer: Coventry All Commercial |
$7,920.00
|
| Rate for Payer: Encore All Commercial |
$8,284.50
|
| Rate for Payer: Frontpath All Commercial |
$8,280.00
|
| Rate for Payer: Humana ChoiceCare |
$7,773.30
|
| Rate for Payer: Humana Medicare |
$4,590.00
|
| Rate for Payer: Lucent All Commercial |
$4,590.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,100.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,750.00
|
| Rate for Payer: PHP All Commercial |
$6,825.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,510.00
|
| Rate for Payer: Sagamore Health Network All Products |
$6,948.00
|
| Rate for Payer: Signature Care EPO |
$7,470.00
|
| Rate for Payer: Signature Care PPO |
$7,920.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,650.00
|
| Rate for Payer: United Healthcare Commercial |
$7,092.00
|
| Rate for Payer: United Healthcare Medicare |
$2,970.00
|
|
|
HC Z FEM STEM TAPER 9
|
Facility
IP
|
$9,000.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,750.00 |
| Max. Negotiated Rate |
$8,370.00 |
| Rate for Payer: Aetna Commercial |
$7,776.00
|
| Rate for Payer: Cash Price |
$5,580.00
|
| Rate for Payer: Cigna All Commercial |
$7,767.00
|
| Rate for Payer: CORVEL All Commercial |
$8,370.00
|
| Rate for Payer: Coventry All Commercial |
$7,920.00
|
| Rate for Payer: Encore All Commercial |
$8,284.50
|
| Rate for Payer: Frontpath All Commercial |
$8,280.00
|
| Rate for Payer: Humana ChoiceCare |
$7,773.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,100.00
|
| Rate for Payer: PHCS All Commercial |
$6,750.00
|
| Rate for Payer: PHP All Commercial |
$6,825.60
|
| Rate for Payer: Sagamore Health Network All Products |
$6,948.00
|
| Rate for Payer: Signature Care EPO |
$7,470.00
|
| Rate for Payer: Signature Care PPO |
$7,920.00
|
| Rate for Payer: United Healthcare Commercial |
$7,092.00
|
|
|
HC Z G7 10 DEG CONSTR LINER 36I
|
Facility
IP
|
$12,427.31
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606095
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9,320.48 |
| Max. Negotiated Rate |
$11,557.40 |
| Rate for Payer: Aetna Commercial |
$10,737.20
|
| Rate for Payer: Cash Price |
$7,704.93
|
| Rate for Payer: Cigna All Commercial |
$10,724.77
|
| Rate for Payer: CORVEL All Commercial |
$11,557.40
|
| Rate for Payer: Coventry All Commercial |
$10,936.03
|
| Rate for Payer: Encore All Commercial |
$11,439.34
|
| Rate for Payer: Frontpath All Commercial |
$11,433.13
|
| Rate for Payer: Humana ChoiceCare |
$10,733.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,184.58
|
| Rate for Payer: PHCS All Commercial |
$9,320.48
|
| Rate for Payer: PHP All Commercial |
$9,424.87
|
| Rate for Payer: Sagamore Health Network All Products |
$9,593.88
|
| Rate for Payer: Signature Care EPO |
$10,314.67
|
| Rate for Payer: Signature Care PPO |
$10,936.03
|
| Rate for Payer: United Healthcare Commercial |
$9,792.72
|
|
|
HC Z G7 10 DEG CONSTR LINER 36I
|
Facility
OP
|
$12,427.31
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606095
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$11,557.40 |
| Rate for Payer: Aetna Commercial |
$10,488.65
|
| Rate for Payer: Aetna Medicare |
$4,101.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,101.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,137.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,768.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,716.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,511.11
|
| Rate for Payer: Cash Price |
$7,704.93
|
| Rate for Payer: Cash Price |
$7,704.93
|
| Rate for Payer: Centivo All Commercial |
$6,337.93
|
| Rate for Payer: Cigna All Commercial |
$10,724.77
|
| Rate for Payer: CORVEL All Commercial |
$11,557.40
|
| Rate for Payer: Coventry All Commercial |
$10,936.03
|
| Rate for Payer: Encore All Commercial |
$11,439.34
|
| Rate for Payer: Frontpath All Commercial |
$11,433.13
|
| Rate for Payer: Humana ChoiceCare |
$10,733.47
|
| Rate for Payer: Humana Medicare |
$6,337.93
|
| Rate for Payer: Lucent All Commercial |
$6,337.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,184.58
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$9,320.48
|
| Rate for Payer: PHP All Commercial |
$9,424.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,846.65
|
| Rate for Payer: Sagamore Health Network All Products |
$9,593.88
|
| Rate for Payer: Signature Care EPO |
$10,314.67
|
| Rate for Payer: Signature Care PPO |
$10,936.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,563.21
|
| Rate for Payer: United Healthcare Commercial |
$9,792.72
|
| Rate for Payer: United Healthcare Medicare |
$4,101.01
|
|
|
HC Z G7 10 DEG E1 LINER 28 A
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606023
|
|
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 G7 10 DEG E1 LINER 28 A
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606023
|
|
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 G7 10 DEG E1 LINER 28 B
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606024
|
|
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 G7 10 DEG E1 LINER 28 B
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606024
|
|
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 G7 10 DEG E1 LINER 28 C
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606025
|
|
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 G7 10 DEG E1 LINER 28 C
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606025
|
|
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 G7 10 DEG E1 LINER 28 D
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606026
|
|
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 G7 10 DEG E1 LINER 28 D
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606026
|
|
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
|
|
