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Service Code CPT C1776
Hospital Charge Code 41605951
Hospital Revenue Code 278
Min. Negotiated Rate $3,240.00
Max. Negotiated Rate $4,017.60
Rate for Payer: Aetna Commercial $3,732.48
Rate for Payer: Cash Price $2,678.40
Rate for Payer: Cigna All Commercial $3,728.16
Rate for Payer: CORVEL All Commercial $4,017.60
Rate for Payer: Coventry All Commercial $3,801.60
Rate for Payer: Encore All Commercial $3,976.56
Rate for Payer: Frontpath All Commercial $3,974.40
Rate for Payer: Humana ChoiceCare $3,731.18
Rate for Payer: Lutheran Preferred All Commercial $3,888.00
Rate for Payer: PHCS All Commercial $3,240.00
Rate for Payer: PHP All Commercial $3,276.29
Rate for Payer: Sagamore Health Network All Products $3,335.04
Rate for Payer: Signature Care EPO $3,585.60
Rate for Payer: Signature Care PPO $3,801.60
Rate for Payer: United Healthcare Commercial $3,404.16
Service Code CPT C1776
Hospital Charge Code 41605952
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605952
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605953
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605953
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605954
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605954
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605955
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605955
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605956
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605956
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605957
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605957
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605958
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605958
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605988
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605988
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605989
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605989
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605990
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605990
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605991
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55
Service Code CPT C1776
Hospital Charge Code 41605991
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605992
Hospital Revenue Code 278
Min. Negotiated Rate $2,980.80
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,433.88
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: United Healthcare Commercial $3,131.83
Service Code CPT C1776
Hospital Charge Code 41605992
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $3,696.19
Rate for Payer: Aetna Commercial $3,354.39
Rate for Payer: Aetna Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN Medicare $1,311.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,282.50
Rate for Payer: Anthem Blue Cross of IN Traditional $2,484.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,508.28
Rate for Payer: CareSource Indiana of IN Medicare $1,442.71
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Cash Price $2,464.13
Rate for Payer: Centivo All Commercial $2,026.94
Rate for Payer: Cigna All Commercial $3,429.91
Rate for Payer: CORVEL All Commercial $3,696.19
Rate for Payer: Coventry All Commercial $3,497.47
Rate for Payer: Encore All Commercial $3,658.44
Rate for Payer: Frontpath All Commercial $3,656.45
Rate for Payer: Humana ChoiceCare $3,432.69
Rate for Payer: Humana Medicare $2,026.94
Rate for Payer: Lucent All Commercial $2,026.94
Rate for Payer: Lutheran Preferred All Commercial $3,576.96
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $2,980.80
Rate for Payer: PHP All Commercial $3,014.18
Rate for Payer: Plain Church Group Ministry All Commercial $1,550.02
Rate for Payer: Sagamore Health Network All Products $3,068.24
Rate for Payer: Signature Care EPO $3,298.75
Rate for Payer: Signature Care PPO $3,497.47
Rate for Payer: Three Rivers Preferred All Commercial $3,378.24
Rate for Payer: United Healthcare Commercial $3,131.83
Rate for Payer: United Healthcare Medicare $1,311.55