|
HC Z G7 10 DEG LINER 45 I
|
Facility
OP
|
$3,974.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605993
|
|
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
|
|
|
HC Z G7 10 DEG LINER 45 I
|
Facility
IP
|
$3,974.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605993
|
|
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
|
|
|
HC Z G7 ACE LINER 36 I
|
Facility
OP
|
$11,592.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606587
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$10,780.56 |
| Rate for Payer: Aetna Commercial |
$9,783.65
|
| Rate for Payer: Aetna Medicare |
$3,825.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,825.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,657.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,246.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,399.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,207.90
|
| Rate for Payer: Cash Price |
$7,187.04
|
| Rate for Payer: Cash Price |
$7,187.04
|
| Rate for Payer: Centivo All Commercial |
$5,911.92
|
| Rate for Payer: Cigna All Commercial |
$10,003.90
|
| Rate for Payer: CORVEL All Commercial |
$10,780.56
|
| Rate for Payer: Coventry All Commercial |
$10,200.96
|
| Rate for Payer: Encore All Commercial |
$10,670.44
|
| Rate for Payer: Frontpath All Commercial |
$10,664.64
|
| Rate for Payer: Humana ChoiceCare |
$10,012.01
|
| Rate for Payer: Humana Medicare |
$5,911.92
|
| Rate for Payer: Lucent All Commercial |
$5,911.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,432.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$8,694.00
|
| Rate for Payer: PHP All Commercial |
$8,791.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,520.88
|
| Rate for Payer: Sagamore Health Network All Products |
$8,949.02
|
| Rate for Payer: Signature Care EPO |
$9,621.36
|
| Rate for Payer: Signature Care PPO |
$10,200.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,853.20
|
| Rate for Payer: United Healthcare Commercial |
$9,134.50
|
| Rate for Payer: United Healthcare Medicare |
$3,825.36
|
|
|
HC Z G7 ACE LINER 36 I
|
Facility
IP
|
$11,592.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606587
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,694.00 |
| Max. Negotiated Rate |
$10,780.56 |
| Rate for Payer: Aetna Commercial |
$10,015.49
|
| Rate for Payer: Cash Price |
$7,187.04
|
| Rate for Payer: Cigna All Commercial |
$10,003.90
|
| Rate for Payer: CORVEL All Commercial |
$10,780.56
|
| Rate for Payer: Coventry All Commercial |
$10,200.96
|
| Rate for Payer: Encore All Commercial |
$10,670.44
|
| Rate for Payer: Frontpath All Commercial |
$10,664.64
|
| Rate for Payer: Humana ChoiceCare |
$10,012.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,432.80
|
| Rate for Payer: PHCS All Commercial |
$8,694.00
|
| Rate for Payer: PHP All Commercial |
$8,791.37
|
| Rate for Payer: Sagamore Health Network All Products |
$8,949.02
|
| Rate for Payer: Signature Care EPO |
$9,621.36
|
| Rate for Payer: Signature Care PPO |
$10,200.96
|
| Rate for Payer: United Healthcare Commercial |
$9,134.50
|
|
|
HC Z G7 ACETAB LINER 36 E
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606901
|
|
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 ACETAB LINER 36 E
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606901
|
|
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 ACETAB LNR NTL 32 B
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608303
|
|
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 ACETAB LNR NTL 32 B
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608303
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,236.27 |
| 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: 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: 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 ACETAB LNR NTL 32 C
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607484
|
|
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 ACETAB LNR NTL 32 C
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607484
|
|
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 ACETAB LNR NTL 36 D
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606910
|
|
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 ACETAB LNR NTL 36 D
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606910
|
|
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 ACETAB LNR NTL 40 F
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606991
|
|
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 ACETAB LNR NTL 40 F
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606991
|
|
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 ACETAB LNR NTL 40 G
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606747
|
|
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 ACETAB LNR NTL 40 G
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606747
|
|
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 ACETAB LNR NTL 40 H
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607606
|
|
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 ACETAB LNR NTL 40 H
|
Facility
OP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607606
|
|
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 ACT ARTIC HD XL 28X50
|
Facility
OP
|
$4,140.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,850.20 |
| Rate for Payer: Aetna Commercial |
$3,494.16
|
| Rate for Payer: Aetna Medicare |
$1,366.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,366.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,377.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,587.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,571.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,502.82
|
| Rate for Payer: Cash Price |
$2,566.80
|
| Rate for Payer: Cash Price |
$2,566.80
|
| Rate for Payer: Centivo All Commercial |
$2,111.40
|
| Rate for Payer: Cigna All Commercial |
$3,572.82
|
| Rate for Payer: CORVEL All Commercial |
$3,850.20
|
| Rate for Payer: Coventry All Commercial |
$3,643.20
|
| Rate for Payer: Encore All Commercial |
$3,810.87
|
| Rate for Payer: Frontpath All Commercial |
$3,808.80
|
| Rate for Payer: Humana ChoiceCare |
$3,575.72
|
| Rate for Payer: Humana Medicare |
$2,111.40
|
| Rate for Payer: Lucent All Commercial |
$2,111.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,726.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,105.00
|
| Rate for Payer: PHP All Commercial |
$3,139.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,614.60
|
| Rate for Payer: Sagamore Health Network All Products |
$3,196.08
|
| Rate for Payer: Signature Care EPO |
$3,436.20
|
| Rate for Payer: Signature Care PPO |
$3,643.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,519.00
|
| Rate for Payer: United Healthcare Commercial |
$3,262.32
|
| Rate for Payer: United Healthcare Medicare |
$1,366.20
|
|
|
HC Z G7 ACT ARTIC HD XL 28X50
|
Facility
IP
|
$4,140.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,105.00 |
| Max. Negotiated Rate |
$3,850.20 |
| Rate for Payer: Aetna Commercial |
$3,576.96
|
| Rate for Payer: Cash Price |
$2,566.80
|
| Rate for Payer: Cigna All Commercial |
$3,572.82
|
| Rate for Payer: CORVEL All Commercial |
$3,850.20
|
| Rate for Payer: Coventry All Commercial |
$3,643.20
|
| Rate for Payer: Encore All Commercial |
$3,810.87
|
| Rate for Payer: Frontpath All Commercial |
$3,808.80
|
| Rate for Payer: Humana ChoiceCare |
$3,575.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,726.00
|
| Rate for Payer: PHCS All Commercial |
$3,105.00
|
| Rate for Payer: PHP All Commercial |
$3,139.78
|
| Rate for Payer: Sagamore Health Network All Products |
$3,196.08
|
| Rate for Payer: Signature Care EPO |
$3,436.20
|
| Rate for Payer: Signature Care PPO |
$3,643.20
|
| Rate for Payer: United Healthcare Commercial |
$3,262.32
|
|
|
HC Z G7 APICAL HOLE PLUG
|
Facility
IP
|
$936.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606094
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$702.00 |
| Max. Negotiated Rate |
$870.48 |
| Rate for Payer: Aetna Commercial |
$808.70
|
| Rate for Payer: Cash Price |
$580.32
|
| Rate for Payer: Cigna All Commercial |
$807.77
|
| Rate for Payer: CORVEL All Commercial |
$870.48
|
| Rate for Payer: Coventry All Commercial |
$823.68
|
| Rate for Payer: Encore All Commercial |
$861.59
|
| Rate for Payer: Frontpath All Commercial |
$861.12
|
| Rate for Payer: Humana ChoiceCare |
$808.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$842.40
|
| Rate for Payer: PHCS All Commercial |
$702.00
|
| Rate for Payer: PHP All Commercial |
$709.86
|
| Rate for Payer: Sagamore Health Network All Products |
$722.59
|
| Rate for Payer: Signature Care EPO |
$776.88
|
| Rate for Payer: Signature Care PPO |
$823.68
|
| Rate for Payer: United Healthcare Commercial |
$737.57
|
|
|
HC Z G7 APICAL HOLE PLUG
|
Facility
OP
|
$936.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606094
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$870.48 |
| Rate for Payer: Aetna Commercial |
$789.98
|
| Rate for Payer: Aetna Medicare |
$308.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$308.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$537.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$585.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$355.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$339.77
|
| Rate for Payer: Cash Price |
$580.32
|
| Rate for Payer: Cash Price |
$580.32
|
| Rate for Payer: Centivo All Commercial |
$477.36
|
| Rate for Payer: Cigna All Commercial |
$807.77
|
| Rate for Payer: CORVEL All Commercial |
$870.48
|
| Rate for Payer: Coventry All Commercial |
$823.68
|
| Rate for Payer: Encore All Commercial |
$861.59
|
| Rate for Payer: Frontpath All Commercial |
$861.12
|
| Rate for Payer: Humana ChoiceCare |
$808.42
|
| Rate for Payer: Humana Medicare |
$477.36
|
| Rate for Payer: Lucent All Commercial |
$477.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$842.40
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$702.00
|
| Rate for Payer: PHP All Commercial |
$709.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$365.04
|
| Rate for Payer: Sagamore Health Network All Products |
$722.59
|
| Rate for Payer: Signature Care EPO |
$776.88
|
| Rate for Payer: Signature Care PPO |
$823.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$795.60
|
| Rate for Payer: United Healthcare Commercial |
$737.57
|
| Rate for Payer: United Healthcare Medicare |
$308.88
|
|
|
HC Z G7 CONST E1 LINER 36 G
|
Facility
IP
|
$11,592.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,694.00 |
| Max. Negotiated Rate |
$10,780.56 |
| Rate for Payer: Aetna Commercial |
$10,015.49
|
| Rate for Payer: Cash Price |
$7,187.04
|
| Rate for Payer: Cigna All Commercial |
$10,003.90
|
| Rate for Payer: CORVEL All Commercial |
$10,780.56
|
| Rate for Payer: Coventry All Commercial |
$10,200.96
|
| Rate for Payer: Encore All Commercial |
$10,670.44
|
| Rate for Payer: Frontpath All Commercial |
$10,664.64
|
| Rate for Payer: Humana ChoiceCare |
$10,012.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,432.80
|
| Rate for Payer: PHCS All Commercial |
$8,694.00
|
| Rate for Payer: PHP All Commercial |
$8,791.37
|
| Rate for Payer: Sagamore Health Network All Products |
$8,949.02
|
| Rate for Payer: Signature Care EPO |
$9,621.36
|
| Rate for Payer: Signature Care PPO |
$10,200.96
|
| Rate for Payer: United Healthcare Commercial |
$9,134.50
|
|
|
HC Z G7 CONST E1 LINER 36 G
|
Facility
OP
|
$11,592.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$10,780.56 |
| Rate for Payer: Aetna Commercial |
$9,783.65
|
| Rate for Payer: Aetna Medicare |
$3,825.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,825.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,657.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,246.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,399.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,207.90
|
| Rate for Payer: Cash Price |
$7,187.04
|
| Rate for Payer: Cash Price |
$7,187.04
|
| Rate for Payer: Centivo All Commercial |
$5,911.92
|
| Rate for Payer: Cigna All Commercial |
$10,003.90
|
| Rate for Payer: CORVEL All Commercial |
$10,780.56
|
| Rate for Payer: Coventry All Commercial |
$10,200.96
|
| Rate for Payer: Encore All Commercial |
$10,670.44
|
| Rate for Payer: Frontpath All Commercial |
$10,664.64
|
| Rate for Payer: Humana ChoiceCare |
$10,012.01
|
| Rate for Payer: Humana Medicare |
$5,911.92
|
| Rate for Payer: Lucent All Commercial |
$5,911.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,432.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$8,694.00
|
| Rate for Payer: PHP All Commercial |
$8,791.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,520.88
|
| Rate for Payer: Sagamore Health Network All Products |
$8,949.02
|
| Rate for Payer: Signature Care EPO |
$9,621.36
|
| Rate for Payer: Signature Care PPO |
$10,200.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,853.20
|
| Rate for Payer: United Healthcare Commercial |
$9,134.50
|
| Rate for Payer: United Healthcare Medicare |
$3,825.36
|
|
|
HC Z G7 DUAL MOB LINDER NTL 54 I
|
Facility
IP
|
$5,630.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41604659
|
|
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
|
|
