|
HC Z G7 OSSEOTI 3H SHELL 50D
|
Facility
IP
|
$12,148.42
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,111.32 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,496.23
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
|
|
HC Z G7 OSSEOTI 3-H SHELL 52 E
|
Facility
IP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603525
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,111.32 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,496.23
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
|
|
HC Z G7 OSSEOTI 3-H SHELL 52 E
|
Facility
OP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603525
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,253.27
|
| Rate for Payer: Aetna Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,976.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,593.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,610.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,409.88
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Centivo All Commercial |
$6,195.69
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Humana Medicare |
$6,195.69
|
| Rate for Payer: Lucent All Commercial |
$6,195.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,737.88
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,326.16
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
| Rate for Payer: United Healthcare Medicare |
$4,008.98
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 54 F
|
Facility
OP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,253.27
|
| Rate for Payer: Aetna Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,976.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,593.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,610.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,409.88
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Centivo All Commercial |
$6,195.69
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Humana Medicare |
$6,195.69
|
| Rate for Payer: Lucent All Commercial |
$6,195.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,737.88
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,326.16
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
| Rate for Payer: United Healthcare Medicare |
$4,008.98
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 54 F
|
Facility
IP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,111.32 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,496.23
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 56 F
|
Facility
IP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603723
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,111.32 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,496.23
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 56 F
|
Facility
OP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603723
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,253.27
|
| Rate for Payer: Aetna Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,976.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,593.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,610.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,409.88
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Centivo All Commercial |
$6,195.69
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Humana Medicare |
$6,195.69
|
| Rate for Payer: Lucent All Commercial |
$6,195.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,737.88
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,326.16
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
| Rate for Payer: United Healthcare Medicare |
$4,008.98
|
|
|
HC Z G 7 OSSEOTI 4H SHELL 58
|
Facility
OP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,253.27
|
| Rate for Payer: Aetna Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,976.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,593.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,610.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,409.88
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Centivo All Commercial |
$6,195.69
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Humana Medicare |
$6,195.69
|
| Rate for Payer: Lucent All Commercial |
$6,195.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,737.88
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,326.16
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
| Rate for Payer: United Healthcare Medicare |
$4,008.98
|
|
|
HC Z G 7 OSSEOTI 4H SHELL 58
|
Facility
IP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,111.32 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,496.23
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 60 G
|
Facility
IP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,111.32 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,496.23
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 60 G
|
Facility
OP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,253.27
|
| Rate for Payer: Aetna Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,976.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,593.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,610.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,409.88
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Centivo All Commercial |
$6,195.69
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Humana Medicare |
$6,195.69
|
| Rate for Payer: Lucent All Commercial |
$6,195.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,737.88
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,326.16
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
| Rate for Payer: United Healthcare Medicare |
$4,008.98
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 62 H
|
Facility
IP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603499
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,111.32 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,496.23
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 62 H
|
Facility
OP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603499
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,253.27
|
| Rate for Payer: Aetna Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,976.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,593.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,610.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,409.88
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Centivo All Commercial |
$6,195.69
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Humana Medicare |
$6,195.69
|
| Rate for Payer: Lucent All Commercial |
$6,195.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,737.88
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,326.16
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
| Rate for Payer: United Healthcare Medicare |
$4,008.98
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 64 H
|
Facility
OP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603494
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,253.27
|
| Rate for Payer: Aetna Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,976.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,593.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,610.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,409.88
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Centivo All Commercial |
$6,195.69
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Humana Medicare |
$6,195.69
|
| Rate for Payer: Lucent All Commercial |
$6,195.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,737.88
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,326.16
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
| Rate for Payer: United Healthcare Medicare |
$4,008.98
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 64 H
|
Facility
IP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603494
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,111.32 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,496.23
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 68 I
|
Facility
OP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41604661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,253.27
|
| Rate for Payer: Aetna Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,008.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,976.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,593.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,610.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,409.88
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Centivo All Commercial |
$6,195.69
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Humana Medicare |
$6,195.69
|
| Rate for Payer: Lucent All Commercial |
$6,195.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,737.88
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,326.16
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
| Rate for Payer: United Healthcare Medicare |
$4,008.98
|
|
|
HC Z G7 OSSEOTI 4-H SHELL 68 I
|
Facility
IP
|
$12,148.42
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41604661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,111.32 |
| Max. Negotiated Rate |
$11,298.03 |
| Rate for Payer: Aetna Commercial |
$10,496.23
|
| Rate for Payer: Cash Price |
$7,532.02
|
| Rate for Payer: Cigna All Commercial |
$10,484.09
|
| Rate for Payer: CORVEL All Commercial |
$11,298.03
|
| Rate for Payer: Coventry All Commercial |
$10,690.61
|
| Rate for Payer: Encore All Commercial |
$11,182.62
|
| Rate for Payer: Frontpath All Commercial |
$11,176.55
|
| Rate for Payer: Humana ChoiceCare |
$10,492.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,933.58
|
| Rate for Payer: PHCS All Commercial |
$9,111.32
|
| Rate for Payer: PHP All Commercial |
$9,213.36
|
| Rate for Payer: Sagamore Health Network All Products |
$9,378.58
|
| Rate for Payer: Signature Care EPO |
$10,083.19
|
| Rate for Payer: Signature Care PPO |
$10,690.61
|
| Rate for Payer: United Healthcare Commercial |
$9,572.95
|
|
|
HC Z G7 OSSEOTI MULT HL SHELL 62
|
Facility
OP
|
$12,314.02
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603442
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,452.04 |
| Rate for Payer: Aetna Commercial |
$10,393.03
|
| Rate for Payer: Aetna Medicare |
$4,063.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,063.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,071.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,697.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,673.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,469.99
|
| Rate for Payer: Cash Price |
$7,634.69
|
| Rate for Payer: Cash Price |
$7,634.69
|
| Rate for Payer: Centivo All Commercial |
$6,280.15
|
| Rate for Payer: Cigna All Commercial |
$10,627.00
|
| Rate for Payer: CORVEL All Commercial |
$11,452.04
|
| Rate for Payer: Coventry All Commercial |
$10,836.34
|
| Rate for Payer: Encore All Commercial |
$11,335.06
|
| Rate for Payer: Frontpath All Commercial |
$11,328.90
|
| Rate for Payer: Humana ChoiceCare |
$10,635.62
|
| Rate for Payer: Humana Medicare |
$6,280.15
|
| Rate for Payer: Lucent All Commercial |
$6,280.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,082.62
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,235.52
|
| Rate for Payer: PHP All Commercial |
$9,338.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,802.47
|
| Rate for Payer: Sagamore Health Network All Products |
$9,506.42
|
| Rate for Payer: Signature Care EPO |
$10,220.64
|
| Rate for Payer: Signature Care PPO |
$10,836.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,466.92
|
| Rate for Payer: United Healthcare Commercial |
$9,703.45
|
| Rate for Payer: United Healthcare Medicare |
$4,063.63
|
|
|
HC Z G7 OSSEOTI MULT HL SHELL 62
|
Facility
IP
|
$12,314.02
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603442
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,235.52 |
| Max. Negotiated Rate |
$11,452.04 |
| Rate for Payer: Aetna Commercial |
$10,639.31
|
| Rate for Payer: Cash Price |
$7,634.69
|
| Rate for Payer: Cigna All Commercial |
$10,627.00
|
| Rate for Payer: CORVEL All Commercial |
$11,452.04
|
| Rate for Payer: Coventry All Commercial |
$10,836.34
|
| Rate for Payer: Encore All Commercial |
$11,335.06
|
| Rate for Payer: Frontpath All Commercial |
$11,328.90
|
| Rate for Payer: Humana ChoiceCare |
$10,635.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,082.62
|
| Rate for Payer: PHCS All Commercial |
$9,235.52
|
| Rate for Payer: PHP All Commercial |
$9,338.95
|
| Rate for Payer: Sagamore Health Network All Products |
$9,506.42
|
| Rate for Payer: Signature Care EPO |
$10,220.64
|
| Rate for Payer: Signature Care PPO |
$10,836.34
|
| Rate for Payer: United Healthcare Commercial |
$9,703.45
|
|
|
HC Z G7 OSSEOTI MULT-H SHELL 64 H
|
Facility
OP
|
$12,314.02
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,452.04 |
| Rate for Payer: Aetna Commercial |
$10,393.03
|
| Rate for Payer: Aetna Medicare |
$4,063.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,063.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,071.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,697.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,673.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,469.99
|
| Rate for Payer: Cash Price |
$7,634.69
|
| Rate for Payer: Cash Price |
$7,634.69
|
| Rate for Payer: Centivo All Commercial |
$6,280.15
|
| Rate for Payer: Cigna All Commercial |
$10,627.00
|
| Rate for Payer: CORVEL All Commercial |
$11,452.04
|
| Rate for Payer: Coventry All Commercial |
$10,836.34
|
| Rate for Payer: Encore All Commercial |
$11,335.06
|
| Rate for Payer: Frontpath All Commercial |
$11,328.90
|
| Rate for Payer: Humana ChoiceCare |
$10,635.62
|
| Rate for Payer: Humana Medicare |
$6,280.15
|
| Rate for Payer: Lucent All Commercial |
$6,280.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,082.62
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,235.52
|
| Rate for Payer: PHP All Commercial |
$9,338.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,802.47
|
| Rate for Payer: Sagamore Health Network All Products |
$9,506.42
|
| Rate for Payer: Signature Care EPO |
$10,220.64
|
| Rate for Payer: Signature Care PPO |
$10,836.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,466.92
|
| Rate for Payer: United Healthcare Commercial |
$9,703.45
|
| Rate for Payer: United Healthcare Medicare |
$4,063.63
|
|
|
HC Z G7 OSSEOTI MULT-H SHELL 64 H
|
Facility
IP
|
$12,314.02
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,235.52 |
| Max. Negotiated Rate |
$11,452.04 |
| Rate for Payer: Aetna Commercial |
$10,639.31
|
| Rate for Payer: Cash Price |
$7,634.69
|
| Rate for Payer: Cigna All Commercial |
$10,627.00
|
| Rate for Payer: CORVEL All Commercial |
$11,452.04
|
| Rate for Payer: Coventry All Commercial |
$10,836.34
|
| Rate for Payer: Encore All Commercial |
$11,335.06
|
| Rate for Payer: Frontpath All Commercial |
$11,328.90
|
| Rate for Payer: Humana ChoiceCare |
$10,635.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,082.62
|
| Rate for Payer: PHCS All Commercial |
$9,235.52
|
| Rate for Payer: PHP All Commercial |
$9,338.95
|
| Rate for Payer: Sagamore Health Network All Products |
$9,506.42
|
| Rate for Payer: Signature Care EPO |
$10,220.64
|
| Rate for Payer: Signature Care PPO |
$10,836.34
|
| Rate for Payer: United Healthcare Commercial |
$9,703.45
|
|
|
HC Z G7 SCREW 6.5X20
|
Facility
OP
|
$175.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$147.70
|
| Rate for Payer: Aetna Medicare |
$57.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$100.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$109.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$66.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$63.52
|
| Rate for Payer: Cash Price |
$108.50
|
| Rate for Payer: Cash Price |
$108.50
|
| Rate for Payer: Centivo All Commercial |
$89.25
|
| Rate for Payer: Cigna All Commercial |
$151.02
|
| Rate for Payer: CORVEL All Commercial |
$162.75
|
| Rate for Payer: Coventry All Commercial |
$154.00
|
| Rate for Payer: Encore All Commercial |
$161.09
|
| Rate for Payer: Frontpath All Commercial |
$161.00
|
| Rate for Payer: Humana ChoiceCare |
$151.15
|
| Rate for Payer: Humana Medicare |
$89.25
|
| Rate for Payer: Lucent All Commercial |
$89.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$157.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$131.25
|
| Rate for Payer: PHP All Commercial |
$132.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.25
|
| Rate for Payer: Sagamore Health Network All Products |
$135.10
|
| Rate for Payer: Signature Care EPO |
$145.25
|
| Rate for Payer: Signature Care PPO |
$154.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$148.75
|
| Rate for Payer: United Healthcare Commercial |
$137.90
|
| Rate for Payer: United Healthcare Medicare |
$57.75
|
|
|
HC Z G7 SCREW 6.5X20
|
Facility
IP
|
$175.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$131.25 |
| Max. Negotiated Rate |
$162.75 |
| Rate for Payer: Aetna Commercial |
$151.20
|
| Rate for Payer: Cash Price |
$108.50
|
| Rate for Payer: Cigna All Commercial |
$151.02
|
| Rate for Payer: CORVEL All Commercial |
$162.75
|
| Rate for Payer: Coventry All Commercial |
$154.00
|
| Rate for Payer: Encore All Commercial |
$161.09
|
| Rate for Payer: Frontpath All Commercial |
$161.00
|
| Rate for Payer: Humana ChoiceCare |
$151.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$157.50
|
| Rate for Payer: PHCS All Commercial |
$131.25
|
| Rate for Payer: PHP All Commercial |
$132.72
|
| Rate for Payer: Sagamore Health Network All Products |
$135.10
|
| Rate for Payer: Signature Care EPO |
$145.25
|
| Rate for Payer: Signature Care PPO |
$154.00
|
| Rate for Payer: United Healthcare Commercial |
$137.90
|
|
|
HC Z G 7 SCREW 6.5X25
|
Facility
OP
|
$175.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$147.70
|
| Rate for Payer: Aetna Medicare |
$57.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$100.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$109.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$66.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$63.52
|
| Rate for Payer: Cash Price |
$108.50
|
| Rate for Payer: Cash Price |
$108.50
|
| Rate for Payer: Centivo All Commercial |
$89.25
|
| Rate for Payer: Cigna All Commercial |
$151.02
|
| Rate for Payer: CORVEL All Commercial |
$162.75
|
| Rate for Payer: Coventry All Commercial |
$154.00
|
| Rate for Payer: Encore All Commercial |
$161.09
|
| Rate for Payer: Frontpath All Commercial |
$161.00
|
| Rate for Payer: Humana ChoiceCare |
$151.15
|
| Rate for Payer: Humana Medicare |
$89.25
|
| Rate for Payer: Lucent All Commercial |
$89.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$157.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$131.25
|
| Rate for Payer: PHP All Commercial |
$132.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.25
|
| Rate for Payer: Sagamore Health Network All Products |
$135.10
|
| Rate for Payer: Signature Care EPO |
$145.25
|
| Rate for Payer: Signature Care PPO |
$154.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$148.75
|
| Rate for Payer: United Healthcare Commercial |
$137.90
|
| Rate for Payer: United Healthcare Medicare |
$57.75
|
|
|
HC Z G 7 SCREW 6.5X25
|
Facility
IP
|
$175.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$131.25 |
| Max. Negotiated Rate |
$162.75 |
| Rate for Payer: Aetna Commercial |
$151.20
|
| Rate for Payer: Cash Price |
$108.50
|
| Rate for Payer: Cigna All Commercial |
$151.02
|
| Rate for Payer: CORVEL All Commercial |
$162.75
|
| Rate for Payer: Coventry All Commercial |
$154.00
|
| Rate for Payer: Encore All Commercial |
$161.09
|
| Rate for Payer: Frontpath All Commercial |
$161.00
|
| Rate for Payer: Humana ChoiceCare |
$151.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$157.50
|
| Rate for Payer: PHCS All Commercial |
$131.25
|
| Rate for Payer: PHP All Commercial |
$132.72
|
| Rate for Payer: Sagamore Health Network All Products |
$135.10
|
| Rate for Payer: Signature Care EPO |
$145.25
|
| Rate for Payer: Signature Care PPO |
$154.00
|
| Rate for Payer: United Healthcare Commercial |
$137.90
|
|
