|
HC Z GLEN MOD 4 PEG SZ4 LT
|
Facility
IP
|
$7,312.90
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607835
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,484.68 |
| Max. Negotiated Rate |
$6,801.00 |
| Rate for Payer: Aetna Commercial |
$6,318.35
|
| Rate for Payer: Cash Price |
$4,534.00
|
| Rate for Payer: Cigna All Commercial |
$6,311.03
|
| Rate for Payer: CORVEL All Commercial |
$6,801.00
|
| Rate for Payer: Coventry All Commercial |
$6,435.35
|
| Rate for Payer: Encore All Commercial |
$6,731.52
|
| Rate for Payer: Frontpath All Commercial |
$6,727.87
|
| Rate for Payer: Humana ChoiceCare |
$6,316.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,581.61
|
| Rate for Payer: PHCS All Commercial |
$5,484.68
|
| Rate for Payer: PHP All Commercial |
$5,546.10
|
| Rate for Payer: Sagamore Health Network All Products |
$5,645.56
|
| Rate for Payer: Signature Care EPO |
$6,069.71
|
| Rate for Payer: Signature Care PPO |
$6,435.35
|
| Rate for Payer: United Healthcare Commercial |
$5,762.57
|
|
|
HC Z GLEN MOD 4 PEG SZ 4 RT
|
Facility
IP
|
$7,312.90
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,484.68 |
| Max. Negotiated Rate |
$6,801.00 |
| Rate for Payer: Aetna Commercial |
$6,318.35
|
| Rate for Payer: Cash Price |
$4,534.00
|
| Rate for Payer: Cigna All Commercial |
$6,311.03
|
| Rate for Payer: CORVEL All Commercial |
$6,801.00
|
| Rate for Payer: Coventry All Commercial |
$6,435.35
|
| Rate for Payer: Encore All Commercial |
$6,731.52
|
| Rate for Payer: Frontpath All Commercial |
$6,727.87
|
| Rate for Payer: Humana ChoiceCare |
$6,316.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,581.61
|
| Rate for Payer: PHCS All Commercial |
$5,484.68
|
| Rate for Payer: PHP All Commercial |
$5,546.10
|
| Rate for Payer: Sagamore Health Network All Products |
$5,645.56
|
| Rate for Payer: Signature Care EPO |
$6,069.71
|
| Rate for Payer: Signature Care PPO |
$6,435.35
|
| Rate for Payer: United Healthcare Commercial |
$5,762.57
|
|
|
HC Z GLEN MOD 4 PEG SZ 4 RT
|
Facility
OP
|
$7,312.90
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,801.00 |
| Rate for Payer: Aetna Commercial |
$6,172.09
|
| Rate for Payer: Aetna Medicare |
$2,413.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,413.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,199.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,571.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,775.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,654.58
|
| Rate for Payer: Cash Price |
$4,534.00
|
| Rate for Payer: Cash Price |
$4,534.00
|
| Rate for Payer: Centivo All Commercial |
$3,729.58
|
| Rate for Payer: Cigna All Commercial |
$6,311.03
|
| Rate for Payer: CORVEL All Commercial |
$6,801.00
|
| Rate for Payer: Coventry All Commercial |
$6,435.35
|
| Rate for Payer: Encore All Commercial |
$6,731.52
|
| Rate for Payer: Frontpath All Commercial |
$6,727.87
|
| Rate for Payer: Humana ChoiceCare |
$6,316.15
|
| Rate for Payer: Humana Medicare |
$3,729.58
|
| Rate for Payer: Lucent All Commercial |
$3,729.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,581.61
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,484.68
|
| Rate for Payer: PHP All Commercial |
$5,546.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,852.03
|
| Rate for Payer: Sagamore Health Network All Products |
$5,645.56
|
| Rate for Payer: Signature Care EPO |
$6,069.71
|
| Rate for Payer: Signature Care PPO |
$6,435.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,215.96
|
| Rate for Payer: United Healthcare Commercial |
$5,762.57
|
| Rate for Payer: United Healthcare Medicare |
$2,413.26
|
|
|
HC Z GLEN MOD 4 PEG SZ 5
|
Facility
OP
|
$5,325.70
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607502
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,952.90 |
| Rate for Payer: Aetna Commercial |
$4,494.89
|
| Rate for Payer: Aetna Medicare |
$1,757.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,757.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,058.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,329.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,021.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,933.23
|
| Rate for Payer: Cash Price |
$3,301.93
|
| Rate for Payer: Cash Price |
$3,301.93
|
| Rate for Payer: Centivo All Commercial |
$2,716.11
|
| Rate for Payer: Cigna All Commercial |
$4,596.08
|
| Rate for Payer: CORVEL All Commercial |
$4,952.90
|
| Rate for Payer: Coventry All Commercial |
$4,686.62
|
| Rate for Payer: Encore All Commercial |
$4,902.31
|
| Rate for Payer: Frontpath All Commercial |
$4,899.64
|
| Rate for Payer: Humana ChoiceCare |
$4,599.81
|
| Rate for Payer: Humana Medicare |
$2,716.11
|
| Rate for Payer: Lucent All Commercial |
$2,716.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,793.13
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,994.28
|
| Rate for Payer: PHP All Commercial |
$4,039.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,077.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,111.44
|
| Rate for Payer: Signature Care EPO |
$4,420.33
|
| Rate for Payer: Signature Care PPO |
$4,686.62
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,526.84
|
| Rate for Payer: United Healthcare Commercial |
$4,196.65
|
| Rate for Payer: United Healthcare Medicare |
$1,757.48
|
|
|
HC Z GLEN MOD 4 PEG SZ 5
|
Facility
IP
|
$5,325.70
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607502
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,994.28 |
| Max. Negotiated Rate |
$4,952.90 |
| Rate for Payer: Aetna Commercial |
$4,601.40
|
| Rate for Payer: Cash Price |
$3,301.93
|
| Rate for Payer: Cigna All Commercial |
$4,596.08
|
| Rate for Payer: CORVEL All Commercial |
$4,952.90
|
| Rate for Payer: Coventry All Commercial |
$4,686.62
|
| Rate for Payer: Encore All Commercial |
$4,902.31
|
| Rate for Payer: Frontpath All Commercial |
$4,899.64
|
| Rate for Payer: Humana ChoiceCare |
$4,599.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,793.13
|
| Rate for Payer: PHCS All Commercial |
$3,994.28
|
| Rate for Payer: PHP All Commercial |
$4,039.01
|
| Rate for Payer: Sagamore Health Network All Products |
$4,111.44
|
| Rate for Payer: Signature Care EPO |
$4,420.33
|
| Rate for Payer: Signature Care PPO |
$4,686.62
|
| Rate for Payer: United Healthcare Commercial |
$4,196.65
|
|
|
HC Z GLEN MOD POST
|
Facility
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,725.00 |
| Max. Negotiated Rate |
$2,139.00 |
| Rate for Payer: Aetna Commercial |
$1,987.20
|
| Rate for Payer: Cash Price |
$1,426.00
|
| Rate for Payer: Cigna All Commercial |
$1,984.90
|
| Rate for Payer: CORVEL All Commercial |
$2,139.00
|
| Rate for Payer: Coventry All Commercial |
$2,024.00
|
| Rate for Payer: Encore All Commercial |
$2,117.15
|
| Rate for Payer: Frontpath All Commercial |
$2,116.00
|
| Rate for Payer: Humana ChoiceCare |
$1,986.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,070.00
|
| Rate for Payer: PHCS All Commercial |
$1,725.00
|
| Rate for Payer: PHP All Commercial |
$1,744.32
|
| Rate for Payer: Sagamore Health Network All Products |
$1,775.60
|
| Rate for Payer: Signature Care EPO |
$1,909.00
|
| Rate for Payer: Signature Care PPO |
$2,024.00
|
| Rate for Payer: United Healthcare Commercial |
$1,812.40
|
|
|
HC Z GLEN MOD POST
|
Facility
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,139.00 |
| Rate for Payer: Aetna Commercial |
$1,941.20
|
| Rate for Payer: Aetna Medicare |
$759.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$759.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,320.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,437.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$872.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$834.90
|
| Rate for Payer: Cash Price |
$1,426.00
|
| Rate for Payer: Cash Price |
$1,426.00
|
| Rate for Payer: Centivo All Commercial |
$1,173.00
|
| Rate for Payer: Cigna All Commercial |
$1,984.90
|
| Rate for Payer: CORVEL All Commercial |
$2,139.00
|
| Rate for Payer: Coventry All Commercial |
$2,024.00
|
| Rate for Payer: Encore All Commercial |
$2,117.15
|
| Rate for Payer: Frontpath All Commercial |
$2,116.00
|
| Rate for Payer: Humana ChoiceCare |
$1,986.51
|
| Rate for Payer: Humana Medicare |
$1,173.00
|
| Rate for Payer: Lucent All Commercial |
$1,173.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,070.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,725.00
|
| Rate for Payer: PHP All Commercial |
$1,744.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$897.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,775.60
|
| Rate for Payer: Signature Care EPO |
$1,909.00
|
| Rate for Payer: Signature Care PPO |
$2,024.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare Commercial |
$1,812.40
|
| Rate for Payer: United Healthcare Medicare |
$759.00
|
|
|
HC Z GLENOID 4MM PEGGED LRG
|
Facility
OP
|
$5,702.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605632
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,303.23 |
| Rate for Payer: Aetna Commercial |
$4,812.83
|
| Rate for Payer: Aetna Medicare |
$1,881.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,881.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,274.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,564.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,164.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,069.97
|
| Rate for Payer: Cash Price |
$3,535.49
|
| Rate for Payer: Cash Price |
$3,535.49
|
| Rate for Payer: Centivo All Commercial |
$2,908.22
|
| Rate for Payer: Cigna All Commercial |
$4,921.17
|
| Rate for Payer: CORVEL All Commercial |
$5,303.23
|
| Rate for Payer: Coventry All Commercial |
$5,018.11
|
| Rate for Payer: Encore All Commercial |
$5,249.06
|
| Rate for Payer: Frontpath All Commercial |
$5,246.21
|
| Rate for Payer: Humana ChoiceCare |
$4,925.16
|
| Rate for Payer: Humana Medicare |
$2,908.22
|
| Rate for Payer: Lucent All Commercial |
$2,908.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,132.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,276.80
|
| Rate for Payer: PHP All Commercial |
$4,324.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,223.94
|
| Rate for Payer: Sagamore Health Network All Products |
$4,402.25
|
| Rate for Payer: Signature Care EPO |
$4,732.99
|
| Rate for Payer: Signature Care PPO |
$5,018.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,847.04
|
| Rate for Payer: United Healthcare Commercial |
$4,493.49
|
| Rate for Payer: United Healthcare Medicare |
$1,881.79
|
|
|
HC Z GLENOID 4MM PEGGED LRG
|
Facility
IP
|
$5,702.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605632
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,276.80 |
| Max. Negotiated Rate |
$5,303.23 |
| Rate for Payer: Aetna Commercial |
$4,926.87
|
| Rate for Payer: Cash Price |
$3,535.49
|
| Rate for Payer: Cigna All Commercial |
$4,921.17
|
| Rate for Payer: CORVEL All Commercial |
$5,303.23
|
| Rate for Payer: Coventry All Commercial |
$5,018.11
|
| Rate for Payer: Encore All Commercial |
$5,249.06
|
| Rate for Payer: Frontpath All Commercial |
$5,246.21
|
| Rate for Payer: Humana ChoiceCare |
$4,925.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,132.16
|
| Rate for Payer: PHCS All Commercial |
$4,276.80
|
| Rate for Payer: PHP All Commercial |
$4,324.70
|
| Rate for Payer: Sagamore Health Network All Products |
$4,402.25
|
| Rate for Payer: Signature Care EPO |
$4,732.99
|
| Rate for Payer: Signature Care PPO |
$5,018.11
|
| Rate for Payer: United Healthcare Commercial |
$4,493.49
|
|
|
HC Z GLENOID 4MM PEGGED MD
|
Facility
IP
|
$5,702.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,276.80 |
| Max. Negotiated Rate |
$5,303.23 |
| Rate for Payer: Aetna Commercial |
$4,926.87
|
| Rate for Payer: Cash Price |
$3,535.49
|
| Rate for Payer: Cigna All Commercial |
$4,921.17
|
| Rate for Payer: CORVEL All Commercial |
$5,303.23
|
| Rate for Payer: Coventry All Commercial |
$5,018.11
|
| Rate for Payer: Encore All Commercial |
$5,249.06
|
| Rate for Payer: Frontpath All Commercial |
$5,246.21
|
| Rate for Payer: Humana ChoiceCare |
$4,925.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,132.16
|
| Rate for Payer: PHCS All Commercial |
$4,276.80
|
| Rate for Payer: PHP All Commercial |
$4,324.70
|
| Rate for Payer: Sagamore Health Network All Products |
$4,402.25
|
| Rate for Payer: Signature Care EPO |
$4,732.99
|
| Rate for Payer: Signature Care PPO |
$5,018.11
|
| Rate for Payer: United Healthcare Commercial |
$4,493.49
|
|
|
HC Z GLENOID 4MM PEGGED MD
|
Facility
OP
|
$5,702.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,303.23 |
| Rate for Payer: Aetna Commercial |
$4,812.83
|
| Rate for Payer: Aetna Medicare |
$1,881.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,881.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,274.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,564.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,164.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,069.97
|
| Rate for Payer: Cash Price |
$3,535.49
|
| Rate for Payer: Cash Price |
$3,535.49
|
| Rate for Payer: Centivo All Commercial |
$2,908.22
|
| Rate for Payer: Cigna All Commercial |
$4,921.17
|
| Rate for Payer: CORVEL All Commercial |
$5,303.23
|
| Rate for Payer: Coventry All Commercial |
$5,018.11
|
| Rate for Payer: Encore All Commercial |
$5,249.06
|
| Rate for Payer: Frontpath All Commercial |
$5,246.21
|
| Rate for Payer: Humana ChoiceCare |
$4,925.16
|
| Rate for Payer: Humana Medicare |
$2,908.22
|
| Rate for Payer: Lucent All Commercial |
$2,908.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,132.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,276.80
|
| Rate for Payer: PHP All Commercial |
$4,324.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,223.94
|
| Rate for Payer: Sagamore Health Network All Products |
$4,402.25
|
| Rate for Payer: Signature Care EPO |
$4,732.99
|
| Rate for Payer: Signature Care PPO |
$5,018.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,847.04
|
| Rate for Payer: United Healthcare Commercial |
$4,493.49
|
| Rate for Payer: United Healthcare Medicare |
$1,881.79
|
|
|
HC Z GLENOID 4MM PEGGED SM
|
Facility
IP
|
$5,702.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,276.80 |
| Max. Negotiated Rate |
$5,303.23 |
| Rate for Payer: Aetna Commercial |
$4,926.87
|
| Rate for Payer: Cash Price |
$3,535.49
|
| Rate for Payer: Cigna All Commercial |
$4,921.17
|
| Rate for Payer: CORVEL All Commercial |
$5,303.23
|
| Rate for Payer: Coventry All Commercial |
$5,018.11
|
| Rate for Payer: Encore All Commercial |
$5,249.06
|
| Rate for Payer: Frontpath All Commercial |
$5,246.21
|
| Rate for Payer: Humana ChoiceCare |
$4,925.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,132.16
|
| Rate for Payer: PHCS All Commercial |
$4,276.80
|
| Rate for Payer: PHP All Commercial |
$4,324.70
|
| Rate for Payer: Sagamore Health Network All Products |
$4,402.25
|
| Rate for Payer: Signature Care EPO |
$4,732.99
|
| Rate for Payer: Signature Care PPO |
$5,018.11
|
| Rate for Payer: United Healthcare Commercial |
$4,493.49
|
|
|
HC Z GLENOID 4MM PEGGED SM
|
Facility
OP
|
$5,702.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,303.23 |
| Rate for Payer: Aetna Commercial |
$4,812.83
|
| Rate for Payer: Aetna Medicare |
$1,881.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,881.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,274.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,564.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,164.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,069.97
|
| Rate for Payer: Cash Price |
$3,535.49
|
| Rate for Payer: Cash Price |
$3,535.49
|
| Rate for Payer: Centivo All Commercial |
$2,908.22
|
| Rate for Payer: Cigna All Commercial |
$4,921.17
|
| Rate for Payer: CORVEL All Commercial |
$5,303.23
|
| Rate for Payer: Coventry All Commercial |
$5,018.11
|
| Rate for Payer: Encore All Commercial |
$5,249.06
|
| Rate for Payer: Frontpath All Commercial |
$5,246.21
|
| Rate for Payer: Humana ChoiceCare |
$4,925.16
|
| Rate for Payer: Humana Medicare |
$2,908.22
|
| Rate for Payer: Lucent All Commercial |
$2,908.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,132.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,276.80
|
| Rate for Payer: PHP All Commercial |
$4,324.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,223.94
|
| Rate for Payer: Sagamore Health Network All Products |
$4,402.25
|
| Rate for Payer: Signature Care EPO |
$4,732.99
|
| Rate for Payer: Signature Care PPO |
$5,018.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,847.04
|
| Rate for Payer: United Healthcare Commercial |
$4,493.49
|
| Rate for Payer: United Healthcare Medicare |
$1,881.79
|
|
|
HC Z GLENOID BASE 4MM LRG
|
Facility
OP
|
$5,745.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605637
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,343.41 |
| Rate for Payer: Aetna Commercial |
$4,849.29
|
| Rate for Payer: Aetna Medicare |
$1,896.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,896.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,299.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,591.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,180.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,085.65
|
| Rate for Payer: Cash Price |
$3,562.27
|
| Rate for Payer: Cash Price |
$3,562.27
|
| Rate for Payer: Centivo All Commercial |
$2,930.26
|
| Rate for Payer: Cigna All Commercial |
$4,958.45
|
| Rate for Payer: CORVEL All Commercial |
$5,343.41
|
| Rate for Payer: Coventry All Commercial |
$5,056.13
|
| Rate for Payer: Encore All Commercial |
$5,288.82
|
| Rate for Payer: Frontpath All Commercial |
$5,285.95
|
| Rate for Payer: Humana ChoiceCare |
$4,962.47
|
| Rate for Payer: Humana Medicare |
$2,930.26
|
| Rate for Payer: Lucent All Commercial |
$2,930.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,171.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,309.20
|
| Rate for Payer: PHP All Commercial |
$4,357.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,240.78
|
| Rate for Payer: Sagamore Health Network All Products |
$4,435.60
|
| Rate for Payer: Signature Care EPO |
$4,768.85
|
| Rate for Payer: Signature Care PPO |
$5,056.13
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,883.76
|
| Rate for Payer: United Healthcare Commercial |
$4,527.53
|
| Rate for Payer: United Healthcare Medicare |
$1,896.05
|
|
|
HC Z GLENOID BASE 4MM LRG
|
Facility
IP
|
$5,745.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605637
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,309.20 |
| Max. Negotiated Rate |
$5,343.41 |
| Rate for Payer: Aetna Commercial |
$4,964.20
|
| Rate for Payer: Cash Price |
$3,562.27
|
| Rate for Payer: Cigna All Commercial |
$4,958.45
|
| Rate for Payer: CORVEL All Commercial |
$5,343.41
|
| Rate for Payer: Coventry All Commercial |
$5,056.13
|
| Rate for Payer: Encore All Commercial |
$5,288.82
|
| Rate for Payer: Frontpath All Commercial |
$5,285.95
|
| Rate for Payer: Humana ChoiceCare |
$4,962.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,171.04
|
| Rate for Payer: PHCS All Commercial |
$4,309.20
|
| Rate for Payer: PHP All Commercial |
$4,357.46
|
| Rate for Payer: Sagamore Health Network All Products |
$4,435.60
|
| Rate for Payer: Signature Care EPO |
$4,768.85
|
| Rate for Payer: Signature Care PPO |
$5,056.13
|
| Rate for Payer: United Healthcare Commercial |
$4,527.53
|
|
|
HC Z GLENOID BASE 4MM MD
|
Facility
OP
|
$5,745.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605636
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,343.41 |
| Rate for Payer: Aetna Commercial |
$4,849.29
|
| Rate for Payer: Aetna Medicare |
$1,896.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,896.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,299.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,591.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,180.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,085.65
|
| Rate for Payer: Cash Price |
$3,562.27
|
| Rate for Payer: Cash Price |
$3,562.27
|
| Rate for Payer: Centivo All Commercial |
$2,930.26
|
| Rate for Payer: Cigna All Commercial |
$4,958.45
|
| Rate for Payer: CORVEL All Commercial |
$5,343.41
|
| Rate for Payer: Coventry All Commercial |
$5,056.13
|
| Rate for Payer: Encore All Commercial |
$5,288.82
|
| Rate for Payer: Frontpath All Commercial |
$5,285.95
|
| Rate for Payer: Humana ChoiceCare |
$4,962.47
|
| Rate for Payer: Humana Medicare |
$2,930.26
|
| Rate for Payer: Lucent All Commercial |
$2,930.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,171.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,309.20
|
| Rate for Payer: PHP All Commercial |
$4,357.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,240.78
|
| Rate for Payer: Sagamore Health Network All Products |
$4,435.60
|
| Rate for Payer: Signature Care EPO |
$4,768.85
|
| Rate for Payer: Signature Care PPO |
$5,056.13
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,883.76
|
| Rate for Payer: United Healthcare Commercial |
$4,527.53
|
| Rate for Payer: United Healthcare Medicare |
$1,896.05
|
|
|
HC Z GLENOID BASE 4MM MD
|
Facility
IP
|
$5,745.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605636
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,309.20 |
| Max. Negotiated Rate |
$5,343.41 |
| Rate for Payer: Aetna Commercial |
$4,964.20
|
| Rate for Payer: Cash Price |
$3,562.27
|
| Rate for Payer: Cigna All Commercial |
$4,958.45
|
| Rate for Payer: CORVEL All Commercial |
$5,343.41
|
| Rate for Payer: Coventry All Commercial |
$5,056.13
|
| Rate for Payer: Encore All Commercial |
$5,288.82
|
| Rate for Payer: Frontpath All Commercial |
$5,285.95
|
| Rate for Payer: Humana ChoiceCare |
$4,962.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,171.04
|
| Rate for Payer: PHCS All Commercial |
$4,309.20
|
| Rate for Payer: PHP All Commercial |
$4,357.46
|
| Rate for Payer: Sagamore Health Network All Products |
$4,435.60
|
| Rate for Payer: Signature Care EPO |
$4,768.85
|
| Rate for Payer: Signature Care PPO |
$5,056.13
|
| Rate for Payer: United Healthcare Commercial |
$4,527.53
|
|
|
HC Z GLENOID BASE 4MM SM
|
Facility
OP
|
$5,745.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,343.41 |
| Rate for Payer: Aetna Commercial |
$4,849.29
|
| Rate for Payer: Aetna Medicare |
$1,896.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,896.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,299.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,591.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,180.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,085.65
|
| Rate for Payer: Cash Price |
$3,562.27
|
| Rate for Payer: Cash Price |
$3,562.27
|
| Rate for Payer: Centivo All Commercial |
$2,930.26
|
| Rate for Payer: Cigna All Commercial |
$4,958.45
|
| Rate for Payer: CORVEL All Commercial |
$5,343.41
|
| Rate for Payer: Coventry All Commercial |
$5,056.13
|
| Rate for Payer: Encore All Commercial |
$5,288.82
|
| Rate for Payer: Frontpath All Commercial |
$5,285.95
|
| Rate for Payer: Humana ChoiceCare |
$4,962.47
|
| Rate for Payer: Humana Medicare |
$2,930.26
|
| Rate for Payer: Lucent All Commercial |
$2,930.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,171.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,309.20
|
| Rate for Payer: PHP All Commercial |
$4,357.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,240.78
|
| Rate for Payer: Sagamore Health Network All Products |
$4,435.60
|
| Rate for Payer: Signature Care EPO |
$4,768.85
|
| Rate for Payer: Signature Care PPO |
$5,056.13
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,883.76
|
| Rate for Payer: United Healthcare Commercial |
$4,527.53
|
| Rate for Payer: United Healthcare Medicare |
$1,896.05
|
|
|
HC Z GLENOID BASE 4MM SM
|
Facility
IP
|
$5,745.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,309.20 |
| Max. Negotiated Rate |
$5,343.41 |
| Rate for Payer: Aetna Commercial |
$4,964.20
|
| Rate for Payer: Cash Price |
$3,562.27
|
| Rate for Payer: Cigna All Commercial |
$4,958.45
|
| Rate for Payer: CORVEL All Commercial |
$5,343.41
|
| Rate for Payer: Coventry All Commercial |
$5,056.13
|
| Rate for Payer: Encore All Commercial |
$5,288.82
|
| Rate for Payer: Frontpath All Commercial |
$5,285.95
|
| Rate for Payer: Humana ChoiceCare |
$4,962.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,171.04
|
| Rate for Payer: PHCS All Commercial |
$4,309.20
|
| Rate for Payer: PHP All Commercial |
$4,357.46
|
| Rate for Payer: Sagamore Health Network All Products |
$4,435.60
|
| Rate for Payer: Signature Care EPO |
$4,768.85
|
| Rate for Payer: Signature Care PPO |
$5,056.13
|
| Rate for Payer: United Healthcare Commercial |
$4,527.53
|
|
|
HC Z GLEN REAMER GUIDE 4 PEG LT
|
Facility
IP
|
$1,403.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607834
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,052.25 |
| Max. Negotiated Rate |
$1,304.79 |
| Rate for Payer: Aetna Commercial |
$1,212.19
|
| Rate for Payer: Cash Price |
$869.86
|
| Rate for Payer: Cigna All Commercial |
$1,210.79
|
| Rate for Payer: CORVEL All Commercial |
$1,304.79
|
| Rate for Payer: Coventry All Commercial |
$1,234.64
|
| Rate for Payer: Encore All Commercial |
$1,291.46
|
| Rate for Payer: Frontpath All Commercial |
$1,290.76
|
| Rate for Payer: Humana ChoiceCare |
$1,211.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,262.70
|
| Rate for Payer: PHCS All Commercial |
$1,052.25
|
| Rate for Payer: PHP All Commercial |
$1,064.04
|
| Rate for Payer: Sagamore Health Network All Products |
$1,083.12
|
| Rate for Payer: Signature Care EPO |
$1,164.49
|
| Rate for Payer: Signature Care PPO |
$1,234.64
|
| Rate for Payer: United Healthcare Commercial |
$1,105.56
|
|
|
HC Z GLEN REAMER GUIDE 4 PEG LT
|
Facility
OP
|
$1,403.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607834
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$462.99 |
| Max. Negotiated Rate |
$1,304.79 |
| Rate for Payer: Aetna Commercial |
$1,184.13
|
| Rate for Payer: Aetna Medicare |
$462.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$462.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$805.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$877.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$532.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$509.29
|
| Rate for Payer: Cash Price |
$869.86
|
| Rate for Payer: Cash Price |
$869.86
|
| Rate for Payer: Centivo All Commercial |
$715.53
|
| Rate for Payer: Cigna All Commercial |
$1,210.79
|
| Rate for Payer: CORVEL All Commercial |
$1,304.79
|
| Rate for Payer: Coventry All Commercial |
$1,234.64
|
| Rate for Payer: Encore All Commercial |
$1,291.46
|
| Rate for Payer: Frontpath All Commercial |
$1,290.76
|
| Rate for Payer: Humana ChoiceCare |
$1,211.77
|
| Rate for Payer: Humana Medicare |
$715.53
|
| Rate for Payer: Lucent All Commercial |
$715.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,262.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,052.25
|
| Rate for Payer: PHP All Commercial |
$1,064.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$547.17
|
| Rate for Payer: Sagamore Health Network All Products |
$1,083.12
|
| Rate for Payer: Signature Care EPO |
$1,164.49
|
| Rate for Payer: Signature Care PPO |
$1,234.64
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,192.55
|
| Rate for Payer: United Healthcare Commercial |
$1,105.56
|
| Rate for Payer: United Healthcare Medicare |
$462.99
|
|
|
HC Z GLEN REAMER GUIDE 4 PEG RT
|
Facility
IP
|
$1,403.00
|
|
| Hospital Charge Code |
41607036
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,052.25 |
| Max. Negotiated Rate |
$1,304.79 |
| Rate for Payer: Aetna Commercial |
$1,212.19
|
| Rate for Payer: Cash Price |
$869.86
|
| Rate for Payer: Cigna All Commercial |
$1,210.79
|
| Rate for Payer: CORVEL All Commercial |
$1,304.79
|
| Rate for Payer: Coventry All Commercial |
$1,234.64
|
| Rate for Payer: Encore All Commercial |
$1,291.46
|
| Rate for Payer: Frontpath All Commercial |
$1,290.76
|
| Rate for Payer: Humana ChoiceCare |
$1,211.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,262.70
|
| Rate for Payer: PHCS All Commercial |
$1,052.25
|
| Rate for Payer: PHP All Commercial |
$1,064.04
|
| Rate for Payer: Sagamore Health Network All Products |
$1,083.12
|
| Rate for Payer: Signature Care EPO |
$1,164.49
|
| Rate for Payer: Signature Care PPO |
$1,234.64
|
| Rate for Payer: United Healthcare Commercial |
$1,105.56
|
|
|
HC Z GLEN REAMER GUIDE 4 PEG RT
|
Facility
OP
|
$1,403.00
|
|
| Hospital Charge Code |
41607036
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,304.79 |
| Rate for Payer: Aetna Commercial |
$1,184.13
|
| Rate for Payer: Aetna Medicare |
$462.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$462.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$805.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$877.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$532.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$509.29
|
| Rate for Payer: Cash Price |
$869.86
|
| Rate for Payer: Cash Price |
$869.86
|
| Rate for Payer: Centivo All Commercial |
$715.53
|
| Rate for Payer: Cigna All Commercial |
$1,210.79
|
| Rate for Payer: CORVEL All Commercial |
$1,304.79
|
| Rate for Payer: Coventry All Commercial |
$1,234.64
|
| Rate for Payer: Encore All Commercial |
$1,291.46
|
| Rate for Payer: Frontpath All Commercial |
$1,290.76
|
| Rate for Payer: Humana ChoiceCare |
$1,211.77
|
| Rate for Payer: Humana Medicare |
$715.53
|
| Rate for Payer: Lucent All Commercial |
$715.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,262.70
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,052.25
|
| Rate for Payer: PHP All Commercial |
$1,064.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$547.17
|
| Rate for Payer: Sagamore Health Network All Products |
$1,083.12
|
| Rate for Payer: Signature Care EPO |
$1,164.49
|
| Rate for Payer: Signature Care PPO |
$1,234.64
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,192.55
|
| Rate for Payer: United Healthcare Commercial |
$1,105.56
|
| Rate for Payer: United Healthcare Medicare |
$462.99
|
|
|
HC Z GRAFT SEMITENDINOSUS ASP
|
Facility
OP
|
$4,453.24
|
|
|
Service Code
|
CPT C1762
|
| Hospital Charge Code |
41606520
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,141.51 |
| Rate for Payer: Aetna Commercial |
$3,758.53
|
| Rate for Payer: Aetna Medicare |
$1,469.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,469.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,557.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,783.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,690.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,616.53
|
| Rate for Payer: Cash Price |
$2,761.01
|
| Rate for Payer: Cash Price |
$2,761.01
|
| Rate for Payer: Centivo All Commercial |
$2,271.15
|
| Rate for Payer: Cigna All Commercial |
$3,843.15
|
| Rate for Payer: CORVEL All Commercial |
$4,141.51
|
| Rate for Payer: Coventry All Commercial |
$3,918.85
|
| Rate for Payer: Encore All Commercial |
$4,099.21
|
| Rate for Payer: Frontpath All Commercial |
$4,096.98
|
| Rate for Payer: Humana ChoiceCare |
$3,846.26
|
| Rate for Payer: Humana Medicare |
$2,271.15
|
| Rate for Payer: Lucent All Commercial |
$2,271.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,007.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,339.93
|
| Rate for Payer: PHP All Commercial |
$3,377.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,736.76
|
| Rate for Payer: Sagamore Health Network All Products |
$3,437.90
|
| Rate for Payer: Signature Care EPO |
$3,696.19
|
| Rate for Payer: Signature Care PPO |
$3,918.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,785.25
|
| Rate for Payer: United Healthcare Commercial |
$3,509.15
|
| Rate for Payer: United Healthcare Medicare |
$1,469.57
|
|
|
HC Z GRAFT SEMITENDINOSUS ASP
|
Facility
IP
|
$4,453.24
|
|
|
Service Code
|
CPT C1762
|
| Hospital Charge Code |
41606520
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,339.93 |
| Max. Negotiated Rate |
$4,141.51 |
| Rate for Payer: Aetna Commercial |
$3,847.60
|
| Rate for Payer: Cash Price |
$2,761.01
|
| Rate for Payer: Cigna All Commercial |
$3,843.15
|
| Rate for Payer: CORVEL All Commercial |
$4,141.51
|
| Rate for Payer: Coventry All Commercial |
$3,918.85
|
| Rate for Payer: Encore All Commercial |
$4,099.21
|
| Rate for Payer: Frontpath All Commercial |
$4,096.98
|
| Rate for Payer: Humana ChoiceCare |
$3,846.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,007.92
|
| Rate for Payer: PHCS All Commercial |
$3,339.93
|
| Rate for Payer: PHP All Commercial |
$3,377.34
|
| Rate for Payer: Sagamore Health Network All Products |
$3,437.90
|
| Rate for Payer: Signature Care EPO |
$3,696.19
|
| Rate for Payer: Signature Care PPO |
$3,918.85
|
| Rate for Payer: United Healthcare Commercial |
$3,509.15
|
|
