|
HC Z GUIDWIRE 1.6 STD
|
Facility
OP
|
$1,231.75
|
|
| Hospital Charge Code |
41606631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,145.53 |
| Rate for Payer: Aetna Commercial |
$1,039.60
|
| Rate for Payer: Aetna Medicare |
$406.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$406.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$707.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$769.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$467.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$447.13
|
| Rate for Payer: Cash Price |
$763.69
|
| Rate for Payer: Cash Price |
$763.69
|
| Rate for Payer: Centivo All Commercial |
$628.19
|
| Rate for Payer: Cigna All Commercial |
$1,063.00
|
| Rate for Payer: CORVEL All Commercial |
$1,145.53
|
| Rate for Payer: Coventry All Commercial |
$1,083.94
|
| Rate for Payer: Encore All Commercial |
$1,133.83
|
| Rate for Payer: Frontpath All Commercial |
$1,133.21
|
| Rate for Payer: Humana ChoiceCare |
$1,063.86
|
| Rate for Payer: Humana Medicare |
$628.19
|
| Rate for Payer: Lucent All Commercial |
$628.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,108.58
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$923.81
|
| Rate for Payer: PHP All Commercial |
$934.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$480.38
|
| Rate for Payer: Sagamore Health Network All Products |
$950.91
|
| Rate for Payer: Signature Care EPO |
$1,022.35
|
| Rate for Payer: Signature Care PPO |
$1,083.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,046.99
|
| Rate for Payer: United Healthcare Commercial |
$970.62
|
| Rate for Payer: United Healthcare Medicare |
$406.48
|
|
|
HC Z GUIDWIRE 1.6 STD
|
Facility
IP
|
$1,231.75
|
|
| Hospital Charge Code |
41606631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$923.81 |
| Max. Negotiated Rate |
$1,145.53 |
| Rate for Payer: Aetna Commercial |
$1,064.23
|
| Rate for Payer: Cash Price |
$763.69
|
| Rate for Payer: Cigna All Commercial |
$1,063.00
|
| Rate for Payer: CORVEL All Commercial |
$1,145.53
|
| Rate for Payer: Coventry All Commercial |
$1,083.94
|
| Rate for Payer: Encore All Commercial |
$1,133.83
|
| Rate for Payer: Frontpath All Commercial |
$1,133.21
|
| Rate for Payer: Humana ChoiceCare |
$1,063.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,108.58
|
| Rate for Payer: PHCS All Commercial |
$923.81
|
| Rate for Payer: PHP All Commercial |
$934.16
|
| Rate for Payer: Sagamore Health Network All Products |
$950.91
|
| Rate for Payer: Signature Care EPO |
$1,022.35
|
| Rate for Payer: Signature Care PPO |
$1,083.94
|
| Rate for Payer: United Healthcare Commercial |
$970.62
|
|
|
HC Z HI PLATE HUM PXML 140 7-H L
|
Facility
OP
|
$6,257.56
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,819.53 |
| Rate for Payer: Aetna Commercial |
$5,281.38
|
| Rate for Payer: Aetna Medicare |
$2,064.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,064.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,593.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,911.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,374.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,271.49
|
| Rate for Payer: Cash Price |
$3,879.69
|
| Rate for Payer: Cash Price |
$3,879.69
|
| Rate for Payer: Centivo All Commercial |
$3,191.36
|
| Rate for Payer: Cigna All Commercial |
$5,400.27
|
| Rate for Payer: CORVEL All Commercial |
$5,819.53
|
| Rate for Payer: Coventry All Commercial |
$5,506.65
|
| Rate for Payer: Encore All Commercial |
$5,760.08
|
| Rate for Payer: Frontpath All Commercial |
$5,756.96
|
| Rate for Payer: Humana ChoiceCare |
$5,404.65
|
| Rate for Payer: Humana Medicare |
$3,191.36
|
| Rate for Payer: Lucent All Commercial |
$3,191.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,631.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,693.17
|
| Rate for Payer: PHP All Commercial |
$4,745.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,440.45
|
| Rate for Payer: Sagamore Health Network All Products |
$4,830.84
|
| Rate for Payer: Signature Care EPO |
$5,193.77
|
| Rate for Payer: Signature Care PPO |
$5,506.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,318.93
|
| Rate for Payer: United Healthcare Commercial |
$4,930.96
|
| Rate for Payer: United Healthcare Medicare |
$2,064.99
|
|
|
HC Z HI PLATE HUM PXML 140 7-H L
|
Facility
IP
|
$6,257.56
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,693.17 |
| Max. Negotiated Rate |
$5,819.53 |
| Rate for Payer: Aetna Commercial |
$5,406.53
|
| Rate for Payer: Cash Price |
$3,879.69
|
| Rate for Payer: Cigna All Commercial |
$5,400.27
|
| Rate for Payer: CORVEL All Commercial |
$5,819.53
|
| Rate for Payer: Coventry All Commercial |
$5,506.65
|
| Rate for Payer: Encore All Commercial |
$5,760.08
|
| Rate for Payer: Frontpath All Commercial |
$5,756.96
|
| Rate for Payer: Humana ChoiceCare |
$5,404.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,631.80
|
| Rate for Payer: PHCS All Commercial |
$4,693.17
|
| Rate for Payer: PHP All Commercial |
$4,745.73
|
| Rate for Payer: Sagamore Health Network All Products |
$4,830.84
|
| Rate for Payer: Signature Care EPO |
$5,193.77
|
| Rate for Payer: Signature Care PPO |
$5,506.65
|
| Rate for Payer: United Healthcare Commercial |
$4,930.96
|
|
|
HC Z HI PLATE HUM PXML 140 7-H R
|
Facility
OP
|
$6,257.56
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,819.53 |
| Rate for Payer: Aetna Commercial |
$5,281.38
|
| Rate for Payer: Aetna Medicare |
$2,064.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,064.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,593.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,911.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,374.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,271.49
|
| Rate for Payer: Cash Price |
$3,879.69
|
| Rate for Payer: Cash Price |
$3,879.69
|
| Rate for Payer: Centivo All Commercial |
$3,191.36
|
| Rate for Payer: Cigna All Commercial |
$5,400.27
|
| Rate for Payer: CORVEL All Commercial |
$5,819.53
|
| Rate for Payer: Coventry All Commercial |
$5,506.65
|
| Rate for Payer: Encore All Commercial |
$5,760.08
|
| Rate for Payer: Frontpath All Commercial |
$5,756.96
|
| Rate for Payer: Humana ChoiceCare |
$5,404.65
|
| Rate for Payer: Humana Medicare |
$3,191.36
|
| Rate for Payer: Lucent All Commercial |
$3,191.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,631.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,693.17
|
| Rate for Payer: PHP All Commercial |
$4,745.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,440.45
|
| Rate for Payer: Sagamore Health Network All Products |
$4,830.84
|
| Rate for Payer: Signature Care EPO |
$5,193.77
|
| Rate for Payer: Signature Care PPO |
$5,506.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,318.93
|
| Rate for Payer: United Healthcare Commercial |
$4,930.96
|
| Rate for Payer: United Healthcare Medicare |
$2,064.99
|
|
|
HC Z HI PLATE HUM PXML 140 7-H R
|
Facility
IP
|
$6,257.56
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,693.17 |
| Max. Negotiated Rate |
$5,819.53 |
| Rate for Payer: Aetna Commercial |
$5,406.53
|
| Rate for Payer: Cash Price |
$3,879.69
|
| Rate for Payer: Cigna All Commercial |
$5,400.27
|
| Rate for Payer: CORVEL All Commercial |
$5,819.53
|
| Rate for Payer: Coventry All Commercial |
$5,506.65
|
| Rate for Payer: Encore All Commercial |
$5,760.08
|
| Rate for Payer: Frontpath All Commercial |
$5,756.96
|
| Rate for Payer: Humana ChoiceCare |
$5,404.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,631.80
|
| Rate for Payer: PHCS All Commercial |
$4,693.17
|
| Rate for Payer: PHP All Commercial |
$4,745.73
|
| Rate for Payer: Sagamore Health Network All Products |
$4,830.84
|
| Rate for Payer: Signature Care EPO |
$5,193.77
|
| Rate for Payer: Signature Care PPO |
$5,506.65
|
| Rate for Payer: United Healthcare Commercial |
$4,930.96
|
|
|
HC Z HI PLATE HUM PXML 197 11-H L
|
Facility
IP
|
$7,039.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603738
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,279.48 |
| Max. Negotiated Rate |
$6,546.55 |
| Rate for Payer: Aetna Commercial |
$6,081.96
|
| Rate for Payer: Cash Price |
$4,364.37
|
| Rate for Payer: Cigna All Commercial |
$6,074.92
|
| Rate for Payer: CORVEL All Commercial |
$6,546.55
|
| Rate for Payer: Coventry All Commercial |
$6,194.58
|
| Rate for Payer: Encore All Commercial |
$6,479.68
|
| Rate for Payer: Frontpath All Commercial |
$6,476.16
|
| Rate for Payer: Humana ChoiceCare |
$6,079.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,335.37
|
| Rate for Payer: PHCS All Commercial |
$5,279.48
|
| Rate for Payer: PHP All Commercial |
$5,338.61
|
| Rate for Payer: Sagamore Health Network All Products |
$5,434.34
|
| Rate for Payer: Signature Care EPO |
$5,842.62
|
| Rate for Payer: Signature Care PPO |
$6,194.58
|
| Rate for Payer: United Healthcare Commercial |
$5,546.97
|
|
|
HC Z HI PLATE HUM PXML 197 11-H L
|
Facility
OP
|
$7,039.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603738
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,546.55 |
| Rate for Payer: Aetna Commercial |
$5,941.17
|
| Rate for Payer: Aetna Medicare |
$2,322.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,322.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,042.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,400.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,671.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,555.27
|
| Rate for Payer: Cash Price |
$4,364.37
|
| Rate for Payer: Cash Price |
$4,364.37
|
| Rate for Payer: Centivo All Commercial |
$3,590.04
|
| Rate for Payer: Cigna All Commercial |
$6,074.92
|
| Rate for Payer: CORVEL All Commercial |
$6,546.55
|
| Rate for Payer: Coventry All Commercial |
$6,194.58
|
| Rate for Payer: Encore All Commercial |
$6,479.68
|
| Rate for Payer: Frontpath All Commercial |
$6,476.16
|
| Rate for Payer: Humana ChoiceCare |
$6,079.84
|
| Rate for Payer: Humana Medicare |
$3,590.04
|
| Rate for Payer: Lucent All Commercial |
$3,590.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,335.37
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,279.48
|
| Rate for Payer: PHP All Commercial |
$5,338.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,745.33
|
| Rate for Payer: Sagamore Health Network All Products |
$5,434.34
|
| Rate for Payer: Signature Care EPO |
$5,842.62
|
| Rate for Payer: Signature Care PPO |
$6,194.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,983.40
|
| Rate for Payer: United Healthcare Commercial |
$5,546.97
|
| Rate for Payer: United Healthcare Medicare |
$2,322.97
|
|
|
HC Z HI PLATE HUM PXML 197 11-H R
|
Facility
OP
|
$7,039.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,546.55 |
| Rate for Payer: Aetna Commercial |
$5,941.17
|
| Rate for Payer: Aetna Medicare |
$2,322.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,322.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,042.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,400.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,671.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,555.27
|
| Rate for Payer: Cash Price |
$4,364.37
|
| Rate for Payer: Cash Price |
$4,364.37
|
| Rate for Payer: Centivo All Commercial |
$3,590.04
|
| Rate for Payer: Cigna All Commercial |
$6,074.92
|
| Rate for Payer: CORVEL All Commercial |
$6,546.55
|
| Rate for Payer: Coventry All Commercial |
$6,194.58
|
| Rate for Payer: Encore All Commercial |
$6,479.68
|
| Rate for Payer: Frontpath All Commercial |
$6,476.16
|
| Rate for Payer: Humana ChoiceCare |
$6,079.84
|
| Rate for Payer: Humana Medicare |
$3,590.04
|
| Rate for Payer: Lucent All Commercial |
$3,590.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,335.37
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,279.48
|
| Rate for Payer: PHP All Commercial |
$5,338.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,745.33
|
| Rate for Payer: Sagamore Health Network All Products |
$5,434.34
|
| Rate for Payer: Signature Care EPO |
$5,842.62
|
| Rate for Payer: Signature Care PPO |
$6,194.58
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,983.40
|
| Rate for Payer: United Healthcare Commercial |
$5,546.97
|
| Rate for Payer: United Healthcare Medicare |
$2,322.97
|
|
|
HC Z HI PLATE HUM PXML 197 11-H R
|
Facility
IP
|
$7,039.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,279.48 |
| Max. Negotiated Rate |
$6,546.55 |
| Rate for Payer: Aetna Commercial |
$6,081.96
|
| Rate for Payer: Cash Price |
$4,364.37
|
| Rate for Payer: Cigna All Commercial |
$6,074.92
|
| Rate for Payer: CORVEL All Commercial |
$6,546.55
|
| Rate for Payer: Coventry All Commercial |
$6,194.58
|
| Rate for Payer: Encore All Commercial |
$6,479.68
|
| Rate for Payer: Frontpath All Commercial |
$6,476.16
|
| Rate for Payer: Humana ChoiceCare |
$6,079.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,335.37
|
| Rate for Payer: PHCS All Commercial |
$5,279.48
|
| Rate for Payer: PHP All Commercial |
$5,338.61
|
| Rate for Payer: Sagamore Health Network All Products |
$5,434.34
|
| Rate for Payer: Signature Care EPO |
$5,842.62
|
| Rate for Payer: Signature Care PPO |
$6,194.58
|
| Rate for Payer: United Healthcare Commercial |
$5,546.97
|
|
|
HC Z HI PLATE HUM PXML 234 14-H L
|
Facility
OP
|
$7,417.44
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603737
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,898.22 |
| Rate for Payer: Aetna Commercial |
$6,260.32
|
| Rate for Payer: Aetna Medicare |
$2,447.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,447.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,259.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,636.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,814.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,692.53
|
| Rate for Payer: Cash Price |
$4,598.81
|
| Rate for Payer: Cash Price |
$4,598.81
|
| Rate for Payer: Centivo All Commercial |
$3,782.89
|
| Rate for Payer: Cigna All Commercial |
$6,401.25
|
| Rate for Payer: CORVEL All Commercial |
$6,898.22
|
| Rate for Payer: Coventry All Commercial |
$6,527.35
|
| Rate for Payer: Encore All Commercial |
$6,827.75
|
| Rate for Payer: Frontpath All Commercial |
$6,824.04
|
| Rate for Payer: Humana ChoiceCare |
$6,406.44
|
| Rate for Payer: Humana Medicare |
$3,782.89
|
| Rate for Payer: Lucent All Commercial |
$3,782.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,675.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,563.08
|
| Rate for Payer: PHP All Commercial |
$5,625.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,892.80
|
| Rate for Payer: Sagamore Health Network All Products |
$5,726.26
|
| Rate for Payer: Signature Care EPO |
$6,156.48
|
| Rate for Payer: Signature Care PPO |
$6,527.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,304.82
|
| Rate for Payer: United Healthcare Commercial |
$5,844.94
|
| Rate for Payer: United Healthcare Medicare |
$2,447.76
|
|
|
HC Z HI PLATE HUM PXML 234 14-H L
|
Facility
IP
|
$7,417.44
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603737
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,563.08 |
| Max. Negotiated Rate |
$6,898.22 |
| Rate for Payer: Aetna Commercial |
$6,408.67
|
| Rate for Payer: Cash Price |
$4,598.81
|
| Rate for Payer: Cigna All Commercial |
$6,401.25
|
| Rate for Payer: CORVEL All Commercial |
$6,898.22
|
| Rate for Payer: Coventry All Commercial |
$6,527.35
|
| Rate for Payer: Encore All Commercial |
$6,827.75
|
| Rate for Payer: Frontpath All Commercial |
$6,824.04
|
| Rate for Payer: Humana ChoiceCare |
$6,406.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,675.70
|
| Rate for Payer: PHCS All Commercial |
$5,563.08
|
| Rate for Payer: PHP All Commercial |
$5,625.39
|
| Rate for Payer: Sagamore Health Network All Products |
$5,726.26
|
| Rate for Payer: Signature Care EPO |
$6,156.48
|
| Rate for Payer: Signature Care PPO |
$6,527.35
|
| Rate for Payer: United Healthcare Commercial |
$5,844.94
|
|
|
HC Z HI PLATE HUM PXML 234 14-H R
|
Facility
IP
|
$7,417.44
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,563.08 |
| Max. Negotiated Rate |
$6,898.22 |
| Rate for Payer: Aetna Commercial |
$6,408.67
|
| Rate for Payer: Cash Price |
$4,598.81
|
| Rate for Payer: Cigna All Commercial |
$6,401.25
|
| Rate for Payer: CORVEL All Commercial |
$6,898.22
|
| Rate for Payer: Coventry All Commercial |
$6,527.35
|
| Rate for Payer: Encore All Commercial |
$6,827.75
|
| Rate for Payer: Frontpath All Commercial |
$6,824.04
|
| Rate for Payer: Humana ChoiceCare |
$6,406.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,675.70
|
| Rate for Payer: PHCS All Commercial |
$5,563.08
|
| Rate for Payer: PHP All Commercial |
$5,625.39
|
| Rate for Payer: Sagamore Health Network All Products |
$5,726.26
|
| Rate for Payer: Signature Care EPO |
$6,156.48
|
| Rate for Payer: Signature Care PPO |
$6,527.35
|
| Rate for Payer: United Healthcare Commercial |
$5,844.94
|
|
|
HC Z HI PLATE HUM PXML 234 14-H R
|
Facility
OP
|
$7,417.44
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,898.22 |
| Rate for Payer: Aetna Commercial |
$6,260.32
|
| Rate for Payer: Aetna Medicare |
$2,447.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,447.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,259.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,636.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,814.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,692.53
|
| Rate for Payer: Cash Price |
$4,598.81
|
| Rate for Payer: Cash Price |
$4,598.81
|
| Rate for Payer: Centivo All Commercial |
$3,782.89
|
| Rate for Payer: Cigna All Commercial |
$6,401.25
|
| Rate for Payer: CORVEL All Commercial |
$6,898.22
|
| Rate for Payer: Coventry All Commercial |
$6,527.35
|
| Rate for Payer: Encore All Commercial |
$6,827.75
|
| Rate for Payer: Frontpath All Commercial |
$6,824.04
|
| Rate for Payer: Humana ChoiceCare |
$6,406.44
|
| Rate for Payer: Humana Medicare |
$3,782.89
|
| Rate for Payer: Lucent All Commercial |
$3,782.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,675.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,563.08
|
| Rate for Payer: PHP All Commercial |
$5,625.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,892.80
|
| Rate for Payer: Sagamore Health Network All Products |
$5,726.26
|
| Rate for Payer: Signature Care EPO |
$6,156.48
|
| Rate for Payer: Signature Care PPO |
$6,527.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,304.82
|
| Rate for Payer: United Healthcare Commercial |
$5,844.94
|
| Rate for Payer: United Healthcare Medicare |
$2,447.76
|
|
|
HC Z HI PLATE HUM PXML 80 3-H L
|
Facility
IP
|
$5,159.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603741
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,869.61 |
| Max. Negotiated Rate |
$4,798.32 |
| Rate for Payer: Aetna Commercial |
$4,457.79
|
| Rate for Payer: Cash Price |
$3,198.88
|
| Rate for Payer: Cigna All Commercial |
$4,452.63
|
| Rate for Payer: CORVEL All Commercial |
$4,798.32
|
| Rate for Payer: Coventry All Commercial |
$4,540.34
|
| Rate for Payer: Encore All Commercial |
$4,749.30
|
| Rate for Payer: Frontpath All Commercial |
$4,746.72
|
| Rate for Payer: Humana ChoiceCare |
$4,456.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,643.53
|
| Rate for Payer: PHCS All Commercial |
$3,869.61
|
| Rate for Payer: PHP All Commercial |
$3,912.95
|
| Rate for Payer: Sagamore Health Network All Products |
$3,983.12
|
| Rate for Payer: Signature Care EPO |
$4,282.37
|
| Rate for Payer: Signature Care PPO |
$4,540.34
|
| Rate for Payer: United Healthcare Commercial |
$4,065.67
|
|
|
HC Z HI PLATE HUM PXML 80 3-H L
|
Facility
OP
|
$5,159.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603741
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,798.32 |
| Rate for Payer: Aetna Commercial |
$4,354.60
|
| Rate for Payer: Aetna Medicare |
$1,702.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,702.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,963.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,225.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,958.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,872.89
|
| Rate for Payer: Cash Price |
$3,198.88
|
| Rate for Payer: Cash Price |
$3,198.88
|
| Rate for Payer: Centivo All Commercial |
$2,631.33
|
| Rate for Payer: Cigna All Commercial |
$4,452.63
|
| Rate for Payer: CORVEL All Commercial |
$4,798.32
|
| Rate for Payer: Coventry All Commercial |
$4,540.34
|
| Rate for Payer: Encore All Commercial |
$4,749.30
|
| Rate for Payer: Frontpath All Commercial |
$4,746.72
|
| Rate for Payer: Humana ChoiceCare |
$4,456.24
|
| Rate for Payer: Humana Medicare |
$2,631.33
|
| Rate for Payer: Lucent All Commercial |
$2,631.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,643.53
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,869.61
|
| Rate for Payer: PHP All Commercial |
$3,912.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,012.20
|
| Rate for Payer: Sagamore Health Network All Products |
$3,983.12
|
| Rate for Payer: Signature Care EPO |
$4,282.37
|
| Rate for Payer: Signature Care PPO |
$4,540.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,385.56
|
| Rate for Payer: United Healthcare Commercial |
$4,065.67
|
| Rate for Payer: United Healthcare Medicare |
$1,702.63
|
|
|
HC Z HI PLATE HUM PXML 80 3-H R
|
Facility
OP
|
$5,159.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603736
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,798.32 |
| Rate for Payer: Aetna Commercial |
$4,354.60
|
| Rate for Payer: Aetna Medicare |
$1,702.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,702.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,963.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,225.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,958.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,872.89
|
| Rate for Payer: Cash Price |
$3,198.88
|
| Rate for Payer: Cash Price |
$3,198.88
|
| Rate for Payer: Centivo All Commercial |
$2,631.33
|
| Rate for Payer: Cigna All Commercial |
$4,452.63
|
| Rate for Payer: CORVEL All Commercial |
$4,798.32
|
| Rate for Payer: Coventry All Commercial |
$4,540.34
|
| Rate for Payer: Encore All Commercial |
$4,749.30
|
| Rate for Payer: Frontpath All Commercial |
$4,746.72
|
| Rate for Payer: Humana ChoiceCare |
$4,456.24
|
| Rate for Payer: Humana Medicare |
$2,631.33
|
| Rate for Payer: Lucent All Commercial |
$2,631.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,643.53
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,869.61
|
| Rate for Payer: PHP All Commercial |
$3,912.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,012.20
|
| Rate for Payer: Sagamore Health Network All Products |
$3,983.12
|
| Rate for Payer: Signature Care EPO |
$4,282.37
|
| Rate for Payer: Signature Care PPO |
$4,540.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,385.56
|
| Rate for Payer: United Healthcare Commercial |
$4,065.67
|
| Rate for Payer: United Healthcare Medicare |
$1,702.63
|
|
|
HC Z HI PLATE HUM PXML 80 3-H R
|
Facility
IP
|
$5,159.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603736
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,869.61 |
| Max. Negotiated Rate |
$4,798.32 |
| Rate for Payer: Aetna Commercial |
$4,457.79
|
| Rate for Payer: Cash Price |
$3,198.88
|
| Rate for Payer: Cigna All Commercial |
$4,452.63
|
| Rate for Payer: CORVEL All Commercial |
$4,798.32
|
| Rate for Payer: Coventry All Commercial |
$4,540.34
|
| Rate for Payer: Encore All Commercial |
$4,749.30
|
| Rate for Payer: Frontpath All Commercial |
$4,746.72
|
| Rate for Payer: Humana ChoiceCare |
$4,456.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,643.53
|
| Rate for Payer: PHCS All Commercial |
$3,869.61
|
| Rate for Payer: PHP All Commercial |
$3,912.95
|
| Rate for Payer: Sagamore Health Network All Products |
$3,983.12
|
| Rate for Payer: Signature Care EPO |
$4,282.37
|
| Rate for Payer: Signature Care PPO |
$4,540.34
|
| Rate for Payer: United Healthcare Commercial |
$4,065.67
|
|
|
HC Z HI PLATE HUM PXML 90 4-H L
|
Facility
OP
|
$5,359.46
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,984.30 |
| Rate for Payer: Aetna Commercial |
$4,523.38
|
| Rate for Payer: Aetna Medicare |
$1,768.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,768.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,077.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,350.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,033.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,945.48
|
| Rate for Payer: Cash Price |
$3,322.87
|
| Rate for Payer: Cash Price |
$3,322.87
|
| Rate for Payer: Centivo All Commercial |
$2,733.32
|
| Rate for Payer: Cigna All Commercial |
$4,625.21
|
| Rate for Payer: CORVEL All Commercial |
$4,984.30
|
| Rate for Payer: Coventry All Commercial |
$4,716.32
|
| Rate for Payer: Encore All Commercial |
$4,933.38
|
| Rate for Payer: Frontpath All Commercial |
$4,930.70
|
| Rate for Payer: Humana ChoiceCare |
$4,628.97
|
| Rate for Payer: Humana Medicare |
$2,733.32
|
| Rate for Payer: Lucent All Commercial |
$2,733.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,823.51
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,019.60
|
| Rate for Payer: PHP All Commercial |
$4,064.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,090.19
|
| Rate for Payer: Sagamore Health Network All Products |
$4,137.50
|
| Rate for Payer: Signature Care EPO |
$4,448.35
|
| Rate for Payer: Signature Care PPO |
$4,716.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,555.54
|
| Rate for Payer: United Healthcare Commercial |
$4,223.25
|
| Rate for Payer: United Healthcare Medicare |
$1,768.62
|
|
|
HC Z HI PLATE HUM PXML 90 4-H L
|
Facility
IP
|
$5,359.46
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,019.60 |
| Max. Negotiated Rate |
$4,984.30 |
| Rate for Payer: Aetna Commercial |
$4,630.57
|
| Rate for Payer: Cash Price |
$3,322.87
|
| Rate for Payer: Cigna All Commercial |
$4,625.21
|
| Rate for Payer: CORVEL All Commercial |
$4,984.30
|
| Rate for Payer: Coventry All Commercial |
$4,716.32
|
| Rate for Payer: Encore All Commercial |
$4,933.38
|
| Rate for Payer: Frontpath All Commercial |
$4,930.70
|
| Rate for Payer: Humana ChoiceCare |
$4,628.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,823.51
|
| Rate for Payer: PHCS All Commercial |
$4,019.60
|
| Rate for Payer: PHP All Commercial |
$4,064.61
|
| Rate for Payer: Sagamore Health Network All Products |
$4,137.50
|
| Rate for Payer: Signature Care EPO |
$4,448.35
|
| Rate for Payer: Signature Care PPO |
$4,716.32
|
| Rate for Payer: United Healthcare Commercial |
$4,223.25
|
|
|
HC Z HI PLATE HUM PXML 90 4-H R
|
Facility
IP
|
$5,359.46
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,019.60 |
| Max. Negotiated Rate |
$4,984.30 |
| Rate for Payer: Aetna Commercial |
$4,630.57
|
| Rate for Payer: Cash Price |
$3,322.87
|
| Rate for Payer: Cigna All Commercial |
$4,625.21
|
| Rate for Payer: CORVEL All Commercial |
$4,984.30
|
| Rate for Payer: Coventry All Commercial |
$4,716.32
|
| Rate for Payer: Encore All Commercial |
$4,933.38
|
| Rate for Payer: Frontpath All Commercial |
$4,930.70
|
| Rate for Payer: Humana ChoiceCare |
$4,628.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,823.51
|
| Rate for Payer: PHCS All Commercial |
$4,019.60
|
| Rate for Payer: PHP All Commercial |
$4,064.61
|
| Rate for Payer: Sagamore Health Network All Products |
$4,137.50
|
| Rate for Payer: Signature Care EPO |
$4,448.35
|
| Rate for Payer: Signature Care PPO |
$4,716.32
|
| Rate for Payer: United Healthcare Commercial |
$4,223.25
|
|
|
HC Z HI PLATE HUM PXML 90 4-H R
|
Facility
OP
|
$5,359.46
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,984.30 |
| Rate for Payer: Aetna Commercial |
$4,523.38
|
| Rate for Payer: Aetna Medicare |
$1,768.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,768.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,077.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,350.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,033.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,945.48
|
| Rate for Payer: Cash Price |
$3,322.87
|
| Rate for Payer: Cash Price |
$3,322.87
|
| Rate for Payer: Centivo All Commercial |
$2,733.32
|
| Rate for Payer: Cigna All Commercial |
$4,625.21
|
| Rate for Payer: CORVEL All Commercial |
$4,984.30
|
| Rate for Payer: Coventry All Commercial |
$4,716.32
|
| Rate for Payer: Encore All Commercial |
$4,933.38
|
| Rate for Payer: Frontpath All Commercial |
$4,930.70
|
| Rate for Payer: Humana ChoiceCare |
$4,628.97
|
| Rate for Payer: Humana Medicare |
$2,733.32
|
| Rate for Payer: Lucent All Commercial |
$2,733.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,823.51
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,019.60
|
| Rate for Payer: PHP All Commercial |
$4,064.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,090.19
|
| Rate for Payer: Sagamore Health Network All Products |
$4,137.50
|
| Rate for Payer: Signature Care EPO |
$4,448.35
|
| Rate for Payer: Signature Care PPO |
$4,716.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,555.54
|
| Rate for Payer: United Healthcare Commercial |
$4,223.25
|
| Rate for Payer: United Healthcare Medicare |
$1,768.62
|
|
|
HC Z HMRL BEARING 40 STD
|
Facility
IP
|
$6,292.80
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,719.60 |
| Max. Negotiated Rate |
$5,852.30 |
| Rate for Payer: Aetna Commercial |
$5,436.98
|
| Rate for Payer: Cash Price |
$3,901.54
|
| Rate for Payer: Cigna All Commercial |
$5,430.69
|
| Rate for Payer: CORVEL All Commercial |
$5,852.30
|
| Rate for Payer: Coventry All Commercial |
$5,537.66
|
| Rate for Payer: Encore All Commercial |
$5,792.52
|
| Rate for Payer: Frontpath All Commercial |
$5,789.38
|
| Rate for Payer: Humana ChoiceCare |
$5,435.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,663.52
|
| Rate for Payer: PHCS All Commercial |
$4,719.60
|
| Rate for Payer: PHP All Commercial |
$4,772.46
|
| Rate for Payer: Sagamore Health Network All Products |
$4,858.04
|
| Rate for Payer: Signature Care EPO |
$5,223.02
|
| Rate for Payer: Signature Care PPO |
$5,537.66
|
| Rate for Payer: United Healthcare Commercial |
$4,958.73
|
|
|
HC Z HMRL BEARING 40 STD
|
Facility
OP
|
$6,292.80
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,852.30 |
| Rate for Payer: Aetna Commercial |
$5,311.12
|
| Rate for Payer: Aetna Medicare |
$2,076.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,076.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,613.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,933.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,388.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,284.29
|
| Rate for Payer: Cash Price |
$3,901.54
|
| Rate for Payer: Cash Price |
$3,901.54
|
| Rate for Payer: Centivo All Commercial |
$3,209.33
|
| Rate for Payer: Cigna All Commercial |
$5,430.69
|
| Rate for Payer: CORVEL All Commercial |
$5,852.30
|
| Rate for Payer: Coventry All Commercial |
$5,537.66
|
| Rate for Payer: Encore All Commercial |
$5,792.52
|
| Rate for Payer: Frontpath All Commercial |
$5,789.38
|
| Rate for Payer: Humana ChoiceCare |
$5,435.09
|
| Rate for Payer: Humana Medicare |
$3,209.33
|
| Rate for Payer: Lucent All Commercial |
$3,209.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,663.52
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,719.60
|
| Rate for Payer: PHP All Commercial |
$4,772.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,454.19
|
| Rate for Payer: Sagamore Health Network All Products |
$4,858.04
|
| Rate for Payer: Signature Care EPO |
$5,223.02
|
| Rate for Payer: Signature Care PPO |
$5,537.66
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,348.88
|
| Rate for Payer: United Healthcare Commercial |
$4,958.73
|
| Rate for Payer: United Healthcare Medicare |
$2,076.62
|
|
|
HC Z HMRL BERAING 36MM STD
|
Facility
IP
|
$6,292.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606096
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,719.60 |
| Max. Negotiated Rate |
$5,852.30 |
| Rate for Payer: Aetna Commercial |
$5,436.98
|
| Rate for Payer: Cash Price |
$3,901.54
|
| Rate for Payer: Cigna All Commercial |
$5,430.69
|
| Rate for Payer: CORVEL All Commercial |
$5,852.30
|
| Rate for Payer: Coventry All Commercial |
$5,537.66
|
| Rate for Payer: Encore All Commercial |
$5,792.52
|
| Rate for Payer: Frontpath All Commercial |
$5,789.38
|
| Rate for Payer: Humana ChoiceCare |
$5,435.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,663.52
|
| Rate for Payer: PHCS All Commercial |
$4,719.60
|
| Rate for Payer: PHP All Commercial |
$4,772.46
|
| Rate for Payer: Sagamore Health Network All Products |
$4,858.04
|
| Rate for Payer: Signature Care EPO |
$5,223.02
|
| Rate for Payer: Signature Care PPO |
$5,537.66
|
| Rate for Payer: United Healthcare Commercial |
$4,958.73
|
|
