|
HC Z HMRL BERAING 36MM STD
|
Facility
OP
|
$6,292.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606096
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| 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 |
$121.68
|
| 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 |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| 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 STEMLESS NANO 34
|
Facility
IP
|
$29,862.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,396.50 |
| Max. Negotiated Rate |
$27,771.66 |
| Rate for Payer: Aetna Commercial |
$25,800.77
|
| Rate for Payer: Cash Price |
$18,514.44
|
| Rate for Payer: Cigna All Commercial |
$25,770.91
|
| Rate for Payer: CORVEL All Commercial |
$27,771.66
|
| Rate for Payer: Coventry All Commercial |
$26,278.56
|
| Rate for Payer: Encore All Commercial |
$27,487.97
|
| Rate for Payer: Frontpath All Commercial |
$27,473.04
|
| Rate for Payer: Humana ChoiceCare |
$25,791.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$26,875.80
|
| Rate for Payer: PHCS All Commercial |
$22,396.50
|
| Rate for Payer: PHP All Commercial |
$22,647.34
|
| Rate for Payer: Sagamore Health Network All Products |
$23,053.46
|
| Rate for Payer: Signature Care EPO |
$24,785.46
|
| Rate for Payer: Signature Care PPO |
$26,278.56
|
| Rate for Payer: United Healthcare Commercial |
$23,531.26
|
|
|
HC Z HMRL STEMLESS NANO 34
|
Facility
OP
|
$29,862.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$27,771.66 |
| Rate for Payer: Aetna Commercial |
$25,203.53
|
| Rate for Payer: Aetna Medicare |
$9,854.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$9,854.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$17,149.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$18,666.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$11,332.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$10,839.91
|
| Rate for Payer: Cash Price |
$18,514.44
|
| Rate for Payer: Cash Price |
$18,514.44
|
| Rate for Payer: Centivo All Commercial |
$15,229.62
|
| Rate for Payer: Cigna All Commercial |
$25,770.91
|
| Rate for Payer: CORVEL All Commercial |
$27,771.66
|
| Rate for Payer: Coventry All Commercial |
$26,278.56
|
| Rate for Payer: Encore All Commercial |
$27,487.97
|
| Rate for Payer: Frontpath All Commercial |
$27,473.04
|
| Rate for Payer: Humana ChoiceCare |
$25,791.81
|
| Rate for Payer: Humana Medicare |
$15,229.62
|
| Rate for Payer: Lucent All Commercial |
$15,229.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$26,875.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$22,396.50
|
| Rate for Payer: PHP All Commercial |
$22,647.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$11,646.18
|
| Rate for Payer: Sagamore Health Network All Products |
$23,053.46
|
| Rate for Payer: Signature Care EPO |
$24,785.46
|
| Rate for Payer: Signature Care PPO |
$26,278.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,382.70
|
| Rate for Payer: United Healthcare Commercial |
$23,531.26
|
| Rate for Payer: United Healthcare Medicare |
$9,854.46
|
|
|
HC Z HMRL STEMLESS NANO 36
|
Facility
OP
|
$29,862.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$27,771.66 |
| Rate for Payer: Aetna Commercial |
$25,203.53
|
| Rate for Payer: Aetna Medicare |
$9,854.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$9,854.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$17,149.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$18,666.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$11,332.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$10,839.91
|
| Rate for Payer: Cash Price |
$18,514.44
|
| Rate for Payer: Cash Price |
$18,514.44
|
| Rate for Payer: Centivo All Commercial |
$15,229.62
|
| Rate for Payer: Cigna All Commercial |
$25,770.91
|
| Rate for Payer: CORVEL All Commercial |
$27,771.66
|
| Rate for Payer: Coventry All Commercial |
$26,278.56
|
| Rate for Payer: Encore All Commercial |
$27,487.97
|
| Rate for Payer: Frontpath All Commercial |
$27,473.04
|
| Rate for Payer: Humana ChoiceCare |
$25,791.81
|
| Rate for Payer: Humana Medicare |
$15,229.62
|
| Rate for Payer: Lucent All Commercial |
$15,229.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$26,875.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$22,396.50
|
| Rate for Payer: PHP All Commercial |
$22,647.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$11,646.18
|
| Rate for Payer: Sagamore Health Network All Products |
$23,053.46
|
| Rate for Payer: Signature Care EPO |
$24,785.46
|
| Rate for Payer: Signature Care PPO |
$26,278.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,382.70
|
| Rate for Payer: United Healthcare Commercial |
$23,531.26
|
| Rate for Payer: United Healthcare Medicare |
$9,854.46
|
|
|
HC Z HMRL STEMLESS NANO 36
|
Facility
IP
|
$29,862.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,396.50 |
| Max. Negotiated Rate |
$27,771.66 |
| Rate for Payer: Aetna Commercial |
$25,800.77
|
| Rate for Payer: Cash Price |
$18,514.44
|
| Rate for Payer: Cigna All Commercial |
$25,770.91
|
| Rate for Payer: CORVEL All Commercial |
$27,771.66
|
| Rate for Payer: Coventry All Commercial |
$26,278.56
|
| Rate for Payer: Encore All Commercial |
$27,487.97
|
| Rate for Payer: Frontpath All Commercial |
$27,473.04
|
| Rate for Payer: Humana ChoiceCare |
$25,791.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$26,875.80
|
| Rate for Payer: PHCS All Commercial |
$22,396.50
|
| Rate for Payer: PHP All Commercial |
$22,647.34
|
| Rate for Payer: Sagamore Health Network All Products |
$23,053.46
|
| Rate for Payer: Signature Care EPO |
$24,785.46
|
| Rate for Payer: Signature Care PPO |
$26,278.56
|
| Rate for Payer: United Healthcare Commercial |
$23,531.26
|
|
|
HC Z HMRL TRAY MINI 40 +3+5
|
Facility
IP
|
$5,299.20
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,974.40 |
| Max. Negotiated Rate |
$4,928.26 |
| Rate for Payer: Aetna Commercial |
$4,578.51
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Cigna All Commercial |
$4,573.21
|
| Rate for Payer: CORVEL All Commercial |
$4,928.26
|
| Rate for Payer: Coventry All Commercial |
$4,663.30
|
| Rate for Payer: Encore All Commercial |
$4,877.91
|
| Rate for Payer: Frontpath All Commercial |
$4,875.26
|
| Rate for Payer: Humana ChoiceCare |
$4,576.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,769.28
|
| Rate for Payer: PHCS All Commercial |
$3,974.40
|
| Rate for Payer: PHP All Commercial |
$4,018.91
|
| Rate for Payer: Sagamore Health Network All Products |
$4,090.98
|
| Rate for Payer: Signature Care EPO |
$4,398.34
|
| Rate for Payer: Signature Care PPO |
$4,663.30
|
| Rate for Payer: United Healthcare Commercial |
$4,175.77
|
|
|
HC Z HMRL TRAY MINI 40 +3+5
|
Facility
OP
|
$5,299.20
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,928.26 |
| Rate for Payer: Aetna Commercial |
$4,472.52
|
| Rate for Payer: Aetna Medicare |
$1,748.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,748.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,043.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,312.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,011.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,923.61
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Centivo All Commercial |
$2,702.59
|
| Rate for Payer: Cigna All Commercial |
$4,573.21
|
| Rate for Payer: CORVEL All Commercial |
$4,928.26
|
| Rate for Payer: Coventry All Commercial |
$4,663.30
|
| Rate for Payer: Encore All Commercial |
$4,877.91
|
| Rate for Payer: Frontpath All Commercial |
$4,875.26
|
| Rate for Payer: Humana ChoiceCare |
$4,576.92
|
| Rate for Payer: Humana Medicare |
$2,702.59
|
| Rate for Payer: Lucent All Commercial |
$2,702.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,769.28
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,974.40
|
| Rate for Payer: PHP All Commercial |
$4,018.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,066.69
|
| Rate for Payer: Sagamore Health Network All Products |
$4,090.98
|
| Rate for Payer: Signature Care EPO |
$4,398.34
|
| Rate for Payer: Signature Care PPO |
$4,663.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,504.32
|
| Rate for Payer: United Healthcare Commercial |
$4,175.77
|
| Rate for Payer: United Healthcare Medicare |
$1,748.74
|
|
|
HC Z HMRL TRAY STD 40MM
|
Facility
OP
|
$5,299.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$4,928.26 |
| Rate for Payer: Aetna Commercial |
$4,472.52
|
| Rate for Payer: Aetna Medicare |
$1,748.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,748.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,043.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,312.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,011.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,923.61
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Centivo All Commercial |
$2,702.59
|
| Rate for Payer: Cigna All Commercial |
$4,573.21
|
| Rate for Payer: CORVEL All Commercial |
$4,928.26
|
| Rate for Payer: Coventry All Commercial |
$4,663.30
|
| Rate for Payer: Encore All Commercial |
$4,877.91
|
| Rate for Payer: Frontpath All Commercial |
$4,875.26
|
| Rate for Payer: Humana ChoiceCare |
$4,576.92
|
| Rate for Payer: Humana Medicare |
$2,702.59
|
| Rate for Payer: Lucent All Commercial |
$2,702.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,769.28
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$3,974.40
|
| Rate for Payer: PHP All Commercial |
$4,018.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,066.69
|
| Rate for Payer: Sagamore Health Network All Products |
$4,090.98
|
| Rate for Payer: Signature Care EPO |
$4,398.34
|
| Rate for Payer: Signature Care PPO |
$4,663.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,504.32
|
| Rate for Payer: United Healthcare Commercial |
$4,175.77
|
| Rate for Payer: United Healthcare Medicare |
$1,748.74
|
|
|
HC Z HMRL TRAY STD 40MM
|
Facility
IP
|
$5,299.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,974.40 |
| Max. Negotiated Rate |
$4,928.26 |
| Rate for Payer: Aetna Commercial |
$4,578.51
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Cigna All Commercial |
$4,573.21
|
| Rate for Payer: CORVEL All Commercial |
$4,928.26
|
| Rate for Payer: Coventry All Commercial |
$4,663.30
|
| Rate for Payer: Encore All Commercial |
$4,877.91
|
| Rate for Payer: Frontpath All Commercial |
$4,875.26
|
| Rate for Payer: Humana ChoiceCare |
$4,576.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,769.28
|
| Rate for Payer: PHCS All Commercial |
$3,974.40
|
| Rate for Payer: PHP All Commercial |
$4,018.91
|
| Rate for Payer: Sagamore Health Network All Products |
$4,090.98
|
| Rate for Payer: Signature Care EPO |
$4,398.34
|
| Rate for Payer: Signature Care PPO |
$4,663.30
|
| Rate for Payer: United Healthcare Commercial |
$4,175.77
|
|
|
HC Z HMRL TRAY STD 40MM +3
|
Facility
IP
|
$5,299.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606973
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,974.40 |
| Max. Negotiated Rate |
$4,928.26 |
| Rate for Payer: Aetna Commercial |
$4,578.51
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Cigna All Commercial |
$4,573.21
|
| Rate for Payer: CORVEL All Commercial |
$4,928.26
|
| Rate for Payer: Coventry All Commercial |
$4,663.30
|
| Rate for Payer: Encore All Commercial |
$4,877.91
|
| Rate for Payer: Frontpath All Commercial |
$4,875.26
|
| Rate for Payer: Humana ChoiceCare |
$4,576.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,769.28
|
| Rate for Payer: PHCS All Commercial |
$3,974.40
|
| Rate for Payer: PHP All Commercial |
$4,018.91
|
| Rate for Payer: Sagamore Health Network All Products |
$4,090.98
|
| Rate for Payer: Signature Care EPO |
$4,398.34
|
| Rate for Payer: Signature Care PPO |
$4,663.30
|
| Rate for Payer: United Healthcare Commercial |
$4,175.77
|
|
|
HC Z HMRL TRAY STD 40MM +3
|
Facility
OP
|
$5,299.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606973
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,928.26 |
| Rate for Payer: Aetna Commercial |
$4,472.52
|
| Rate for Payer: Aetna Medicare |
$1,748.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,748.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,043.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,312.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,011.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,923.61
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Centivo All Commercial |
$2,702.59
|
| Rate for Payer: Cigna All Commercial |
$4,573.21
|
| Rate for Payer: CORVEL All Commercial |
$4,928.26
|
| Rate for Payer: Coventry All Commercial |
$4,663.30
|
| Rate for Payer: Encore All Commercial |
$4,877.91
|
| Rate for Payer: Frontpath All Commercial |
$4,875.26
|
| Rate for Payer: Humana ChoiceCare |
$4,576.92
|
| Rate for Payer: Humana Medicare |
$2,702.59
|
| Rate for Payer: Lucent All Commercial |
$2,702.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,769.28
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,974.40
|
| Rate for Payer: PHP All Commercial |
$4,018.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,066.69
|
| Rate for Payer: Sagamore Health Network All Products |
$4,090.98
|
| Rate for Payer: Signature Care EPO |
$4,398.34
|
| Rate for Payer: Signature Care PPO |
$4,663.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,504.32
|
| Rate for Payer: United Healthcare Commercial |
$4,175.77
|
| Rate for Payer: United Healthcare Medicare |
$1,748.74
|
|
|
HC Z HMRL TRAY STD 40MM +3 MINI
|
Facility
OP
|
$6,127.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607829
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,698.30 |
| Rate for Payer: Aetna Commercial |
$5,171.36
|
| Rate for Payer: Aetna Medicare |
$2,021.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,021.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,518.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,830.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,325.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,224.17
|
| Rate for Payer: Cash Price |
$3,798.86
|
| Rate for Payer: Cash Price |
$3,798.86
|
| Rate for Payer: Centivo All Commercial |
$3,124.87
|
| Rate for Payer: Cigna All Commercial |
$5,287.77
|
| Rate for Payer: CORVEL All Commercial |
$5,698.30
|
| Rate for Payer: Coventry All Commercial |
$5,391.94
|
| Rate for Payer: Encore All Commercial |
$5,640.09
|
| Rate for Payer: Frontpath All Commercial |
$5,637.02
|
| Rate for Payer: Humana ChoiceCare |
$5,292.06
|
| Rate for Payer: Humana Medicare |
$3,124.87
|
| Rate for Payer: Lucent All Commercial |
$3,124.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,514.48
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,595.40
|
| Rate for Payer: PHP All Commercial |
$4,646.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,389.61
|
| Rate for Payer: Sagamore Health Network All Products |
$4,730.20
|
| Rate for Payer: Signature Care EPO |
$5,085.58
|
| Rate for Payer: Signature Care PPO |
$5,391.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,208.12
|
| Rate for Payer: United Healthcare Commercial |
$4,828.23
|
| Rate for Payer: United Healthcare Medicare |
$2,021.98
|
|
|
HC Z HMRL TRAY STD 40MM +3 MINI
|
Facility
IP
|
$6,127.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607829
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,595.40 |
| Max. Negotiated Rate |
$5,698.30 |
| Rate for Payer: Aetna Commercial |
$5,293.90
|
| Rate for Payer: Cash Price |
$3,798.86
|
| Rate for Payer: Cigna All Commercial |
$5,287.77
|
| Rate for Payer: CORVEL All Commercial |
$5,698.30
|
| Rate for Payer: Coventry All Commercial |
$5,391.94
|
| Rate for Payer: Encore All Commercial |
$5,640.09
|
| Rate for Payer: Frontpath All Commercial |
$5,637.02
|
| Rate for Payer: Humana ChoiceCare |
$5,292.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,514.48
|
| Rate for Payer: PHCS All Commercial |
$4,595.40
|
| Rate for Payer: PHP All Commercial |
$4,646.87
|
| Rate for Payer: Sagamore Health Network All Products |
$4,730.20
|
| Rate for Payer: Signature Care EPO |
$5,085.58
|
| Rate for Payer: Signature Care PPO |
$5,391.94
|
| Rate for Payer: United Healthcare Commercial |
$4,828.23
|
|
|
HC Z HMRL TRAY STD 40MM +6
|
Facility
OP
|
$5,299.20
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607871
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,928.26 |
| Rate for Payer: Aetna Commercial |
$4,472.52
|
| Rate for Payer: Aetna Medicare |
$1,748.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,748.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,043.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,312.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,011.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,923.61
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Centivo All Commercial |
$2,702.59
|
| Rate for Payer: Cigna All Commercial |
$4,573.21
|
| Rate for Payer: CORVEL All Commercial |
$4,928.26
|
| Rate for Payer: Coventry All Commercial |
$4,663.30
|
| Rate for Payer: Encore All Commercial |
$4,877.91
|
| Rate for Payer: Frontpath All Commercial |
$4,875.26
|
| Rate for Payer: Humana ChoiceCare |
$4,576.92
|
| Rate for Payer: Humana Medicare |
$2,702.59
|
| Rate for Payer: Lucent All Commercial |
$2,702.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,769.28
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,974.40
|
| Rate for Payer: PHP All Commercial |
$4,018.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,066.69
|
| Rate for Payer: Sagamore Health Network All Products |
$4,090.98
|
| Rate for Payer: Signature Care EPO |
$4,398.34
|
| Rate for Payer: Signature Care PPO |
$4,663.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,504.32
|
| Rate for Payer: United Healthcare Commercial |
$4,175.77
|
| Rate for Payer: United Healthcare Medicare |
$1,748.74
|
|
|
HC Z HMRL TRAY STD 40MM +6
|
Facility
IP
|
$5,299.20
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607871
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,974.40 |
| Max. Negotiated Rate |
$4,928.26 |
| Rate for Payer: Aetna Commercial |
$4,578.51
|
| Rate for Payer: Cash Price |
$3,285.50
|
| Rate for Payer: Cigna All Commercial |
$4,573.21
|
| Rate for Payer: CORVEL All Commercial |
$4,928.26
|
| Rate for Payer: Coventry All Commercial |
$4,663.30
|
| Rate for Payer: Encore All Commercial |
$4,877.91
|
| Rate for Payer: Frontpath All Commercial |
$4,875.26
|
| Rate for Payer: Humana ChoiceCare |
$4,576.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,769.28
|
| Rate for Payer: PHCS All Commercial |
$3,974.40
|
| Rate for Payer: PHP All Commercial |
$4,018.91
|
| Rate for Payer: Sagamore Health Network All Products |
$4,090.98
|
| Rate for Payer: Signature Care EPO |
$4,398.34
|
| Rate for Payer: Signature Care PPO |
$4,663.30
|
| Rate for Payer: United Healthcare Commercial |
$4,175.77
|
|
|
HC Z HUMERAL BRG 36 VITE +3
|
Facility
OP
|
$6,292.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606113
|
|
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 HUMERAL BRG 36 VITE +3
|
Facility
IP
|
$6,292.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606113
|
|
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 HUMERAL HD 38X19X39
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605610
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,635.14 |
| Max. Negotiated Rate |
$5,747.58 |
| Rate for Payer: Aetna Commercial |
$5,339.68
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Cigna All Commercial |
$5,333.50
|
| Rate for Payer: CORVEL All Commercial |
$5,747.58
|
| Rate for Payer: Coventry All Commercial |
$5,438.57
|
| Rate for Payer: Encore All Commercial |
$5,688.86
|
| Rate for Payer: Frontpath All Commercial |
$5,685.77
|
| Rate for Payer: Humana ChoiceCare |
$5,337.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,562.17
|
| Rate for Payer: PHCS All Commercial |
$4,635.14
|
| Rate for Payer: PHP All Commercial |
$4,687.06
|
| Rate for Payer: Sagamore Health Network All Products |
$4,771.11
|
| Rate for Payer: Signature Care EPO |
$5,129.56
|
| Rate for Payer: Signature Care PPO |
$5,438.57
|
| Rate for Payer: United Healthcare Commercial |
$4,869.99
|
|
|
HC Z HUMERAL HD 38X19X39
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605610
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,747.58 |
| Rate for Payer: Aetna Commercial |
$5,216.08
|
| Rate for Payer: Aetna Medicare |
$2,039.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,039.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,549.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,863.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,345.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,243.41
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Centivo All Commercial |
$3,151.90
|
| Rate for Payer: Cigna All Commercial |
$5,333.50
|
| Rate for Payer: CORVEL All Commercial |
$5,747.58
|
| Rate for Payer: Coventry All Commercial |
$5,438.57
|
| Rate for Payer: Encore All Commercial |
$5,688.86
|
| Rate for Payer: Frontpath All Commercial |
$5,685.77
|
| Rate for Payer: Humana ChoiceCare |
$5,337.83
|
| Rate for Payer: Humana Medicare |
$3,151.90
|
| Rate for Payer: Lucent All Commercial |
$3,151.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,562.17
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,635.14
|
| Rate for Payer: PHP All Commercial |
$4,687.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,410.27
|
| Rate for Payer: Sagamore Health Network All Products |
$4,771.11
|
| Rate for Payer: Signature Care EPO |
$5,129.56
|
| Rate for Payer: Signature Care PPO |
$5,438.57
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,253.16
|
| Rate for Payer: United Healthcare Commercial |
$4,869.99
|
| Rate for Payer: United Healthcare Medicare |
$2,039.46
|
|
|
HC Z HUMERAL HD 38X21X38
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,747.58 |
| Rate for Payer: Aetna Commercial |
$5,216.08
|
| Rate for Payer: Aetna Medicare |
$2,039.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,039.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,549.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,863.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,345.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,243.41
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Centivo All Commercial |
$3,151.90
|
| Rate for Payer: Cigna All Commercial |
$5,333.50
|
| Rate for Payer: CORVEL All Commercial |
$5,747.58
|
| Rate for Payer: Coventry All Commercial |
$5,438.57
|
| Rate for Payer: Encore All Commercial |
$5,688.86
|
| Rate for Payer: Frontpath All Commercial |
$5,685.77
|
| Rate for Payer: Humana ChoiceCare |
$5,337.83
|
| Rate for Payer: Humana Medicare |
$3,151.90
|
| Rate for Payer: Lucent All Commercial |
$3,151.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,562.17
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,635.14
|
| Rate for Payer: PHP All Commercial |
$4,687.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,410.27
|
| Rate for Payer: Sagamore Health Network All Products |
$4,771.11
|
| Rate for Payer: Signature Care EPO |
$5,129.56
|
| Rate for Payer: Signature Care PPO |
$5,438.57
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,253.16
|
| Rate for Payer: United Healthcare Commercial |
$4,869.99
|
| Rate for Payer: United Healthcare Medicare |
$2,039.46
|
|
|
HC Z HUMERAL HD 38X21X38
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,635.14 |
| Max. Negotiated Rate |
$5,747.58 |
| Rate for Payer: Aetna Commercial |
$5,339.68
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Cigna All Commercial |
$5,333.50
|
| Rate for Payer: CORVEL All Commercial |
$5,747.58
|
| Rate for Payer: Coventry All Commercial |
$5,438.57
|
| Rate for Payer: Encore All Commercial |
$5,688.86
|
| Rate for Payer: Frontpath All Commercial |
$5,685.77
|
| Rate for Payer: Humana ChoiceCare |
$5,337.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,562.17
|
| Rate for Payer: PHCS All Commercial |
$4,635.14
|
| Rate for Payer: PHP All Commercial |
$4,687.06
|
| Rate for Payer: Sagamore Health Network All Products |
$4,771.11
|
| Rate for Payer: Signature Care EPO |
$5,129.56
|
| Rate for Payer: Signature Care PPO |
$5,438.57
|
| Rate for Payer: United Healthcare Commercial |
$4,869.99
|
|
|
HC Z HUMERAL HD 42X18X46
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605612
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,747.58 |
| Rate for Payer: Aetna Commercial |
$5,216.08
|
| Rate for Payer: Aetna Medicare |
$2,039.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,039.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,549.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,863.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,345.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,243.41
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Centivo All Commercial |
$3,151.90
|
| Rate for Payer: Cigna All Commercial |
$5,333.50
|
| Rate for Payer: CORVEL All Commercial |
$5,747.58
|
| Rate for Payer: Coventry All Commercial |
$5,438.57
|
| Rate for Payer: Encore All Commercial |
$5,688.86
|
| Rate for Payer: Frontpath All Commercial |
$5,685.77
|
| Rate for Payer: Humana ChoiceCare |
$5,337.83
|
| Rate for Payer: Humana Medicare |
$3,151.90
|
| Rate for Payer: Lucent All Commercial |
$3,151.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,562.17
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,635.14
|
| Rate for Payer: PHP All Commercial |
$4,687.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,410.27
|
| Rate for Payer: Sagamore Health Network All Products |
$4,771.11
|
| Rate for Payer: Signature Care EPO |
$5,129.56
|
| Rate for Payer: Signature Care PPO |
$5,438.57
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,253.16
|
| Rate for Payer: United Healthcare Commercial |
$4,869.99
|
| Rate for Payer: United Healthcare Medicare |
$2,039.46
|
|
|
HC Z HUMERAL HD 42X18X46
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605612
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,635.14 |
| Max. Negotiated Rate |
$5,747.58 |
| Rate for Payer: Aetna Commercial |
$5,339.68
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Cigna All Commercial |
$5,333.50
|
| Rate for Payer: CORVEL All Commercial |
$5,747.58
|
| Rate for Payer: Coventry All Commercial |
$5,438.57
|
| Rate for Payer: Encore All Commercial |
$5,688.86
|
| Rate for Payer: Frontpath All Commercial |
$5,685.77
|
| Rate for Payer: Humana ChoiceCare |
$5,337.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,562.17
|
| Rate for Payer: PHCS All Commercial |
$4,635.14
|
| Rate for Payer: PHP All Commercial |
$4,687.06
|
| Rate for Payer: Sagamore Health Network All Products |
$4,771.11
|
| Rate for Payer: Signature Care EPO |
$5,129.56
|
| Rate for Payer: Signature Care PPO |
$5,438.57
|
| Rate for Payer: United Healthcare Commercial |
$4,869.99
|
|
|
HC Z HUMERAL HD 42X21X43
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605613
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,635.14 |
| Max. Negotiated Rate |
$5,747.58 |
| Rate for Payer: Aetna Commercial |
$5,339.68
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Cigna All Commercial |
$5,333.50
|
| Rate for Payer: CORVEL All Commercial |
$5,747.58
|
| Rate for Payer: Coventry All Commercial |
$5,438.57
|
| Rate for Payer: Encore All Commercial |
$5,688.86
|
| Rate for Payer: Frontpath All Commercial |
$5,685.77
|
| Rate for Payer: Humana ChoiceCare |
$5,337.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,562.17
|
| Rate for Payer: PHCS All Commercial |
$4,635.14
|
| Rate for Payer: PHP All Commercial |
$4,687.06
|
| Rate for Payer: Sagamore Health Network All Products |
$4,771.11
|
| Rate for Payer: Signature Care EPO |
$5,129.56
|
| Rate for Payer: Signature Care PPO |
$5,438.57
|
| Rate for Payer: United Healthcare Commercial |
$4,869.99
|
|
|
HC Z HUMERAL HD 42X21X43
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605613
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,747.58 |
| Rate for Payer: Aetna Commercial |
$5,216.08
|
| Rate for Payer: Aetna Medicare |
$2,039.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,039.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,549.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,863.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,345.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,243.41
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Cash Price |
$3,831.72
|
| Rate for Payer: Centivo All Commercial |
$3,151.90
|
| Rate for Payer: Cigna All Commercial |
$5,333.50
|
| Rate for Payer: CORVEL All Commercial |
$5,747.58
|
| Rate for Payer: Coventry All Commercial |
$5,438.57
|
| Rate for Payer: Encore All Commercial |
$5,688.86
|
| Rate for Payer: Frontpath All Commercial |
$5,685.77
|
| Rate for Payer: Humana ChoiceCare |
$5,337.83
|
| Rate for Payer: Humana Medicare |
$3,151.90
|
| Rate for Payer: Lucent All Commercial |
$3,151.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,562.17
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,635.14
|
| Rate for Payer: PHP All Commercial |
$4,687.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,410.27
|
| Rate for Payer: Sagamore Health Network All Products |
$4,771.11
|
| Rate for Payer: Signature Care EPO |
$5,129.56
|
| Rate for Payer: Signature Care PPO |
$5,438.57
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,253.16
|
| Rate for Payer: United Healthcare Commercial |
$4,869.99
|
| Rate for Payer: United Healthcare Medicare |
$2,039.46
|
|
