|
HC Z HUMERAL HD 42X24X42
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605614
|
|
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 42X24X42
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605614
|
|
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 46X18X53
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605615
|
|
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 46X18X53
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605615
|
|
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 46X21X50
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605616
|
|
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 46X21X50
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605616
|
|
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 46X24X47
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605617
|
|
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 46X24X47
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605617
|
|
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 46X27X46
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605618
|
|
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 46X27X46
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605618
|
|
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 48X24
|
Facility
OP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607849
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,590.66
|
| Rate for Payer: Aetna Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,804.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,140.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,513.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,404.51
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Centivo All Commercial |
$3,378.24
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Humana Medicare |
$3,378.24
|
| Rate for Payer: Lucent All Commercial |
$3,378.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,583.36
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,630.40
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
| Rate for Payer: United Healthcare Medicare |
$2,185.92
|
|
|
HC Z HUMERAL HD 48X24
|
Facility
IP
|
$6,624.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607849
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,968.00 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,723.14
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
|
|
HC Z HUMERAL HD 50X21X57
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605619
|
|
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 50X21X57
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605619
|
|
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 50X24X52
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605620
|
|
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 50X24X52
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605620
|
|
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 50X27X50
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605621
|
|
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 50X27X50
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605621
|
|
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 54X21X64
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605622
|
|
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 54X21X64
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605622
|
|
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 54X24X58
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605623
|
|
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 54X24X58
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605623
|
|
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 54X27X55
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605624
|
|
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 54X27X55
|
Facility
OP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605624
|
|
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 58X24X64
|
Facility
IP
|
$6,180.19
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605625
|
|
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
|
|
