|
HC Z HUM SLEEVE 13MM
|
Facility
OP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.75 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,024.95
|
| Rate for Payer: Aetna Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$697.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$759.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.83
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Centivo All Commercial |
$619.34
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Humana Medicare |
$619.34
|
| Rate for Payer: Lucent All Commercial |
$619.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$473.62
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,032.24
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
| Rate for Payer: United Healthcare Medicare |
$400.75
|
|
|
HC Z HUM SLEEVE 13MM
|
Facility
IP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$910.80 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,049.24
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
|
|
HC Z HUM SLEEVE 14MM
|
Facility
IP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$910.80 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,049.24
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
|
|
HC Z HUM SLEEVE 14MM
|
Facility
OP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.75 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,024.95
|
| Rate for Payer: Aetna Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$697.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$759.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.83
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Centivo All Commercial |
$619.34
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Humana Medicare |
$619.34
|
| Rate for Payer: Lucent All Commercial |
$619.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$473.62
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,032.24
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
| Rate for Payer: United Healthcare Medicare |
$400.75
|
|
|
HC Z HUM SLEEVE 15MM
|
Facility
IP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$910.80 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,049.24
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
|
|
HC Z HUM SLEEVE 15MM
|
Facility
OP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.75 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,024.95
|
| Rate for Payer: Aetna Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$697.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$759.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.83
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Centivo All Commercial |
$619.34
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Humana Medicare |
$619.34
|
| Rate for Payer: Lucent All Commercial |
$619.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$473.62
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,032.24
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
| Rate for Payer: United Healthcare Medicare |
$400.75
|
|
|
HC Z HUM SLEEVE 16MM
|
Facility
IP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605650
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$910.80 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,049.24
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
|
|
HC Z HUM SLEEVE 16MM
|
Facility
OP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605650
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.75 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,024.95
|
| Rate for Payer: Aetna Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$697.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$759.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.83
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Centivo All Commercial |
$619.34
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Humana Medicare |
$619.34
|
| Rate for Payer: Lucent All Commercial |
$619.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$473.62
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,032.24
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
| Rate for Payer: United Healthcare Medicare |
$400.75
|
|
|
HC Z HUM SLEEVE 17MM
|
Facility
OP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605651
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.75 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,024.95
|
| Rate for Payer: Aetna Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$697.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$759.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.83
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Centivo All Commercial |
$619.34
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Humana Medicare |
$619.34
|
| Rate for Payer: Lucent All Commercial |
$619.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$473.62
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,032.24
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
| Rate for Payer: United Healthcare Medicare |
$400.75
|
|
|
HC Z HUM SLEEVE 17MM
|
Facility
IP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605651
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$910.80 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,049.24
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
|
|
HC Z HUM SLEEVE 6MM
|
Facility
OP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.75 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,024.95
|
| Rate for Payer: Aetna Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$697.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$759.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.83
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Centivo All Commercial |
$619.34
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Humana Medicare |
$619.34
|
| Rate for Payer: Lucent All Commercial |
$619.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$473.62
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,032.24
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
| Rate for Payer: United Healthcare Medicare |
$400.75
|
|
|
HC Z HUM SLEEVE 6MM
|
Facility
IP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$910.80 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,049.24
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
|
|
HC Z HUM SLEEVE 7MM
|
Facility
IP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605641
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$910.80 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,049.24
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
|
|
HC Z HUM SLEEVE 7MM
|
Facility
OP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605641
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.75 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,024.95
|
| Rate for Payer: Aetna Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$697.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$759.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.83
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Centivo All Commercial |
$619.34
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Humana Medicare |
$619.34
|
| Rate for Payer: Lucent All Commercial |
$619.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$473.62
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,032.24
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
| Rate for Payer: United Healthcare Medicare |
$400.75
|
|
|
HC Z HUM SLEEVE 8MM
|
Facility
OP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605642
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.75 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,024.95
|
| Rate for Payer: Aetna Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$697.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$759.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.83
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Centivo All Commercial |
$619.34
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Humana Medicare |
$619.34
|
| Rate for Payer: Lucent All Commercial |
$619.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$473.62
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,032.24
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
| Rate for Payer: United Healthcare Medicare |
$400.75
|
|
|
HC Z HUM SLEEVE 8MM
|
Facility
IP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605642
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$910.80 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,049.24
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
|
|
HC Z HUM SLEEVE 9MM
|
Facility
IP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605643
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$910.80 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,049.24
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
|
|
HC Z HUM SLEEVE 9MM
|
Facility
OP
|
$1,214.40
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605643
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.75 |
| Max. Negotiated Rate |
$1,129.39 |
| Rate for Payer: Aetna Commercial |
$1,024.95
|
| Rate for Payer: Aetna Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$400.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$697.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$759.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$460.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$440.83
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Cash Price |
$752.93
|
| Rate for Payer: Centivo All Commercial |
$619.34
|
| Rate for Payer: Cigna All Commercial |
$1,048.03
|
| Rate for Payer: CORVEL All Commercial |
$1,129.39
|
| Rate for Payer: Coventry All Commercial |
$1,068.67
|
| Rate for Payer: Encore All Commercial |
$1,117.86
|
| Rate for Payer: Frontpath All Commercial |
$1,117.25
|
| Rate for Payer: Humana ChoiceCare |
$1,048.88
|
| Rate for Payer: Humana Medicare |
$619.34
|
| Rate for Payer: Lucent All Commercial |
$619.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,092.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$910.80
|
| Rate for Payer: PHP All Commercial |
$921.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$473.62
|
| Rate for Payer: Sagamore Health Network All Products |
$937.52
|
| Rate for Payer: Signature Care EPO |
$1,007.95
|
| Rate for Payer: Signature Care PPO |
$1,068.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,032.24
|
| Rate for Payer: United Healthcare Commercial |
$956.95
|
| Rate for Payer: United Healthcare Medicare |
$400.75
|
|
|
HC Z HUM STEM 10 MICRO
|
Facility
OP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608266
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$15,400.80 |
| Rate for Payer: Aetna Commercial |
$13,976.64
|
| Rate for Payer: Aetna Medicare |
$5,464.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,464.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,510.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,351.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,284.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,011.28
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Centivo All Commercial |
$8,445.60
|
| Rate for Payer: Cigna All Commercial |
$14,291.28
|
| Rate for Payer: CORVEL All Commercial |
$15,400.80
|
| Rate for Payer: Coventry All Commercial |
$14,572.80
|
| Rate for Payer: Encore All Commercial |
$15,243.48
|
| Rate for Payer: Frontpath All Commercial |
$15,235.20
|
| Rate for Payer: Humana ChoiceCare |
$14,302.87
|
| Rate for Payer: Humana Medicare |
$8,445.60
|
| Rate for Payer: Lucent All Commercial |
$8,445.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,904.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$12,420.00
|
| Rate for Payer: PHP All Commercial |
$12,559.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,458.40
|
| Rate for Payer: Sagamore Health Network All Products |
$12,784.32
|
| Rate for Payer: Signature Care EPO |
$13,744.80
|
| Rate for Payer: Signature Care PPO |
$14,572.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,076.00
|
| Rate for Payer: United Healthcare Commercial |
$13,049.28
|
| Rate for Payer: United Healthcare Medicare |
$5,464.80
|
|
|
HC Z HUM STEM 10 MICRO
|
Facility
IP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608266
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,420.00 |
| Max. Negotiated Rate |
$15,400.80 |
| Rate for Payer: Aetna Commercial |
$14,307.84
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Cigna All Commercial |
$14,291.28
|
| Rate for Payer: CORVEL All Commercial |
$15,400.80
|
| Rate for Payer: Coventry All Commercial |
$14,572.80
|
| Rate for Payer: Encore All Commercial |
$15,243.48
|
| Rate for Payer: Frontpath All Commercial |
$15,235.20
|
| Rate for Payer: Humana ChoiceCare |
$14,302.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,904.00
|
| Rate for Payer: PHCS All Commercial |
$12,420.00
|
| Rate for Payer: PHP All Commercial |
$12,559.10
|
| Rate for Payer: Sagamore Health Network All Products |
$12,784.32
|
| Rate for Payer: Signature Care EPO |
$13,744.80
|
| Rate for Payer: Signature Care PPO |
$14,572.80
|
| Rate for Payer: United Healthcare Commercial |
$13,049.28
|
|
|
HC Z HUM STEM 10 STD
|
Facility
OP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608320
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$15,400.80 |
| Rate for Payer: Aetna Commercial |
$13,976.64
|
| Rate for Payer: Aetna Medicare |
$5,464.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,464.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,510.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,351.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,284.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,011.28
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Centivo All Commercial |
$8,445.60
|
| Rate for Payer: Cigna All Commercial |
$14,291.28
|
| Rate for Payer: CORVEL All Commercial |
$15,400.80
|
| Rate for Payer: Coventry All Commercial |
$14,572.80
|
| Rate for Payer: Encore All Commercial |
$15,243.48
|
| Rate for Payer: Frontpath All Commercial |
$15,235.20
|
| Rate for Payer: Humana ChoiceCare |
$14,302.87
|
| Rate for Payer: Humana Medicare |
$8,445.60
|
| Rate for Payer: Lucent All Commercial |
$8,445.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,904.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$12,420.00
|
| Rate for Payer: PHP All Commercial |
$12,559.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,458.40
|
| Rate for Payer: Sagamore Health Network All Products |
$12,784.32
|
| Rate for Payer: Signature Care EPO |
$13,744.80
|
| Rate for Payer: Signature Care PPO |
$14,572.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,076.00
|
| Rate for Payer: United Healthcare Commercial |
$13,049.28
|
| Rate for Payer: United Healthcare Medicare |
$5,464.80
|
|
|
HC Z HUM STEM 10 STD
|
Facility
IP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608320
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,420.00 |
| Max. Negotiated Rate |
$15,400.80 |
| Rate for Payer: Aetna Commercial |
$14,307.84
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Cigna All Commercial |
$14,291.28
|
| Rate for Payer: CORVEL All Commercial |
$15,400.80
|
| Rate for Payer: Coventry All Commercial |
$14,572.80
|
| Rate for Payer: Encore All Commercial |
$15,243.48
|
| Rate for Payer: Frontpath All Commercial |
$15,235.20
|
| Rate for Payer: Humana ChoiceCare |
$14,302.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,904.00
|
| Rate for Payer: PHCS All Commercial |
$12,420.00
|
| Rate for Payer: PHP All Commercial |
$12,559.10
|
| Rate for Payer: Sagamore Health Network All Products |
$12,784.32
|
| Rate for Payer: Signature Care EPO |
$13,744.80
|
| Rate for Payer: Signature Care PPO |
$14,572.80
|
| Rate for Payer: United Healthcare Commercial |
$13,049.28
|
|
|
HC Z HUM STEM 12 MICRO
|
Facility
IP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,420.00 |
| Max. Negotiated Rate |
$15,400.80 |
| Rate for Payer: Aetna Commercial |
$14,307.84
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Cigna All Commercial |
$14,291.28
|
| Rate for Payer: CORVEL All Commercial |
$15,400.80
|
| Rate for Payer: Coventry All Commercial |
$14,572.80
|
| Rate for Payer: Encore All Commercial |
$15,243.48
|
| Rate for Payer: Frontpath All Commercial |
$15,235.20
|
| Rate for Payer: Humana ChoiceCare |
$14,302.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,904.00
|
| Rate for Payer: PHCS All Commercial |
$12,420.00
|
| Rate for Payer: PHP All Commercial |
$12,559.10
|
| Rate for Payer: Sagamore Health Network All Products |
$12,784.32
|
| Rate for Payer: Signature Care EPO |
$13,744.80
|
| Rate for Payer: Signature Care PPO |
$14,572.80
|
| Rate for Payer: United Healthcare Commercial |
$13,049.28
|
|
|
HC Z HUM STEM 12 MICRO
|
Facility
OP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$15,400.80 |
| Rate for Payer: Aetna Commercial |
$13,976.64
|
| Rate for Payer: Aetna Medicare |
$5,464.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,464.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,510.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,351.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,284.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,011.28
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Centivo All Commercial |
$8,445.60
|
| Rate for Payer: Cigna All Commercial |
$14,291.28
|
| Rate for Payer: CORVEL All Commercial |
$15,400.80
|
| Rate for Payer: Coventry All Commercial |
$14,572.80
|
| Rate for Payer: Encore All Commercial |
$15,243.48
|
| Rate for Payer: Frontpath All Commercial |
$15,235.20
|
| Rate for Payer: Humana ChoiceCare |
$14,302.87
|
| Rate for Payer: Humana Medicare |
$8,445.60
|
| Rate for Payer: Lucent All Commercial |
$8,445.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,904.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$12,420.00
|
| Rate for Payer: PHP All Commercial |
$12,559.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,458.40
|
| Rate for Payer: Sagamore Health Network All Products |
$12,784.32
|
| Rate for Payer: Signature Care EPO |
$13,744.80
|
| Rate for Payer: Signature Care PPO |
$14,572.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,076.00
|
| Rate for Payer: United Healthcare Commercial |
$13,049.28
|
| Rate for Payer: United Healthcare Medicare |
$5,464.80
|
|
|
HC Z HUM STEM 12 STD
|
Facility
OP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608332
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$15,400.80 |
| Rate for Payer: Aetna Commercial |
$13,976.64
|
| Rate for Payer: Aetna Medicare |
$5,464.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,464.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,510.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,351.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,284.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,011.28
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Cash Price |
$10,267.20
|
| Rate for Payer: Centivo All Commercial |
$8,445.60
|
| Rate for Payer: Cigna All Commercial |
$14,291.28
|
| Rate for Payer: CORVEL All Commercial |
$15,400.80
|
| Rate for Payer: Coventry All Commercial |
$14,572.80
|
| Rate for Payer: Encore All Commercial |
$15,243.48
|
| Rate for Payer: Frontpath All Commercial |
$15,235.20
|
| Rate for Payer: Humana ChoiceCare |
$14,302.87
|
| Rate for Payer: Humana Medicare |
$8,445.60
|
| Rate for Payer: Lucent All Commercial |
$8,445.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,904.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$12,420.00
|
| Rate for Payer: PHP All Commercial |
$12,559.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,458.40
|
| Rate for Payer: Sagamore Health Network All Products |
$12,784.32
|
| Rate for Payer: Signature Care EPO |
$13,744.80
|
| Rate for Payer: Signature Care PPO |
$14,572.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,076.00
|
| Rate for Payer: United Healthcare Commercial |
$13,049.28
|
| Rate for Payer: United Healthcare Medicare |
$5,464.80
|
|
