|
HC Z HUM STEM 12 STD
|
Facility
IP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608332
|
|
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 13 MICRO
|
Facility
IP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608226
|
|
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 13 MICRO
|
Facility
OP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608226
|
|
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 14 MICRO
|
Facility
IP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608170
|
|
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 14 MICRO
|
Facility
OP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608170
|
|
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 15 MICRO
|
Facility
IP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608290
|
|
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 15 MICRO
|
Facility
OP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608290
|
|
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 8 MICRO
|
Facility
OP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608339
|
|
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 8 MICRO
|
Facility
IP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608339
|
|
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 ADAP 135
|
Facility
OP
|
$2,370.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,204.10 |
| Rate for Payer: Aetna Commercial |
$2,000.28
|
| Rate for Payer: Aetna Medicare |
$782.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$782.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,361.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,481.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$899.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$860.31
|
| Rate for Payer: Cash Price |
$1,469.40
|
| Rate for Payer: Cash Price |
$1,469.40
|
| Rate for Payer: Centivo All Commercial |
$1,208.70
|
| Rate for Payer: Cigna All Commercial |
$2,045.31
|
| Rate for Payer: CORVEL All Commercial |
$2,204.10
|
| Rate for Payer: Coventry All Commercial |
$2,085.60
|
| Rate for Payer: Encore All Commercial |
$2,181.58
|
| Rate for Payer: Frontpath All Commercial |
$2,180.40
|
| Rate for Payer: Humana ChoiceCare |
$2,046.97
|
| Rate for Payer: Humana Medicare |
$1,208.70
|
| Rate for Payer: Lucent All Commercial |
$1,208.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,133.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,777.50
|
| Rate for Payer: PHP All Commercial |
$1,797.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$924.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,829.64
|
| Rate for Payer: Signature Care EPO |
$1,967.10
|
| Rate for Payer: Signature Care PPO |
$2,085.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,014.50
|
| Rate for Payer: United Healthcare Commercial |
$1,867.56
|
| Rate for Payer: United Healthcare Medicare |
$782.10
|
|
|
HC Z HUM STEM ADAP 135
|
Facility
IP
|
$2,370.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,777.50 |
| Max. Negotiated Rate |
$2,204.10 |
| Rate for Payer: Aetna Commercial |
$2,047.68
|
| Rate for Payer: Cash Price |
$1,469.40
|
| Rate for Payer: Cigna All Commercial |
$2,045.31
|
| Rate for Payer: CORVEL All Commercial |
$2,204.10
|
| Rate for Payer: Coventry All Commercial |
$2,085.60
|
| Rate for Payer: Encore All Commercial |
$2,181.58
|
| Rate for Payer: Frontpath All Commercial |
$2,180.40
|
| Rate for Payer: Humana ChoiceCare |
$2,046.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,133.00
|
| Rate for Payer: PHCS All Commercial |
$1,777.50
|
| Rate for Payer: PHP All Commercial |
$1,797.41
|
| Rate for Payer: Sagamore Health Network All Products |
$1,829.64
|
| Rate for Payer: Signature Care EPO |
$1,967.10
|
| Rate for Payer: Signature Care PPO |
$2,085.60
|
| Rate for Payer: United Healthcare Commercial |
$1,867.56
|
|
|
HC Z HUM STEM MICRO 11
|
Facility
OP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608220
|
|
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 MICRO 11
|
Facility
IP
|
$16,560.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608220
|
|
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 TRAY -6
|
Facility
OP
|
$8,694.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,085.42 |
| Rate for Payer: Aetna Commercial |
$7,337.74
|
| Rate for Payer: Aetna Medicare |
$2,869.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,869.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,992.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,434.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,299.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,155.92
|
| Rate for Payer: Cash Price |
$5,390.28
|
| Rate for Payer: Cash Price |
$5,390.28
|
| Rate for Payer: Centivo All Commercial |
$4,433.94
|
| Rate for Payer: Cigna All Commercial |
$7,502.92
|
| Rate for Payer: CORVEL All Commercial |
$8,085.42
|
| Rate for Payer: Coventry All Commercial |
$7,650.72
|
| Rate for Payer: Encore All Commercial |
$8,002.83
|
| Rate for Payer: Frontpath All Commercial |
$7,998.48
|
| Rate for Payer: Humana ChoiceCare |
$7,509.01
|
| Rate for Payer: Humana Medicare |
$4,433.94
|
| Rate for Payer: Lucent All Commercial |
$4,433.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,824.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,520.50
|
| Rate for Payer: PHP All Commercial |
$6,593.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,390.66
|
| Rate for Payer: Sagamore Health Network All Products |
$6,711.77
|
| Rate for Payer: Signature Care EPO |
$7,216.02
|
| Rate for Payer: Signature Care PPO |
$7,650.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,389.90
|
| Rate for Payer: United Healthcare Commercial |
$6,850.87
|
| Rate for Payer: United Healthcare Medicare |
$2,869.02
|
|
|
HC Z HUM TRAY -6
|
Facility
IP
|
$8,694.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,520.50 |
| Max. Negotiated Rate |
$8,085.42 |
| Rate for Payer: Aetna Commercial |
$7,511.62
|
| Rate for Payer: Cash Price |
$5,390.28
|
| Rate for Payer: Cigna All Commercial |
$7,502.92
|
| Rate for Payer: CORVEL All Commercial |
$8,085.42
|
| Rate for Payer: Coventry All Commercial |
$7,650.72
|
| Rate for Payer: Encore All Commercial |
$8,002.83
|
| Rate for Payer: Frontpath All Commercial |
$7,998.48
|
| Rate for Payer: Humana ChoiceCare |
$7,509.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,824.60
|
| Rate for Payer: PHCS All Commercial |
$6,520.50
|
| Rate for Payer: PHP All Commercial |
$6,593.53
|
| Rate for Payer: Sagamore Health Network All Products |
$6,711.77
|
| Rate for Payer: Signature Care EPO |
$7,216.02
|
| Rate for Payer: Signature Care PPO |
$7,650.72
|
| Rate for Payer: United Healthcare Commercial |
$6,850.87
|
|
|
HC ZINC
|
Facility
IP
|
$153.67
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
63001718
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$115.25 |
| Max. Negotiated Rate |
$142.92 |
| Rate for Payer: Cigna All Commercial |
$132.62
|
| Rate for Payer: Aetna Commercial |
$132.77
|
| Rate for Payer: Cash Price |
$95.28
|
| Rate for Payer: CORVEL All Commercial |
$142.92
|
| Rate for Payer: Coventry All Commercial |
$135.23
|
| Rate for Payer: Encore All Commercial |
$141.46
|
| Rate for Payer: Frontpath All Commercial |
$141.38
|
| Rate for Payer: Humana ChoiceCare |
$132.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$138.31
|
| Rate for Payer: PHCS All Commercial |
$115.25
|
| Rate for Payer: PHP All Commercial |
$116.55
|
| Rate for Payer: Sagamore Health Network All Products |
$118.64
|
| Rate for Payer: Signature Care EPO |
$127.55
|
| Rate for Payer: Signature Care PPO |
$135.23
|
| Rate for Payer: United Healthcare Commercial |
$121.09
|
|
|
HC ZINC
|
Facility
OP
|
$153.67
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
63001718
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$142.92 |
| Rate for Payer: Aetna Commercial |
$129.70
|
| Rate for Payer: Aetna Medicare |
$50.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$50.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$70.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$70.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$6.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.78
|
| Rate for Payer: Cash Price |
$95.28
|
| Rate for Payer: Cash Price |
$95.28
|
| Rate for Payer: Centivo All Commercial |
$78.37
|
| Rate for Payer: Cigna All Commercial |
$132.62
|
| Rate for Payer: CORVEL All Commercial |
$142.92
|
| Rate for Payer: Coventry All Commercial |
$135.23
|
| Rate for Payer: Encore All Commercial |
$141.46
|
| Rate for Payer: Frontpath All Commercial |
$141.38
|
| Rate for Payer: Humana ChoiceCare |
$132.73
|
| Rate for Payer: Humana Medicare |
$78.37
|
| Rate for Payer: Lucent All Commercial |
$78.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$138.31
|
| Rate for Payer: Managed Health Services Medicaid |
$6.45
|
| Rate for Payer: MDWise Medicaid |
$6.45
|
| Rate for Payer: PHCS All Commercial |
$115.25
|
| Rate for Payer: PHP All Commercial |
$116.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$59.93
|
| Rate for Payer: Sagamore Health Network All Products |
$118.64
|
| Rate for Payer: Signature Care EPO |
$127.55
|
| Rate for Payer: Signature Care PPO |
$135.23
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$130.62
|
| Rate for Payer: United Healthcare Commercial |
$121.09
|
| Rate for Payer: United Healthcare Medicare |
$50.71
|
|
|
HC ZINC, RBC
|
Facility
OP
|
$153.67
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
63001719
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$142.92 |
| Rate for Payer: Aetna Commercial |
$129.70
|
| Rate for Payer: Aetna Medicare |
$50.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$50.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$70.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$70.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$6.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.78
|
| Rate for Payer: Cash Price |
$95.28
|
| Rate for Payer: Cash Price |
$95.28
|
| Rate for Payer: Centivo All Commercial |
$78.37
|
| Rate for Payer: Cigna All Commercial |
$132.62
|
| Rate for Payer: CORVEL All Commercial |
$142.92
|
| Rate for Payer: Coventry All Commercial |
$135.23
|
| Rate for Payer: Encore All Commercial |
$141.46
|
| Rate for Payer: Frontpath All Commercial |
$141.38
|
| Rate for Payer: Humana ChoiceCare |
$132.73
|
| Rate for Payer: Humana Medicare |
$78.37
|
| Rate for Payer: Lucent All Commercial |
$78.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$138.31
|
| Rate for Payer: Managed Health Services Medicaid |
$6.45
|
| Rate for Payer: MDWise Medicaid |
$6.45
|
| Rate for Payer: PHCS All Commercial |
$115.25
|
| Rate for Payer: PHP All Commercial |
$116.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$59.93
|
| Rate for Payer: Sagamore Health Network All Products |
$118.64
|
| Rate for Payer: Signature Care EPO |
$127.55
|
| Rate for Payer: Signature Care PPO |
$135.23
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$130.62
|
| Rate for Payer: United Healthcare Commercial |
$121.09
|
| Rate for Payer: United Healthcare Medicare |
$50.71
|
|
|
HC ZINC, RBC
|
Facility
IP
|
$153.67
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
63001719
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$115.25 |
| Max. Negotiated Rate |
$142.92 |
| Rate for Payer: Aetna Commercial |
$132.77
|
| Rate for Payer: Cash Price |
$95.28
|
| Rate for Payer: Cigna All Commercial |
$132.62
|
| Rate for Payer: CORVEL All Commercial |
$142.92
|
| Rate for Payer: Coventry All Commercial |
$135.23
|
| Rate for Payer: Encore All Commercial |
$141.46
|
| Rate for Payer: Frontpath All Commercial |
$141.38
|
| Rate for Payer: Humana ChoiceCare |
$132.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$138.31
|
| Rate for Payer: PHCS All Commercial |
$115.25
|
| Rate for Payer: PHP All Commercial |
$116.55
|
| Rate for Payer: Sagamore Health Network All Products |
$118.64
|
| Rate for Payer: Signature Care EPO |
$127.55
|
| Rate for Payer: Signature Care PPO |
$135.23
|
| Rate for Payer: United Healthcare Commercial |
$121.09
|
|
|
HC Z INTEGRAL SHRT GTR 23X53
|
Facility
IP
|
$5,225.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605876
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,918.86 |
| Max. Negotiated Rate |
$4,859.39 |
| Rate for Payer: Aetna Commercial |
$4,514.53
|
| Rate for Payer: Cash Price |
$3,239.59
|
| Rate for Payer: Cigna All Commercial |
$4,509.30
|
| Rate for Payer: CORVEL All Commercial |
$4,859.39
|
| Rate for Payer: Coventry All Commercial |
$4,598.13
|
| Rate for Payer: Encore All Commercial |
$4,809.75
|
| Rate for Payer: Frontpath All Commercial |
$4,807.14
|
| Rate for Payer: Humana ChoiceCare |
$4,512.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,702.64
|
| Rate for Payer: PHCS All Commercial |
$3,918.86
|
| Rate for Payer: PHP All Commercial |
$3,962.75
|
| Rate for Payer: Sagamore Health Network All Products |
$4,033.82
|
| Rate for Payer: Signature Care EPO |
$4,336.87
|
| Rate for Payer: Signature Care PPO |
$4,598.13
|
| Rate for Payer: United Healthcare Commercial |
$4,117.42
|
|
|
HC Z INTEGRAL SHRT GTR 23X53
|
Facility
OP
|
$5,225.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605876
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,859.39 |
| Rate for Payer: Aetna Commercial |
$4,410.03
|
| Rate for Payer: Aetna Medicare |
$1,724.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,724.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,000.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,266.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,982.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,896.73
|
| Rate for Payer: Cash Price |
$3,239.59
|
| Rate for Payer: Cash Price |
$3,239.59
|
| Rate for Payer: Centivo All Commercial |
$2,664.83
|
| Rate for Payer: Cigna All Commercial |
$4,509.30
|
| Rate for Payer: CORVEL All Commercial |
$4,859.39
|
| Rate for Payer: Coventry All Commercial |
$4,598.13
|
| Rate for Payer: Encore All Commercial |
$4,809.75
|
| Rate for Payer: Frontpath All Commercial |
$4,807.14
|
| Rate for Payer: Humana ChoiceCare |
$4,512.96
|
| Rate for Payer: Humana Medicare |
$2,664.83
|
| Rate for Payer: Lucent All Commercial |
$2,664.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,702.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,918.86
|
| Rate for Payer: PHP All Commercial |
$3,962.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,037.81
|
| Rate for Payer: Sagamore Health Network All Products |
$4,033.82
|
| Rate for Payer: Signature Care EPO |
$4,336.87
|
| Rate for Payer: Signature Care PPO |
$4,598.13
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,441.38
|
| Rate for Payer: United Healthcare Commercial |
$4,117.42
|
| Rate for Payer: United Healthcare Medicare |
$1,724.30
|
|
|
HC Z INTGL FEM STEM PP T1 11X180
|
Facility
OP
|
$30,232.80
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$28,116.50 |
| Rate for Payer: Aetna Commercial |
$25,516.48
|
| Rate for Payer: Aetna Medicare |
$9,976.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$9,976.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$17,362.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$18,898.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$11,473.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$10,974.51
|
| Rate for Payer: Cash Price |
$18,744.34
|
| Rate for Payer: Cash Price |
$18,744.34
|
| Rate for Payer: Centivo All Commercial |
$15,418.73
|
| Rate for Payer: Cigna All Commercial |
$26,090.91
|
| Rate for Payer: CORVEL All Commercial |
$28,116.50
|
| Rate for Payer: Coventry All Commercial |
$26,604.86
|
| Rate for Payer: Encore All Commercial |
$27,829.29
|
| Rate for Payer: Frontpath All Commercial |
$27,814.18
|
| Rate for Payer: Humana ChoiceCare |
$26,112.07
|
| Rate for Payer: Humana Medicare |
$15,418.73
|
| Rate for Payer: Lucent All Commercial |
$15,418.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$27,209.52
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$22,674.60
|
| Rate for Payer: PHP All Commercial |
$22,928.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$11,790.79
|
| Rate for Payer: Sagamore Health Network All Products |
$23,339.72
|
| Rate for Payer: Signature Care EPO |
$25,093.22
|
| Rate for Payer: Signature Care PPO |
$26,604.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,697.88
|
| Rate for Payer: United Healthcare Commercial |
$23,823.45
|
| Rate for Payer: United Healthcare Medicare |
$9,976.82
|
|
|
HC Z INTGL FEM STEM PP T1 11X180
|
Facility
IP
|
$30,232.80
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,674.60 |
| Max. Negotiated Rate |
$28,116.50 |
| Rate for Payer: Aetna Commercial |
$26,121.14
|
| Rate for Payer: Cash Price |
$18,744.34
|
| Rate for Payer: Cigna All Commercial |
$26,090.91
|
| Rate for Payer: CORVEL All Commercial |
$28,116.50
|
| Rate for Payer: Coventry All Commercial |
$26,604.86
|
| Rate for Payer: Encore All Commercial |
$27,829.29
|
| Rate for Payer: Frontpath All Commercial |
$27,814.18
|
| Rate for Payer: Humana ChoiceCare |
$26,112.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$27,209.52
|
| Rate for Payer: PHCS All Commercial |
$22,674.60
|
| Rate for Payer: PHP All Commercial |
$22,928.56
|
| Rate for Payer: Sagamore Health Network All Products |
$23,339.72
|
| Rate for Payer: Signature Care EPO |
$25,093.22
|
| Rate for Payer: Signature Care PPO |
$26,604.86
|
| Rate for Payer: United Healthcare Commercial |
$23,823.45
|
|
|
HC Z INTGL X FEM STEM PP 8X120 T1
|
Facility
IP
|
$9,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603592
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,750.00 |
| Max. Negotiated Rate |
$8,370.00 |
| Rate for Payer: Aetna Commercial |
$7,776.00
|
| Rate for Payer: Cash Price |
$5,580.00
|
| Rate for Payer: Cigna All Commercial |
$7,767.00
|
| Rate for Payer: CORVEL All Commercial |
$8,370.00
|
| Rate for Payer: Coventry All Commercial |
$7,920.00
|
| Rate for Payer: Encore All Commercial |
$8,284.50
|
| Rate for Payer: Frontpath All Commercial |
$8,280.00
|
| Rate for Payer: Humana ChoiceCare |
$7,773.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,100.00
|
| Rate for Payer: PHCS All Commercial |
$6,750.00
|
| Rate for Payer: PHP All Commercial |
$6,825.60
|
| Rate for Payer: Sagamore Health Network All Products |
$6,948.00
|
| Rate for Payer: Signature Care EPO |
$7,470.00
|
| Rate for Payer: Signature Care PPO |
$7,920.00
|
| Rate for Payer: United Healthcare Commercial |
$7,092.00
|
|
|
HC Z INTGL X FEM STEM PP 8X120 T1
|
Facility
OP
|
$9,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603592
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,370.00 |
| Rate for Payer: Aetna Commercial |
$7,596.00
|
| Rate for Payer: Aetna Medicare |
$2,970.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,970.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,168.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,625.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,415.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,267.00
|
| Rate for Payer: Cash Price |
$5,580.00
|
| Rate for Payer: Cash Price |
$5,580.00
|
| Rate for Payer: Centivo All Commercial |
$4,590.00
|
| Rate for Payer: Cigna All Commercial |
$7,767.00
|
| Rate for Payer: CORVEL All Commercial |
$8,370.00
|
| Rate for Payer: Coventry All Commercial |
$7,920.00
|
| Rate for Payer: Encore All Commercial |
$8,284.50
|
| Rate for Payer: Frontpath All Commercial |
$8,280.00
|
| Rate for Payer: Humana ChoiceCare |
$7,773.30
|
| Rate for Payer: Humana Medicare |
$4,590.00
|
| Rate for Payer: Lucent All Commercial |
$4,590.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,100.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,750.00
|
| Rate for Payer: PHP All Commercial |
$6,825.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,510.00
|
| Rate for Payer: Sagamore Health Network All Products |
$6,948.00
|
| Rate for Payer: Signature Care EPO |
$7,470.00
|
| Rate for Payer: Signature Care PPO |
$7,920.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,650.00
|
| Rate for Payer: United Healthcare Commercial |
$7,092.00
|
| Rate for Payer: United Healthcare Medicare |
$2,970.00
|
|
