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Service Code CPT C1713
Hospital Charge Code 41602569
Hospital Revenue Code 278
Min. Negotiated Rate $3,864.92
Max. Negotiated Rate $4,792.49
Rate for Payer: Aetna Commercial $4,452.38
Rate for Payer: Cash Price $3,195.00
Rate for Payer: Cigna All Commercial $4,447.23
Rate for Payer: CORVEL All Commercial $4,792.49
Rate for Payer: Coventry All Commercial $4,534.83
Rate for Payer: Encore All Commercial $4,743.54
Rate for Payer: Frontpath All Commercial $4,740.96
Rate for Payer: Humana ChoiceCare $4,450.84
Rate for Payer: Lutheran Preferred All Commercial $4,637.90
Rate for Payer: PHCS All Commercial $3,864.92
Rate for Payer: PHP All Commercial $3,908.20
Rate for Payer: Sagamore Health Network All Products $3,978.29
Rate for Payer: Signature Care EPO $4,277.17
Rate for Payer: Signature Care PPO $4,534.83
Rate for Payer: United Healthcare Commercial $4,060.74
Service Code CPT C1713
Hospital Charge Code 41602978
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $4,792.49
Rate for Payer: Aetna Commercial $4,349.32
Rate for Payer: Aetna Medicare $1,700.56
Rate for Payer: Anthem Blue Cross of IN Medicare $1,700.56
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,959.49
Rate for Payer: Anthem Blue Cross of IN Traditional $3,221.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,955.65
Rate for Payer: CareSource Indiana of IN Medicare $1,870.62
Rate for Payer: Cash Price $3,195.00
Rate for Payer: Cash Price $3,195.00
Rate for Payer: Centivo All Commercial $2,628.14
Rate for Payer: Cigna All Commercial $4,447.23
Rate for Payer: CORVEL All Commercial $4,792.49
Rate for Payer: Coventry All Commercial $4,534.83
Rate for Payer: Encore All Commercial $4,743.54
Rate for Payer: Frontpath All Commercial $4,740.96
Rate for Payer: Humana ChoiceCare $4,450.84
Rate for Payer: Humana Medicare $2,628.14
Rate for Payer: Lucent All Commercial $2,628.14
Rate for Payer: Lutheran Preferred All Commercial $4,637.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $3,864.92
Rate for Payer: PHP All Commercial $3,908.20
Rate for Payer: Plain Church Group Ministry All Commercial $2,009.76
Rate for Payer: Sagamore Health Network All Products $3,978.29
Rate for Payer: Signature Care EPO $4,277.17
Rate for Payer: Signature Care PPO $4,534.83
Rate for Payer: Three Rivers Preferred All Commercial $4,380.24
Rate for Payer: United Healthcare Commercial $4,060.74
Rate for Payer: United Healthcare Medicare $1,700.56
Service Code CPT C1713
Hospital Charge Code 41602978
Hospital Revenue Code 278
Min. Negotiated Rate $3,864.92
Max. Negotiated Rate $4,792.49
Rate for Payer: Aetna Commercial $4,452.38
Rate for Payer: Cash Price $3,195.00
Rate for Payer: Cigna All Commercial $4,447.23
Rate for Payer: CORVEL All Commercial $4,792.49
Rate for Payer: Coventry All Commercial $4,534.83
Rate for Payer: Encore All Commercial $4,743.54
Rate for Payer: Frontpath All Commercial $4,740.96
Rate for Payer: Humana ChoiceCare $4,450.84
Rate for Payer: Lutheran Preferred All Commercial $4,637.90
Rate for Payer: PHCS All Commercial $3,864.92
Rate for Payer: PHP All Commercial $3,908.20
Rate for Payer: Sagamore Health Network All Products $3,978.29
Rate for Payer: Signature Care EPO $4,277.17
Rate for Payer: Signature Care PPO $4,534.83
Rate for Payer: United Healthcare Commercial $4,060.74
Service Code CPT C1713
Hospital Charge Code 41602940
Hospital Revenue Code 278
Min. Negotiated Rate $3,864.92
Max. Negotiated Rate $4,792.49
Rate for Payer: Aetna Commercial $4,452.38
Rate for Payer: Cash Price $3,195.00
Rate for Payer: Cigna All Commercial $4,447.23
Rate for Payer: CORVEL All Commercial $4,792.49
Rate for Payer: Coventry All Commercial $4,534.83
Rate for Payer: Encore All Commercial $4,743.54
Rate for Payer: Frontpath All Commercial $4,740.96
Rate for Payer: Humana ChoiceCare $4,450.84
Rate for Payer: Lutheran Preferred All Commercial $4,637.90
Rate for Payer: PHCS All Commercial $3,864.92
Rate for Payer: PHP All Commercial $3,908.20
Rate for Payer: Sagamore Health Network All Products $3,978.29
Rate for Payer: Signature Care EPO $4,277.17
Rate for Payer: Signature Care PPO $4,534.83
Rate for Payer: United Healthcare Commercial $4,060.74
Service Code CPT C1713
Hospital Charge Code 41602940
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $4,792.49
Rate for Payer: Aetna Commercial $4,349.32
Rate for Payer: Aetna Medicare $1,700.56
Rate for Payer: Anthem Blue Cross of IN Medicare $1,700.56
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,959.49
Rate for Payer: Anthem Blue Cross of IN Traditional $3,221.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,955.65
Rate for Payer: CareSource Indiana of IN Medicare $1,870.62
Rate for Payer: Cash Price $3,195.00
Rate for Payer: Cash Price $3,195.00
Rate for Payer: Centivo All Commercial $2,628.14
Rate for Payer: Cigna All Commercial $4,447.23
Rate for Payer: CORVEL All Commercial $4,792.49
Rate for Payer: Coventry All Commercial $4,534.83
Rate for Payer: Encore All Commercial $4,743.54
Rate for Payer: Frontpath All Commercial $4,740.96
Rate for Payer: Humana ChoiceCare $4,450.84
Rate for Payer: Humana Medicare $2,628.14
Rate for Payer: Lucent All Commercial $2,628.14
Rate for Payer: Lutheran Preferred All Commercial $4,637.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $3,864.92
Rate for Payer: PHP All Commercial $3,908.20
Rate for Payer: Plain Church Group Ministry All Commercial $2,009.76
Rate for Payer: Sagamore Health Network All Products $3,978.29
Rate for Payer: Signature Care EPO $4,277.17
Rate for Payer: Signature Care PPO $4,534.83
Rate for Payer: Three Rivers Preferred All Commercial $4,380.24
Rate for Payer: United Healthcare Commercial $4,060.74
Rate for Payer: United Healthcare Medicare $1,700.56
Service Code CPT C1713
Hospital Charge Code 41602981
Hospital Revenue Code 278
Min. Negotiated Rate $3,864.92
Max. Negotiated Rate $4,792.49
Rate for Payer: Aetna Commercial $4,452.38
Rate for Payer: Cash Price $3,195.00
Rate for Payer: Cigna All Commercial $4,447.23
Rate for Payer: CORVEL All Commercial $4,792.49
Rate for Payer: Coventry All Commercial $4,534.83
Rate for Payer: Encore All Commercial $4,743.54
Rate for Payer: Frontpath All Commercial $4,740.96
Rate for Payer: Humana ChoiceCare $4,450.84
Rate for Payer: Lutheran Preferred All Commercial $4,637.90
Rate for Payer: PHCS All Commercial $3,864.92
Rate for Payer: PHP All Commercial $3,908.20
Rate for Payer: Sagamore Health Network All Products $3,978.29
Rate for Payer: Signature Care EPO $4,277.17
Rate for Payer: Signature Care PPO $4,534.83
Rate for Payer: United Healthcare Commercial $4,060.74
Service Code CPT C1713
Hospital Charge Code 41602981
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $4,792.49
Rate for Payer: Aetna Commercial $4,349.32
Rate for Payer: Aetna Medicare $1,700.56
Rate for Payer: Anthem Blue Cross of IN Medicare $1,700.56
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,959.49
Rate for Payer: Anthem Blue Cross of IN Traditional $3,221.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,955.65
Rate for Payer: CareSource Indiana of IN Medicare $1,870.62
Rate for Payer: Cash Price $3,195.00
Rate for Payer: Cash Price $3,195.00
Rate for Payer: Centivo All Commercial $2,628.14
Rate for Payer: Cigna All Commercial $4,447.23
Rate for Payer: CORVEL All Commercial $4,792.49
Rate for Payer: Coventry All Commercial $4,534.83
Rate for Payer: Encore All Commercial $4,743.54
Rate for Payer: Frontpath All Commercial $4,740.96
Rate for Payer: Humana ChoiceCare $4,450.84
Rate for Payer: Humana Medicare $2,628.14
Rate for Payer: Lucent All Commercial $2,628.14
Rate for Payer: Lutheran Preferred All Commercial $4,637.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $3,864.92
Rate for Payer: PHP All Commercial $3,908.20
Rate for Payer: Plain Church Group Ministry All Commercial $2,009.76
Rate for Payer: Sagamore Health Network All Products $3,978.29
Rate for Payer: Signature Care EPO $4,277.17
Rate for Payer: Signature Care PPO $4,534.83
Rate for Payer: Three Rivers Preferred All Commercial $4,380.24
Rate for Payer: United Healthcare Commercial $4,060.74
Rate for Payer: United Healthcare Medicare $1,700.56
Service Code CPT C1713
Hospital Charge Code 41602985
Hospital Revenue Code 278
Min. Negotiated Rate $5,806.38
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,688.95
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: United Healthcare Commercial $6,100.57
Service Code CPT C1713
Hospital Charge Code 41602985
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,534.11
Rate for Payer: Aetna Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $4,446.14
Rate for Payer: Anthem Blue Cross of IN Traditional $4,839.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $2,938.03
Rate for Payer: CareSource Indiana of IN Medicare $2,810.29
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Centivo All Commercial $3,948.34
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Humana Medicare $3,948.34
Rate for Payer: Lucent All Commercial $3,948.34
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Plain Church Group Ministry All Commercial $3,019.32
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: Three Rivers Preferred All Commercial $6,580.56
Rate for Payer: United Healthcare Commercial $6,100.57
Rate for Payer: United Healthcare Medicare $2,554.81
Service Code CPT C1713
Hospital Charge Code 41602944
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,534.11
Rate for Payer: Aetna Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $4,446.14
Rate for Payer: Anthem Blue Cross of IN Traditional $4,839.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $2,938.03
Rate for Payer: CareSource Indiana of IN Medicare $2,810.29
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Centivo All Commercial $3,948.34
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Humana Medicare $3,948.34
Rate for Payer: Lucent All Commercial $3,948.34
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Plain Church Group Ministry All Commercial $3,019.32
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: Three Rivers Preferred All Commercial $6,580.56
Rate for Payer: United Healthcare Commercial $6,100.57
Rate for Payer: United Healthcare Medicare $2,554.81
Service Code CPT C1713
Hospital Charge Code 41602944
Hospital Revenue Code 278
Min. Negotiated Rate $5,806.38
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,688.95
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: United Healthcare Commercial $6,100.57
Service Code CPT C1713
Hospital Charge Code 41602988
Hospital Revenue Code 278
Min. Negotiated Rate $5,806.38
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,688.95
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: United Healthcare Commercial $6,100.57
Service Code CPT C1713
Hospital Charge Code 41602988
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,534.11
Rate for Payer: Aetna Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $4,446.14
Rate for Payer: Anthem Blue Cross of IN Traditional $4,839.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $2,938.03
Rate for Payer: CareSource Indiana of IN Medicare $2,810.29
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Centivo All Commercial $3,948.34
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Humana Medicare $3,948.34
Rate for Payer: Lucent All Commercial $3,948.34
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Plain Church Group Ministry All Commercial $3,019.32
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: Three Rivers Preferred All Commercial $6,580.56
Rate for Payer: United Healthcare Commercial $6,100.57
Rate for Payer: United Healthcare Medicare $2,554.81
Service Code CPT C1713
Hospital Charge Code 41602947
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,534.11
Rate for Payer: Aetna Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $4,446.14
Rate for Payer: Anthem Blue Cross of IN Traditional $4,839.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $2,938.03
Rate for Payer: CareSource Indiana of IN Medicare $2,810.29
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Centivo All Commercial $3,948.34
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Humana Medicare $3,948.34
Rate for Payer: Lucent All Commercial $3,948.34
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Plain Church Group Ministry All Commercial $3,019.32
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: Three Rivers Preferred All Commercial $6,580.56
Rate for Payer: United Healthcare Commercial $6,100.57
Rate for Payer: United Healthcare Medicare $2,554.81
Service Code CPT C1713
Hospital Charge Code 41602947
Hospital Revenue Code 278
Min. Negotiated Rate $5,806.38
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,688.95
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: United Healthcare Commercial $6,100.57
Service Code CPT C1713
Hospital Charge Code 41602991
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,534.11
Rate for Payer: Aetna Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $4,446.14
Rate for Payer: Anthem Blue Cross of IN Traditional $4,839.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $2,938.03
Rate for Payer: CareSource Indiana of IN Medicare $2,810.29
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Centivo All Commercial $3,948.34
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Humana Medicare $3,948.34
Rate for Payer: Lucent All Commercial $3,948.34
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Plain Church Group Ministry All Commercial $3,019.32
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: Three Rivers Preferred All Commercial $6,580.56
Rate for Payer: United Healthcare Commercial $6,100.57
Rate for Payer: United Healthcare Medicare $2,554.81
Service Code CPT C1713
Hospital Charge Code 41602991
Hospital Revenue Code 278
Min. Negotiated Rate $5,806.38
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,688.95
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: United Healthcare Commercial $6,100.57
Service Code CPT C1713
Hospital Charge Code 41602950
Hospital Revenue Code 278
Min. Negotiated Rate $5,806.38
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,688.95
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: United Healthcare Commercial $6,100.57
Service Code CPT C1713
Hospital Charge Code 41602950
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,534.11
Rate for Payer: Aetna Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $4,446.14
Rate for Payer: Anthem Blue Cross of IN Traditional $4,839.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $2,938.03
Rate for Payer: CareSource Indiana of IN Medicare $2,810.29
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Centivo All Commercial $3,948.34
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Humana Medicare $3,948.34
Rate for Payer: Lucent All Commercial $3,948.34
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Plain Church Group Ministry All Commercial $3,019.32
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: Three Rivers Preferred All Commercial $6,580.56
Rate for Payer: United Healthcare Commercial $6,100.57
Rate for Payer: United Healthcare Medicare $2,554.81
Service Code CPT C1713
Hospital Charge Code 41602994
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,534.11
Rate for Payer: Aetna Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $4,446.14
Rate for Payer: Anthem Blue Cross of IN Traditional $4,839.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $2,938.03
Rate for Payer: CareSource Indiana of IN Medicare $2,810.29
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Centivo All Commercial $3,948.34
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Humana Medicare $3,948.34
Rate for Payer: Lucent All Commercial $3,948.34
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Plain Church Group Ministry All Commercial $3,019.32
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: Three Rivers Preferred All Commercial $6,580.56
Rate for Payer: United Healthcare Commercial $6,100.57
Rate for Payer: United Healthcare Medicare $2,554.81
Service Code CPT C1713
Hospital Charge Code 41602994
Hospital Revenue Code 278
Min. Negotiated Rate $5,806.38
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,688.95
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: United Healthcare Commercial $6,100.57
Service Code CPT C1713
Hospital Charge Code 41602953
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,534.11
Rate for Payer: Aetna Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $4,446.14
Rate for Payer: Anthem Blue Cross of IN Traditional $4,839.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $2,938.03
Rate for Payer: CareSource Indiana of IN Medicare $2,810.29
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Centivo All Commercial $3,948.34
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Humana Medicare $3,948.34
Rate for Payer: Lucent All Commercial $3,948.34
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Plain Church Group Ministry All Commercial $3,019.32
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: Three Rivers Preferred All Commercial $6,580.56
Rate for Payer: United Healthcare Commercial $6,100.57
Rate for Payer: United Healthcare Medicare $2,554.81
Service Code CPT C1713
Hospital Charge Code 41602953
Hospital Revenue Code 278
Min. Negotiated Rate $5,806.38
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,688.95
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: United Healthcare Commercial $6,100.57
Service Code CPT C1713
Hospital Charge Code 41602997
Hospital Revenue Code 278
Min. Negotiated Rate $5,806.38
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,688.95
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: United Healthcare Commercial $6,100.57
Service Code CPT C1713
Hospital Charge Code 41602997
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $7,199.91
Rate for Payer: Aetna Commercial $6,534.11
Rate for Payer: Aetna Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN Medicare $2,554.81
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $4,446.14
Rate for Payer: Anthem Blue Cross of IN Traditional $4,839.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $2,938.03
Rate for Payer: CareSource Indiana of IN Medicare $2,810.29
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Cash Price $4,799.94
Rate for Payer: Centivo All Commercial $3,948.34
Rate for Payer: Cigna All Commercial $6,681.21
Rate for Payer: CORVEL All Commercial $7,199.91
Rate for Payer: Coventry All Commercial $6,812.82
Rate for Payer: Encore All Commercial $7,126.36
Rate for Payer: Frontpath All Commercial $7,122.49
Rate for Payer: Humana ChoiceCare $6,686.63
Rate for Payer: Humana Medicare $3,948.34
Rate for Payer: Lucent All Commercial $3,948.34
Rate for Payer: Lutheran Preferred All Commercial $6,967.66
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $5,806.38
Rate for Payer: PHP All Commercial $5,871.41
Rate for Payer: Plain Church Group Ministry All Commercial $3,019.32
Rate for Payer: Sagamore Health Network All Products $5,976.70
Rate for Payer: Signature Care EPO $6,425.73
Rate for Payer: Signature Care PPO $6,812.82
Rate for Payer: Three Rivers Preferred All Commercial $6,580.56
Rate for Payer: United Healthcare Commercial $6,100.57
Rate for Payer: United Healthcare Medicare $2,554.81