|
HC Z PEG SCREW 2.5X34
|
Facility
OP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$205.31 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$357.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$236.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.84
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Centivo All Commercial |
$317.30
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Humana Medicare |
$317.30
|
| Rate for Payer: Lucent All Commercial |
$317.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.64
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.84
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
| Rate for Payer: United Healthcare Medicare |
$205.31
|
|
|
HC Z PEG SCREW 2.5X36
|
Facility
OP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$205.31 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$357.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$236.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.84
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Centivo All Commercial |
$317.30
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Humana Medicare |
$317.30
|
| Rate for Payer: Lucent All Commercial |
$317.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.64
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.84
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
| Rate for Payer: United Healthcare Medicare |
$205.31
|
|
|
HC Z PEG SCREW 2.5X36
|
Facility
IP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$466.62 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$537.55
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
|
|
HC Z PEG SCREW 2.5X38
|
Facility
OP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$205.31 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$357.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$236.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.84
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Centivo All Commercial |
$317.30
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Humana Medicare |
$317.30
|
| Rate for Payer: Lucent All Commercial |
$317.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.64
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.84
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
| Rate for Payer: United Healthcare Medicare |
$205.31
|
|
|
HC Z PEG SCREW 2.5X38
|
Facility
IP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$466.62 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$537.55
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
|
|
HC Z PEG SCREW 2.5X40
|
Facility
IP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$466.62 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$537.55
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
|
|
HC Z PEG SCREW 2.5X40
|
Facility
OP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$205.31 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$357.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$236.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.84
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Centivo All Commercial |
$317.30
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Humana Medicare |
$317.30
|
| Rate for Payer: Lucent All Commercial |
$317.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.64
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.84
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
| Rate for Payer: United Healthcare Medicare |
$205.31
|
|
|
HC Z PEG SCREW 2.5X8
|
Facility
OP
|
$620.55
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.78 |
| Max. Negotiated Rate |
$577.11 |
| Rate for Payer: Centivo All Commercial |
$316.48
|
| Rate for Payer: Aetna Commercial |
$523.74
|
| Rate for Payer: Aetna Medicare |
$204.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$204.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$356.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$387.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$235.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.26
|
| Rate for Payer: Cash Price |
$384.74
|
| Rate for Payer: Cash Price |
$384.74
|
| Rate for Payer: Cigna All Commercial |
$535.53
|
| Rate for Payer: CORVEL All Commercial |
$577.11
|
| Rate for Payer: Coventry All Commercial |
$546.08
|
| Rate for Payer: Encore All Commercial |
$571.22
|
| Rate for Payer: Frontpath All Commercial |
$570.91
|
| Rate for Payer: Humana ChoiceCare |
$535.97
|
| Rate for Payer: Humana Medicare |
$316.48
|
| Rate for Payer: Lucent All Commercial |
$316.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$558.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$465.41
|
| Rate for Payer: PHP All Commercial |
$470.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.01
|
| Rate for Payer: Sagamore Health Network All Products |
$479.06
|
| Rate for Payer: Signature Care EPO |
$515.06
|
| Rate for Payer: Signature Care PPO |
$546.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$527.47
|
| Rate for Payer: United Healthcare Commercial |
$488.99
|
| Rate for Payer: United Healthcare Medicare |
$204.78
|
|
|
HC Z PEG SCREW 2.5X8
|
Facility
IP
|
$620.55
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.41 |
| Max. Negotiated Rate |
$577.11 |
| Rate for Payer: Aetna Commercial |
$536.16
|
| Rate for Payer: Cash Price |
$384.74
|
| Rate for Payer: Cigna All Commercial |
$535.53
|
| Rate for Payer: CORVEL All Commercial |
$577.11
|
| Rate for Payer: Coventry All Commercial |
$546.08
|
| Rate for Payer: Encore All Commercial |
$571.22
|
| Rate for Payer: Frontpath All Commercial |
$570.91
|
| Rate for Payer: Humana ChoiceCare |
$535.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$558.50
|
| Rate for Payer: PHCS All Commercial |
$465.41
|
| Rate for Payer: PHP All Commercial |
$470.63
|
| Rate for Payer: Sagamore Health Network All Products |
$479.06
|
| Rate for Payer: Signature Care EPO |
$515.06
|
| Rate for Payer: Signature Care PPO |
$546.08
|
| Rate for Payer: United Healthcare Commercial |
$488.99
|
|
|
HC Z P-FIT 11X120
|
Facility
OP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,557.60
|
| Rate for Payer: Aetna Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,101.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,375.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,049.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,960.20
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Centivo All Commercial |
$2,754.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Humana Medicare |
$2,754.00
|
| Rate for Payer: Lucent All Commercial |
$2,754.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,106.00
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,590.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
| Rate for Payer: United Healthcare Medicare |
$1,782.00
|
|
|
HC Z P-FIT 11X120
|
Facility
IP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,050.00 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,665.60
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
|
|
HC Z P-FIT 12X125
|
Facility
IP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,050.00 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,665.60
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
|
|
HC Z P-FIT 12X125
|
Facility
OP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,557.60
|
| Rate for Payer: Aetna Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,101.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,375.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,049.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,960.20
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Centivo All Commercial |
$2,754.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Humana Medicare |
$2,754.00
|
| Rate for Payer: Lucent All Commercial |
$2,754.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,106.00
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,590.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
| Rate for Payer: United Healthcare Medicare |
$1,782.00
|
|
|
HC Z P-FIT 13X130
|
Facility
OP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,557.60
|
| Rate for Payer: Aetna Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,101.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,375.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,049.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,960.20
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Centivo All Commercial |
$2,754.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Humana Medicare |
$2,754.00
|
| Rate for Payer: Lucent All Commercial |
$2,754.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,106.00
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,590.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
| Rate for Payer: United Healthcare Medicare |
$1,782.00
|
|
|
HC Z P-FIT 13X130
|
Facility
IP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,050.00 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,665.60
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
|
|
HC Z P-FIT 14X135
|
Facility
OP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605414
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,557.60
|
| Rate for Payer: Aetna Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,101.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,375.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,049.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,960.20
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Centivo All Commercial |
$2,754.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Humana Medicare |
$2,754.00
|
| Rate for Payer: Lucent All Commercial |
$2,754.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,106.00
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,590.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
| Rate for Payer: United Healthcare Medicare |
$1,782.00
|
|
|
HC Z P-FIT 14X135
|
Facility
IP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605414
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,050.00 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,665.60
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
|
|
HC Z P-FIT 15X140
|
Facility
IP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,050.00 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,665.60
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
|
|
HC Z P-FIT 15X140
|
Facility
OP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,557.60
|
| Rate for Payer: Aetna Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,101.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,375.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,049.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,960.20
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Centivo All Commercial |
$2,754.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Humana Medicare |
$2,754.00
|
| Rate for Payer: Lucent All Commercial |
$2,754.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,106.00
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,590.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
| Rate for Payer: United Healthcare Medicare |
$1,782.00
|
|
|
HC Z P-FIT 16X145
|
Facility
IP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605416
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,050.00 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,665.60
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
|
|
HC Z P-FIT 16X145
|
Facility
OP
|
$5,400.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605416
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,557.60
|
| Rate for Payer: Aetna Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,782.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,101.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,375.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,049.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,960.20
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Centivo All Commercial |
$2,754.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Humana Medicare |
$2,754.00
|
| Rate for Payer: Lucent All Commercial |
$2,754.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,106.00
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,590.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
| Rate for Payer: United Healthcare Medicare |
$1,782.00
|
|
|
HC Z PIN .125X2.5
|
Facility
IP
|
$1,166.10
|
|
| Hospital Charge Code |
41605696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$874.58 |
| Max. Negotiated Rate |
$1,084.47 |
| Rate for Payer: Aetna Commercial |
$1,007.51
|
| Rate for Payer: Cash Price |
$722.98
|
| Rate for Payer: Cigna All Commercial |
$1,006.34
|
| Rate for Payer: CORVEL All Commercial |
$1,084.47
|
| Rate for Payer: Coventry All Commercial |
$1,026.17
|
| Rate for Payer: Encore All Commercial |
$1,073.40
|
| Rate for Payer: Frontpath All Commercial |
$1,072.81
|
| Rate for Payer: Humana ChoiceCare |
$1,007.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,049.49
|
| Rate for Payer: PHCS All Commercial |
$874.58
|
| Rate for Payer: PHP All Commercial |
$884.37
|
| Rate for Payer: Sagamore Health Network All Products |
$900.23
|
| Rate for Payer: Signature Care EPO |
$967.86
|
| Rate for Payer: Signature Care PPO |
$1,026.17
|
| Rate for Payer: United Healthcare Commercial |
$918.89
|
|
|
HC Z PIN .125X2.5
|
Facility
OP
|
$1,166.10
|
|
| Hospital Charge Code |
41605696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,084.47 |
| Rate for Payer: Aetna Commercial |
$984.19
|
| Rate for Payer: Aetna Medicare |
$384.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$384.81
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$669.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$728.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$442.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$423.29
|
| Rate for Payer: Cash Price |
$722.98
|
| Rate for Payer: Cash Price |
$722.98
|
| Rate for Payer: Centivo All Commercial |
$594.71
|
| Rate for Payer: Cigna All Commercial |
$1,006.34
|
| Rate for Payer: CORVEL All Commercial |
$1,084.47
|
| Rate for Payer: Coventry All Commercial |
$1,026.17
|
| Rate for Payer: Encore All Commercial |
$1,073.40
|
| Rate for Payer: Frontpath All Commercial |
$1,072.81
|
| Rate for Payer: Humana ChoiceCare |
$1,007.16
|
| Rate for Payer: Humana Medicare |
$594.71
|
| Rate for Payer: Lucent All Commercial |
$594.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,049.49
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$874.58
|
| Rate for Payer: PHP All Commercial |
$884.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$454.78
|
| Rate for Payer: Sagamore Health Network All Products |
$900.23
|
| Rate for Payer: Signature Care EPO |
$967.86
|
| Rate for Payer: Signature Care PPO |
$1,026.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$991.18
|
| Rate for Payer: United Healthcare Commercial |
$918.89
|
| Rate for Payer: United Healthcare Medicare |
$384.81
|
|
|
HC Z PIN 2.0 4620
|
Facility
OP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606992
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$531.07
|
| Rate for Payer: Aetna Medicare |
$207.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$207.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$361.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$393.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$238.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.41
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Centivo All Commercial |
$320.91
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Humana Medicare |
$320.91
|
| Rate for Payer: Lucent All Commercial |
$320.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$245.40
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$534.85
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
| Rate for Payer: United Healthcare Medicare |
$207.65
|
|
|
HC Z PIN 2.0 4620
|
Facility
IP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606992
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$471.92 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$543.65
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
|
