|
HC Z PIN 3.0 1230
|
Facility
IP
|
$605.92
|
|
| Hospital Charge Code |
41606751
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$454.44 |
| Max. Negotiated Rate |
$563.51 |
| Rate for Payer: Aetna Commercial |
$523.51
|
| Rate for Payer: Cash Price |
$375.67
|
| Rate for Payer: Cigna All Commercial |
$522.91
|
| Rate for Payer: CORVEL All Commercial |
$563.51
|
| Rate for Payer: Coventry All Commercial |
$533.21
|
| Rate for Payer: Encore All Commercial |
$557.75
|
| Rate for Payer: Frontpath All Commercial |
$557.45
|
| Rate for Payer: Humana ChoiceCare |
$523.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$545.33
|
| Rate for Payer: PHCS All Commercial |
$454.44
|
| Rate for Payer: PHP All Commercial |
$459.53
|
| Rate for Payer: Sagamore Health Network All Products |
$467.77
|
| Rate for Payer: Signature Care EPO |
$502.91
|
| Rate for Payer: Signature Care PPO |
$533.21
|
| Rate for Payer: United Healthcare Commercial |
$477.46
|
|
|
HC Z PIN 3.0 1230
|
Facility
OP
|
$605.92
|
|
| Hospital Charge Code |
41606751
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$563.51 |
| Rate for Payer: Aetna Commercial |
$511.40
|
| Rate for Payer: Aetna Medicare |
$199.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$199.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$347.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$378.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$229.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$219.95
|
| Rate for Payer: Cash Price |
$375.67
|
| Rate for Payer: Cash Price |
$375.67
|
| Rate for Payer: Centivo All Commercial |
$309.02
|
| Rate for Payer: Cigna All Commercial |
$522.91
|
| Rate for Payer: CORVEL All Commercial |
$563.51
|
| Rate for Payer: Coventry All Commercial |
$533.21
|
| Rate for Payer: Encore All Commercial |
$557.75
|
| Rate for Payer: Frontpath All Commercial |
$557.45
|
| Rate for Payer: Humana ChoiceCare |
$523.33
|
| Rate for Payer: Humana Medicare |
$309.02
|
| Rate for Payer: Lucent All Commercial |
$309.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$545.33
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$454.44
|
| Rate for Payer: PHP All Commercial |
$459.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$236.31
|
| Rate for Payer: Sagamore Health Network All Products |
$467.77
|
| Rate for Payer: Signature Care EPO |
$502.91
|
| Rate for Payer: Signature Care PPO |
$533.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$515.03
|
| Rate for Payer: United Healthcare Commercial |
$477.46
|
| Rate for Payer: United Healthcare Medicare |
$199.95
|
|
|
HC Z PIN 3.0, 355
|
Facility
OP
|
$745.71
|
|
| Hospital Charge Code |
41603455
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$693.51 |
| Rate for Payer: Aetna Commercial |
$629.38
|
| Rate for Payer: Aetna Medicare |
$246.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$246.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$428.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$466.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$283.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$270.69
|
| Rate for Payer: Cash Price |
$462.34
|
| Rate for Payer: Cash Price |
$462.34
|
| Rate for Payer: Centivo All Commercial |
$380.31
|
| Rate for Payer: Cigna All Commercial |
$643.55
|
| Rate for Payer: CORVEL All Commercial |
$693.51
|
| Rate for Payer: Coventry All Commercial |
$656.22
|
| Rate for Payer: Encore All Commercial |
$686.43
|
| Rate for Payer: Frontpath All Commercial |
$686.05
|
| Rate for Payer: Humana ChoiceCare |
$644.07
|
| Rate for Payer: Humana Medicare |
$380.31
|
| Rate for Payer: Lucent All Commercial |
$380.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$671.14
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$559.28
|
| Rate for Payer: PHP All Commercial |
$565.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$290.83
|
| Rate for Payer: Sagamore Health Network All Products |
$575.69
|
| Rate for Payer: Signature Care EPO |
$618.94
|
| Rate for Payer: Signature Care PPO |
$656.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$633.85
|
| Rate for Payer: United Healthcare Commercial |
$587.62
|
| Rate for Payer: United Healthcare Medicare |
$246.08
|
|
|
HC Z PIN 3.0, 355
|
Facility
IP
|
$745.71
|
|
| Hospital Charge Code |
41603455
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$559.28 |
| Max. Negotiated Rate |
$693.51 |
| Rate for Payer: Aetna Commercial |
$644.29
|
| Rate for Payer: Cash Price |
$462.34
|
| Rate for Payer: Cigna All Commercial |
$643.55
|
| Rate for Payer: CORVEL All Commercial |
$693.51
|
| Rate for Payer: Coventry All Commercial |
$656.22
|
| Rate for Payer: Encore All Commercial |
$686.43
|
| Rate for Payer: Frontpath All Commercial |
$686.05
|
| Rate for Payer: Humana ChoiceCare |
$644.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$671.14
|
| Rate for Payer: PHCS All Commercial |
$559.28
|
| Rate for Payer: PHP All Commercial |
$565.55
|
| Rate for Payer: Sagamore Health Network All Products |
$575.69
|
| Rate for Payer: Signature Care EPO |
$618.94
|
| Rate for Payer: Signature Care PPO |
$656.22
|
| Rate for Payer: United Healthcare Commercial |
$587.62
|
|
|
HC Z PIN 3.2MM STEINMANN
|
Facility
OP
|
$920.92
|
|
| Hospital Charge Code |
41605693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$856.46 |
| Rate for Payer: Aetna Commercial |
$777.26
|
| Rate for Payer: Aetna Medicare |
$303.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$303.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$528.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$575.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$349.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$334.29
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Centivo All Commercial |
$469.67
|
| Rate for Payer: Cigna All Commercial |
$794.75
|
| Rate for Payer: CORVEL All Commercial |
$856.46
|
| Rate for Payer: Coventry All Commercial |
$810.41
|
| Rate for Payer: Encore All Commercial |
$847.71
|
| Rate for Payer: Frontpath All Commercial |
$847.25
|
| Rate for Payer: Humana ChoiceCare |
$795.40
|
| Rate for Payer: Humana Medicare |
$469.67
|
| Rate for Payer: Lucent All Commercial |
$469.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.83
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$690.69
|
| Rate for Payer: PHP All Commercial |
$698.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$359.16
|
| Rate for Payer: Sagamore Health Network All Products |
$710.95
|
| Rate for Payer: Signature Care EPO |
$764.36
|
| Rate for Payer: Signature Care PPO |
$810.41
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$782.78
|
| Rate for Payer: United Healthcare Commercial |
$725.68
|
| Rate for Payer: United Healthcare Medicare |
$303.90
|
|
|
HC Z PIN 3.2MM STEINMANN
|
Facility
IP
|
$920.92
|
|
| Hospital Charge Code |
41605693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$690.69 |
| Max. Negotiated Rate |
$856.46 |
| Rate for Payer: Aetna Commercial |
$795.67
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Cigna All Commercial |
$794.75
|
| Rate for Payer: CORVEL All Commercial |
$856.46
|
| Rate for Payer: Coventry All Commercial |
$810.41
|
| Rate for Payer: Encore All Commercial |
$847.71
|
| Rate for Payer: Frontpath All Commercial |
$847.25
|
| Rate for Payer: Humana ChoiceCare |
$795.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.83
|
| Rate for Payer: PHCS All Commercial |
$690.69
|
| Rate for Payer: PHP All Commercial |
$698.43
|
| Rate for Payer: Sagamore Health Network All Products |
$710.95
|
| Rate for Payer: Signature Care EPO |
$764.36
|
| Rate for Payer: Signature Care PPO |
$810.41
|
| Rate for Payer: United Healthcare Commercial |
$725.68
|
|
|
HC Z PIN 4X100X35
|
Facility
OP
|
$880.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$290.40 |
| Max. Negotiated Rate |
$818.40 |
| Rate for Payer: Aetna Commercial |
$742.72
|
| Rate for Payer: Aetna Medicare |
$290.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$290.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$505.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$550.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$333.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$319.44
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Centivo All Commercial |
$448.80
|
| Rate for Payer: Cigna All Commercial |
$759.44
|
| Rate for Payer: CORVEL All Commercial |
$818.40
|
| Rate for Payer: Coventry All Commercial |
$774.40
|
| Rate for Payer: Encore All Commercial |
$810.04
|
| Rate for Payer: Frontpath All Commercial |
$809.60
|
| Rate for Payer: Humana ChoiceCare |
$760.06
|
| Rate for Payer: Humana Medicare |
$448.80
|
| Rate for Payer: Lucent All Commercial |
$448.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$792.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$660.00
|
| Rate for Payer: PHP All Commercial |
$667.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$343.20
|
| Rate for Payer: Sagamore Health Network All Products |
$679.36
|
| Rate for Payer: Signature Care EPO |
$730.40
|
| Rate for Payer: Signature Care PPO |
$774.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$748.00
|
| Rate for Payer: United Healthcare Commercial |
$693.44
|
| Rate for Payer: United Healthcare Medicare |
$290.40
|
|
|
HC Z PIN 4X100X35
|
Facility
IP
|
$880.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$660.00 |
| Max. Negotiated Rate |
$818.40 |
| Rate for Payer: Aetna Commercial |
$760.32
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cigna All Commercial |
$759.44
|
| Rate for Payer: CORVEL All Commercial |
$818.40
|
| Rate for Payer: Coventry All Commercial |
$774.40
|
| Rate for Payer: Encore All Commercial |
$810.04
|
| Rate for Payer: Frontpath All Commercial |
$809.60
|
| Rate for Payer: Humana ChoiceCare |
$760.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$792.00
|
| Rate for Payer: PHCS All Commercial |
$660.00
|
| Rate for Payer: PHP All Commercial |
$667.39
|
| Rate for Payer: Sagamore Health Network All Products |
$679.36
|
| Rate for Payer: Signature Care EPO |
$730.40
|
| Rate for Payer: Signature Care PPO |
$774.40
|
| Rate for Payer: United Healthcare Commercial |
$693.44
|
|
|
HC Z PIN 5X160X35
|
Facility
OP
|
$1,002.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$330.68 |
| Max. Negotiated Rate |
$931.91 |
| Rate for Payer: Aetna Commercial |
$845.73
|
| Rate for Payer: Aetna Medicare |
$330.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$330.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$575.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$626.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$380.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$363.74
|
| Rate for Payer: Cash Price |
$621.27
|
| Rate for Payer: Cash Price |
$621.27
|
| Rate for Payer: Centivo All Commercial |
$511.05
|
| Rate for Payer: Cigna All Commercial |
$864.77
|
| Rate for Payer: CORVEL All Commercial |
$931.91
|
| Rate for Payer: Coventry All Commercial |
$881.80
|
| Rate for Payer: Encore All Commercial |
$922.39
|
| Rate for Payer: Frontpath All Commercial |
$921.89
|
| Rate for Payer: Humana ChoiceCare |
$865.47
|
| Rate for Payer: Humana Medicare |
$511.05
|
| Rate for Payer: Lucent All Commercial |
$511.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$901.84
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$751.54
|
| Rate for Payer: PHP All Commercial |
$759.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.80
|
| Rate for Payer: Sagamore Health Network All Products |
$773.58
|
| Rate for Payer: Signature Care EPO |
$831.70
|
| Rate for Payer: Signature Care PPO |
$881.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$851.74
|
| Rate for Payer: United Healthcare Commercial |
$789.62
|
| Rate for Payer: United Healthcare Medicare |
$330.68
|
|
|
HC Z PIN 5X160X35
|
Facility
IP
|
$1,002.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$751.54 |
| Max. Negotiated Rate |
$931.91 |
| Rate for Payer: Aetna Commercial |
$865.77
|
| Rate for Payer: Cash Price |
$621.27
|
| Rate for Payer: Cigna All Commercial |
$864.77
|
| Rate for Payer: CORVEL All Commercial |
$931.91
|
| Rate for Payer: Coventry All Commercial |
$881.80
|
| Rate for Payer: Encore All Commercial |
$922.39
|
| Rate for Payer: Frontpath All Commercial |
$921.89
|
| Rate for Payer: Humana ChoiceCare |
$865.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$901.84
|
| Rate for Payer: PHCS All Commercial |
$751.54
|
| Rate for Payer: PHP All Commercial |
$759.95
|
| Rate for Payer: Sagamore Health Network All Products |
$773.58
|
| Rate for Payer: Signature Care EPO |
$831.70
|
| Rate for Payer: Signature Care PPO |
$881.80
|
| Rate for Payer: United Healthcare Commercial |
$789.62
|
|
|
HC Z PIN 5X275 LG
|
Facility
IP
|
$882.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$661.65 |
| Max. Negotiated Rate |
$820.45 |
| Rate for Payer: Aetna Commercial |
$762.22
|
| Rate for Payer: Cash Price |
$546.96
|
| Rate for Payer: Cigna All Commercial |
$761.34
|
| Rate for Payer: CORVEL All Commercial |
$820.45
|
| Rate for Payer: Coventry All Commercial |
$776.34
|
| Rate for Payer: Encore All Commercial |
$812.07
|
| Rate for Payer: Frontpath All Commercial |
$811.62
|
| Rate for Payer: Humana ChoiceCare |
$761.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$793.98
|
| Rate for Payer: PHCS All Commercial |
$661.65
|
| Rate for Payer: PHP All Commercial |
$669.06
|
| Rate for Payer: Sagamore Health Network All Products |
$681.06
|
| Rate for Payer: Signature Care EPO |
$732.23
|
| Rate for Payer: Signature Care PPO |
$776.34
|
| Rate for Payer: United Healthcare Commercial |
$695.17
|
|
|
HC Z PIN 5X275 LG
|
Facility
OP
|
$882.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$820.45 |
| Rate for Payer: Aetna Commercial |
$744.58
|
| Rate for Payer: Aetna Medicare |
$291.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$291.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$506.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$551.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$334.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$320.24
|
| Rate for Payer: Cash Price |
$546.96
|
| Rate for Payer: Cash Price |
$546.96
|
| Rate for Payer: Centivo All Commercial |
$449.92
|
| Rate for Payer: Cigna All Commercial |
$761.34
|
| Rate for Payer: CORVEL All Commercial |
$820.45
|
| Rate for Payer: Coventry All Commercial |
$776.34
|
| Rate for Payer: Encore All Commercial |
$812.07
|
| Rate for Payer: Frontpath All Commercial |
$811.62
|
| Rate for Payer: Humana ChoiceCare |
$761.96
|
| Rate for Payer: Humana Medicare |
$449.92
|
| Rate for Payer: Lucent All Commercial |
$449.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$793.98
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$661.65
|
| Rate for Payer: PHP All Commercial |
$669.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$344.06
|
| Rate for Payer: Sagamore Health Network All Products |
$681.06
|
| Rate for Payer: Signature Care EPO |
$732.23
|
| Rate for Payer: Signature Care PPO |
$776.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$749.87
|
| Rate for Payer: United Healthcare Commercial |
$695.17
|
| Rate for Payer: United Healthcare Medicare |
$291.13
|
|
|
HC Z PIN 9IN
|
Facility
OP
|
$962.78
|
|
| Hospital Charge Code |
41605697
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$895.39 |
| Rate for Payer: Aetna Commercial |
$812.59
|
| Rate for Payer: Aetna Medicare |
$317.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$317.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$552.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$601.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$365.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$349.49
|
| Rate for Payer: Cash Price |
$596.92
|
| Rate for Payer: Cash Price |
$596.92
|
| Rate for Payer: Centivo All Commercial |
$491.02
|
| Rate for Payer: Cigna All Commercial |
$830.88
|
| Rate for Payer: CORVEL All Commercial |
$895.39
|
| Rate for Payer: Coventry All Commercial |
$847.25
|
| Rate for Payer: Encore All Commercial |
$886.24
|
| Rate for Payer: Frontpath All Commercial |
$885.76
|
| Rate for Payer: Humana ChoiceCare |
$831.55
|
| Rate for Payer: Humana Medicare |
$491.02
|
| Rate for Payer: Lucent All Commercial |
$491.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$866.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$722.08
|
| Rate for Payer: PHP All Commercial |
$730.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$375.48
|
| Rate for Payer: Sagamore Health Network All Products |
$743.27
|
| Rate for Payer: Signature Care EPO |
$799.11
|
| Rate for Payer: Signature Care PPO |
$847.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$818.36
|
| Rate for Payer: United Healthcare Commercial |
$758.67
|
| Rate for Payer: United Healthcare Medicare |
$317.72
|
|
|
HC Z PIN 9IN
|
Facility
IP
|
$962.78
|
|
| Hospital Charge Code |
41605697
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$722.08 |
| Max. Negotiated Rate |
$895.39 |
| Rate for Payer: Aetna Commercial |
$831.84
|
| Rate for Payer: Cash Price |
$596.92
|
| Rate for Payer: Cigna All Commercial |
$830.88
|
| Rate for Payer: CORVEL All Commercial |
$895.39
|
| Rate for Payer: Coventry All Commercial |
$847.25
|
| Rate for Payer: Encore All Commercial |
$886.24
|
| Rate for Payer: Frontpath All Commercial |
$885.76
|
| Rate for Payer: Humana ChoiceCare |
$831.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$866.50
|
| Rate for Payer: PHCS All Commercial |
$722.08
|
| Rate for Payer: PHP All Commercial |
$730.17
|
| Rate for Payer: Sagamore Health Network All Products |
$743.27
|
| Rate for Payer: Signature Care EPO |
$799.11
|
| Rate for Payer: Signature Care PPO |
$847.25
|
| Rate for Payer: United Healthcare Commercial |
$758.67
|
|
|
HC Z PIN CLAMP LG
|
Facility
IP
|
$2,025.36
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,519.02 |
| Max. Negotiated Rate |
$1,883.58 |
| Rate for Payer: Aetna Commercial |
$1,749.91
|
| Rate for Payer: Cash Price |
$1,255.72
|
| Rate for Payer: Cigna All Commercial |
$1,747.89
|
| Rate for Payer: CORVEL All Commercial |
$1,883.58
|
| Rate for Payer: Coventry All Commercial |
$1,782.32
|
| Rate for Payer: Encore All Commercial |
$1,864.34
|
| Rate for Payer: Frontpath All Commercial |
$1,863.33
|
| Rate for Payer: Humana ChoiceCare |
$1,749.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,822.82
|
| Rate for Payer: PHCS All Commercial |
$1,519.02
|
| Rate for Payer: PHP All Commercial |
$1,536.03
|
| Rate for Payer: Sagamore Health Network All Products |
$1,563.58
|
| Rate for Payer: Signature Care EPO |
$1,681.05
|
| Rate for Payer: Signature Care PPO |
$1,782.32
|
| Rate for Payer: United Healthcare Commercial |
$1,595.98
|
|
|
HC Z PIN CLAMP LG
|
Facility
OP
|
$2,025.36
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,883.58 |
| Rate for Payer: Aetna Commercial |
$1,709.40
|
| Rate for Payer: Aetna Medicare |
$668.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$668.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,163.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,266.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$768.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$735.21
|
| Rate for Payer: Cash Price |
$1,255.72
|
| Rate for Payer: Cash Price |
$1,255.72
|
| Rate for Payer: Centivo All Commercial |
$1,032.93
|
| Rate for Payer: Cigna All Commercial |
$1,747.89
|
| Rate for Payer: CORVEL All Commercial |
$1,883.58
|
| Rate for Payer: Coventry All Commercial |
$1,782.32
|
| Rate for Payer: Encore All Commercial |
$1,864.34
|
| Rate for Payer: Frontpath All Commercial |
$1,863.33
|
| Rate for Payer: Humana ChoiceCare |
$1,749.30
|
| Rate for Payer: Humana Medicare |
$1,032.93
|
| Rate for Payer: Lucent All Commercial |
$1,032.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,822.82
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,519.02
|
| Rate for Payer: PHP All Commercial |
$1,536.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$789.89
|
| Rate for Payer: Sagamore Health Network All Products |
$1,563.58
|
| Rate for Payer: Signature Care EPO |
$1,681.05
|
| Rate for Payer: Signature Care PPO |
$1,782.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,721.56
|
| Rate for Payer: United Healthcare Commercial |
$1,595.98
|
| Rate for Payer: United Healthcare Medicare |
$668.37
|
|
|
HC Z PIN CLAMP LG 2-BAR
|
Facility
IP
|
$4,793.69
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607492
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,595.27 |
| Max. Negotiated Rate |
$4,458.13 |
| Rate for Payer: Aetna Commercial |
$4,141.75
|
| Rate for Payer: Cash Price |
$2,972.09
|
| Rate for Payer: Cigna All Commercial |
$4,136.95
|
| Rate for Payer: CORVEL All Commercial |
$4,458.13
|
| Rate for Payer: Coventry All Commercial |
$4,218.45
|
| Rate for Payer: Encore All Commercial |
$4,412.59
|
| Rate for Payer: Frontpath All Commercial |
$4,410.19
|
| Rate for Payer: Humana ChoiceCare |
$4,140.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,314.32
|
| Rate for Payer: PHCS All Commercial |
$3,595.27
|
| Rate for Payer: PHP All Commercial |
$3,635.53
|
| Rate for Payer: Sagamore Health Network All Products |
$3,700.73
|
| Rate for Payer: Signature Care EPO |
$3,978.76
|
| Rate for Payer: Signature Care PPO |
$4,218.45
|
| Rate for Payer: United Healthcare Commercial |
$3,777.43
|
|
|
HC Z PIN CLAMP LG 2-BAR
|
Facility
OP
|
$4,793.69
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607492
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$4,458.13 |
| Rate for Payer: Aetna Commercial |
$4,045.87
|
| Rate for Payer: Aetna Medicare |
$1,581.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,581.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,753.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,996.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,819.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,740.11
|
| Rate for Payer: Cash Price |
$2,972.09
|
| Rate for Payer: Cash Price |
$2,972.09
|
| Rate for Payer: Centivo All Commercial |
$2,444.78
|
| Rate for Payer: Cigna All Commercial |
$4,136.95
|
| Rate for Payer: CORVEL All Commercial |
$4,458.13
|
| Rate for Payer: Coventry All Commercial |
$4,218.45
|
| Rate for Payer: Encore All Commercial |
$4,412.59
|
| Rate for Payer: Frontpath All Commercial |
$4,410.19
|
| Rate for Payer: Humana ChoiceCare |
$4,140.31
|
| Rate for Payer: Humana Medicare |
$2,444.78
|
| Rate for Payer: Lucent All Commercial |
$2,444.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,314.32
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$3,595.27
|
| Rate for Payer: PHP All Commercial |
$3,635.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,869.54
|
| Rate for Payer: Sagamore Health Network All Products |
$3,700.73
|
| Rate for Payer: Signature Care EPO |
$3,978.76
|
| Rate for Payer: Signature Care PPO |
$4,218.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,074.64
|
| Rate for Payer: United Healthcare Commercial |
$3,777.43
|
| Rate for Payer: United Healthcare Medicare |
$1,581.92
|
|
|
HC Z PIN NANO STEIN 7
|
Facility
OP
|
$1,536.40
|
|
| Hospital Charge Code |
41607856
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,428.85 |
| Rate for Payer: Aetna Commercial |
$1,296.72
|
| Rate for Payer: Aetna Medicare |
$507.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$507.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$882.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$960.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$583.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$557.71
|
| Rate for Payer: Cash Price |
$952.57
|
| Rate for Payer: Cash Price |
$952.57
|
| Rate for Payer: Centivo All Commercial |
$783.56
|
| Rate for Payer: Cigna All Commercial |
$1,325.91
|
| Rate for Payer: CORVEL All Commercial |
$1,428.85
|
| Rate for Payer: Coventry All Commercial |
$1,352.03
|
| Rate for Payer: Encore All Commercial |
$1,414.26
|
| Rate for Payer: Frontpath All Commercial |
$1,413.49
|
| Rate for Payer: Humana ChoiceCare |
$1,326.99
|
| Rate for Payer: Humana Medicare |
$783.56
|
| Rate for Payer: Lucent All Commercial |
$783.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,382.76
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,152.30
|
| Rate for Payer: PHP All Commercial |
$1,165.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$599.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,186.10
|
| Rate for Payer: Signature Care EPO |
$1,275.21
|
| Rate for Payer: Signature Care PPO |
$1,352.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,305.94
|
| Rate for Payer: United Healthcare Commercial |
$1,210.68
|
| Rate for Payer: United Healthcare Medicare |
$507.01
|
|
|
HC Z PIN NANO STEIN 7
|
Facility
IP
|
$1,536.40
|
|
| Hospital Charge Code |
41607856
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,152.30 |
| Max. Negotiated Rate |
$1,428.85 |
| Rate for Payer: Aetna Commercial |
$1,327.45
|
| Rate for Payer: Cash Price |
$952.57
|
| Rate for Payer: Cigna All Commercial |
$1,325.91
|
| Rate for Payer: CORVEL All Commercial |
$1,428.85
|
| Rate for Payer: Coventry All Commercial |
$1,352.03
|
| Rate for Payer: Encore All Commercial |
$1,414.26
|
| Rate for Payer: Frontpath All Commercial |
$1,413.49
|
| Rate for Payer: Humana ChoiceCare |
$1,326.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,382.76
|
| Rate for Payer: PHCS All Commercial |
$1,152.30
|
| Rate for Payer: PHP All Commercial |
$1,165.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,186.10
|
| Rate for Payer: Signature Care EPO |
$1,275.21
|
| Rate for Payer: Signature Care PPO |
$1,352.03
|
| Rate for Payer: United Healthcare Commercial |
$1,210.68
|
|
|
HC Z PIN STEIN 1.6X6 BT
|
Facility
OP
|
$260.61
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$219.95
|
| Rate for Payer: Aetna Medicare |
$86.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$86.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$149.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$162.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$98.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$94.60
|
| Rate for Payer: Cash Price |
$161.58
|
| Rate for Payer: Cash Price |
$161.58
|
| Rate for Payer: Centivo All Commercial |
$132.91
|
| Rate for Payer: Cigna All Commercial |
$224.91
|
| Rate for Payer: CORVEL All Commercial |
$242.37
|
| Rate for Payer: Coventry All Commercial |
$229.34
|
| Rate for Payer: Encore All Commercial |
$239.89
|
| Rate for Payer: Frontpath All Commercial |
$239.76
|
| Rate for Payer: Humana ChoiceCare |
$225.09
|
| Rate for Payer: Humana Medicare |
$132.91
|
| Rate for Payer: Lucent All Commercial |
$132.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$234.55
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$195.46
|
| Rate for Payer: PHP All Commercial |
$197.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$101.64
|
| Rate for Payer: Sagamore Health Network All Products |
$201.19
|
| Rate for Payer: Signature Care EPO |
$216.31
|
| Rate for Payer: Signature Care PPO |
$229.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$221.52
|
| Rate for Payer: United Healthcare Commercial |
$205.36
|
| Rate for Payer: United Healthcare Medicare |
$86.00
|
|
|
HC Z PIN STEIN 1.6X6 BT
|
Facility
IP
|
$260.61
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$195.46 |
| Max. Negotiated Rate |
$242.37 |
| Rate for Payer: Aetna Commercial |
$225.17
|
| Rate for Payer: Cash Price |
$161.58
|
| Rate for Payer: Cigna All Commercial |
$224.91
|
| Rate for Payer: CORVEL All Commercial |
$242.37
|
| Rate for Payer: Coventry All Commercial |
$229.34
|
| Rate for Payer: Encore All Commercial |
$239.89
|
| Rate for Payer: Frontpath All Commercial |
$239.76
|
| Rate for Payer: Humana ChoiceCare |
$225.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$234.55
|
| Rate for Payer: PHCS All Commercial |
$195.46
|
| Rate for Payer: PHP All Commercial |
$197.65
|
| Rate for Payer: Sagamore Health Network All Products |
$201.19
|
| Rate for Payer: Signature Care EPO |
$216.31
|
| Rate for Payer: Signature Care PPO |
$229.34
|
| Rate for Payer: United Healthcare Commercial |
$205.36
|
|
|
HC Z PIN THREADED 3.0
|
Facility
OP
|
$652.47
|
|
| Hospital Charge Code |
41603898
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$606.80 |
| Rate for Payer: Aetna Commercial |
$550.68
|
| Rate for Payer: Aetna Medicare |
$215.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$215.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$374.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$407.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$247.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$236.85
|
| Rate for Payer: Cash Price |
$404.53
|
| Rate for Payer: Cash Price |
$404.53
|
| Rate for Payer: Centivo All Commercial |
$332.76
|
| Rate for Payer: Cigna All Commercial |
$563.08
|
| Rate for Payer: CORVEL All Commercial |
$606.80
|
| Rate for Payer: Coventry All Commercial |
$574.17
|
| Rate for Payer: Encore All Commercial |
$600.60
|
| Rate for Payer: Frontpath All Commercial |
$600.27
|
| Rate for Payer: Humana ChoiceCare |
$563.54
|
| Rate for Payer: Humana Medicare |
$332.76
|
| Rate for Payer: Lucent All Commercial |
$332.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$587.22
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$489.35
|
| Rate for Payer: PHP All Commercial |
$494.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$254.46
|
| Rate for Payer: Sagamore Health Network All Products |
$503.71
|
| Rate for Payer: Signature Care EPO |
$541.55
|
| Rate for Payer: Signature Care PPO |
$574.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$554.60
|
| Rate for Payer: United Healthcare Commercial |
$514.15
|
| Rate for Payer: United Healthcare Medicare |
$215.32
|
|
|
HC Z PIN THREADED 3.0
|
Facility
IP
|
$652.47
|
|
| Hospital Charge Code |
41603898
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$489.35 |
| Max. Negotiated Rate |
$606.80 |
| Rate for Payer: Aetna Commercial |
$563.73
|
| Rate for Payer: Cash Price |
$404.53
|
| Rate for Payer: Cigna All Commercial |
$563.08
|
| Rate for Payer: CORVEL All Commercial |
$606.80
|
| Rate for Payer: Coventry All Commercial |
$574.17
|
| Rate for Payer: Encore All Commercial |
$600.60
|
| Rate for Payer: Frontpath All Commercial |
$600.27
|
| Rate for Payer: Humana ChoiceCare |
$563.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$587.22
|
| Rate for Payer: PHCS All Commercial |
$489.35
|
| Rate for Payer: PHP All Commercial |
$494.83
|
| Rate for Payer: Sagamore Health Network All Products |
$503.71
|
| Rate for Payer: Signature Care EPO |
$541.55
|
| Rate for Payer: Signature Care PPO |
$574.17
|
| Rate for Payer: United Healthcare Commercial |
$514.15
|
|
|
HC Z PIN THREADED 3.0 305
|
Facility
OP
|
$605.92
|
|
| Hospital Charge Code |
41608305
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$563.51 |
| Rate for Payer: Cash Price |
$375.67
|
| Rate for Payer: Centivo All Commercial |
$309.02
|
| Rate for Payer: Cigna All Commercial |
$522.91
|
| Rate for Payer: CORVEL All Commercial |
$563.51
|
| Rate for Payer: Coventry All Commercial |
$533.21
|
| Rate for Payer: Encore All Commercial |
$557.75
|
| Rate for Payer: Frontpath All Commercial |
$557.45
|
| Rate for Payer: Humana ChoiceCare |
$523.33
|
| Rate for Payer: Humana Medicare |
$309.02
|
| Rate for Payer: Lucent All Commercial |
$309.02
|
| Rate for Payer: Aetna Commercial |
$511.40
|
| Rate for Payer: Aetna Medicare |
$199.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$199.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$347.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$378.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$229.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$219.95
|
| Rate for Payer: Cash Price |
$375.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$545.33
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$454.44
|
| Rate for Payer: PHP All Commercial |
$459.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$236.31
|
| Rate for Payer: Sagamore Health Network All Products |
$467.77
|
| Rate for Payer: Signature Care EPO |
$502.91
|
| Rate for Payer: Signature Care PPO |
$533.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$515.03
|
| Rate for Payer: United Healthcare Commercial |
$477.46
|
| Rate for Payer: United Healthcare Medicare |
$199.95
|
|
