|
HC Z PLATE DIST MED TIB 9H R
|
Facility
IP
|
$5,121.07
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607957
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,840.80 |
| Max. Negotiated Rate |
$4,762.60 |
| Rate for Payer: Aetna Commercial |
$4,424.60
|
| Rate for Payer: Cash Price |
$3,175.06
|
| Rate for Payer: Cigna All Commercial |
$4,419.48
|
| Rate for Payer: CORVEL All Commercial |
$4,762.60
|
| Rate for Payer: Coventry All Commercial |
$4,506.54
|
| Rate for Payer: Encore All Commercial |
$4,713.94
|
| Rate for Payer: Frontpath All Commercial |
$4,711.38
|
| Rate for Payer: Humana ChoiceCare |
$4,423.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,608.96
|
| Rate for Payer: PHCS All Commercial |
$3,840.80
|
| Rate for Payer: PHP All Commercial |
$3,883.82
|
| Rate for Payer: Sagamore Health Network All Products |
$3,953.47
|
| Rate for Payer: Signature Care EPO |
$4,250.49
|
| Rate for Payer: Signature Care PPO |
$4,506.54
|
| Rate for Payer: United Healthcare Commercial |
$4,035.40
|
|
|
HC Z PLATE DORSAL L
|
Facility
OP
|
$3,137.87
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606422
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,918.22 |
| Rate for Payer: Aetna Commercial |
$2,648.36
|
| Rate for Payer: Aetna Medicare |
$1,035.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,035.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,802.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,961.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,190.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,139.05
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Centivo All Commercial |
$1,600.31
|
| Rate for Payer: Cigna All Commercial |
$2,707.98
|
| Rate for Payer: CORVEL All Commercial |
$2,918.22
|
| Rate for Payer: Coventry All Commercial |
$2,761.33
|
| Rate for Payer: Encore All Commercial |
$2,888.41
|
| Rate for Payer: Frontpath All Commercial |
$2,886.84
|
| Rate for Payer: Humana ChoiceCare |
$2,710.18
|
| Rate for Payer: Humana Medicare |
$1,600.31
|
| Rate for Payer: Lucent All Commercial |
$1,600.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,824.08
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,353.40
|
| Rate for Payer: PHP All Commercial |
$2,379.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,223.77
|
| Rate for Payer: Sagamore Health Network All Products |
$2,422.44
|
| Rate for Payer: Signature Care EPO |
$2,604.43
|
| Rate for Payer: Signature Care PPO |
$2,761.33
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,667.19
|
| Rate for Payer: United Healthcare Commercial |
$2,472.64
|
| Rate for Payer: United Healthcare Medicare |
$1,035.50
|
|
|
HC Z PLATE DORSAL L
|
Facility
IP
|
$3,137.87
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606422
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,353.40 |
| Max. Negotiated Rate |
$2,918.22 |
| Rate for Payer: Aetna Commercial |
$2,711.12
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Cigna All Commercial |
$2,707.98
|
| Rate for Payer: CORVEL All Commercial |
$2,918.22
|
| Rate for Payer: Coventry All Commercial |
$2,761.33
|
| Rate for Payer: Encore All Commercial |
$2,888.41
|
| Rate for Payer: Frontpath All Commercial |
$2,886.84
|
| Rate for Payer: Humana ChoiceCare |
$2,710.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,824.08
|
| Rate for Payer: PHCS All Commercial |
$2,353.40
|
| Rate for Payer: PHP All Commercial |
$2,379.76
|
| Rate for Payer: Sagamore Health Network All Products |
$2,422.44
|
| Rate for Payer: Signature Care EPO |
$2,604.43
|
| Rate for Payer: Signature Care PPO |
$2,761.33
|
| Rate for Payer: United Healthcare Commercial |
$2,472.64
|
|
|
HC Z PLATE DORSAL R
|
Facility
IP
|
$3,137.87
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,353.40 |
| Max. Negotiated Rate |
$2,918.22 |
| Rate for Payer: Aetna Commercial |
$2,711.12
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Cigna All Commercial |
$2,707.98
|
| Rate for Payer: CORVEL All Commercial |
$2,918.22
|
| Rate for Payer: Coventry All Commercial |
$2,761.33
|
| Rate for Payer: Encore All Commercial |
$2,888.41
|
| Rate for Payer: Frontpath All Commercial |
$2,886.84
|
| Rate for Payer: Humana ChoiceCare |
$2,710.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,824.08
|
| Rate for Payer: PHCS All Commercial |
$2,353.40
|
| Rate for Payer: PHP All Commercial |
$2,379.76
|
| Rate for Payer: Sagamore Health Network All Products |
$2,422.44
|
| Rate for Payer: Signature Care EPO |
$2,604.43
|
| Rate for Payer: Signature Care PPO |
$2,761.33
|
| Rate for Payer: United Healthcare Commercial |
$2,472.64
|
|
|
HC Z PLATE DORSAL R
|
Facility
OP
|
$3,137.87
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,918.22 |
| Rate for Payer: Aetna Commercial |
$2,648.36
|
| Rate for Payer: Aetna Medicare |
$1,035.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,035.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,802.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,961.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,190.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,139.05
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Centivo All Commercial |
$1,600.31
|
| Rate for Payer: Cigna All Commercial |
$2,707.98
|
| Rate for Payer: CORVEL All Commercial |
$2,918.22
|
| Rate for Payer: Coventry All Commercial |
$2,761.33
|
| Rate for Payer: Encore All Commercial |
$2,888.41
|
| Rate for Payer: Frontpath All Commercial |
$2,886.84
|
| Rate for Payer: Humana ChoiceCare |
$2,710.18
|
| Rate for Payer: Humana Medicare |
$1,600.31
|
| Rate for Payer: Lucent All Commercial |
$1,600.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,824.08
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,353.40
|
| Rate for Payer: PHP All Commercial |
$2,379.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,223.77
|
| Rate for Payer: Sagamore Health Network All Products |
$2,422.44
|
| Rate for Payer: Signature Care EPO |
$2,604.43
|
| Rate for Payer: Signature Care PPO |
$2,761.33
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,667.19
|
| Rate for Payer: United Healthcare Commercial |
$2,472.64
|
| Rate for Payer: United Healthcare Medicare |
$1,035.50
|
|
|
HC Z PLATE DT MD TIB 6-H
|
Facility
IP
|
$4,865.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606192
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,649.22 |
| Max. Negotiated Rate |
$4,525.03 |
| Rate for Payer: Aetna Commercial |
$4,203.90
|
| Rate for Payer: Cash Price |
$3,016.68
|
| Rate for Payer: Cigna All Commercial |
$4,199.03
|
| Rate for Payer: CORVEL All Commercial |
$4,525.03
|
| Rate for Payer: Coventry All Commercial |
$4,281.75
|
| Rate for Payer: Encore All Commercial |
$4,478.80
|
| Rate for Payer: Frontpath All Commercial |
$4,476.37
|
| Rate for Payer: Humana ChoiceCare |
$4,202.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,379.06
|
| Rate for Payer: PHCS All Commercial |
$3,649.22
|
| Rate for Payer: PHP All Commercial |
$3,690.09
|
| Rate for Payer: Sagamore Health Network All Products |
$3,756.26
|
| Rate for Payer: Signature Care EPO |
$4,038.46
|
| Rate for Payer: Signature Care PPO |
$4,281.75
|
| Rate for Payer: United Healthcare Commercial |
$3,834.11
|
|
|
HC Z PLATE DT MD TIB 6-H
|
Facility
OP
|
$4,865.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606192
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,525.03 |
| Rate for Payer: Aetna Commercial |
$4,106.58
|
| Rate for Payer: Aetna Medicare |
$1,605.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,605.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,794.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,041.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,846.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,766.22
|
| Rate for Payer: Cash Price |
$3,016.68
|
| Rate for Payer: Cash Price |
$3,016.68
|
| Rate for Payer: Centivo All Commercial |
$2,481.47
|
| Rate for Payer: Cigna All Commercial |
$4,199.03
|
| Rate for Payer: CORVEL All Commercial |
$4,525.03
|
| Rate for Payer: Coventry All Commercial |
$4,281.75
|
| Rate for Payer: Encore All Commercial |
$4,478.80
|
| Rate for Payer: Frontpath All Commercial |
$4,476.37
|
| Rate for Payer: Humana ChoiceCare |
$4,202.44
|
| Rate for Payer: Humana Medicare |
$2,481.47
|
| Rate for Payer: Lucent All Commercial |
$2,481.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,379.06
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,649.22
|
| Rate for Payer: PHP All Commercial |
$3,690.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,897.59
|
| Rate for Payer: Sagamore Health Network All Products |
$3,756.26
|
| Rate for Payer: Signature Care EPO |
$4,038.46
|
| Rate for Payer: Signature Care PPO |
$4,281.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,135.78
|
| Rate for Payer: United Healthcare Commercial |
$3,834.11
|
| Rate for Payer: United Healthcare Medicare |
$1,605.65
|
|
|
HC Z PLATE EXT EXT LONG LOCK L ST
|
Facility
IP
|
$4,937.69
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,703.27 |
| Max. Negotiated Rate |
$4,592.05 |
| Rate for Payer: Aetna Commercial |
$4,266.16
|
| Rate for Payer: Cash Price |
$3,061.37
|
| Rate for Payer: Cigna All Commercial |
$4,261.23
|
| Rate for Payer: CORVEL All Commercial |
$4,592.05
|
| Rate for Payer: Coventry All Commercial |
$4,345.17
|
| Rate for Payer: Encore All Commercial |
$4,545.14
|
| Rate for Payer: Frontpath All Commercial |
$4,542.67
|
| Rate for Payer: Humana ChoiceCare |
$4,264.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,443.92
|
| Rate for Payer: PHCS All Commercial |
$3,703.27
|
| Rate for Payer: PHP All Commercial |
$3,744.74
|
| Rate for Payer: Sagamore Health Network All Products |
$3,811.90
|
| Rate for Payer: Signature Care EPO |
$4,098.28
|
| Rate for Payer: Signature Care PPO |
$4,345.17
|
| Rate for Payer: United Healthcare Commercial |
$3,890.90
|
|
|
HC Z PLATE EXT EXT LONG LOCK L ST
|
Facility
OP
|
$4,937.69
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,592.05 |
| Rate for Payer: Aetna Commercial |
$4,167.41
|
| Rate for Payer: Aetna Medicare |
$1,629.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,629.44
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,835.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,086.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,873.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,792.38
|
| Rate for Payer: Cash Price |
$3,061.37
|
| Rate for Payer: Cash Price |
$3,061.37
|
| Rate for Payer: Centivo All Commercial |
$2,518.22
|
| Rate for Payer: Cigna All Commercial |
$4,261.23
|
| Rate for Payer: CORVEL All Commercial |
$4,592.05
|
| Rate for Payer: Coventry All Commercial |
$4,345.17
|
| Rate for Payer: Encore All Commercial |
$4,545.14
|
| Rate for Payer: Frontpath All Commercial |
$4,542.67
|
| Rate for Payer: Humana ChoiceCare |
$4,264.68
|
| Rate for Payer: Humana Medicare |
$2,518.22
|
| Rate for Payer: Lucent All Commercial |
$2,518.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,443.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,703.27
|
| Rate for Payer: PHP All Commercial |
$3,744.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,925.70
|
| Rate for Payer: Sagamore Health Network All Products |
$3,811.90
|
| Rate for Payer: Signature Care EPO |
$4,098.28
|
| Rate for Payer: Signature Care PPO |
$4,345.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,197.04
|
| Rate for Payer: United Healthcare Commercial |
$3,890.90
|
| Rate for Payer: United Healthcare Medicare |
$1,629.44
|
|
|
HC Z PLATE EXT EXT LONG LOCK R ST
|
Facility
OP
|
$4,937.69
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606393
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,592.05 |
| Rate for Payer: Aetna Commercial |
$4,167.41
|
| Rate for Payer: Aetna Medicare |
$1,629.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,629.44
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,835.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,086.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,873.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,792.38
|
| Rate for Payer: Cash Price |
$3,061.37
|
| Rate for Payer: Cash Price |
$3,061.37
|
| Rate for Payer: Centivo All Commercial |
$2,518.22
|
| Rate for Payer: Cigna All Commercial |
$4,261.23
|
| Rate for Payer: CORVEL All Commercial |
$4,592.05
|
| Rate for Payer: Coventry All Commercial |
$4,345.17
|
| Rate for Payer: Encore All Commercial |
$4,545.14
|
| Rate for Payer: Frontpath All Commercial |
$4,542.67
|
| Rate for Payer: Humana ChoiceCare |
$4,264.68
|
| Rate for Payer: Humana Medicare |
$2,518.22
|
| Rate for Payer: Lucent All Commercial |
$2,518.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,443.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,703.27
|
| Rate for Payer: PHP All Commercial |
$3,744.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,925.70
|
| Rate for Payer: Sagamore Health Network All Products |
$3,811.90
|
| Rate for Payer: Signature Care EPO |
$4,098.28
|
| Rate for Payer: Signature Care PPO |
$4,345.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,197.04
|
| Rate for Payer: United Healthcare Commercial |
$3,890.90
|
| Rate for Payer: United Healthcare Medicare |
$1,629.44
|
|
|
HC Z PLATE EXT EXT LONG LOCK R ST
|
Facility
IP
|
$4,937.69
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606393
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,703.27 |
| Max. Negotiated Rate |
$4,592.05 |
| Rate for Payer: Aetna Commercial |
$4,266.16
|
| Rate for Payer: Cash Price |
$3,061.37
|
| Rate for Payer: Cigna All Commercial |
$4,261.23
|
| Rate for Payer: CORVEL All Commercial |
$4,592.05
|
| Rate for Payer: Coventry All Commercial |
$4,345.17
|
| Rate for Payer: Encore All Commercial |
$4,545.14
|
| Rate for Payer: Frontpath All Commercial |
$4,542.67
|
| Rate for Payer: Humana ChoiceCare |
$4,264.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,443.92
|
| Rate for Payer: PHCS All Commercial |
$3,703.27
|
| Rate for Payer: PHP All Commercial |
$3,744.74
|
| Rate for Payer: Sagamore Health Network All Products |
$3,811.90
|
| Rate for Payer: Signature Care EPO |
$4,098.28
|
| Rate for Payer: Signature Care PPO |
$4,345.17
|
| Rate for Payer: United Healthcare Commercial |
$3,890.90
|
|
|
HC Z PLATE EXT LONG LOCK L ST
|
Facility
OP
|
$4,497.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606414
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,182.89 |
| Rate for Payer: Aetna Commercial |
$3,796.08
|
| Rate for Payer: Aetna Medicare |
$1,484.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,484.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,583.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,811.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,706.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,632.68
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Centivo All Commercial |
$2,293.84
|
| Rate for Payer: Cigna All Commercial |
$3,881.54
|
| Rate for Payer: CORVEL All Commercial |
$4,182.89
|
| Rate for Payer: Coventry All Commercial |
$3,958.00
|
| Rate for Payer: Encore All Commercial |
$4,140.16
|
| Rate for Payer: Frontpath All Commercial |
$4,137.91
|
| Rate for Payer: Humana ChoiceCare |
$3,884.69
|
| Rate for Payer: Humana Medicare |
$2,293.84
|
| Rate for Payer: Lucent All Commercial |
$2,293.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,047.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,373.30
|
| Rate for Payer: PHP All Commercial |
$3,411.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,754.11
|
| Rate for Payer: Sagamore Health Network All Products |
$3,472.25
|
| Rate for Payer: Signature Care EPO |
$3,733.12
|
| Rate for Payer: Signature Care PPO |
$3,958.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,823.07
|
| Rate for Payer: United Healthcare Commercial |
$3,544.21
|
| Rate for Payer: United Healthcare Medicare |
$1,484.25
|
|
|
HC Z PLATE EXT LONG LOCK L ST
|
Facility
IP
|
$4,497.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606414
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,373.30 |
| Max. Negotiated Rate |
$4,182.89 |
| Rate for Payer: Aetna Commercial |
$3,886.04
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Cigna All Commercial |
$3,881.54
|
| Rate for Payer: CORVEL All Commercial |
$4,182.89
|
| Rate for Payer: Coventry All Commercial |
$3,958.00
|
| Rate for Payer: Encore All Commercial |
$4,140.16
|
| Rate for Payer: Frontpath All Commercial |
$4,137.91
|
| Rate for Payer: Humana ChoiceCare |
$3,884.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,047.96
|
| Rate for Payer: PHCS All Commercial |
$3,373.30
|
| Rate for Payer: PHP All Commercial |
$3,411.08
|
| Rate for Payer: Sagamore Health Network All Products |
$3,472.25
|
| Rate for Payer: Signature Care EPO |
$3,733.12
|
| Rate for Payer: Signature Care PPO |
$3,958.00
|
| Rate for Payer: United Healthcare Commercial |
$3,544.21
|
|
|
HC Z PLATE EXT LONG LOCK R ST
|
Facility
IP
|
$4,497.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,373.30 |
| Max. Negotiated Rate |
$4,182.89 |
| Rate for Payer: Aetna Commercial |
$3,886.04
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Cigna All Commercial |
$3,881.54
|
| Rate for Payer: CORVEL All Commercial |
$4,182.89
|
| Rate for Payer: Coventry All Commercial |
$3,958.00
|
| Rate for Payer: Encore All Commercial |
$4,140.16
|
| Rate for Payer: Frontpath All Commercial |
$4,137.91
|
| Rate for Payer: Humana ChoiceCare |
$3,884.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,047.96
|
| Rate for Payer: PHCS All Commercial |
$3,373.30
|
| Rate for Payer: PHP All Commercial |
$3,411.08
|
| Rate for Payer: Sagamore Health Network All Products |
$3,472.25
|
| Rate for Payer: Signature Care EPO |
$3,733.12
|
| Rate for Payer: Signature Care PPO |
$3,958.00
|
| Rate for Payer: United Healthcare Commercial |
$3,544.21
|
|
|
HC Z PLATE EXT LONG LOCK R ST
|
Facility
OP
|
$4,497.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,182.89 |
| Rate for Payer: Aetna Commercial |
$3,796.08
|
| Rate for Payer: Aetna Medicare |
$1,484.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,484.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,583.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,811.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,706.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,632.68
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Centivo All Commercial |
$2,293.84
|
| Rate for Payer: Cigna All Commercial |
$3,881.54
|
| Rate for Payer: CORVEL All Commercial |
$4,182.89
|
| Rate for Payer: Coventry All Commercial |
$3,958.00
|
| Rate for Payer: Encore All Commercial |
$4,140.16
|
| Rate for Payer: Frontpath All Commercial |
$4,137.91
|
| Rate for Payer: Humana ChoiceCare |
$3,884.69
|
| Rate for Payer: Humana Medicare |
$2,293.84
|
| Rate for Payer: Lucent All Commercial |
$2,293.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,047.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,373.30
|
| Rate for Payer: PHP All Commercial |
$3,411.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,754.11
|
| Rate for Payer: Sagamore Health Network All Products |
$3,472.25
|
| Rate for Payer: Signature Care EPO |
$3,733.12
|
| Rate for Payer: Signature Care PPO |
$3,958.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,823.07
|
| Rate for Payer: United Healthcare Commercial |
$3,544.21
|
| Rate for Payer: United Healthcare Medicare |
$1,484.25
|
|
|
HC Z PLATE EXT NARROW LOCK L ST
|
Facility
OP
|
$2,719.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,529.35 |
| Rate for Payer: Aetna Commercial |
$2,295.45
|
| Rate for Payer: Aetna Medicare |
$897.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$897.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,561.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,700.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,032.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$987.26
|
| Rate for Payer: Cash Price |
$1,686.23
|
| Rate for Payer: Cash Price |
$1,686.23
|
| Rate for Payer: Centivo All Commercial |
$1,387.06
|
| Rate for Payer: Cigna All Commercial |
$2,347.13
|
| Rate for Payer: CORVEL All Commercial |
$2,529.35
|
| Rate for Payer: Coventry All Commercial |
$2,393.36
|
| Rate for Payer: Encore All Commercial |
$2,503.51
|
| Rate for Payer: Frontpath All Commercial |
$2,502.15
|
| Rate for Payer: Humana ChoiceCare |
$2,349.03
|
| Rate for Payer: Humana Medicare |
$1,387.06
|
| Rate for Payer: Lucent All Commercial |
$1,387.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,447.76
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,039.80
|
| Rate for Payer: PHP All Commercial |
$2,062.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,060.69
|
| Rate for Payer: Sagamore Health Network All Products |
$2,099.63
|
| Rate for Payer: Signature Care EPO |
$2,257.38
|
| Rate for Payer: Signature Care PPO |
$2,393.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,311.77
|
| Rate for Payer: United Healthcare Commercial |
$2,143.15
|
| Rate for Payer: United Healthcare Medicare |
$897.51
|
|
|
HC Z PLATE EXT NARROW LOCK L ST
|
Facility
IP
|
$2,719.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,039.80 |
| Max. Negotiated Rate |
$2,529.35 |
| Rate for Payer: Aetna Commercial |
$2,349.85
|
| Rate for Payer: Cash Price |
$1,686.23
|
| Rate for Payer: Cigna All Commercial |
$2,347.13
|
| Rate for Payer: CORVEL All Commercial |
$2,529.35
|
| Rate for Payer: Coventry All Commercial |
$2,393.36
|
| Rate for Payer: Encore All Commercial |
$2,503.51
|
| Rate for Payer: Frontpath All Commercial |
$2,502.15
|
| Rate for Payer: Humana ChoiceCare |
$2,349.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,447.76
|
| Rate for Payer: PHCS All Commercial |
$2,039.80
|
| Rate for Payer: PHP All Commercial |
$2,062.64
|
| Rate for Payer: Sagamore Health Network All Products |
$2,099.63
|
| Rate for Payer: Signature Care EPO |
$2,257.38
|
| Rate for Payer: Signature Care PPO |
$2,393.36
|
| Rate for Payer: United Healthcare Commercial |
$2,143.15
|
|
|
HC Z PLATE EXT NARROW LOCK R ST
|
Facility
IP
|
$2,719.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606308
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,039.80 |
| Max. Negotiated Rate |
$2,529.35 |
| Rate for Payer: Aetna Commercial |
$2,349.85
|
| Rate for Payer: Cash Price |
$1,686.23
|
| Rate for Payer: Cigna All Commercial |
$2,347.13
|
| Rate for Payer: CORVEL All Commercial |
$2,529.35
|
| Rate for Payer: Coventry All Commercial |
$2,393.36
|
| Rate for Payer: Encore All Commercial |
$2,503.51
|
| Rate for Payer: Frontpath All Commercial |
$2,502.15
|
| Rate for Payer: Humana ChoiceCare |
$2,349.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,447.76
|
| Rate for Payer: PHCS All Commercial |
$2,039.80
|
| Rate for Payer: PHP All Commercial |
$2,062.64
|
| Rate for Payer: Sagamore Health Network All Products |
$2,099.63
|
| Rate for Payer: Signature Care EPO |
$2,257.38
|
| Rate for Payer: Signature Care PPO |
$2,393.36
|
| Rate for Payer: United Healthcare Commercial |
$2,143.15
|
|
|
HC Z PLATE EXT NARROW LOCK R ST
|
Facility
OP
|
$2,719.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606308
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,529.35 |
| Rate for Payer: Aetna Commercial |
$2,295.45
|
| Rate for Payer: Aetna Medicare |
$897.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$897.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,561.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,700.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,032.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$987.26
|
| Rate for Payer: Cash Price |
$1,686.23
|
| Rate for Payer: Cash Price |
$1,686.23
|
| Rate for Payer: Centivo All Commercial |
$1,387.06
|
| Rate for Payer: Cigna All Commercial |
$2,347.13
|
| Rate for Payer: CORVEL All Commercial |
$2,529.35
|
| Rate for Payer: Coventry All Commercial |
$2,393.36
|
| Rate for Payer: Encore All Commercial |
$2,503.51
|
| Rate for Payer: Frontpath All Commercial |
$2,502.15
|
| Rate for Payer: Humana ChoiceCare |
$2,349.03
|
| Rate for Payer: Humana Medicare |
$1,387.06
|
| Rate for Payer: Lucent All Commercial |
$1,387.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,447.76
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,039.80
|
| Rate for Payer: PHP All Commercial |
$2,062.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,060.69
|
| Rate for Payer: Sagamore Health Network All Products |
$2,099.63
|
| Rate for Payer: Signature Care EPO |
$2,257.38
|
| Rate for Payer: Signature Care PPO |
$2,393.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,311.77
|
| Rate for Payer: United Healthcare Commercial |
$2,143.15
|
| Rate for Payer: United Healthcare Medicare |
$897.51
|
|
|
HC Z PLATE FIB 6-H LOCK
|
Facility
IP
|
$1,156.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$867.04 |
| Max. Negotiated Rate |
$1,075.13 |
| Rate for Payer: Aetna Commercial |
$998.83
|
| Rate for Payer: Cash Price |
$716.75
|
| Rate for Payer: Cigna All Commercial |
$997.67
|
| Rate for Payer: CORVEL All Commercial |
$1,075.13
|
| Rate for Payer: Coventry All Commercial |
$1,017.32
|
| Rate for Payer: Encore All Commercial |
$1,064.14
|
| Rate for Payer: Frontpath All Commercial |
$1,063.57
|
| Rate for Payer: Humana ChoiceCare |
$998.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,040.44
|
| Rate for Payer: PHCS All Commercial |
$867.04
|
| Rate for Payer: PHP All Commercial |
$876.75
|
| Rate for Payer: Sagamore Health Network All Products |
$892.47
|
| Rate for Payer: Signature Care EPO |
$959.52
|
| Rate for Payer: Signature Care PPO |
$1,017.32
|
| Rate for Payer: United Healthcare Commercial |
$910.97
|
|
|
HC Z PLATE FIB 6-H LOCK
|
Facility
OP
|
$1,156.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.50 |
| Max. Negotiated Rate |
$1,075.13 |
| Rate for Payer: Aetna Commercial |
$975.71
|
| Rate for Payer: Aetna Medicare |
$381.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$381.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$663.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$722.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$438.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$419.65
|
| Rate for Payer: Cash Price |
$716.75
|
| Rate for Payer: Cash Price |
$716.75
|
| Rate for Payer: Centivo All Commercial |
$589.59
|
| Rate for Payer: Cigna All Commercial |
$997.67
|
| Rate for Payer: CORVEL All Commercial |
$1,075.13
|
| Rate for Payer: Coventry All Commercial |
$1,017.32
|
| Rate for Payer: Encore All Commercial |
$1,064.14
|
| Rate for Payer: Frontpath All Commercial |
$1,063.57
|
| Rate for Payer: Humana ChoiceCare |
$998.48
|
| Rate for Payer: Humana Medicare |
$589.59
|
| Rate for Payer: Lucent All Commercial |
$589.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,040.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$867.04
|
| Rate for Payer: PHP All Commercial |
$876.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$450.86
|
| Rate for Payer: Sagamore Health Network All Products |
$892.47
|
| Rate for Payer: Signature Care EPO |
$959.52
|
| Rate for Payer: Signature Care PPO |
$1,017.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$982.64
|
| Rate for Payer: United Healthcare Commercial |
$910.97
|
| Rate for Payer: United Healthcare Medicare |
$381.50
|
|
|
HC Z PLATE FIB 7H LOCK
|
Facility
IP
|
$1,263.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607861
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$947.85 |
| Max. Negotiated Rate |
$1,175.33 |
| Rate for Payer: Aetna Commercial |
$1,091.92
|
| Rate for Payer: Cash Price |
$783.56
|
| Rate for Payer: Cigna All Commercial |
$1,090.66
|
| Rate for Payer: CORVEL All Commercial |
$1,175.33
|
| Rate for Payer: Coventry All Commercial |
$1,112.14
|
| Rate for Payer: Encore All Commercial |
$1,163.33
|
| Rate for Payer: Frontpath All Commercial |
$1,162.70
|
| Rate for Payer: Humana ChoiceCare |
$1,091.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,137.42
|
| Rate for Payer: PHCS All Commercial |
$947.85
|
| Rate for Payer: PHP All Commercial |
$958.47
|
| Rate for Payer: Sagamore Health Network All Products |
$975.65
|
| Rate for Payer: Signature Care EPO |
$1,048.95
|
| Rate for Payer: Signature Care PPO |
$1,112.14
|
| Rate for Payer: United Healthcare Commercial |
$995.87
|
|
|
HC Z PLATE FIB 7H LOCK
|
Facility
OP
|
$1,263.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607861
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$417.05 |
| Max. Negotiated Rate |
$1,175.33 |
| Rate for Payer: Aetna Commercial |
$1,066.65
|
| Rate for Payer: Aetna Medicare |
$417.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$417.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$725.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$790.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$479.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$458.76
|
| Rate for Payer: Cash Price |
$783.56
|
| Rate for Payer: Cash Price |
$783.56
|
| Rate for Payer: Centivo All Commercial |
$644.54
|
| Rate for Payer: Cigna All Commercial |
$1,090.66
|
| Rate for Payer: CORVEL All Commercial |
$1,175.33
|
| Rate for Payer: Coventry All Commercial |
$1,112.14
|
| Rate for Payer: Encore All Commercial |
$1,163.33
|
| Rate for Payer: Frontpath All Commercial |
$1,162.70
|
| Rate for Payer: Humana ChoiceCare |
$1,091.54
|
| Rate for Payer: Humana Medicare |
$644.54
|
| Rate for Payer: Lucent All Commercial |
$644.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,137.42
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$947.85
|
| Rate for Payer: PHP All Commercial |
$958.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$492.88
|
| Rate for Payer: Sagamore Health Network All Products |
$975.65
|
| Rate for Payer: Signature Care EPO |
$1,048.95
|
| Rate for Payer: Signature Care PPO |
$1,112.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,074.23
|
| Rate for Payer: United Healthcare Commercial |
$995.87
|
| Rate for Payer: United Healthcare Medicare |
$417.05
|
|
|
HC Z PLATE FIB 8H COMP
|
Facility
OP
|
$2,988.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,778.84 |
| Rate for Payer: Aetna Commercial |
$2,521.87
|
| Rate for Payer: Aetna Medicare |
$986.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$986.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,716.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,867.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,133.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,084.64
|
| Rate for Payer: Cash Price |
$1,852.56
|
| Rate for Payer: Cash Price |
$1,852.56
|
| Rate for Payer: Centivo All Commercial |
$1,523.88
|
| Rate for Payer: Cigna All Commercial |
$2,578.64
|
| Rate for Payer: CORVEL All Commercial |
$2,778.84
|
| Rate for Payer: Coventry All Commercial |
$2,629.44
|
| Rate for Payer: Encore All Commercial |
$2,750.45
|
| Rate for Payer: Frontpath All Commercial |
$2,748.96
|
| Rate for Payer: Humana ChoiceCare |
$2,580.74
|
| Rate for Payer: Humana Medicare |
$1,523.88
|
| Rate for Payer: Lucent All Commercial |
$1,523.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,689.20
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,241.00
|
| Rate for Payer: PHP All Commercial |
$2,266.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,165.32
|
| Rate for Payer: Sagamore Health Network All Products |
$2,306.74
|
| Rate for Payer: Signature Care EPO |
$2,480.04
|
| Rate for Payer: Signature Care PPO |
$2,629.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,539.80
|
| Rate for Payer: United Healthcare Commercial |
$2,354.54
|
| Rate for Payer: United Healthcare Medicare |
$986.04
|
|
|
HC Z PLATE FIB 8H COMP
|
Facility
IP
|
$2,988.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,241.00 |
| Max. Negotiated Rate |
$2,778.84 |
| Rate for Payer: Aetna Commercial |
$2,581.63
|
| Rate for Payer: Cash Price |
$1,852.56
|
| Rate for Payer: Cigna All Commercial |
$2,578.64
|
| Rate for Payer: CORVEL All Commercial |
$2,778.84
|
| Rate for Payer: Coventry All Commercial |
$2,629.44
|
| Rate for Payer: Encore All Commercial |
$2,750.45
|
| Rate for Payer: Frontpath All Commercial |
$2,748.96
|
| Rate for Payer: Humana ChoiceCare |
$2,580.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,689.20
|
| Rate for Payer: PHCS All Commercial |
$2,241.00
|
| Rate for Payer: PHP All Commercial |
$2,266.10
|
| Rate for Payer: Sagamore Health Network All Products |
$2,306.74
|
| Rate for Payer: Signature Care EPO |
$2,480.04
|
| Rate for Payer: Signature Care PPO |
$2,629.44
|
| Rate for Payer: United Healthcare Commercial |
$2,354.54
|
|
