|
HC Z PLATE FIB 8H LOCK
|
Facility
OP
|
$1,293.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.76 |
| Max. Negotiated Rate |
$1,202.68 |
| Rate for Payer: Aetna Commercial |
$1,091.46
|
| Rate for Payer: Aetna Medicare |
$426.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$426.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$742.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$808.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$490.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$469.43
|
| Rate for Payer: Cash Price |
$801.78
|
| Rate for Payer: Cash Price |
$801.78
|
| Rate for Payer: Centivo All Commercial |
$659.53
|
| Rate for Payer: Cigna All Commercial |
$1,116.03
|
| Rate for Payer: CORVEL All Commercial |
$1,202.68
|
| Rate for Payer: Coventry All Commercial |
$1,138.02
|
| Rate for Payer: Encore All Commercial |
$1,190.39
|
| Rate for Payer: Frontpath All Commercial |
$1,189.74
|
| Rate for Payer: Humana ChoiceCare |
$1,116.94
|
| Rate for Payer: Humana Medicare |
$659.53
|
| Rate for Payer: Lucent All Commercial |
$659.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,163.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$969.90
|
| Rate for Payer: PHP All Commercial |
$980.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$504.35
|
| Rate for Payer: Sagamore Health Network All Products |
$998.35
|
| Rate for Payer: Signature Care EPO |
$1,073.36
|
| Rate for Payer: Signature Care PPO |
$1,138.02
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,099.22
|
| Rate for Payer: United Healthcare Commercial |
$1,019.04
|
| Rate for Payer: United Healthcare Medicare |
$426.76
|
|
|
HC Z PLATE FIB 8H LOCK
|
Facility
IP
|
$1,293.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$969.90 |
| Max. Negotiated Rate |
$1,202.68 |
| Rate for Payer: Aetna Commercial |
$1,117.32
|
| Rate for Payer: Cash Price |
$801.78
|
| Rate for Payer: Cigna All Commercial |
$1,116.03
|
| Rate for Payer: CORVEL All Commercial |
$1,202.68
|
| Rate for Payer: Coventry All Commercial |
$1,138.02
|
| Rate for Payer: Encore All Commercial |
$1,190.39
|
| Rate for Payer: Frontpath All Commercial |
$1,189.74
|
| Rate for Payer: Humana ChoiceCare |
$1,116.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,163.88
|
| Rate for Payer: PHCS All Commercial |
$969.90
|
| Rate for Payer: PHP All Commercial |
$980.76
|
| Rate for Payer: Sagamore Health Network All Products |
$998.35
|
| Rate for Payer: Signature Care EPO |
$1,073.36
|
| Rate for Payer: Signature Care PPO |
$1,138.02
|
| Rate for Payer: United Healthcare Commercial |
$1,019.04
|
|
|
HC Z PLATE FIB ANTMC 3-H L LOCK
|
Facility
OP
|
$2,461.79
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603885
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,289.46 |
| Rate for Payer: Aetna Commercial |
$2,077.75
|
| Rate for Payer: Aetna Medicare |
$812.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$812.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,413.81
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,538.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$934.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$893.63
|
| Rate for Payer: Cash Price |
$1,526.31
|
| Rate for Payer: Cash Price |
$1,526.31
|
| Rate for Payer: Centivo All Commercial |
$1,255.51
|
| Rate for Payer: Cigna All Commercial |
$2,124.52
|
| Rate for Payer: CORVEL All Commercial |
$2,289.46
|
| Rate for Payer: Coventry All Commercial |
$2,166.38
|
| Rate for Payer: Encore All Commercial |
$2,266.08
|
| Rate for Payer: Frontpath All Commercial |
$2,264.85
|
| Rate for Payer: Humana ChoiceCare |
$2,126.25
|
| Rate for Payer: Humana Medicare |
$1,255.51
|
| Rate for Payer: Lucent All Commercial |
$1,255.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,215.61
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,846.34
|
| Rate for Payer: PHP All Commercial |
$1,867.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$960.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,900.50
|
| Rate for Payer: Signature Care EPO |
$2,043.29
|
| Rate for Payer: Signature Care PPO |
$2,166.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,092.52
|
| Rate for Payer: United Healthcare Commercial |
$1,939.89
|
| Rate for Payer: United Healthcare Medicare |
$812.39
|
|
|
HC Z PLATE FIB ANTMC 3-H L LOCK
|
Facility
IP
|
$2,461.79
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603885
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,846.34 |
| Max. Negotiated Rate |
$2,289.46 |
| Rate for Payer: Aetna Commercial |
$2,126.99
|
| Rate for Payer: Cash Price |
$1,526.31
|
| Rate for Payer: Cigna All Commercial |
$2,124.52
|
| Rate for Payer: CORVEL All Commercial |
$2,289.46
|
| Rate for Payer: Coventry All Commercial |
$2,166.38
|
| Rate for Payer: Encore All Commercial |
$2,266.08
|
| Rate for Payer: Frontpath All Commercial |
$2,264.85
|
| Rate for Payer: Humana ChoiceCare |
$2,126.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,215.61
|
| Rate for Payer: PHCS All Commercial |
$1,846.34
|
| Rate for Payer: PHP All Commercial |
$1,867.02
|
| Rate for Payer: Sagamore Health Network All Products |
$1,900.50
|
| Rate for Payer: Signature Care EPO |
$2,043.29
|
| Rate for Payer: Signature Care PPO |
$2,166.38
|
| Rate for Payer: United Healthcare Commercial |
$1,939.89
|
|
|
HC Z PLATE FIB ANTMC 3-H LOCK R
|
Facility
OP
|
$2,461.79
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,289.46 |
| Rate for Payer: Aetna Commercial |
$2,077.75
|
| Rate for Payer: Aetna Medicare |
$812.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$812.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,413.81
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,538.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$934.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$893.63
|
| Rate for Payer: Cash Price |
$1,526.31
|
| Rate for Payer: Cash Price |
$1,526.31
|
| Rate for Payer: Centivo All Commercial |
$1,255.51
|
| Rate for Payer: Cigna All Commercial |
$2,124.52
|
| Rate for Payer: CORVEL All Commercial |
$2,289.46
|
| Rate for Payer: Coventry All Commercial |
$2,166.38
|
| Rate for Payer: Encore All Commercial |
$2,266.08
|
| Rate for Payer: Frontpath All Commercial |
$2,264.85
|
| Rate for Payer: Humana ChoiceCare |
$2,126.25
|
| Rate for Payer: Humana Medicare |
$1,255.51
|
| Rate for Payer: Lucent All Commercial |
$1,255.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,215.61
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,846.34
|
| Rate for Payer: PHP All Commercial |
$1,867.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$960.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,900.50
|
| Rate for Payer: Signature Care EPO |
$2,043.29
|
| Rate for Payer: Signature Care PPO |
$2,166.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,092.52
|
| Rate for Payer: United Healthcare Commercial |
$1,939.89
|
| Rate for Payer: United Healthcare Medicare |
$812.39
|
|
|
HC Z PLATE FIB ANTMC 3-H LOCK R
|
Facility
IP
|
$2,461.79
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,846.34 |
| Max. Negotiated Rate |
$2,289.46 |
| Rate for Payer: Aetna Commercial |
$2,126.99
|
| Rate for Payer: Cash Price |
$1,526.31
|
| Rate for Payer: Cigna All Commercial |
$2,124.52
|
| Rate for Payer: CORVEL All Commercial |
$2,289.46
|
| Rate for Payer: Coventry All Commercial |
$2,166.38
|
| Rate for Payer: Encore All Commercial |
$2,266.08
|
| Rate for Payer: Frontpath All Commercial |
$2,264.85
|
| Rate for Payer: Humana ChoiceCare |
$2,126.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,215.61
|
| Rate for Payer: PHCS All Commercial |
$1,846.34
|
| Rate for Payer: PHP All Commercial |
$1,867.02
|
| Rate for Payer: Sagamore Health Network All Products |
$1,900.50
|
| Rate for Payer: Signature Care EPO |
$2,043.29
|
| Rate for Payer: Signature Care PPO |
$2,166.38
|
| Rate for Payer: United Healthcare Commercial |
$1,939.89
|
|
|
HC Z PLATE FIB LOCK 6H LT
|
Facility
IP
|
$2,909.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,182.28 |
| Max. Negotiated Rate |
$2,706.02 |
| Rate for Payer: Aetna Commercial |
$2,513.98
|
| Rate for Payer: Cash Price |
$1,804.01
|
| Rate for Payer: Cigna All Commercial |
$2,511.07
|
| Rate for Payer: CORVEL All Commercial |
$2,706.02
|
| Rate for Payer: Coventry All Commercial |
$2,560.54
|
| Rate for Payer: Encore All Commercial |
$2,678.38
|
| Rate for Payer: Frontpath All Commercial |
$2,676.92
|
| Rate for Payer: Humana ChoiceCare |
$2,513.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,618.73
|
| Rate for Payer: PHCS All Commercial |
$2,182.28
|
| Rate for Payer: PHP All Commercial |
$2,206.72
|
| Rate for Payer: Sagamore Health Network All Products |
$2,246.29
|
| Rate for Payer: Signature Care EPO |
$2,415.05
|
| Rate for Payer: Signature Care PPO |
$2,560.54
|
| Rate for Payer: United Healthcare Commercial |
$2,292.84
|
|
|
HC Z PLATE FIB LOCK 6H LT
|
Facility
OP
|
$2,909.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,706.02 |
| Rate for Payer: Aetna Commercial |
$2,455.79
|
| Rate for Payer: Aetna Medicare |
$960.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$960.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,671.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,818.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,104.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,056.22
|
| Rate for Payer: Cash Price |
$1,804.01
|
| Rate for Payer: Cash Price |
$1,804.01
|
| Rate for Payer: Centivo All Commercial |
$1,483.95
|
| Rate for Payer: Cigna All Commercial |
$2,511.07
|
| Rate for Payer: CORVEL All Commercial |
$2,706.02
|
| Rate for Payer: Coventry All Commercial |
$2,560.54
|
| Rate for Payer: Encore All Commercial |
$2,678.38
|
| Rate for Payer: Frontpath All Commercial |
$2,676.92
|
| Rate for Payer: Humana ChoiceCare |
$2,513.11
|
| Rate for Payer: Humana Medicare |
$1,483.95
|
| Rate for Payer: Lucent All Commercial |
$1,483.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,618.73
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,182.28
|
| Rate for Payer: PHP All Commercial |
$2,206.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,134.78
|
| Rate for Payer: Sagamore Health Network All Products |
$2,246.29
|
| Rate for Payer: Signature Care EPO |
$2,415.05
|
| Rate for Payer: Signature Care PPO |
$2,560.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,473.24
|
| Rate for Payer: United Healthcare Commercial |
$2,292.84
|
| Rate for Payer: United Healthcare Medicare |
$960.20
|
|
|
HC Z PLATE LAT FIB 10H 15
|
Facility
IP
|
$2,756.38
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,067.28 |
| Max. Negotiated Rate |
$2,563.43 |
| Rate for Payer: Aetna Commercial |
$2,381.51
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Cigna All Commercial |
$2,378.76
|
| Rate for Payer: CORVEL All Commercial |
$2,563.43
|
| Rate for Payer: Coventry All Commercial |
$2,425.61
|
| Rate for Payer: Encore All Commercial |
$2,537.25
|
| Rate for Payer: Frontpath All Commercial |
$2,535.87
|
| Rate for Payer: Humana ChoiceCare |
$2,380.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,480.74
|
| Rate for Payer: PHCS All Commercial |
$2,067.28
|
| Rate for Payer: PHP All Commercial |
$2,090.44
|
| Rate for Payer: Sagamore Health Network All Products |
$2,127.93
|
| Rate for Payer: Signature Care EPO |
$2,287.80
|
| Rate for Payer: Signature Care PPO |
$2,425.61
|
| Rate for Payer: United Healthcare Commercial |
$2,172.03
|
|
|
HC Z PLATE LAT FIB 10H 15
|
Facility
IP
|
$2,756.38
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,067.28 |
| Max. Negotiated Rate |
$2,563.43 |
| Rate for Payer: Aetna Commercial |
$2,381.51
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Cigna All Commercial |
$2,378.76
|
| Rate for Payer: CORVEL All Commercial |
$2,563.43
|
| Rate for Payer: Coventry All Commercial |
$2,425.61
|
| Rate for Payer: Encore All Commercial |
$2,537.25
|
| Rate for Payer: Frontpath All Commercial |
$2,535.87
|
| Rate for Payer: Humana ChoiceCare |
$2,380.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,480.74
|
| Rate for Payer: PHCS All Commercial |
$2,067.28
|
| Rate for Payer: PHP All Commercial |
$2,090.44
|
| Rate for Payer: Sagamore Health Network All Products |
$2,127.93
|
| Rate for Payer: Signature Care EPO |
$2,287.80
|
| Rate for Payer: Signature Care PPO |
$2,425.61
|
| Rate for Payer: United Healthcare Commercial |
$2,172.03
|
|
|
HC Z PLATE LAT FIB 10H 15
|
Facility
OP
|
$2,756.38
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,563.43 |
| Rate for Payer: Aetna Commercial |
$2,326.38
|
| Rate for Payer: Aetna Medicare |
$909.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$909.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,582.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,723.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,046.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,000.57
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Centivo All Commercial |
$1,405.75
|
| Rate for Payer: Cigna All Commercial |
$2,378.76
|
| Rate for Payer: CORVEL All Commercial |
$2,563.43
|
| Rate for Payer: Coventry All Commercial |
$2,425.61
|
| Rate for Payer: Encore All Commercial |
$2,537.25
|
| Rate for Payer: Frontpath All Commercial |
$2,535.87
|
| Rate for Payer: Humana ChoiceCare |
$2,380.69
|
| Rate for Payer: Humana Medicare |
$1,405.75
|
| Rate for Payer: Lucent All Commercial |
$1,405.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,480.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,067.28
|
| Rate for Payer: PHP All Commercial |
$2,090.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,074.99
|
| Rate for Payer: Sagamore Health Network All Products |
$2,127.93
|
| Rate for Payer: Signature Care EPO |
$2,287.80
|
| Rate for Payer: Signature Care PPO |
$2,425.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,342.92
|
| Rate for Payer: United Healthcare Commercial |
$2,172.03
|
| Rate for Payer: United Healthcare Medicare |
$909.61
|
|
|
HC Z PLATE LAT FIB 10H 15
|
Facility
OP
|
$2,756.38
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,563.43 |
| Rate for Payer: Aetna Commercial |
$2,326.38
|
| Rate for Payer: Aetna Medicare |
$909.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$909.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,582.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,723.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,046.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,000.57
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Centivo All Commercial |
$1,405.75
|
| Rate for Payer: Cigna All Commercial |
$2,378.76
|
| Rate for Payer: CORVEL All Commercial |
$2,563.43
|
| Rate for Payer: Coventry All Commercial |
$2,425.61
|
| Rate for Payer: Encore All Commercial |
$2,537.25
|
| Rate for Payer: Frontpath All Commercial |
$2,535.87
|
| Rate for Payer: Humana ChoiceCare |
$2,380.69
|
| Rate for Payer: Humana Medicare |
$1,405.75
|
| Rate for Payer: Lucent All Commercial |
$1,405.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,480.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,067.28
|
| Rate for Payer: PHP All Commercial |
$2,090.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,074.99
|
| Rate for Payer: Sagamore Health Network All Products |
$2,127.93
|
| Rate for Payer: Signature Care EPO |
$2,287.80
|
| Rate for Payer: Signature Care PPO |
$2,425.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,342.92
|
| Rate for Payer: United Healthcare Commercial |
$2,172.03
|
| Rate for Payer: United Healthcare Medicare |
$909.61
|
|
|
HC Z PLATE LAT FIB 18-H L
|
Facility
IP
|
$5,488.81
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606178
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,116.61 |
| Max. Negotiated Rate |
$5,104.59 |
| Rate for Payer: Aetna Commercial |
$4,742.33
|
| Rate for Payer: Cash Price |
$3,403.06
|
| Rate for Payer: Cigna All Commercial |
$4,736.84
|
| Rate for Payer: CORVEL All Commercial |
$5,104.59
|
| Rate for Payer: Coventry All Commercial |
$4,830.15
|
| Rate for Payer: Encore All Commercial |
$5,052.45
|
| Rate for Payer: Frontpath All Commercial |
$5,049.71
|
| Rate for Payer: Humana ChoiceCare |
$4,740.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,939.93
|
| Rate for Payer: PHCS All Commercial |
$4,116.61
|
| Rate for Payer: PHP All Commercial |
$4,162.71
|
| Rate for Payer: Sagamore Health Network All Products |
$4,237.36
|
| Rate for Payer: Signature Care EPO |
$4,555.71
|
| Rate for Payer: Signature Care PPO |
$4,830.15
|
| Rate for Payer: United Healthcare Commercial |
$4,325.18
|
|
|
HC Z PLATE LAT FIB 18-H L
|
Facility
OP
|
$5,488.81
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606178
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,104.59 |
| Rate for Payer: Aetna Commercial |
$4,632.56
|
| Rate for Payer: Aetna Medicare |
$1,811.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,811.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,152.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,431.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,083.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,992.44
|
| Rate for Payer: Cash Price |
$3,403.06
|
| Rate for Payer: Cash Price |
$3,403.06
|
| Rate for Payer: Centivo All Commercial |
$2,799.29
|
| Rate for Payer: Cigna All Commercial |
$4,736.84
|
| Rate for Payer: CORVEL All Commercial |
$5,104.59
|
| Rate for Payer: Coventry All Commercial |
$4,830.15
|
| Rate for Payer: Encore All Commercial |
$5,052.45
|
| Rate for Payer: Frontpath All Commercial |
$5,049.71
|
| Rate for Payer: Humana ChoiceCare |
$4,740.69
|
| Rate for Payer: Humana Medicare |
$2,799.29
|
| Rate for Payer: Lucent All Commercial |
$2,799.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,939.93
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,116.61
|
| Rate for Payer: PHP All Commercial |
$4,162.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,140.64
|
| Rate for Payer: Sagamore Health Network All Products |
$4,237.36
|
| Rate for Payer: Signature Care EPO |
$4,555.71
|
| Rate for Payer: Signature Care PPO |
$4,830.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,665.49
|
| Rate for Payer: United Healthcare Commercial |
$4,325.18
|
| Rate for Payer: United Healthcare Medicare |
$1,811.31
|
|
|
HC Z PLATE LAT FIB 4-H 80
|
Facility
OP
|
$2,241.07
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,084.20 |
| Rate for Payer: Aetna Commercial |
$1,891.46
|
| Rate for Payer: Aetna Medicare |
$739.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$739.55
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,287.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,400.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$850.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$813.51
|
| Rate for Payer: Cash Price |
$1,389.46
|
| Rate for Payer: Cash Price |
$1,389.46
|
| Rate for Payer: Centivo All Commercial |
$1,142.95
|
| Rate for Payer: Cigna All Commercial |
$1,934.04
|
| Rate for Payer: CORVEL All Commercial |
$2,084.20
|
| Rate for Payer: Coventry All Commercial |
$1,972.14
|
| Rate for Payer: Encore All Commercial |
$2,062.90
|
| Rate for Payer: Frontpath All Commercial |
$2,061.78
|
| Rate for Payer: Humana ChoiceCare |
$1,935.61
|
| Rate for Payer: Humana Medicare |
$1,142.95
|
| Rate for Payer: Lucent All Commercial |
$1,142.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,016.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,680.80
|
| Rate for Payer: PHP All Commercial |
$1,699.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$874.02
|
| Rate for Payer: Sagamore Health Network All Products |
$1,730.11
|
| Rate for Payer: Signature Care EPO |
$1,860.09
|
| Rate for Payer: Signature Care PPO |
$1,972.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,904.91
|
| Rate for Payer: United Healthcare Commercial |
$1,765.96
|
| Rate for Payer: United Healthcare Medicare |
$739.55
|
|
|
HC Z PLATE LAT FIB 4-H 80
|
Facility
IP
|
$2,241.07
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,680.80 |
| Max. Negotiated Rate |
$2,084.20 |
| Rate for Payer: Aetna Commercial |
$1,936.28
|
| Rate for Payer: Cash Price |
$1,389.46
|
| Rate for Payer: Cigna All Commercial |
$1,934.04
|
| Rate for Payer: CORVEL All Commercial |
$2,084.20
|
| Rate for Payer: Coventry All Commercial |
$1,972.14
|
| Rate for Payer: Encore All Commercial |
$2,062.90
|
| Rate for Payer: Frontpath All Commercial |
$2,061.78
|
| Rate for Payer: Humana ChoiceCare |
$1,935.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,016.96
|
| Rate for Payer: PHCS All Commercial |
$1,680.80
|
| Rate for Payer: PHP All Commercial |
$1,699.63
|
| Rate for Payer: Sagamore Health Network All Products |
$1,730.11
|
| Rate for Payer: Signature Care EPO |
$1,860.09
|
| Rate for Payer: Signature Care PPO |
$1,972.14
|
| Rate for Payer: United Healthcare Commercial |
$1,765.96
|
|
|
HC Z PLATE LAT FIB 6-H 10
|
Facility
OP
|
$2,396.84
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,229.06 |
| Rate for Payer: Aetna Commercial |
$2,022.93
|
| Rate for Payer: Aetna Medicare |
$790.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$790.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,376.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,498.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$909.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$870.05
|
| Rate for Payer: Cash Price |
$1,486.04
|
| Rate for Payer: Cash Price |
$1,486.04
|
| Rate for Payer: Centivo All Commercial |
$1,222.39
|
| Rate for Payer: Cigna All Commercial |
$2,068.47
|
| Rate for Payer: CORVEL All Commercial |
$2,229.06
|
| Rate for Payer: Coventry All Commercial |
$2,109.22
|
| Rate for Payer: Encore All Commercial |
$2,206.29
|
| Rate for Payer: Frontpath All Commercial |
$2,205.09
|
| Rate for Payer: Humana ChoiceCare |
$2,070.15
|
| Rate for Payer: Humana Medicare |
$1,222.39
|
| Rate for Payer: Lucent All Commercial |
$1,222.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,157.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,797.63
|
| Rate for Payer: PHP All Commercial |
$1,817.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$934.77
|
| Rate for Payer: Sagamore Health Network All Products |
$1,850.36
|
| Rate for Payer: Signature Care EPO |
$1,989.38
|
| Rate for Payer: Signature Care PPO |
$2,109.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,037.31
|
| Rate for Payer: United Healthcare Commercial |
$1,888.71
|
| Rate for Payer: United Healthcare Medicare |
$790.96
|
|
|
HC Z PLATE LAT FIB 6-H 10
|
Facility
IP
|
$2,396.84
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,797.63 |
| Max. Negotiated Rate |
$2,229.06 |
| Rate for Payer: Aetna Commercial |
$2,070.87
|
| Rate for Payer: Cash Price |
$1,486.04
|
| Rate for Payer: Cigna All Commercial |
$2,068.47
|
| Rate for Payer: CORVEL All Commercial |
$2,229.06
|
| Rate for Payer: Coventry All Commercial |
$2,109.22
|
| Rate for Payer: Encore All Commercial |
$2,206.29
|
| Rate for Payer: Frontpath All Commercial |
$2,205.09
|
| Rate for Payer: Humana ChoiceCare |
$2,070.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,157.16
|
| Rate for Payer: PHCS All Commercial |
$1,797.63
|
| Rate for Payer: PHP All Commercial |
$1,817.76
|
| Rate for Payer: Sagamore Health Network All Products |
$1,850.36
|
| Rate for Payer: Signature Care EPO |
$1,989.38
|
| Rate for Payer: Signature Care PPO |
$2,109.22
|
| Rate for Payer: United Healthcare Commercial |
$1,888.71
|
|
|
HC Z PLATE LAT FIB 6-H 106 LOCK R
|
Facility
OP
|
$2,396.84
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603994
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,229.06 |
| Rate for Payer: Aetna Commercial |
$2,022.93
|
| Rate for Payer: Aetna Medicare |
$790.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$790.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,376.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,498.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$909.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$870.05
|
| Rate for Payer: Cash Price |
$1,486.04
|
| Rate for Payer: Cash Price |
$1,486.04
|
| Rate for Payer: Centivo All Commercial |
$1,222.39
|
| Rate for Payer: Cigna All Commercial |
$2,068.47
|
| Rate for Payer: CORVEL All Commercial |
$2,229.06
|
| Rate for Payer: Coventry All Commercial |
$2,109.22
|
| Rate for Payer: Encore All Commercial |
$2,206.29
|
| Rate for Payer: Frontpath All Commercial |
$2,205.09
|
| Rate for Payer: Humana ChoiceCare |
$2,070.15
|
| Rate for Payer: Humana Medicare |
$1,222.39
|
| Rate for Payer: Lucent All Commercial |
$1,222.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,157.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,797.63
|
| Rate for Payer: PHP All Commercial |
$1,817.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$934.77
|
| Rate for Payer: Sagamore Health Network All Products |
$1,850.36
|
| Rate for Payer: Signature Care EPO |
$1,989.38
|
| Rate for Payer: Signature Care PPO |
$2,109.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,037.31
|
| Rate for Payer: United Healthcare Commercial |
$1,888.71
|
| Rate for Payer: United Healthcare Medicare |
$790.96
|
|
|
HC Z PLATE LAT FIB 6-H 106 LOCK R
|
Facility
IP
|
$2,396.84
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603994
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,797.63 |
| Max. Negotiated Rate |
$2,229.06 |
| Rate for Payer: Aetna Commercial |
$2,070.87
|
| Rate for Payer: Cash Price |
$1,486.04
|
| Rate for Payer: Cigna All Commercial |
$2,068.47
|
| Rate for Payer: CORVEL All Commercial |
$2,229.06
|
| Rate for Payer: Coventry All Commercial |
$2,109.22
|
| Rate for Payer: Encore All Commercial |
$2,206.29
|
| Rate for Payer: Frontpath All Commercial |
$2,205.09
|
| Rate for Payer: Humana ChoiceCare |
$2,070.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,157.16
|
| Rate for Payer: PHCS All Commercial |
$1,797.63
|
| Rate for Payer: PHP All Commercial |
$1,817.76
|
| Rate for Payer: Sagamore Health Network All Products |
$1,850.36
|
| Rate for Payer: Signature Care EPO |
$1,989.38
|
| Rate for Payer: Signature Care PPO |
$2,109.22
|
| Rate for Payer: United Healthcare Commercial |
$1,888.71
|
|
|
HC Z PLATE LAT FIB 8-H 13
|
Facility
OP
|
$2,588.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,407.42 |
| Rate for Payer: Aetna Commercial |
$2,184.80
|
| Rate for Payer: Aetna Medicare |
$854.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$854.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,486.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,618.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$982.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$939.67
|
| Rate for Payer: Cash Price |
$1,604.94
|
| Rate for Payer: Cash Price |
$1,604.94
|
| Rate for Payer: Centivo All Commercial |
$1,320.20
|
| Rate for Payer: Cigna All Commercial |
$2,233.98
|
| Rate for Payer: CORVEL All Commercial |
$2,407.42
|
| Rate for Payer: Coventry All Commercial |
$2,277.99
|
| Rate for Payer: Encore All Commercial |
$2,382.82
|
| Rate for Payer: Frontpath All Commercial |
$2,381.53
|
| Rate for Payer: Humana ChoiceCare |
$2,235.79
|
| Rate for Payer: Humana Medicare |
$1,320.20
|
| Rate for Payer: Lucent All Commercial |
$1,320.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,329.76
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,941.46
|
| Rate for Payer: PHP All Commercial |
$1,963.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,009.56
|
| Rate for Payer: Sagamore Health Network All Products |
$1,998.41
|
| Rate for Payer: Signature Care EPO |
$2,148.55
|
| Rate for Payer: Signature Care PPO |
$2,277.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,200.33
|
| Rate for Payer: United Healthcare Commercial |
$2,039.83
|
| Rate for Payer: United Healthcare Medicare |
$854.24
|
|
|
HC Z PLATE LAT FIB 8-H 13
|
Facility
IP
|
$2,588.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,941.46 |
| Max. Negotiated Rate |
$2,407.42 |
| Rate for Payer: Aetna Commercial |
$2,236.57
|
| Rate for Payer: Cash Price |
$1,604.94
|
| Rate for Payer: Cigna All Commercial |
$2,233.98
|
| Rate for Payer: CORVEL All Commercial |
$2,407.42
|
| Rate for Payer: Coventry All Commercial |
$2,277.99
|
| Rate for Payer: Encore All Commercial |
$2,382.82
|
| Rate for Payer: Frontpath All Commercial |
$2,381.53
|
| Rate for Payer: Humana ChoiceCare |
$2,235.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,329.76
|
| Rate for Payer: PHCS All Commercial |
$1,941.46
|
| Rate for Payer: PHP All Commercial |
$1,963.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,998.41
|
| Rate for Payer: Signature Care EPO |
$2,148.55
|
| Rate for Payer: Signature Care PPO |
$2,277.99
|
| Rate for Payer: United Healthcare Commercial |
$2,039.83
|
|
|
HC Z PLATE LAT FIB 8-H 13
|
Facility
OP
|
$2,588.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,407.42 |
| Rate for Payer: Aetna Commercial |
$2,184.80
|
| Rate for Payer: Aetna Medicare |
$854.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$854.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,486.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,618.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$982.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$939.67
|
| Rate for Payer: Cash Price |
$1,604.94
|
| Rate for Payer: Cash Price |
$1,604.94
|
| Rate for Payer: Centivo All Commercial |
$1,320.20
|
| Rate for Payer: Cigna All Commercial |
$2,233.98
|
| Rate for Payer: CORVEL All Commercial |
$2,407.42
|
| Rate for Payer: Coventry All Commercial |
$2,277.99
|
| Rate for Payer: Encore All Commercial |
$2,382.82
|
| Rate for Payer: Frontpath All Commercial |
$2,381.53
|
| Rate for Payer: Humana ChoiceCare |
$2,235.79
|
| Rate for Payer: Humana Medicare |
$1,320.20
|
| Rate for Payer: Lucent All Commercial |
$1,320.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,329.76
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,941.46
|
| Rate for Payer: PHP All Commercial |
$1,963.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,009.56
|
| Rate for Payer: Sagamore Health Network All Products |
$1,998.41
|
| Rate for Payer: Signature Care EPO |
$2,148.55
|
| Rate for Payer: Signature Care PPO |
$2,277.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,200.33
|
| Rate for Payer: United Healthcare Commercial |
$2,039.83
|
| Rate for Payer: United Healthcare Medicare |
$854.24
|
|
|
HC Z PLATE LAT FIB 8-H 13
|
Facility
IP
|
$2,588.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,941.46 |
| Max. Negotiated Rate |
$2,407.42 |
| Rate for Payer: Aetna Commercial |
$2,236.57
|
| Rate for Payer: Cash Price |
$1,604.94
|
| Rate for Payer: Cigna All Commercial |
$2,233.98
|
| Rate for Payer: CORVEL All Commercial |
$2,407.42
|
| Rate for Payer: Coventry All Commercial |
$2,277.99
|
| Rate for Payer: Encore All Commercial |
$2,382.82
|
| Rate for Payer: Frontpath All Commercial |
$2,381.53
|
| Rate for Payer: Humana ChoiceCare |
$2,235.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,329.76
|
| Rate for Payer: PHCS All Commercial |
$1,941.46
|
| Rate for Payer: PHP All Commercial |
$1,963.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,998.41
|
| Rate for Payer: Signature Care EPO |
$2,148.55
|
| Rate for Payer: Signature Care PPO |
$2,277.99
|
| Rate for Payer: United Healthcare Commercial |
$2,039.83
|
|
|
HC Z PLATE LAT TIB 6H RT
|
Facility
IP
|
$4,434.19
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,325.64 |
| Max. Negotiated Rate |
$4,123.80 |
| Rate for Payer: Aetna Commercial |
$3,831.14
|
| Rate for Payer: Cash Price |
$2,749.20
|
| Rate for Payer: Cigna All Commercial |
$3,826.71
|
| Rate for Payer: CORVEL All Commercial |
$4,123.80
|
| Rate for Payer: Coventry All Commercial |
$3,902.09
|
| Rate for Payer: Encore All Commercial |
$4,081.67
|
| Rate for Payer: Frontpath All Commercial |
$4,079.45
|
| Rate for Payer: Humana ChoiceCare |
$3,829.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,990.77
|
| Rate for Payer: PHCS All Commercial |
$3,325.64
|
| Rate for Payer: PHP All Commercial |
$3,362.89
|
| Rate for Payer: Sagamore Health Network All Products |
$3,423.19
|
| Rate for Payer: Signature Care EPO |
$3,680.38
|
| Rate for Payer: Signature Care PPO |
$3,902.09
|
| Rate for Payer: United Healthcare Commercial |
$3,494.14
|
|
