|
HC Z PLATE LAT TIB 6H RT
|
Facility
OP
|
$4,434.19
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,123.80 |
| Rate for Payer: Aetna Commercial |
$3,742.46
|
| Rate for Payer: Aetna Medicare |
$1,463.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,463.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,546.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,771.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,682.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,609.61
|
| Rate for Payer: Cash Price |
$2,749.20
|
| Rate for Payer: Cash Price |
$2,749.20
|
| Rate for Payer: Centivo All Commercial |
$2,261.44
|
| 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: Humana Medicare |
$2,261.44
|
| Rate for Payer: Lucent All Commercial |
$2,261.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,990.77
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,325.64
|
| Rate for Payer: PHP All Commercial |
$3,362.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,729.33
|
| 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: Three Rivers Preferred All Commercial |
$3,769.06
|
| Rate for Payer: United Healthcare Commercial |
$3,494.14
|
| Rate for Payer: United Healthcare Medicare |
$1,463.28
|
|
|
HC Z PLATE LOCK BRD 4.5 8-H
|
Facility
OP
|
$1,833.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,704.83 |
| Rate for Payer: Aetna Commercial |
$1,547.18
|
| Rate for Payer: Aetna Medicare |
$604.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$604.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,052.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,145.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$695.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$665.43
|
| Rate for Payer: Cash Price |
$1,136.55
|
| Rate for Payer: Cash Price |
$1,136.55
|
| Rate for Payer: Centivo All Commercial |
$934.91
|
| Rate for Payer: Cigna All Commercial |
$1,582.01
|
| Rate for Payer: CORVEL All Commercial |
$1,704.83
|
| Rate for Payer: Coventry All Commercial |
$1,613.17
|
| Rate for Payer: Encore All Commercial |
$1,687.41
|
| Rate for Payer: Frontpath All Commercial |
$1,686.50
|
| Rate for Payer: Humana ChoiceCare |
$1,583.29
|
| Rate for Payer: Humana Medicare |
$934.91
|
| Rate for Payer: Lucent All Commercial |
$934.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,649.84
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,374.86
|
| Rate for Payer: PHP All Commercial |
$1,390.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$714.93
|
| Rate for Payer: Sagamore Health Network All Products |
$1,415.19
|
| Rate for Payer: Signature Care EPO |
$1,521.51
|
| Rate for Payer: Signature Care PPO |
$1,613.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,558.18
|
| Rate for Payer: United Healthcare Commercial |
$1,444.52
|
| Rate for Payer: United Healthcare Medicare |
$604.94
|
|
|
HC Z PLATE LOCK BRD 4.5 8-H
|
Facility
IP
|
$1,833.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,374.86 |
| Max. Negotiated Rate |
$1,704.83 |
| Rate for Payer: Aetna Commercial |
$1,583.84
|
| Rate for Payer: Cash Price |
$1,136.55
|
| Rate for Payer: Cigna All Commercial |
$1,582.01
|
| Rate for Payer: CORVEL All Commercial |
$1,704.83
|
| Rate for Payer: Coventry All Commercial |
$1,613.17
|
| Rate for Payer: Encore All Commercial |
$1,687.41
|
| Rate for Payer: Frontpath All Commercial |
$1,686.50
|
| Rate for Payer: Humana ChoiceCare |
$1,583.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,649.84
|
| Rate for Payer: PHCS All Commercial |
$1,374.86
|
| Rate for Payer: PHP All Commercial |
$1,390.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,415.19
|
| Rate for Payer: Signature Care EPO |
$1,521.51
|
| Rate for Payer: Signature Care PPO |
$1,613.17
|
| Rate for Payer: United Healthcare Commercial |
$1,444.52
|
|
|
HC Z PLATE LOCK NRW 4.5 10-H
|
Facility
OP
|
$1,444.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$476.62 |
| Max. Negotiated Rate |
$1,343.20 |
| Rate for Payer: Aetna Commercial |
$1,218.99
|
| Rate for Payer: Aetna Medicare |
$476.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$476.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$829.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$902.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$548.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$524.28
|
| Rate for Payer: Cash Price |
$895.47
|
| Rate for Payer: Cash Price |
$895.47
|
| Rate for Payer: Centivo All Commercial |
$736.59
|
| Rate for Payer: Cigna All Commercial |
$1,246.43
|
| Rate for Payer: CORVEL All Commercial |
$1,343.20
|
| Rate for Payer: Coventry All Commercial |
$1,270.98
|
| Rate for Payer: Encore All Commercial |
$1,329.48
|
| Rate for Payer: Frontpath All Commercial |
$1,328.76
|
| Rate for Payer: Humana ChoiceCare |
$1,247.44
|
| Rate for Payer: Humana Medicare |
$736.59
|
| Rate for Payer: Lucent All Commercial |
$736.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,299.87
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,083.22
|
| Rate for Payer: PHP All Commercial |
$1,095.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$563.28
|
| Rate for Payer: Sagamore Health Network All Products |
$1,115.00
|
| Rate for Payer: Signature Care EPO |
$1,198.77
|
| Rate for Payer: Signature Care PPO |
$1,270.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,227.66
|
| Rate for Payer: United Healthcare Commercial |
$1,138.11
|
| Rate for Payer: United Healthcare Medicare |
$476.62
|
|
|
HC Z PLATE LOCK NRW 4.5 10-H
|
Facility
IP
|
$1,444.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,083.22 |
| Max. Negotiated Rate |
$1,343.20 |
| Rate for Payer: Aetna Commercial |
$1,247.88
|
| Rate for Payer: Cash Price |
$895.47
|
| Rate for Payer: Cigna All Commercial |
$1,246.43
|
| Rate for Payer: CORVEL All Commercial |
$1,343.20
|
| Rate for Payer: Coventry All Commercial |
$1,270.98
|
| Rate for Payer: Encore All Commercial |
$1,329.48
|
| Rate for Payer: Frontpath All Commercial |
$1,328.76
|
| Rate for Payer: Humana ChoiceCare |
$1,247.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,299.87
|
| Rate for Payer: PHCS All Commercial |
$1,083.22
|
| Rate for Payer: PHP All Commercial |
$1,095.36
|
| Rate for Payer: Sagamore Health Network All Products |
$1,115.00
|
| Rate for Payer: Signature Care EPO |
$1,198.77
|
| Rate for Payer: Signature Care PPO |
$1,270.98
|
| Rate for Payer: United Healthcare Commercial |
$1,138.11
|
|
|
HC Z PLATE LONG LOCK L
|
Facility
OP
|
$3,577.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,327.37 |
| Rate for Payer: Aetna Commercial |
$3,019.68
|
| Rate for Payer: Aetna Medicare |
$1,180.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,180.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,054.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,236.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,357.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,298.75
|
| Rate for Payer: Cash Price |
$2,218.25
|
| Rate for Payer: Cash Price |
$2,218.25
|
| Rate for Payer: Centivo All Commercial |
$1,824.69
|
| Rate for Payer: Cigna All Commercial |
$3,087.66
|
| Rate for Payer: CORVEL All Commercial |
$3,327.37
|
| Rate for Payer: Coventry All Commercial |
$3,148.48
|
| Rate for Payer: Encore All Commercial |
$3,293.38
|
| Rate for Payer: Frontpath All Commercial |
$3,291.59
|
| Rate for Payer: Humana ChoiceCare |
$3,090.16
|
| Rate for Payer: Humana Medicare |
$1,824.69
|
| Rate for Payer: Lucent All Commercial |
$1,824.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,220.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,683.36
|
| Rate for Payer: PHP All Commercial |
$2,713.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,395.35
|
| Rate for Payer: Sagamore Health Network All Products |
$2,762.08
|
| Rate for Payer: Signature Care EPO |
$2,969.59
|
| Rate for Payer: Signature Care PPO |
$3,148.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,041.15
|
| Rate for Payer: United Healthcare Commercial |
$2,819.32
|
| Rate for Payer: United Healthcare Medicare |
$1,180.68
|
|
|
HC Z PLATE LONG LOCK L
|
Facility
IP
|
$3,577.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,683.36 |
| Max. Negotiated Rate |
$3,327.37 |
| Rate for Payer: Aetna Commercial |
$3,091.24
|
| Rate for Payer: Cash Price |
$2,218.25
|
| Rate for Payer: Cigna All Commercial |
$3,087.66
|
| Rate for Payer: CORVEL All Commercial |
$3,327.37
|
| Rate for Payer: Coventry All Commercial |
$3,148.48
|
| Rate for Payer: Encore All Commercial |
$3,293.38
|
| Rate for Payer: Frontpath All Commercial |
$3,291.59
|
| Rate for Payer: Humana ChoiceCare |
$3,090.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,220.04
|
| Rate for Payer: PHCS All Commercial |
$2,683.36
|
| Rate for Payer: PHP All Commercial |
$2,713.42
|
| Rate for Payer: Sagamore Health Network All Products |
$2,762.08
|
| Rate for Payer: Signature Care EPO |
$2,969.59
|
| Rate for Payer: Signature Care PPO |
$3,148.48
|
| Rate for Payer: United Healthcare Commercial |
$2,819.32
|
|
|
HC Z PLATE LONG LOCK L ST
|
Facility
IP
|
$3,319.67
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,489.75 |
| Max. Negotiated Rate |
$3,087.29 |
| Rate for Payer: Aetna Commercial |
$2,868.19
|
| Rate for Payer: Cash Price |
$2,058.20
|
| Rate for Payer: Cigna All Commercial |
$2,864.88
|
| Rate for Payer: CORVEL All Commercial |
$3,087.29
|
| Rate for Payer: Coventry All Commercial |
$2,921.31
|
| Rate for Payer: Encore All Commercial |
$3,055.76
|
| Rate for Payer: Frontpath All Commercial |
$3,054.10
|
| Rate for Payer: Humana ChoiceCare |
$2,867.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,987.70
|
| Rate for Payer: PHCS All Commercial |
$2,489.75
|
| Rate for Payer: PHP All Commercial |
$2,517.64
|
| Rate for Payer: Sagamore Health Network All Products |
$2,562.79
|
| Rate for Payer: Signature Care EPO |
$2,755.33
|
| Rate for Payer: Signature Care PPO |
$2,921.31
|
| Rate for Payer: United Healthcare Commercial |
$2,615.90
|
|
|
HC Z PLATE LONG LOCK L ST
|
Facility
OP
|
$3,319.67
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,087.29 |
| Rate for Payer: Aetna Commercial |
$2,801.80
|
| Rate for Payer: Aetna Medicare |
$1,095.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,095.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,906.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,075.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,259.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,205.04
|
| Rate for Payer: Cash Price |
$2,058.20
|
| Rate for Payer: Cash Price |
$2,058.20
|
| Rate for Payer: Centivo All Commercial |
$1,693.03
|
| Rate for Payer: Cigna All Commercial |
$2,864.88
|
| Rate for Payer: CORVEL All Commercial |
$3,087.29
|
| Rate for Payer: Coventry All Commercial |
$2,921.31
|
| Rate for Payer: Encore All Commercial |
$3,055.76
|
| Rate for Payer: Frontpath All Commercial |
$3,054.10
|
| Rate for Payer: Humana ChoiceCare |
$2,867.20
|
| Rate for Payer: Humana Medicare |
$1,693.03
|
| Rate for Payer: Lucent All Commercial |
$1,693.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,987.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,489.75
|
| Rate for Payer: PHP All Commercial |
$2,517.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,294.67
|
| Rate for Payer: Sagamore Health Network All Products |
$2,562.79
|
| Rate for Payer: Signature Care EPO |
$2,755.33
|
| Rate for Payer: Signature Care PPO |
$2,921.31
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,821.72
|
| Rate for Payer: United Healthcare Commercial |
$2,615.90
|
| Rate for Payer: United Healthcare Medicare |
$1,095.49
|
|
|
HC Z PLATE LONG LOCK R
|
Facility
OP
|
$3,577.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,327.37 |
| Rate for Payer: Aetna Commercial |
$3,019.68
|
| Rate for Payer: Aetna Medicare |
$1,180.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,180.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,054.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,236.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,357.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,298.75
|
| Rate for Payer: Cash Price |
$2,218.25
|
| Rate for Payer: Cash Price |
$2,218.25
|
| Rate for Payer: Centivo All Commercial |
$1,824.69
|
| Rate for Payer: Cigna All Commercial |
$3,087.66
|
| Rate for Payer: CORVEL All Commercial |
$3,327.37
|
| Rate for Payer: Coventry All Commercial |
$3,148.48
|
| Rate for Payer: Encore All Commercial |
$3,293.38
|
| Rate for Payer: Frontpath All Commercial |
$3,291.59
|
| Rate for Payer: Humana ChoiceCare |
$3,090.16
|
| Rate for Payer: Humana Medicare |
$1,824.69
|
| Rate for Payer: Lucent All Commercial |
$1,824.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,220.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,683.36
|
| Rate for Payer: PHP All Commercial |
$2,713.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,395.35
|
| Rate for Payer: Sagamore Health Network All Products |
$2,762.08
|
| Rate for Payer: Signature Care EPO |
$2,969.59
|
| Rate for Payer: Signature Care PPO |
$3,148.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,041.15
|
| Rate for Payer: United Healthcare Commercial |
$2,819.32
|
| Rate for Payer: United Healthcare Medicare |
$1,180.68
|
|
|
HC Z PLATE LONG LOCK R
|
Facility
IP
|
$3,577.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,683.36 |
| Max. Negotiated Rate |
$3,327.37 |
| Rate for Payer: Aetna Commercial |
$3,091.24
|
| Rate for Payer: Cash Price |
$2,218.25
|
| Rate for Payer: Cigna All Commercial |
$3,087.66
|
| Rate for Payer: CORVEL All Commercial |
$3,327.37
|
| Rate for Payer: Coventry All Commercial |
$3,148.48
|
| Rate for Payer: Encore All Commercial |
$3,293.38
|
| Rate for Payer: Frontpath All Commercial |
$3,291.59
|
| Rate for Payer: Humana ChoiceCare |
$3,090.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,220.04
|
| Rate for Payer: PHCS All Commercial |
$2,683.36
|
| Rate for Payer: PHP All Commercial |
$2,713.42
|
| Rate for Payer: Sagamore Health Network All Products |
$2,762.08
|
| Rate for Payer: Signature Care EPO |
$2,969.59
|
| Rate for Payer: Signature Care PPO |
$3,148.48
|
| Rate for Payer: United Healthcare Commercial |
$2,819.32
|
|
|
HC Z PLATE LONG LOCK R ST
|
Facility
IP
|
$3,319.67
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,489.75 |
| Max. Negotiated Rate |
$3,087.29 |
| Rate for Payer: Aetna Commercial |
$2,868.19
|
| Rate for Payer: Cash Price |
$2,058.20
|
| Rate for Payer: Cigna All Commercial |
$2,864.88
|
| Rate for Payer: CORVEL All Commercial |
$3,087.29
|
| Rate for Payer: Coventry All Commercial |
$2,921.31
|
| Rate for Payer: Encore All Commercial |
$3,055.76
|
| Rate for Payer: Frontpath All Commercial |
$3,054.10
|
| Rate for Payer: Humana ChoiceCare |
$2,867.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,987.70
|
| Rate for Payer: PHCS All Commercial |
$2,489.75
|
| Rate for Payer: PHP All Commercial |
$2,517.64
|
| Rate for Payer: Sagamore Health Network All Products |
$2,562.79
|
| Rate for Payer: Signature Care EPO |
$2,755.33
|
| Rate for Payer: Signature Care PPO |
$2,921.31
|
| Rate for Payer: United Healthcare Commercial |
$2,615.90
|
|
|
HC Z PLATE LONG LOCK R ST
|
Facility
OP
|
$3,319.67
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,087.29 |
| Rate for Payer: Aetna Commercial |
$2,801.80
|
| Rate for Payer: Aetna Medicare |
$1,095.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,095.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,906.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,075.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,259.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,205.04
|
| Rate for Payer: Cash Price |
$2,058.20
|
| Rate for Payer: Cash Price |
$2,058.20
|
| Rate for Payer: Centivo All Commercial |
$1,693.03
|
| Rate for Payer: Cigna All Commercial |
$2,864.88
|
| Rate for Payer: CORVEL All Commercial |
$3,087.29
|
| Rate for Payer: Coventry All Commercial |
$2,921.31
|
| Rate for Payer: Encore All Commercial |
$3,055.76
|
| Rate for Payer: Frontpath All Commercial |
$3,054.10
|
| Rate for Payer: Humana ChoiceCare |
$2,867.20
|
| Rate for Payer: Humana Medicare |
$1,693.03
|
| Rate for Payer: Lucent All Commercial |
$1,693.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,987.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,489.75
|
| Rate for Payer: PHP All Commercial |
$2,517.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,294.67
|
| Rate for Payer: Sagamore Health Network All Products |
$2,562.79
|
| Rate for Payer: Signature Care EPO |
$2,755.33
|
| Rate for Payer: Signature Care PPO |
$2,921.31
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,821.72
|
| Rate for Payer: United Healthcare Commercial |
$2,615.90
|
| Rate for Payer: United Healthcare Medicare |
$1,095.49
|
|
|
HC Z PLATE MD LOCK L
|
Facility
IP
|
$3,337.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606410
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,503.39 |
| Max. Negotiated Rate |
$3,104.20 |
| Rate for Payer: Aetna Commercial |
$2,883.90
|
| Rate for Payer: Cash Price |
$2,069.47
|
| Rate for Payer: Cigna All Commercial |
$2,880.56
|
| Rate for Payer: CORVEL All Commercial |
$3,104.20
|
| Rate for Payer: Coventry All Commercial |
$2,937.31
|
| Rate for Payer: Encore All Commercial |
$3,072.49
|
| Rate for Payer: Frontpath All Commercial |
$3,070.82
|
| Rate for Payer: Humana ChoiceCare |
$2,882.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,004.06
|
| Rate for Payer: PHCS All Commercial |
$2,503.39
|
| Rate for Payer: PHP All Commercial |
$2,531.43
|
| Rate for Payer: Sagamore Health Network All Products |
$2,576.82
|
| Rate for Payer: Signature Care EPO |
$2,770.42
|
| Rate for Payer: Signature Care PPO |
$2,937.31
|
| Rate for Payer: United Healthcare Commercial |
$2,630.23
|
|
|
HC Z PLATE MD LOCK L
|
Facility
OP
|
$3,337.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606410
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,104.20 |
| Rate for Payer: Aetna Commercial |
$2,817.15
|
| Rate for Payer: Aetna Medicare |
$1,101.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,101.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,916.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,086.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,266.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,211.64
|
| Rate for Payer: Cash Price |
$2,069.47
|
| Rate for Payer: Cash Price |
$2,069.47
|
| Rate for Payer: Centivo All Commercial |
$1,702.30
|
| Rate for Payer: Cigna All Commercial |
$2,880.56
|
| Rate for Payer: CORVEL All Commercial |
$3,104.20
|
| Rate for Payer: Coventry All Commercial |
$2,937.31
|
| Rate for Payer: Encore All Commercial |
$3,072.49
|
| Rate for Payer: Frontpath All Commercial |
$3,070.82
|
| Rate for Payer: Humana ChoiceCare |
$2,882.90
|
| Rate for Payer: Humana Medicare |
$1,702.30
|
| Rate for Payer: Lucent All Commercial |
$1,702.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,004.06
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,503.39
|
| Rate for Payer: PHP All Commercial |
$2,531.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,301.76
|
| Rate for Payer: Sagamore Health Network All Products |
$2,576.82
|
| Rate for Payer: Signature Care EPO |
$2,770.42
|
| Rate for Payer: Signature Care PPO |
$2,937.31
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,837.17
|
| Rate for Payer: United Healthcare Commercial |
$2,630.23
|
| Rate for Payer: United Healthcare Medicare |
$1,101.49
|
|
|
HC Z PLATE MD LOCK L ST
|
Facility
OP
|
$3,457.84
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,215.79 |
| Rate for Payer: Aetna Commercial |
$2,918.42
|
| Rate for Payer: Aetna Medicare |
$1,141.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,141.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,985.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,161.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,312.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,255.20
|
| Rate for Payer: Cash Price |
$2,143.86
|
| Rate for Payer: Cash Price |
$2,143.86
|
| Rate for Payer: Centivo All Commercial |
$1,763.50
|
| Rate for Payer: Cigna All Commercial |
$2,984.12
|
| Rate for Payer: CORVEL All Commercial |
$3,215.79
|
| Rate for Payer: Coventry All Commercial |
$3,042.90
|
| Rate for Payer: Encore All Commercial |
$3,182.94
|
| Rate for Payer: Frontpath All Commercial |
$3,181.21
|
| Rate for Payer: Humana ChoiceCare |
$2,986.54
|
| Rate for Payer: Humana Medicare |
$1,763.50
|
| Rate for Payer: Lucent All Commercial |
$1,763.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,112.06
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,593.38
|
| Rate for Payer: PHP All Commercial |
$2,622.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,348.56
|
| Rate for Payer: Sagamore Health Network All Products |
$2,669.45
|
| Rate for Payer: Signature Care EPO |
$2,870.01
|
| Rate for Payer: Signature Care PPO |
$3,042.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,939.16
|
| Rate for Payer: United Healthcare Commercial |
$2,724.78
|
| Rate for Payer: United Healthcare Medicare |
$1,141.09
|
|
|
HC Z PLATE MD LOCK L ST
|
Facility
IP
|
$3,457.84
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,593.38 |
| Max. Negotiated Rate |
$3,215.79 |
| Rate for Payer: Aetna Commercial |
$2,987.57
|
| Rate for Payer: Cash Price |
$2,143.86
|
| Rate for Payer: Cigna All Commercial |
$2,984.12
|
| Rate for Payer: CORVEL All Commercial |
$3,215.79
|
| Rate for Payer: Coventry All Commercial |
$3,042.90
|
| Rate for Payer: Encore All Commercial |
$3,182.94
|
| Rate for Payer: Frontpath All Commercial |
$3,181.21
|
| Rate for Payer: Humana ChoiceCare |
$2,986.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,112.06
|
| Rate for Payer: PHCS All Commercial |
$2,593.38
|
| Rate for Payer: PHP All Commercial |
$2,622.43
|
| Rate for Payer: Sagamore Health Network All Products |
$2,669.45
|
| Rate for Payer: Signature Care EPO |
$2,870.01
|
| Rate for Payer: Signature Care PPO |
$3,042.90
|
| Rate for Payer: United Healthcare Commercial |
$2,724.78
|
|
|
HC Z PLATE MD LOCK R
|
Facility
OP
|
$3,337.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606388
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,104.20 |
| Rate for Payer: Aetna Commercial |
$2,817.15
|
| Rate for Payer: Aetna Medicare |
$1,101.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,101.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,916.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,086.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,266.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,211.64
|
| Rate for Payer: Cash Price |
$2,069.47
|
| Rate for Payer: Cash Price |
$2,069.47
|
| Rate for Payer: Centivo All Commercial |
$1,702.30
|
| Rate for Payer: Cigna All Commercial |
$2,880.56
|
| Rate for Payer: CORVEL All Commercial |
$3,104.20
|
| Rate for Payer: Coventry All Commercial |
$2,937.31
|
| Rate for Payer: Encore All Commercial |
$3,072.49
|
| Rate for Payer: Frontpath All Commercial |
$3,070.82
|
| Rate for Payer: Humana ChoiceCare |
$2,882.90
|
| Rate for Payer: Humana Medicare |
$1,702.30
|
| Rate for Payer: Lucent All Commercial |
$1,702.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,004.06
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,503.39
|
| Rate for Payer: PHP All Commercial |
$2,531.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,301.76
|
| Rate for Payer: Sagamore Health Network All Products |
$2,576.82
|
| Rate for Payer: Signature Care EPO |
$2,770.42
|
| Rate for Payer: Signature Care PPO |
$2,937.31
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,837.17
|
| Rate for Payer: United Healthcare Commercial |
$2,630.23
|
| Rate for Payer: United Healthcare Medicare |
$1,101.49
|
|
|
HC Z PLATE MD LOCK R
|
Facility
IP
|
$3,337.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606388
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,503.39 |
| Max. Negotiated Rate |
$3,104.20 |
| Rate for Payer: Aetna Commercial |
$2,883.90
|
| Rate for Payer: Cash Price |
$2,069.47
|
| Rate for Payer: Cigna All Commercial |
$2,880.56
|
| Rate for Payer: CORVEL All Commercial |
$3,104.20
|
| Rate for Payer: Coventry All Commercial |
$2,937.31
|
| Rate for Payer: Encore All Commercial |
$3,072.49
|
| Rate for Payer: Frontpath All Commercial |
$3,070.82
|
| Rate for Payer: Humana ChoiceCare |
$2,882.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,004.06
|
| Rate for Payer: PHCS All Commercial |
$2,503.39
|
| Rate for Payer: PHP All Commercial |
$2,531.43
|
| Rate for Payer: Sagamore Health Network All Products |
$2,576.82
|
| Rate for Payer: Signature Care EPO |
$2,770.42
|
| Rate for Payer: Signature Care PPO |
$2,937.31
|
| Rate for Payer: United Healthcare Commercial |
$2,630.23
|
|
|
HC Z PLATE MD LOCK R ST
|
Facility
IP
|
$3,457.84
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606389
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,593.38 |
| Max. Negotiated Rate |
$3,215.79 |
| Rate for Payer: Aetna Commercial |
$2,987.57
|
| Rate for Payer: Cash Price |
$2,143.86
|
| Rate for Payer: Cigna All Commercial |
$2,984.12
|
| Rate for Payer: CORVEL All Commercial |
$3,215.79
|
| Rate for Payer: Coventry All Commercial |
$3,042.90
|
| Rate for Payer: Encore All Commercial |
$3,182.94
|
| Rate for Payer: Frontpath All Commercial |
$3,181.21
|
| Rate for Payer: Humana ChoiceCare |
$2,986.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,112.06
|
| Rate for Payer: PHCS All Commercial |
$2,593.38
|
| Rate for Payer: PHP All Commercial |
$2,622.43
|
| Rate for Payer: Sagamore Health Network All Products |
$2,669.45
|
| Rate for Payer: Signature Care EPO |
$2,870.01
|
| Rate for Payer: Signature Care PPO |
$3,042.90
|
| Rate for Payer: United Healthcare Commercial |
$2,724.78
|
|
|
HC Z PLATE MD LOCK R ST
|
Facility
OP
|
$3,457.84
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606389
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,215.79 |
| Rate for Payer: Aetna Commercial |
$2,918.42
|
| Rate for Payer: Aetna Medicare |
$1,141.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,141.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,985.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,161.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,312.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,255.20
|
| Rate for Payer: Cash Price |
$2,143.86
|
| Rate for Payer: Cash Price |
$2,143.86
|
| Rate for Payer: Centivo All Commercial |
$1,763.50
|
| Rate for Payer: Cigna All Commercial |
$2,984.12
|
| Rate for Payer: CORVEL All Commercial |
$3,215.79
|
| Rate for Payer: Coventry All Commercial |
$3,042.90
|
| Rate for Payer: Encore All Commercial |
$3,182.94
|
| Rate for Payer: Frontpath All Commercial |
$3,181.21
|
| Rate for Payer: Humana ChoiceCare |
$2,986.54
|
| Rate for Payer: Humana Medicare |
$1,763.50
|
| Rate for Payer: Lucent All Commercial |
$1,763.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,112.06
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,593.38
|
| Rate for Payer: PHP All Commercial |
$2,622.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,348.56
|
| Rate for Payer: Sagamore Health Network All Products |
$2,669.45
|
| Rate for Payer: Signature Care EPO |
$2,870.01
|
| Rate for Payer: Signature Care PPO |
$3,042.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,939.16
|
| Rate for Payer: United Healthcare Commercial |
$2,724.78
|
| Rate for Payer: United Healthcare Medicare |
$1,141.09
|
|
|
HC Z PLATE MINI LOCK L
|
Facility
IP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,233.41 |
| Max. Negotiated Rate |
$2,769.43 |
| Rate for Payer: Aetna Commercial |
$2,572.89
|
| Rate for Payer: Cash Price |
$1,846.29
|
| Rate for Payer: Cigna All Commercial |
$2,569.91
|
| Rate for Payer: CORVEL All Commercial |
$2,769.43
|
| Rate for Payer: Coventry All Commercial |
$2,620.53
|
| Rate for Payer: Encore All Commercial |
$2,741.14
|
| Rate for Payer: Frontpath All Commercial |
$2,739.65
|
| Rate for Payer: Humana ChoiceCare |
$2,571.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,680.09
|
| Rate for Payer: PHCS All Commercial |
$2,233.41
|
| Rate for Payer: PHP All Commercial |
$2,258.42
|
| Rate for Payer: Sagamore Health Network All Products |
$2,298.92
|
| Rate for Payer: Signature Care EPO |
$2,471.64
|
| Rate for Payer: Signature Care PPO |
$2,620.53
|
| Rate for Payer: United Healthcare Commercial |
$2,346.57
|
|
|
HC Z PLATE MINI LOCK L
|
Facility
OP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,769.43 |
| Rate for Payer: Aetna Commercial |
$2,513.33
|
| Rate for Payer: Aetna Medicare |
$982.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$982.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,710.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,861.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,130.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,080.97
|
| Rate for Payer: Cash Price |
$1,846.29
|
| Rate for Payer: Cash Price |
$1,846.29
|
| Rate for Payer: Centivo All Commercial |
$1,518.72
|
| Rate for Payer: Cigna All Commercial |
$2,569.91
|
| Rate for Payer: CORVEL All Commercial |
$2,769.43
|
| Rate for Payer: Coventry All Commercial |
$2,620.53
|
| Rate for Payer: Encore All Commercial |
$2,741.14
|
| Rate for Payer: Frontpath All Commercial |
$2,739.65
|
| Rate for Payer: Humana ChoiceCare |
$2,571.99
|
| Rate for Payer: Humana Medicare |
$1,518.72
|
| Rate for Payer: Lucent All Commercial |
$1,518.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,680.09
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,233.41
|
| Rate for Payer: PHP All Commercial |
$2,258.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,161.37
|
| Rate for Payer: Sagamore Health Network All Products |
$2,298.92
|
| Rate for Payer: Signature Care EPO |
$2,471.64
|
| Rate for Payer: Signature Care PPO |
$2,620.53
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,531.20
|
| Rate for Payer: United Healthcare Commercial |
$2,346.57
|
| Rate for Payer: United Healthcare Medicare |
$982.70
|
|
|
HC Z PLATE MINI LOCK L ST
|
Facility
IP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,143.42 |
| Max. Negotiated Rate |
$2,657.85 |
| Rate for Payer: Aetna Commercial |
$2,469.23
|
| Rate for Payer: Cash Price |
$1,771.90
|
| Rate for Payer: Cigna All Commercial |
$2,466.37
|
| Rate for Payer: CORVEL All Commercial |
$2,657.85
|
| Rate for Payer: Coventry All Commercial |
$2,514.95
|
| Rate for Payer: Encore All Commercial |
$2,630.70
|
| Rate for Payer: Frontpath All Commercial |
$2,629.27
|
| Rate for Payer: Humana ChoiceCare |
$2,468.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,572.11
|
| Rate for Payer: PHCS All Commercial |
$2,143.42
|
| Rate for Payer: PHP All Commercial |
$2,167.43
|
| Rate for Payer: Sagamore Health Network All Products |
$2,206.30
|
| Rate for Payer: Signature Care EPO |
$2,372.06
|
| Rate for Payer: Signature Care PPO |
$2,514.95
|
| Rate for Payer: United Healthcare Commercial |
$2,252.03
|
|
|
HC Z PLATE MINI LOCK L ST
|
Facility
OP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,657.85 |
| Rate for Payer: Aetna Commercial |
$2,412.07
|
| Rate for Payer: Aetna Medicare |
$943.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$943.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,641.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,786.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,084.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,037.42
|
| Rate for Payer: Cash Price |
$1,771.90
|
| Rate for Payer: Cash Price |
$1,771.90
|
| Rate for Payer: Centivo All Commercial |
$1,457.53
|
| Rate for Payer: Cigna All Commercial |
$2,466.37
|
| Rate for Payer: CORVEL All Commercial |
$2,657.85
|
| Rate for Payer: Coventry All Commercial |
$2,514.95
|
| Rate for Payer: Encore All Commercial |
$2,630.70
|
| Rate for Payer: Frontpath All Commercial |
$2,629.27
|
| Rate for Payer: Humana ChoiceCare |
$2,468.37
|
| Rate for Payer: Humana Medicare |
$1,457.53
|
| Rate for Payer: Lucent All Commercial |
$1,457.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,572.11
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,143.42
|
| Rate for Payer: PHP All Commercial |
$2,167.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,114.58
|
| Rate for Payer: Sagamore Health Network All Products |
$2,206.30
|
| Rate for Payer: Signature Care EPO |
$2,372.06
|
| Rate for Payer: Signature Care PPO |
$2,514.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,429.22
|
| Rate for Payer: United Healthcare Commercial |
$2,252.03
|
| Rate for Payer: United Healthcare Medicare |
$943.11
|
|
