|
HC Z PLATE MINI LOCK R
|
Facility
OP
|
$3,945.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606384
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,669.41 |
| Rate for Payer: Aetna Commercial |
$3,330.09
|
| Rate for Payer: Aetna Medicare |
$1,302.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,302.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,265.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,466.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,497.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,432.25
|
| Rate for Payer: Cash Price |
$2,446.27
|
| Rate for Payer: Cash Price |
$2,446.27
|
| Rate for Payer: Centivo All Commercial |
$2,012.26
|
| Rate for Payer: Cigna All Commercial |
$3,405.05
|
| Rate for Payer: CORVEL All Commercial |
$3,669.41
|
| Rate for Payer: Coventry All Commercial |
$3,472.13
|
| Rate for Payer: Encore All Commercial |
$3,631.92
|
| Rate for Payer: Frontpath All Commercial |
$3,629.95
|
| Rate for Payer: Humana ChoiceCare |
$3,407.81
|
| Rate for Payer: Humana Medicare |
$2,012.26
|
| Rate for Payer: Lucent All Commercial |
$2,012.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,551.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,959.20
|
| Rate for Payer: PHP All Commercial |
$2,992.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,538.78
|
| Rate for Payer: Sagamore Health Network All Products |
$3,046.00
|
| Rate for Payer: Signature Care EPO |
$3,274.85
|
| Rate for Payer: Signature Care PPO |
$3,472.13
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,353.76
|
| Rate for Payer: United Healthcare Commercial |
$3,109.13
|
| Rate for Payer: United Healthcare Medicare |
$1,302.05
|
|
|
HC Z PLATE MINI LOCK R
|
Facility
IP
|
$3,945.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606384
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,959.20 |
| Max. Negotiated Rate |
$3,669.41 |
| Rate for Payer: Aetna Commercial |
$3,409.00
|
| Rate for Payer: Cash Price |
$2,446.27
|
| Rate for Payer: Cigna All Commercial |
$3,405.05
|
| Rate for Payer: CORVEL All Commercial |
$3,669.41
|
| Rate for Payer: Coventry All Commercial |
$3,472.13
|
| Rate for Payer: Encore All Commercial |
$3,631.92
|
| Rate for Payer: Frontpath All Commercial |
$3,629.95
|
| Rate for Payer: Humana ChoiceCare |
$3,407.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,551.04
|
| Rate for Payer: PHCS All Commercial |
$2,959.20
|
| Rate for Payer: PHP All Commercial |
$2,992.34
|
| Rate for Payer: Sagamore Health Network All Products |
$3,046.00
|
| Rate for Payer: Signature Care EPO |
$3,274.85
|
| Rate for Payer: Signature Care PPO |
$3,472.13
|
| Rate for Payer: United Healthcare Commercial |
$3,109.13
|
|
|
HC Z PLATE MINI LOCK R ST
|
Facility
IP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606385
|
|
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 R ST
|
Facility
OP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606385
|
|
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
|
|
|
HC Z PLATE MINI NARROW LOCK L
|
Facility
IP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606403
|
|
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 NARROW LOCK L
|
Facility
OP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606403
|
|
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 NARROW LOCK L ST
|
Facility
OP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606404
|
|
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
|
|
|
HC Z PLATE MINI NARROW LOCK L ST
|
Facility
IP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606404
|
|
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 NARROW LOCK R
|
Facility
IP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606380
|
|
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 NARROW LOCK R
|
Facility
OP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606380
|
|
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 NARROW LOCK R ST
|
Facility
IP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606381
|
|
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 NARROW LOCK R ST
|
Facility
OP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606381
|
|
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
|
|
|
HC Z PLATE NARROW LOCK L
|
Facility
OP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606229
|
|
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 NARROW LOCK L
|
Facility
IP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606229
|
|
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 NARROW LOCK L ST
|
Facility
OP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606405
|
|
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
|
|
|
HC Z PLATE NARROW LOCK L ST
|
Facility
IP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606405
|
|
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 NARROW LOCK R
|
Facility
IP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606382
|
|
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 NARROW LOCK R
|
Facility
OP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606382
|
|
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 NARROW LOCK R ST
|
Facility
OP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606383
|
|
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
|
|
|
HC Z PLATE NARROW LOCK R ST
|
Facility
IP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606383
|
|
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 OLECRAN 10H
|
Facility
OP
|
$3,297.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,067.00 |
| Rate for Payer: Aetna Commercial |
$2,783.39
|
| Rate for Payer: Aetna Medicare |
$1,088.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,088.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,893.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,061.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,251.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,197.12
|
| Rate for Payer: Cash Price |
$2,044.67
|
| Rate for Payer: Cash Price |
$2,044.67
|
| Rate for Payer: Centivo All Commercial |
$1,681.90
|
| Rate for Payer: Cigna All Commercial |
$2,846.04
|
| Rate for Payer: CORVEL All Commercial |
$3,067.00
|
| Rate for Payer: Coventry All Commercial |
$2,902.11
|
| Rate for Payer: Encore All Commercial |
$3,035.67
|
| Rate for Payer: Frontpath All Commercial |
$3,034.02
|
| Rate for Payer: Humana ChoiceCare |
$2,848.35
|
| Rate for Payer: Humana Medicare |
$1,681.90
|
| Rate for Payer: Lucent All Commercial |
$1,681.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,968.06
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,473.39
|
| Rate for Payer: PHP All Commercial |
$2,501.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,286.16
|
| Rate for Payer: Sagamore Health Network All Products |
$2,545.94
|
| Rate for Payer: Signature Care EPO |
$2,737.22
|
| Rate for Payer: Signature Care PPO |
$2,902.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,803.17
|
| Rate for Payer: United Healthcare Commercial |
$2,598.71
|
| Rate for Payer: United Healthcare Medicare |
$1,088.29
|
|
|
HC Z PLATE OLECRAN 10H
|
Facility
IP
|
$3,297.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,473.39 |
| Max. Negotiated Rate |
$3,067.00 |
| Rate for Payer: Aetna Commercial |
$2,849.34
|
| Rate for Payer: Cash Price |
$2,044.67
|
| Rate for Payer: Cigna All Commercial |
$2,846.04
|
| Rate for Payer: CORVEL All Commercial |
$3,067.00
|
| Rate for Payer: Coventry All Commercial |
$2,902.11
|
| Rate for Payer: Encore All Commercial |
$3,035.67
|
| Rate for Payer: Frontpath All Commercial |
$3,034.02
|
| Rate for Payer: Humana ChoiceCare |
$2,848.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,968.06
|
| Rate for Payer: PHCS All Commercial |
$2,473.39
|
| Rate for Payer: PHP All Commercial |
$2,501.09
|
| Rate for Payer: Sagamore Health Network All Products |
$2,545.94
|
| Rate for Payer: Signature Care EPO |
$2,737.22
|
| Rate for Payer: Signature Care PPO |
$2,902.11
|
| Rate for Payer: United Healthcare Commercial |
$2,598.71
|
|
|
HC Z PLATE OLECRAN 13H
|
Facility
OP
|
$3,297.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606736
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,067.00 |
| Rate for Payer: Aetna Commercial |
$2,783.39
|
| Rate for Payer: Aetna Medicare |
$1,088.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,088.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,893.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,061.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,251.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,197.12
|
| Rate for Payer: Cash Price |
$2,044.67
|
| Rate for Payer: Cash Price |
$2,044.67
|
| Rate for Payer: Centivo All Commercial |
$1,681.90
|
| Rate for Payer: Cigna All Commercial |
$2,846.04
|
| Rate for Payer: CORVEL All Commercial |
$3,067.00
|
| Rate for Payer: Coventry All Commercial |
$2,902.11
|
| Rate for Payer: Encore All Commercial |
$3,035.67
|
| Rate for Payer: Frontpath All Commercial |
$3,034.02
|
| Rate for Payer: Humana ChoiceCare |
$2,848.35
|
| Rate for Payer: Humana Medicare |
$1,681.90
|
| Rate for Payer: Lucent All Commercial |
$1,681.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,968.06
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,473.39
|
| Rate for Payer: PHP All Commercial |
$2,501.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,286.16
|
| Rate for Payer: Sagamore Health Network All Products |
$2,545.94
|
| Rate for Payer: Signature Care EPO |
$2,737.22
|
| Rate for Payer: Signature Care PPO |
$2,902.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,803.17
|
| Rate for Payer: United Healthcare Commercial |
$2,598.71
|
| Rate for Payer: United Healthcare Medicare |
$1,088.29
|
|
|
HC Z PLATE OLECRAN 13H
|
Facility
IP
|
$3,297.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606736
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,473.39 |
| Max. Negotiated Rate |
$3,067.00 |
| Rate for Payer: Aetna Commercial |
$2,849.34
|
| Rate for Payer: Cash Price |
$2,044.67
|
| Rate for Payer: Cigna All Commercial |
$2,846.04
|
| Rate for Payer: CORVEL All Commercial |
$3,067.00
|
| Rate for Payer: Coventry All Commercial |
$2,902.11
|
| Rate for Payer: Encore All Commercial |
$3,035.67
|
| Rate for Payer: Frontpath All Commercial |
$3,034.02
|
| Rate for Payer: Humana ChoiceCare |
$2,848.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,968.06
|
| Rate for Payer: PHCS All Commercial |
$2,473.39
|
| Rate for Payer: PHP All Commercial |
$2,501.09
|
| Rate for Payer: Sagamore Health Network All Products |
$2,545.94
|
| Rate for Payer: Signature Care EPO |
$2,737.22
|
| Rate for Payer: Signature Care PPO |
$2,902.11
|
| Rate for Payer: United Healthcare Commercial |
$2,598.71
|
|
|
HC Z PLATE PROX FEM NCB 324 R
|
Facility
OP
|
$5,033.38
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607446
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,681.04 |
| Rate for Payer: Aetna Commercial |
$4,248.17
|
| Rate for Payer: Aetna Medicare |
$1,661.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,661.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,890.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,146.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,910.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,827.12
|
| Rate for Payer: Cash Price |
$3,120.70
|
| Rate for Payer: Cash Price |
$3,120.70
|
| Rate for Payer: Centivo All Commercial |
$2,567.02
|
| Rate for Payer: Cigna All Commercial |
$4,343.81
|
| Rate for Payer: CORVEL All Commercial |
$4,681.04
|
| Rate for Payer: Coventry All Commercial |
$4,429.37
|
| Rate for Payer: Encore All Commercial |
$4,633.23
|
| Rate for Payer: Frontpath All Commercial |
$4,630.71
|
| Rate for Payer: Humana ChoiceCare |
$4,347.33
|
| Rate for Payer: Humana Medicare |
$2,567.02
|
| Rate for Payer: Lucent All Commercial |
$2,567.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,530.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,775.04
|
| Rate for Payer: PHP All Commercial |
$3,817.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,963.02
|
| Rate for Payer: Sagamore Health Network All Products |
$3,885.77
|
| Rate for Payer: Signature Care EPO |
$4,177.71
|
| Rate for Payer: Signature Care PPO |
$4,429.37
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,278.37
|
| Rate for Payer: United Healthcare Commercial |
$3,966.30
|
| Rate for Payer: United Healthcare Medicare |
$1,661.02
|
|
