|
HC Z PLATE PROX FEM NCB 324 R
|
Facility
IP
|
$5,033.38
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607446
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,775.04 |
| Max. Negotiated Rate |
$4,681.04 |
| Rate for Payer: Aetna Commercial |
$4,348.84
|
| Rate for Payer: Cash Price |
$3,120.70
|
| 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: Lutheran Preferred All Commercial |
$4,530.04
|
| Rate for Payer: PHCS All Commercial |
$3,775.04
|
| Rate for Payer: PHP All Commercial |
$3,817.32
|
| 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: United Healthcare Commercial |
$3,966.30
|
|
|
HC Z PLATE PROX RAD LG
|
Facility
OP
|
$2,537.93
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,360.27 |
| Rate for Payer: Aetna Commercial |
$2,142.01
|
| Rate for Payer: Aetna Medicare |
$837.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$837.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,457.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,586.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$963.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$921.27
|
| Rate for Payer: Cash Price |
$1,573.52
|
| Rate for Payer: Cash Price |
$1,573.52
|
| Rate for Payer: Centivo All Commercial |
$1,294.34
|
| Rate for Payer: Cigna All Commercial |
$2,190.23
|
| Rate for Payer: CORVEL All Commercial |
$2,360.27
|
| Rate for Payer: Coventry All Commercial |
$2,233.38
|
| Rate for Payer: Encore All Commercial |
$2,336.16
|
| Rate for Payer: Frontpath All Commercial |
$2,334.90
|
| Rate for Payer: Humana ChoiceCare |
$2,192.01
|
| Rate for Payer: Humana Medicare |
$1,294.34
|
| Rate for Payer: Lucent All Commercial |
$1,294.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,284.14
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,903.45
|
| Rate for Payer: PHP All Commercial |
$1,924.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$989.79
|
| Rate for Payer: Sagamore Health Network All Products |
$1,959.28
|
| Rate for Payer: Signature Care EPO |
$2,106.48
|
| Rate for Payer: Signature Care PPO |
$2,233.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,157.24
|
| Rate for Payer: United Healthcare Commercial |
$1,999.89
|
| Rate for Payer: United Healthcare Medicare |
$837.52
|
|
|
HC Z PLATE PROX RAD LG
|
Facility
IP
|
$2,537.93
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,903.45 |
| Max. Negotiated Rate |
$2,360.27 |
| Rate for Payer: Aetna Commercial |
$2,192.77
|
| Rate for Payer: Cash Price |
$1,573.52
|
| Rate for Payer: Cigna All Commercial |
$2,190.23
|
| Rate for Payer: CORVEL All Commercial |
$2,360.27
|
| Rate for Payer: Coventry All Commercial |
$2,233.38
|
| Rate for Payer: Encore All Commercial |
$2,336.16
|
| Rate for Payer: Frontpath All Commercial |
$2,334.90
|
| Rate for Payer: Humana ChoiceCare |
$2,192.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,284.14
|
| Rate for Payer: PHCS All Commercial |
$1,903.45
|
| Rate for Payer: PHP All Commercial |
$1,924.77
|
| Rate for Payer: Sagamore Health Network All Products |
$1,959.28
|
| Rate for Payer: Signature Care EPO |
$2,106.48
|
| Rate for Payer: Signature Care PPO |
$2,233.38
|
| Rate for Payer: United Healthcare Commercial |
$1,999.89
|
|
|
HC Z PLATE PROX RAD SM
|
Facility
OP
|
$2,537.93
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606731
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,360.27 |
| Rate for Payer: Aetna Commercial |
$2,142.01
|
| Rate for Payer: Aetna Medicare |
$837.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$837.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,457.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,586.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$963.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$921.27
|
| Rate for Payer: Cash Price |
$1,573.52
|
| Rate for Payer: Cash Price |
$1,573.52
|
| Rate for Payer: Centivo All Commercial |
$1,294.34
|
| Rate for Payer: Cigna All Commercial |
$2,190.23
|
| Rate for Payer: CORVEL All Commercial |
$2,360.27
|
| Rate for Payer: Coventry All Commercial |
$2,233.38
|
| Rate for Payer: Encore All Commercial |
$2,336.16
|
| Rate for Payer: Frontpath All Commercial |
$2,334.90
|
| Rate for Payer: Humana ChoiceCare |
$2,192.01
|
| Rate for Payer: Humana Medicare |
$1,294.34
|
| Rate for Payer: Lucent All Commercial |
$1,294.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,284.14
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,903.45
|
| Rate for Payer: PHP All Commercial |
$1,924.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$989.79
|
| Rate for Payer: Sagamore Health Network All Products |
$1,959.28
|
| Rate for Payer: Signature Care EPO |
$2,106.48
|
| Rate for Payer: Signature Care PPO |
$2,233.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,157.24
|
| Rate for Payer: United Healthcare Commercial |
$1,999.89
|
| Rate for Payer: United Healthcare Medicare |
$837.52
|
|
|
HC Z PLATE PROX RAD SM
|
Facility
IP
|
$2,537.93
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606731
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,903.45 |
| Max. Negotiated Rate |
$2,360.27 |
| Rate for Payer: Aetna Commercial |
$2,192.77
|
| Rate for Payer: Cash Price |
$1,573.52
|
| Rate for Payer: Cigna All Commercial |
$2,190.23
|
| Rate for Payer: CORVEL All Commercial |
$2,360.27
|
| Rate for Payer: Coventry All Commercial |
$2,233.38
|
| Rate for Payer: Encore All Commercial |
$2,336.16
|
| Rate for Payer: Frontpath All Commercial |
$2,334.90
|
| Rate for Payer: Humana ChoiceCare |
$2,192.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,284.14
|
| Rate for Payer: PHCS All Commercial |
$1,903.45
|
| Rate for Payer: PHP All Commercial |
$1,924.77
|
| Rate for Payer: Sagamore Health Network All Products |
$1,959.28
|
| Rate for Payer: Signature Care EPO |
$2,106.48
|
| Rate for Payer: Signature Care PPO |
$2,233.38
|
| Rate for Payer: United Healthcare Commercial |
$1,999.89
|
|
|
HC Z PLATE PROX TIB 5H RT
|
Facility
IP
|
$4,457.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607753
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,343.30 |
| Max. Negotiated Rate |
$4,145.70 |
| Rate for Payer: Aetna Commercial |
$3,851.49
|
| Rate for Payer: Cash Price |
$2,763.80
|
| Rate for Payer: Cigna All Commercial |
$3,847.03
|
| Rate for Payer: CORVEL All Commercial |
$4,145.70
|
| Rate for Payer: Coventry All Commercial |
$3,922.81
|
| Rate for Payer: Encore All Commercial |
$4,103.35
|
| Rate for Payer: Frontpath All Commercial |
$4,101.12
|
| Rate for Payer: Humana ChoiceCare |
$3,850.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,011.97
|
| Rate for Payer: PHCS All Commercial |
$3,343.30
|
| Rate for Payer: PHP All Commercial |
$3,380.75
|
| Rate for Payer: Sagamore Health Network All Products |
$3,441.38
|
| Rate for Payer: Signature Care EPO |
$3,699.92
|
| Rate for Payer: Signature Care PPO |
$3,922.81
|
| Rate for Payer: United Healthcare Commercial |
$3,512.70
|
|
|
HC Z PLATE PROX TIB 5H RT
|
Facility
OP
|
$4,457.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607753
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,145.70 |
| Rate for Payer: Aetna Commercial |
$3,762.33
|
| Rate for Payer: Aetna Medicare |
$1,471.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,471.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,560.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,786.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,691.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,618.16
|
| Rate for Payer: Cash Price |
$2,763.80
|
| Rate for Payer: Cash Price |
$2,763.80
|
| Rate for Payer: Centivo All Commercial |
$2,273.45
|
| Rate for Payer: Cigna All Commercial |
$3,847.03
|
| Rate for Payer: CORVEL All Commercial |
$4,145.70
|
| Rate for Payer: Coventry All Commercial |
$3,922.81
|
| Rate for Payer: Encore All Commercial |
$4,103.35
|
| Rate for Payer: Frontpath All Commercial |
$4,101.12
|
| Rate for Payer: Humana ChoiceCare |
$3,850.15
|
| Rate for Payer: Humana Medicare |
$2,273.45
|
| Rate for Payer: Lucent All Commercial |
$2,273.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,011.97
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,343.30
|
| Rate for Payer: PHP All Commercial |
$3,380.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,738.52
|
| Rate for Payer: Sagamore Health Network All Products |
$3,441.38
|
| Rate for Payer: Signature Care EPO |
$3,699.92
|
| Rate for Payer: Signature Care PPO |
$3,922.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,789.08
|
| Rate for Payer: United Healthcare Commercial |
$3,512.70
|
| Rate for Payer: United Healthcare Medicare |
$1,471.05
|
|
|
HC Z PLATE PROX TIB 6H R
|
Facility
IP
|
$4,497.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,373.30 |
| Max. Negotiated Rate |
$4,182.89 |
| Rate for Payer: Aetna Commercial |
$3,886.04
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Cigna All Commercial |
$3,881.54
|
| Rate for Payer: CORVEL All Commercial |
$4,182.89
|
| Rate for Payer: Coventry All Commercial |
$3,958.00
|
| Rate for Payer: Encore All Commercial |
$4,140.16
|
| Rate for Payer: Frontpath All Commercial |
$4,137.91
|
| Rate for Payer: Humana ChoiceCare |
$3,884.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,047.96
|
| Rate for Payer: PHCS All Commercial |
$3,373.30
|
| Rate for Payer: PHP All Commercial |
$3,411.08
|
| Rate for Payer: Sagamore Health Network All Products |
$3,472.25
|
| Rate for Payer: Signature Care EPO |
$3,733.12
|
| Rate for Payer: Signature Care PPO |
$3,958.00
|
| Rate for Payer: United Healthcare Commercial |
$3,544.21
|
|
|
HC Z PLATE PROX TIB 6H R
|
Facility
OP
|
$4,497.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,182.89 |
| Rate for Payer: Aetna Commercial |
$3,796.08
|
| Rate for Payer: Aetna Medicare |
$1,484.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,484.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,583.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,811.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,706.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,632.68
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Centivo All Commercial |
$2,293.84
|
| Rate for Payer: Cigna All Commercial |
$3,881.54
|
| Rate for Payer: CORVEL All Commercial |
$4,182.89
|
| Rate for Payer: Coventry All Commercial |
$3,958.00
|
| Rate for Payer: Encore All Commercial |
$4,140.16
|
| Rate for Payer: Frontpath All Commercial |
$4,137.91
|
| Rate for Payer: Humana ChoiceCare |
$3,884.69
|
| Rate for Payer: Humana Medicare |
$2,293.84
|
| Rate for Payer: Lucent All Commercial |
$2,293.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,047.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,373.30
|
| Rate for Payer: PHP All Commercial |
$3,411.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,754.11
|
| Rate for Payer: Sagamore Health Network All Products |
$3,472.25
|
| Rate for Payer: Signature Care EPO |
$3,733.12
|
| Rate for Payer: Signature Care PPO |
$3,958.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,823.07
|
| Rate for Payer: United Healthcare Commercial |
$3,544.21
|
| Rate for Payer: United Healthcare Medicare |
$1,484.25
|
|
|
HC Z PLATE PROX TIB 7H L
|
Facility
OP
|
$4,497.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,182.89 |
| Rate for Payer: Aetna Commercial |
$3,796.08
|
| Rate for Payer: Aetna Medicare |
$1,484.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,484.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,583.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,811.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,706.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,632.68
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Centivo All Commercial |
$2,293.84
|
| Rate for Payer: Cigna All Commercial |
$3,881.54
|
| Rate for Payer: CORVEL All Commercial |
$4,182.89
|
| Rate for Payer: Coventry All Commercial |
$3,958.00
|
| Rate for Payer: Encore All Commercial |
$4,140.16
|
| Rate for Payer: Frontpath All Commercial |
$4,137.91
|
| Rate for Payer: Humana ChoiceCare |
$3,884.69
|
| Rate for Payer: Humana Medicare |
$2,293.84
|
| Rate for Payer: Lucent All Commercial |
$2,293.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,047.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,373.30
|
| Rate for Payer: PHP All Commercial |
$3,411.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,754.11
|
| Rate for Payer: Sagamore Health Network All Products |
$3,472.25
|
| Rate for Payer: Signature Care EPO |
$3,733.12
|
| Rate for Payer: Signature Care PPO |
$3,958.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,823.07
|
| Rate for Payer: United Healthcare Commercial |
$3,544.21
|
| Rate for Payer: United Healthcare Medicare |
$1,484.25
|
|
|
HC Z PLATE PROX TIB 7H L
|
Facility
IP
|
$4,497.73
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,373.30 |
| Max. Negotiated Rate |
$4,182.89 |
| Rate for Payer: Aetna Commercial |
$3,886.04
|
| Rate for Payer: Cash Price |
$2,788.59
|
| Rate for Payer: Cigna All Commercial |
$3,881.54
|
| Rate for Payer: CORVEL All Commercial |
$4,182.89
|
| Rate for Payer: Coventry All Commercial |
$3,958.00
|
| Rate for Payer: Encore All Commercial |
$4,140.16
|
| Rate for Payer: Frontpath All Commercial |
$4,137.91
|
| Rate for Payer: Humana ChoiceCare |
$3,884.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,047.96
|
| Rate for Payer: PHCS All Commercial |
$3,373.30
|
| Rate for Payer: PHP All Commercial |
$3,411.08
|
| Rate for Payer: Sagamore Health Network All Products |
$3,472.25
|
| Rate for Payer: Signature Care EPO |
$3,733.12
|
| Rate for Payer: Signature Care PPO |
$3,958.00
|
| Rate for Payer: United Healthcare Commercial |
$3,544.21
|
|
|
HC Z PLATE PXML ULNA 3H R
|
Facility
IP
|
$2,564.64
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606652
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,923.48 |
| Max. Negotiated Rate |
$2,385.12 |
| Rate for Payer: Aetna Commercial |
$2,215.85
|
| Rate for Payer: Cash Price |
$1,590.08
|
| Rate for Payer: Cigna All Commercial |
$2,213.28
|
| Rate for Payer: CORVEL All Commercial |
$2,385.12
|
| Rate for Payer: Coventry All Commercial |
$2,256.88
|
| Rate for Payer: Encore All Commercial |
$2,360.75
|
| Rate for Payer: Frontpath All Commercial |
$2,359.47
|
| Rate for Payer: Humana ChoiceCare |
$2,215.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,308.18
|
| Rate for Payer: PHCS All Commercial |
$1,923.48
|
| Rate for Payer: PHP All Commercial |
$1,945.02
|
| Rate for Payer: Sagamore Health Network All Products |
$1,979.90
|
| Rate for Payer: Signature Care EPO |
$2,128.65
|
| Rate for Payer: Signature Care PPO |
$2,256.88
|
| Rate for Payer: United Healthcare Commercial |
$2,020.94
|
|
|
HC Z PLATE PXML ULNA 3H R
|
Facility
OP
|
$2,564.64
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606652
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,385.12 |
| Rate for Payer: Aetna Commercial |
$2,164.56
|
| Rate for Payer: Aetna Medicare |
$846.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$846.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,472.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,603.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$973.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$930.96
|
| Rate for Payer: Cash Price |
$1,590.08
|
| Rate for Payer: Cash Price |
$1,590.08
|
| Rate for Payer: Centivo All Commercial |
$1,307.97
|
| Rate for Payer: Cigna All Commercial |
$2,213.28
|
| Rate for Payer: CORVEL All Commercial |
$2,385.12
|
| Rate for Payer: Coventry All Commercial |
$2,256.88
|
| Rate for Payer: Encore All Commercial |
$2,360.75
|
| Rate for Payer: Frontpath All Commercial |
$2,359.47
|
| Rate for Payer: Humana ChoiceCare |
$2,215.08
|
| Rate for Payer: Humana Medicare |
$1,307.97
|
| Rate for Payer: Lucent All Commercial |
$1,307.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,308.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,923.48
|
| Rate for Payer: PHP All Commercial |
$1,945.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,000.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,979.90
|
| Rate for Payer: Signature Care EPO |
$2,128.65
|
| Rate for Payer: Signature Care PPO |
$2,256.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,179.94
|
| Rate for Payer: United Healthcare Commercial |
$2,020.94
|
| Rate for Payer: United Healthcare Medicare |
$846.33
|
|
|
HC Z PLATE PXML ULNAR 5-H LK R
|
Facility
IP
|
$2,708.46
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604621
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,031.34 |
| Max. Negotiated Rate |
$2,518.87 |
| Rate for Payer: Aetna Commercial |
$2,340.11
|
| Rate for Payer: Cash Price |
$1,679.25
|
| Rate for Payer: Cigna All Commercial |
$2,337.40
|
| Rate for Payer: CORVEL All Commercial |
$2,518.87
|
| Rate for Payer: Coventry All Commercial |
$2,383.44
|
| Rate for Payer: Encore All Commercial |
$2,493.14
|
| Rate for Payer: Frontpath All Commercial |
$2,491.78
|
| Rate for Payer: Humana ChoiceCare |
$2,339.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,437.61
|
| Rate for Payer: PHCS All Commercial |
$2,031.34
|
| Rate for Payer: PHP All Commercial |
$2,054.10
|
| Rate for Payer: Sagamore Health Network All Products |
$2,090.93
|
| Rate for Payer: Signature Care EPO |
$2,248.02
|
| Rate for Payer: Signature Care PPO |
$2,383.44
|
| Rate for Payer: United Healthcare Commercial |
$2,134.27
|
|
|
HC Z PLATE PXML ULNAR 5-H LK R
|
Facility
OP
|
$2,708.46
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604621
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,518.87 |
| Rate for Payer: Aetna Commercial |
$2,285.94
|
| Rate for Payer: Aetna Medicare |
$893.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$893.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,555.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,693.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,027.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$983.17
|
| Rate for Payer: Cash Price |
$1,679.25
|
| Rate for Payer: Cash Price |
$1,679.25
|
| Rate for Payer: Centivo All Commercial |
$1,381.31
|
| Rate for Payer: Cigna All Commercial |
$2,337.40
|
| Rate for Payer: CORVEL All Commercial |
$2,518.87
|
| Rate for Payer: Coventry All Commercial |
$2,383.44
|
| Rate for Payer: Encore All Commercial |
$2,493.14
|
| Rate for Payer: Frontpath All Commercial |
$2,491.78
|
| Rate for Payer: Humana ChoiceCare |
$2,339.30
|
| Rate for Payer: Humana Medicare |
$1,381.31
|
| Rate for Payer: Lucent All Commercial |
$1,381.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,437.61
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,031.34
|
| Rate for Payer: PHP All Commercial |
$2,054.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,056.30
|
| Rate for Payer: Sagamore Health Network All Products |
$2,090.93
|
| Rate for Payer: Signature Care EPO |
$2,248.02
|
| Rate for Payer: Signature Care PPO |
$2,383.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,302.19
|
| Rate for Payer: United Healthcare Commercial |
$2,134.27
|
| Rate for Payer: United Healthcare Medicare |
$893.79
|
|
|
HC Z PLATE RADIAL L
|
Facility
IP
|
$3,137.87
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606423
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,353.40 |
| Max. Negotiated Rate |
$2,918.22 |
| Rate for Payer: Aetna Commercial |
$2,711.12
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Cigna All Commercial |
$2,707.98
|
| Rate for Payer: CORVEL All Commercial |
$2,918.22
|
| Rate for Payer: Coventry All Commercial |
$2,761.33
|
| Rate for Payer: Encore All Commercial |
$2,888.41
|
| Rate for Payer: Frontpath All Commercial |
$2,886.84
|
| Rate for Payer: Humana ChoiceCare |
$2,710.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,824.08
|
| Rate for Payer: PHCS All Commercial |
$2,353.40
|
| Rate for Payer: PHP All Commercial |
$2,379.76
|
| Rate for Payer: Sagamore Health Network All Products |
$2,422.44
|
| Rate for Payer: Signature Care EPO |
$2,604.43
|
| Rate for Payer: Signature Care PPO |
$2,761.33
|
| Rate for Payer: United Healthcare Commercial |
$2,472.64
|
|
|
HC Z PLATE RADIAL L
|
Facility
OP
|
$3,137.87
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606423
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,918.22 |
| Rate for Payer: Aetna Commercial |
$2,648.36
|
| Rate for Payer: Aetna Medicare |
$1,035.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,035.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,802.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,961.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,190.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,139.05
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Centivo All Commercial |
$1,600.31
|
| Rate for Payer: Cigna All Commercial |
$2,707.98
|
| Rate for Payer: CORVEL All Commercial |
$2,918.22
|
| Rate for Payer: Coventry All Commercial |
$2,761.33
|
| Rate for Payer: Encore All Commercial |
$2,888.41
|
| Rate for Payer: Frontpath All Commercial |
$2,886.84
|
| Rate for Payer: Humana ChoiceCare |
$2,710.18
|
| Rate for Payer: Humana Medicare |
$1,600.31
|
| Rate for Payer: Lucent All Commercial |
$1,600.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,824.08
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,353.40
|
| Rate for Payer: PHP All Commercial |
$2,379.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,223.77
|
| Rate for Payer: Sagamore Health Network All Products |
$2,422.44
|
| Rate for Payer: Signature Care EPO |
$2,604.43
|
| Rate for Payer: Signature Care PPO |
$2,761.33
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,667.19
|
| Rate for Payer: United Healthcare Commercial |
$2,472.64
|
| Rate for Payer: United Healthcare Medicare |
$1,035.50
|
|
|
HC Z PLATE RADIAL R
|
Facility
OP
|
$3,137.87
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,918.22 |
| Rate for Payer: Aetna Commercial |
$2,648.36
|
| Rate for Payer: Aetna Medicare |
$1,035.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,035.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,802.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,961.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,190.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,139.05
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Centivo All Commercial |
$1,600.31
|
| Rate for Payer: Cigna All Commercial |
$2,707.98
|
| Rate for Payer: CORVEL All Commercial |
$2,918.22
|
| Rate for Payer: Coventry All Commercial |
$2,761.33
|
| Rate for Payer: Encore All Commercial |
$2,888.41
|
| Rate for Payer: Frontpath All Commercial |
$2,886.84
|
| Rate for Payer: Humana ChoiceCare |
$2,710.18
|
| Rate for Payer: Humana Medicare |
$1,600.31
|
| Rate for Payer: Lucent All Commercial |
$1,600.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,824.08
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,353.40
|
| Rate for Payer: PHP All Commercial |
$2,379.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,223.77
|
| Rate for Payer: Sagamore Health Network All Products |
$2,422.44
|
| Rate for Payer: Signature Care EPO |
$2,604.43
|
| Rate for Payer: Signature Care PPO |
$2,761.33
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,667.19
|
| Rate for Payer: United Healthcare Commercial |
$2,472.64
|
| Rate for Payer: United Healthcare Medicare |
$1,035.50
|
|
|
HC Z PLATE RADIAL R
|
Facility
IP
|
$3,137.87
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,353.40 |
| Max. Negotiated Rate |
$2,918.22 |
| Rate for Payer: Aetna Commercial |
$2,711.12
|
| Rate for Payer: Cash Price |
$1,945.48
|
| Rate for Payer: Cigna All Commercial |
$2,707.98
|
| Rate for Payer: CORVEL All Commercial |
$2,918.22
|
| Rate for Payer: Coventry All Commercial |
$2,761.33
|
| Rate for Payer: Encore All Commercial |
$2,888.41
|
| Rate for Payer: Frontpath All Commercial |
$2,886.84
|
| Rate for Payer: Humana ChoiceCare |
$2,710.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,824.08
|
| Rate for Payer: PHCS All Commercial |
$2,353.40
|
| Rate for Payer: PHP All Commercial |
$2,379.76
|
| Rate for Payer: Sagamore Health Network All Products |
$2,422.44
|
| Rate for Payer: Signature Care EPO |
$2,604.43
|
| Rate for Payer: Signature Care PPO |
$2,761.33
|
| Rate for Payer: United Healthcare Commercial |
$2,472.64
|
|
|
HC Z PLATE SPIDER OFFSET SM FRAG
|
Facility
OP
|
$896.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$295.68 |
| Max. Negotiated Rate |
$833.28 |
| Rate for Payer: Aetna Commercial |
$756.22
|
| Rate for Payer: Aetna Medicare |
$295.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$295.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$514.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$560.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$340.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$325.25
|
| Rate for Payer: Cash Price |
$555.52
|
| Rate for Payer: Cash Price |
$555.52
|
| Rate for Payer: Centivo All Commercial |
$456.96
|
| Rate for Payer: Cigna All Commercial |
$773.25
|
| Rate for Payer: CORVEL All Commercial |
$833.28
|
| Rate for Payer: Coventry All Commercial |
$788.48
|
| Rate for Payer: Encore All Commercial |
$824.77
|
| Rate for Payer: Frontpath All Commercial |
$824.32
|
| Rate for Payer: Humana ChoiceCare |
$773.88
|
| Rate for Payer: Humana Medicare |
$456.96
|
| Rate for Payer: Lucent All Commercial |
$456.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$806.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$672.00
|
| Rate for Payer: PHP All Commercial |
$679.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$349.44
|
| Rate for Payer: Sagamore Health Network All Products |
$691.71
|
| Rate for Payer: Signature Care EPO |
$743.68
|
| Rate for Payer: Signature Care PPO |
$788.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$761.60
|
| Rate for Payer: United Healthcare Commercial |
$706.05
|
| Rate for Payer: United Healthcare Medicare |
$295.68
|
|
|
HC Z PLATE SPIDER OFFSET SM FRAG
|
Facility
IP
|
$896.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$672.00 |
| Max. Negotiated Rate |
$833.28 |
| Rate for Payer: Aetna Commercial |
$774.14
|
| Rate for Payer: Cash Price |
$555.52
|
| Rate for Payer: Cigna All Commercial |
$773.25
|
| Rate for Payer: CORVEL All Commercial |
$833.28
|
| Rate for Payer: Coventry All Commercial |
$788.48
|
| Rate for Payer: Encore All Commercial |
$824.77
|
| Rate for Payer: Frontpath All Commercial |
$824.32
|
| Rate for Payer: Humana ChoiceCare |
$773.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$806.40
|
| Rate for Payer: PHCS All Commercial |
$672.00
|
| Rate for Payer: PHP All Commercial |
$679.53
|
| Rate for Payer: Sagamore Health Network All Products |
$691.71
|
| Rate for Payer: Signature Care EPO |
$743.68
|
| Rate for Payer: Signature Care PPO |
$788.48
|
| Rate for Payer: United Healthcare Commercial |
$706.05
|
|
|
HC Z PLATE STD LOCK L
|
Facility
OP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606408
|
|
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 STD LOCK L
|
Facility
IP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606408
|
|
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 STD LOCK L ST
|
Facility
IP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606409
|
|
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 STD LOCK L ST
|
Facility
OP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606409
|
|
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
|
|
