|
HC Z PLATE STD LOCK R
|
Facility
IP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606386
|
|
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 R
|
Facility
OP
|
$2,977.88
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606386
|
|
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 R ST
|
Facility
IP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606387
|
|
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 R ST
|
Facility
OP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606387
|
|
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 STYLD RAD L
|
Facility
IP
|
$3,139.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604301
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,354.40 |
| Max. Negotiated Rate |
$2,919.46 |
| Rate for Payer: Aetna Commercial |
$2,712.27
|
| Rate for Payer: Cash Price |
$1,946.30
|
| Rate for Payer: Cigna All Commercial |
$2,709.13
|
| Rate for Payer: CORVEL All Commercial |
$2,919.46
|
| Rate for Payer: Coventry All Commercial |
$2,762.50
|
| Rate for Payer: Encore All Commercial |
$2,889.63
|
| Rate for Payer: Frontpath All Commercial |
$2,888.06
|
| Rate for Payer: Humana ChoiceCare |
$2,711.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,825.28
|
| Rate for Payer: PHCS All Commercial |
$2,354.40
|
| Rate for Payer: PHP All Commercial |
$2,380.77
|
| Rate for Payer: Sagamore Health Network All Products |
$2,423.46
|
| Rate for Payer: Signature Care EPO |
$2,605.54
|
| Rate for Payer: Signature Care PPO |
$2,762.50
|
| Rate for Payer: United Healthcare Commercial |
$2,473.69
|
|
|
HC Z PLATE STYLD RAD L
|
Facility
OP
|
$3,139.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604301
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,919.46 |
| Rate for Payer: Aetna Commercial |
$2,649.48
|
| Rate for Payer: Aetna Medicare |
$1,035.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,035.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,802.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,962.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,191.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,139.53
|
| Rate for Payer: Cash Price |
$1,946.30
|
| Rate for Payer: Cash Price |
$1,946.30
|
| Rate for Payer: Centivo All Commercial |
$1,600.99
|
| Rate for Payer: Cigna All Commercial |
$2,709.13
|
| Rate for Payer: CORVEL All Commercial |
$2,919.46
|
| Rate for Payer: Coventry All Commercial |
$2,762.50
|
| Rate for Payer: Encore All Commercial |
$2,889.63
|
| Rate for Payer: Frontpath All Commercial |
$2,888.06
|
| Rate for Payer: Humana ChoiceCare |
$2,711.33
|
| Rate for Payer: Humana Medicare |
$1,600.99
|
| Rate for Payer: Lucent All Commercial |
$1,600.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,825.28
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,354.40
|
| Rate for Payer: PHP All Commercial |
$2,380.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,224.29
|
| Rate for Payer: Sagamore Health Network All Products |
$2,423.46
|
| Rate for Payer: Signature Care EPO |
$2,605.54
|
| Rate for Payer: Signature Care PPO |
$2,762.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,668.32
|
| Rate for Payer: United Healthcare Commercial |
$2,473.69
|
| Rate for Payer: United Healthcare Medicare |
$1,035.94
|
|
|
HC Z PLATE STYLD RAD R
|
Facility
IP
|
$3,139.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604302
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,354.40 |
| Max. Negotiated Rate |
$2,919.46 |
| Rate for Payer: Aetna Commercial |
$2,712.27
|
| Rate for Payer: Cash Price |
$1,946.30
|
| Rate for Payer: Cigna All Commercial |
$2,709.13
|
| Rate for Payer: CORVEL All Commercial |
$2,919.46
|
| Rate for Payer: Coventry All Commercial |
$2,762.50
|
| Rate for Payer: Encore All Commercial |
$2,889.63
|
| Rate for Payer: Frontpath All Commercial |
$2,888.06
|
| Rate for Payer: Humana ChoiceCare |
$2,711.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,825.28
|
| Rate for Payer: PHCS All Commercial |
$2,354.40
|
| Rate for Payer: PHP All Commercial |
$2,380.77
|
| Rate for Payer: Sagamore Health Network All Products |
$2,423.46
|
| Rate for Payer: Signature Care EPO |
$2,605.54
|
| Rate for Payer: Signature Care PPO |
$2,762.50
|
| Rate for Payer: United Healthcare Commercial |
$2,473.69
|
|
|
HC Z PLATE STYLD RAD R
|
Facility
OP
|
$3,139.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604302
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,919.46 |
| Rate for Payer: Aetna Commercial |
$2,649.48
|
| Rate for Payer: Aetna Medicare |
$1,035.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,035.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,802.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,962.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,191.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,139.53
|
| Rate for Payer: Cash Price |
$1,946.30
|
| Rate for Payer: Cash Price |
$1,946.30
|
| Rate for Payer: Centivo All Commercial |
$1,600.99
|
| Rate for Payer: Cigna All Commercial |
$2,709.13
|
| Rate for Payer: CORVEL All Commercial |
$2,919.46
|
| Rate for Payer: Coventry All Commercial |
$2,762.50
|
| Rate for Payer: Encore All Commercial |
$2,889.63
|
| Rate for Payer: Frontpath All Commercial |
$2,888.06
|
| Rate for Payer: Humana ChoiceCare |
$2,711.33
|
| Rate for Payer: Humana Medicare |
$1,600.99
|
| Rate for Payer: Lucent All Commercial |
$1,600.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,825.28
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,354.40
|
| Rate for Payer: PHP All Commercial |
$2,380.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,224.29
|
| Rate for Payer: Sagamore Health Network All Products |
$2,423.46
|
| Rate for Payer: Signature Care EPO |
$2,605.54
|
| Rate for Payer: Signature Care PPO |
$2,762.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,668.32
|
| Rate for Payer: United Healthcare Commercial |
$2,473.69
|
| Rate for Payer: United Healthcare Medicare |
$1,035.94
|
|
|
HC Z PLATE TEMPLATE SET STE
|
Facility
OP
|
$424.20
|
|
| Hospital Charge Code |
41606485
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$394.51 |
| Rate for Payer: Aetna Commercial |
$358.02
|
| Rate for Payer: Aetna Medicare |
$139.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$139.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$243.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$265.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$160.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$153.98
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Centivo All Commercial |
$216.34
|
| Rate for Payer: Cigna All Commercial |
$366.08
|
| Rate for Payer: CORVEL All Commercial |
$394.51
|
| Rate for Payer: Coventry All Commercial |
$373.30
|
| Rate for Payer: Encore All Commercial |
$390.48
|
| Rate for Payer: Frontpath All Commercial |
$390.26
|
| Rate for Payer: Humana ChoiceCare |
$366.38
|
| Rate for Payer: Humana Medicare |
$216.34
|
| Rate for Payer: Lucent All Commercial |
$216.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.78
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$318.15
|
| Rate for Payer: PHP All Commercial |
$321.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$165.44
|
| Rate for Payer: Sagamore Health Network All Products |
$327.48
|
| Rate for Payer: Signature Care EPO |
$352.09
|
| Rate for Payer: Signature Care PPO |
$373.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$360.57
|
| Rate for Payer: United Healthcare Commercial |
$334.27
|
| Rate for Payer: United Healthcare Medicare |
$139.99
|
|
|
HC Z PLATE TEMPLATE SET STE
|
Facility
IP
|
$424.20
|
|
| Hospital Charge Code |
41606485
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$318.15 |
| Max. Negotiated Rate |
$394.51 |
| Rate for Payer: Aetna Commercial |
$366.51
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Cigna All Commercial |
$366.08
|
| Rate for Payer: CORVEL All Commercial |
$394.51
|
| Rate for Payer: Coventry All Commercial |
$373.30
|
| Rate for Payer: Encore All Commercial |
$390.48
|
| Rate for Payer: Frontpath All Commercial |
$390.26
|
| Rate for Payer: Humana ChoiceCare |
$366.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.78
|
| Rate for Payer: PHCS All Commercial |
$318.15
|
| Rate for Payer: PHP All Commercial |
$321.71
|
| Rate for Payer: Sagamore Health Network All Products |
$327.48
|
| Rate for Payer: Signature Care EPO |
$352.09
|
| Rate for Payer: Signature Care PPO |
$373.30
|
| Rate for Payer: United Healthcare Commercial |
$334.27
|
|
|
HC Z PLATE TROCH NCB NRW R
|
Facility
OP
|
$3,259.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,031.58 |
| Rate for Payer: Aetna Commercial |
$2,751.24
|
| Rate for Payer: Aetna Medicare |
$1,075.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,075.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,872.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,037.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,237.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,183.29
|
| Rate for Payer: Cash Price |
$2,021.05
|
| Rate for Payer: Cash Price |
$2,021.05
|
| Rate for Payer: Centivo All Commercial |
$1,662.48
|
| Rate for Payer: Cigna All Commercial |
$2,813.17
|
| Rate for Payer: CORVEL All Commercial |
$3,031.58
|
| Rate for Payer: Coventry All Commercial |
$2,868.59
|
| Rate for Payer: Encore All Commercial |
$3,000.61
|
| Rate for Payer: Frontpath All Commercial |
$2,998.98
|
| Rate for Payer: Humana ChoiceCare |
$2,815.45
|
| Rate for Payer: Humana Medicare |
$1,662.48
|
| Rate for Payer: Lucent All Commercial |
$1,662.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,933.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,444.82
|
| Rate for Payer: PHP All Commercial |
$2,472.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,271.31
|
| Rate for Payer: Sagamore Health Network All Products |
$2,516.53
|
| Rate for Payer: Signature Care EPO |
$2,705.60
|
| Rate for Payer: Signature Care PPO |
$2,868.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,770.80
|
| Rate for Payer: United Healthcare Commercial |
$2,568.69
|
| Rate for Payer: United Healthcare Medicare |
$1,075.72
|
|
|
HC Z PLATE TROCH NCB NRW R
|
Facility
IP
|
$3,259.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,444.82 |
| Max. Negotiated Rate |
$3,031.58 |
| Rate for Payer: Aetna Commercial |
$2,816.43
|
| Rate for Payer: Cash Price |
$2,021.05
|
| Rate for Payer: Cigna All Commercial |
$2,813.17
|
| Rate for Payer: CORVEL All Commercial |
$3,031.58
|
| Rate for Payer: Coventry All Commercial |
$2,868.59
|
| Rate for Payer: Encore All Commercial |
$3,000.61
|
| Rate for Payer: Frontpath All Commercial |
$2,998.98
|
| Rate for Payer: Humana ChoiceCare |
$2,815.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,933.78
|
| Rate for Payer: PHCS All Commercial |
$2,444.82
|
| Rate for Payer: PHP All Commercial |
$2,472.20
|
| Rate for Payer: Sagamore Health Network All Products |
$2,516.53
|
| Rate for Payer: Signature Care EPO |
$2,705.60
|
| Rate for Payer: Signature Care PPO |
$2,868.59
|
| Rate for Payer: United Healthcare Commercial |
$2,568.69
|
|
|
HC Z PLATE ULNA BILAT
|
Facility
IP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605880
|
|
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 ULNA BILAT
|
Facility
OP
|
$2,857.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605880
|
|
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 VOLAR NARROW 3-H R
|
Facility
IP
|
$2,756.38
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603602
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,067.28 |
| Max. Negotiated Rate |
$2,563.43 |
| Rate for Payer: Aetna Commercial |
$2,381.51
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Cigna All Commercial |
$2,378.76
|
| Rate for Payer: CORVEL All Commercial |
$2,563.43
|
| Rate for Payer: Coventry All Commercial |
$2,425.61
|
| Rate for Payer: Encore All Commercial |
$2,537.25
|
| Rate for Payer: Frontpath All Commercial |
$2,535.87
|
| Rate for Payer: Humana ChoiceCare |
$2,380.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,480.74
|
| Rate for Payer: PHCS All Commercial |
$2,067.28
|
| Rate for Payer: PHP All Commercial |
$2,090.44
|
| Rate for Payer: Sagamore Health Network All Products |
$2,127.93
|
| Rate for Payer: Signature Care EPO |
$2,287.80
|
| Rate for Payer: Signature Care PPO |
$2,425.61
|
| Rate for Payer: United Healthcare Commercial |
$2,172.03
|
|
|
HC Z PLATE VOLAR NARROW 3-H R
|
Facility
OP
|
$2,756.38
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603602
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,563.43 |
| Rate for Payer: Aetna Commercial |
$2,326.38
|
| Rate for Payer: Aetna Medicare |
$909.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$909.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,582.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,723.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,046.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,000.57
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Centivo All Commercial |
$1,405.75
|
| Rate for Payer: Cigna All Commercial |
$2,378.76
|
| Rate for Payer: CORVEL All Commercial |
$2,563.43
|
| Rate for Payer: Coventry All Commercial |
$2,425.61
|
| Rate for Payer: Encore All Commercial |
$2,537.25
|
| Rate for Payer: Frontpath All Commercial |
$2,535.87
|
| Rate for Payer: Humana ChoiceCare |
$2,380.69
|
| Rate for Payer: Humana Medicare |
$1,405.75
|
| Rate for Payer: Lucent All Commercial |
$1,405.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,480.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,067.28
|
| Rate for Payer: PHP All Commercial |
$2,090.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,074.99
|
| Rate for Payer: Sagamore Health Network All Products |
$2,127.93
|
| Rate for Payer: Signature Care EPO |
$2,287.80
|
| Rate for Payer: Signature Care PPO |
$2,425.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,342.92
|
| Rate for Payer: United Healthcare Commercial |
$2,172.03
|
| Rate for Payer: United Healthcare Medicare |
$909.61
|
|
|
HC Z PLATE VOLAR NRW 3-H L
|
Facility
IP
|
$2,756.38
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603869
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,067.28 |
| Max. Negotiated Rate |
$2,563.43 |
| Rate for Payer: Aetna Commercial |
$2,381.51
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Cigna All Commercial |
$2,378.76
|
| Rate for Payer: CORVEL All Commercial |
$2,563.43
|
| Rate for Payer: Coventry All Commercial |
$2,425.61
|
| Rate for Payer: Encore All Commercial |
$2,537.25
|
| Rate for Payer: Frontpath All Commercial |
$2,535.87
|
| Rate for Payer: Humana ChoiceCare |
$2,380.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,480.74
|
| Rate for Payer: PHCS All Commercial |
$2,067.28
|
| Rate for Payer: PHP All Commercial |
$2,090.44
|
| Rate for Payer: Sagamore Health Network All Products |
$2,127.93
|
| Rate for Payer: Signature Care EPO |
$2,287.80
|
| Rate for Payer: Signature Care PPO |
$2,425.61
|
| Rate for Payer: United Healthcare Commercial |
$2,172.03
|
|
|
HC Z PLATE VOLAR NRW 3-H L
|
Facility
OP
|
$2,756.38
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603869
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,563.43 |
| Rate for Payer: Aetna Commercial |
$2,326.38
|
| Rate for Payer: Aetna Medicare |
$909.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$909.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,582.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,723.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,046.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,000.57
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Cash Price |
$1,708.96
|
| Rate for Payer: Centivo All Commercial |
$1,405.75
|
| Rate for Payer: Cigna All Commercial |
$2,378.76
|
| Rate for Payer: CORVEL All Commercial |
$2,563.43
|
| Rate for Payer: Coventry All Commercial |
$2,425.61
|
| Rate for Payer: Encore All Commercial |
$2,537.25
|
| Rate for Payer: Frontpath All Commercial |
$2,535.87
|
| Rate for Payer: Humana ChoiceCare |
$2,380.69
|
| Rate for Payer: Humana Medicare |
$1,405.75
|
| Rate for Payer: Lucent All Commercial |
$1,405.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,480.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,067.28
|
| Rate for Payer: PHP All Commercial |
$2,090.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,074.99
|
| Rate for Payer: Sagamore Health Network All Products |
$2,127.93
|
| Rate for Payer: Signature Care EPO |
$2,287.80
|
| Rate for Payer: Signature Care PPO |
$2,425.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,342.92
|
| Rate for Payer: United Healthcare Commercial |
$2,172.03
|
| Rate for Payer: United Healthcare Medicare |
$909.61
|
|
|
HC Z PLATE VOLAR NRW 5-H
|
Facility
IP
|
$2,996.06
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604295
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,247.04 |
| Max. Negotiated Rate |
$2,786.34 |
| Rate for Payer: Aetna Commercial |
$2,588.60
|
| Rate for Payer: Cash Price |
$1,857.56
|
| Rate for Payer: Cigna All Commercial |
$2,585.60
|
| Rate for Payer: CORVEL All Commercial |
$2,786.34
|
| Rate for Payer: Coventry All Commercial |
$2,636.53
|
| Rate for Payer: Encore All Commercial |
$2,757.87
|
| Rate for Payer: Frontpath All Commercial |
$2,756.38
|
| Rate for Payer: Humana ChoiceCare |
$2,587.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,696.45
|
| Rate for Payer: PHCS All Commercial |
$2,247.04
|
| Rate for Payer: PHP All Commercial |
$2,272.21
|
| Rate for Payer: Sagamore Health Network All Products |
$2,312.96
|
| Rate for Payer: Signature Care EPO |
$2,486.73
|
| Rate for Payer: Signature Care PPO |
$2,636.53
|
| Rate for Payer: United Healthcare Commercial |
$2,360.90
|
|
|
HC Z PLATE VOLAR NRW 5-H
|
Facility
OP
|
$2,996.06
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604295
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,786.34 |
| Rate for Payer: Aetna Commercial |
$2,528.67
|
| Rate for Payer: Aetna Medicare |
$988.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$988.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,720.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,872.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,137.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,087.57
|
| Rate for Payer: Cash Price |
$1,857.56
|
| Rate for Payer: Cash Price |
$1,857.56
|
| Rate for Payer: Centivo All Commercial |
$1,527.99
|
| Rate for Payer: Cigna All Commercial |
$2,585.60
|
| Rate for Payer: CORVEL All Commercial |
$2,786.34
|
| Rate for Payer: Coventry All Commercial |
$2,636.53
|
| Rate for Payer: Encore All Commercial |
$2,757.87
|
| Rate for Payer: Frontpath All Commercial |
$2,756.38
|
| Rate for Payer: Humana ChoiceCare |
$2,587.70
|
| Rate for Payer: Humana Medicare |
$1,527.99
|
| Rate for Payer: Lucent All Commercial |
$1,527.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,696.45
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,247.04
|
| Rate for Payer: PHP All Commercial |
$2,272.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,168.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,312.96
|
| Rate for Payer: Signature Care EPO |
$2,486.73
|
| Rate for Payer: Signature Care PPO |
$2,636.53
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,546.65
|
| Rate for Payer: United Healthcare Commercial |
$2,360.90
|
| Rate for Payer: United Healthcare Medicare |
$988.70
|
|
|
HC Z PLATE VOLAR NRW 5-H
|
Facility
IP
|
$2,996.06
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604296
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,247.04 |
| Max. Negotiated Rate |
$2,786.34 |
| Rate for Payer: Aetna Commercial |
$2,588.60
|
| Rate for Payer: Cash Price |
$1,857.56
|
| Rate for Payer: Cigna All Commercial |
$2,585.60
|
| Rate for Payer: CORVEL All Commercial |
$2,786.34
|
| Rate for Payer: Coventry All Commercial |
$2,636.53
|
| Rate for Payer: Encore All Commercial |
$2,757.87
|
| Rate for Payer: Frontpath All Commercial |
$2,756.38
|
| Rate for Payer: Humana ChoiceCare |
$2,587.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,696.45
|
| Rate for Payer: PHCS All Commercial |
$2,247.04
|
| Rate for Payer: PHP All Commercial |
$2,272.21
|
| Rate for Payer: Sagamore Health Network All Products |
$2,312.96
|
| Rate for Payer: Signature Care EPO |
$2,486.73
|
| Rate for Payer: Signature Care PPO |
$2,636.53
|
| Rate for Payer: United Healthcare Commercial |
$2,360.90
|
|
|
HC Z PLATE VOLAR NRW 5-H
|
Facility
OP
|
$2,996.06
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604296
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,786.34 |
| Rate for Payer: Aetna Commercial |
$2,528.67
|
| Rate for Payer: Aetna Medicare |
$988.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$988.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,720.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,872.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,137.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,087.57
|
| Rate for Payer: Cash Price |
$1,857.56
|
| Rate for Payer: Cash Price |
$1,857.56
|
| Rate for Payer: Centivo All Commercial |
$1,527.99
|
| Rate for Payer: Cigna All Commercial |
$2,585.60
|
| Rate for Payer: CORVEL All Commercial |
$2,786.34
|
| Rate for Payer: Coventry All Commercial |
$2,636.53
|
| Rate for Payer: Encore All Commercial |
$2,757.87
|
| Rate for Payer: Frontpath All Commercial |
$2,756.38
|
| Rate for Payer: Humana ChoiceCare |
$2,587.70
|
| Rate for Payer: Humana Medicare |
$1,527.99
|
| Rate for Payer: Lucent All Commercial |
$1,527.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,696.45
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,247.04
|
| Rate for Payer: PHP All Commercial |
$2,272.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,168.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,312.96
|
| Rate for Payer: Signature Care EPO |
$2,486.73
|
| Rate for Payer: Signature Care PPO |
$2,636.53
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,546.65
|
| Rate for Payer: United Healthcare Commercial |
$2,360.90
|
| Rate for Payer: United Healthcare Medicare |
$988.70
|
|
|
HC Z PLATE VOLAR RIM L
|
Facility
OP
|
$3,297.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606418
|
|
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 VOLAR RIM L
|
Facility
IP
|
$3,297.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606418
|
|
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 VOLAR RIM L ST
|
Facility
OP
|
$3,159.68
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606419
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,938.50 |
| Rate for Payer: Aetna Commercial |
$2,666.77
|
| Rate for Payer: Aetna Medicare |
$1,042.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,042.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,814.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,975.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,199.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,146.96
|
| Rate for Payer: Cash Price |
$1,959.00
|
| Rate for Payer: Cash Price |
$1,959.00
|
| Rate for Payer: Centivo All Commercial |
$1,611.44
|
| Rate for Payer: Cigna All Commercial |
$2,726.80
|
| Rate for Payer: CORVEL All Commercial |
$2,938.50
|
| Rate for Payer: Coventry All Commercial |
$2,780.52
|
| Rate for Payer: Encore All Commercial |
$2,908.49
|
| Rate for Payer: Frontpath All Commercial |
$2,906.91
|
| Rate for Payer: Humana ChoiceCare |
$2,729.02
|
| Rate for Payer: Humana Medicare |
$1,611.44
|
| Rate for Payer: Lucent All Commercial |
$1,611.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,843.71
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,369.76
|
| Rate for Payer: PHP All Commercial |
$2,396.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,232.28
|
| Rate for Payer: Sagamore Health Network All Products |
$2,439.27
|
| Rate for Payer: Signature Care EPO |
$2,622.53
|
| Rate for Payer: Signature Care PPO |
$2,780.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,685.73
|
| Rate for Payer: United Healthcare Commercial |
$2,489.83
|
| Rate for Payer: United Healthcare Medicare |
$1,042.69
|
|
