|
HC Z PSN FEM 12 CR STD R
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z PSN FEM 4 CR STD L
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z PSN FEM 4 CR STD L
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 5 CR STD L
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 5 CR STD L
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z PSN FEM 5 CR STD R
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607947
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z PSN FEM 5 CR STD R
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607947
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 6 CMT STD R
|
Facility
IP
|
$13,680.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,260.00 |
| Max. Negotiated Rate |
$12,722.40 |
| Rate for Payer: Aetna Commercial |
$11,819.52
|
| Rate for Payer: Cash Price |
$8,481.60
|
| Rate for Payer: Cigna All Commercial |
$11,805.84
|
| Rate for Payer: CORVEL All Commercial |
$12,722.40
|
| Rate for Payer: Coventry All Commercial |
$12,038.40
|
| Rate for Payer: Encore All Commercial |
$12,592.44
|
| Rate for Payer: Frontpath All Commercial |
$12,585.60
|
| Rate for Payer: Humana ChoiceCare |
$11,815.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,312.00
|
| Rate for Payer: PHCS All Commercial |
$10,260.00
|
| Rate for Payer: PHP All Commercial |
$10,374.91
|
| Rate for Payer: Sagamore Health Network All Products |
$10,560.96
|
| Rate for Payer: Signature Care EPO |
$11,354.40
|
| Rate for Payer: Signature Care PPO |
$12,038.40
|
| Rate for Payer: United Healthcare Commercial |
$10,779.84
|
|
|
HC Z PSN FEM 6 CMT STD R
|
Facility
OP
|
$13,680.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$12,722.40 |
| Rate for Payer: Aetna Commercial |
$11,545.92
|
| Rate for Payer: Aetna Medicare |
$4,514.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,514.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,856.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,551.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,191.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,965.84
|
| Rate for Payer: Cash Price |
$8,481.60
|
| Rate for Payer: Cash Price |
$8,481.60
|
| Rate for Payer: Centivo All Commercial |
$6,976.80
|
| Rate for Payer: Cigna All Commercial |
$11,805.84
|
| Rate for Payer: CORVEL All Commercial |
$12,722.40
|
| Rate for Payer: Coventry All Commercial |
$12,038.40
|
| Rate for Payer: Encore All Commercial |
$12,592.44
|
| Rate for Payer: Frontpath All Commercial |
$12,585.60
|
| Rate for Payer: Humana ChoiceCare |
$11,815.42
|
| Rate for Payer: Humana Medicare |
$6,976.80
|
| Rate for Payer: Lucent All Commercial |
$6,976.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,312.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$10,260.00
|
| Rate for Payer: PHP All Commercial |
$10,374.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,335.20
|
| Rate for Payer: Sagamore Health Network All Products |
$10,560.96
|
| Rate for Payer: Signature Care EPO |
$11,354.40
|
| Rate for Payer: Signature Care PPO |
$12,038.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,628.00
|
| Rate for Payer: United Healthcare Commercial |
$10,779.84
|
| Rate for Payer: United Healthcare Medicare |
$4,514.40
|
|
|
HC Z PSN FEM 6 CR NRW COCR R
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608238
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z PSN FEM 6 CR NRW COCR R
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608238
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 6 CR NRW R
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608099
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z PSN FEM 6 CR NRW R
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608099
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 6 CR STD L
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z PSN FEM 6 CR STD L
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 6 CR STD R
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608084
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 6 CR STD R
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608084
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z PSN FEM 7 CR NRW L
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 7 CR NRW L
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z PSN FEM 7 CR NRW L
|
Facility
OP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607848
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$12,215.91 |
| Rate for Payer: Aetna Commercial |
$11,086.27
|
| Rate for Payer: Aetna Medicare |
$4,334.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,334.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,543.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,210.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,984.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,768.15
|
| Rate for Payer: Cash Price |
$8,143.94
|
| Rate for Payer: Cash Price |
$8,143.94
|
| Rate for Payer: Centivo All Commercial |
$6,699.05
|
| Rate for Payer: Cigna All Commercial |
$11,335.84
|
| Rate for Payer: CORVEL All Commercial |
$12,215.91
|
| Rate for Payer: Coventry All Commercial |
$11,559.14
|
| Rate for Payer: Encore All Commercial |
$12,091.13
|
| Rate for Payer: Frontpath All Commercial |
$12,084.56
|
| Rate for Payer: Humana ChoiceCare |
$11,345.04
|
| Rate for Payer: Humana Medicare |
$6,699.05
|
| Rate for Payer: Lucent All Commercial |
$6,699.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,821.85
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,851.54
|
| Rate for Payer: PHP All Commercial |
$9,961.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,122.80
|
| Rate for Payer: Sagamore Health Network All Products |
$10,140.52
|
| Rate for Payer: Signature Care EPO |
$10,902.37
|
| Rate for Payer: Signature Care PPO |
$11,559.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,165.08
|
| Rate for Payer: United Healthcare Commercial |
$10,350.69
|
| Rate for Payer: United Healthcare Medicare |
$4,334.68
|
|
|
HC Z PSN FEM 7 CR NRW L
|
Facility
IP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607848
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,851.54 |
| Max. Negotiated Rate |
$12,215.91 |
| Rate for Payer: Aetna Commercial |
$11,348.98
|
| Rate for Payer: Cash Price |
$8,143.94
|
| Rate for Payer: Cigna All Commercial |
$11,335.84
|
| Rate for Payer: CORVEL All Commercial |
$12,215.91
|
| Rate for Payer: Coventry All Commercial |
$11,559.14
|
| Rate for Payer: Encore All Commercial |
$12,091.13
|
| Rate for Payer: Frontpath All Commercial |
$12,084.56
|
| Rate for Payer: Humana ChoiceCare |
$11,345.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,821.85
|
| Rate for Payer: PHCS All Commercial |
$9,851.54
|
| Rate for Payer: PHP All Commercial |
$9,961.88
|
| Rate for Payer: Sagamore Health Network All Products |
$10,140.52
|
| Rate for Payer: Signature Care EPO |
$10,902.37
|
| Rate for Payer: Signature Care PPO |
$11,559.14
|
| Rate for Payer: United Healthcare Commercial |
$10,350.69
|
|
|
HC Z PSN FEM 7 CR NRW R
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z PSN FEM 7 CR NRW R
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 7 CR STD L
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607881
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z PSN FEM 7 CR STD L
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607881
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
