|
HC Z PSN FEM 7 CR STD R
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607687
|
|
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 R
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607687
|
|
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 8 CR STD L
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607633
|
|
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 8 CR STD L
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607633
|
|
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 8 CR STD R
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607053
|
|
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 8 CR STD R
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607053
|
|
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 9 CR CMT NRW L
|
Facility
IP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607608
|
|
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 9 CR CMT NRW L
|
Facility
OP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607608
|
|
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 9 CR NRW R
|
Facility
IP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607929
|
|
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 9 CR NRW R
|
Facility
OP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607929
|
|
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 9 CR STD L
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608046
|
|
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 9 CR STD L
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608046
|
|
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 9 CR STD R
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608053
|
|
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 9 CR STD R
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608053
|
|
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 9 PS STD L
|
Facility
IP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608292
|
|
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 9 PS STD L
|
Facility
OP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608292
|
|
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 FEMUR 8 CR NRW L
|
Facility
OP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607385
|
|
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 FEMUR 8 CR NRW L
|
Facility
IP
|
$13,135.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607385
|
|
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 INSERTER TIP
|
Facility
IP
|
$528.08
|
|
| Hospital Charge Code |
41607515
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.06 |
| Max. Negotiated Rate |
$491.11 |
| Rate for Payer: Aetna Commercial |
$456.26
|
| Rate for Payer: Cash Price |
$327.41
|
| Rate for Payer: Cigna All Commercial |
$455.73
|
| Rate for Payer: CORVEL All Commercial |
$491.11
|
| Rate for Payer: Coventry All Commercial |
$464.71
|
| Rate for Payer: Encore All Commercial |
$486.10
|
| Rate for Payer: Frontpath All Commercial |
$485.83
|
| Rate for Payer: Humana ChoiceCare |
$456.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$475.27
|
| Rate for Payer: PHCS All Commercial |
$396.06
|
| Rate for Payer: PHP All Commercial |
$400.50
|
| Rate for Payer: Sagamore Health Network All Products |
$407.68
|
| Rate for Payer: Signature Care EPO |
$438.31
|
| Rate for Payer: Signature Care PPO |
$464.71
|
| Rate for Payer: United Healthcare Commercial |
$416.13
|
|
|
HC Z PSN INSERTER TIP
|
Facility
OP
|
$528.08
|
|
| Hospital Charge Code |
41607515
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$491.11 |
| Rate for Payer: Aetna Commercial |
$445.70
|
| Rate for Payer: Aetna Medicare |
$174.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$174.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$303.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$330.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$200.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$191.69
|
| Rate for Payer: Cash Price |
$327.41
|
| Rate for Payer: Cash Price |
$327.41
|
| Rate for Payer: Centivo All Commercial |
$269.32
|
| Rate for Payer: Cigna All Commercial |
$455.73
|
| Rate for Payer: CORVEL All Commercial |
$491.11
|
| Rate for Payer: Coventry All Commercial |
$464.71
|
| Rate for Payer: Encore All Commercial |
$486.10
|
| Rate for Payer: Frontpath All Commercial |
$485.83
|
| Rate for Payer: Humana ChoiceCare |
$456.10
|
| Rate for Payer: Humana Medicare |
$269.32
|
| Rate for Payer: Lucent All Commercial |
$269.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$475.27
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$396.06
|
| Rate for Payer: PHP All Commercial |
$400.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$205.95
|
| Rate for Payer: Sagamore Health Network All Products |
$407.68
|
| Rate for Payer: Signature Care EPO |
$438.31
|
| Rate for Payer: Signature Care PPO |
$464.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$448.87
|
| Rate for Payer: United Healthcare Commercial |
$416.13
|
| Rate for Payer: United Healthcare Medicare |
$174.27
|
|
|
HC Z PSN PART FEM 2 R
|
Facility
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607847
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,967.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,967.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,262.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,164.06
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Centivo All Commercial |
$3,040.42
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$3,040.42
|
| Rate for Payer: Lucent All Commercial |
$3,040.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,967.33
|
|
|
HC Z PSN PART FEM 2 R
|
Facility
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607847
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z PSN PART FEM 3 L
|
Facility
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607519
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,967.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,967.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,262.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,164.06
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Centivo All Commercial |
$3,040.42
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$3,040.42
|
| Rate for Payer: Lucent All Commercial |
$3,040.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,967.33
|
|
|
HC Z PSN PART FEM 3 L
|
Facility
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607519
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z PSN PART FEM 4 LM
|
Facility
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
