|
HC ACU 2 VDR PR PLT NARR LONG R
|
Facility
OP
|
$6,908.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602882
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,424.81 |
| Rate for Payer: Aetna Commercial |
$5,830.69
|
| Rate for Payer: Aetna Medicare |
$2,279.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,279.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,967.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,318.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,621.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,507.75
|
| Rate for Payer: Cash Price |
$4,283.21
|
| Rate for Payer: Cash Price |
$4,283.21
|
| Rate for Payer: Centivo All Commercial |
$3,523.28
|
| Rate for Payer: Cigna All Commercial |
$5,961.95
|
| Rate for Payer: CORVEL All Commercial |
$6,424.81
|
| Rate for Payer: Coventry All Commercial |
$6,079.39
|
| Rate for Payer: Encore All Commercial |
$6,359.18
|
| Rate for Payer: Frontpath All Commercial |
$6,355.73
|
| Rate for Payer: Humana ChoiceCare |
$5,966.79
|
| Rate for Payer: Humana Medicare |
$3,523.28
|
| Rate for Payer: Lucent All Commercial |
$3,523.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,217.56
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,181.30
|
| Rate for Payer: PHP All Commercial |
$5,239.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,694.28
|
| Rate for Payer: Sagamore Health Network All Products |
$5,333.28
|
| Rate for Payer: Signature Care EPO |
$5,733.97
|
| Rate for Payer: Signature Care PPO |
$6,079.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,872.14
|
| Rate for Payer: United Healthcare Commercial |
$5,443.82
|
| Rate for Payer: United Healthcare Medicare |
$2,279.77
|
|
|
HC ACU 2 VDR PR PLT STD LONG L
|
Facility
OP
|
$6,908.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,424.81 |
| Rate for Payer: Aetna Commercial |
$5,830.69
|
| Rate for Payer: Aetna Medicare |
$2,279.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,279.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,967.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,318.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,621.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,507.75
|
| Rate for Payer: Cash Price |
$4,283.21
|
| Rate for Payer: Cash Price |
$4,283.21
|
| Rate for Payer: Centivo All Commercial |
$3,523.28
|
| Rate for Payer: Cigna All Commercial |
$5,961.95
|
| Rate for Payer: CORVEL All Commercial |
$6,424.81
|
| Rate for Payer: Coventry All Commercial |
$6,079.39
|
| Rate for Payer: Encore All Commercial |
$6,359.18
|
| Rate for Payer: Frontpath All Commercial |
$6,355.73
|
| Rate for Payer: Humana ChoiceCare |
$5,966.79
|
| Rate for Payer: Humana Medicare |
$3,523.28
|
| Rate for Payer: Lucent All Commercial |
$3,523.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,217.56
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,181.30
|
| Rate for Payer: PHP All Commercial |
$5,239.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,694.28
|
| Rate for Payer: Sagamore Health Network All Products |
$5,333.28
|
| Rate for Payer: Signature Care EPO |
$5,733.97
|
| Rate for Payer: Signature Care PPO |
$6,079.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,872.14
|
| Rate for Payer: United Healthcare Commercial |
$5,443.82
|
| Rate for Payer: United Healthcare Medicare |
$2,279.77
|
|
|
HC ACU 2 VDR PR PLT STD LONG L
|
Facility
IP
|
$6,908.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,181.30 |
| Max. Negotiated Rate |
$6,424.81 |
| Rate for Payer: Aetna Commercial |
$5,968.86
|
| Rate for Payer: Cash Price |
$4,283.21
|
| Rate for Payer: Cigna All Commercial |
$5,961.95
|
| Rate for Payer: CORVEL All Commercial |
$6,424.81
|
| Rate for Payer: Coventry All Commercial |
$6,079.39
|
| Rate for Payer: Encore All Commercial |
$6,359.18
|
| Rate for Payer: Frontpath All Commercial |
$6,355.73
|
| Rate for Payer: Humana ChoiceCare |
$5,966.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,217.56
|
| Rate for Payer: PHCS All Commercial |
$5,181.30
|
| Rate for Payer: PHP All Commercial |
$5,239.33
|
| Rate for Payer: Sagamore Health Network All Products |
$5,333.28
|
| Rate for Payer: Signature Care EPO |
$5,733.97
|
| Rate for Payer: Signature Care PPO |
$6,079.39
|
| Rate for Payer: United Healthcare Commercial |
$5,443.82
|
|
|
HC ACU 2 VDR PR PLT STD LONG R
|
Facility
IP
|
$6,908.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,181.30 |
| Max. Negotiated Rate |
$6,424.81 |
| Rate for Payer: Aetna Commercial |
$5,968.86
|
| Rate for Payer: Cash Price |
$4,283.21
|
| Rate for Payer: Cigna All Commercial |
$5,961.95
|
| Rate for Payer: CORVEL All Commercial |
$6,424.81
|
| Rate for Payer: Coventry All Commercial |
$6,079.39
|
| Rate for Payer: Encore All Commercial |
$6,359.18
|
| Rate for Payer: Frontpath All Commercial |
$6,355.73
|
| Rate for Payer: Humana ChoiceCare |
$5,966.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,217.56
|
| Rate for Payer: PHCS All Commercial |
$5,181.30
|
| Rate for Payer: PHP All Commercial |
$5,239.33
|
| Rate for Payer: Sagamore Health Network All Products |
$5,333.28
|
| Rate for Payer: Signature Care EPO |
$5,733.97
|
| Rate for Payer: Signature Care PPO |
$6,079.39
|
| Rate for Payer: United Healthcare Commercial |
$5,443.82
|
|
|
HC ACU 2 VDR PR PLT STD LONG R
|
Facility
OP
|
$6,908.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,424.81 |
| Rate for Payer: Aetna Commercial |
$5,830.69
|
| Rate for Payer: Aetna Medicare |
$2,279.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,279.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,967.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,318.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,621.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,507.75
|
| Rate for Payer: Cash Price |
$4,283.21
|
| Rate for Payer: Cash Price |
$4,283.21
|
| Rate for Payer: Centivo All Commercial |
$3,523.28
|
| Rate for Payer: Cigna All Commercial |
$5,961.95
|
| Rate for Payer: CORVEL All Commercial |
$6,424.81
|
| Rate for Payer: Coventry All Commercial |
$6,079.39
|
| Rate for Payer: Encore All Commercial |
$6,359.18
|
| Rate for Payer: Frontpath All Commercial |
$6,355.73
|
| Rate for Payer: Humana ChoiceCare |
$5,966.79
|
| Rate for Payer: Humana Medicare |
$3,523.28
|
| Rate for Payer: Lucent All Commercial |
$3,523.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,217.56
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,181.30
|
| Rate for Payer: PHP All Commercial |
$5,239.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,694.28
|
| Rate for Payer: Sagamore Health Network All Products |
$5,333.28
|
| Rate for Payer: Signature Care EPO |
$5,733.97
|
| Rate for Payer: Signature Care PPO |
$6,079.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,872.14
|
| Rate for Payer: United Healthcare Commercial |
$5,443.82
|
| Rate for Payer: United Healthcare Medicare |
$2,279.77
|
|
|
HC ACU 30 TWIST-TRAK COMP SCREW
|
Facility
OP
|
$1,635.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602811
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,520.55 |
| Rate for Payer: Aetna Commercial |
$1,379.94
|
| Rate for Payer: Aetna Medicare |
$539.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$539.55
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$938.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,022.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$620.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$593.50
|
| Rate for Payer: Cash Price |
$1,013.70
|
| Rate for Payer: Cash Price |
$1,013.70
|
| Rate for Payer: Centivo All Commercial |
$833.85
|
| Rate for Payer: Cigna All Commercial |
$1,411.00
|
| Rate for Payer: CORVEL All Commercial |
$1,520.55
|
| Rate for Payer: Coventry All Commercial |
$1,438.80
|
| Rate for Payer: Encore All Commercial |
$1,505.02
|
| Rate for Payer: Frontpath All Commercial |
$1,504.20
|
| Rate for Payer: Humana ChoiceCare |
$1,412.15
|
| Rate for Payer: Humana Medicare |
$833.85
|
| Rate for Payer: Lucent All Commercial |
$833.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,471.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,226.25
|
| Rate for Payer: PHP All Commercial |
$1,239.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$637.65
|
| Rate for Payer: Sagamore Health Network All Products |
$1,262.22
|
| Rate for Payer: Signature Care EPO |
$1,357.05
|
| Rate for Payer: Signature Care PPO |
$1,438.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,389.75
|
| Rate for Payer: United Healthcare Commercial |
$1,288.38
|
| Rate for Payer: United Healthcare Medicare |
$539.55
|
|
|
HC ACU 30 TWIST-TRAK COMP SCREW
|
Facility
IP
|
$1,635.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602811
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,226.25 |
| Max. Negotiated Rate |
$1,520.55 |
| Rate for Payer: Aetna Commercial |
$1,412.64
|
| Rate for Payer: Cash Price |
$1,013.70
|
| Rate for Payer: Cigna All Commercial |
$1,411.00
|
| Rate for Payer: CORVEL All Commercial |
$1,520.55
|
| Rate for Payer: Coventry All Commercial |
$1,438.80
|
| Rate for Payer: Encore All Commercial |
$1,505.02
|
| Rate for Payer: Frontpath All Commercial |
$1,504.20
|
| Rate for Payer: Humana ChoiceCare |
$1,412.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,471.50
|
| Rate for Payer: PHCS All Commercial |
$1,226.25
|
| Rate for Payer: PHP All Commercial |
$1,239.98
|
| Rate for Payer: Sagamore Health Network All Products |
$1,262.22
|
| Rate for Payer: Signature Care EPO |
$1,357.05
|
| Rate for Payer: Signature Care PPO |
$1,438.80
|
| Rate for Payer: United Healthcare Commercial |
$1,288.38
|
|
|
HC ACU 3.5 QR SURGIBIT DRILL LAG
|
Facility
OP
|
$790.00
|
|
| Hospital Charge Code |
41602817
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$734.70 |
| Rate for Payer: Aetna Commercial |
$666.76
|
| Rate for Payer: Aetna Medicare |
$260.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$260.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$453.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$493.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$299.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$286.77
|
| Rate for Payer: Cash Price |
$489.80
|
| Rate for Payer: Cash Price |
$489.80
|
| Rate for Payer: Centivo All Commercial |
$402.90
|
| Rate for Payer: Cigna All Commercial |
$681.77
|
| Rate for Payer: CORVEL All Commercial |
$734.70
|
| Rate for Payer: Coventry All Commercial |
$695.20
|
| Rate for Payer: Encore All Commercial |
$727.20
|
| Rate for Payer: Frontpath All Commercial |
$726.80
|
| Rate for Payer: Humana ChoiceCare |
$682.32
|
| Rate for Payer: Humana Medicare |
$402.90
|
| Rate for Payer: Lucent All Commercial |
$402.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$711.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$592.50
|
| Rate for Payer: PHP All Commercial |
$599.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$308.10
|
| Rate for Payer: Sagamore Health Network All Products |
$609.88
|
| Rate for Payer: Signature Care EPO |
$655.70
|
| Rate for Payer: Signature Care PPO |
$695.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$671.50
|
| Rate for Payer: United Healthcare Commercial |
$622.52
|
| Rate for Payer: United Healthcare Medicare |
$260.70
|
|
|
HC ACU 3.5 QR SURGIBIT DRILL LAG
|
Facility
IP
|
$790.00
|
|
| Hospital Charge Code |
41602817
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$592.50 |
| Max. Negotiated Rate |
$734.70 |
| Rate for Payer: Aetna Commercial |
$682.56
|
| Rate for Payer: Cash Price |
$489.80
|
| Rate for Payer: Cigna All Commercial |
$681.77
|
| Rate for Payer: CORVEL All Commercial |
$734.70
|
| Rate for Payer: Coventry All Commercial |
$695.20
|
| Rate for Payer: Encore All Commercial |
$727.20
|
| Rate for Payer: Frontpath All Commercial |
$726.80
|
| Rate for Payer: Humana ChoiceCare |
$682.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$711.00
|
| Rate for Payer: PHCS All Commercial |
$592.50
|
| Rate for Payer: PHP All Commercial |
$599.14
|
| Rate for Payer: Sagamore Health Network All Products |
$609.88
|
| Rate for Payer: Signature Care EPO |
$655.70
|
| Rate for Payer: Signature Care PPO |
$695.20
|
| Rate for Payer: United Healthcare Commercial |
$622.52
|
|
|
HC ACU 3.5X10 LOCK HEX SCREW
|
Facility
OP
|
$1,022.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602827
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$337.26 |
| Max. Negotiated Rate |
$950.46 |
| Rate for Payer: Aetna Commercial |
$862.57
|
| Rate for Payer: Aetna Medicare |
$337.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$337.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$586.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$638.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$387.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$370.99
|
| Rate for Payer: Cash Price |
$633.64
|
| Rate for Payer: Cash Price |
$633.64
|
| Rate for Payer: Centivo All Commercial |
$521.22
|
| Rate for Payer: Cigna All Commercial |
$881.99
|
| Rate for Payer: CORVEL All Commercial |
$950.46
|
| Rate for Payer: Coventry All Commercial |
$899.36
|
| Rate for Payer: Encore All Commercial |
$940.75
|
| Rate for Payer: Frontpath All Commercial |
$940.24
|
| Rate for Payer: Humana ChoiceCare |
$882.70
|
| Rate for Payer: Humana Medicare |
$521.22
|
| Rate for Payer: Lucent All Commercial |
$521.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$919.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$766.50
|
| Rate for Payer: PHP All Commercial |
$775.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$398.58
|
| Rate for Payer: Sagamore Health Network All Products |
$788.98
|
| Rate for Payer: Signature Care EPO |
$848.26
|
| Rate for Payer: Signature Care PPO |
$899.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$868.70
|
| Rate for Payer: United Healthcare Commercial |
$805.34
|
| Rate for Payer: United Healthcare Medicare |
$337.26
|
|
|
HC ACU 3.5X10 LOCK HEX SCREW
|
Facility
IP
|
$1,022.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602827
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$766.50 |
| Max. Negotiated Rate |
$950.46 |
| Rate for Payer: Aetna Commercial |
$883.01
|
| Rate for Payer: Cash Price |
$633.64
|
| Rate for Payer: Cigna All Commercial |
$881.99
|
| Rate for Payer: CORVEL All Commercial |
$950.46
|
| Rate for Payer: Coventry All Commercial |
$899.36
|
| Rate for Payer: Encore All Commercial |
$940.75
|
| Rate for Payer: Frontpath All Commercial |
$940.24
|
| Rate for Payer: Humana ChoiceCare |
$882.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$919.80
|
| Rate for Payer: PHCS All Commercial |
$766.50
|
| Rate for Payer: PHP All Commercial |
$775.08
|
| Rate for Payer: Sagamore Health Network All Products |
$788.98
|
| Rate for Payer: Signature Care EPO |
$848.26
|
| Rate for Payer: Signature Care PPO |
$899.36
|
| Rate for Payer: United Healthcare Commercial |
$805.34
|
|
|
HC ACU 3.5X10 NON-LOCK HEX SCREW
|
Facility
IP
|
$609.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602832
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$456.75 |
| Max. Negotiated Rate |
$566.37 |
| Rate for Payer: Aetna Commercial |
$526.18
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Cigna All Commercial |
$525.57
|
| Rate for Payer: CORVEL All Commercial |
$566.37
|
| Rate for Payer: Coventry All Commercial |
$535.92
|
| Rate for Payer: Encore All Commercial |
$560.58
|
| Rate for Payer: Frontpath All Commercial |
$560.28
|
| Rate for Payer: Humana ChoiceCare |
$525.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$548.10
|
| Rate for Payer: PHCS All Commercial |
$456.75
|
| Rate for Payer: PHP All Commercial |
$461.87
|
| Rate for Payer: Sagamore Health Network All Products |
$470.15
|
| Rate for Payer: Signature Care EPO |
$505.47
|
| Rate for Payer: Signature Care PPO |
$535.92
|
| Rate for Payer: United Healthcare Commercial |
$479.89
|
|
|
HC ACU 3.5X10 NON-LOCK HEX SCREW
|
Facility
OP
|
$609.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602832
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$200.97 |
| Max. Negotiated Rate |
$566.37 |
| Rate for Payer: Aetna Commercial |
$514.00
|
| Rate for Payer: Aetna Medicare |
$200.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$200.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$349.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$380.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$231.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$221.07
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Centivo All Commercial |
$310.59
|
| Rate for Payer: Cigna All Commercial |
$525.57
|
| Rate for Payer: CORVEL All Commercial |
$566.37
|
| Rate for Payer: Coventry All Commercial |
$535.92
|
| Rate for Payer: Encore All Commercial |
$560.58
|
| Rate for Payer: Frontpath All Commercial |
$560.28
|
| Rate for Payer: Humana ChoiceCare |
$525.99
|
| Rate for Payer: Humana Medicare |
$310.59
|
| Rate for Payer: Lucent All Commercial |
$310.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$548.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$456.75
|
| Rate for Payer: PHP All Commercial |
$461.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$237.51
|
| Rate for Payer: Sagamore Health Network All Products |
$470.15
|
| Rate for Payer: Signature Care EPO |
$505.47
|
| Rate for Payer: Signature Care PPO |
$535.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$517.65
|
| Rate for Payer: United Healthcare Commercial |
$479.89
|
| Rate for Payer: United Healthcare Medicare |
$200.97
|
|
|
HC ACU 3.5X12 LOCK HEX SCREW
|
Facility
OP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602828
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$962.16
|
| Rate for Payer: Aetna Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$712.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.82
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Centivo All Commercial |
$581.40
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Humana Medicare |
$581.40
|
| Rate for Payer: Lucent All Commercial |
$581.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.60
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$969.00
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
| Rate for Payer: United Healthcare Medicare |
$376.20
|
|
|
HC ACU 3.5X12 LOCK HEX SCREW
|
Facility
IP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602828
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$984.96
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
|
|
HC ACU 3.5X12 NON-LOCK HEX SCREW
|
Facility
OP
|
$609.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602833
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$200.97 |
| Max. Negotiated Rate |
$566.37 |
| Rate for Payer: Aetna Commercial |
$514.00
|
| Rate for Payer: Aetna Medicare |
$200.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$200.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$349.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$380.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$231.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$221.07
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Centivo All Commercial |
$310.59
|
| Rate for Payer: Cigna All Commercial |
$525.57
|
| Rate for Payer: CORVEL All Commercial |
$566.37
|
| Rate for Payer: Coventry All Commercial |
$535.92
|
| Rate for Payer: Encore All Commercial |
$560.58
|
| Rate for Payer: Frontpath All Commercial |
$560.28
|
| Rate for Payer: Humana ChoiceCare |
$525.99
|
| Rate for Payer: Humana Medicare |
$310.59
|
| Rate for Payer: Lucent All Commercial |
$310.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$548.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$456.75
|
| Rate for Payer: PHP All Commercial |
$461.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$237.51
|
| Rate for Payer: Sagamore Health Network All Products |
$470.15
|
| Rate for Payer: Signature Care EPO |
$505.47
|
| Rate for Payer: Signature Care PPO |
$535.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$517.65
|
| Rate for Payer: United Healthcare Commercial |
$479.89
|
| Rate for Payer: United Healthcare Medicare |
$200.97
|
|
|
HC ACU 3.5X12 NON-LOCK HEX SCREW
|
Facility
IP
|
$609.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602833
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$456.75 |
| Max. Negotiated Rate |
$566.37 |
| Rate for Payer: Aetna Commercial |
$526.18
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Cigna All Commercial |
$525.57
|
| Rate for Payer: CORVEL All Commercial |
$566.37
|
| Rate for Payer: Coventry All Commercial |
$535.92
|
| Rate for Payer: Encore All Commercial |
$560.58
|
| Rate for Payer: Frontpath All Commercial |
$560.28
|
| Rate for Payer: Humana ChoiceCare |
$525.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$548.10
|
| Rate for Payer: PHCS All Commercial |
$456.75
|
| Rate for Payer: PHP All Commercial |
$461.87
|
| Rate for Payer: Sagamore Health Network All Products |
$470.15
|
| Rate for Payer: Signature Care EPO |
$505.47
|
| Rate for Payer: Signature Care PPO |
$535.92
|
| Rate for Payer: United Healthcare Commercial |
$479.89
|
|
|
HC ACU 3.5X14 LOCK HEX SCREW
|
Facility
IP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602829
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$984.96
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
|
|
HC ACU 3.5X14 LOCK HEX SCREW
|
Facility
OP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602829
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$962.16
|
| Rate for Payer: Aetna Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$712.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.82
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Centivo All Commercial |
$581.40
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Humana Medicare |
$581.40
|
| Rate for Payer: Lucent All Commercial |
$581.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.60
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$969.00
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
| Rate for Payer: United Healthcare Medicare |
$376.20
|
|
|
HC ACU 3.5X14 NON-LOCK HEX SCREW
|
Facility
IP
|
$609.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602834
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$456.75 |
| Max. Negotiated Rate |
$566.37 |
| Rate for Payer: Aetna Commercial |
$526.18
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Cigna All Commercial |
$525.57
|
| Rate for Payer: CORVEL All Commercial |
$566.37
|
| Rate for Payer: Coventry All Commercial |
$535.92
|
| Rate for Payer: Encore All Commercial |
$560.58
|
| Rate for Payer: Frontpath All Commercial |
$560.28
|
| Rate for Payer: Humana ChoiceCare |
$525.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$548.10
|
| Rate for Payer: PHCS All Commercial |
$456.75
|
| Rate for Payer: PHP All Commercial |
$461.87
|
| Rate for Payer: Sagamore Health Network All Products |
$470.15
|
| Rate for Payer: Signature Care EPO |
$505.47
|
| Rate for Payer: Signature Care PPO |
$535.92
|
| Rate for Payer: United Healthcare Commercial |
$479.89
|
|
|
HC ACU 3.5X14 NON-LOCK HEX SCREW
|
Facility
OP
|
$609.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602834
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$200.97 |
| Max. Negotiated Rate |
$566.37 |
| Rate for Payer: Aetna Commercial |
$514.00
|
| Rate for Payer: Aetna Medicare |
$200.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$200.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$349.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$380.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$231.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$221.07
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Centivo All Commercial |
$310.59
|
| Rate for Payer: Cigna All Commercial |
$525.57
|
| Rate for Payer: CORVEL All Commercial |
$566.37
|
| Rate for Payer: Coventry All Commercial |
$535.92
|
| Rate for Payer: Encore All Commercial |
$560.58
|
| Rate for Payer: Frontpath All Commercial |
$560.28
|
| Rate for Payer: Humana ChoiceCare |
$525.99
|
| Rate for Payer: Humana Medicare |
$310.59
|
| Rate for Payer: Lucent All Commercial |
$310.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$548.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$456.75
|
| Rate for Payer: PHP All Commercial |
$461.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$237.51
|
| Rate for Payer: Sagamore Health Network All Products |
$470.15
|
| Rate for Payer: Signature Care EPO |
$505.47
|
| Rate for Payer: Signature Care PPO |
$535.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$517.65
|
| Rate for Payer: United Healthcare Commercial |
$479.89
|
| Rate for Payer: United Healthcare Medicare |
$200.97
|
|
|
HC ACU 3.5X16 LOCK HEX SCREW
|
Facility
OP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602830
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$962.16
|
| Rate for Payer: Aetna Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$712.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.82
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Centivo All Commercial |
$581.40
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Humana Medicare |
$581.40
|
| Rate for Payer: Lucent All Commercial |
$581.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.60
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$969.00
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
| Rate for Payer: United Healthcare Medicare |
$376.20
|
|
|
HC ACU 3.5X16 LOCK HEX SCREW
|
Facility
IP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602830
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$984.96
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
|
|
HC ACU 3.5X16 NON-LOCK HEX SCREW
|
Facility
OP
|
$609.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602835
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$200.97 |
| Max. Negotiated Rate |
$566.37 |
| Rate for Payer: Aetna Commercial |
$514.00
|
| Rate for Payer: Aetna Medicare |
$200.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$200.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$349.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$380.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$231.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$221.07
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Centivo All Commercial |
$310.59
|
| Rate for Payer: Cigna All Commercial |
$525.57
|
| Rate for Payer: CORVEL All Commercial |
$566.37
|
| Rate for Payer: Coventry All Commercial |
$535.92
|
| Rate for Payer: Encore All Commercial |
$560.58
|
| Rate for Payer: Frontpath All Commercial |
$560.28
|
| Rate for Payer: Humana ChoiceCare |
$525.99
|
| Rate for Payer: Humana Medicare |
$310.59
|
| Rate for Payer: Lucent All Commercial |
$310.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$548.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$456.75
|
| Rate for Payer: PHP All Commercial |
$461.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$237.51
|
| Rate for Payer: Sagamore Health Network All Products |
$470.15
|
| Rate for Payer: Signature Care EPO |
$505.47
|
| Rate for Payer: Signature Care PPO |
$535.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$517.65
|
| Rate for Payer: United Healthcare Commercial |
$479.89
|
| Rate for Payer: United Healthcare Medicare |
$200.97
|
|
|
HC ACU 3.5X16 NON-LOCK HEX SCREW
|
Facility
IP
|
$609.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602835
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$456.75 |
| Max. Negotiated Rate |
$566.37 |
| Rate for Payer: Aetna Commercial |
$526.18
|
| Rate for Payer: Cash Price |
$377.58
|
| Rate for Payer: Cigna All Commercial |
$525.57
|
| Rate for Payer: CORVEL All Commercial |
$566.37
|
| Rate for Payer: Coventry All Commercial |
$535.92
|
| Rate for Payer: Encore All Commercial |
$560.58
|
| Rate for Payer: Frontpath All Commercial |
$560.28
|
| Rate for Payer: Humana ChoiceCare |
$525.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$548.10
|
| Rate for Payer: PHCS All Commercial |
$456.75
|
| Rate for Payer: PHP All Commercial |
$461.87
|
| Rate for Payer: Sagamore Health Network All Products |
$470.15
|
| Rate for Payer: Signature Care EPO |
$505.47
|
| Rate for Payer: Signature Care PPO |
$535.92
|
| Rate for Payer: United Healthcare Commercial |
$479.89
|
|
