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Service Code CPT C1713
Hospital Charge Code 41604562
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604563
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604563
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604549
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604549
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604550
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604550
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604564
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604564
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604565
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604565
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604566
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604566
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604567
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604567
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604568
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604568
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604569
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604569
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604570
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604570
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604571
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32
Service Code CPT C1713
Hospital Charge Code 41604571
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604572
Hospital Revenue Code 278
Min. Negotiated Rate $1,271.18
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,464.39
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: United Healthcare Commercial $1,335.58
Service Code CPT C1713
Hospital Charge Code 41604572
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $1,576.26
Rate for Payer: Aetna Commercial $1,430.50
Rate for Payer: Aetna Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN Medicare $559.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $973.38
Rate for Payer: Anthem Blue Cross of IN Traditional $1,059.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $643.21
Rate for Payer: CareSource Indiana of IN Medicare $615.25
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Cash Price $1,050.84
Rate for Payer: Centivo All Commercial $864.40
Rate for Payer: Cigna All Commercial $1,462.70
Rate for Payer: CORVEL All Commercial $1,576.26
Rate for Payer: Coventry All Commercial $1,491.51
Rate for Payer: Encore All Commercial $1,560.16
Rate for Payer: Frontpath All Commercial $1,559.31
Rate for Payer: Humana ChoiceCare $1,463.89
Rate for Payer: Humana Medicare $864.40
Rate for Payer: Lucent All Commercial $864.40
Rate for Payer: Lutheran Preferred All Commercial $1,525.41
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $1,271.18
Rate for Payer: PHP All Commercial $1,285.41
Rate for Payer: Plain Church Group Ministry All Commercial $661.01
Rate for Payer: Sagamore Health Network All Products $1,308.46
Rate for Payer: Signature Care EPO $1,406.77
Rate for Payer: Signature Care PPO $1,491.51
Rate for Payer: Three Rivers Preferred All Commercial $1,440.66
Rate for Payer: United Healthcare Commercial $1,335.58
Rate for Payer: United Healthcare Medicare $559.32