|
HC Z SF SCREW HEX 4.0X50
|
Facility
OP
|
$139.86
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604222
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$46.15 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$118.04
|
| Rate for Payer: Aetna Medicare |
$46.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$46.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$80.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$87.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$53.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$50.77
|
| Rate for Payer: Cash Price |
$86.71
|
| Rate for Payer: Cash Price |
$86.71
|
| Rate for Payer: Centivo All Commercial |
$71.33
|
| Rate for Payer: Cigna All Commercial |
$120.70
|
| Rate for Payer: CORVEL All Commercial |
$130.07
|
| Rate for Payer: Coventry All Commercial |
$123.08
|
| Rate for Payer: Encore All Commercial |
$128.74
|
| Rate for Payer: Frontpath All Commercial |
$128.67
|
| Rate for Payer: Humana ChoiceCare |
$120.80
|
| Rate for Payer: Humana Medicare |
$71.33
|
| Rate for Payer: Lucent All Commercial |
$71.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.87
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$104.90
|
| Rate for Payer: PHP All Commercial |
$106.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$54.55
|
| Rate for Payer: Sagamore Health Network All Products |
$107.97
|
| Rate for Payer: Signature Care EPO |
$116.08
|
| Rate for Payer: Signature Care PPO |
$123.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$118.88
|
| Rate for Payer: United Healthcare Commercial |
$110.21
|
| Rate for Payer: United Healthcare Medicare |
$46.15
|
|
|
HC Z SF SCREW HEX 4.0X50
|
Facility
IP
|
$139.86
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604222
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.90 |
| Max. Negotiated Rate |
$130.07 |
| Rate for Payer: Aetna Commercial |
$120.84
|
| Rate for Payer: Cash Price |
$86.71
|
| Rate for Payer: Cigna All Commercial |
$120.70
|
| Rate for Payer: CORVEL All Commercial |
$130.07
|
| Rate for Payer: Coventry All Commercial |
$123.08
|
| Rate for Payer: Encore All Commercial |
$128.74
|
| Rate for Payer: Frontpath All Commercial |
$128.67
|
| Rate for Payer: Humana ChoiceCare |
$120.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.87
|
| Rate for Payer: PHCS All Commercial |
$104.90
|
| Rate for Payer: PHP All Commercial |
$106.07
|
| Rate for Payer: Sagamore Health Network All Products |
$107.97
|
| Rate for Payer: Signature Care EPO |
$116.08
|
| Rate for Payer: Signature Care PPO |
$123.08
|
| Rate for Payer: United Healthcare Commercial |
$110.21
|
|
|
HC Z SF SCREW HEX 4.0X55
|
Facility
OP
|
$139.86
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604223
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$46.15 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$118.04
|
| Rate for Payer: Aetna Medicare |
$46.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$46.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$80.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$87.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$53.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$50.77
|
| Rate for Payer: Cash Price |
$86.71
|
| Rate for Payer: Cash Price |
$86.71
|
| Rate for Payer: Centivo All Commercial |
$71.33
|
| Rate for Payer: Cigna All Commercial |
$120.70
|
| Rate for Payer: CORVEL All Commercial |
$130.07
|
| Rate for Payer: Coventry All Commercial |
$123.08
|
| Rate for Payer: Encore All Commercial |
$128.74
|
| Rate for Payer: Frontpath All Commercial |
$128.67
|
| Rate for Payer: Humana ChoiceCare |
$120.80
|
| Rate for Payer: Humana Medicare |
$71.33
|
| Rate for Payer: Lucent All Commercial |
$71.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.87
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$104.90
|
| Rate for Payer: PHP All Commercial |
$106.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$54.55
|
| Rate for Payer: Sagamore Health Network All Products |
$107.97
|
| Rate for Payer: Signature Care EPO |
$116.08
|
| Rate for Payer: Signature Care PPO |
$123.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$118.88
|
| Rate for Payer: United Healthcare Commercial |
$110.21
|
| Rate for Payer: United Healthcare Medicare |
$46.15
|
|
|
HC Z SF SCREW HEX 4.0X55
|
Facility
IP
|
$139.86
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604223
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.90 |
| Max. Negotiated Rate |
$130.07 |
| Rate for Payer: Aetna Commercial |
$120.84
|
| Rate for Payer: Cash Price |
$86.71
|
| Rate for Payer: Cigna All Commercial |
$120.70
|
| Rate for Payer: CORVEL All Commercial |
$130.07
|
| Rate for Payer: Coventry All Commercial |
$123.08
|
| Rate for Payer: Encore All Commercial |
$128.74
|
| Rate for Payer: Frontpath All Commercial |
$128.67
|
| Rate for Payer: Humana ChoiceCare |
$120.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.87
|
| Rate for Payer: PHCS All Commercial |
$104.90
|
| Rate for Payer: PHP All Commercial |
$106.07
|
| Rate for Payer: Sagamore Health Network All Products |
$107.97
|
| Rate for Payer: Signature Care EPO |
$116.08
|
| Rate for Payer: Signature Care PPO |
$123.08
|
| Rate for Payer: United Healthcare Commercial |
$110.21
|
|
|
HC Z SF SCREW HEX 4.0X60
|
Facility
IP
|
$139.86
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604224
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.90 |
| Max. Negotiated Rate |
$130.07 |
| Rate for Payer: Aetna Commercial |
$120.84
|
| Rate for Payer: Cash Price |
$86.71
|
| Rate for Payer: Cigna All Commercial |
$120.70
|
| Rate for Payer: CORVEL All Commercial |
$130.07
|
| Rate for Payer: Coventry All Commercial |
$123.08
|
| Rate for Payer: Encore All Commercial |
$128.74
|
| Rate for Payer: Frontpath All Commercial |
$128.67
|
| Rate for Payer: Humana ChoiceCare |
$120.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.87
|
| Rate for Payer: PHCS All Commercial |
$104.90
|
| Rate for Payer: PHP All Commercial |
$106.07
|
| Rate for Payer: Sagamore Health Network All Products |
$107.97
|
| Rate for Payer: Signature Care EPO |
$116.08
|
| Rate for Payer: Signature Care PPO |
$123.08
|
| Rate for Payer: United Healthcare Commercial |
$110.21
|
|
|
HC Z SF SCREW HEX 4.0X60
|
Facility
OP
|
$139.86
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604224
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$46.15 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$118.04
|
| Rate for Payer: Aetna Medicare |
$46.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$46.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$80.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$87.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$53.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$50.77
|
| Rate for Payer: Cash Price |
$86.71
|
| Rate for Payer: Cash Price |
$86.71
|
| Rate for Payer: Centivo All Commercial |
$71.33
|
| Rate for Payer: Cigna All Commercial |
$120.70
|
| Rate for Payer: CORVEL All Commercial |
$130.07
|
| Rate for Payer: Coventry All Commercial |
$123.08
|
| Rate for Payer: Encore All Commercial |
$128.74
|
| Rate for Payer: Frontpath All Commercial |
$128.67
|
| Rate for Payer: Humana ChoiceCare |
$120.80
|
| Rate for Payer: Humana Medicare |
$71.33
|
| Rate for Payer: Lucent All Commercial |
$71.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.87
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$104.90
|
| Rate for Payer: PHP All Commercial |
$106.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$54.55
|
| Rate for Payer: Sagamore Health Network All Products |
$107.97
|
| Rate for Payer: Signature Care EPO |
$116.08
|
| Rate for Payer: Signature Care PPO |
$123.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$118.88
|
| Rate for Payer: United Healthcare Commercial |
$110.21
|
| Rate for Payer: United Healthcare Medicare |
$46.15
|
|
|
HC Z SF T-PLATE 3.5 3-H 5
|
Facility
IP
|
$1,581.25
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,185.94 |
| Max. Negotiated Rate |
$1,470.56 |
| Rate for Payer: Aetna Commercial |
$1,366.20
|
| Rate for Payer: Cash Price |
$980.38
|
| Rate for Payer: Cigna All Commercial |
$1,364.62
|
| Rate for Payer: CORVEL All Commercial |
$1,470.56
|
| Rate for Payer: Coventry All Commercial |
$1,391.50
|
| Rate for Payer: Encore All Commercial |
$1,455.54
|
| Rate for Payer: Frontpath All Commercial |
$1,454.75
|
| Rate for Payer: Humana ChoiceCare |
$1,365.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,423.12
|
| Rate for Payer: PHCS All Commercial |
$1,185.94
|
| Rate for Payer: PHP All Commercial |
$1,199.22
|
| Rate for Payer: Sagamore Health Network All Products |
$1,220.72
|
| Rate for Payer: Signature Care EPO |
$1,312.44
|
| Rate for Payer: Signature Care PPO |
$1,391.50
|
| Rate for Payer: United Healthcare Commercial |
$1,246.02
|
|
|
HC Z SF T-PLATE 3.5 3-H 5
|
Facility
OP
|
$1,581.25
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.81 |
| Max. Negotiated Rate |
$1,470.56 |
| Rate for Payer: Aetna Commercial |
$1,334.58
|
| Rate for Payer: Aetna Medicare |
$521.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$521.81
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$908.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$988.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$600.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$573.99
|
| Rate for Payer: Cash Price |
$980.38
|
| Rate for Payer: Cash Price |
$980.38
|
| Rate for Payer: Centivo All Commercial |
$806.44
|
| Rate for Payer: Cigna All Commercial |
$1,364.62
|
| Rate for Payer: CORVEL All Commercial |
$1,470.56
|
| Rate for Payer: Coventry All Commercial |
$1,391.50
|
| Rate for Payer: Encore All Commercial |
$1,455.54
|
| Rate for Payer: Frontpath All Commercial |
$1,454.75
|
| Rate for Payer: Humana ChoiceCare |
$1,365.73
|
| Rate for Payer: Humana Medicare |
$806.44
|
| Rate for Payer: Lucent All Commercial |
$806.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,423.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,185.94
|
| Rate for Payer: PHP All Commercial |
$1,199.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$616.69
|
| Rate for Payer: Sagamore Health Network All Products |
$1,220.72
|
| Rate for Payer: Signature Care EPO |
$1,312.44
|
| Rate for Payer: Signature Care PPO |
$1,391.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,344.06
|
| Rate for Payer: United Healthcare Commercial |
$1,246.02
|
| Rate for Payer: United Healthcare Medicare |
$521.81
|
|
|
HC Z SF T-PLATE 3.5 3-H 5
|
Facility
IP
|
$1,581.25
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,185.94 |
| Max. Negotiated Rate |
$1,470.56 |
| Rate for Payer: Aetna Commercial |
$1,366.20
|
| Rate for Payer: Cash Price |
$980.38
|
| Rate for Payer: Cigna All Commercial |
$1,364.62
|
| Rate for Payer: CORVEL All Commercial |
$1,470.56
|
| Rate for Payer: Coventry All Commercial |
$1,391.50
|
| Rate for Payer: Encore All Commercial |
$1,455.54
|
| Rate for Payer: Frontpath All Commercial |
$1,454.75
|
| Rate for Payer: Humana ChoiceCare |
$1,365.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,423.12
|
| Rate for Payer: PHCS All Commercial |
$1,185.94
|
| Rate for Payer: PHP All Commercial |
$1,199.22
|
| Rate for Payer: Sagamore Health Network All Products |
$1,220.72
|
| Rate for Payer: Signature Care EPO |
$1,312.44
|
| Rate for Payer: Signature Care PPO |
$1,391.50
|
| Rate for Payer: United Healthcare Commercial |
$1,246.02
|
|
|
HC Z SF T-PLATE 3.5 3-H 5
|
Facility
OP
|
$1,581.25
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.81 |
| Max. Negotiated Rate |
$1,470.56 |
| Rate for Payer: Aetna Commercial |
$1,334.58
|
| Rate for Payer: Aetna Medicare |
$521.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$521.81
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$908.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$988.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$600.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$573.99
|
| Rate for Payer: Cash Price |
$980.38
|
| Rate for Payer: Cash Price |
$980.38
|
| Rate for Payer: Centivo All Commercial |
$806.44
|
| Rate for Payer: Cigna All Commercial |
$1,364.62
|
| Rate for Payer: CORVEL All Commercial |
$1,470.56
|
| Rate for Payer: Coventry All Commercial |
$1,391.50
|
| Rate for Payer: Encore All Commercial |
$1,455.54
|
| Rate for Payer: Frontpath All Commercial |
$1,454.75
|
| Rate for Payer: Humana ChoiceCare |
$1,365.73
|
| Rate for Payer: Humana Medicare |
$806.44
|
| Rate for Payer: Lucent All Commercial |
$806.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,423.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,185.94
|
| Rate for Payer: PHP All Commercial |
$1,199.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$616.69
|
| Rate for Payer: Sagamore Health Network All Products |
$1,220.72
|
| Rate for Payer: Signature Care EPO |
$1,312.44
|
| Rate for Payer: Signature Care PPO |
$1,391.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,344.06
|
| Rate for Payer: United Healthcare Commercial |
$1,246.02
|
| Rate for Payer: United Healthcare Medicare |
$521.81
|
|
|
HC Z SF T-PLATE 3.5 4-H 6
|
Facility
IP
|
$1,647.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,235.89 |
| Max. Negotiated Rate |
$1,532.50 |
| Rate for Payer: Aetna Commercial |
$1,423.74
|
| Rate for Payer: Cash Price |
$1,021.67
|
| Rate for Payer: Cigna All Commercial |
$1,422.09
|
| Rate for Payer: CORVEL All Commercial |
$1,532.50
|
| Rate for Payer: Coventry All Commercial |
$1,450.11
|
| Rate for Payer: Encore All Commercial |
$1,516.85
|
| Rate for Payer: Frontpath All Commercial |
$1,516.02
|
| Rate for Payer: Humana ChoiceCare |
$1,423.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,483.06
|
| Rate for Payer: PHCS All Commercial |
$1,235.89
|
| Rate for Payer: PHP All Commercial |
$1,249.73
|
| Rate for Payer: Sagamore Health Network All Products |
$1,272.14
|
| Rate for Payer: Signature Care EPO |
$1,367.72
|
| Rate for Payer: Signature Care PPO |
$1,450.11
|
| Rate for Payer: United Healthcare Commercial |
$1,298.51
|
|
|
HC Z SF T-PLATE 3.5 4-H 6
|
Facility
OP
|
$1,647.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,532.50 |
| Rate for Payer: Aetna Commercial |
$1,390.79
|
| Rate for Payer: Aetna Medicare |
$543.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$543.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$946.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,030.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$625.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$598.17
|
| Rate for Payer: Cash Price |
$1,021.67
|
| Rate for Payer: Cash Price |
$1,021.67
|
| Rate for Payer: Centivo All Commercial |
$840.40
|
| Rate for Payer: Cigna All Commercial |
$1,422.09
|
| Rate for Payer: CORVEL All Commercial |
$1,532.50
|
| Rate for Payer: Coventry All Commercial |
$1,450.11
|
| Rate for Payer: Encore All Commercial |
$1,516.85
|
| Rate for Payer: Frontpath All Commercial |
$1,516.02
|
| Rate for Payer: Humana ChoiceCare |
$1,423.25
|
| Rate for Payer: Humana Medicare |
$840.40
|
| Rate for Payer: Lucent All Commercial |
$840.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,483.06
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,235.89
|
| Rate for Payer: PHP All Commercial |
$1,249.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$642.66
|
| Rate for Payer: Sagamore Health Network All Products |
$1,272.14
|
| Rate for Payer: Signature Care EPO |
$1,367.72
|
| Rate for Payer: Signature Care PPO |
$1,450.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,400.67
|
| Rate for Payer: United Healthcare Commercial |
$1,298.51
|
| Rate for Payer: United Healthcare Medicare |
$543.79
|
|
|
HC Z SF T-PLATE 3.5 4-H 6
|
Facility
IP
|
$1,647.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,235.89 |
| Max. Negotiated Rate |
$1,532.50 |
| Rate for Payer: Aetna Commercial |
$1,423.74
|
| Rate for Payer: Cash Price |
$1,021.67
|
| Rate for Payer: Cigna All Commercial |
$1,422.09
|
| Rate for Payer: CORVEL All Commercial |
$1,532.50
|
| Rate for Payer: Coventry All Commercial |
$1,450.11
|
| Rate for Payer: Encore All Commercial |
$1,516.85
|
| Rate for Payer: Frontpath All Commercial |
$1,516.02
|
| Rate for Payer: Humana ChoiceCare |
$1,423.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,483.06
|
| Rate for Payer: PHCS All Commercial |
$1,235.89
|
| Rate for Payer: PHP All Commercial |
$1,249.73
|
| Rate for Payer: Sagamore Health Network All Products |
$1,272.14
|
| Rate for Payer: Signature Care EPO |
$1,367.72
|
| Rate for Payer: Signature Care PPO |
$1,450.11
|
| Rate for Payer: United Healthcare Commercial |
$1,298.51
|
|
|
HC Z SF T-PLATE 3.5 4-H 6
|
Facility
OP
|
$1,647.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,532.50 |
| Rate for Payer: Aetna Commercial |
$1,390.79
|
| Rate for Payer: Aetna Medicare |
$543.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$543.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$946.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,030.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$625.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$598.17
|
| Rate for Payer: Cash Price |
$1,021.67
|
| Rate for Payer: Cash Price |
$1,021.67
|
| Rate for Payer: Centivo All Commercial |
$840.40
|
| Rate for Payer: Cigna All Commercial |
$1,422.09
|
| Rate for Payer: CORVEL All Commercial |
$1,532.50
|
| Rate for Payer: Coventry All Commercial |
$1,450.11
|
| Rate for Payer: Encore All Commercial |
$1,516.85
|
| Rate for Payer: Frontpath All Commercial |
$1,516.02
|
| Rate for Payer: Humana ChoiceCare |
$1,423.25
|
| Rate for Payer: Humana Medicare |
$840.40
|
| Rate for Payer: Lucent All Commercial |
$840.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,483.06
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,235.89
|
| Rate for Payer: PHP All Commercial |
$1,249.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$642.66
|
| Rate for Payer: Sagamore Health Network All Products |
$1,272.14
|
| Rate for Payer: Signature Care EPO |
$1,367.72
|
| Rate for Payer: Signature Care PPO |
$1,450.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,400.67
|
| Rate for Payer: United Healthcare Commercial |
$1,298.51
|
| Rate for Payer: United Healthcare Medicare |
$543.79
|
|
|
HC Z SF T-PLATE 3.5 5-H 7
|
Facility
OP
|
$1,581.25
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.81 |
| Max. Negotiated Rate |
$1,470.56 |
| Rate for Payer: Aetna Commercial |
$1,334.58
|
| Rate for Payer: Aetna Medicare |
$521.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$521.81
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$908.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$988.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$600.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$573.99
|
| Rate for Payer: Cash Price |
$980.38
|
| Rate for Payer: Cash Price |
$980.38
|
| Rate for Payer: Centivo All Commercial |
$806.44
|
| Rate for Payer: Cigna All Commercial |
$1,364.62
|
| Rate for Payer: CORVEL All Commercial |
$1,470.56
|
| Rate for Payer: Coventry All Commercial |
$1,391.50
|
| Rate for Payer: Encore All Commercial |
$1,455.54
|
| Rate for Payer: Frontpath All Commercial |
$1,454.75
|
| Rate for Payer: Humana ChoiceCare |
$1,365.73
|
| Rate for Payer: Humana Medicare |
$806.44
|
| Rate for Payer: Lucent All Commercial |
$806.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,423.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,185.94
|
| Rate for Payer: PHP All Commercial |
$1,199.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$616.69
|
| Rate for Payer: Sagamore Health Network All Products |
$1,220.72
|
| Rate for Payer: Signature Care EPO |
$1,312.44
|
| Rate for Payer: Signature Care PPO |
$1,391.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,344.06
|
| Rate for Payer: United Healthcare Commercial |
$1,246.02
|
| Rate for Payer: United Healthcare Medicare |
$521.81
|
|
|
HC Z SF T-PLATE 3.5 5-H 7
|
Facility
IP
|
$1,581.25
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,185.94 |
| Max. Negotiated Rate |
$1,470.56 |
| Rate for Payer: Aetna Commercial |
$1,366.20
|
| Rate for Payer: Cash Price |
$980.38
|
| Rate for Payer: Cigna All Commercial |
$1,364.62
|
| Rate for Payer: CORVEL All Commercial |
$1,470.56
|
| Rate for Payer: Coventry All Commercial |
$1,391.50
|
| Rate for Payer: Encore All Commercial |
$1,455.54
|
| Rate for Payer: Frontpath All Commercial |
$1,454.75
|
| Rate for Payer: Humana ChoiceCare |
$1,365.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,423.12
|
| Rate for Payer: PHCS All Commercial |
$1,185.94
|
| Rate for Payer: PHP All Commercial |
$1,199.22
|
| Rate for Payer: Sagamore Health Network All Products |
$1,220.72
|
| Rate for Payer: Signature Care EPO |
$1,312.44
|
| Rate for Payer: Signature Care PPO |
$1,391.50
|
| Rate for Payer: United Healthcare Commercial |
$1,246.02
|
|
|
HC Z SF T-PLATE 3.5 6-H 8
|
Facility
OP
|
$1,830.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,702.78 |
| Rate for Payer: Aetna Commercial |
$1,545.32
|
| Rate for Payer: Aetna Medicare |
$604.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$604.21
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,051.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,144.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$694.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$664.63
|
| Rate for Payer: Cash Price |
$1,135.19
|
| Rate for Payer: Cash Price |
$1,135.19
|
| Rate for Payer: Centivo All Commercial |
$933.78
|
| Rate for Payer: Cigna All Commercial |
$1,580.11
|
| Rate for Payer: CORVEL All Commercial |
$1,702.78
|
| Rate for Payer: Coventry All Commercial |
$1,611.24
|
| Rate for Payer: Encore All Commercial |
$1,685.39
|
| Rate for Payer: Frontpath All Commercial |
$1,684.47
|
| Rate for Payer: Humana ChoiceCare |
$1,581.39
|
| Rate for Payer: Humana Medicare |
$933.78
|
| Rate for Payer: Lucent All Commercial |
$933.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,647.86
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,373.21
|
| Rate for Payer: PHP All Commercial |
$1,388.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$714.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,413.49
|
| Rate for Payer: Signature Care EPO |
$1,519.69
|
| Rate for Payer: Signature Care PPO |
$1,611.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,556.31
|
| Rate for Payer: United Healthcare Commercial |
$1,442.79
|
| Rate for Payer: United Healthcare Medicare |
$604.21
|
|
|
HC Z SF T-PLATE 3.5 6-H 8
|
Facility
IP
|
$1,830.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,373.21 |
| Max. Negotiated Rate |
$1,702.78 |
| Rate for Payer: Aetna Commercial |
$1,581.94
|
| Rate for Payer: Cash Price |
$1,135.19
|
| Rate for Payer: Cigna All Commercial |
$1,580.11
|
| Rate for Payer: CORVEL All Commercial |
$1,702.78
|
| Rate for Payer: Coventry All Commercial |
$1,611.24
|
| Rate for Payer: Encore All Commercial |
$1,685.39
|
| Rate for Payer: Frontpath All Commercial |
$1,684.47
|
| Rate for Payer: Humana ChoiceCare |
$1,581.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,647.86
|
| Rate for Payer: PHCS All Commercial |
$1,373.21
|
| Rate for Payer: PHP All Commercial |
$1,388.59
|
| Rate for Payer: Sagamore Health Network All Products |
$1,413.49
|
| Rate for Payer: Signature Care EPO |
$1,519.69
|
| Rate for Payer: Signature Care PPO |
$1,611.24
|
| Rate for Payer: United Healthcare Commercial |
$1,442.79
|
|
|
HC Z SHLDR GD AND BN R
|
Facility
IP
|
$4,809.02
|
|
| Hospital Charge Code |
41606753
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,606.76 |
| Max. Negotiated Rate |
$4,472.39 |
| Rate for Payer: Aetna Commercial |
$4,154.99
|
| Rate for Payer: Cash Price |
$2,981.59
|
| Rate for Payer: Cigna All Commercial |
$4,150.18
|
| Rate for Payer: CORVEL All Commercial |
$4,472.39
|
| Rate for Payer: Coventry All Commercial |
$4,231.94
|
| Rate for Payer: Encore All Commercial |
$4,426.70
|
| Rate for Payer: Frontpath All Commercial |
$4,424.30
|
| Rate for Payer: Humana ChoiceCare |
$4,153.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,328.12
|
| Rate for Payer: PHCS All Commercial |
$3,606.76
|
| Rate for Payer: PHP All Commercial |
$3,647.16
|
| Rate for Payer: Sagamore Health Network All Products |
$3,712.56
|
| Rate for Payer: Signature Care EPO |
$3,991.49
|
| Rate for Payer: Signature Care PPO |
$4,231.94
|
| Rate for Payer: United Healthcare Commercial |
$3,789.51
|
|
|
HC Z SHLDR GD AND BN R
|
Facility
OP
|
$4,809.02
|
|
| Hospital Charge Code |
41606753
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$4,472.39 |
| Rate for Payer: Aetna Commercial |
$4,058.81
|
| Rate for Payer: Aetna Medicare |
$1,586.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,586.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,761.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,006.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,825.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,745.67
|
| Rate for Payer: Cash Price |
$2,981.59
|
| Rate for Payer: Cash Price |
$2,981.59
|
| Rate for Payer: Centivo All Commercial |
$2,452.60
|
| Rate for Payer: Cigna All Commercial |
$4,150.18
|
| Rate for Payer: CORVEL All Commercial |
$4,472.39
|
| Rate for Payer: Coventry All Commercial |
$4,231.94
|
| Rate for Payer: Encore All Commercial |
$4,426.70
|
| Rate for Payer: Frontpath All Commercial |
$4,424.30
|
| Rate for Payer: Humana ChoiceCare |
$4,153.55
|
| Rate for Payer: Humana Medicare |
$2,452.60
|
| Rate for Payer: Lucent All Commercial |
$2,452.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,328.12
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$3,606.76
|
| Rate for Payer: PHP All Commercial |
$3,647.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,875.52
|
| Rate for Payer: Sagamore Health Network All Products |
$3,712.56
|
| Rate for Payer: Signature Care EPO |
$3,991.49
|
| Rate for Payer: Signature Care PPO |
$4,231.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,087.67
|
| Rate for Payer: United Healthcare Commercial |
$3,789.51
|
| Rate for Payer: United Healthcare Medicare |
$1,586.98
|
|
|
HC Z SHLDR GD AND BN R 01
|
Facility
OP
|
$4,809.02
|
|
| Hospital Charge Code |
41607393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$4,472.39 |
| Rate for Payer: Aetna Commercial |
$4,058.81
|
| Rate for Payer: Aetna Medicare |
$1,586.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,586.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,761.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,006.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,825.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,745.67
|
| Rate for Payer: Cash Price |
$2,981.59
|
| Rate for Payer: Cash Price |
$2,981.59
|
| Rate for Payer: Centivo All Commercial |
$2,452.60
|
| Rate for Payer: Cigna All Commercial |
$4,150.18
|
| Rate for Payer: CORVEL All Commercial |
$4,472.39
|
| Rate for Payer: Coventry All Commercial |
$4,231.94
|
| Rate for Payer: Encore All Commercial |
$4,426.70
|
| Rate for Payer: Frontpath All Commercial |
$4,424.30
|
| Rate for Payer: Humana ChoiceCare |
$4,153.55
|
| Rate for Payer: Humana Medicare |
$2,452.60
|
| Rate for Payer: Lucent All Commercial |
$2,452.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,328.12
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$3,606.76
|
| Rate for Payer: PHP All Commercial |
$3,647.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,875.52
|
| Rate for Payer: Sagamore Health Network All Products |
$3,712.56
|
| Rate for Payer: Signature Care EPO |
$3,991.49
|
| Rate for Payer: Signature Care PPO |
$4,231.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,087.67
|
| Rate for Payer: United Healthcare Commercial |
$3,789.51
|
| Rate for Payer: United Healthcare Medicare |
$1,586.98
|
|
|
HC Z SHLDR GD AND BN R 01
|
Facility
IP
|
$4,809.02
|
|
| Hospital Charge Code |
41607393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,606.76 |
| Max. Negotiated Rate |
$4,472.39 |
| Rate for Payer: Aetna Commercial |
$4,154.99
|
| Rate for Payer: Cash Price |
$2,981.59
|
| Rate for Payer: Cigna All Commercial |
$4,150.18
|
| Rate for Payer: CORVEL All Commercial |
$4,472.39
|
| Rate for Payer: Coventry All Commercial |
$4,231.94
|
| Rate for Payer: Encore All Commercial |
$4,426.70
|
| Rate for Payer: Frontpath All Commercial |
$4,424.30
|
| Rate for Payer: Humana ChoiceCare |
$4,153.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,328.12
|
| Rate for Payer: PHCS All Commercial |
$3,606.76
|
| Rate for Payer: PHP All Commercial |
$3,647.16
|
| Rate for Payer: Sagamore Health Network All Products |
$3,712.56
|
| Rate for Payer: Signature Care EPO |
$3,991.49
|
| Rate for Payer: Signature Care PPO |
$4,231.94
|
| Rate for Payer: United Healthcare Commercial |
$3,789.51
|
|
|
HC Z SIG TKA GDE/MDL SET
|
Facility
OP
|
$2,980.80
|
|
| Hospital Charge Code |
41606378
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,772.14 |
| Rate for Payer: Aetna Commercial |
$2,515.80
|
| Rate for Payer: Aetna Medicare |
$983.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$983.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,711.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,863.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,131.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,082.03
|
| Rate for Payer: Cash Price |
$1,848.10
|
| Rate for Payer: Cash Price |
$1,848.10
|
| Rate for Payer: Centivo All Commercial |
$1,520.21
|
| Rate for Payer: Cigna All Commercial |
$2,572.43
|
| Rate for Payer: CORVEL All Commercial |
$2,772.14
|
| Rate for Payer: Coventry All Commercial |
$2,623.10
|
| Rate for Payer: Encore All Commercial |
$2,743.83
|
| Rate for Payer: Frontpath All Commercial |
$2,742.34
|
| Rate for Payer: Humana ChoiceCare |
$2,574.52
|
| Rate for Payer: Humana Medicare |
$1,520.21
|
| Rate for Payer: Lucent All Commercial |
$1,520.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,682.72
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$2,235.60
|
| Rate for Payer: PHP All Commercial |
$2,260.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,162.51
|
| Rate for Payer: Sagamore Health Network All Products |
$2,301.18
|
| Rate for Payer: Signature Care EPO |
$2,474.06
|
| Rate for Payer: Signature Care PPO |
$2,623.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,533.68
|
| Rate for Payer: United Healthcare Commercial |
$2,348.87
|
| Rate for Payer: United Healthcare Medicare |
$983.66
|
|
|
HC Z SIG TKA GDE/MDL SET
|
Facility
IP
|
$2,980.80
|
|
| Hospital Charge Code |
41606378
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,235.60 |
| Max. Negotiated Rate |
$2,772.14 |
| Rate for Payer: Aetna Commercial |
$2,575.41
|
| Rate for Payer: Cash Price |
$1,848.10
|
| Rate for Payer: Cigna All Commercial |
$2,572.43
|
| Rate for Payer: CORVEL All Commercial |
$2,772.14
|
| Rate for Payer: Coventry All Commercial |
$2,623.10
|
| Rate for Payer: Encore All Commercial |
$2,743.83
|
| Rate for Payer: Frontpath All Commercial |
$2,742.34
|
| Rate for Payer: Humana ChoiceCare |
$2,574.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,682.72
|
| Rate for Payer: PHCS All Commercial |
$2,235.60
|
| Rate for Payer: PHP All Commercial |
$2,260.64
|
| Rate for Payer: Sagamore Health Network All Products |
$2,301.18
|
| Rate for Payer: Signature Care EPO |
$2,474.06
|
| Rate for Payer: Signature Care PPO |
$2,623.10
|
| Rate for Payer: United Healthcare Commercial |
$2,348.87
|
|
|
HC Z SM AUG BASEPLATE
|
Facility
OP
|
$8,694.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607139
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,085.42 |
| Rate for Payer: Aetna Commercial |
$7,337.74
|
| Rate for Payer: Aetna Medicare |
$2,869.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,869.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,992.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,434.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,299.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,155.92
|
| Rate for Payer: Cash Price |
$5,390.28
|
| Rate for Payer: Cash Price |
$5,390.28
|
| Rate for Payer: Centivo All Commercial |
$4,433.94
|
| Rate for Payer: Cigna All Commercial |
$7,502.92
|
| Rate for Payer: CORVEL All Commercial |
$8,085.42
|
| Rate for Payer: Coventry All Commercial |
$7,650.72
|
| Rate for Payer: Encore All Commercial |
$8,002.83
|
| Rate for Payer: Frontpath All Commercial |
$7,998.48
|
| Rate for Payer: Humana ChoiceCare |
$7,509.01
|
| Rate for Payer: Humana Medicare |
$4,433.94
|
| Rate for Payer: Lucent All Commercial |
$4,433.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,824.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,520.50
|
| Rate for Payer: PHP All Commercial |
$6,593.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,390.66
|
| Rate for Payer: Sagamore Health Network All Products |
$6,711.77
|
| Rate for Payer: Signature Care EPO |
$7,216.02
|
| Rate for Payer: Signature Care PPO |
$7,650.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,389.90
|
| Rate for Payer: United Healthcare Commercial |
$6,850.87
|
| Rate for Payer: United Healthcare Medicare |
$2,869.02
|
|
