|
HC Z TIB STM 5 DEG H L
|
Facility
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB STM 5 DEG H R
|
Facility
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,967.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,967.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,262.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,164.06
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Centivo All Commercial |
$3,040.42
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$3,040.42
|
| Rate for Payer: Lucent All Commercial |
$3,040.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,967.33
|
|
|
HC Z TIB STM 5 DEG H R
|
Facility
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB STM 5 DEG J L
|
Facility
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB STM 5 DEG J L
|
Facility
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,967.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,967.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,262.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,164.06
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Centivo All Commercial |
$3,040.42
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$3,040.42
|
| Rate for Payer: Lucent All Commercial |
$3,040.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,967.33
|
|
|
HC Z TIB STM 5 DEG J R
|
Facility
OP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,031.59
|
| Rate for Payer: Aetna Medicare |
$1,967.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,967.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,423.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,726.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,262.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,164.06
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Centivo All Commercial |
$3,040.42
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Humana Medicare |
$3,040.42
|
| Rate for Payer: Lucent All Commercial |
$3,040.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,325.02
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,067.36
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
| Rate for Payer: United Healthcare Medicare |
$1,967.33
|
|
|
HC Z TIB STM 5 DEG J R
|
Facility
IP
|
$5,961.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,471.20 |
| Max. Negotiated Rate |
$5,544.29 |
| Rate for Payer: Aetna Commercial |
$5,150.82
|
| Rate for Payer: Cash Price |
$3,696.19
|
| Rate for Payer: Cigna All Commercial |
$5,144.86
|
| Rate for Payer: CORVEL All Commercial |
$5,544.29
|
| Rate for Payer: Coventry All Commercial |
$5,246.21
|
| Rate for Payer: Encore All Commercial |
$5,487.65
|
| Rate for Payer: Frontpath All Commercial |
$5,484.67
|
| Rate for Payer: Humana ChoiceCare |
$5,149.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,365.44
|
| Rate for Payer: PHCS All Commercial |
$4,471.20
|
| Rate for Payer: PHP All Commercial |
$4,521.28
|
| Rate for Payer: Sagamore Health Network All Products |
$4,602.36
|
| Rate for Payer: Signature Care EPO |
$4,948.13
|
| Rate for Payer: Signature Care PPO |
$5,246.21
|
| Rate for Payer: United Healthcare Commercial |
$4,697.74
|
|
|
HC Z TIB TRAY 83MM
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606371
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,483.93
|
| Rate for Payer: Aetna Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,881.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,494.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,246.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,613.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,369.27
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Centivo All Commercial |
$7,543.61
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Humana Medicare |
$7,543.61
|
| Rate for Payer: Lucent All Commercial |
$7,543.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,768.64
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,572.68
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
| Rate for Payer: United Healthcare Medicare |
$4,881.16
|
|
|
HC Z TIB TRAY 83MM
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606371
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,093.54 |
| Max. Negotiated Rate |
$13,755.99 |
| Rate for Payer: Aetna Commercial |
$12,779.76
|
| Rate for Payer: Cash Price |
$9,170.66
|
| Rate for Payer: Cigna All Commercial |
$12,764.97
|
| Rate for Payer: CORVEL All Commercial |
$13,755.99
|
| Rate for Payer: Coventry All Commercial |
$13,016.42
|
| Rate for Payer: Encore All Commercial |
$13,615.47
|
| Rate for Payer: Frontpath All Commercial |
$13,608.08
|
| Rate for Payer: Humana ChoiceCare |
$12,775.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,312.25
|
| Rate for Payer: PHCS All Commercial |
$11,093.54
|
| Rate for Payer: PHP All Commercial |
$11,217.79
|
| Rate for Payer: Sagamore Health Network All Products |
$11,418.95
|
| Rate for Payer: Signature Care EPO |
$12,276.85
|
| Rate for Payer: Signature Care PPO |
$13,016.42
|
| Rate for Payer: United Healthcare Commercial |
$11,655.62
|
|
|
HC Z TOGGLELOC/WASHER KIT
|
Facility
IP
|
$2,923.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,192.40 |
| Max. Negotiated Rate |
$2,718.58 |
| Rate for Payer: Aetna Commercial |
$2,525.64
|
| Rate for Payer: Cash Price |
$1,812.38
|
| Rate for Payer: Cigna All Commercial |
$2,522.72
|
| Rate for Payer: CORVEL All Commercial |
$2,718.58
|
| Rate for Payer: Coventry All Commercial |
$2,572.42
|
| Rate for Payer: Encore All Commercial |
$2,690.81
|
| Rate for Payer: Frontpath All Commercial |
$2,689.34
|
| Rate for Payer: Humana ChoiceCare |
$2,524.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,630.88
|
| Rate for Payer: PHCS All Commercial |
$2,192.40
|
| Rate for Payer: PHP All Commercial |
$2,216.95
|
| Rate for Payer: Sagamore Health Network All Products |
$2,256.71
|
| Rate for Payer: Signature Care EPO |
$2,426.26
|
| Rate for Payer: Signature Care PPO |
$2,572.42
|
| Rate for Payer: United Healthcare Commercial |
$2,303.48
|
|
|
HC Z TOGGLELOC/WASHER KIT
|
Facility
OP
|
$2,923.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,718.58 |
| Rate for Payer: Aetna Commercial |
$2,467.18
|
| Rate for Payer: Aetna Medicare |
$964.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$964.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,678.79
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,827.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,109.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,061.12
|
| Rate for Payer: Cash Price |
$1,812.38
|
| Rate for Payer: Cash Price |
$1,812.38
|
| Rate for Payer: Centivo All Commercial |
$1,490.83
|
| Rate for Payer: Cigna All Commercial |
$2,522.72
|
| Rate for Payer: CORVEL All Commercial |
$2,718.58
|
| Rate for Payer: Coventry All Commercial |
$2,572.42
|
| Rate for Payer: Encore All Commercial |
$2,690.81
|
| Rate for Payer: Frontpath All Commercial |
$2,689.34
|
| Rate for Payer: Humana ChoiceCare |
$2,524.77
|
| Rate for Payer: Humana Medicare |
$1,490.83
|
| Rate for Payer: Lucent All Commercial |
$1,490.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,630.88
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$2,192.40
|
| Rate for Payer: PHP All Commercial |
$2,216.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,140.05
|
| Rate for Payer: Sagamore Health Network All Products |
$2,256.71
|
| Rate for Payer: Signature Care EPO |
$2,426.26
|
| Rate for Payer: Signature Care PPO |
$2,572.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,484.72
|
| Rate for Payer: United Healthcare Commercial |
$2,303.48
|
| Rate for Payer: United Healthcare Medicare |
$964.66
|
|
|
HC Z TOGGLELOC/ZIPLOOP 7
|
Facility
IP
|
$2,016.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604940
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,512.00 |
| Max. Negotiated Rate |
$1,874.88 |
| Rate for Payer: Aetna Commercial |
$1,741.82
|
| Rate for Payer: Cash Price |
$1,249.92
|
| Rate for Payer: Cigna All Commercial |
$1,739.81
|
| Rate for Payer: CORVEL All Commercial |
$1,874.88
|
| Rate for Payer: Coventry All Commercial |
$1,774.08
|
| Rate for Payer: Encore All Commercial |
$1,855.73
|
| Rate for Payer: Frontpath All Commercial |
$1,854.72
|
| Rate for Payer: Humana ChoiceCare |
$1,741.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,814.40
|
| Rate for Payer: PHCS All Commercial |
$1,512.00
|
| Rate for Payer: PHP All Commercial |
$1,528.93
|
| Rate for Payer: Sagamore Health Network All Products |
$1,556.35
|
| Rate for Payer: Signature Care EPO |
$1,673.28
|
| Rate for Payer: Signature Care PPO |
$1,774.08
|
| Rate for Payer: United Healthcare Commercial |
$1,588.61
|
|
|
HC Z TOGGLELOC/ZIPLOOP 7
|
Facility
OP
|
$2,016.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604940
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,874.88 |
| Rate for Payer: Aetna Commercial |
$1,701.50
|
| Rate for Payer: Aetna Medicare |
$665.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$665.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,157.79
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,260.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$765.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$731.81
|
| Rate for Payer: Cash Price |
$1,249.92
|
| Rate for Payer: Cash Price |
$1,249.92
|
| Rate for Payer: Centivo All Commercial |
$1,028.16
|
| Rate for Payer: Cigna All Commercial |
$1,739.81
|
| Rate for Payer: CORVEL All Commercial |
$1,874.88
|
| Rate for Payer: Coventry All Commercial |
$1,774.08
|
| Rate for Payer: Encore All Commercial |
$1,855.73
|
| Rate for Payer: Frontpath All Commercial |
$1,854.72
|
| Rate for Payer: Humana ChoiceCare |
$1,741.22
|
| Rate for Payer: Humana Medicare |
$1,028.16
|
| Rate for Payer: Lucent All Commercial |
$1,028.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,814.40
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,512.00
|
| Rate for Payer: PHP All Commercial |
$1,528.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$786.24
|
| Rate for Payer: Sagamore Health Network All Products |
$1,556.35
|
| Rate for Payer: Signature Care EPO |
$1,673.28
|
| Rate for Payer: Signature Care PPO |
$1,774.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,713.60
|
| Rate for Payer: United Healthcare Commercial |
$1,588.61
|
| Rate for Payer: United Healthcare Medicare |
$665.28
|
|
|
HC Z TOGGLELOC ZIPLOOP ELBOW
|
Facility
IP
|
$5,760.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603173
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,320.00 |
| Max. Negotiated Rate |
$5,356.80 |
| Rate for Payer: Aetna Commercial |
$4,976.64
|
| Rate for Payer: Cash Price |
$3,571.20
|
| Rate for Payer: Cigna All Commercial |
$4,970.88
|
| Rate for Payer: CORVEL All Commercial |
$5,356.80
|
| Rate for Payer: Coventry All Commercial |
$5,068.80
|
| Rate for Payer: Encore All Commercial |
$5,302.08
|
| Rate for Payer: Frontpath All Commercial |
$5,299.20
|
| Rate for Payer: Humana ChoiceCare |
$4,974.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,184.00
|
| Rate for Payer: PHCS All Commercial |
$4,320.00
|
| Rate for Payer: PHP All Commercial |
$4,368.38
|
| Rate for Payer: Sagamore Health Network All Products |
$4,446.72
|
| Rate for Payer: Signature Care EPO |
$4,780.80
|
| Rate for Payer: Signature Care PPO |
$5,068.80
|
| Rate for Payer: United Healthcare Commercial |
$4,538.88
|
|
|
HC Z TOGGLELOC ZIPLOOP ELBOW
|
Facility
OP
|
$5,760.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603173
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,356.80 |
| Rate for Payer: Aetna Commercial |
$4,861.44
|
| Rate for Payer: Aetna Medicare |
$1,900.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,900.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,307.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,600.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,185.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,090.88
|
| Rate for Payer: Cash Price |
$3,571.20
|
| Rate for Payer: Cash Price |
$3,571.20
|
| Rate for Payer: Centivo All Commercial |
$2,937.60
|
| Rate for Payer: Cigna All Commercial |
$4,970.88
|
| Rate for Payer: CORVEL All Commercial |
$5,356.80
|
| Rate for Payer: Coventry All Commercial |
$5,068.80
|
| Rate for Payer: Encore All Commercial |
$5,302.08
|
| Rate for Payer: Frontpath All Commercial |
$5,299.20
|
| Rate for Payer: Humana ChoiceCare |
$4,974.91
|
| Rate for Payer: Humana Medicare |
$2,937.60
|
| Rate for Payer: Lucent All Commercial |
$2,937.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,184.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,320.00
|
| Rate for Payer: PHP All Commercial |
$4,368.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,246.40
|
| Rate for Payer: Sagamore Health Network All Products |
$4,446.72
|
| Rate for Payer: Signature Care EPO |
$4,780.80
|
| Rate for Payer: Signature Care PPO |
$5,068.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,896.00
|
| Rate for Payer: United Healthcare Commercial |
$4,538.88
|
| Rate for Payer: United Healthcare Medicare |
$1,900.80
|
|
|
HC Z T-PLATE 2.7 2H/5H 62
|
Facility
OP
|
$1,664.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,547.98 |
| Rate for Payer: Aetna Commercial |
$1,404.84
|
| Rate for Payer: Aetna Medicare |
$549.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$549.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$955.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,040.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$631.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$604.21
|
| Rate for Payer: Cash Price |
$1,031.99
|
| Rate for Payer: Cash Price |
$1,031.99
|
| Rate for Payer: Centivo All Commercial |
$848.90
|
| Rate for Payer: Cigna All Commercial |
$1,436.46
|
| Rate for Payer: CORVEL All Commercial |
$1,547.98
|
| Rate for Payer: Coventry All Commercial |
$1,464.76
|
| Rate for Payer: Encore All Commercial |
$1,532.17
|
| Rate for Payer: Frontpath All Commercial |
$1,531.34
|
| Rate for Payer: Humana ChoiceCare |
$1,437.63
|
| Rate for Payer: Humana Medicare |
$848.90
|
| Rate for Payer: Lucent All Commercial |
$848.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,498.05
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,248.38
|
| Rate for Payer: PHP All Commercial |
$1,262.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$649.16
|
| Rate for Payer: Sagamore Health Network All Products |
$1,284.99
|
| Rate for Payer: Signature Care EPO |
$1,381.54
|
| Rate for Payer: Signature Care PPO |
$1,464.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,414.82
|
| Rate for Payer: United Healthcare Commercial |
$1,311.63
|
| Rate for Payer: United Healthcare Medicare |
$549.28
|
|
|
HC Z T-PLATE 2.7 2H/5H 62
|
Facility
IP
|
$1,664.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,248.38 |
| Max. Negotiated Rate |
$1,547.98 |
| Rate for Payer: Aetna Commercial |
$1,438.13
|
| Rate for Payer: Cash Price |
$1,031.99
|
| Rate for Payer: Cigna All Commercial |
$1,436.46
|
| Rate for Payer: CORVEL All Commercial |
$1,547.98
|
| Rate for Payer: Coventry All Commercial |
$1,464.76
|
| Rate for Payer: Encore All Commercial |
$1,532.17
|
| Rate for Payer: Frontpath All Commercial |
$1,531.34
|
| Rate for Payer: Humana ChoiceCare |
$1,437.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,498.05
|
| Rate for Payer: PHCS All Commercial |
$1,248.38
|
| Rate for Payer: PHP All Commercial |
$1,262.36
|
| Rate for Payer: Sagamore Health Network All Products |
$1,284.99
|
| Rate for Payer: Signature Care EPO |
$1,381.54
|
| Rate for Payer: Signature Care PPO |
$1,464.76
|
| Rate for Payer: United Healthcare Commercial |
$1,311.63
|
|
|
HC Z TPLC FEM STEM HO T1 13X146
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,210.00 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$7,153.92
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
|
|
HC Z TPLC FEM STEM HO T1 13X146
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$6,988.32
|
| Rate for Payer: Aetna Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,755.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,175.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,142.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,005.64
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Centivo All Commercial |
$4,222.80
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Humana Medicare |
$4,222.80
|
| Rate for Payer: Lucent All Commercial |
$4,222.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,229.20
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,038.00
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
| Rate for Payer: United Healthcare Medicare |
$2,732.40
|
|
|
HC Z TPLC FEM STEM SO T1 10X105
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$6,988.32
|
| Rate for Payer: Aetna Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,755.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,175.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,142.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,005.64
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Centivo All Commercial |
$4,222.80
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Humana Medicare |
$4,222.80
|
| Rate for Payer: Lucent All Commercial |
$4,222.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,229.20
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,038.00
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
| Rate for Payer: United Healthcare Medicare |
$2,732.40
|
|
|
HC Z TPLC FEM STEM SO T1 10X105
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,210.00 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$7,153.92
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
|
|
HC Z TPLC FEM STEM SO T1 11X107.5
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606902
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$6,988.32
|
| Rate for Payer: Aetna Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,755.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,175.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,142.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,005.64
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Centivo All Commercial |
$4,222.80
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Humana Medicare |
$4,222.80
|
| Rate for Payer: Lucent All Commercial |
$4,222.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,229.20
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,038.00
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
| Rate for Payer: United Healthcare Medicare |
$2,732.40
|
|
|
HC Z TPLC FEM STEM SO T1 11X107.5
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606902
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,210.00 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$7,153.92
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
|
|
HC Z TPLC FEM STEM SO T1 11X142
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603498
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,210.00 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$7,153.92
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
|
|
HC Z TPLC FEM STEM SO T1 11X142
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603498
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,700.40 |
| Rate for Payer: Aetna Commercial |
$6,988.32
|
| Rate for Payer: Aetna Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,732.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,755.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,175.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,142.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,005.64
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Cash Price |
$5,133.60
|
| Rate for Payer: Centivo All Commercial |
$4,222.80
|
| Rate for Payer: Cigna All Commercial |
$7,145.64
|
| Rate for Payer: CORVEL All Commercial |
$7,700.40
|
| Rate for Payer: Coventry All Commercial |
$7,286.40
|
| Rate for Payer: Encore All Commercial |
$7,621.74
|
| Rate for Payer: Frontpath All Commercial |
$7,617.60
|
| Rate for Payer: Humana ChoiceCare |
$7,151.44
|
| Rate for Payer: Humana Medicare |
$4,222.80
|
| Rate for Payer: Lucent All Commercial |
$4,222.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,452.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,210.00
|
| Rate for Payer: PHP All Commercial |
$6,279.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,229.20
|
| Rate for Payer: Sagamore Health Network All Products |
$6,392.16
|
| Rate for Payer: Signature Care EPO |
$6,872.40
|
| Rate for Payer: Signature Care PPO |
$7,286.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,038.00
|
| Rate for Payer: United Healthcare Commercial |
$6,524.64
|
| Rate for Payer: United Healthcare Medicare |
$2,732.40
|
|
