|
HC Z TPRLC 133 T1 PPS SO 17X119
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606909
|
|
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 TPRLC 133 T1 PPS SO 17X154
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607063
|
|
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 TPRLC 133 T1 PPS SO 17X154
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607063
|
|
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 TPRLC 133 T1 PPS SO 20X160
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603729
|
|
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 TPRLC 133 T1 PPS SO 20X160
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603729
|
|
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 TPRLC 133 TYPE 1 PPS HO 16.0
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603403
|
|
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 TPRLC 133 TYPE 1 PPS HO 16.0
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603403
|
|
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 TPRLC 133 TYPE 1 PPS HO 17.0
|
Facility
OP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603446
|
|
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 TPRLC 133 TYPE 1 PPS HO 17.0
|
Facility
IP
|
$8,280.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603446
|
|
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 TROCAR 3.5 4.0
|
Facility
OP
|
$535.99
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$176.88 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$452.38
|
| Rate for Payer: Aetna Medicare |
$176.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$176.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$307.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$335.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$203.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$194.56
|
| Rate for Payer: Cash Price |
$332.31
|
| Rate for Payer: Cash Price |
$332.31
|
| Rate for Payer: Centivo All Commercial |
$273.35
|
| Rate for Payer: Cigna All Commercial |
$462.56
|
| Rate for Payer: CORVEL All Commercial |
$498.47
|
| Rate for Payer: Coventry All Commercial |
$471.67
|
| Rate for Payer: Encore All Commercial |
$493.38
|
| Rate for Payer: Frontpath All Commercial |
$493.11
|
| Rate for Payer: Humana ChoiceCare |
$462.93
|
| Rate for Payer: Humana Medicare |
$273.35
|
| Rate for Payer: Lucent All Commercial |
$273.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$482.39
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$401.99
|
| Rate for Payer: PHP All Commercial |
$406.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$209.04
|
| Rate for Payer: Sagamore Health Network All Products |
$413.78
|
| Rate for Payer: Signature Care EPO |
$444.87
|
| Rate for Payer: Signature Care PPO |
$471.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$455.59
|
| Rate for Payer: United Healthcare Commercial |
$422.36
|
| Rate for Payer: United Healthcare Medicare |
$176.88
|
|
|
HC Z TROCAR 3.5 4.0
|
Facility
IP
|
$535.99
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$401.99 |
| Max. Negotiated Rate |
$498.47 |
| Rate for Payer: Aetna Commercial |
$463.10
|
| Rate for Payer: Cash Price |
$332.31
|
| Rate for Payer: Cigna All Commercial |
$462.56
|
| Rate for Payer: CORVEL All Commercial |
$498.47
|
| Rate for Payer: Coventry All Commercial |
$471.67
|
| Rate for Payer: Encore All Commercial |
$493.38
|
| Rate for Payer: Frontpath All Commercial |
$493.11
|
| Rate for Payer: Humana ChoiceCare |
$462.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$482.39
|
| Rate for Payer: PHCS All Commercial |
$401.99
|
| Rate for Payer: PHP All Commercial |
$406.49
|
| Rate for Payer: Sagamore Health Network All Products |
$413.78
|
| Rate for Payer: Signature Care EPO |
$444.87
|
| Rate for Payer: Signature Care PPO |
$471.67
|
| Rate for Payer: United Healthcare Commercial |
$422.36
|
|
|
HC Z VANGAURD STD PAT 37 3 PEG
|
Facility
OP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606203
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,236.26
|
| Rate for Payer: Aetna Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,521.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,656.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,005.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$961.80
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Centivo All Commercial |
$1,351.30
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Humana Medicare |
$1,351.30
|
| Rate for Payer: Lucent All Commercial |
$1,351.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,033.34
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,252.16
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
| Rate for Payer: United Healthcare Medicare |
$874.37
|
|
|
HC Z VANGAURD STD PAT 37 3 PEG
|
Facility
IP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606203
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,987.20 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,289.25
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
|
|
HC Z VANG CR ILOK FEM 60
|
Facility
IP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,131.67 |
| Max. Negotiated Rate |
$11,323.27 |
| Rate for Payer: Aetna Commercial |
$10,519.68
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Cigna All Commercial |
$10,507.51
|
| Rate for Payer: CORVEL All Commercial |
$11,323.27
|
| Rate for Payer: Coventry All Commercial |
$10,714.49
|
| Rate for Payer: Encore All Commercial |
$11,207.60
|
| Rate for Payer: Frontpath All Commercial |
$11,201.52
|
| Rate for Payer: Humana ChoiceCare |
$10,516.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,958.00
|
| Rate for Payer: PHCS All Commercial |
$9,131.67
|
| Rate for Payer: PHP All Commercial |
$9,233.94
|
| Rate for Payer: Sagamore Health Network All Products |
$9,399.53
|
| Rate for Payer: Signature Care EPO |
$10,105.71
|
| Rate for Payer: Signature Care PPO |
$10,714.49
|
| Rate for Payer: United Healthcare Commercial |
$9,594.34
|
|
|
HC Z VANG CR ILOK FEM 60
|
Facility
OP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,323.27 |
| Rate for Payer: Aetna Commercial |
$10,276.17
|
| Rate for Payer: Aetna Medicare |
$4,017.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,017.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,992.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,610.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,620.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,419.73
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Centivo All Commercial |
$6,209.54
|
| Rate for Payer: Cigna All Commercial |
$10,507.51
|
| Rate for Payer: CORVEL All Commercial |
$11,323.27
|
| Rate for Payer: Coventry All Commercial |
$10,714.49
|
| Rate for Payer: Encore All Commercial |
$11,207.60
|
| Rate for Payer: Frontpath All Commercial |
$11,201.52
|
| Rate for Payer: Humana ChoiceCare |
$10,516.03
|
| Rate for Payer: Humana Medicare |
$6,209.54
|
| Rate for Payer: Lucent All Commercial |
$6,209.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,958.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,131.67
|
| Rate for Payer: PHP All Commercial |
$9,233.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,748.47
|
| Rate for Payer: Sagamore Health Network All Products |
$9,399.53
|
| Rate for Payer: Signature Care EPO |
$10,105.71
|
| Rate for Payer: Signature Care PPO |
$10,714.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,349.23
|
| Rate for Payer: United Healthcare Commercial |
$9,594.34
|
| Rate for Payer: United Healthcare Medicare |
$4,017.93
|
|
|
HC Z VANG CR ILOK FEM-LT 55
|
Facility
OP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603292
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,323.27 |
| Rate for Payer: Aetna Commercial |
$10,276.17
|
| Rate for Payer: Aetna Medicare |
$4,017.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,017.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,992.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,610.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,620.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,419.73
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Centivo All Commercial |
$6,209.54
|
| Rate for Payer: Cigna All Commercial |
$10,507.51
|
| Rate for Payer: CORVEL All Commercial |
$11,323.27
|
| Rate for Payer: Coventry All Commercial |
$10,714.49
|
| Rate for Payer: Encore All Commercial |
$11,207.60
|
| Rate for Payer: Frontpath All Commercial |
$11,201.52
|
| Rate for Payer: Humana ChoiceCare |
$10,516.03
|
| Rate for Payer: Humana Medicare |
$6,209.54
|
| Rate for Payer: Lucent All Commercial |
$6,209.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,958.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,131.67
|
| Rate for Payer: PHP All Commercial |
$9,233.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,748.47
|
| Rate for Payer: Sagamore Health Network All Products |
$9,399.53
|
| Rate for Payer: Signature Care EPO |
$10,105.71
|
| Rate for Payer: Signature Care PPO |
$10,714.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,349.23
|
| Rate for Payer: United Healthcare Commercial |
$9,594.34
|
| Rate for Payer: United Healthcare Medicare |
$4,017.93
|
|
|
HC Z VANG CR ILOK FEM-LT 55
|
Facility
IP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603292
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,131.67 |
| Max. Negotiated Rate |
$11,323.27 |
| Rate for Payer: Aetna Commercial |
$10,519.68
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Cigna All Commercial |
$10,507.51
|
| Rate for Payer: CORVEL All Commercial |
$11,323.27
|
| Rate for Payer: Coventry All Commercial |
$10,714.49
|
| Rate for Payer: Encore All Commercial |
$11,207.60
|
| Rate for Payer: Frontpath All Commercial |
$11,201.52
|
| Rate for Payer: Humana ChoiceCare |
$10,516.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,958.00
|
| Rate for Payer: PHCS All Commercial |
$9,131.67
|
| Rate for Payer: PHP All Commercial |
$9,233.94
|
| Rate for Payer: Sagamore Health Network All Products |
$9,399.53
|
| Rate for Payer: Signature Care EPO |
$10,105.71
|
| Rate for Payer: Signature Care PPO |
$10,714.49
|
| Rate for Payer: United Healthcare Commercial |
$9,594.34
|
|
|
HC Z VANG CR ILOK FEM-LT 70
|
Facility
OP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,323.27 |
| Rate for Payer: Aetna Commercial |
$10,276.17
|
| Rate for Payer: Aetna Medicare |
$4,017.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,017.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,992.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,610.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,620.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,419.73
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Centivo All Commercial |
$6,209.54
|
| Rate for Payer: Cigna All Commercial |
$10,507.51
|
| Rate for Payer: CORVEL All Commercial |
$11,323.27
|
| Rate for Payer: Coventry All Commercial |
$10,714.49
|
| Rate for Payer: Encore All Commercial |
$11,207.60
|
| Rate for Payer: Frontpath All Commercial |
$11,201.52
|
| Rate for Payer: Humana ChoiceCare |
$10,516.03
|
| Rate for Payer: Humana Medicare |
$6,209.54
|
| Rate for Payer: Lucent All Commercial |
$6,209.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,958.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,131.67
|
| Rate for Payer: PHP All Commercial |
$9,233.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,748.47
|
| Rate for Payer: Sagamore Health Network All Products |
$9,399.53
|
| Rate for Payer: Signature Care EPO |
$10,105.71
|
| Rate for Payer: Signature Care PPO |
$10,714.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,349.23
|
| Rate for Payer: United Healthcare Commercial |
$9,594.34
|
| Rate for Payer: United Healthcare Medicare |
$4,017.93
|
|
|
HC Z VANG CR ILOK FEM-LT 70
|
Facility
IP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,131.67 |
| Max. Negotiated Rate |
$11,323.27 |
| Rate for Payer: Aetna Commercial |
$10,519.68
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Cigna All Commercial |
$10,507.51
|
| Rate for Payer: CORVEL All Commercial |
$11,323.27
|
| Rate for Payer: Coventry All Commercial |
$10,714.49
|
| Rate for Payer: Encore All Commercial |
$11,207.60
|
| Rate for Payer: Frontpath All Commercial |
$11,201.52
|
| Rate for Payer: Humana ChoiceCare |
$10,516.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,958.00
|
| Rate for Payer: PHCS All Commercial |
$9,131.67
|
| Rate for Payer: PHP All Commercial |
$9,233.94
|
| Rate for Payer: Sagamore Health Network All Products |
$9,399.53
|
| Rate for Payer: Signature Care EPO |
$10,105.71
|
| Rate for Payer: Signature Care PPO |
$10,714.49
|
| Rate for Payer: United Healthcare Commercial |
$9,594.34
|
|
|
HC Z VANG CR ILOK FEM-RT 60
|
Facility
IP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603386
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,131.67 |
| Max. Negotiated Rate |
$11,323.27 |
| Rate for Payer: Aetna Commercial |
$10,519.68
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Cigna All Commercial |
$10,507.51
|
| Rate for Payer: CORVEL All Commercial |
$11,323.27
|
| Rate for Payer: Coventry All Commercial |
$10,714.49
|
| Rate for Payer: Encore All Commercial |
$11,207.60
|
| Rate for Payer: Frontpath All Commercial |
$11,201.52
|
| Rate for Payer: Humana ChoiceCare |
$10,516.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,958.00
|
| Rate for Payer: PHCS All Commercial |
$9,131.67
|
| Rate for Payer: PHP All Commercial |
$9,233.94
|
| Rate for Payer: Sagamore Health Network All Products |
$9,399.53
|
| Rate for Payer: Signature Care EPO |
$10,105.71
|
| Rate for Payer: Signature Care PPO |
$10,714.49
|
| Rate for Payer: United Healthcare Commercial |
$9,594.34
|
|
|
HC Z VANG CR ILOK FEM-RT 60
|
Facility
OP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603386
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,323.27 |
| Rate for Payer: Aetna Commercial |
$10,276.17
|
| Rate for Payer: Aetna Medicare |
$4,017.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,017.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,992.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,610.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,620.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,419.73
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Centivo All Commercial |
$6,209.54
|
| Rate for Payer: Cigna All Commercial |
$10,507.51
|
| Rate for Payer: CORVEL All Commercial |
$11,323.27
|
| Rate for Payer: Coventry All Commercial |
$10,714.49
|
| Rate for Payer: Encore All Commercial |
$11,207.60
|
| Rate for Payer: Frontpath All Commercial |
$11,201.52
|
| Rate for Payer: Humana ChoiceCare |
$10,516.03
|
| Rate for Payer: Humana Medicare |
$6,209.54
|
| Rate for Payer: Lucent All Commercial |
$6,209.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,958.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,131.67
|
| Rate for Payer: PHP All Commercial |
$9,233.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,748.47
|
| Rate for Payer: Sagamore Health Network All Products |
$9,399.53
|
| Rate for Payer: Signature Care EPO |
$10,105.71
|
| Rate for Payer: Signature Care PPO |
$10,714.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,349.23
|
| Rate for Payer: United Healthcare Commercial |
$9,594.34
|
| Rate for Payer: United Healthcare Medicare |
$4,017.93
|
|
|
HC Z VANG CR ILOK FEM-RT 62.5
|
Facility
IP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41602624
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,131.67 |
| Max. Negotiated Rate |
$11,323.27 |
| Rate for Payer: Aetna Commercial |
$10,519.68
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Cigna All Commercial |
$10,507.51
|
| Rate for Payer: CORVEL All Commercial |
$11,323.27
|
| Rate for Payer: Coventry All Commercial |
$10,714.49
|
| Rate for Payer: Encore All Commercial |
$11,207.60
|
| Rate for Payer: Frontpath All Commercial |
$11,201.52
|
| Rate for Payer: Humana ChoiceCare |
$10,516.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,958.00
|
| Rate for Payer: PHCS All Commercial |
$9,131.67
|
| Rate for Payer: PHP All Commercial |
$9,233.94
|
| Rate for Payer: Sagamore Health Network All Products |
$9,399.53
|
| Rate for Payer: Signature Care EPO |
$10,105.71
|
| Rate for Payer: Signature Care PPO |
$10,714.49
|
| Rate for Payer: United Healthcare Commercial |
$9,594.34
|
|
|
HC Z VANG CR ILOK FEM-RT 62.5
|
Facility
OP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41602624
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,323.27 |
| Rate for Payer: Aetna Commercial |
$10,276.17
|
| Rate for Payer: Aetna Medicare |
$4,017.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,017.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,992.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,610.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,620.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,419.73
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Cash Price |
$7,548.85
|
| Rate for Payer: Centivo All Commercial |
$6,209.54
|
| Rate for Payer: Cigna All Commercial |
$10,507.51
|
| Rate for Payer: CORVEL All Commercial |
$11,323.27
|
| Rate for Payer: Coventry All Commercial |
$10,714.49
|
| Rate for Payer: Encore All Commercial |
$11,207.60
|
| Rate for Payer: Frontpath All Commercial |
$11,201.52
|
| Rate for Payer: Humana ChoiceCare |
$10,516.03
|
| Rate for Payer: Humana Medicare |
$6,209.54
|
| Rate for Payer: Lucent All Commercial |
$6,209.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,958.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,131.67
|
| Rate for Payer: PHP All Commercial |
$9,233.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,748.47
|
| Rate for Payer: Sagamore Health Network All Products |
$9,399.53
|
| Rate for Payer: Signature Care EPO |
$10,105.71
|
| Rate for Payer: Signature Care PPO |
$10,714.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,349.23
|
| Rate for Payer: United Healthcare Commercial |
$9,594.34
|
| Rate for Payer: United Healthcare Medicare |
$4,017.93
|
|
|
HC Z VANGUARD STD PAT 28 3 PEG
|
Facility
IP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,987.20 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,289.25
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
|
|
HC Z VANGUARD STD PAT 28 3 PEG
|
Facility
OP
|
$2,649.60
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,236.26
|
| Rate for Payer: Aetna Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$874.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,521.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,656.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,005.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$961.80
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Centivo All Commercial |
$1,351.30
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Humana Medicare |
$1,351.30
|
| Rate for Payer: Lucent All Commercial |
$1,351.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,033.34
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,252.16
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
| Rate for Payer: United Healthcare Medicare |
$874.37
|
|
