|
HC Z VNGD AS TIB BRG 10X67
|
Facility
OP
|
$7,525.04
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606986
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: Aetna Commercial |
$6,351.13
|
| Rate for Payer: Aetna Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,321.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,703.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,855.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,731.59
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Centivo All Commercial |
$3,837.77
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Humana Medicare |
$3,837.77
|
| Rate for Payer: Lucent All Commercial |
$3,837.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,934.77
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,396.28
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
| Rate for Payer: United Healthcare Medicare |
$2,483.26
|
|
|
HC Z VNGD AS TIB BRG 10X79
|
Facility
IP
|
$7,525.04
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606951
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,643.78 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: Aetna Commercial |
$6,501.63
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
|
|
HC Z VNGD AS TIB BRG 10X79
|
Facility
OP
|
$7,525.04
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606951
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: Aetna Commercial |
$6,351.13
|
| Rate for Payer: Aetna Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,321.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,703.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,855.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,731.59
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Centivo All Commercial |
$3,837.77
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Humana Medicare |
$3,837.77
|
| Rate for Payer: Lucent All Commercial |
$3,837.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,934.77
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,396.28
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
| Rate for Payer: United Healthcare Medicare |
$2,483.26
|
|
|
HC Z VNGD AS TIB BRG 10X83
|
Facility
OP
|
$7,525.04
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606904
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: Aetna Commercial |
$6,351.13
|
| Rate for Payer: Aetna Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,321.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,703.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,855.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,731.59
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Centivo All Commercial |
$3,837.77
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Humana Medicare |
$3,837.77
|
| Rate for Payer: Lucent All Commercial |
$3,837.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,934.77
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,396.28
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
| Rate for Payer: United Healthcare Medicare |
$2,483.26
|
|
|
HC Z VNGD AS TIB BRG 10X83
|
Facility
IP
|
$7,525.04
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606904
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,643.78 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: Aetna Commercial |
$6,501.63
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
|
|
HC Z VNGD AS TIB BRG 10X87
|
Facility
OP
|
$7,525.04
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: Aetna Commercial |
$6,351.13
|
| Rate for Payer: Aetna Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,321.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,703.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,855.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,731.59
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Centivo All Commercial |
$3,837.77
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Humana Medicare |
$3,837.77
|
| Rate for Payer: Lucent All Commercial |
$3,837.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,934.77
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,396.28
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
| Rate for Payer: United Healthcare Medicare |
$2,483.26
|
|
|
HC Z VNGD AS TIB BRG 10X87
|
Facility
IP
|
$7,525.04
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,643.78 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: Aetna Commercial |
$6,501.63
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
|
|
HC Z VNGD AS TIB BRG 12X67
|
Facility
IP
|
$7,525.04
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,643.78 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: Aetna Commercial |
$6,501.63
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
|
|
HC Z VNGD AS TIB BRG 12X67
|
Facility
OP
|
$7,525.04
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: United Healthcare Medicare |
$2,483.26
|
| Rate for Payer: Aetna Commercial |
$6,351.13
|
| Rate for Payer: Aetna Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,321.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,703.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,855.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,731.59
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Centivo All Commercial |
$3,837.77
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Humana Medicare |
$3,837.77
|
| Rate for Payer: Lucent All Commercial |
$3,837.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,934.77
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,396.28
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
|
|
HC Z VNGD AS TIB BRG 71X10
|
Facility
OP
|
$7,525.04
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606969
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: Aetna Commercial |
$6,351.13
|
| Rate for Payer: Aetna Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,483.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,321.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,703.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,855.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,731.59
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Centivo All Commercial |
$3,837.77
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Humana Medicare |
$3,837.77
|
| Rate for Payer: Lucent All Commercial |
$3,837.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,934.77
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,396.28
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
| Rate for Payer: United Healthcare Medicare |
$2,483.26
|
|
|
HC Z VNGD AS TIB BRG 71X10
|
Facility
IP
|
$7,525.04
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606969
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,643.78 |
| Max. Negotiated Rate |
$6,998.29 |
| Rate for Payer: Aetna Commercial |
$6,501.63
|
| Rate for Payer: Cash Price |
$4,665.53
|
| Rate for Payer: Cigna All Commercial |
$6,494.11
|
| Rate for Payer: CORVEL All Commercial |
$6,998.29
|
| Rate for Payer: Coventry All Commercial |
$6,622.04
|
| Rate for Payer: Encore All Commercial |
$6,926.80
|
| Rate for Payer: Frontpath All Commercial |
$6,923.04
|
| Rate for Payer: Humana ChoiceCare |
$6,499.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,772.54
|
| Rate for Payer: PHCS All Commercial |
$5,643.78
|
| Rate for Payer: PHP All Commercial |
$5,706.99
|
| Rate for Payer: Sagamore Health Network All Products |
$5,809.33
|
| Rate for Payer: Signature Care EPO |
$6,245.78
|
| Rate for Payer: Signature Care PPO |
$6,622.04
|
| Rate for Payer: United Healthcare Commercial |
$5,929.73
|
|
|
HC Z VNGD CR FEM 75MM
|
Facility
OP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606372
|
|
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 VNGD CR FEM 75MM
|
Facility
IP
|
$14,791.39
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41606372
|
|
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 VNGD CR ILOK FEM 57.5 L
|
Facility
IP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603555
|
|
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 VNGD CR ILOK FEM 57.5 L
|
Facility
OP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603555
|
|
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 VNGD CR ILOK FEM 57.5 R
|
Facility
OP
|
$13,234.32
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$12,307.92 |
| Rate for Payer: Aetna Commercial |
$11,169.77
|
| Rate for Payer: Aetna Medicare |
$4,367.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,367.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,600.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,272.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,022.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,804.06
|
| Rate for Payer: Cash Price |
$8,205.28
|
| Rate for Payer: Cash Price |
$8,205.28
|
| Rate for Payer: Centivo All Commercial |
$6,749.50
|
| Rate for Payer: Cigna All Commercial |
$11,421.22
|
| Rate for Payer: CORVEL All Commercial |
$12,307.92
|
| Rate for Payer: Coventry All Commercial |
$11,646.20
|
| Rate for Payer: Encore All Commercial |
$12,182.19
|
| Rate for Payer: Frontpath All Commercial |
$12,175.57
|
| Rate for Payer: Humana ChoiceCare |
$11,430.48
|
| Rate for Payer: Humana Medicare |
$6,749.50
|
| Rate for Payer: Lucent All Commercial |
$6,749.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,910.89
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,925.74
|
| Rate for Payer: PHP All Commercial |
$10,036.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,161.38
|
| Rate for Payer: Sagamore Health Network All Products |
$10,216.90
|
| Rate for Payer: Signature Care EPO |
$10,984.49
|
| Rate for Payer: Signature Care PPO |
$11,646.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,249.17
|
| Rate for Payer: United Healthcare Commercial |
$10,428.64
|
| Rate for Payer: United Healthcare Medicare |
$4,367.33
|
|
|
HC Z VNGD CR ILOK FEM 57.5 R
|
Facility
IP
|
$13,234.32
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,925.74 |
| Max. Negotiated Rate |
$12,307.92 |
| Rate for Payer: Aetna Commercial |
$11,434.45
|
| Rate for Payer: Cash Price |
$8,205.28
|
| Rate for Payer: Cigna All Commercial |
$11,421.22
|
| Rate for Payer: CORVEL All Commercial |
$12,307.92
|
| Rate for Payer: Coventry All Commercial |
$11,646.20
|
| Rate for Payer: Encore All Commercial |
$12,182.19
|
| Rate for Payer: Frontpath All Commercial |
$12,175.57
|
| Rate for Payer: Humana ChoiceCare |
$11,430.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,910.89
|
| Rate for Payer: PHCS All Commercial |
$9,925.74
|
| Rate for Payer: PHP All Commercial |
$10,036.91
|
| Rate for Payer: Sagamore Health Network All Products |
$10,216.90
|
| Rate for Payer: Signature Care EPO |
$10,984.49
|
| Rate for Payer: Signature Care PPO |
$11,646.20
|
| Rate for Payer: United Healthcare Commercial |
$10,428.64
|
|
|
HC Z VNGD CR ILOK FEM 62.5 L
|
Facility
IP
|
$13,234.32
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603505
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,925.74 |
| Max. Negotiated Rate |
$12,307.92 |
| Rate for Payer: Aetna Commercial |
$11,434.45
|
| Rate for Payer: Cash Price |
$8,205.28
|
| Rate for Payer: Cigna All Commercial |
$11,421.22
|
| Rate for Payer: CORVEL All Commercial |
$12,307.92
|
| Rate for Payer: Coventry All Commercial |
$11,646.20
|
| Rate for Payer: Encore All Commercial |
$12,182.19
|
| Rate for Payer: Frontpath All Commercial |
$12,175.57
|
| Rate for Payer: Humana ChoiceCare |
$11,430.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,910.89
|
| Rate for Payer: PHCS All Commercial |
$9,925.74
|
| Rate for Payer: PHP All Commercial |
$10,036.91
|
| Rate for Payer: Sagamore Health Network All Products |
$10,216.90
|
| Rate for Payer: Signature Care EPO |
$10,984.49
|
| Rate for Payer: Signature Care PPO |
$11,646.20
|
| Rate for Payer: United Healthcare Commercial |
$10,428.64
|
|
|
HC Z VNGD CR ILOK FEM 62.5 L
|
Facility
OP
|
$13,234.32
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603505
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$12,307.92 |
| Rate for Payer: Aetna Commercial |
$11,169.77
|
| Rate for Payer: Aetna Medicare |
$4,367.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,367.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,600.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,272.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,022.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,804.06
|
| Rate for Payer: Cash Price |
$8,205.28
|
| Rate for Payer: Cash Price |
$8,205.28
|
| Rate for Payer: Centivo All Commercial |
$6,749.50
|
| Rate for Payer: Cigna All Commercial |
$11,421.22
|
| Rate for Payer: CORVEL All Commercial |
$12,307.92
|
| Rate for Payer: Coventry All Commercial |
$11,646.20
|
| Rate for Payer: Encore All Commercial |
$12,182.19
|
| Rate for Payer: Frontpath All Commercial |
$12,175.57
|
| Rate for Payer: Humana ChoiceCare |
$11,430.48
|
| Rate for Payer: Humana Medicare |
$6,749.50
|
| Rate for Payer: Lucent All Commercial |
$6,749.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,910.89
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,925.74
|
| Rate for Payer: PHP All Commercial |
$10,036.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,161.38
|
| Rate for Payer: Sagamore Health Network All Products |
$10,216.90
|
| Rate for Payer: Signature Care EPO |
$10,984.49
|
| Rate for Payer: Signature Care PPO |
$11,646.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,249.17
|
| Rate for Payer: United Healthcare Commercial |
$10,428.64
|
| Rate for Payer: United Healthcare Medicare |
$4,367.33
|
|
|
HC Z VNGD CR ILOK FEM 65 L
|
Facility
OP
|
$12,175.56
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603481
|
|
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 VNGD CR ILOK FEM 65 L
|
Facility
IP
|
$12,175.56
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603481
|
|
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 VNGD CR ILOK FEM 65 R
|
Facility
IP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603522
|
|
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 VNGD CR ILOK FEM 65 R
|
Facility
OP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603522
|
|
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 VNGD CR ILOK FEM 67.5 L
|
Facility
IP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603515
|
|
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 VNGD CR ILOK FEM 67.5 L
|
Facility
OP
|
$12,175.56
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603515
|
|
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
|
|
