|
HC ACU DORSAL PLATE NARR LT
|
Facility
OP
|
$5,382.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602854
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,005.26 |
| Rate for Payer: Aetna Commercial |
$4,542.41
|
| Rate for Payer: Aetna Medicare |
$1,776.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,776.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,090.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,364.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,042.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,953.67
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Centivo All Commercial |
$2,744.82
|
| Rate for Payer: Cigna All Commercial |
$4,644.67
|
| Rate for Payer: CORVEL All Commercial |
$5,005.26
|
| Rate for Payer: Coventry All Commercial |
$4,736.16
|
| Rate for Payer: Encore All Commercial |
$4,954.13
|
| Rate for Payer: Frontpath All Commercial |
$4,951.44
|
| Rate for Payer: Humana ChoiceCare |
$4,648.43
|
| Rate for Payer: Humana Medicare |
$2,744.82
|
| Rate for Payer: Lucent All Commercial |
$2,744.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,843.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,036.50
|
| Rate for Payer: PHP All Commercial |
$4,081.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,098.98
|
| Rate for Payer: Sagamore Health Network All Products |
$4,154.90
|
| Rate for Payer: Signature Care EPO |
$4,467.06
|
| Rate for Payer: Signature Care PPO |
$4,736.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,574.70
|
| Rate for Payer: United Healthcare Commercial |
$4,241.02
|
| Rate for Payer: United Healthcare Medicare |
$1,776.06
|
|
|
HC ACU DORSAL PLATE NARR RT
|
Facility
OP
|
$5,382.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602855
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,005.26 |
| Rate for Payer: Aetna Commercial |
$4,542.41
|
| Rate for Payer: Aetna Medicare |
$1,776.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,776.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,090.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,364.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,042.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,953.67
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Centivo All Commercial |
$2,744.82
|
| Rate for Payer: Cigna All Commercial |
$4,644.67
|
| Rate for Payer: CORVEL All Commercial |
$5,005.26
|
| Rate for Payer: Coventry All Commercial |
$4,736.16
|
| Rate for Payer: Encore All Commercial |
$4,954.13
|
| Rate for Payer: Frontpath All Commercial |
$4,951.44
|
| Rate for Payer: Humana ChoiceCare |
$4,648.43
|
| Rate for Payer: Humana Medicare |
$2,744.82
|
| Rate for Payer: Lucent All Commercial |
$2,744.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,843.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,036.50
|
| Rate for Payer: PHP All Commercial |
$4,081.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,098.98
|
| Rate for Payer: Sagamore Health Network All Products |
$4,154.90
|
| Rate for Payer: Signature Care EPO |
$4,467.06
|
| Rate for Payer: Signature Care PPO |
$4,736.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,574.70
|
| Rate for Payer: United Healthcare Commercial |
$4,241.02
|
| Rate for Payer: United Healthcare Medicare |
$1,776.06
|
|
|
HC ACU DORSAL PLATE NARR RT
|
Facility
IP
|
$5,382.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602855
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,036.50 |
| Max. Negotiated Rate |
$5,005.26 |
| Rate for Payer: Aetna Commercial |
$4,650.05
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Cigna All Commercial |
$4,644.67
|
| Rate for Payer: CORVEL All Commercial |
$5,005.26
|
| Rate for Payer: Coventry All Commercial |
$4,736.16
|
| Rate for Payer: Encore All Commercial |
$4,954.13
|
| Rate for Payer: Frontpath All Commercial |
$4,951.44
|
| Rate for Payer: Humana ChoiceCare |
$4,648.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,843.80
|
| Rate for Payer: PHCS All Commercial |
$4,036.50
|
| Rate for Payer: PHP All Commercial |
$4,081.71
|
| Rate for Payer: Sagamore Health Network All Products |
$4,154.90
|
| Rate for Payer: Signature Care EPO |
$4,467.06
|
| Rate for Payer: Signature Care PPO |
$4,736.16
|
| Rate for Payer: United Healthcare Commercial |
$4,241.02
|
|
|
HC ACU DORSAL PLATE STND LT
|
Facility
IP
|
$5,382.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602852
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,036.50 |
| Max. Negotiated Rate |
$5,005.26 |
| Rate for Payer: Aetna Commercial |
$4,650.05
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Cigna All Commercial |
$4,644.67
|
| Rate for Payer: CORVEL All Commercial |
$5,005.26
|
| Rate for Payer: Coventry All Commercial |
$4,736.16
|
| Rate for Payer: Encore All Commercial |
$4,954.13
|
| Rate for Payer: Frontpath All Commercial |
$4,951.44
|
| Rate for Payer: Humana ChoiceCare |
$4,648.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,843.80
|
| Rate for Payer: PHCS All Commercial |
$4,036.50
|
| Rate for Payer: PHP All Commercial |
$4,081.71
|
| Rate for Payer: Sagamore Health Network All Products |
$4,154.90
|
| Rate for Payer: Signature Care EPO |
$4,467.06
|
| Rate for Payer: Signature Care PPO |
$4,736.16
|
| Rate for Payer: United Healthcare Commercial |
$4,241.02
|
|
|
HC ACU DORSAL PLATE STND LT
|
Facility
OP
|
$5,382.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602852
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,005.26 |
| Rate for Payer: Aetna Commercial |
$4,542.41
|
| Rate for Payer: Aetna Medicare |
$1,776.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,776.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,090.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,364.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,042.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,953.67
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Centivo All Commercial |
$2,744.82
|
| Rate for Payer: Cigna All Commercial |
$4,644.67
|
| Rate for Payer: CORVEL All Commercial |
$5,005.26
|
| Rate for Payer: Coventry All Commercial |
$4,736.16
|
| Rate for Payer: Encore All Commercial |
$4,954.13
|
| Rate for Payer: Frontpath All Commercial |
$4,951.44
|
| Rate for Payer: Humana ChoiceCare |
$4,648.43
|
| Rate for Payer: Humana Medicare |
$2,744.82
|
| Rate for Payer: Lucent All Commercial |
$2,744.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,843.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,036.50
|
| Rate for Payer: PHP All Commercial |
$4,081.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,098.98
|
| Rate for Payer: Sagamore Health Network All Products |
$4,154.90
|
| Rate for Payer: Signature Care EPO |
$4,467.06
|
| Rate for Payer: Signature Care PPO |
$4,736.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,574.70
|
| Rate for Payer: United Healthcare Commercial |
$4,241.02
|
| Rate for Payer: United Healthcare Medicare |
$1,776.06
|
|
|
HC ACU DORSAL PLATE STND RT
|
Facility
IP
|
$5,382.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602853
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,036.50 |
| Max. Negotiated Rate |
$5,005.26 |
| Rate for Payer: Aetna Commercial |
$4,650.05
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Cigna All Commercial |
$4,644.67
|
| Rate for Payer: CORVEL All Commercial |
$5,005.26
|
| Rate for Payer: Coventry All Commercial |
$4,736.16
|
| Rate for Payer: Encore All Commercial |
$4,954.13
|
| Rate for Payer: Frontpath All Commercial |
$4,951.44
|
| Rate for Payer: Humana ChoiceCare |
$4,648.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,843.80
|
| Rate for Payer: PHCS All Commercial |
$4,036.50
|
| Rate for Payer: PHP All Commercial |
$4,081.71
|
| Rate for Payer: Sagamore Health Network All Products |
$4,154.90
|
| Rate for Payer: Signature Care EPO |
$4,467.06
|
| Rate for Payer: Signature Care PPO |
$4,736.16
|
| Rate for Payer: United Healthcare Commercial |
$4,241.02
|
|
|
HC ACU DORSAL PLATE STND RT
|
Facility
OP
|
$5,382.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602853
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,005.26 |
| Rate for Payer: Aetna Commercial |
$4,542.41
|
| Rate for Payer: Aetna Medicare |
$1,776.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,776.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,090.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,364.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,042.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,953.67
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Cash Price |
$3,336.84
|
| Rate for Payer: Centivo All Commercial |
$2,744.82
|
| Rate for Payer: Cigna All Commercial |
$4,644.67
|
| Rate for Payer: CORVEL All Commercial |
$5,005.26
|
| Rate for Payer: Coventry All Commercial |
$4,736.16
|
| Rate for Payer: Encore All Commercial |
$4,954.13
|
| Rate for Payer: Frontpath All Commercial |
$4,951.44
|
| Rate for Payer: Humana ChoiceCare |
$4,648.43
|
| Rate for Payer: Humana Medicare |
$2,744.82
|
| Rate for Payer: Lucent All Commercial |
$2,744.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,843.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,036.50
|
| Rate for Payer: PHP All Commercial |
$4,081.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,098.98
|
| Rate for Payer: Sagamore Health Network All Products |
$4,154.90
|
| Rate for Payer: Signature Care EPO |
$4,467.06
|
| Rate for Payer: Signature Care PPO |
$4,736.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,574.70
|
| Rate for Payer: United Healthcare Commercial |
$4,241.02
|
| Rate for Payer: United Healthcare Medicare |
$1,776.06
|
|
|
HC ACU DORSAL RIM BUTT PLATE LT
|
Facility
IP
|
$4,950.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602859
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,712.50 |
| Max. Negotiated Rate |
$4,603.50 |
| Rate for Payer: Aetna Commercial |
$4,276.80
|
| Rate for Payer: Cash Price |
$3,069.00
|
| Rate for Payer: Cigna All Commercial |
$4,271.85
|
| Rate for Payer: CORVEL All Commercial |
$4,603.50
|
| Rate for Payer: Coventry All Commercial |
$4,356.00
|
| Rate for Payer: Encore All Commercial |
$4,556.48
|
| Rate for Payer: Frontpath All Commercial |
$4,554.00
|
| Rate for Payer: Humana ChoiceCare |
$4,275.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,455.00
|
| Rate for Payer: PHCS All Commercial |
$3,712.50
|
| Rate for Payer: PHP All Commercial |
$3,754.08
|
| Rate for Payer: Sagamore Health Network All Products |
$3,821.40
|
| Rate for Payer: Signature Care EPO |
$4,108.50
|
| Rate for Payer: Signature Care PPO |
$4,356.00
|
| Rate for Payer: United Healthcare Commercial |
$3,900.60
|
|
|
HC ACU DORSAL RIM BUTT PLATE LT
|
Facility
OP
|
$4,950.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602859
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,603.50 |
| Rate for Payer: Aetna Commercial |
$4,177.80
|
| Rate for Payer: Aetna Medicare |
$1,633.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,633.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,842.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,094.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,878.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,796.85
|
| Rate for Payer: Cash Price |
$3,069.00
|
| Rate for Payer: Cash Price |
$3,069.00
|
| Rate for Payer: Centivo All Commercial |
$2,524.50
|
| Rate for Payer: Cigna All Commercial |
$4,271.85
|
| Rate for Payer: CORVEL All Commercial |
$4,603.50
|
| Rate for Payer: Coventry All Commercial |
$4,356.00
|
| Rate for Payer: Encore All Commercial |
$4,556.48
|
| Rate for Payer: Frontpath All Commercial |
$4,554.00
|
| Rate for Payer: Humana ChoiceCare |
$4,275.32
|
| Rate for Payer: Humana Medicare |
$2,524.50
|
| Rate for Payer: Lucent All Commercial |
$2,524.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,455.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,712.50
|
| Rate for Payer: PHP All Commercial |
$3,754.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,930.50
|
| Rate for Payer: Sagamore Health Network All Products |
$3,821.40
|
| Rate for Payer: Signature Care EPO |
$4,108.50
|
| Rate for Payer: Signature Care PPO |
$4,356.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,207.50
|
| Rate for Payer: United Healthcare Commercial |
$3,900.60
|
| Rate for Payer: United Healthcare Medicare |
$1,633.50
|
|
|
HC ACU DORSAL RIM BUTT PLATE RT
|
Facility
OP
|
$4,950.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602858
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,603.50 |
| Rate for Payer: Aetna Commercial |
$4,177.80
|
| Rate for Payer: Aetna Medicare |
$1,633.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,633.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,842.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,094.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,878.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,796.85
|
| Rate for Payer: Cash Price |
$3,069.00
|
| Rate for Payer: Cash Price |
$3,069.00
|
| Rate for Payer: Centivo All Commercial |
$2,524.50
|
| Rate for Payer: Cigna All Commercial |
$4,271.85
|
| Rate for Payer: CORVEL All Commercial |
$4,603.50
|
| Rate for Payer: Coventry All Commercial |
$4,356.00
|
| Rate for Payer: Encore All Commercial |
$4,556.48
|
| Rate for Payer: Frontpath All Commercial |
$4,554.00
|
| Rate for Payer: Humana ChoiceCare |
$4,275.32
|
| Rate for Payer: Humana Medicare |
$2,524.50
|
| Rate for Payer: Lucent All Commercial |
$2,524.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,455.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,712.50
|
| Rate for Payer: PHP All Commercial |
$3,754.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,930.50
|
| Rate for Payer: Sagamore Health Network All Products |
$3,821.40
|
| Rate for Payer: Signature Care EPO |
$4,108.50
|
| Rate for Payer: Signature Care PPO |
$4,356.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,207.50
|
| Rate for Payer: United Healthcare Commercial |
$3,900.60
|
| Rate for Payer: United Healthcare Medicare |
$1,633.50
|
|
|
HC ACU DORSAL RIM BUTT PLATE RT
|
Facility
IP
|
$4,950.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602858
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,712.50 |
| Max. Negotiated Rate |
$4,603.50 |
| Rate for Payer: Aetna Commercial |
$4,276.80
|
| Rate for Payer: Cash Price |
$3,069.00
|
| Rate for Payer: Cigna All Commercial |
$4,271.85
|
| Rate for Payer: CORVEL All Commercial |
$4,603.50
|
| Rate for Payer: Coventry All Commercial |
$4,356.00
|
| Rate for Payer: Encore All Commercial |
$4,556.48
|
| Rate for Payer: Frontpath All Commercial |
$4,554.00
|
| Rate for Payer: Humana ChoiceCare |
$4,275.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,455.00
|
| Rate for Payer: PHCS All Commercial |
$3,712.50
|
| Rate for Payer: PHP All Commercial |
$3,754.08
|
| Rate for Payer: Sagamore Health Network All Products |
$3,821.40
|
| Rate for Payer: Signature Care EPO |
$4,108.50
|
| Rate for Payer: Signature Care PPO |
$4,356.00
|
| Rate for Payer: United Healthcare Commercial |
$3,900.60
|
|
|
HC ACU DRILL 3.5 X 5 QUICK REL
|
Facility
IP
|
$602.00
|
|
| Hospital Charge Code |
41603397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$451.50 |
| Max. Negotiated Rate |
$559.86 |
| Rate for Payer: Aetna Commercial |
$520.13
|
| Rate for Payer: Cash Price |
$373.24
|
| Rate for Payer: Cigna All Commercial |
$519.53
|
| Rate for Payer: CORVEL All Commercial |
$559.86
|
| Rate for Payer: Coventry All Commercial |
$529.76
|
| Rate for Payer: Encore All Commercial |
$554.14
|
| Rate for Payer: Frontpath All Commercial |
$553.84
|
| Rate for Payer: Humana ChoiceCare |
$519.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$541.80
|
| Rate for Payer: PHCS All Commercial |
$451.50
|
| Rate for Payer: PHP All Commercial |
$456.56
|
| Rate for Payer: Sagamore Health Network All Products |
$464.74
|
| Rate for Payer: Signature Care EPO |
$499.66
|
| Rate for Payer: Signature Care PPO |
$529.76
|
| Rate for Payer: United Healthcare Commercial |
$474.38
|
|
|
HC ACU DRILL 3.5 X 5 QUICK REL
|
Facility
OP
|
$602.00
|
|
| Hospital Charge Code |
41603397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$559.86 |
| Rate for Payer: Aetna Commercial |
$508.09
|
| Rate for Payer: Aetna Medicare |
$198.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$198.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$345.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$376.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$228.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$218.53
|
| Rate for Payer: Cash Price |
$373.24
|
| Rate for Payer: Cash Price |
$373.24
|
| Rate for Payer: Centivo All Commercial |
$307.02
|
| Rate for Payer: Cigna All Commercial |
$519.53
|
| Rate for Payer: CORVEL All Commercial |
$559.86
|
| Rate for Payer: Coventry All Commercial |
$529.76
|
| Rate for Payer: Encore All Commercial |
$554.14
|
| Rate for Payer: Frontpath All Commercial |
$553.84
|
| Rate for Payer: Humana ChoiceCare |
$519.95
|
| Rate for Payer: Humana Medicare |
$307.02
|
| Rate for Payer: Lucent All Commercial |
$307.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$541.80
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$451.50
|
| Rate for Payer: PHP All Commercial |
$456.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$234.78
|
| Rate for Payer: Sagamore Health Network All Products |
$464.74
|
| Rate for Payer: Signature Care EPO |
$499.66
|
| Rate for Payer: Signature Care PPO |
$529.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$511.70
|
| Rate for Payer: United Healthcare Commercial |
$474.38
|
| Rate for Payer: United Healthcare Medicare |
$198.66
|
|
|
HC ACU DRILL BIT POLARUS 2.8 SHRT
|
Facility
OP
|
$1,029.00
|
|
| Hospital Charge Code |
41603547
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$956.97 |
| Rate for Payer: Aetna Commercial |
$868.48
|
| Rate for Payer: Aetna Medicare |
$339.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$339.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$590.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$643.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$390.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$373.53
|
| Rate for Payer: Cash Price |
$637.98
|
| Rate for Payer: Cash Price |
$637.98
|
| Rate for Payer: Centivo All Commercial |
$524.79
|
| Rate for Payer: Cigna All Commercial |
$888.03
|
| Rate for Payer: CORVEL All Commercial |
$956.97
|
| Rate for Payer: Coventry All Commercial |
$905.52
|
| Rate for Payer: Encore All Commercial |
$947.19
|
| Rate for Payer: Frontpath All Commercial |
$946.68
|
| Rate for Payer: Humana ChoiceCare |
$888.75
|
| Rate for Payer: Humana Medicare |
$524.79
|
| Rate for Payer: Lucent All Commercial |
$524.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$926.10
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$771.75
|
| Rate for Payer: PHP All Commercial |
$780.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$401.31
|
| Rate for Payer: Sagamore Health Network All Products |
$794.39
|
| Rate for Payer: Signature Care EPO |
$854.07
|
| Rate for Payer: Signature Care PPO |
$905.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$874.65
|
| Rate for Payer: United Healthcare Commercial |
$810.85
|
| Rate for Payer: United Healthcare Medicare |
$339.57
|
|
|
HC ACU DRILL BIT POLARUS 2.8 SHRT
|
Facility
IP
|
$1,029.00
|
|
| Hospital Charge Code |
41603547
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$771.75 |
| Max. Negotiated Rate |
$956.97 |
| Rate for Payer: Aetna Commercial |
$889.06
|
| Rate for Payer: Cash Price |
$637.98
|
| Rate for Payer: Cigna All Commercial |
$888.03
|
| Rate for Payer: CORVEL All Commercial |
$956.97
|
| Rate for Payer: Coventry All Commercial |
$905.52
|
| Rate for Payer: Encore All Commercial |
$947.19
|
| Rate for Payer: Frontpath All Commercial |
$946.68
|
| Rate for Payer: Humana ChoiceCare |
$888.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$926.10
|
| Rate for Payer: PHCS All Commercial |
$771.75
|
| Rate for Payer: PHP All Commercial |
$780.39
|
| Rate for Payer: Sagamore Health Network All Products |
$794.39
|
| Rate for Payer: Signature Care EPO |
$854.07
|
| Rate for Payer: Signature Care PPO |
$905.52
|
| Rate for Payer: United Healthcare Commercial |
$810.85
|
|
|
HC ACU FRAG-LOC COMP SCREW
|
Facility
IP
|
$1,110.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602838
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$832.50 |
| Max. Negotiated Rate |
$1,032.30 |
| Rate for Payer: Aetna Commercial |
$959.04
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cigna All Commercial |
$957.93
|
| Rate for Payer: CORVEL All Commercial |
$1,032.30
|
| Rate for Payer: Coventry All Commercial |
$976.80
|
| Rate for Payer: Encore All Commercial |
$1,021.76
|
| Rate for Payer: Frontpath All Commercial |
$1,021.20
|
| Rate for Payer: Humana ChoiceCare |
$958.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$999.00
|
| Rate for Payer: PHCS All Commercial |
$832.50
|
| Rate for Payer: PHP All Commercial |
$841.82
|
| Rate for Payer: Sagamore Health Network All Products |
$856.92
|
| Rate for Payer: Signature Care EPO |
$921.30
|
| Rate for Payer: Signature Care PPO |
$976.80
|
| Rate for Payer: United Healthcare Commercial |
$874.68
|
|
|
HC ACU FRAG-LOC COMP SCREW
|
Facility
OP
|
$1,110.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602838
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$366.30 |
| Max. Negotiated Rate |
$1,032.30 |
| Rate for Payer: Aetna Commercial |
$936.84
|
| Rate for Payer: Aetna Medicare |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$637.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$693.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$421.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$402.93
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Centivo All Commercial |
$566.10
|
| Rate for Payer: Cigna All Commercial |
$957.93
|
| Rate for Payer: CORVEL All Commercial |
$1,032.30
|
| Rate for Payer: Coventry All Commercial |
$976.80
|
| Rate for Payer: Encore All Commercial |
$1,021.76
|
| Rate for Payer: Frontpath All Commercial |
$1,021.20
|
| Rate for Payer: Humana ChoiceCare |
$958.71
|
| Rate for Payer: Humana Medicare |
$566.10
|
| Rate for Payer: Lucent All Commercial |
$566.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$999.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$832.50
|
| Rate for Payer: PHP All Commercial |
$841.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$432.90
|
| Rate for Payer: Sagamore Health Network All Products |
$856.92
|
| Rate for Payer: Signature Care EPO |
$921.30
|
| Rate for Payer: Signature Care PPO |
$976.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$943.50
|
| Rate for Payer: United Healthcare Commercial |
$874.68
|
| Rate for Payer: United Healthcare Medicare |
$366.30
|
|
|
HC ACU FRAG-LOC COMP SCREW LONG
|
Facility
IP
|
$1,110.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$832.50 |
| Max. Negotiated Rate |
$1,032.30 |
| Rate for Payer: Aetna Commercial |
$959.04
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cigna All Commercial |
$957.93
|
| Rate for Payer: CORVEL All Commercial |
$1,032.30
|
| Rate for Payer: Coventry All Commercial |
$976.80
|
| Rate for Payer: Encore All Commercial |
$1,021.76
|
| Rate for Payer: Frontpath All Commercial |
$1,021.20
|
| Rate for Payer: Humana ChoiceCare |
$958.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$999.00
|
| Rate for Payer: PHCS All Commercial |
$832.50
|
| Rate for Payer: PHP All Commercial |
$841.82
|
| Rate for Payer: Sagamore Health Network All Products |
$856.92
|
| Rate for Payer: Signature Care EPO |
$921.30
|
| Rate for Payer: Signature Care PPO |
$976.80
|
| Rate for Payer: United Healthcare Commercial |
$874.68
|
|
|
HC ACU FRAG-LOC COMP SCREW LONG
|
Facility
OP
|
$1,110.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$366.30 |
| Max. Negotiated Rate |
$1,032.30 |
| Rate for Payer: Aetna Commercial |
$936.84
|
| Rate for Payer: Aetna Medicare |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$366.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$637.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$693.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$421.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$402.93
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Centivo All Commercial |
$566.10
|
| Rate for Payer: Cigna All Commercial |
$957.93
|
| Rate for Payer: CORVEL All Commercial |
$1,032.30
|
| Rate for Payer: Coventry All Commercial |
$976.80
|
| Rate for Payer: Encore All Commercial |
$1,021.76
|
| Rate for Payer: Frontpath All Commercial |
$1,021.20
|
| Rate for Payer: Humana ChoiceCare |
$958.71
|
| Rate for Payer: Humana Medicare |
$566.10
|
| Rate for Payer: Lucent All Commercial |
$566.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$999.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$832.50
|
| Rate for Payer: PHP All Commercial |
$841.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$432.90
|
| Rate for Payer: Sagamore Health Network All Products |
$856.92
|
| Rate for Payer: Signature Care EPO |
$921.30
|
| Rate for Payer: Signature Care PPO |
$976.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$943.50
|
| Rate for Payer: United Healthcare Commercial |
$874.68
|
| Rate for Payer: United Healthcare Medicare |
$366.30
|
|
|
HC ACU FRAG-LOC COMP SLEEVE
|
Facility
OP
|
$1,850.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602837
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,720.50 |
| Rate for Payer: Aetna Commercial |
$1,561.40
|
| Rate for Payer: Aetna Medicare |
$610.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$610.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,062.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,156.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$702.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$671.55
|
| Rate for Payer: Cash Price |
$1,147.00
|
| Rate for Payer: Cash Price |
$1,147.00
|
| Rate for Payer: Centivo All Commercial |
$943.50
|
| Rate for Payer: Cigna All Commercial |
$1,596.55
|
| Rate for Payer: CORVEL All Commercial |
$1,720.50
|
| Rate for Payer: Coventry All Commercial |
$1,628.00
|
| Rate for Payer: Encore All Commercial |
$1,702.92
|
| Rate for Payer: Frontpath All Commercial |
$1,702.00
|
| Rate for Payer: Humana ChoiceCare |
$1,597.84
|
| Rate for Payer: Humana Medicare |
$943.50
|
| Rate for Payer: Lucent All Commercial |
$943.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,665.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,387.50
|
| Rate for Payer: PHP All Commercial |
$1,403.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$721.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,428.20
|
| Rate for Payer: Signature Care EPO |
$1,535.50
|
| Rate for Payer: Signature Care PPO |
$1,628.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,572.50
|
| Rate for Payer: United Healthcare Commercial |
$1,457.80
|
| Rate for Payer: United Healthcare Medicare |
$610.50
|
|
|
HC ACU FRAG-LOC COMP SLEEVE
|
Facility
IP
|
$1,850.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602837
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,387.50 |
| Max. Negotiated Rate |
$1,720.50 |
| Rate for Payer: Aetna Commercial |
$1,598.40
|
| Rate for Payer: Cash Price |
$1,147.00
|
| Rate for Payer: Cigna All Commercial |
$1,596.55
|
| Rate for Payer: CORVEL All Commercial |
$1,720.50
|
| Rate for Payer: Coventry All Commercial |
$1,628.00
|
| Rate for Payer: Encore All Commercial |
$1,702.92
|
| Rate for Payer: Frontpath All Commercial |
$1,702.00
|
| Rate for Payer: Humana ChoiceCare |
$1,597.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,665.00
|
| Rate for Payer: PHCS All Commercial |
$1,387.50
|
| Rate for Payer: PHP All Commercial |
$1,403.04
|
| Rate for Payer: Sagamore Health Network All Products |
$1,428.20
|
| Rate for Payer: Signature Care EPO |
$1,535.50
|
| Rate for Payer: Signature Care PPO |
$1,628.00
|
| Rate for Payer: United Healthcare Commercial |
$1,457.80
|
|
|
HC ACU FRAGMENT PLATE 2.7MM
|
Facility
OP
|
$2,160.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602805
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,008.80 |
| Rate for Payer: Aetna Commercial |
$1,823.04
|
| Rate for Payer: Aetna Medicare |
$712.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$712.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,240.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,350.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$819.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$784.08
|
| Rate for Payer: Cash Price |
$1,339.20
|
| Rate for Payer: Cash Price |
$1,339.20
|
| Rate for Payer: Centivo All Commercial |
$1,101.60
|
| Rate for Payer: Cigna All Commercial |
$1,864.08
|
| Rate for Payer: CORVEL All Commercial |
$2,008.80
|
| Rate for Payer: Coventry All Commercial |
$1,900.80
|
| Rate for Payer: Encore All Commercial |
$1,988.28
|
| Rate for Payer: Frontpath All Commercial |
$1,987.20
|
| Rate for Payer: Humana ChoiceCare |
$1,865.59
|
| Rate for Payer: Humana Medicare |
$1,101.60
|
| Rate for Payer: Lucent All Commercial |
$1,101.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,944.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,620.00
|
| Rate for Payer: PHP All Commercial |
$1,638.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$842.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,667.52
|
| Rate for Payer: Signature Care EPO |
$1,792.80
|
| Rate for Payer: Signature Care PPO |
$1,900.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,836.00
|
| Rate for Payer: United Healthcare Commercial |
$1,702.08
|
| Rate for Payer: United Healthcare Medicare |
$712.80
|
|
|
HC ACU FRAGMENT PLATE 2.7MM
|
Facility
IP
|
$2,160.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602805
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,620.00 |
| Max. Negotiated Rate |
$2,008.80 |
| Rate for Payer: Aetna Commercial |
$1,866.24
|
| Rate for Payer: Cash Price |
$1,339.20
|
| Rate for Payer: Cigna All Commercial |
$1,864.08
|
| Rate for Payer: CORVEL All Commercial |
$2,008.80
|
| Rate for Payer: Coventry All Commercial |
$1,900.80
|
| Rate for Payer: Encore All Commercial |
$1,988.28
|
| Rate for Payer: Frontpath All Commercial |
$1,987.20
|
| Rate for Payer: Humana ChoiceCare |
$1,865.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,944.00
|
| Rate for Payer: PHCS All Commercial |
$1,620.00
|
| Rate for Payer: PHP All Commercial |
$1,638.14
|
| Rate for Payer: Sagamore Health Network All Products |
$1,667.52
|
| Rate for Payer: Signature Care EPO |
$1,792.80
|
| Rate for Payer: Signature Care PPO |
$1,900.80
|
| Rate for Payer: United Healthcare Commercial |
$1,702.08
|
|
|
HC ACU GUIDEWIRE 2.0X9 ST
|
Facility
OP
|
$168.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603546
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$55.44 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$141.79
|
| Rate for Payer: Aetna Medicare |
$55.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$55.44
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$96.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$105.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$63.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$60.98
|
| Rate for Payer: Cash Price |
$104.16
|
| Rate for Payer: Cash Price |
$104.16
|
| Rate for Payer: Centivo All Commercial |
$85.68
|
| Rate for Payer: Cigna All Commercial |
$144.98
|
| Rate for Payer: CORVEL All Commercial |
$156.24
|
| Rate for Payer: Coventry All Commercial |
$147.84
|
| Rate for Payer: Encore All Commercial |
$154.64
|
| Rate for Payer: Frontpath All Commercial |
$154.56
|
| Rate for Payer: Humana ChoiceCare |
$145.10
|
| Rate for Payer: Humana Medicare |
$85.68
|
| Rate for Payer: Lucent All Commercial |
$85.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$151.20
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$126.00
|
| Rate for Payer: PHP All Commercial |
$127.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$65.52
|
| Rate for Payer: Sagamore Health Network All Products |
$129.70
|
| Rate for Payer: Signature Care EPO |
$139.44
|
| Rate for Payer: Signature Care PPO |
$147.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$142.80
|
| Rate for Payer: United Healthcare Commercial |
$132.38
|
| Rate for Payer: United Healthcare Medicare |
$55.44
|
|
|
HC ACU GUIDEWIRE 2.0X9 ST
|
Facility
IP
|
$168.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603546
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$156.24 |
| Rate for Payer: Aetna Commercial |
$145.15
|
| Rate for Payer: Cash Price |
$104.16
|
| Rate for Payer: Cigna All Commercial |
$144.98
|
| Rate for Payer: CORVEL All Commercial |
$156.24
|
| Rate for Payer: Coventry All Commercial |
$147.84
|
| Rate for Payer: Encore All Commercial |
$154.64
|
| Rate for Payer: Frontpath All Commercial |
$154.56
|
| Rate for Payer: Humana ChoiceCare |
$145.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$151.20
|
| Rate for Payer: PHCS All Commercial |
$126.00
|
| Rate for Payer: PHP All Commercial |
$127.41
|
| Rate for Payer: Sagamore Health Network All Products |
$129.70
|
| Rate for Payer: Signature Care EPO |
$139.44
|
| Rate for Payer: Signature Care PPO |
$147.84
|
| Rate for Payer: United Healthcare Commercial |
$132.38
|
|
