|
PR APPLY FOREARM SPLINT,STATIC
|
Professional
|
$120.54
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
z29125
|
| Min. Negotiated Rate |
$37.38 |
| Max. Negotiated Rate |
$95.70 |
| Rate for Payer: Aetna Medicare |
$37.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$95.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$95.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$42.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$41.12
|
| Rate for Payer: Cash Price |
$74.73
|
| Rate for Payer: Cash Price |
$74.73
|
| Rate for Payer: Coventry All Commercial |
$44.86
|
| Rate for Payer: Frontpath All Commercial |
$50.75
|
| Rate for Payer: Humana ChoiceCare |
$42.52
|
| Rate for Payer: Humana Medicare |
$37.38
|
| Rate for Payer: Lucent All Commercial |
$63.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$60.00
|
| Rate for Payer: PHCS All Commercial |
$90.40
|
| Rate for Payer: PHP All Commercial |
$63.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$37.38
|
| Rate for Payer: Signature Care EPO |
$89.25
|
| Rate for Payer: Signature Care PPO |
$89.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$56.00
|
| Rate for Payer: United Healthcare Commercial |
$45.88
|
| Rate for Payer: United Healthcare Medicare |
$37.38
|
|
|
PR APPLY HAND/WRIST CAST
|
Professional
|
$174.90
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
z29085
|
| Min. Negotiated Rate |
$62.16 |
| Max. Negotiated Rate |
$131.18 |
| Rate for Payer: Aetna Medicare |
$62.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$113.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$113.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$71.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$68.38
|
| Rate for Payer: Cash Price |
$108.44
|
| Rate for Payer: Cash Price |
$108.44
|
| Rate for Payer: Coventry All Commercial |
$74.59
|
| Rate for Payer: Frontpath All Commercial |
$86.11
|
| Rate for Payer: Humana ChoiceCare |
$65.57
|
| Rate for Payer: Humana Medicare |
$62.16
|
| Rate for Payer: Lucent All Commercial |
$105.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$99.00
|
| Rate for Payer: PHCS All Commercial |
$131.18
|
| Rate for Payer: PHP All Commercial |
$105.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$62.16
|
| Rate for Payer: Signature Care EPO |
$119.85
|
| Rate for Payer: Signature Care PPO |
$119.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$93.00
|
| Rate for Payer: United Healthcare Commercial |
$71.15
|
| Rate for Payer: United Healthcare Medicare |
$62.16
|
|
|
PR APPLY LONG ARM CAST
|
Professional
|
$175.82
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
z29065
|
| Min. Negotiated Rate |
$62.94 |
| Max. Negotiated Rate |
$131.86 |
| Rate for Payer: Aetna Medicare |
$62.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$115.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$115.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$72.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$69.23
|
| Rate for Payer: Cash Price |
$109.01
|
| Rate for Payer: Cash Price |
$109.01
|
| Rate for Payer: Coventry All Commercial |
$75.53
|
| Rate for Payer: Frontpath All Commercial |
$87.42
|
| Rate for Payer: Humana ChoiceCare |
$70.50
|
| Rate for Payer: Humana Medicare |
$62.94
|
| Rate for Payer: Lucent All Commercial |
$107.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$101.00
|
| Rate for Payer: PHCS All Commercial |
$131.86
|
| Rate for Payer: PHP All Commercial |
$106.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$62.94
|
| Rate for Payer: Signature Care EPO |
$121.55
|
| Rate for Payer: Signature Care PPO |
$121.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94.00
|
| Rate for Payer: United Healthcare Commercial |
$73.08
|
| Rate for Payer: United Healthcare Medicare |
$62.94
|
|
|
PR APPLY LONG ARM SPLINT
|
Professional
|
$150.40
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
z29105
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Medicare |
$38.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$112.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$112.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$44.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$42.68
|
| Rate for Payer: Cash Price |
$93.25
|
| Rate for Payer: Cash Price |
$93.25
|
| Rate for Payer: Coventry All Commercial |
$46.56
|
| Rate for Payer: Frontpath All Commercial |
$54.38
|
| Rate for Payer: Humana ChoiceCare |
$60.43
|
| Rate for Payer: Humana Medicare |
$38.80
|
| Rate for Payer: Lucent All Commercial |
$65.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$62.00
|
| Rate for Payer: PHCS All Commercial |
$112.80
|
| Rate for Payer: PHP All Commercial |
$65.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.80
|
| Rate for Payer: Signature Care EPO |
$117.30
|
| Rate for Payer: Signature Care PPO |
$117.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$58.00
|
| Rate for Payer: United Healthcare Commercial |
$64.40
|
| Rate for Payer: United Healthcare Medicare |
$38.80
|
|
|
PR APPLY LONG LEG CAST
|
Professional
|
$246.22
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
z29345
|
| Min. Negotiated Rate |
$91.92 |
| Max. Negotiated Rate |
$184.66 |
| Rate for Payer: Aetna Medicare |
$91.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$168.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$105.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$101.11
|
| Rate for Payer: Cash Price |
$152.66
|
| Rate for Payer: Cash Price |
$152.66
|
| Rate for Payer: Coventry All Commercial |
$110.30
|
| Rate for Payer: Frontpath All Commercial |
$127.61
|
| Rate for Payer: Humana ChoiceCare |
$107.62
|
| Rate for Payer: Humana Medicare |
$91.92
|
| Rate for Payer: Lucent All Commercial |
$156.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$147.00
|
| Rate for Payer: PHCS All Commercial |
$184.66
|
| Rate for Payer: PHP All Commercial |
$156.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$91.92
|
| Rate for Payer: Signature Care EPO |
$177.65
|
| Rate for Payer: Signature Care PPO |
$177.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$138.00
|
| Rate for Payer: United Healthcare Commercial |
$110.58
|
| Rate for Payer: United Healthcare Medicare |
$91.92
|
|
|
PR APPLY LONG LEG CAST,CYLINDER
|
Professional
|
$225.00
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
z29365
|
| Min. Negotiated Rate |
$80.43 |
| Max. Negotiated Rate |
$168.75 |
| Rate for Payer: Aetna Medicare |
$80.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$150.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$150.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$92.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$88.47
|
| Rate for Payer: Cash Price |
$139.50
|
| Rate for Payer: Cash Price |
$139.50
|
| Rate for Payer: Coventry All Commercial |
$96.52
|
| Rate for Payer: Frontpath All Commercial |
$111.72
|
| Rate for Payer: Humana ChoiceCare |
$92.90
|
| Rate for Payer: Humana Medicare |
$80.43
|
| Rate for Payer: Lucent All Commercial |
$136.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.00
|
| Rate for Payer: PHCS All Commercial |
$168.75
|
| Rate for Payer: PHP All Commercial |
$136.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$80.43
|
| Rate for Payer: Signature Care EPO |
$158.95
|
| Rate for Payer: Signature Care PPO |
$158.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$121.00
|
| Rate for Payer: United Healthcare Commercial |
$95.85
|
| Rate for Payer: United Healthcare Medicare |
$80.43
|
|
|
PR APPLY LONG LEG SPLINT
|
Professional
|
$160.84
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
z29505
|
| Min. Negotiated Rate |
$48.16 |
| Max. Negotiated Rate |
$120.63 |
| Rate for Payer: Aetna Medicare |
$48.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$100.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$100.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$55.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$52.98
|
| Rate for Payer: Cash Price |
$99.72
|
| Rate for Payer: Cash Price |
$99.72
|
| Rate for Payer: Coventry All Commercial |
$57.79
|
| Rate for Payer: Frontpath All Commercial |
$65.21
|
| Rate for Payer: Humana ChoiceCare |
$49.44
|
| Rate for Payer: Humana Medicare |
$48.16
|
| Rate for Payer: Lucent All Commercial |
$81.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.00
|
| Rate for Payer: PHCS All Commercial |
$120.63
|
| Rate for Payer: PHP All Commercial |
$81.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$48.16
|
| Rate for Payer: Signature Care EPO |
$103.70
|
| Rate for Payer: Signature Care PPO |
$103.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$72.00
|
| Rate for Payer: United Healthcare Commercial |
$51.89
|
| Rate for Payer: United Healthcare Medicare |
$48.16
|
|
|
PR APPLY LOWER LEG SPLINT
|
Professional
|
$130.64
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
z29515
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$97.98 |
| Rate for Payer: Aetna Medicare |
$45.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$94.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$94.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$52.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$50.56
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Coventry All Commercial |
$55.15
|
| Rate for Payer: Frontpath All Commercial |
$62.89
|
| Rate for Payer: Humana ChoiceCare |
$51.78
|
| Rate for Payer: Humana Medicare |
$45.96
|
| Rate for Payer: Lucent All Commercial |
$78.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$74.00
|
| Rate for Payer: PHCS All Commercial |
$97.98
|
| Rate for Payer: PHP All Commercial |
$78.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$45.96
|
| Rate for Payer: Signature Care EPO |
$90.10
|
| Rate for Payer: Signature Care PPO |
$90.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69.00
|
| Rate for Payer: United Healthcare Commercial |
$54.38
|
| Rate for Payer: United Healthcare Medicare |
$45.96
|
|
|
PR APPLY OF CLUBFOOT CAST
|
Professional
|
$266.46
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
z29450
|
| Min. Negotiated Rate |
$106.00 |
| Max. Negotiated Rate |
$202.30 |
| Rate for Payer: Aetna Medicare |
$106.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$187.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$187.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$121.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$116.60
|
| Rate for Payer: Cash Price |
$165.21
|
| Rate for Payer: Cash Price |
$165.21
|
| Rate for Payer: Coventry All Commercial |
$127.20
|
| Rate for Payer: Frontpath All Commercial |
$147.77
|
| Rate for Payer: Humana ChoiceCare |
$139.06
|
| Rate for Payer: Humana Medicare |
$106.00
|
| Rate for Payer: Lucent All Commercial |
$180.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$170.00
|
| Rate for Payer: PHCS All Commercial |
$199.84
|
| Rate for Payer: PHP All Commercial |
$180.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$106.00
|
| Rate for Payer: Signature Care EPO |
$202.30
|
| Rate for Payer: Signature Care PPO |
$202.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$159.00
|
| Rate for Payer: United Healthcare Commercial |
$139.55
|
| Rate for Payer: United Healthcare Medicare |
$106.00
|
|
|
PR APPLY SHORT LEG CAST
|
Professional
|
$145.82
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
z29405
|
| Min. Negotiated Rate |
$54.36 |
| Max. Negotiated Rate |
$116.45 |
| Rate for Payer: Aetna Medicare |
$54.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$110.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$110.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$62.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$59.80
|
| Rate for Payer: Cash Price |
$90.41
|
| Rate for Payer: Cash Price |
$90.41
|
| Rate for Payer: Coventry All Commercial |
$65.23
|
| Rate for Payer: Frontpath All Commercial |
$73.93
|
| Rate for Payer: Humana ChoiceCare |
$68.29
|
| Rate for Payer: Humana Medicare |
$54.36
|
| Rate for Payer: Lucent All Commercial |
$92.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$87.00
|
| Rate for Payer: PHCS All Commercial |
$109.36
|
| Rate for Payer: PHP All Commercial |
$92.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$54.36
|
| Rate for Payer: Signature Care EPO |
$116.45
|
| Rate for Payer: Signature Care PPO |
$116.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$82.00
|
| Rate for Payer: United Healthcare Commercial |
$70.28
|
| Rate for Payer: United Healthcare Medicare |
$54.36
|
|
|
PR APPLY SHORT LEG CAST,WALKER
|
Professional
|
$137.36
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
z29425
|
| Min. Negotiated Rate |
$50.64 |
| Max. Negotiated Rate |
$119.94 |
| Rate for Payer: Aetna Medicare |
$50.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$119.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$119.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.70
|
| Rate for Payer: Cash Price |
$85.16
|
| Rate for Payer: Cash Price |
$85.16
|
| Rate for Payer: Coventry All Commercial |
$60.77
|
| Rate for Payer: Frontpath All Commercial |
$68.85
|
| Rate for Payer: Humana ChoiceCare |
$76.22
|
| Rate for Payer: Humana Medicare |
$50.64
|
| Rate for Payer: Lucent All Commercial |
$86.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$81.00
|
| Rate for Payer: PHCS All Commercial |
$103.02
|
| Rate for Payer: PHP All Commercial |
$85.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.64
|
| Rate for Payer: Signature Care EPO |
$118.63
|
| Rate for Payer: Signature Care PPO |
$118.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$76.00
|
| Rate for Payer: United Healthcare Commercial |
$77.73
|
| Rate for Payer: United Healthcare Medicare |
$50.64
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/>100SCM 1ST 100SCM
|
Professional
|
$563.26
|
|
|
Service Code
|
CPT 15273
|
| Hospital Charge Code |
z15273
|
| Min. Negotiated Rate |
$180.01 |
| Max. Negotiated Rate |
$422.44 |
| Rate for Payer: Aetna Medicare |
$180.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$207.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$198.01
|
| Rate for Payer: Cash Price |
$349.22
|
| Rate for Payer: Cash Price |
$349.22
|
| Rate for Payer: Coventry All Commercial |
$216.01
|
| Rate for Payer: Frontpath All Commercial |
$258.04
|
| Rate for Payer: Humana ChoiceCare |
$195.84
|
| Rate for Payer: Humana Medicare |
$180.01
|
| Rate for Payer: Lucent All Commercial |
$306.02
|
| Rate for Payer: PHCS All Commercial |
$422.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$180.01
|
| Rate for Payer: United Healthcare Commercial |
$258.55
|
| Rate for Payer: United Healthcare Medicare |
$180.01
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM
|
Professional
|
$279.58
|
|
|
Service Code
|
CPT 15271
|
| Hospital Charge Code |
z15271
|
| Min. Negotiated Rate |
$77.53 |
| Max. Negotiated Rate |
$209.68 |
| Rate for Payer: Aetna Medicare |
$77.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$89.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$85.28
|
| Rate for Payer: Cash Price |
$173.34
|
| Rate for Payer: Cash Price |
$173.34
|
| Rate for Payer: Coventry All Commercial |
$93.04
|
| Rate for Payer: Frontpath All Commercial |
$108.71
|
| Rate for Payer: Humana ChoiceCare |
$82.35
|
| Rate for Payer: Humana Medicare |
$77.53
|
| Rate for Payer: Lucent All Commercial |
$131.80
|
| Rate for Payer: PHCS All Commercial |
$209.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$77.53
|
| Rate for Payer: United Healthcare Commercial |
$108.73
|
| Rate for Payer: United Healthcare Medicare |
$77.53
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/>100SCM ADL 100SCM
|
Professional
|
$148.90
|
|
|
Service Code
|
CPT 15274
|
| Hospital Charge Code |
z15274
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$111.68 |
| Rate for Payer: Aetna Medicare |
$40.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$46.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$44.89
|
| Rate for Payer: Cash Price |
$92.32
|
| Rate for Payer: Cash Price |
$92.32
|
| Rate for Payer: Coventry All Commercial |
$48.97
|
| Rate for Payer: Frontpath All Commercial |
$59.63
|
| Rate for Payer: Humana ChoiceCare |
$41.88
|
| Rate for Payer: Humana Medicare |
$40.81
|
| Rate for Payer: Lucent All Commercial |
$69.38
|
| Rate for Payer: PHCS All Commercial |
$111.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.81
|
| Rate for Payer: United Healthcare Commercial |
$55.33
|
| Rate for Payer: United Healthcare Medicare |
$40.81
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM
|
Professional
|
$44.16
|
|
|
Service Code
|
CPT 15272
|
| Hospital Charge Code |
z15272
|
| Min. Negotiated Rate |
$15.53 |
| Max. Negotiated Rate |
$33.12 |
| Rate for Payer: Aetna Medicare |
$15.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.08
|
| Rate for Payer: Cash Price |
$27.38
|
| Rate for Payer: Cash Price |
$27.38
|
| Rate for Payer: Coventry All Commercial |
$18.64
|
| Rate for Payer: Frontpath All Commercial |
$23.22
|
| Rate for Payer: Humana ChoiceCare |
$16.47
|
| Rate for Payer: Humana Medicare |
$15.53
|
| Rate for Payer: Lucent All Commercial |
$26.40
|
| Rate for Payer: PHCS All Commercial |
$33.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$15.53
|
| Rate for Payer: United Healthcare Commercial |
$21.75
|
| Rate for Payer: United Healthcare Medicare |
$15.53
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US
|
Professional
|
$201.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
z20605
|
| Min. Negotiated Rate |
$34.53 |
| Max. Negotiated Rate |
$150.75 |
| Rate for Payer: Aetna Medicare |
$34.53
|
| Rate for Payer: Aetna Medicare |
$34.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.98
|
| Rate for Payer: Cash Price |
$62.31
|
| Rate for Payer: Cash Price |
$62.31
|
| Rate for Payer: Cash Price |
$124.62
|
| Rate for Payer: Cash Price |
$124.62
|
| Rate for Payer: Coventry All Commercial |
$41.44
|
| Rate for Payer: Coventry All Commercial |
$41.44
|
| Rate for Payer: Frontpath All Commercial |
$48.16
|
| Rate for Payer: Frontpath All Commercial |
$48.16
|
| Rate for Payer: Humana ChoiceCare |
$45.45
|
| Rate for Payer: Humana ChoiceCare |
$45.45
|
| Rate for Payer: Humana Medicare |
$34.53
|
| Rate for Payer: Humana Medicare |
$34.53
|
| Rate for Payer: Lucent All Commercial |
$58.70
|
| Rate for Payer: Lucent All Commercial |
$58.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.00
|
| Rate for Payer: PHCS All Commercial |
$75.38
|
| Rate for Payer: PHCS All Commercial |
$150.75
|
| Rate for Payer: PHP All Commercial |
$58.62
|
| Rate for Payer: PHP All Commercial |
$58.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.53
|
| Rate for Payer: Signature Care EPO |
$80.90
|
| Rate for Payer: Signature Care EPO |
$80.90
|
| Rate for Payer: Signature Care PPO |
$80.90
|
| Rate for Payer: Signature Care PPO |
$80.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$52.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$52.00
|
| Rate for Payer: United Healthcare Commercial |
$46.89
|
| Rate for Payer: United Healthcare Commercial |
$46.89
|
| Rate for Payer: United Healthcare Medicare |
$34.53
|
| Rate for Payer: United Healthcare Medicare |
$34.53
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US
|
Professional
|
$163.26
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
z20606
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$122.44 |
| Rate for Payer: Aetna Medicare |
$48.78
|
| Rate for Payer: Aetna Medicare |
$48.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$86.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$86.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.66
|
| Rate for Payer: Cash Price |
$202.44
|
| Rate for Payer: Cash Price |
$101.22
|
| Rate for Payer: Cash Price |
$202.44
|
| Rate for Payer: Cash Price |
$101.22
|
| Rate for Payer: Coventry All Commercial |
$58.54
|
| Rate for Payer: Coventry All Commercial |
$58.54
|
| Rate for Payer: Frontpath All Commercial |
$67.24
|
| Rate for Payer: Frontpath All Commercial |
$67.24
|
| Rate for Payer: Humana ChoiceCare |
$59.03
|
| Rate for Payer: Humana ChoiceCare |
$59.03
|
| Rate for Payer: Humana Medicare |
$48.78
|
| Rate for Payer: Humana Medicare |
$48.78
|
| Rate for Payer: Lucent All Commercial |
$82.93
|
| Rate for Payer: Lucent All Commercial |
$82.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$78.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$78.00
|
| Rate for Payer: PHCS All Commercial |
$122.44
|
| Rate for Payer: PHCS All Commercial |
$244.89
|
| Rate for Payer: PHP All Commercial |
$82.82
|
| Rate for Payer: PHP All Commercial |
$82.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$48.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$48.78
|
| Rate for Payer: Signature Care EPO |
$103.73
|
| Rate for Payer: Signature Care EPO |
$103.73
|
| Rate for Payer: Signature Care PPO |
$103.73
|
| Rate for Payer: Signature Care PPO |
$103.73
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$73.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$73.00
|
| Rate for Payer: United Healthcare Commercial |
$64.46
|
| Rate for Payer: United Healthcare Commercial |
$64.46
|
| Rate for Payer: United Healthcare Medicare |
$48.78
|
| Rate for Payer: United Healthcare Medicare |
$48.78
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
$234.88
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
z20610
|
| Min. Negotiated Rate |
$41.98 |
| Max. Negotiated Rate |
$176.16 |
| Rate for Payer: Aetna Medicare |
$41.98
|
| Rate for Payer: Aetna Medicare |
$41.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$89.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$89.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.18
|
| Rate for Payer: Cash Price |
$72.81
|
| Rate for Payer: Cash Price |
$72.81
|
| Rate for Payer: Cash Price |
$145.63
|
| Rate for Payer: Cash Price |
$145.63
|
| Rate for Payer: Coventry All Commercial |
$50.38
|
| Rate for Payer: Coventry All Commercial |
$50.38
|
| Rate for Payer: Frontpath All Commercial |
$58.70
|
| Rate for Payer: Frontpath All Commercial |
$58.70
|
| Rate for Payer: Humana ChoiceCare |
$53.20
|
| Rate for Payer: Humana ChoiceCare |
$53.20
|
| Rate for Payer: Humana Medicare |
$41.98
|
| Rate for Payer: Humana Medicare |
$41.98
|
| Rate for Payer: Lucent All Commercial |
$71.37
|
| Rate for Payer: Lucent All Commercial |
$71.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.00
|
| Rate for Payer: PHCS All Commercial |
$176.16
|
| Rate for Payer: PHCS All Commercial |
$88.08
|
| Rate for Payer: PHP All Commercial |
$65.53
|
| Rate for Payer: PHP All Commercial |
$65.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.98
|
| Rate for Payer: Signature Care EPO |
$97.50
|
| Rate for Payer: Signature Care EPO |
$97.50
|
| Rate for Payer: Signature Care PPO |
$97.50
|
| Rate for Payer: Signature Care PPO |
$97.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$63.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$63.00
|
| Rate for Payer: United Healthcare Commercial |
$55.96
|
| Rate for Payer: United Healthcare Commercial |
$55.96
|
| Rate for Payer: United Healthcare Medicare |
$41.98
|
| Rate for Payer: United Healthcare Medicare |
$41.98
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
$363.36
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
z20611
|
| Min. Negotiated Rate |
$55.76 |
| Max. Negotiated Rate |
$272.52 |
| Rate for Payer: Aetna Medicare |
$55.76
|
| Rate for Payer: Aetna Medicare |
$55.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$99.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$99.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$61.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$61.34
|
| Rate for Payer: Cash Price |
$225.28
|
| Rate for Payer: Cash Price |
$112.64
|
| Rate for Payer: Cash Price |
$225.28
|
| Rate for Payer: Cash Price |
$112.64
|
| Rate for Payer: Coventry All Commercial |
$66.91
|
| Rate for Payer: Coventry All Commercial |
$66.91
|
| Rate for Payer: Frontpath All Commercial |
$76.91
|
| Rate for Payer: Frontpath All Commercial |
$76.91
|
| Rate for Payer: Humana ChoiceCare |
$68.97
|
| Rate for Payer: Humana ChoiceCare |
$68.97
|
| Rate for Payer: Humana Medicare |
$55.76
|
| Rate for Payer: Humana Medicare |
$55.76
|
| Rate for Payer: Lucent All Commercial |
$94.79
|
| Rate for Payer: Lucent All Commercial |
$94.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.00
|
| Rate for Payer: PHCS All Commercial |
$136.26
|
| Rate for Payer: PHCS All Commercial |
$272.52
|
| Rate for Payer: PHP All Commercial |
$94.65
|
| Rate for Payer: PHP All Commercial |
$94.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.76
|
| Rate for Payer: Signature Care EPO |
$79.54
|
| Rate for Payer: Signature Care EPO |
$79.54
|
| Rate for Payer: Signature Care PPO |
$79.54
|
| Rate for Payer: Signature Care PPO |
$79.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$84.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$84.00
|
| Rate for Payer: United Healthcare Commercial |
$75.29
|
| Rate for Payer: United Healthcare Commercial |
$75.29
|
| Rate for Payer: United Healthcare Medicare |
$55.76
|
| Rate for Payer: United Healthcare Medicare |
$55.76
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
$96.76
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
z20600
|
| Min. Negotiated Rate |
$33.22 |
| Max. Negotiated Rate |
$74.80 |
| Rate for Payer: Cash Price |
$59.99
|
| Rate for Payer: Aetna Medicare |
$33.22
|
| Rate for Payer: Aetna Medicare |
$33.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$69.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$69.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$38.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$38.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.54
|
| Rate for Payer: Cash Price |
$119.98
|
| Rate for Payer: Cash Price |
$119.98
|
| Rate for Payer: Cash Price |
$59.99
|
| Rate for Payer: Coventry All Commercial |
$39.86
|
| Rate for Payer: Coventry All Commercial |
$39.86
|
| Rate for Payer: Frontpath All Commercial |
$46.45
|
| Rate for Payer: Frontpath All Commercial |
$46.45
|
| Rate for Payer: Humana ChoiceCare |
$44.18
|
| Rate for Payer: Humana ChoiceCare |
$44.18
|
| Rate for Payer: Humana Medicare |
$33.22
|
| Rate for Payer: Humana Medicare |
$33.22
|
| Rate for Payer: Lucent All Commercial |
$56.47
|
| Rate for Payer: Lucent All Commercial |
$56.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$53.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$53.00
|
| Rate for Payer: PHCS All Commercial |
$145.14
|
| Rate for Payer: PHCS All Commercial |
$72.57
|
| Rate for Payer: PHP All Commercial |
$56.40
|
| Rate for Payer: PHP All Commercial |
$56.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$33.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$33.22
|
| Rate for Payer: Signature Care EPO |
$74.80
|
| Rate for Payer: Signature Care EPO |
$74.80
|
| Rate for Payer: Signature Care PPO |
$74.80
|
| Rate for Payer: Signature Care PPO |
$74.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$50.00
|
| Rate for Payer: United Healthcare Commercial |
$45.16
|
| Rate for Payer: United Healthcare Commercial |
$45.16
|
| Rate for Payer: United Healthcare Medicare |
$33.22
|
| Rate for Payer: United Healthcare Medicare |
$33.22
|
|
|
PR ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
$301.08
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
z20604
|
| Min. Negotiated Rate |
$43.19 |
| Max. Negotiated Rate |
$225.81 |
| Rate for Payer: Aetna Medicare |
$43.19
|
| Rate for Payer: Aetna Medicare |
$43.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$78.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$78.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.51
|
| Rate for Payer: Cash Price |
$186.67
|
| Rate for Payer: Cash Price |
$93.33
|
| Rate for Payer: Cash Price |
$93.33
|
| Rate for Payer: Cash Price |
$186.67
|
| Rate for Payer: Coventry All Commercial |
$51.83
|
| Rate for Payer: Coventry All Commercial |
$51.83
|
| Rate for Payer: Frontpath All Commercial |
$59.75
|
| Rate for Payer: Frontpath All Commercial |
$59.75
|
| Rate for Payer: Humana ChoiceCare |
$51.71
|
| Rate for Payer: Humana ChoiceCare |
$51.71
|
| Rate for Payer: Humana Medicare |
$43.19
|
| Rate for Payer: Humana Medicare |
$43.19
|
| Rate for Payer: Lucent All Commercial |
$73.42
|
| Rate for Payer: Lucent All Commercial |
$73.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$69.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$69.00
|
| Rate for Payer: PHCS All Commercial |
$225.81
|
| Rate for Payer: PHCS All Commercial |
$112.90
|
| Rate for Payer: PHP All Commercial |
$73.32
|
| Rate for Payer: PHP All Commercial |
$73.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.19
|
| Rate for Payer: Signature Care EPO |
$102.54
|
| Rate for Payer: Signature Care EPO |
$102.54
|
| Rate for Payer: Signature Care PPO |
$102.54
|
| Rate for Payer: Signature Care PPO |
$102.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$65.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$65.00
|
| Rate for Payer: United Healthcare Commercial |
$56.49
|
| Rate for Payer: United Healthcare Commercial |
$56.49
|
| Rate for Payer: United Healthcare Medicare |
$43.19
|
| Rate for Payer: United Healthcare Medicare |
$43.19
|
|
|
PR ARTHRODESIS,ANKLE,OPEN
|
Professional
|
$1,835.82
|
|
|
Service Code
|
CPT 27870
|
| Hospital Charge Code |
z27870
|
| Min. Negotiated Rate |
$941.02 |
| Max. Negotiated Rate |
$1,599.73 |
| Rate for Payer: Aetna Medicare |
$941.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,352.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,352.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,082.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,035.12
|
| Rate for Payer: Cash Price |
$1,138.21
|
| Rate for Payer: Cash Price |
$1,138.21
|
| Rate for Payer: Coventry All Commercial |
$1,129.22
|
| Rate for Payer: Frontpath All Commercial |
$1,313.78
|
| Rate for Payer: Humana ChoiceCare |
$1,068.63
|
| Rate for Payer: Humana Medicare |
$941.02
|
| Rate for Payer: Lucent All Commercial |
$1,599.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,506.00
|
| Rate for Payer: PHCS All Commercial |
$1,376.86
|
| Rate for Payer: PHP All Commercial |
$1,597.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$941.02
|
| Rate for Payer: Signature Care EPO |
$1,431.40
|
| Rate for Payer: Signature Care PPO |
$1,431.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,412.00
|
| Rate for Payer: United Healthcare Commercial |
$1,150.75
|
| Rate for Payer: United Healthcare Medicare |
$941.02
|
|
|
PR ARTHROPLASTY PATELLA WITH IMPLANT
|
Professional
|
$1,525.00
|
|
|
Service Code
|
CPT 27438
|
| Hospital Charge Code |
z27438
|
| Min. Negotiated Rate |
$781.56 |
| Max. Negotiated Rate |
$1,328.65 |
| Rate for Payer: Aetna Medicare |
$781.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,135.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,135.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$898.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$859.72
|
| Rate for Payer: Cash Price |
$945.50
|
| Rate for Payer: Cash Price |
$945.50
|
| Rate for Payer: Coventry All Commercial |
$937.87
|
| Rate for Payer: Frontpath All Commercial |
$1,092.03
|
| Rate for Payer: Humana ChoiceCare |
$865.11
|
| Rate for Payer: Humana Medicare |
$781.56
|
| Rate for Payer: Lucent All Commercial |
$1,328.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,251.00
|
| Rate for Payer: PHCS All Commercial |
$1,143.75
|
| Rate for Payer: PHP All Commercial |
$1,326.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$781.56
|
| Rate for Payer: Signature Care EPO |
$1,152.60
|
| Rate for Payer: Signature Care PPO |
$1,152.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,172.00
|
| Rate for Payer: United Healthcare Commercial |
$913.41
|
| Rate for Payer: United Healthcare Medicare |
$781.56
|
|
|
PR ARTHROSCOPY SHOULDER SURGICAL BICEPS TENODESIS
|
Professional
|
$1,660.70
|
|
|
Service Code
|
CPT 29828
|
| Hospital Charge Code |
z29828
|
| Min. Negotiated Rate |
$851.11 |
| Max. Negotiated Rate |
$1,446.89 |
| Rate for Payer: Aetna Medicare |
$851.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,251.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,251.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$978.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$936.22
|
| Rate for Payer: Cash Price |
$1,029.63
|
| Rate for Payer: Cash Price |
$1,029.63
|
| Rate for Payer: Coventry All Commercial |
$1,021.33
|
| Rate for Payer: Frontpath All Commercial |
$1,190.80
|
| Rate for Payer: Humana ChoiceCare |
$878.64
|
| Rate for Payer: Humana Medicare |
$851.11
|
| Rate for Payer: Lucent All Commercial |
$1,446.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,362.00
|
| Rate for Payer: PHCS All Commercial |
$1,245.52
|
| Rate for Payer: PHP All Commercial |
$1,444.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$851.11
|
| Rate for Payer: Signature Care EPO |
$1,192.88
|
| Rate for Payer: Signature Care PPO |
$1,192.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,277.00
|
| Rate for Payer: United Healthcare Commercial |
$994.81
|
| Rate for Payer: United Healthcare Medicare |
$851.11
|
|
|
PR ARTHROTOMY/EXPLORE/TREAT KNEE JOINT
|
Professional
|
$871.86
|
|
|
Service Code
|
CPT 27331
|
| Hospital Charge Code |
z27331
|
| Min. Negotiated Rate |
$446.82 |
| Max. Negotiated Rate |
$759.59 |
| Rate for Payer: Aetna Medicare |
$446.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$513.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$491.50
|
| Rate for Payer: Cash Price |
$540.55
|
| Rate for Payer: Cash Price |
$540.55
|
| Rate for Payer: Coventry All Commercial |
$536.18
|
| Rate for Payer: Frontpath All Commercial |
$617.49
|
| Rate for Payer: Humana ChoiceCare |
$494.82
|
| Rate for Payer: Humana Medicare |
$446.82
|
| Rate for Payer: Lucent All Commercial |
$759.59
|
| Rate for Payer: PHCS All Commercial |
$653.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$446.82
|
| Rate for Payer: United Healthcare Commercial |
$504.30
|
| Rate for Payer: United Healthcare Medicare |
$446.82
|
|
