Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
LAC REPAIR SIMPLE12.6-20CM, SNAGTE
Bloomington, IN
Negotiated rates from the hospital’s own file: 6 payers, 19 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna aetna medicare fee schedule · outpatient | $428 | $428 | — | — | — | $428 – $428 |
| 2 | Blue Cross Blue Shield bcbs medicaid - healthy indiana plan - hip fee schedule · outpatient | $428 | $428 | — | — | — | $428 – $428 |
| 3 | Blue Cross Blue Shield bcbs medicare fee schedule · outpatient | $428 | $428 | — | — | — | $428 – $428 |
| 4 | Caresource care source medicare fee schedule · outpatient | $428 | $428 | — | — | — | $428 – $428 |
| 5 | Tricare tricare fee schedule · outpatient | $428 | $428 | — | — | — | $428 – $428 |
| 6 | UnitedHealthcare uhc medicare fee schedule · outpatient | $428 | $428 | — | — | — | $428 – $428 |
| 7 | UnitedHealthcare uhc va ccn fee schedule · outpatient | $428 | $428 | — | — | — | $428 – $428 |
| 8 | Caresource care source exchange - qhp fee schedule · outpatient | $621 | $621 | — | — | — | $621 – $621 |
| 9 | Blue Cross Blue Shield bcbs workers compensation fee schedule · outpatient | $770 | $770 | — | — | — | $770 – $770 |
| 10 | MultiPlan multiplan workers compensation fee schedule · outpatient | $830 | $830 | — | — | — | $830 – $830 |
| 11 | Blue Cross Blue Shield bcbs commercial hmo case rate · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 12 | Blue Cross Blue Shield bcbs commercial insurance off exchange pathway case rate · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 13 | Blue Cross Blue Shield bcbs commercial insurance on exchange pathway case rate · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 14 | Blue Cross Blue Shield bcbs commercial ppo case rate · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 15 | Blue Cross Blue Shield bcbs commercial traditional case rate · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 16 | Blue Cross Blue Shield bcbs medicaid - hoosier healthwise case rate · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 17 | Caresource care source medicaid - healthy indiana plan - hip case rate · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 18 | Caresource care source medicaid - hoosier healthwise case rate · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 19 | UnitedHealthcare uhc medicaid chip - hoosier care case rate · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |