|
ANGIOGRAPH
|
Facility
|
OP
|
$7,388.00
|
|
| Hospital Charge Code |
2959803
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,151.39 |
| Max. Negotiated Rate |
$7,068.84 |
| Rate for Payer: Aetna Commercial |
$6,915.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,607.83
|
| Rate for Payer: Aetna Managed Medicare |
$2,151.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,994.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,841.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,688.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,072.27
|
| Rate for Payer: Cash Price |
$2,216.40
|
| Rate for Payer: Cigna Commercial |
$7,068.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,299.82
|
| Rate for Payer: Health EOS Commercial |
$6,838.33
|
| Rate for Payer: HFN Commercial |
$7,068.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,762.64
|
| Rate for Payer: Multiplan Commercial |
$6,146.82
|
| Rate for Payer: NAPHCARE Commercial |
$4,610.11
|
| Rate for Payer: Preferred Network Access Commercial |
$7,068.84
|
| Rate for Payer: Quartz Beloit One Network |
$3,764.92
|
| Rate for Payer: Quartz Commercial |
$4,994.29
|
| Rate for Payer: Quartz Medicare Advantage |
$4,610.11
|
| Rate for Payer: The Alliance Commercial |
$3,841.76
|
| Rate for Payer: WEA Trust Commercial |
$4,225.94
|
| Rate for Payer: WPS Commercial |
$5,690.98
|
|
|
ANGIOGRAPH
|
Facility
|
IP
|
$7,388.00
|
|
| Hospital Charge Code |
2959803
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,764.92 |
| Max. Negotiated Rate |
$7,068.84 |
| Rate for Payer: Aetna Commercial |
$6,915.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,607.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,072.27
|
| Rate for Payer: Cash Price |
$2,216.40
|
| Rate for Payer: Cigna Commercial |
$7,068.84
|
| Rate for Payer: Health EOS Commercial |
$6,838.33
|
| Rate for Payer: HFN Commercial |
$7,068.84
|
| Rate for Payer: Multiplan Commercial |
$6,146.82
|
| Rate for Payer: Preferred Network Access Commercial |
$7,068.84
|
| Rate for Payer: Quartz Beloit One Network |
$3,764.92
|
| Rate for Payer: Quartz Commercial |
$4,610.11
|
| Rate for Payer: WEA Trust Commercial |
$4,225.94
|
| Rate for Payer: WPS Commercial |
$5,690.98
|
|
|
ANGIOGRAPHY INTERNAL MAMMARY RS&I 7575626
|
Professional
|
Both
|
$627.00
|
|
|
Service Code
|
CPT 75756 26
|
| Hospital Charge Code |
5381661
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$52.82 |
| Max. Negotiated Rate |
$619.48 |
| Rate for Payer: Aetna Commercial |
$619.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$560.79
|
| Rate for Payer: Aetna Managed Medicare |
$52.82
|
| Rate for Payer: Anthem Medicare Advantage |
$52.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$52.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$52.82
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cigna Commercial |
$619.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$326.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$52.82
|
| Rate for Payer: Health EOS Commercial |
$593.39
|
| Rate for Payer: HFN Commercial |
$619.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$191.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$191.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$52.82
|
| Rate for Payer: Multiplan Commercial |
$521.66
|
| Rate for Payer: NAPHCARE Commercial |
$79.23
|
| Rate for Payer: Preferred Network Access Commercial |
$619.48
|
| Rate for Payer: Quartz Beloit One Network |
$286.92
|
| Rate for Payer: Quartz Commercial |
$371.69
|
| Rate for Payer: Quartz Medicare Advantage |
$52.82
|
| Rate for Payer: The Alliance Commercial |
$200.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$52.82
|
| Rate for Payer: WEA Trust Commercial |
$358.64
|
| Rate for Payer: WPS Commercial |
$264.11
|
|
|
ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV 75736
|
Professional
|
Both
|
$795.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
5104621
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$141.90 |
| Max. Negotiated Rate |
$785.46 |
| Rate for Payer: Aetna Commercial |
$785.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$711.05
|
| Rate for Payer: Aetna Managed Medicare |
$141.90
|
| Rate for Payer: Anthem Medicare Advantage |
$141.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$141.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$141.90
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cigna Commercial |
$785.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$413.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$141.90
|
| Rate for Payer: Health EOS Commercial |
$752.39
|
| Rate for Payer: HFN Commercial |
$785.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$514.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$514.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$141.90
|
| Rate for Payer: Multiplan Commercial |
$661.44
|
| Rate for Payer: NAPHCARE Commercial |
$212.85
|
| Rate for Payer: Preferred Network Access Commercial |
$785.46
|
| Rate for Payer: Quartz Beloit One Network |
$363.79
|
| Rate for Payer: Quartz Commercial |
$471.28
|
| Rate for Payer: Quartz Medicare Advantage |
$141.90
|
| Rate for Payer: The Alliance Commercial |
$539.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$141.90
|
| Rate for Payer: WEA Trust Commercial |
$454.74
|
| Rate for Payer: WPS Commercial |
$709.49
|
|
|
ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV 7573626
|
Professional
|
Both
|
$795.00
|
|
|
Service Code
|
CPT 75736 26
|
| Hospital Charge Code |
5104622
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$785.46 |
| Rate for Payer: Aetna Commercial |
$785.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$711.05
|
| Rate for Payer: Aetna Managed Medicare |
$49.73
|
| Rate for Payer: Anthem Medicare Advantage |
$49.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$49.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$49.73
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cigna Commercial |
$785.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$413.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$49.73
|
| Rate for Payer: Health EOS Commercial |
$752.39
|
| Rate for Payer: HFN Commercial |
$785.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$186.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$186.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$49.73
|
| Rate for Payer: Multiplan Commercial |
$661.44
|
| Rate for Payer: NAPHCARE Commercial |
$74.60
|
| Rate for Payer: Preferred Network Access Commercial |
$785.46
|
| Rate for Payer: Quartz Beloit One Network |
$363.79
|
| Rate for Payer: Quartz Commercial |
$471.28
|
| Rate for Payer: Quartz Medicare Advantage |
$49.73
|
| Rate for Payer: The Alliance Commercial |
$188.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$49.73
|
| Rate for Payer: WEA Trust Commercial |
$454.74
|
| Rate for Payer: WPS Commercial |
$248.66
|
|
|
Angio Non Select Vert Uni w/wo Arch
|
Facility
|
IP
|
$2,836.00
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
3052422
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,445.23 |
| Max. Negotiated Rate |
$2,713.48 |
| Rate for Payer: Aetna Commercial |
$2,654.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,536.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,563.20
|
| Rate for Payer: Cash Price |
$850.80
|
| Rate for Payer: Cigna Commercial |
$2,713.48
|
| Rate for Payer: Health EOS Commercial |
$2,625.00
|
| Rate for Payer: HFN Commercial |
$2,713.48
|
| Rate for Payer: Multiplan Commercial |
$2,359.55
|
| Rate for Payer: Preferred Network Access Commercial |
$2,713.48
|
| Rate for Payer: Quartz Beloit One Network |
$1,445.23
|
| Rate for Payer: Quartz Commercial |
$1,769.66
|
| Rate for Payer: WEA Trust Commercial |
$1,622.19
|
| Rate for Payer: WPS Commercial |
$2,184.57
|
|
|
Angio Non Select Vert Uni w/wo Arch
|
Facility
|
OP
|
$2,836.00
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
3052422
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,445.23 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$2,654.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,536.52
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,563.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$850.80
|
| Rate for Payer: Cash Price |
$850.80
|
| Rate for Payer: Cash Price |
$850.80
|
| Rate for Payer: Cigna Commercial |
$2,713.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$2,625.00
|
| Rate for Payer: HFN Commercial |
$2,713.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$2,359.55
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$2,713.48
|
| Rate for Payer: Quartz Beloit One Network |
$1,445.23
|
| Rate for Payer: Quartz Commercial |
$1,917.14
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$1,622.19
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$2,184.57
|
|
|
Angio Pelvic Select S & I
|
Facility
|
IP
|
$2,888.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
3052540
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,471.72 |
| Max. Negotiated Rate |
$2,763.24 |
| Rate for Payer: Aetna Commercial |
$2,703.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,583.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,591.87
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Cigna Commercial |
$2,763.24
|
| Rate for Payer: Health EOS Commercial |
$2,673.13
|
| Rate for Payer: HFN Commercial |
$2,763.24
|
| Rate for Payer: Multiplan Commercial |
$2,402.82
|
| Rate for Payer: Preferred Network Access Commercial |
$2,763.24
|
| Rate for Payer: Quartz Beloit One Network |
$1,471.72
|
| Rate for Payer: Quartz Commercial |
$1,802.11
|
| Rate for Payer: WEA Trust Commercial |
$1,651.94
|
| Rate for Payer: WPS Commercial |
$2,224.63
|
|
|
Angio Pelvic Select S & I
|
Facility
|
OP
|
$2,888.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
3052540
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,441.69 |
| Max. Negotiated Rate |
$23,424.04 |
| Rate for Payer: Aetna Commercial |
$2,703.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,583.03
|
| Rate for Payer: Aetna Managed Medicare |
$5,856.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,952.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,501.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,441.69
|
| Rate for Payer: Anthem Medicare Advantage |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,591.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,856.01
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Cigna Commercial |
$2,763.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,856.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,680.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,856.01
|
| Rate for Payer: Health EOS Commercial |
$2,673.13
|
| Rate for Payer: HFN Commercial |
$2,763.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,784.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,856.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,856.01
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,856.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,856.01
|
| Rate for Payer: Multiplan Commercial |
$2,402.82
|
| Rate for Payer: NAPHCARE Commercial |
$8,784.02
|
| Rate for Payer: Preferred Network Access Commercial |
$2,763.24
|
| Rate for Payer: Quartz Beloit One Network |
$1,471.72
|
| Rate for Payer: Quartz Commercial |
$1,952.29
|
| Rate for Payer: Quartz Medicare Advantage |
$5,856.01
|
| Rate for Payer: The Alliance Commercial |
$23,424.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,856.01
|
| Rate for Payer: WEA Trust Commercial |
$1,651.94
|
| Rate for Payer: Wellcare Medicare |
$5,856.01
|
| Rate for Payer: WPS Commercial |
$2,224.63
|
|
|
ANGIOPLASTY, DIALYSIS
|
Facility
|
OP
|
$1,872.00
|
|
| Hospital Charge Code |
5260619
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$545.13 |
| Max. Negotiated Rate |
$1,791.13 |
| Rate for Payer: Aetna Commercial |
$1,752.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,674.32
|
| Rate for Payer: Aetna Managed Medicare |
$545.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,265.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$973.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$934.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,031.85
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cigna Commercial |
$1,791.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,089.50
|
| Rate for Payer: Health EOS Commercial |
$1,732.72
|
| Rate for Payer: HFN Commercial |
$1,791.13
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,460.16
|
| Rate for Payer: Multiplan Commercial |
$1,557.50
|
| Rate for Payer: NAPHCARE Commercial |
$1,168.13
|
| Rate for Payer: Preferred Network Access Commercial |
$1,791.13
|
| Rate for Payer: Quartz Beloit One Network |
$953.97
|
| Rate for Payer: Quartz Commercial |
$1,265.47
|
| Rate for Payer: Quartz Medicare Advantage |
$1,168.13
|
| Rate for Payer: The Alliance Commercial |
$973.44
|
| Rate for Payer: WEA Trust Commercial |
$1,070.78
|
| Rate for Payer: WPS Commercial |
$1,442.00
|
|
|
ANGIOPLASTY, DIALYSIS
|
Facility
|
IP
|
$1,872.00
|
|
| Hospital Charge Code |
5260619
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$953.97 |
| Max. Negotiated Rate |
$1,791.13 |
| Rate for Payer: Aetna Commercial |
$1,752.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,674.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,031.85
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cigna Commercial |
$1,791.13
|
| Rate for Payer: Health EOS Commercial |
$1,732.72
|
| Rate for Payer: HFN Commercial |
$1,791.13
|
| Rate for Payer: Multiplan Commercial |
$1,557.50
|
| Rate for Payer: Preferred Network Access Commercial |
$1,791.13
|
| Rate for Payer: Quartz Beloit One Network |
$953.97
|
| Rate for Payer: Quartz Commercial |
$1,168.13
|
| Rate for Payer: WEA Trust Commercial |
$1,070.78
|
| Rate for Payer: WPS Commercial |
$1,442.00
|
|
|
Angio Renal Bilateral w/wo Aorta
|
Facility
|
OP
|
$11,723.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
3052427
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$10,972.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,485.05
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,461.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$3,516.90
|
| Rate for Payer: Cash Price |
$3,516.90
|
| Rate for Payer: Cash Price |
$3,516.90
|
| Rate for Payer: Cigna Commercial |
$11,216.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$10,850.81
|
| Rate for Payer: HFN Commercial |
$11,216.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$9,753.54
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$11,216.57
|
| Rate for Payer: Quartz Beloit One Network |
$5,974.04
|
| Rate for Payer: Quartz Commercial |
$7,924.75
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$6,705.56
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$9,030.23
|
|
|
Angio Renal Bilateral w/wo Aorta
|
Facility
|
IP
|
$11,723.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
3052427
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,974.04 |
| Max. Negotiated Rate |
$11,216.57 |
| Rate for Payer: Aetna Commercial |
$10,972.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,485.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,461.72
|
| Rate for Payer: Cash Price |
$3,516.90
|
| Rate for Payer: Cigna Commercial |
$11,216.57
|
| Rate for Payer: Health EOS Commercial |
$10,850.81
|
| Rate for Payer: HFN Commercial |
$11,216.57
|
| Rate for Payer: Multiplan Commercial |
$9,753.54
|
| Rate for Payer: Preferred Network Access Commercial |
$11,216.57
|
| Rate for Payer: Quartz Beloit One Network |
$5,974.04
|
| Rate for Payer: Quartz Commercial |
$7,315.15
|
| Rate for Payer: WEA Trust Commercial |
$6,705.56
|
| Rate for Payer: WPS Commercial |
$9,030.23
|
|
|
Angio Renal Uni w/wo Aorta
|
Facility
|
IP
|
$11,248.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
3052426
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,731.98 |
| Max. Negotiated Rate |
$10,762.09 |
| Rate for Payer: Aetna Commercial |
$10,528.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,060.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,199.90
|
| Rate for Payer: Cash Price |
$3,374.40
|
| Rate for Payer: Cigna Commercial |
$10,762.09
|
| Rate for Payer: Health EOS Commercial |
$10,411.15
|
| Rate for Payer: HFN Commercial |
$10,762.09
|
| Rate for Payer: Multiplan Commercial |
$9,358.34
|
| Rate for Payer: Preferred Network Access Commercial |
$10,762.09
|
| Rate for Payer: Quartz Beloit One Network |
$5,731.98
|
| Rate for Payer: Quartz Commercial |
$7,018.75
|
| Rate for Payer: WEA Trust Commercial |
$6,433.86
|
| Rate for Payer: WPS Commercial |
$8,664.33
|
|
|
Angio Renal Uni w/wo Aorta
|
Facility
|
OP
|
$11,248.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
3052426
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$10,528.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,060.21
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,199.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$3,374.40
|
| Rate for Payer: Cash Price |
$3,374.40
|
| Rate for Payer: Cash Price |
$3,374.40
|
| Rate for Payer: Cigna Commercial |
$10,762.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$10,411.15
|
| Rate for Payer: HFN Commercial |
$10,762.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$9,358.34
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$10,762.09
|
| Rate for Payer: Quartz Beloit One Network |
$5,731.98
|
| Rate for Payer: Quartz Commercial |
$7,603.65
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$6,433.86
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$8,664.33
|
|
|
ANGIOSCOPY
|
Facility
|
OP
|
$7,388.00
|
|
| Hospital Charge Code |
2959804
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,151.39 |
| Max. Negotiated Rate |
$7,068.84 |
| Rate for Payer: Aetna Commercial |
$6,915.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,607.83
|
| Rate for Payer: Aetna Managed Medicare |
$2,151.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,994.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,841.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,688.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,072.27
|
| Rate for Payer: Cash Price |
$2,216.40
|
| Rate for Payer: Cigna Commercial |
$7,068.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,299.82
|
| Rate for Payer: Health EOS Commercial |
$6,838.33
|
| Rate for Payer: HFN Commercial |
$7,068.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,762.64
|
| Rate for Payer: Multiplan Commercial |
$6,146.82
|
| Rate for Payer: NAPHCARE Commercial |
$4,610.11
|
| Rate for Payer: Preferred Network Access Commercial |
$7,068.84
|
| Rate for Payer: Quartz Beloit One Network |
$3,764.92
|
| Rate for Payer: Quartz Commercial |
$4,994.29
|
| Rate for Payer: Quartz Medicare Advantage |
$4,610.11
|
| Rate for Payer: The Alliance Commercial |
$3,841.76
|
| Rate for Payer: WEA Trust Commercial |
$4,225.94
|
| Rate for Payer: WPS Commercial |
$5,690.98
|
|
|
ANGIOSCOPY
|
Facility
|
IP
|
$7,388.00
|
|
| Hospital Charge Code |
2959804
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,764.92 |
| Max. Negotiated Rate |
$7,068.84 |
| Rate for Payer: Aetna Commercial |
$6,915.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,607.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,072.27
|
| Rate for Payer: Cash Price |
$2,216.40
|
| Rate for Payer: Cigna Commercial |
$7,068.84
|
| Rate for Payer: Health EOS Commercial |
$6,838.33
|
| Rate for Payer: HFN Commercial |
$7,068.84
|
| Rate for Payer: Multiplan Commercial |
$6,146.82
|
| Rate for Payer: Preferred Network Access Commercial |
$7,068.84
|
| Rate for Payer: Quartz Beloit One Network |
$3,764.92
|
| Rate for Payer: Quartz Commercial |
$4,610.11
|
| Rate for Payer: WEA Trust Commercial |
$4,225.94
|
| Rate for Payer: WPS Commercial |
$5,690.98
|
|
|
Angioseal 6Fr
|
Facility
|
IP
|
$2,187.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
2550962
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,114.50 |
| Max. Negotiated Rate |
$2,092.52 |
| Rate for Payer: Aetna Commercial |
$2,047.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,956.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,205.47
|
| Rate for Payer: Cash Price |
$656.10
|
| Rate for Payer: Cigna Commercial |
$2,092.52
|
| Rate for Payer: Health EOS Commercial |
$2,024.29
|
| Rate for Payer: HFN Commercial |
$2,092.52
|
| Rate for Payer: Multiplan Commercial |
$1,819.58
|
| Rate for Payer: Preferred Network Access Commercial |
$2,092.52
|
| Rate for Payer: Quartz Beloit One Network |
$1,114.50
|
| Rate for Payer: Quartz Commercial |
$1,364.69
|
| Rate for Payer: WEA Trust Commercial |
$1,250.96
|
| Rate for Payer: WPS Commercial |
$1,684.65
|
|
|
Angioseal 6Fr
|
Facility
|
OP
|
$2,187.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
2550962
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$636.85 |
| Max. Negotiated Rate |
$2,092.52 |
| Rate for Payer: Aetna Commercial |
$2,047.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,956.05
|
| Rate for Payer: Aetna Managed Medicare |
$636.85
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,478.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,137.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,091.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,205.47
|
| Rate for Payer: Cash Price |
$656.10
|
| Rate for Payer: Cigna Commercial |
$2,092.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,272.83
|
| Rate for Payer: Health EOS Commercial |
$2,024.29
|
| Rate for Payer: HFN Commercial |
$2,092.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,705.86
|
| Rate for Payer: Multiplan Commercial |
$1,819.58
|
| Rate for Payer: NAPHCARE Commercial |
$1,364.69
|
| Rate for Payer: Preferred Network Access Commercial |
$2,092.52
|
| Rate for Payer: Quartz Beloit One Network |
$1,114.50
|
| Rate for Payer: Quartz Commercial |
$1,478.41
|
| Rate for Payer: Quartz Medicare Advantage |
$1,364.69
|
| Rate for Payer: The Alliance Commercial |
$1,137.24
|
| Rate for Payer: WEA Trust Commercial |
$1,250.96
|
| Rate for Payer: WPS Commercial |
$1,684.65
|
|
|
Angioseal 6Fr
|
Professional
|
Both
|
$2,187.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
2550962
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,000.77 |
| Max. Negotiated Rate |
$2,160.76 |
| Rate for Payer: Aetna Commercial |
$2,160.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,956.05
|
| Rate for Payer: Cash Price |
$656.10
|
| Rate for Payer: Cigna Commercial |
$2,160.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,137.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,364.69
|
| Rate for Payer: Health EOS Commercial |
$2,069.78
|
| Rate for Payer: HFN Commercial |
$2,160.76
|
| Rate for Payer: Multiplan Commercial |
$1,819.58
|
| Rate for Payer: Preferred Network Access Commercial |
$2,160.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,000.77
|
| Rate for Payer: Quartz Commercial |
$1,296.45
|
| Rate for Payer: The Alliance Commercial |
$1,137.24
|
| Rate for Payer: WEA Trust Commercial |
$1,250.96
|
| Rate for Payer: WPS Commercial |
$1,684.65
|
|
|
ANGIOSEAL 6fr VIP CLOSURE 610130
|
Facility
|
IP
|
$4,055.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
2973459
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,066.43 |
| Max. Negotiated Rate |
$3,879.82 |
| Rate for Payer: Aetna Commercial |
$3,795.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,626.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,235.12
|
| Rate for Payer: Cash Price |
$1,216.50
|
| Rate for Payer: Cigna Commercial |
$3,879.82
|
| Rate for Payer: Health EOS Commercial |
$3,753.31
|
| Rate for Payer: HFN Commercial |
$3,879.82
|
| Rate for Payer: Multiplan Commercial |
$3,373.76
|
| Rate for Payer: Preferred Network Access Commercial |
$3,879.82
|
| Rate for Payer: Quartz Beloit One Network |
$2,066.43
|
| Rate for Payer: Quartz Commercial |
$2,530.32
|
| Rate for Payer: WEA Trust Commercial |
$2,319.46
|
| Rate for Payer: WPS Commercial |
$3,123.57
|
|
|
ANGIOSEAL 6fr VIP CLOSURE 610130
|
Facility
|
OP
|
$4,055.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
2973459
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,180.82 |
| Max. Negotiated Rate |
$3,879.82 |
| Rate for Payer: Aetna Commercial |
$3,795.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,626.79
|
| Rate for Payer: Aetna Managed Medicare |
$1,180.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,741.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,108.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,024.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,235.12
|
| Rate for Payer: Cash Price |
$1,216.50
|
| Rate for Payer: Cigna Commercial |
$3,879.82
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,360.01
|
| Rate for Payer: Health EOS Commercial |
$3,753.31
|
| Rate for Payer: HFN Commercial |
$3,879.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,162.90
|
| Rate for Payer: Multiplan Commercial |
$3,373.76
|
| Rate for Payer: NAPHCARE Commercial |
$2,530.32
|
| Rate for Payer: Preferred Network Access Commercial |
$3,879.82
|
| Rate for Payer: Quartz Beloit One Network |
$2,066.43
|
| Rate for Payer: Quartz Commercial |
$2,741.18
|
| Rate for Payer: Quartz Medicare Advantage |
$2,530.32
|
| Rate for Payer: The Alliance Commercial |
$2,108.60
|
| Rate for Payer: WEA Trust Commercial |
$2,319.46
|
| Rate for Payer: WPS Commercial |
$3,123.57
|
|
|
Angiotensin Converting Enzyme
|
Facility
|
IP
|
$293.00
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
977869
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$149.31 |
| Max. Negotiated Rate |
$280.34 |
| Rate for Payer: Aetna Commercial |
$274.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.50
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$280.34
|
| Rate for Payer: Health EOS Commercial |
$271.20
|
| Rate for Payer: HFN Commercial |
$280.34
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: Preferred Network Access Commercial |
$280.34
|
| Rate for Payer: Quartz Beloit One Network |
$149.31
|
| Rate for Payer: Quartz Commercial |
$182.83
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: WPS Commercial |
$225.70
|
|
|
Angiotensin Converting Enzyme
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
977869
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$289.48 |
| Rate for Payer: Aetna Commercial |
$289.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Aetna Managed Medicare |
$15.18
|
| Rate for Payer: Anthem Medicare Advantage |
$15.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.18
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$289.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$152.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.18
|
| Rate for Payer: Health EOS Commercial |
$277.30
|
| Rate for Payer: HFN Commercial |
$289.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: NAPHCARE Commercial |
$22.78
|
| Rate for Payer: Preferred Network Access Commercial |
$289.48
|
| Rate for Payer: Quartz Beloit One Network |
$134.08
|
| Rate for Payer: Quartz Commercial |
$173.69
|
| Rate for Payer: Quartz Medicare Advantage |
$15.18
|
| Rate for Payer: The Alliance Commercial |
$59.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.18
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: WPS Commercial |
$66.81
|
|
|
Angiotensin Converting Enzyme
|
Facility
|
OP
|
$293.00
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
977869
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$280.34 |
| Rate for Payer: Aetna Commercial |
$274.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Aetna Managed Medicare |
$15.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26.57
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.21
|
| Rate for Payer: Anthem Medicare Advantage |
$15.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.18
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$280.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.18
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$170.53
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.18
|
| Rate for Payer: Health EOS Commercial |
$271.20
|
| Rate for Payer: HFN Commercial |
$280.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$56.48
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.18
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.18
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.18
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: NAPHCARE Commercial |
$22.78
|
| Rate for Payer: Preferred Network Access Commercial |
$280.34
|
| Rate for Payer: Quartz Beloit One Network |
$149.31
|
| Rate for Payer: Quartz Commercial |
$198.07
|
| Rate for Payer: Quartz Medicare Advantage |
$15.18
|
| Rate for Payer: The Alliance Commercial |
$60.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.18
|
| Rate for Payer: United Healthcare PPO |
$228.54
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: Wellcare Medicare |
$15.18
|
| Rate for Payer: WPS Commercial |
$225.70
|
|
