|
MRA Upper Extremity w/ + w/o Contrast Lt
|
Professional
|
Both
|
$5,965.00
|
|
|
Service Code
|
CPT 73225 LT,TC
|
| Hospital Charge Code |
1610873
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,363.26 |
| Max. Negotiated Rate |
$5,893.42 |
| Rate for Payer: Aetna Commercial |
$5,893.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,335.10
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cigna Commercial |
$5,893.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,101.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,722.16
|
| Rate for Payer: Health EOS Commercial |
$5,645.28
|
| Rate for Payer: HFN Commercial |
$5,893.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,363.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,363.26
|
| Rate for Payer: Multiplan Commercial |
$4,962.88
|
| Rate for Payer: Preferred Network Access Commercial |
$5,893.42
|
| Rate for Payer: Quartz Beloit One Network |
$2,729.58
|
| Rate for Payer: Quartz Commercial |
$3,536.05
|
| Rate for Payer: The Alliance Commercial |
$3,101.80
|
| Rate for Payer: WEA Trust Commercial |
$3,411.98
|
| Rate for Payer: WPS Commercial |
$4,594.84
|
|
|
MRA Upper Extremity w/ + w/o Contrast Lt
|
Facility
|
OP
|
$5,965.00
|
|
|
Service Code
|
CPT 73225 LT,TC
|
| Hospital Charge Code |
1610873
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,737.01 |
| Max. Negotiated Rate |
$5,707.31 |
| Rate for Payer: Aetna Commercial |
$5,583.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,335.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,737.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,287.91
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cigna Commercial |
$5,707.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,471.63
|
| Rate for Payer: Health EOS Commercial |
$5,521.20
|
| Rate for Payer: HFN Commercial |
$5,707.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,652.70
|
| Rate for Payer: Multiplan Commercial |
$4,962.88
|
| Rate for Payer: NAPHCARE Commercial |
$3,722.16
|
| Rate for Payer: Preferred Network Access Commercial |
$5,707.31
|
| Rate for Payer: Quartz Beloit One Network |
$3,039.76
|
| Rate for Payer: Quartz Commercial |
$4,032.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3,722.16
|
| Rate for Payer: The Alliance Commercial |
$3,101.80
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,411.98
|
| Rate for Payer: WPS Commercial |
$4,594.84
|
|
|
MRA Upper Extremity w/ + w/o Contrast Lt
|
Professional
|
Both
|
$6,080.00
|
|
|
Service Code
|
CPT 73225
|
| Hospital Charge Code |
711764
|
| Min. Negotiated Rate |
$321.55 |
| Max. Negotiated Rate |
$6,007.04 |
| Rate for Payer: Aetna Commercial |
$6,007.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,437.95
|
| Rate for Payer: Aetna Managed Medicare |
$321.55
|
| Rate for Payer: Anthem Medicare Advantage |
$321.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$321.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$321.55
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cigna Commercial |
$6,007.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,161.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$321.55
|
| Rate for Payer: Health EOS Commercial |
$5,754.11
|
| Rate for Payer: HFN Commercial |
$6,007.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,363.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,363.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$321.55
|
| Rate for Payer: Multiplan Commercial |
$5,058.56
|
| Rate for Payer: NAPHCARE Commercial |
$482.32
|
| Rate for Payer: Preferred Network Access Commercial |
$6,007.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,782.21
|
| Rate for Payer: Quartz Commercial |
$3,604.22
|
| Rate for Payer: Quartz Medicare Advantage |
$321.55
|
| Rate for Payer: The Alliance Commercial |
$1,221.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$321.55
|
| Rate for Payer: WEA Trust Commercial |
$3,477.76
|
| Rate for Payer: WPS Commercial |
$1,607.74
|
|
|
MRA Upper Extremity w/ + w/o Contrast Lt
|
Facility
|
IP
|
$5,965.00
|
|
|
Service Code
|
CPT 73225 LT,TC
|
| Hospital Charge Code |
1610873
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$3,039.76 |
| Max. Negotiated Rate |
$5,707.31 |
| Rate for Payer: Aetna Commercial |
$5,583.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,335.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,287.91
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cigna Commercial |
$5,707.31
|
| Rate for Payer: Health EOS Commercial |
$5,521.20
|
| Rate for Payer: HFN Commercial |
$5,707.31
|
| Rate for Payer: Multiplan Commercial |
$4,962.88
|
| Rate for Payer: Preferred Network Access Commercial |
$5,707.31
|
| Rate for Payer: Quartz Beloit One Network |
$3,039.76
|
| Rate for Payer: Quartz Commercial |
$3,722.16
|
| Rate for Payer: WEA Trust Commercial |
$3,411.98
|
| Rate for Payer: WPS Commercial |
$4,594.84
|
|
|
MRA Upper Extremity w/ + w/o Contrast Right
|
Facility
|
OP
|
$5,965.00
|
|
|
Service Code
|
CPT 73225 TC,RT
|
| Hospital Charge Code |
2980051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,737.01 |
| Max. Negotiated Rate |
$5,707.31 |
| Rate for Payer: Aetna Commercial |
$5,583.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,335.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,737.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,287.91
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cigna Commercial |
$5,707.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,471.63
|
| Rate for Payer: Health EOS Commercial |
$5,521.20
|
| Rate for Payer: HFN Commercial |
$5,707.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,652.70
|
| Rate for Payer: Multiplan Commercial |
$4,962.88
|
| Rate for Payer: NAPHCARE Commercial |
$3,722.16
|
| Rate for Payer: Preferred Network Access Commercial |
$5,707.31
|
| Rate for Payer: Quartz Beloit One Network |
$3,039.76
|
| Rate for Payer: Quartz Commercial |
$4,032.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3,722.16
|
| Rate for Payer: The Alliance Commercial |
$3,101.80
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,411.98
|
| Rate for Payer: WPS Commercial |
$4,594.84
|
|
|
MRA Upper Extremity w/ + w/o Contrast Right
|
Professional
|
Both
|
$5,965.00
|
|
|
Service Code
|
CPT 73225 TC,RT
|
| Hospital Charge Code |
2980051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,363.26 |
| Max. Negotiated Rate |
$5,893.42 |
| Rate for Payer: Aetna Commercial |
$5,893.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,335.10
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cigna Commercial |
$5,893.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,101.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,722.16
|
| Rate for Payer: Health EOS Commercial |
$5,645.28
|
| Rate for Payer: HFN Commercial |
$5,893.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,363.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,363.26
|
| Rate for Payer: Multiplan Commercial |
$4,962.88
|
| Rate for Payer: Preferred Network Access Commercial |
$5,893.42
|
| Rate for Payer: Quartz Beloit One Network |
$2,729.58
|
| Rate for Payer: Quartz Commercial |
$3,536.05
|
| Rate for Payer: The Alliance Commercial |
$3,101.80
|
| Rate for Payer: WEA Trust Commercial |
$3,411.98
|
| Rate for Payer: WPS Commercial |
$4,594.84
|
|
|
MRA Upper Extremity w/ + w/o Contrast Right
|
Facility
|
IP
|
$5,965.00
|
|
|
Service Code
|
CPT 73225 TC,RT
|
| Hospital Charge Code |
2980051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$3,039.76 |
| Max. Negotiated Rate |
$5,707.31 |
| Rate for Payer: Aetna Commercial |
$5,583.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,335.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,287.91
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cigna Commercial |
$5,707.31
|
| Rate for Payer: Health EOS Commercial |
$5,521.20
|
| Rate for Payer: HFN Commercial |
$5,707.31
|
| Rate for Payer: Multiplan Commercial |
$4,962.88
|
| Rate for Payer: Preferred Network Access Commercial |
$5,707.31
|
| Rate for Payer: Quartz Beloit One Network |
$3,039.76
|
| Rate for Payer: Quartz Commercial |
$3,722.16
|
| Rate for Payer: WEA Trust Commercial |
$3,411.98
|
| Rate for Payer: WPS Commercial |
$4,594.84
|
|
|
MRA Upper Extremity w/ + w/o Contrast Rt
|
Facility
|
OP
|
$6,080.00
|
|
|
Service Code
|
CPT 73225
|
| Hospital Charge Code |
711765
|
| Min. Negotiated Rate |
$1,286.19 |
| Max. Negotiated Rate |
$5,817.34 |
| Rate for Payer: Aetna Commercial |
$5,690.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,437.95
|
| Rate for Payer: Aetna Managed Medicare |
$1,770.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,110.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,161.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,035.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,351.30
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cigna Commercial |
$5,817.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,538.56
|
| Rate for Payer: Health EOS Commercial |
$5,627.65
|
| Rate for Payer: HFN Commercial |
$5,817.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,742.40
|
| Rate for Payer: Multiplan Commercial |
$5,058.56
|
| Rate for Payer: NAPHCARE Commercial |
$3,793.92
|
| Rate for Payer: Preferred Network Access Commercial |
$5,817.34
|
| Rate for Payer: Quartz Beloit One Network |
$3,098.37
|
| Rate for Payer: Quartz Commercial |
$4,110.08
|
| Rate for Payer: Quartz Medicare Advantage |
$3,793.92
|
| Rate for Payer: The Alliance Commercial |
$1,286.19
|
| Rate for Payer: WEA Trust Commercial |
$3,477.76
|
| Rate for Payer: WPS Commercial |
$4,683.42
|
|
|
MRA Upper Extremity w/ + w/o Contrast Rt
|
Professional
|
Both
|
$5,965.00
|
|
|
Service Code
|
CPT 73225 RT,TC
|
| Hospital Charge Code |
1610876
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,363.26 |
| Max. Negotiated Rate |
$5,893.42 |
| Rate for Payer: Aetna Commercial |
$5,893.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,335.10
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cigna Commercial |
$5,893.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,101.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,722.16
|
| Rate for Payer: Health EOS Commercial |
$5,645.28
|
| Rate for Payer: HFN Commercial |
$5,893.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,363.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,363.26
|
| Rate for Payer: Multiplan Commercial |
$4,962.88
|
| Rate for Payer: Preferred Network Access Commercial |
$5,893.42
|
| Rate for Payer: Quartz Beloit One Network |
$2,729.58
|
| Rate for Payer: Quartz Commercial |
$3,536.05
|
| Rate for Payer: The Alliance Commercial |
$3,101.80
|
| Rate for Payer: WEA Trust Commercial |
$3,411.98
|
| Rate for Payer: WPS Commercial |
$4,594.84
|
|
|
MRA Upper Extremity w/ + w/o Contrast Rt
|
Facility
|
IP
|
$6,080.00
|
|
|
Service Code
|
CPT 73225
|
| Hospital Charge Code |
711765
|
| Min. Negotiated Rate |
$3,098.37 |
| Max. Negotiated Rate |
$5,817.34 |
| Rate for Payer: Aetna Commercial |
$5,690.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,437.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,351.30
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cigna Commercial |
$5,817.34
|
| Rate for Payer: Health EOS Commercial |
$5,627.65
|
| Rate for Payer: HFN Commercial |
$5,817.34
|
| Rate for Payer: Multiplan Commercial |
$5,058.56
|
| Rate for Payer: Preferred Network Access Commercial |
$5,817.34
|
| Rate for Payer: Quartz Beloit One Network |
$3,098.37
|
| Rate for Payer: Quartz Commercial |
$3,793.92
|
| Rate for Payer: WEA Trust Commercial |
$3,477.76
|
| Rate for Payer: WPS Commercial |
$4,683.42
|
|
|
MRA Upper Extremity w/ + w/o Contrast Rt
|
Facility
|
OP
|
$5,965.00
|
|
|
Service Code
|
CPT 73225 RT,TC
|
| Hospital Charge Code |
1610876
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,737.01 |
| Max. Negotiated Rate |
$5,707.31 |
| Rate for Payer: Aetna Commercial |
$5,583.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,335.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,737.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,287.91
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cigna Commercial |
$5,707.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,471.63
|
| Rate for Payer: Health EOS Commercial |
$5,521.20
|
| Rate for Payer: HFN Commercial |
$5,707.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,652.70
|
| Rate for Payer: Multiplan Commercial |
$4,962.88
|
| Rate for Payer: NAPHCARE Commercial |
$3,722.16
|
| Rate for Payer: Preferred Network Access Commercial |
$5,707.31
|
| Rate for Payer: Quartz Beloit One Network |
$3,039.76
|
| Rate for Payer: Quartz Commercial |
$4,032.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3,722.16
|
| Rate for Payer: The Alliance Commercial |
$3,101.80
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,411.98
|
| Rate for Payer: WPS Commercial |
$4,594.84
|
|
|
MRA Upper Extremity w/ + w/o Contrast Rt
|
Facility
|
IP
|
$5,965.00
|
|
|
Service Code
|
CPT 73225 RT,TC
|
| Hospital Charge Code |
1610876
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$3,039.76 |
| Max. Negotiated Rate |
$5,707.31 |
| Rate for Payer: Aetna Commercial |
$5,583.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,335.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,287.91
|
| Rate for Payer: Cash Price |
$1,789.50
|
| Rate for Payer: Cigna Commercial |
$5,707.31
|
| Rate for Payer: Health EOS Commercial |
$5,521.20
|
| Rate for Payer: HFN Commercial |
$5,707.31
|
| Rate for Payer: Multiplan Commercial |
$4,962.88
|
| Rate for Payer: Preferred Network Access Commercial |
$5,707.31
|
| Rate for Payer: Quartz Beloit One Network |
$3,039.76
|
| Rate for Payer: Quartz Commercial |
$3,722.16
|
| Rate for Payer: WEA Trust Commercial |
$3,411.98
|
| Rate for Payer: WPS Commercial |
$4,594.84
|
|
|
MRA Upper Extremity w/ + w/o Contrast Rt
|
Professional
|
Both
|
$6,080.00
|
|
|
Service Code
|
CPT 73225
|
| Hospital Charge Code |
711765
|
| Min. Negotiated Rate |
$321.55 |
| Max. Negotiated Rate |
$6,007.04 |
| Rate for Payer: Aetna Commercial |
$6,007.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,437.95
|
| Rate for Payer: Aetna Managed Medicare |
$321.55
|
| Rate for Payer: Anthem Medicare Advantage |
$321.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$321.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$321.55
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cigna Commercial |
$6,007.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,161.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$321.55
|
| Rate for Payer: Health EOS Commercial |
$5,754.11
|
| Rate for Payer: HFN Commercial |
$6,007.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,363.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,363.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$321.55
|
| Rate for Payer: Multiplan Commercial |
$5,058.56
|
| Rate for Payer: NAPHCARE Commercial |
$482.32
|
| Rate for Payer: Preferred Network Access Commercial |
$6,007.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,782.21
|
| Rate for Payer: Quartz Commercial |
$3,604.22
|
| Rate for Payer: Quartz Medicare Advantage |
$321.55
|
| Rate for Payer: The Alliance Commercial |
$1,221.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$321.55
|
| Rate for Payer: WEA Trust Commercial |
$3,477.76
|
| Rate for Payer: WPS Commercial |
$1,607.74
|
|
|
MRCP MRI Common Duct/Pancreas w/o
|
Facility
|
IP
|
$4,611.00
|
|
|
Service Code
|
CPT 74181 TC
|
| Hospital Charge Code |
4600643
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,349.77 |
| Max. Negotiated Rate |
$4,411.80 |
| Rate for Payer: Aetna Commercial |
$4,315.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,124.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,541.58
|
| Rate for Payer: Cash Price |
$1,383.30
|
| Rate for Payer: Cigna Commercial |
$4,411.80
|
| Rate for Payer: Health EOS Commercial |
$4,267.94
|
| Rate for Payer: HFN Commercial |
$4,411.80
|
| Rate for Payer: Multiplan Commercial |
$3,836.35
|
| Rate for Payer: Preferred Network Access Commercial |
$4,411.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,349.77
|
| Rate for Payer: Quartz Commercial |
$2,877.26
|
| Rate for Payer: WEA Trust Commercial |
$2,637.49
|
| Rate for Payer: WPS Commercial |
$3,551.85
|
|
|
MRCP MRI Common Duct/Pancreas w/o
|
Facility
|
OP
|
$4,611.00
|
|
|
Service Code
|
CPT 74181 TC
|
| Hospital Charge Code |
4600643
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$505.36 |
| Max. Negotiated Rate |
$4,411.80 |
| Rate for Payer: Aetna Commercial |
$4,315.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,124.08
|
| Rate for Payer: Aetna Managed Medicare |
$1,342.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,541.58
|
| Rate for Payer: Cash Price |
$1,383.30
|
| Rate for Payer: Cash Price |
$1,383.30
|
| Rate for Payer: Cash Price |
$1,383.30
|
| Rate for Payer: Cash Price |
$1,383.30
|
| Rate for Payer: Cigna Commercial |
$4,411.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,683.60
|
| Rate for Payer: Health EOS Commercial |
$4,267.94
|
| Rate for Payer: HFN Commercial |
$4,411.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,596.58
|
| Rate for Payer: Multiplan Commercial |
$3,836.35
|
| Rate for Payer: NAPHCARE Commercial |
$2,877.26
|
| Rate for Payer: Preferred Network Access Commercial |
$4,411.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,349.77
|
| Rate for Payer: Quartz Commercial |
$3,117.04
|
| Rate for Payer: Quartz Medicare Advantage |
$2,877.26
|
| Rate for Payer: The Alliance Commercial |
$505.36
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$2,637.49
|
| Rate for Payer: WPS Commercial |
$884.37
|
|
|
MRCP MRI Common Duct/Pancreas w/o
|
Professional
|
Both
|
$4,611.00
|
|
|
Service Code
|
CPT 74181 TC
|
| Hospital Charge Code |
4600643
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.34 |
| Max. Negotiated Rate |
$4,555.67 |
| Rate for Payer: Aetna Commercial |
$4,555.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,124.08
|
| Rate for Payer: Aetna Managed Medicare |
$126.34
|
| Rate for Payer: Anthem Medicare Advantage |
$126.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$126.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$126.34
|
| Rate for Payer: Cash Price |
$1,383.30
|
| Rate for Payer: Cash Price |
$1,383.30
|
| Rate for Payer: Cash Price |
$1,383.30
|
| Rate for Payer: Cigna Commercial |
$4,555.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,397.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$126.34
|
| Rate for Payer: Health EOS Commercial |
$4,363.85
|
| Rate for Payer: HFN Commercial |
$4,555.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$524.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$524.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$126.34
|
| Rate for Payer: Multiplan Commercial |
$3,836.35
|
| Rate for Payer: NAPHCARE Commercial |
$189.51
|
| Rate for Payer: Preferred Network Access Commercial |
$4,555.67
|
| Rate for Payer: Quartz Beloit One Network |
$2,109.99
|
| Rate for Payer: Quartz Commercial |
$2,733.40
|
| Rate for Payer: Quartz Medicare Advantage |
$126.34
|
| Rate for Payer: The Alliance Commercial |
$480.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.34
|
| Rate for Payer: WEA Trust Commercial |
$2,637.49
|
| Rate for Payer: WPS Commercial |
$631.70
|
|
|
MRCP MRI Common Duct/Pancreas w/ +w/o
|
Facility
|
OP
|
$5,795.00
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
1608800
|
| Min. Negotiated Rate |
$367.15 |
| Max. Negotiated Rate |
$5,544.66 |
| Rate for Payer: Aetna Commercial |
$5,424.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,183.05
|
| Rate for Payer: Aetna Managed Medicare |
$367.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,917.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,013.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,892.86
|
| Rate for Payer: Anthem Medicare Advantage |
$367.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,194.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$367.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$367.15
|
| Rate for Payer: Cash Price |
$1,738.50
|
| Rate for Payer: Cash Price |
$1,738.50
|
| Rate for Payer: Cigna Commercial |
$5,544.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$367.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,372.69
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$367.15
|
| Rate for Payer: Health EOS Commercial |
$5,363.85
|
| Rate for Payer: HFN Commercial |
$5,544.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,365.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$367.15
|
| Rate for Payer: Independent Care Health Plan Medicare |
$367.15
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$367.15
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$367.15
|
| Rate for Payer: Multiplan Commercial |
$4,821.44
|
| Rate for Payer: NAPHCARE Commercial |
$550.73
|
| Rate for Payer: Preferred Network Access Commercial |
$5,544.66
|
| Rate for Payer: Quartz Beloit One Network |
$2,953.13
|
| Rate for Payer: Quartz Commercial |
$3,917.42
|
| Rate for Payer: Quartz Medicare Advantage |
$367.15
|
| Rate for Payer: The Alliance Commercial |
$1,468.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$367.15
|
| Rate for Payer: WEA Trust Commercial |
$3,314.74
|
| Rate for Payer: Wellcare Medicare |
$367.15
|
| Rate for Payer: WPS Commercial |
$4,463.89
|
|
|
MRCP MRI Common Duct/Pancreas w/ +w/o
|
Facility
|
IP
|
$5,795.00
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
1608800
|
| Min. Negotiated Rate |
$2,953.13 |
| Max. Negotiated Rate |
$5,544.66 |
| Rate for Payer: Aetna Commercial |
$5,424.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,183.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,194.20
|
| Rate for Payer: Cash Price |
$1,738.50
|
| Rate for Payer: Cigna Commercial |
$5,544.66
|
| Rate for Payer: Health EOS Commercial |
$5,363.85
|
| Rate for Payer: HFN Commercial |
$5,544.66
|
| Rate for Payer: Multiplan Commercial |
$4,821.44
|
| Rate for Payer: Preferred Network Access Commercial |
$5,544.66
|
| Rate for Payer: Quartz Beloit One Network |
$2,953.13
|
| Rate for Payer: Quartz Commercial |
$3,616.08
|
| Rate for Payer: WEA Trust Commercial |
$3,314.74
|
| Rate for Payer: WPS Commercial |
$4,463.89
|
|
|
MRCP MRI Common Duct/Pancreas w/ +w/o
|
Professional
|
Both
|
$6,365.00
|
|
|
Service Code
|
CPT 74183 TC
|
| Hospital Charge Code |
1610897
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$232.94 |
| Max. Negotiated Rate |
$6,288.62 |
| Rate for Payer: Aetna Commercial |
$6,288.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,692.86
|
| Rate for Payer: Aetna Managed Medicare |
$232.94
|
| Rate for Payer: Anthem Medicare Advantage |
$232.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$232.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$232.94
|
| Rate for Payer: Cash Price |
$1,909.50
|
| Rate for Payer: Cash Price |
$1,909.50
|
| Rate for Payer: Cash Price |
$1,909.50
|
| Rate for Payer: Cigna Commercial |
$6,288.62
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,309.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$232.94
|
| Rate for Payer: Health EOS Commercial |
$6,023.84
|
| Rate for Payer: HFN Commercial |
$6,288.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$973.38
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$973.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$232.94
|
| Rate for Payer: Multiplan Commercial |
$5,295.68
|
| Rate for Payer: NAPHCARE Commercial |
$349.41
|
| Rate for Payer: Preferred Network Access Commercial |
$6,288.62
|
| Rate for Payer: Quartz Beloit One Network |
$2,912.62
|
| Rate for Payer: Quartz Commercial |
$3,773.17
|
| Rate for Payer: Quartz Medicare Advantage |
$232.94
|
| Rate for Payer: The Alliance Commercial |
$885.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$232.94
|
| Rate for Payer: WEA Trust Commercial |
$3,640.78
|
| Rate for Payer: WPS Commercial |
$1,164.70
|
|
|
MRCP MRI Common Duct/Pancreas w/ +w/o
|
Professional
|
Both
|
$5,795.00
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
1608800
|
| Min. Negotiated Rate |
$334.30 |
| Max. Negotiated Rate |
$5,725.46 |
| Rate for Payer: Aetna Commercial |
$5,725.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,183.05
|
| Rate for Payer: Aetna Managed Medicare |
$334.30
|
| Rate for Payer: Anthem Medicare Advantage |
$334.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$334.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$334.30
|
| Rate for Payer: Cash Price |
$1,738.50
|
| Rate for Payer: Cash Price |
$1,738.50
|
| Rate for Payer: Cash Price |
$1,738.50
|
| Rate for Payer: Cigna Commercial |
$5,725.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,013.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$334.30
|
| Rate for Payer: Health EOS Commercial |
$5,484.39
|
| Rate for Payer: HFN Commercial |
$5,725.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,354.31
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,354.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$334.30
|
| Rate for Payer: Multiplan Commercial |
$4,821.44
|
| Rate for Payer: NAPHCARE Commercial |
$501.45
|
| Rate for Payer: Preferred Network Access Commercial |
$5,725.46
|
| Rate for Payer: Quartz Beloit One Network |
$2,651.79
|
| Rate for Payer: Quartz Commercial |
$3,435.28
|
| Rate for Payer: Quartz Medicare Advantage |
$334.30
|
| Rate for Payer: The Alliance Commercial |
$1,270.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$334.30
|
| Rate for Payer: WEA Trust Commercial |
$3,314.74
|
| Rate for Payer: WPS Commercial |
$1,671.49
|
|
|
MRCP MRI Common Duct/Pancreas w/ +w/o
|
Facility
|
OP
|
$6,365.00
|
|
|
Service Code
|
CPT 74183 TC
|
| Hospital Charge Code |
1610897
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$931.76 |
| Max. Negotiated Rate |
$6,090.03 |
| Rate for Payer: Aetna Commercial |
$5,957.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,692.86
|
| Rate for Payer: Aetna Managed Medicare |
$1,853.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,508.39
|
| Rate for Payer: Cash Price |
$1,909.50
|
| Rate for Payer: Cash Price |
$1,909.50
|
| Rate for Payer: Cash Price |
$1,909.50
|
| Rate for Payer: Cash Price |
$1,909.50
|
| Rate for Payer: Cigna Commercial |
$6,090.03
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,704.43
|
| Rate for Payer: Health EOS Commercial |
$5,891.44
|
| Rate for Payer: HFN Commercial |
$6,090.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,964.70
|
| Rate for Payer: Multiplan Commercial |
$5,295.68
|
| Rate for Payer: NAPHCARE Commercial |
$3,971.76
|
| Rate for Payer: Preferred Network Access Commercial |
$6,090.03
|
| Rate for Payer: Quartz Beloit One Network |
$3,243.60
|
| Rate for Payer: Quartz Commercial |
$4,302.74
|
| Rate for Payer: Quartz Medicare Advantage |
$3,971.76
|
| Rate for Payer: The Alliance Commercial |
$931.76
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,640.78
|
| Rate for Payer: WPS Commercial |
$1,630.57
|
|
|
MRCP MRI Common Duct/Pancreas w/ +w/o
|
Facility
|
IP
|
$6,365.00
|
|
|
Service Code
|
CPT 74183 TC
|
| Hospital Charge Code |
1610897
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$3,243.60 |
| Max. Negotiated Rate |
$6,090.03 |
| Rate for Payer: Aetna Commercial |
$5,957.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,692.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,508.39
|
| Rate for Payer: Cash Price |
$1,909.50
|
| Rate for Payer: Cigna Commercial |
$6,090.03
|
| Rate for Payer: Health EOS Commercial |
$5,891.44
|
| Rate for Payer: HFN Commercial |
$6,090.03
|
| Rate for Payer: Multiplan Commercial |
$5,295.68
|
| Rate for Payer: Preferred Network Access Commercial |
$6,090.03
|
| Rate for Payer: Quartz Beloit One Network |
$3,243.60
|
| Rate for Payer: Quartz Commercial |
$3,971.76
|
| Rate for Payer: WEA Trust Commercial |
$3,640.78
|
| Rate for Payer: WPS Commercial |
$4,902.96
|
|
|
MRI Abdomen w/ Contrast
|
Professional
|
Both
|
$6,850.00
|
|
|
Service Code
|
CPT 74182 TC
|
| Hospital Charge Code |
1610904
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$219.63 |
| Max. Negotiated Rate |
$6,767.80 |
| Rate for Payer: Aetna Commercial |
$6,767.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,126.64
|
| Rate for Payer: Aetna Managed Medicare |
$219.63
|
| Rate for Payer: Anthem Medicare Advantage |
$219.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$219.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$219.63
|
| Rate for Payer: Cash Price |
$2,055.00
|
| Rate for Payer: Cash Price |
$2,055.00
|
| Rate for Payer: Cash Price |
$2,055.00
|
| Rate for Payer: Cigna Commercial |
$6,767.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,562.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$219.63
|
| Rate for Payer: Health EOS Commercial |
$6,482.84
|
| Rate for Payer: HFN Commercial |
$6,767.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$914.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$914.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$219.63
|
| Rate for Payer: Multiplan Commercial |
$5,699.20
|
| Rate for Payer: NAPHCARE Commercial |
$329.44
|
| Rate for Payer: Preferred Network Access Commercial |
$6,767.80
|
| Rate for Payer: Quartz Beloit One Network |
$3,134.56
|
| Rate for Payer: Quartz Commercial |
$4,060.68
|
| Rate for Payer: Quartz Medicare Advantage |
$219.63
|
| Rate for Payer: The Alliance Commercial |
$834.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$219.63
|
| Rate for Payer: WEA Trust Commercial |
$3,918.20
|
| Rate for Payer: WPS Commercial |
$1,098.14
|
|
|
MRI Abdomen w/ Contrast
|
Facility
|
OP
|
$6,850.00
|
|
|
Service Code
|
CPT 74182 TC
|
| Hospital Charge Code |
1610904
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$878.51 |
| Max. Negotiated Rate |
$6,554.08 |
| Rate for Payer: Aetna Commercial |
$6,411.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,126.64
|
| Rate for Payer: Aetna Managed Medicare |
$1,994.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,775.72
|
| Rate for Payer: Cash Price |
$2,055.00
|
| Rate for Payer: Cash Price |
$2,055.00
|
| Rate for Payer: Cash Price |
$2,055.00
|
| Rate for Payer: Cash Price |
$2,055.00
|
| Rate for Payer: Cigna Commercial |
$6,554.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,986.70
|
| Rate for Payer: Health EOS Commercial |
$6,340.36
|
| Rate for Payer: HFN Commercial |
$6,554.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,343.00
|
| Rate for Payer: Multiplan Commercial |
$5,699.20
|
| Rate for Payer: NAPHCARE Commercial |
$4,274.40
|
| Rate for Payer: Preferred Network Access Commercial |
$6,554.08
|
| Rate for Payer: Quartz Beloit One Network |
$3,490.76
|
| Rate for Payer: Quartz Commercial |
$4,630.60
|
| Rate for Payer: Quartz Medicare Advantage |
$4,274.40
|
| Rate for Payer: The Alliance Commercial |
$878.51
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,918.20
|
| Rate for Payer: WPS Commercial |
$1,537.39
|
|
|
MRI Abdomen w/ Contrast
|
Facility
|
IP
|
$4,890.00
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
625606
|
| Min. Negotiated Rate |
$2,491.94 |
| Max. Negotiated Rate |
$4,678.75 |
| Rate for Payer: Aetna Commercial |
$4,577.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,373.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,695.37
|
| Rate for Payer: Cash Price |
$1,467.00
|
| Rate for Payer: Cigna Commercial |
$4,678.75
|
| Rate for Payer: Health EOS Commercial |
$4,526.18
|
| Rate for Payer: HFN Commercial |
$4,678.75
|
| Rate for Payer: Multiplan Commercial |
$4,068.48
|
| Rate for Payer: Preferred Network Access Commercial |
$4,678.75
|
| Rate for Payer: Quartz Beloit One Network |
$2,491.94
|
| Rate for Payer: Quartz Commercial |
$3,051.36
|
| Rate for Payer: WEA Trust Commercial |
$2,797.08
|
| Rate for Payer: WPS Commercial |
$3,766.77
|
|
