|
MRI Hand w/ Contrast Right
|
Facility
|
OP
|
$5,063.00
|
|
|
Service Code
|
CPT 73219 TC,RT
|
| Hospital Charge Code |
2980032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,474.35 |
| Max. Negotiated Rate |
$4,844.28 |
| Rate for Payer: Aetna Commercial |
$4,738.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,528.35
|
| Rate for Payer: Aetna Managed Medicare |
$1,474.35
|
| 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 |
$2,790.73
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cigna Commercial |
$4,844.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,946.67
|
| Rate for Payer: Health EOS Commercial |
$4,686.31
|
| Rate for Payer: HFN Commercial |
$4,844.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,949.14
|
| Rate for Payer: Multiplan Commercial |
$4,212.42
|
| Rate for Payer: NAPHCARE Commercial |
$3,159.31
|
| Rate for Payer: Preferred Network Access Commercial |
$4,844.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,580.10
|
| Rate for Payer: Quartz Commercial |
$3,422.59
|
| Rate for Payer: Quartz Medicare Advantage |
$3,159.31
|
| Rate for Payer: The Alliance Commercial |
$2,632.76
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$2,896.04
|
| Rate for Payer: WPS Commercial |
$3,900.03
|
|
|
MRI Hand w/ Contrast Right
|
Facility
|
IP
|
$5,063.00
|
|
|
Service Code
|
CPT 73219 TC,RT
|
| Hospital Charge Code |
1611127
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,580.10 |
| Max. Negotiated Rate |
$4,844.28 |
| Rate for Payer: Aetna Commercial |
$4,738.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,528.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,790.73
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cigna Commercial |
$4,844.28
|
| Rate for Payer: Health EOS Commercial |
$4,686.31
|
| Rate for Payer: HFN Commercial |
$4,844.28
|
| Rate for Payer: Multiplan Commercial |
$4,212.42
|
| Rate for Payer: Preferred Network Access Commercial |
$4,844.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,580.10
|
| Rate for Payer: Quartz Commercial |
$3,159.31
|
| Rate for Payer: WEA Trust Commercial |
$2,896.04
|
| Rate for Payer: WPS Commercial |
$3,900.03
|
|
|
MRI Hand w/ Contrast Right
|
Professional
|
Both
|
$5,162.00
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
630966
|
| Min. Negotiated Rate |
$328.28 |
| Max. Negotiated Rate |
$5,100.06 |
| Rate for Payer: Aetna Commercial |
$5,100.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,616.89
|
| Rate for Payer: Aetna Managed Medicare |
$328.28
|
| Rate for Payer: Anthem Medicare Advantage |
$328.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$328.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$328.28
|
| Rate for Payer: Cash Price |
$1,548.60
|
| Rate for Payer: Cash Price |
$1,548.60
|
| Rate for Payer: Cash Price |
$1,548.60
|
| Rate for Payer: Cigna Commercial |
$5,100.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,684.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$328.28
|
| Rate for Payer: Health EOS Commercial |
$4,885.32
|
| Rate for Payer: HFN Commercial |
$5,100.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,339.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,339.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$328.28
|
| Rate for Payer: Multiplan Commercial |
$4,294.78
|
| Rate for Payer: NAPHCARE Commercial |
$492.41
|
| Rate for Payer: Preferred Network Access Commercial |
$5,100.06
|
| Rate for Payer: Quartz Beloit One Network |
$2,362.13
|
| Rate for Payer: Quartz Commercial |
$3,060.03
|
| Rate for Payer: Quartz Medicare Advantage |
$328.28
|
| Rate for Payer: The Alliance Commercial |
$1,247.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$328.28
|
| Rate for Payer: WEA Trust Commercial |
$2,952.66
|
| Rate for Payer: WPS Commercial |
$1,641.38
|
|
|
MRI Hand w/ Contrast Right
|
Facility
|
OP
|
$5,162.00
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
630966
|
| Min. Negotiated Rate |
$367.15 |
| Max. Negotiated Rate |
$4,939.00 |
| Rate for Payer: Aetna Commercial |
$4,831.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,616.89
|
| Rate for Payer: Aetna Managed Medicare |
$367.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,489.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,684.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,576.87
|
| Rate for Payer: Anthem Medicare Advantage |
$367.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,845.29
|
| 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 |
$1,548.60
|
| Rate for Payer: Cash Price |
$1,548.60
|
| Rate for Payer: Cigna Commercial |
$4,939.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$367.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,004.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$367.15
|
| Rate for Payer: Health EOS Commercial |
$4,777.95
|
| Rate for Payer: HFN Commercial |
$4,939.00
|
| 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 |
$4,294.78
|
| Rate for Payer: NAPHCARE Commercial |
$550.73
|
| Rate for Payer: Preferred Network Access Commercial |
$4,939.00
|
| Rate for Payer: Quartz Beloit One Network |
$2,630.56
|
| Rate for Payer: Quartz Commercial |
$3,489.51
|
| 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 |
$2,952.66
|
| Rate for Payer: Wellcare Medicare |
$367.15
|
| Rate for Payer: WPS Commercial |
$3,976.29
|
|
|
MRI Hand w/ Contrast Right
|
Facility
|
IP
|
$5,063.00
|
|
|
Service Code
|
CPT 73219 TC,RT
|
| Hospital Charge Code |
2980032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,580.10 |
| Max. Negotiated Rate |
$4,844.28 |
| Rate for Payer: Aetna Commercial |
$4,738.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,528.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,790.73
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cigna Commercial |
$4,844.28
|
| Rate for Payer: Health EOS Commercial |
$4,686.31
|
| Rate for Payer: HFN Commercial |
$4,844.28
|
| Rate for Payer: Multiplan Commercial |
$4,212.42
|
| Rate for Payer: Preferred Network Access Commercial |
$4,844.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,580.10
|
| Rate for Payer: Quartz Commercial |
$3,159.31
|
| Rate for Payer: WEA Trust Commercial |
$2,896.04
|
| Rate for Payer: WPS Commercial |
$3,900.03
|
|
|
MRI Hand w/ Contrast Right
|
Professional
|
Both
|
$5,063.00
|
|
|
Service Code
|
CPT 73219 TC,RT
|
| Hospital Charge Code |
2980032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,339.95 |
| Max. Negotiated Rate |
$5,002.24 |
| Rate for Payer: Aetna Commercial |
$5,002.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,528.35
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cigna Commercial |
$5,002.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,632.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,159.31
|
| Rate for Payer: Health EOS Commercial |
$4,791.62
|
| Rate for Payer: HFN Commercial |
$5,002.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,339.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,339.95
|
| Rate for Payer: Multiplan Commercial |
$4,212.42
|
| Rate for Payer: Preferred Network Access Commercial |
$5,002.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,316.83
|
| Rate for Payer: Quartz Commercial |
$3,001.35
|
| Rate for Payer: The Alliance Commercial |
$2,632.76
|
| Rate for Payer: WEA Trust Commercial |
$2,896.04
|
| Rate for Payer: WPS Commercial |
$3,900.03
|
|
|
MRI Hand w/ Contrast Right
|
Facility
|
IP
|
$5,162.00
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
630966
|
| Min. Negotiated Rate |
$2,630.56 |
| Max. Negotiated Rate |
$4,939.00 |
| Rate for Payer: Aetna Commercial |
$4,831.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,616.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,845.29
|
| Rate for Payer: Cash Price |
$1,548.60
|
| Rate for Payer: Cigna Commercial |
$4,939.00
|
| Rate for Payer: Health EOS Commercial |
$4,777.95
|
| Rate for Payer: HFN Commercial |
$4,939.00
|
| Rate for Payer: Multiplan Commercial |
$4,294.78
|
| Rate for Payer: Preferred Network Access Commercial |
$4,939.00
|
| Rate for Payer: Quartz Beloit One Network |
$2,630.56
|
| Rate for Payer: Quartz Commercial |
$3,221.09
|
| Rate for Payer: WEA Trust Commercial |
$2,952.66
|
| Rate for Payer: WPS Commercial |
$3,976.29
|
|
|
MRI Hand w/ Contrast Right
|
Facility
|
OP
|
$5,063.00
|
|
|
Service Code
|
CPT 73219 TC,RT
|
| Hospital Charge Code |
1611127
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,474.35 |
| Max. Negotiated Rate |
$4,844.28 |
| Rate for Payer: Aetna Commercial |
$4,738.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,528.35
|
| Rate for Payer: Aetna Managed Medicare |
$1,474.35
|
| 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 |
$2,790.73
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cash Price |
$1,518.90
|
| Rate for Payer: Cigna Commercial |
$4,844.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,946.67
|
| Rate for Payer: Health EOS Commercial |
$4,686.31
|
| Rate for Payer: HFN Commercial |
$4,844.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,949.14
|
| Rate for Payer: Multiplan Commercial |
$4,212.42
|
| Rate for Payer: NAPHCARE Commercial |
$3,159.31
|
| Rate for Payer: Preferred Network Access Commercial |
$4,844.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,580.10
|
| Rate for Payer: Quartz Commercial |
$3,422.59
|
| Rate for Payer: Quartz Medicare Advantage |
$3,159.31
|
| Rate for Payer: The Alliance Commercial |
$2,632.76
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$2,896.04
|
| Rate for Payer: WPS Commercial |
$3,900.03
|
|
|
MRI Hand w/o Contrast Bilateral
|
Professional
|
Both
|
$9,441.00
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
630970
|
| Min. Negotiated Rate |
$301.83 |
| Max. Negotiated Rate |
$9,327.71 |
| Rate for Payer: Aetna Commercial |
$9,327.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,444.03
|
| Rate for Payer: Aetna Managed Medicare |
$301.83
|
| Rate for Payer: Anthem Medicare Advantage |
$301.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$301.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$301.83
|
| Rate for Payer: Cash Price |
$2,832.30
|
| Rate for Payer: Cash Price |
$2,832.30
|
| Rate for Payer: Cash Price |
$2,832.30
|
| Rate for Payer: Cigna Commercial |
$9,327.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,909.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$301.83
|
| Rate for Payer: Health EOS Commercial |
$8,934.96
|
| Rate for Payer: HFN Commercial |
$9,327.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,227.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,227.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$301.83
|
| Rate for Payer: Multiplan Commercial |
$7,854.91
|
| Rate for Payer: NAPHCARE Commercial |
$452.74
|
| Rate for Payer: Preferred Network Access Commercial |
$9,327.71
|
| Rate for Payer: Quartz Beloit One Network |
$4,320.20
|
| Rate for Payer: Quartz Commercial |
$5,596.62
|
| Rate for Payer: Quartz Medicare Advantage |
$301.83
|
| Rate for Payer: The Alliance Commercial |
$1,146.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$301.83
|
| Rate for Payer: WEA Trust Commercial |
$5,400.25
|
| Rate for Payer: WPS Commercial |
$1,509.14
|
|
|
MRI Hand w/o Contrast Bilateral
|
Facility
|
OP
|
$9,441.00
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
630970
|
| Min. Negotiated Rate |
$251.10 |
| Max. Negotiated Rate |
$9,033.15 |
| Rate for Payer: Aetna Commercial |
$8,836.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,444.03
|
| Rate for Payer: Aetna Managed Medicare |
$251.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,382.12
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,909.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,712.95
|
| Rate for Payer: Anthem Medicare Advantage |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,203.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$251.10
|
| Rate for Payer: Cash Price |
$2,832.30
|
| Rate for Payer: Cash Price |
$2,832.30
|
| Rate for Payer: Cigna Commercial |
$9,033.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$251.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,494.66
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$251.10
|
| Rate for Payer: Health EOS Commercial |
$8,738.59
|
| Rate for Payer: HFN Commercial |
$9,033.15
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$934.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$251.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$251.10
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$251.10
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$251.10
|
| Rate for Payer: Multiplan Commercial |
$7,854.91
|
| Rate for Payer: NAPHCARE Commercial |
$376.65
|
| Rate for Payer: Preferred Network Access Commercial |
$9,033.15
|
| Rate for Payer: Quartz Beloit One Network |
$4,811.13
|
| Rate for Payer: Quartz Commercial |
$6,382.12
|
| Rate for Payer: Quartz Medicare Advantage |
$251.10
|
| Rate for Payer: The Alliance Commercial |
$1,004.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$251.10
|
| Rate for Payer: WEA Trust Commercial |
$5,400.25
|
| Rate for Payer: Wellcare Medicare |
$251.10
|
| Rate for Payer: WPS Commercial |
$7,272.40
|
|
|
MRI Hand w/o Contrast Bilateral
|
Facility
|
IP
|
$4,631.00
|
|
|
Service Code
|
CPT 73218 TC,LT
|
| Hospital Charge Code |
1611129
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,359.96 |
| Max. Negotiated Rate |
$4,430.94 |
| Rate for Payer: Aetna Commercial |
$4,334.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,141.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,552.61
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cigna Commercial |
$4,430.94
|
| Rate for Payer: Health EOS Commercial |
$4,286.45
|
| Rate for Payer: HFN Commercial |
$4,430.94
|
| Rate for Payer: Multiplan Commercial |
$3,852.99
|
| Rate for Payer: Preferred Network Access Commercial |
$4,430.94
|
| Rate for Payer: Quartz Beloit One Network |
$2,359.96
|
| Rate for Payer: Quartz Commercial |
$2,889.74
|
| Rate for Payer: WEA Trust Commercial |
$2,648.93
|
| Rate for Payer: WPS Commercial |
$3,567.26
|
|
|
MRI Hand w/o Contrast Bilateral
|
Professional
|
Both
|
$4,631.00
|
|
|
Service Code
|
CPT 73218 TC,LT
|
| Hospital Charge Code |
1611129
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,227.83 |
| Max. Negotiated Rate |
$4,575.43 |
| Rate for Payer: Aetna Commercial |
$4,575.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,141.97
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cigna Commercial |
$4,575.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,408.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,889.74
|
| Rate for Payer: Health EOS Commercial |
$4,382.78
|
| Rate for Payer: HFN Commercial |
$4,575.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,227.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,227.83
|
| Rate for Payer: Multiplan Commercial |
$3,852.99
|
| Rate for Payer: Preferred Network Access Commercial |
$4,575.43
|
| Rate for Payer: Quartz Beloit One Network |
$2,119.15
|
| Rate for Payer: Quartz Commercial |
$2,745.26
|
| Rate for Payer: The Alliance Commercial |
$2,408.12
|
| Rate for Payer: WEA Trust Commercial |
$2,648.93
|
| Rate for Payer: WPS Commercial |
$3,567.26
|
|
|
MRI Hand w/o Contrast Bilateral
|
Facility
|
OP
|
$4,631.00
|
|
|
Service Code
|
CPT 73218 TC,LT
|
| Hospital Charge Code |
1611129
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,348.55 |
| Max. Negotiated Rate |
$4,430.94 |
| Rate for Payer: Aetna Commercial |
$4,334.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,141.97
|
| Rate for Payer: Aetna Managed Medicare |
$1,348.55
|
| 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 |
$2,552.61
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cigna Commercial |
$4,430.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,695.24
|
| Rate for Payer: Health EOS Commercial |
$4,286.45
|
| Rate for Payer: HFN Commercial |
$4,430.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,612.18
|
| Rate for Payer: Multiplan Commercial |
$3,852.99
|
| Rate for Payer: NAPHCARE Commercial |
$2,889.74
|
| Rate for Payer: Preferred Network Access Commercial |
$4,430.94
|
| Rate for Payer: Quartz Beloit One Network |
$2,359.96
|
| Rate for Payer: Quartz Commercial |
$3,130.56
|
| Rate for Payer: Quartz Medicare Advantage |
$2,889.74
|
| Rate for Payer: The Alliance Commercial |
$2,408.12
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$2,648.93
|
| Rate for Payer: WPS Commercial |
$3,567.26
|
|
|
MRI Hand w/o Contrast Bilateral
|
Facility
|
IP
|
$9,441.00
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
630970
|
| Min. Negotiated Rate |
$4,811.13 |
| Max. Negotiated Rate |
$9,033.15 |
| Rate for Payer: Aetna Commercial |
$8,836.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,444.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,203.88
|
| Rate for Payer: Cash Price |
$2,832.30
|
| Rate for Payer: Cigna Commercial |
$9,033.15
|
| Rate for Payer: Health EOS Commercial |
$8,738.59
|
| Rate for Payer: HFN Commercial |
$9,033.15
|
| Rate for Payer: Multiplan Commercial |
$7,854.91
|
| Rate for Payer: Preferred Network Access Commercial |
$9,033.15
|
| Rate for Payer: Quartz Beloit One Network |
$4,811.13
|
| Rate for Payer: Quartz Commercial |
$5,891.18
|
| Rate for Payer: WEA Trust Commercial |
$5,400.25
|
| Rate for Payer: WPS Commercial |
$7,272.40
|
|
|
MRI Hand w/o Contrast Left
|
Professional
|
Both
|
$4,810.00
|
|
|
Service Code
|
CPT 73218 TC,LT
|
| Hospital Charge Code |
1611131
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,227.83 |
| Max. Negotiated Rate |
$4,752.28 |
| Rate for Payer: Aetna Commercial |
$4,752.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,302.06
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cigna Commercial |
$4,752.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,501.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,001.44
|
| Rate for Payer: Health EOS Commercial |
$4,552.18
|
| Rate for Payer: HFN Commercial |
$4,752.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,227.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,227.83
|
| Rate for Payer: Multiplan Commercial |
$4,001.92
|
| Rate for Payer: Preferred Network Access Commercial |
$4,752.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,201.06
|
| Rate for Payer: Quartz Commercial |
$2,851.37
|
| Rate for Payer: The Alliance Commercial |
$2,501.20
|
| Rate for Payer: WEA Trust Commercial |
$2,751.32
|
| Rate for Payer: WPS Commercial |
$3,705.14
|
|
|
MRI Hand w/o Contrast Left
|
Facility
|
IP
|
$4,810.00
|
|
|
Service Code
|
CPT 73218 TC,LT
|
| Hospital Charge Code |
1611131
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,451.18 |
| Max. Negotiated Rate |
$4,602.21 |
| Rate for Payer: Aetna Commercial |
$4,502.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,302.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,651.27
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cigna Commercial |
$4,602.21
|
| Rate for Payer: Health EOS Commercial |
$4,452.14
|
| Rate for Payer: HFN Commercial |
$4,602.21
|
| Rate for Payer: Multiplan Commercial |
$4,001.92
|
| Rate for Payer: Preferred Network Access Commercial |
$4,602.21
|
| Rate for Payer: Quartz Beloit One Network |
$2,451.18
|
| Rate for Payer: Quartz Commercial |
$3,001.44
|
| Rate for Payer: WEA Trust Commercial |
$2,751.32
|
| Rate for Payer: WPS Commercial |
$3,705.14
|
|
|
MRI Hand w/o Contrast Left
|
Facility
|
OP
|
$4,721.00
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
630973
|
| Min. Negotiated Rate |
$251.10 |
| Max. Negotiated Rate |
$4,517.05 |
| Rate for Payer: Aetna Commercial |
$4,418.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,222.46
|
| Rate for Payer: Aetna Managed Medicare |
$251.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,191.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,454.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,356.72
|
| Rate for Payer: Anthem Medicare Advantage |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,602.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$251.10
|
| Rate for Payer: Cash Price |
$1,416.30
|
| Rate for Payer: Cash Price |
$1,416.30
|
| Rate for Payer: Cigna Commercial |
$4,517.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$251.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,747.62
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$251.10
|
| Rate for Payer: Health EOS Commercial |
$4,369.76
|
| Rate for Payer: HFN Commercial |
$4,517.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$934.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$251.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$251.10
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$251.10
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$251.10
|
| Rate for Payer: Multiplan Commercial |
$3,927.87
|
| Rate for Payer: NAPHCARE Commercial |
$376.65
|
| Rate for Payer: Preferred Network Access Commercial |
$4,517.05
|
| Rate for Payer: Quartz Beloit One Network |
$2,405.82
|
| Rate for Payer: Quartz Commercial |
$3,191.40
|
| Rate for Payer: Quartz Medicare Advantage |
$251.10
|
| Rate for Payer: The Alliance Commercial |
$1,004.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$251.10
|
| Rate for Payer: WEA Trust Commercial |
$2,700.41
|
| Rate for Payer: Wellcare Medicare |
$251.10
|
| Rate for Payer: WPS Commercial |
$3,636.59
|
|
|
MRI Hand w/o Contrast Left
|
Professional
|
Both
|
$4,721.00
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
630973
|
| Min. Negotiated Rate |
$301.83 |
| Max. Negotiated Rate |
$4,664.35 |
| Rate for Payer: Aetna Commercial |
$4,664.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,222.46
|
| Rate for Payer: Aetna Managed Medicare |
$301.83
|
| Rate for Payer: Anthem Medicare Advantage |
$301.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$301.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$301.83
|
| Rate for Payer: Cash Price |
$1,416.30
|
| Rate for Payer: Cash Price |
$1,416.30
|
| Rate for Payer: Cash Price |
$1,416.30
|
| Rate for Payer: Cigna Commercial |
$4,664.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,454.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$301.83
|
| Rate for Payer: Health EOS Commercial |
$4,467.95
|
| Rate for Payer: HFN Commercial |
$4,664.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,227.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,227.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$301.83
|
| Rate for Payer: Multiplan Commercial |
$3,927.87
|
| Rate for Payer: NAPHCARE Commercial |
$452.74
|
| Rate for Payer: Preferred Network Access Commercial |
$4,664.35
|
| Rate for Payer: Quartz Beloit One Network |
$2,160.33
|
| Rate for Payer: Quartz Commercial |
$2,798.61
|
| Rate for Payer: Quartz Medicare Advantage |
$301.83
|
| Rate for Payer: The Alliance Commercial |
$1,146.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$301.83
|
| Rate for Payer: WEA Trust Commercial |
$2,700.41
|
| Rate for Payer: WPS Commercial |
$1,509.14
|
|
|
MRI Hand w/o Contrast Left
|
Facility
|
IP
|
$4,721.00
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
630973
|
| Min. Negotiated Rate |
$2,405.82 |
| Max. Negotiated Rate |
$4,517.05 |
| Rate for Payer: Aetna Commercial |
$4,418.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,222.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,602.22
|
| Rate for Payer: Cash Price |
$1,416.30
|
| Rate for Payer: Cigna Commercial |
$4,517.05
|
| Rate for Payer: Health EOS Commercial |
$4,369.76
|
| Rate for Payer: HFN Commercial |
$4,517.05
|
| Rate for Payer: Multiplan Commercial |
$3,927.87
|
| Rate for Payer: Preferred Network Access Commercial |
$4,517.05
|
| Rate for Payer: Quartz Beloit One Network |
$2,405.82
|
| Rate for Payer: Quartz Commercial |
$2,945.90
|
| Rate for Payer: WEA Trust Commercial |
$2,700.41
|
| Rate for Payer: WPS Commercial |
$3,636.59
|
|
|
MRI Hand w/o Contrast Left
|
Facility
|
OP
|
$4,810.00
|
|
|
Service Code
|
CPT 73218 TC,LT
|
| Hospital Charge Code |
1611131
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,400.67 |
| Max. Negotiated Rate |
$4,602.21 |
| Rate for Payer: Aetna Commercial |
$4,502.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,302.06
|
| Rate for Payer: Aetna Managed Medicare |
$1,400.67
|
| 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 |
$2,651.27
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cigna Commercial |
$4,602.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,799.42
|
| Rate for Payer: Health EOS Commercial |
$4,452.14
|
| Rate for Payer: HFN Commercial |
$4,602.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,751.80
|
| Rate for Payer: Multiplan Commercial |
$4,001.92
|
| Rate for Payer: NAPHCARE Commercial |
$3,001.44
|
| Rate for Payer: Preferred Network Access Commercial |
$4,602.21
|
| Rate for Payer: Quartz Beloit One Network |
$2,451.18
|
| Rate for Payer: Quartz Commercial |
$3,251.56
|
| Rate for Payer: Quartz Medicare Advantage |
$3,001.44
|
| Rate for Payer: The Alliance Commercial |
$2,501.20
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$2,751.32
|
| Rate for Payer: WPS Commercial |
$3,705.14
|
|
|
MRI Hand w/o Contrast Right
|
Professional
|
Both
|
$4,810.00
|
|
|
Service Code
|
CPT 73218 TC,RT
|
| Hospital Charge Code |
1611133
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,227.83 |
| Max. Negotiated Rate |
$4,752.28 |
| Rate for Payer: Aetna Commercial |
$4,752.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,302.06
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cigna Commercial |
$4,752.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,501.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,001.44
|
| Rate for Payer: Health EOS Commercial |
$4,552.18
|
| Rate for Payer: HFN Commercial |
$4,752.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,227.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,227.83
|
| Rate for Payer: Multiplan Commercial |
$4,001.92
|
| Rate for Payer: Preferred Network Access Commercial |
$4,752.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,201.06
|
| Rate for Payer: Quartz Commercial |
$2,851.37
|
| Rate for Payer: The Alliance Commercial |
$2,501.20
|
| Rate for Payer: WEA Trust Commercial |
$2,751.32
|
| Rate for Payer: WPS Commercial |
$3,705.14
|
|
|
MRI Hand w/o Contrast Right
|
Facility
|
OP
|
$4,810.00
|
|
|
Service Code
|
CPT 73218 TC,RT
|
| Hospital Charge Code |
1611133
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,400.67 |
| Max. Negotiated Rate |
$4,602.21 |
| Rate for Payer: Aetna Commercial |
$4,502.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,302.06
|
| Rate for Payer: Aetna Managed Medicare |
$1,400.67
|
| 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 |
$2,651.27
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cash Price |
$1,443.00
|
| Rate for Payer: Cigna Commercial |
$4,602.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,799.42
|
| Rate for Payer: Health EOS Commercial |
$4,452.14
|
| Rate for Payer: HFN Commercial |
$4,602.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,751.80
|
| Rate for Payer: Multiplan Commercial |
$4,001.92
|
| Rate for Payer: NAPHCARE Commercial |
$3,001.44
|
| Rate for Payer: Preferred Network Access Commercial |
$4,602.21
|
| Rate for Payer: Quartz Beloit One Network |
$2,451.18
|
| Rate for Payer: Quartz Commercial |
$3,251.56
|
| Rate for Payer: Quartz Medicare Advantage |
$3,001.44
|
| Rate for Payer: The Alliance Commercial |
$2,501.20
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$2,751.32
|
| Rate for Payer: WPS Commercial |
$3,705.14
|
|
|
MRI Hand w/o Contrast Right
|
Facility
|
OP
|
$4,631.00
|
|
|
Service Code
|
CPT 73218 TC,RT
|
| Hospital Charge Code |
2980028
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,348.55 |
| Max. Negotiated Rate |
$4,430.94 |
| Rate for Payer: Aetna Commercial |
$4,334.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,141.97
|
| Rate for Payer: Aetna Managed Medicare |
$1,348.55
|
| 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 |
$2,552.61
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cigna Commercial |
$4,430.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,695.24
|
| Rate for Payer: Health EOS Commercial |
$4,286.45
|
| Rate for Payer: HFN Commercial |
$4,430.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,612.18
|
| Rate for Payer: Multiplan Commercial |
$3,852.99
|
| Rate for Payer: NAPHCARE Commercial |
$2,889.74
|
| Rate for Payer: Preferred Network Access Commercial |
$4,430.94
|
| Rate for Payer: Quartz Beloit One Network |
$2,359.96
|
| Rate for Payer: Quartz Commercial |
$3,130.56
|
| Rate for Payer: Quartz Medicare Advantage |
$2,889.74
|
| Rate for Payer: The Alliance Commercial |
$2,408.12
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$2,648.93
|
| Rate for Payer: WPS Commercial |
$3,567.26
|
|
|
MRI Hand w/o Contrast Right
|
Facility
|
IP
|
$4,631.00
|
|
|
Service Code
|
CPT 73218 TC,RT
|
| Hospital Charge Code |
2980028
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,359.96 |
| Max. Negotiated Rate |
$4,430.94 |
| Rate for Payer: Aetna Commercial |
$4,334.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,141.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,552.61
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cigna Commercial |
$4,430.94
|
| Rate for Payer: Health EOS Commercial |
$4,286.45
|
| Rate for Payer: HFN Commercial |
$4,430.94
|
| Rate for Payer: Multiplan Commercial |
$3,852.99
|
| Rate for Payer: Preferred Network Access Commercial |
$4,430.94
|
| Rate for Payer: Quartz Beloit One Network |
$2,359.96
|
| Rate for Payer: Quartz Commercial |
$2,889.74
|
| Rate for Payer: WEA Trust Commercial |
$2,648.93
|
| Rate for Payer: WPS Commercial |
$3,567.26
|
|
|
MRI Hand w/o Contrast Right
|
Professional
|
Both
|
$4,631.00
|
|
|
Service Code
|
CPT 73218 TC,RT
|
| Hospital Charge Code |
2980028
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,227.83 |
| Max. Negotiated Rate |
$4,575.43 |
| Rate for Payer: Aetna Commercial |
$4,575.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,141.97
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cash Price |
$1,389.30
|
| Rate for Payer: Cigna Commercial |
$4,575.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,408.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,889.74
|
| Rate for Payer: Health EOS Commercial |
$4,382.78
|
| Rate for Payer: HFN Commercial |
$4,575.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,227.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,227.83
|
| Rate for Payer: Multiplan Commercial |
$3,852.99
|
| Rate for Payer: Preferred Network Access Commercial |
$4,575.43
|
| Rate for Payer: Quartz Beloit One Network |
$2,119.15
|
| Rate for Payer: Quartz Commercial |
$2,745.26
|
| Rate for Payer: The Alliance Commercial |
$2,408.12
|
| Rate for Payer: WEA Trust Commercial |
$2,648.93
|
| Rate for Payer: WPS Commercial |
$3,567.26
|
|
