|
MRI Hand w/o Contrast Right
|
Facility
|
OP
|
$4,721.00
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
630975
|
| 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 Right
|
Professional
|
Both
|
$4,721.00
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
630975
|
| 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 Right
|
Facility
|
IP
|
$4,721.00
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
630975
|
| 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 Right
|
Facility
|
IP
|
$4,810.00
|
|
|
Service Code
|
CPT 73218 TC,RT
|
| Hospital Charge Code |
1611133
|
|
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/ + w/o Contrast Bilateral
|
Facility
|
OP
|
$11,535.00
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
630951
|
| Min. Negotiated Rate |
$367.15 |
| Max. Negotiated Rate |
$11,036.69 |
| Rate for Payer: Aetna Commercial |
$10,796.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,316.90
|
| Rate for Payer: Aetna Managed Medicare |
$367.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,797.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,998.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,758.27
|
| Rate for Payer: Anthem Medicare Advantage |
$367.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,358.09
|
| 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 |
$3,460.50
|
| Rate for Payer: Cash Price |
$3,460.50
|
| Rate for Payer: Cigna Commercial |
$11,036.69
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$367.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,713.37
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$367.15
|
| Rate for Payer: Health EOS Commercial |
$10,676.80
|
| Rate for Payer: HFN Commercial |
$11,036.69
|
| 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 |
$9,597.12
|
| Rate for Payer: NAPHCARE Commercial |
$550.73
|
| Rate for Payer: Preferred Network Access Commercial |
$11,036.69
|
| Rate for Payer: Quartz Beloit One Network |
$5,878.24
|
| Rate for Payer: Quartz Commercial |
$7,797.66
|
| 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 |
$6,598.02
|
| Rate for Payer: Wellcare Medicare |
$367.15
|
| Rate for Payer: WPS Commercial |
$8,885.41
|
|
|
MRI Hand w/ + w/o Contrast Bilateral
|
Professional
|
Both
|
$6,397.00
|
|
|
Service Code
|
CPT 73220 TC,LT
|
| Hospital Charge Code |
1611117
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,659.96 |
| Max. Negotiated Rate |
$6,320.24 |
| Rate for Payer: Aetna Commercial |
$6,320.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,721.48
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cigna Commercial |
$6,320.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,326.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,991.73
|
| Rate for Payer: Health EOS Commercial |
$6,054.12
|
| Rate for Payer: HFN Commercial |
$6,320.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,659.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,659.96
|
| Rate for Payer: Multiplan Commercial |
$5,322.30
|
| Rate for Payer: Preferred Network Access Commercial |
$6,320.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,927.27
|
| Rate for Payer: Quartz Commercial |
$3,792.14
|
| Rate for Payer: The Alliance Commercial |
$3,326.44
|
| Rate for Payer: WEA Trust Commercial |
$3,659.08
|
| Rate for Payer: WPS Commercial |
$4,927.61
|
|
|
MRI Hand w/ + w/o Contrast Bilateral
|
Facility
|
OP
|
$6,397.00
|
|
|
Service Code
|
CPT 73220 TC,LT
|
| Hospital Charge Code |
1611117
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,862.81 |
| Max. Negotiated Rate |
$6,120.65 |
| Rate for Payer: Aetna Commercial |
$5,987.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,721.48
|
| Rate for Payer: Aetna Managed Medicare |
$1,862.81
|
| 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 |
$3,526.03
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cigna Commercial |
$6,120.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,723.05
|
| Rate for Payer: Health EOS Commercial |
$5,921.06
|
| Rate for Payer: HFN Commercial |
$6,120.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,989.66
|
| Rate for Payer: Multiplan Commercial |
$5,322.30
|
| Rate for Payer: NAPHCARE Commercial |
$3,991.73
|
| Rate for Payer: Preferred Network Access Commercial |
$6,120.65
|
| Rate for Payer: Quartz Beloit One Network |
$3,259.91
|
| Rate for Payer: Quartz Commercial |
$4,324.37
|
| Rate for Payer: Quartz Medicare Advantage |
$3,991.73
|
| Rate for Payer: The Alliance Commercial |
$3,326.44
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,659.08
|
| Rate for Payer: WPS Commercial |
$4,927.61
|
|
|
MRI Hand w/ + w/o Contrast Bilateral
|
Facility
|
IP
|
$6,397.00
|
|
|
Service Code
|
CPT 73220 TC,LT
|
| Hospital Charge Code |
1611117
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$3,259.91 |
| Max. Negotiated Rate |
$6,120.65 |
| Rate for Payer: Aetna Commercial |
$5,987.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,721.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,526.03
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cigna Commercial |
$6,120.65
|
| Rate for Payer: Health EOS Commercial |
$5,921.06
|
| Rate for Payer: HFN Commercial |
$6,120.65
|
| Rate for Payer: Multiplan Commercial |
$5,322.30
|
| Rate for Payer: Preferred Network Access Commercial |
$6,120.65
|
| Rate for Payer: Quartz Beloit One Network |
$3,259.91
|
| Rate for Payer: Quartz Commercial |
$3,991.73
|
| Rate for Payer: WEA Trust Commercial |
$3,659.08
|
| Rate for Payer: WPS Commercial |
$4,927.61
|
|
|
MRI Hand w/ + w/o Contrast Bilateral
|
Facility
|
IP
|
$11,535.00
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
630951
|
| Min. Negotiated Rate |
$5,878.24 |
| Max. Negotiated Rate |
$11,036.69 |
| Rate for Payer: Aetna Commercial |
$10,796.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,316.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,358.09
|
| Rate for Payer: Cash Price |
$3,460.50
|
| Rate for Payer: Cigna Commercial |
$11,036.69
|
| Rate for Payer: Health EOS Commercial |
$10,676.80
|
| Rate for Payer: HFN Commercial |
$11,036.69
|
| Rate for Payer: Multiplan Commercial |
$9,597.12
|
| Rate for Payer: Preferred Network Access Commercial |
$11,036.69
|
| Rate for Payer: Quartz Beloit One Network |
$5,878.24
|
| Rate for Payer: Quartz Commercial |
$7,197.84
|
| Rate for Payer: WEA Trust Commercial |
$6,598.02
|
| Rate for Payer: WPS Commercial |
$8,885.41
|
|
|
MRI Hand w/ + w/o Contrast Bilateral
|
Professional
|
Both
|
$11,535.00
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
630951
|
| Min. Negotiated Rate |
$404.78 |
| Max. Negotiated Rate |
$11,396.58 |
| Rate for Payer: Aetna Commercial |
$11,396.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,316.90
|
| Rate for Payer: Aetna Managed Medicare |
$404.78
|
| Rate for Payer: Anthem Medicare Advantage |
$404.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$404.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$404.78
|
| Rate for Payer: Cash Price |
$3,460.50
|
| Rate for Payer: Cash Price |
$3,460.50
|
| Rate for Payer: Cash Price |
$3,460.50
|
| Rate for Payer: Cigna Commercial |
$11,396.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5,998.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$404.78
|
| Rate for Payer: Health EOS Commercial |
$10,916.72
|
| Rate for Payer: HFN Commercial |
$11,396.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,659.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,659.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$404.78
|
| Rate for Payer: Multiplan Commercial |
$9,597.12
|
| Rate for Payer: NAPHCARE Commercial |
$607.17
|
| Rate for Payer: Preferred Network Access Commercial |
$11,396.58
|
| Rate for Payer: Quartz Beloit One Network |
$5,278.42
|
| Rate for Payer: Quartz Commercial |
$6,837.95
|
| Rate for Payer: Quartz Medicare Advantage |
$404.78
|
| Rate for Payer: The Alliance Commercial |
$1,538.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$404.78
|
| Rate for Payer: WEA Trust Commercial |
$6,598.02
|
| Rate for Payer: WPS Commercial |
$2,023.89
|
|
|
MRI Hand w/ + w/o Contrast Left
|
Facility
|
OP
|
$5,767.00
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
630953
|
| Min. Negotiated Rate |
$367.15 |
| Max. Negotiated Rate |
$5,517.87 |
| Rate for Payer: Aetna Commercial |
$5,397.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,158.00
|
| Rate for Payer: Aetna Managed Medicare |
$367.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,898.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,998.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,878.89
|
| Rate for Payer: Anthem Medicare Advantage |
$367.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,178.77
|
| 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 |
$1,730.10
|
| Rate for Payer: Cash Price |
$1,730.10
|
| Rate for Payer: Cigna Commercial |
$5,517.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$367.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,356.39
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$367.15
|
| Rate for Payer: Health EOS Commercial |
$5,337.94
|
| Rate for Payer: HFN Commercial |
$5,517.87
|
| 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 |
$4,798.14
|
| Rate for Payer: NAPHCARE Commercial |
$550.73
|
| Rate for Payer: Preferred Network Access Commercial |
$5,517.87
|
| Rate for Payer: Quartz Beloit One Network |
$2,938.86
|
| Rate for Payer: Quartz Commercial |
$3,898.49
|
| 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 |
$3,298.72
|
| Rate for Payer: Wellcare Medicare |
$367.15
|
| Rate for Payer: WPS Commercial |
$4,442.32
|
|
|
MRI Hand w/ + w/o Contrast Left
|
Facility
|
IP
|
$6,636.00
|
|
|
Service Code
|
CPT 73220 TC,LT
|
| Hospital Charge Code |
1611119
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$3,381.71 |
| Max. Negotiated Rate |
$6,349.32 |
| Rate for Payer: Aetna Commercial |
$6,211.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,935.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,657.76
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cigna Commercial |
$6,349.32
|
| Rate for Payer: Health EOS Commercial |
$6,142.28
|
| Rate for Payer: HFN Commercial |
$6,349.32
|
| Rate for Payer: Multiplan Commercial |
$5,521.15
|
| Rate for Payer: Preferred Network Access Commercial |
$6,349.32
|
| Rate for Payer: Quartz Beloit One Network |
$3,381.71
|
| Rate for Payer: Quartz Commercial |
$4,140.86
|
| Rate for Payer: WEA Trust Commercial |
$3,795.79
|
| Rate for Payer: WPS Commercial |
$5,111.71
|
|
|
MRI Hand w/ + w/o Contrast Left
|
Facility
|
OP
|
$6,636.00
|
|
|
Service Code
|
CPT 73220 TC,LT
|
| Hospital Charge Code |
1611119
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,932.40 |
| Max. Negotiated Rate |
$6,349.32 |
| Rate for Payer: Aetna Commercial |
$6,211.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,935.24
|
| Rate for Payer: Aetna Managed Medicare |
$1,932.40
|
| 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 |
$3,657.76
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cigna Commercial |
$6,349.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,862.15
|
| Rate for Payer: Health EOS Commercial |
$6,142.28
|
| Rate for Payer: HFN Commercial |
$6,349.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,176.08
|
| Rate for Payer: Multiplan Commercial |
$5,521.15
|
| Rate for Payer: NAPHCARE Commercial |
$4,140.86
|
| Rate for Payer: Preferred Network Access Commercial |
$6,349.32
|
| Rate for Payer: Quartz Beloit One Network |
$3,381.71
|
| Rate for Payer: Quartz Commercial |
$4,485.94
|
| Rate for Payer: Quartz Medicare Advantage |
$4,140.86
|
| Rate for Payer: The Alliance Commercial |
$3,450.72
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,795.79
|
| Rate for Payer: WPS Commercial |
$5,111.71
|
|
|
MRI Hand w/ + w/o Contrast Left
|
Professional
|
Both
|
$5,767.00
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
630953
|
| Min. Negotiated Rate |
$404.78 |
| Max. Negotiated Rate |
$5,697.80 |
| Rate for Payer: Aetna Commercial |
$5,697.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,158.00
|
| Rate for Payer: Aetna Managed Medicare |
$404.78
|
| Rate for Payer: Anthem Medicare Advantage |
$404.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$404.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$404.78
|
| Rate for Payer: Cash Price |
$1,730.10
|
| Rate for Payer: Cash Price |
$1,730.10
|
| Rate for Payer: Cash Price |
$1,730.10
|
| Rate for Payer: Cigna Commercial |
$5,697.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,998.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$404.78
|
| Rate for Payer: Health EOS Commercial |
$5,457.89
|
| Rate for Payer: HFN Commercial |
$5,697.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,659.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,659.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$404.78
|
| Rate for Payer: Multiplan Commercial |
$4,798.14
|
| Rate for Payer: NAPHCARE Commercial |
$607.17
|
| Rate for Payer: Preferred Network Access Commercial |
$5,697.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,638.98
|
| Rate for Payer: Quartz Commercial |
$3,418.68
|
| Rate for Payer: Quartz Medicare Advantage |
$404.78
|
| Rate for Payer: The Alliance Commercial |
$1,538.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$404.78
|
| Rate for Payer: WEA Trust Commercial |
$3,298.72
|
| Rate for Payer: WPS Commercial |
$2,023.89
|
|
|
MRI Hand w/ + w/o Contrast Left
|
Professional
|
Both
|
$6,636.00
|
|
|
Service Code
|
CPT 73220 TC,LT
|
| Hospital Charge Code |
1611119
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,659.96 |
| Max. Negotiated Rate |
$6,556.37 |
| Rate for Payer: Aetna Commercial |
$6,556.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,935.24
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cigna Commercial |
$6,556.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,450.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,140.86
|
| Rate for Payer: Health EOS Commercial |
$6,280.31
|
| Rate for Payer: HFN Commercial |
$6,556.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,659.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,659.96
|
| Rate for Payer: Multiplan Commercial |
$5,521.15
|
| Rate for Payer: Preferred Network Access Commercial |
$6,556.37
|
| Rate for Payer: Quartz Beloit One Network |
$3,036.63
|
| Rate for Payer: Quartz Commercial |
$3,933.82
|
| Rate for Payer: The Alliance Commercial |
$3,450.72
|
| Rate for Payer: WEA Trust Commercial |
$3,795.79
|
| Rate for Payer: WPS Commercial |
$5,111.71
|
|
|
MRI Hand w/ + w/o Contrast Left
|
Facility
|
IP
|
$5,767.00
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
630953
|
| Min. Negotiated Rate |
$2,938.86 |
| Max. Negotiated Rate |
$5,517.87 |
| Rate for Payer: Aetna Commercial |
$5,397.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,158.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,178.77
|
| Rate for Payer: Cash Price |
$1,730.10
|
| Rate for Payer: Cigna Commercial |
$5,517.87
|
| Rate for Payer: Health EOS Commercial |
$5,337.94
|
| Rate for Payer: HFN Commercial |
$5,517.87
|
| Rate for Payer: Multiplan Commercial |
$4,798.14
|
| Rate for Payer: Preferred Network Access Commercial |
$5,517.87
|
| Rate for Payer: Quartz Beloit One Network |
$2,938.86
|
| Rate for Payer: Quartz Commercial |
$3,598.61
|
| Rate for Payer: WEA Trust Commercial |
$3,298.72
|
| Rate for Payer: WPS Commercial |
$4,442.32
|
|
|
MRI Hand w/ + w/o Contrast Right
|
Professional
|
Both
|
$6,636.00
|
|
|
Service Code
|
CPT 73220 TC,RT
|
| Hospital Charge Code |
1611121
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,659.96 |
| Max. Negotiated Rate |
$6,556.37 |
| Rate for Payer: Aetna Commercial |
$6,556.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,935.24
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cigna Commercial |
$6,556.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,450.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,140.86
|
| Rate for Payer: Health EOS Commercial |
$6,280.31
|
| Rate for Payer: HFN Commercial |
$6,556.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,659.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,659.96
|
| Rate for Payer: Multiplan Commercial |
$5,521.15
|
| Rate for Payer: Preferred Network Access Commercial |
$6,556.37
|
| Rate for Payer: Quartz Beloit One Network |
$3,036.63
|
| Rate for Payer: Quartz Commercial |
$3,933.82
|
| Rate for Payer: The Alliance Commercial |
$3,450.72
|
| Rate for Payer: WEA Trust Commercial |
$3,795.79
|
| Rate for Payer: WPS Commercial |
$5,111.71
|
|
|
MRI Hand w/ + w/o Contrast Right
|
Facility
|
OP
|
$6,636.00
|
|
|
Service Code
|
CPT 73220 TC,RT
|
| Hospital Charge Code |
1611121
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,932.40 |
| Max. Negotiated Rate |
$6,349.32 |
| Rate for Payer: Aetna Commercial |
$6,211.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,935.24
|
| Rate for Payer: Aetna Managed Medicare |
$1,932.40
|
| 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 |
$3,657.76
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cigna Commercial |
$6,349.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,862.15
|
| Rate for Payer: Health EOS Commercial |
$6,142.28
|
| Rate for Payer: HFN Commercial |
$6,349.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,176.08
|
| Rate for Payer: Multiplan Commercial |
$5,521.15
|
| Rate for Payer: NAPHCARE Commercial |
$4,140.86
|
| Rate for Payer: Preferred Network Access Commercial |
$6,349.32
|
| Rate for Payer: Quartz Beloit One Network |
$3,381.71
|
| Rate for Payer: Quartz Commercial |
$4,485.94
|
| Rate for Payer: Quartz Medicare Advantage |
$4,140.86
|
| Rate for Payer: The Alliance Commercial |
$3,450.72
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,795.79
|
| Rate for Payer: WPS Commercial |
$5,111.71
|
|
|
MRI Hand w/ + w/o Contrast Right
|
Facility
|
OP
|
$6,397.00
|
|
|
Service Code
|
CPT 73220 TC,RT
|
| Hospital Charge Code |
2980036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,862.81 |
| Max. Negotiated Rate |
$6,120.65 |
| Rate for Payer: Aetna Commercial |
$5,987.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,721.48
|
| Rate for Payer: Aetna Managed Medicare |
$1,862.81
|
| 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 |
$3,526.03
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cigna Commercial |
$6,120.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,723.05
|
| Rate for Payer: Health EOS Commercial |
$5,921.06
|
| Rate for Payer: HFN Commercial |
$6,120.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,989.66
|
| Rate for Payer: Multiplan Commercial |
$5,322.30
|
| Rate for Payer: NAPHCARE Commercial |
$3,991.73
|
| Rate for Payer: Preferred Network Access Commercial |
$6,120.65
|
| Rate for Payer: Quartz Beloit One Network |
$3,259.91
|
| Rate for Payer: Quartz Commercial |
$4,324.37
|
| Rate for Payer: Quartz Medicare Advantage |
$3,991.73
|
| Rate for Payer: The Alliance Commercial |
$3,326.44
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,659.08
|
| Rate for Payer: WPS Commercial |
$4,927.61
|
|
|
MRI Hand w/ + w/o Contrast Right
|
Professional
|
Both
|
$6,397.00
|
|
|
Service Code
|
CPT 73220 TC,RT
|
| Hospital Charge Code |
2980036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,659.96 |
| Max. Negotiated Rate |
$6,320.24 |
| Rate for Payer: Aetna Commercial |
$6,320.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,721.48
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cigna Commercial |
$6,320.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,326.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,991.73
|
| Rate for Payer: Health EOS Commercial |
$6,054.12
|
| Rate for Payer: HFN Commercial |
$6,320.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,659.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,659.96
|
| Rate for Payer: Multiplan Commercial |
$5,322.30
|
| Rate for Payer: Preferred Network Access Commercial |
$6,320.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,927.27
|
| Rate for Payer: Quartz Commercial |
$3,792.14
|
| Rate for Payer: The Alliance Commercial |
$3,326.44
|
| Rate for Payer: WEA Trust Commercial |
$3,659.08
|
| Rate for Payer: WPS Commercial |
$4,927.61
|
|
|
MRI Hand w/ + w/o Contrast Right
|
Facility
|
OP
|
$5,767.00
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
630955
|
| Min. Negotiated Rate |
$367.15 |
| Max. Negotiated Rate |
$5,517.87 |
| Rate for Payer: Aetna Commercial |
$5,397.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,158.00
|
| Rate for Payer: Aetna Managed Medicare |
$367.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,898.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,998.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,878.89
|
| Rate for Payer: Anthem Medicare Advantage |
$367.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,178.77
|
| 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 |
$1,730.10
|
| Rate for Payer: Cash Price |
$1,730.10
|
| Rate for Payer: Cigna Commercial |
$5,517.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$367.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,356.39
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$367.15
|
| Rate for Payer: Health EOS Commercial |
$5,337.94
|
| Rate for Payer: HFN Commercial |
$5,517.87
|
| 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 |
$4,798.14
|
| Rate for Payer: NAPHCARE Commercial |
$550.73
|
| Rate for Payer: Preferred Network Access Commercial |
$5,517.87
|
| Rate for Payer: Quartz Beloit One Network |
$2,938.86
|
| Rate for Payer: Quartz Commercial |
$3,898.49
|
| 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 |
$3,298.72
|
| Rate for Payer: Wellcare Medicare |
$367.15
|
| Rate for Payer: WPS Commercial |
$4,442.32
|
|
|
MRI Hand w/ + w/o Contrast Right
|
Professional
|
Both
|
$5,767.00
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
630955
|
| Min. Negotiated Rate |
$404.78 |
| Max. Negotiated Rate |
$5,697.80 |
| Rate for Payer: Aetna Commercial |
$5,697.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,158.00
|
| Rate for Payer: Aetna Managed Medicare |
$404.78
|
| Rate for Payer: Anthem Medicare Advantage |
$404.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$404.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$404.78
|
| Rate for Payer: Cash Price |
$1,730.10
|
| Rate for Payer: Cash Price |
$1,730.10
|
| Rate for Payer: Cash Price |
$1,730.10
|
| Rate for Payer: Cigna Commercial |
$5,697.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,998.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$404.78
|
| Rate for Payer: Health EOS Commercial |
$5,457.89
|
| Rate for Payer: HFN Commercial |
$5,697.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,659.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,659.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$404.78
|
| Rate for Payer: Multiplan Commercial |
$4,798.14
|
| Rate for Payer: NAPHCARE Commercial |
$607.17
|
| Rate for Payer: Preferred Network Access Commercial |
$5,697.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,638.98
|
| Rate for Payer: Quartz Commercial |
$3,418.68
|
| Rate for Payer: Quartz Medicare Advantage |
$404.78
|
| Rate for Payer: The Alliance Commercial |
$1,538.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$404.78
|
| Rate for Payer: WEA Trust Commercial |
$3,298.72
|
| Rate for Payer: WPS Commercial |
$2,023.89
|
|
|
MRI Hand w/ + w/o Contrast Right
|
Facility
|
IP
|
$6,397.00
|
|
|
Service Code
|
CPT 73220 TC,RT
|
| Hospital Charge Code |
2980036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$3,259.91 |
| Max. Negotiated Rate |
$6,120.65 |
| Rate for Payer: Aetna Commercial |
$5,987.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,721.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,526.03
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cigna Commercial |
$6,120.65
|
| Rate for Payer: Health EOS Commercial |
$5,921.06
|
| Rate for Payer: HFN Commercial |
$6,120.65
|
| Rate for Payer: Multiplan Commercial |
$5,322.30
|
| Rate for Payer: Preferred Network Access Commercial |
$6,120.65
|
| Rate for Payer: Quartz Beloit One Network |
$3,259.91
|
| Rate for Payer: Quartz Commercial |
$3,991.73
|
| Rate for Payer: WEA Trust Commercial |
$3,659.08
|
| Rate for Payer: WPS Commercial |
$4,927.61
|
|
|
MRI Hand w/ + w/o Contrast Right
|
Facility
|
IP
|
$6,636.00
|
|
|
Service Code
|
CPT 73220 TC,RT
|
| Hospital Charge Code |
1611121
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$3,381.71 |
| Max. Negotiated Rate |
$6,349.32 |
| Rate for Payer: Aetna Commercial |
$6,211.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,935.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,657.76
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cigna Commercial |
$6,349.32
|
| Rate for Payer: Health EOS Commercial |
$6,142.28
|
| Rate for Payer: HFN Commercial |
$6,349.32
|
| Rate for Payer: Multiplan Commercial |
$5,521.15
|
| Rate for Payer: Preferred Network Access Commercial |
$6,349.32
|
| Rate for Payer: Quartz Beloit One Network |
$3,381.71
|
| Rate for Payer: Quartz Commercial |
$4,140.86
|
| Rate for Payer: WEA Trust Commercial |
$3,795.79
|
| Rate for Payer: WPS Commercial |
$5,111.71
|
|
|
MRI Hand w/ + w/o Contrast Right
|
Facility
|
IP
|
$5,767.00
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
630955
|
| Min. Negotiated Rate |
$2,938.86 |
| Max. Negotiated Rate |
$5,517.87 |
| Rate for Payer: Aetna Commercial |
$5,397.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,158.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,178.77
|
| Rate for Payer: Cash Price |
$1,730.10
|
| Rate for Payer: Cigna Commercial |
$5,517.87
|
| Rate for Payer: Health EOS Commercial |
$5,337.94
|
| Rate for Payer: HFN Commercial |
$5,517.87
|
| Rate for Payer: Multiplan Commercial |
$4,798.14
|
| Rate for Payer: Preferred Network Access Commercial |
$5,517.87
|
| Rate for Payer: Quartz Beloit One Network |
$2,938.86
|
| Rate for Payer: Quartz Commercial |
$3,598.61
|
| Rate for Payer: WEA Trust Commercial |
$3,298.72
|
| Rate for Payer: WPS Commercial |
$4,442.32
|
|
