|
MRI Wrist w/o Contrast Right
|
Facility
|
OP
|
$5,085.00
|
|
|
Service Code
|
CPT 73221 RT,TC
|
| Hospital Charge Code |
1611403
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,480.75 |
| Max. Negotiated Rate |
$4,865.33 |
| Rate for Payer: Aetna Commercial |
$4,759.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,548.02
|
| Rate for Payer: Aetna Managed Medicare |
$1,480.75
|
| 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 |
$2,802.85
|
| Rate for Payer: Cash Price |
$1,525.50
|
| Rate for Payer: Cash Price |
$1,525.50
|
| Rate for Payer: Cash Price |
$1,525.50
|
| Rate for Payer: Cigna Commercial |
$4,865.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,959.47
|
| Rate for Payer: Health EOS Commercial |
$4,706.68
|
| Rate for Payer: HFN Commercial |
$4,865.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,966.30
|
| Rate for Payer: Multiplan Commercial |
$4,230.72
|
| Rate for Payer: NAPHCARE Commercial |
$3,173.04
|
| Rate for Payer: Preferred Network Access Commercial |
$4,865.33
|
| Rate for Payer: Quartz Beloit One Network |
$2,591.32
|
| Rate for Payer: Quartz Commercial |
$3,437.46
|
| Rate for Payer: Quartz Medicare Advantage |
$3,173.04
|
| Rate for Payer: The Alliance Commercial |
$2,644.20
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$2,908.62
|
| Rate for Payer: WPS Commercial |
$3,916.98
|
|
|
MRI Wrist w/o Contrast Right
|
Facility
|
OP
|
$4,561.00
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
631482
|
| Min. Negotiated Rate |
$251.10 |
| Max. Negotiated Rate |
$4,363.96 |
| Rate for Payer: Aetna Commercial |
$4,269.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,079.36
|
| Rate for Payer: Aetna Managed Medicare |
$251.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,083.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,371.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,276.85
|
| Rate for Payer: Anthem Medicare Advantage |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,514.02
|
| 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 |
$1,368.30
|
| Rate for Payer: Cash Price |
$1,368.30
|
| Rate for Payer: Cigna Commercial |
$4,363.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$251.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,654.50
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$251.10
|
| Rate for Payer: Health EOS Commercial |
$4,221.66
|
| Rate for Payer: HFN Commercial |
$4,363.96
|
| 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 |
$3,794.75
|
| Rate for Payer: NAPHCARE Commercial |
$376.65
|
| Rate for Payer: Preferred Network Access Commercial |
$4,363.96
|
| Rate for Payer: Quartz Beloit One Network |
$2,324.29
|
| Rate for Payer: Quartz Commercial |
$3,083.24
|
| 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 |
$2,608.89
|
| Rate for Payer: Wellcare Medicare |
$251.10
|
| Rate for Payer: WPS Commercial |
$3,513.34
|
|
|
MRI Wrist w/o Contrast Right
|
Facility
|
IP
|
$5,533.00
|
|
|
Service Code
|
CPT 73221 TC,RT
|
| Hospital Charge Code |
2980042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,819.62 |
| Max. Negotiated Rate |
$5,293.97 |
| Rate for Payer: Aetna Commercial |
$5,178.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,948.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,049.79
|
| Rate for Payer: Cash Price |
$1,659.90
|
| Rate for Payer: Cigna Commercial |
$5,293.97
|
| Rate for Payer: Health EOS Commercial |
$5,121.34
|
| Rate for Payer: HFN Commercial |
$5,293.97
|
| Rate for Payer: Multiplan Commercial |
$4,603.46
|
| Rate for Payer: Preferred Network Access Commercial |
$5,293.97
|
| Rate for Payer: Quartz Beloit One Network |
$2,819.62
|
| Rate for Payer: Quartz Commercial |
$3,452.59
|
| Rate for Payer: WEA Trust Commercial |
$3,164.88
|
| Rate for Payer: WPS Commercial |
$4,262.07
|
|
|
MRI Wrist w/o Contrast Right
|
Professional
|
Both
|
$5,533.00
|
|
|
Service Code
|
CPT 73221 TC,RT
|
| Hospital Charge Code |
2980042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$795.00 |
| Max. Negotiated Rate |
$5,466.60 |
| Rate for Payer: Aetna Commercial |
$5,466.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,948.72
|
| Rate for Payer: Cash Price |
$1,659.90
|
| Rate for Payer: Cash Price |
$1,659.90
|
| Rate for Payer: Cash Price |
$1,659.90
|
| Rate for Payer: Cigna Commercial |
$5,466.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,877.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,452.59
|
| Rate for Payer: Health EOS Commercial |
$5,236.43
|
| Rate for Payer: HFN Commercial |
$5,466.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$795.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$795.00
|
| Rate for Payer: Multiplan Commercial |
$4,603.46
|
| Rate for Payer: Preferred Network Access Commercial |
$5,466.60
|
| Rate for Payer: Quartz Beloit One Network |
$2,531.90
|
| Rate for Payer: Quartz Commercial |
$3,279.96
|
| Rate for Payer: The Alliance Commercial |
$2,877.16
|
| Rate for Payer: WEA Trust Commercial |
$3,164.88
|
| Rate for Payer: WPS Commercial |
$4,262.07
|
|
|
MRI Wrist w/o Contrast Right
|
Facility
|
OP
|
$5,533.00
|
|
|
Service Code
|
CPT 73221 TC,RT
|
| Hospital Charge Code |
2980042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,611.21 |
| Max. Negotiated Rate |
$5,293.97 |
| Rate for Payer: Aetna Commercial |
$5,178.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,948.72
|
| Rate for Payer: Aetna Managed Medicare |
$1,611.21
|
| 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 |
$3,049.79
|
| Rate for Payer: Cash Price |
$1,659.90
|
| Rate for Payer: Cash Price |
$1,659.90
|
| Rate for Payer: Cash Price |
$1,659.90
|
| Rate for Payer: Cigna Commercial |
$5,293.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,220.21
|
| Rate for Payer: Health EOS Commercial |
$5,121.34
|
| Rate for Payer: HFN Commercial |
$5,293.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,315.74
|
| Rate for Payer: Multiplan Commercial |
$4,603.46
|
| Rate for Payer: NAPHCARE Commercial |
$3,452.59
|
| Rate for Payer: Preferred Network Access Commercial |
$5,293.97
|
| Rate for Payer: Quartz Beloit One Network |
$2,819.62
|
| Rate for Payer: Quartz Commercial |
$3,740.31
|
| Rate for Payer: Quartz Medicare Advantage |
$3,452.59
|
| Rate for Payer: The Alliance Commercial |
$2,877.16
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,164.88
|
| Rate for Payer: WPS Commercial |
$4,262.07
|
|
|
MRI Wrist w/ + w/o Contrast Bilateral
|
Facility
|
OP
|
$6,397.00
|
|
|
Service Code
|
CPT 73223 LT,TC
|
| Hospital Charge Code |
1611387
|
|
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 Wrist w/ + w/o Contrast Bilateral
|
Professional
|
Both
|
$6,397.00
|
|
|
Service Code
|
CPT 73223 LT,TC
|
| Hospital Charge Code |
1611387
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,567.53 |
| 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 |
$1,567.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,567.53
|
| 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 Wrist w/ + w/o Contrast Bilateral
|
Professional
|
Both
|
$11,703.00
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
631418
|
| Min. Negotiated Rate |
$381.38 |
| Max. Negotiated Rate |
$11,562.56 |
| Rate for Payer: Aetna Commercial |
$11,562.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,467.16
|
| Rate for Payer: Aetna Managed Medicare |
$381.38
|
| Rate for Payer: Anthem Medicare Advantage |
$381.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$381.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$381.38
|
| Rate for Payer: Cash Price |
$3,510.90
|
| Rate for Payer: Cash Price |
$3,510.90
|
| Rate for Payer: Cash Price |
$3,510.90
|
| Rate for Payer: Cigna Commercial |
$11,562.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,085.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$381.38
|
| Rate for Payer: Health EOS Commercial |
$11,075.72
|
| Rate for Payer: HFN Commercial |
$11,562.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,567.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,567.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$381.38
|
| Rate for Payer: Multiplan Commercial |
$9,736.90
|
| Rate for Payer: NAPHCARE Commercial |
$572.07
|
| Rate for Payer: Preferred Network Access Commercial |
$11,562.56
|
| Rate for Payer: Quartz Beloit One Network |
$5,355.29
|
| Rate for Payer: Quartz Commercial |
$6,937.54
|
| Rate for Payer: Quartz Medicare Advantage |
$381.38
|
| Rate for Payer: The Alliance Commercial |
$1,449.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$381.38
|
| Rate for Payer: WEA Trust Commercial |
$6,694.12
|
| Rate for Payer: WPS Commercial |
$1,906.89
|
|
|
MRI Wrist w/ + w/o Contrast Bilateral
|
Facility
|
OP
|
$11,703.00
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
631418
|
| Min. Negotiated Rate |
$367.15 |
| Max. Negotiated Rate |
$11,197.43 |
| Rate for Payer: Aetna Commercial |
$10,954.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,467.16
|
| Rate for Payer: Aetna Managed Medicare |
$367.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,911.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6,085.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,842.14
|
| Rate for Payer: Anthem Medicare Advantage |
$367.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,450.69
|
| 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 |
$3,510.90
|
| Rate for Payer: Cash Price |
$3,510.90
|
| Rate for Payer: Cigna Commercial |
$11,197.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$367.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,811.15
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$367.15
|
| Rate for Payer: Health EOS Commercial |
$10,832.30
|
| Rate for Payer: HFN Commercial |
$11,197.43
|
| 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 |
$9,736.90
|
| Rate for Payer: NAPHCARE Commercial |
$550.73
|
| Rate for Payer: Preferred Network Access Commercial |
$11,197.43
|
| Rate for Payer: Quartz Beloit One Network |
$5,963.85
|
| Rate for Payer: Quartz Commercial |
$7,911.23
|
| 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 |
$6,694.12
|
| Rate for Payer: Wellcare Medicare |
$367.15
|
| Rate for Payer: WPS Commercial |
$9,014.82
|
|
|
MRI Wrist w/ + w/o Contrast Bilateral
|
Facility
|
IP
|
$6,397.00
|
|
|
Service Code
|
CPT 73223 LT,TC
|
| Hospital Charge Code |
1611387
|
|
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 Wrist w/ + w/o Contrast Bilateral
|
Facility
|
IP
|
$11,703.00
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
631418
|
| Min. Negotiated Rate |
$5,963.85 |
| Max. Negotiated Rate |
$11,197.43 |
| Rate for Payer: Aetna Commercial |
$10,954.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,467.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,450.69
|
| Rate for Payer: Cash Price |
$3,510.90
|
| Rate for Payer: Cigna Commercial |
$11,197.43
|
| Rate for Payer: Health EOS Commercial |
$10,832.30
|
| Rate for Payer: HFN Commercial |
$11,197.43
|
| Rate for Payer: Multiplan Commercial |
$9,736.90
|
| Rate for Payer: Preferred Network Access Commercial |
$11,197.43
|
| Rate for Payer: Quartz Beloit One Network |
$5,963.85
|
| Rate for Payer: Quartz Commercial |
$7,302.67
|
| Rate for Payer: WEA Trust Commercial |
$6,694.12
|
| Rate for Payer: WPS Commercial |
$9,014.82
|
|
|
MRI Wrist w/ + w/o Contrast Left
|
Facility
|
OP
|
$6,421.00
|
|
|
Service Code
|
CPT 73223 LT,TC
|
| Hospital Charge Code |
1611389
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,869.80 |
| Max. Negotiated Rate |
$6,143.61 |
| Rate for Payer: Aetna Commercial |
$6,010.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,742.94
|
| Rate for Payer: Aetna Managed Medicare |
$1,869.80
|
| 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 |
$3,539.26
|
| Rate for Payer: Cash Price |
$1,926.30
|
| Rate for Payer: Cash Price |
$1,926.30
|
| Rate for Payer: Cash Price |
$1,926.30
|
| Rate for Payer: Cigna Commercial |
$6,143.61
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,737.02
|
| Rate for Payer: Health EOS Commercial |
$5,943.28
|
| Rate for Payer: HFN Commercial |
$6,143.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,008.38
|
| Rate for Payer: Multiplan Commercial |
$5,342.27
|
| Rate for Payer: NAPHCARE Commercial |
$4,006.70
|
| Rate for Payer: Preferred Network Access Commercial |
$6,143.61
|
| Rate for Payer: Quartz Beloit One Network |
$3,272.14
|
| Rate for Payer: Quartz Commercial |
$4,340.60
|
| Rate for Payer: Quartz Medicare Advantage |
$4,006.70
|
| Rate for Payer: The Alliance Commercial |
$3,338.92
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$3,672.81
|
| Rate for Payer: WPS Commercial |
$4,946.10
|
|
|
MRI Wrist w/ + w/o Contrast Left
|
Facility
|
OP
|
$5,851.00
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
631423
|
| Min. Negotiated Rate |
$367.15 |
| Max. Negotiated Rate |
$5,598.24 |
| Rate for Payer: Aetna Commercial |
$5,476.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,233.13
|
| Rate for Payer: Aetna Managed Medicare |
$367.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,955.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,042.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,920.82
|
| Rate for Payer: Anthem Medicare Advantage |
$367.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,225.07
|
| 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 |
$1,755.30
|
| Rate for Payer: Cash Price |
$1,755.30
|
| Rate for Payer: Cigna Commercial |
$5,598.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$367.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,405.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$367.15
|
| Rate for Payer: Health EOS Commercial |
$5,415.69
|
| Rate for Payer: HFN Commercial |
$5,598.24
|
| 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 |
$4,868.03
|
| Rate for Payer: NAPHCARE Commercial |
$550.73
|
| Rate for Payer: Preferred Network Access Commercial |
$5,598.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,981.67
|
| Rate for Payer: Quartz Commercial |
$3,955.28
|
| 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 |
$3,346.77
|
| Rate for Payer: Wellcare Medicare |
$367.15
|
| Rate for Payer: WPS Commercial |
$4,507.03
|
|
|
MRI Wrist w/ + w/o Contrast Left
|
Facility
|
IP
|
$6,421.00
|
|
|
Service Code
|
CPT 73223 LT,TC
|
| Hospital Charge Code |
1611389
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$3,272.14 |
| Max. Negotiated Rate |
$6,143.61 |
| Rate for Payer: Aetna Commercial |
$6,010.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,742.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,539.26
|
| Rate for Payer: Cash Price |
$1,926.30
|
| Rate for Payer: Cigna Commercial |
$6,143.61
|
| Rate for Payer: Health EOS Commercial |
$5,943.28
|
| Rate for Payer: HFN Commercial |
$6,143.61
|
| Rate for Payer: Multiplan Commercial |
$5,342.27
|
| Rate for Payer: Preferred Network Access Commercial |
$6,143.61
|
| Rate for Payer: Quartz Beloit One Network |
$3,272.14
|
| Rate for Payer: Quartz Commercial |
$4,006.70
|
| Rate for Payer: WEA Trust Commercial |
$3,672.81
|
| Rate for Payer: WPS Commercial |
$4,946.10
|
|
|
MRI Wrist w/ + w/o Contrast Left
|
Professional
|
Both
|
$5,851.00
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
631423
|
| Min. Negotiated Rate |
$381.38 |
| Max. Negotiated Rate |
$5,780.79 |
| Rate for Payer: Aetna Commercial |
$5,780.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,233.13
|
| Rate for Payer: Aetna Managed Medicare |
$381.38
|
| Rate for Payer: Anthem Medicare Advantage |
$381.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$381.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$381.38
|
| Rate for Payer: Cash Price |
$1,755.30
|
| Rate for Payer: Cash Price |
$1,755.30
|
| Rate for Payer: Cash Price |
$1,755.30
|
| Rate for Payer: Cigna Commercial |
$5,780.79
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,042.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$381.38
|
| Rate for Payer: Health EOS Commercial |
$5,537.39
|
| Rate for Payer: HFN Commercial |
$5,780.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,567.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,567.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$381.38
|
| Rate for Payer: Multiplan Commercial |
$4,868.03
|
| Rate for Payer: NAPHCARE Commercial |
$572.07
|
| Rate for Payer: Preferred Network Access Commercial |
$5,780.79
|
| Rate for Payer: Quartz Beloit One Network |
$2,677.42
|
| Rate for Payer: Quartz Commercial |
$3,468.47
|
| Rate for Payer: Quartz Medicare Advantage |
$381.38
|
| Rate for Payer: The Alliance Commercial |
$1,449.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$381.38
|
| Rate for Payer: WEA Trust Commercial |
$3,346.77
|
| Rate for Payer: WPS Commercial |
$1,906.89
|
|
|
MRI Wrist w/ + w/o Contrast Left
|
Professional
|
Both
|
$6,421.00
|
|
|
Service Code
|
CPT 73223 LT,TC
|
| Hospital Charge Code |
1611389
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,567.53 |
| Max. Negotiated Rate |
$6,343.95 |
| Rate for Payer: Aetna Commercial |
$6,343.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,742.94
|
| Rate for Payer: Cash Price |
$1,926.30
|
| Rate for Payer: Cash Price |
$1,926.30
|
| Rate for Payer: Cash Price |
$1,926.30
|
| Rate for Payer: Cigna Commercial |
$6,343.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,338.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,006.70
|
| Rate for Payer: Health EOS Commercial |
$6,076.83
|
| Rate for Payer: HFN Commercial |
$6,343.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,567.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,567.53
|
| Rate for Payer: Multiplan Commercial |
$5,342.27
|
| Rate for Payer: Preferred Network Access Commercial |
$6,343.95
|
| Rate for Payer: Quartz Beloit One Network |
$2,938.25
|
| Rate for Payer: Quartz Commercial |
$3,806.37
|
| Rate for Payer: The Alliance Commercial |
$3,338.92
|
| Rate for Payer: WEA Trust Commercial |
$3,672.81
|
| Rate for Payer: WPS Commercial |
$4,946.10
|
|
|
MRI Wrist w/ + w/o Contrast Left
|
Facility
|
IP
|
$5,851.00
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
631423
|
| Min. Negotiated Rate |
$2,981.67 |
| Max. Negotiated Rate |
$5,598.24 |
| Rate for Payer: Aetna Commercial |
$5,476.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,233.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,225.07
|
| Rate for Payer: Cash Price |
$1,755.30
|
| Rate for Payer: Cigna Commercial |
$5,598.24
|
| Rate for Payer: Health EOS Commercial |
$5,415.69
|
| Rate for Payer: HFN Commercial |
$5,598.24
|
| Rate for Payer: Multiplan Commercial |
$4,868.03
|
| Rate for Payer: Preferred Network Access Commercial |
$5,598.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,981.67
|
| Rate for Payer: Quartz Commercial |
$3,651.02
|
| Rate for Payer: WEA Trust Commercial |
$3,346.77
|
| Rate for Payer: WPS Commercial |
$4,507.03
|
|
|
MRI Wrist w/ + w/o Contrast Right
|
Professional
|
Both
|
$6,397.00
|
|
|
Service Code
|
CPT 73223 TC,RT
|
| Hospital Charge Code |
2980050
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,567.53 |
| 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 |
$1,567.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,567.53
|
| 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 Wrist w/ + w/o Contrast Right
|
Facility
|
OP
|
$5,851.00
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
631429
|
| Min. Negotiated Rate |
$367.15 |
| Max. Negotiated Rate |
$5,598.24 |
| Rate for Payer: Aetna Commercial |
$5,476.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,233.13
|
| Rate for Payer: Aetna Managed Medicare |
$367.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,955.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,042.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,920.82
|
| Rate for Payer: Anthem Medicare Advantage |
$367.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,225.07
|
| 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 |
$1,755.30
|
| Rate for Payer: Cash Price |
$1,755.30
|
| Rate for Payer: Cigna Commercial |
$5,598.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$367.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,405.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$367.15
|
| Rate for Payer: Health EOS Commercial |
$5,415.69
|
| Rate for Payer: HFN Commercial |
$5,598.24
|
| 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 |
$4,868.03
|
| Rate for Payer: NAPHCARE Commercial |
$550.73
|
| Rate for Payer: Preferred Network Access Commercial |
$5,598.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,981.67
|
| Rate for Payer: Quartz Commercial |
$3,955.28
|
| 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 |
$3,346.77
|
| Rate for Payer: Wellcare Medicare |
$367.15
|
| Rate for Payer: WPS Commercial |
$4,507.03
|
|
|
MRI Wrist w/ + w/o Contrast Right
|
Facility
|
IP
|
$6,397.00
|
|
|
Service Code
|
CPT 73223 TC,RT
|
| Hospital Charge Code |
2980050
|
|
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 Wrist w/ + w/o Contrast Right
|
Facility
|
IP
|
$6,397.00
|
|
|
Service Code
|
CPT 73223 RT,TC
|
| Hospital Charge Code |
1611391
|
|
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 Wrist w/ + w/o Contrast Right
|
Facility
|
IP
|
$5,851.00
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
631429
|
| Min. Negotiated Rate |
$2,981.67 |
| Max. Negotiated Rate |
$5,598.24 |
| Rate for Payer: Aetna Commercial |
$5,476.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,233.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,225.07
|
| Rate for Payer: Cash Price |
$1,755.30
|
| Rate for Payer: Cigna Commercial |
$5,598.24
|
| Rate for Payer: Health EOS Commercial |
$5,415.69
|
| Rate for Payer: HFN Commercial |
$5,598.24
|
| Rate for Payer: Multiplan Commercial |
$4,868.03
|
| Rate for Payer: Preferred Network Access Commercial |
$5,598.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,981.67
|
| Rate for Payer: Quartz Commercial |
$3,651.02
|
| Rate for Payer: WEA Trust Commercial |
$3,346.77
|
| Rate for Payer: WPS Commercial |
$4,507.03
|
|
|
MRI Wrist w/ + w/o Contrast Right
|
Professional
|
Both
|
$5,851.00
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
631429
|
| Min. Negotiated Rate |
$381.38 |
| Max. Negotiated Rate |
$5,780.79 |
| Rate for Payer: Aetna Commercial |
$5,780.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,233.13
|
| Rate for Payer: Aetna Managed Medicare |
$381.38
|
| Rate for Payer: Anthem Medicare Advantage |
$381.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$381.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$381.38
|
| Rate for Payer: Cash Price |
$1,755.30
|
| Rate for Payer: Cash Price |
$1,755.30
|
| Rate for Payer: Cash Price |
$1,755.30
|
| Rate for Payer: Cigna Commercial |
$5,780.79
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,042.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$381.38
|
| Rate for Payer: Health EOS Commercial |
$5,537.39
|
| Rate for Payer: HFN Commercial |
$5,780.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,567.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,567.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$381.38
|
| Rate for Payer: Multiplan Commercial |
$4,868.03
|
| Rate for Payer: NAPHCARE Commercial |
$572.07
|
| Rate for Payer: Preferred Network Access Commercial |
$5,780.79
|
| Rate for Payer: Quartz Beloit One Network |
$2,677.42
|
| Rate for Payer: Quartz Commercial |
$3,468.47
|
| Rate for Payer: Quartz Medicare Advantage |
$381.38
|
| Rate for Payer: The Alliance Commercial |
$1,449.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$381.38
|
| Rate for Payer: WEA Trust Commercial |
$3,346.77
|
| Rate for Payer: WPS Commercial |
$1,906.89
|
|
|
MRI Wrist w/ + w/o Contrast Right
|
Facility
|
OP
|
$6,397.00
|
|
|
Service Code
|
CPT 73223 RT,TC
|
| Hospital Charge Code |
1611391
|
|
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 Wrist w/ + w/o Contrast Right
|
Professional
|
Both
|
$6,397.00
|
|
|
Service Code
|
CPT 73223 RT,TC
|
| Hospital Charge Code |
1611391
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,567.53 |
| 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 |
$1,567.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,567.53
|
| 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
|
|
