|
MRV Head Venous Angiogram w + w/o Contrast
|
Professional
|
Both
|
$6,121.00
|
|
|
Service Code
|
CPT 70546 TC
|
| Hospital Charge Code |
5288676
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$258.00 |
| Max. Negotiated Rate |
$6,047.55 |
| Rate for Payer: Aetna Commercial |
$6,047.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,474.62
|
| Rate for Payer: Aetna Managed Medicare |
$258.00
|
| Rate for Payer: Anthem Medicare Advantage |
$258.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$258.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$258.00
|
| Rate for Payer: Cash Price |
$1,836.30
|
| Rate for Payer: Cash Price |
$1,836.30
|
| Rate for Payer: Cash Price |
$1,836.30
|
| Rate for Payer: Cigna Commercial |
$6,047.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,182.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$258.00
|
| Rate for Payer: Health EOS Commercial |
$5,792.91
|
| Rate for Payer: HFN Commercial |
$6,047.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,034.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,034.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$258.00
|
| Rate for Payer: Multiplan Commercial |
$5,092.67
|
| Rate for Payer: NAPHCARE Commercial |
$387.00
|
| Rate for Payer: Preferred Network Access Commercial |
$6,047.55
|
| Rate for Payer: Quartz Beloit One Network |
$2,800.97
|
| Rate for Payer: Quartz Commercial |
$3,628.53
|
| Rate for Payer: Quartz Medicare Advantage |
$258.00
|
| Rate for Payer: The Alliance Commercial |
$980.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$258.00
|
| Rate for Payer: WEA Trust Commercial |
$3,501.21
|
| Rate for Payer: WPS Commercial |
$1,290.02
|
|
|
MSH6
|
Facility
|
OP
|
$668.00
|
|
|
Service Code
|
CPT 81298
|
| Hospital Charge Code |
5542925
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$340.41 |
| Max. Negotiated Rate |
$2,670.10 |
| Rate for Payer: Aetna Commercial |
$625.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$597.46
|
| Rate for Payer: Aetna Managed Medicare |
$667.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,503.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,168.17
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,108.09
|
| Rate for Payer: Anthem Medicare Advantage |
$667.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$368.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$667.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$667.52
|
| Rate for Payer: Cash Price |
$200.40
|
| Rate for Payer: Cash Price |
$200.40
|
| Rate for Payer: Cigna Commercial |
$639.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$667.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$388.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$667.52
|
| Rate for Payer: Health EOS Commercial |
$618.30
|
| Rate for Payer: HFN Commercial |
$639.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,483.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$667.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$667.52
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$667.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$667.52
|
| Rate for Payer: Multiplan Commercial |
$555.78
|
| Rate for Payer: NAPHCARE Commercial |
$1,001.29
|
| Rate for Payer: Preferred Network Access Commercial |
$639.14
|
| Rate for Payer: Quartz Beloit One Network |
$340.41
|
| Rate for Payer: Quartz Commercial |
$451.57
|
| Rate for Payer: Quartz Medicare Advantage |
$667.52
|
| Rate for Payer: The Alliance Commercial |
$2,670.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$667.52
|
| Rate for Payer: United Healthcare PPO |
$521.04
|
| Rate for Payer: WEA Trust Commercial |
$382.10
|
| Rate for Payer: Wellcare Medicare |
$667.52
|
| Rate for Payer: WPS Commercial |
$514.56
|
|
|
MSH6
|
Professional
|
Both
|
$668.00
|
|
|
Service Code
|
CPT 81298
|
| Hospital Charge Code |
5542925
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$305.68 |
| Max. Negotiated Rate |
$2,937.11 |
| Rate for Payer: Aetna Commercial |
$659.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$597.46
|
| Rate for Payer: Aetna Managed Medicare |
$667.52
|
| Rate for Payer: Anthem Medicare Advantage |
$667.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$667.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$667.52
|
| Rate for Payer: Cash Price |
$200.40
|
| Rate for Payer: Cash Price |
$200.40
|
| Rate for Payer: Cigna Commercial |
$659.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$347.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$667.52
|
| Rate for Payer: Health EOS Commercial |
$632.20
|
| Rate for Payer: HFN Commercial |
$659.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,356.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,356.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$667.52
|
| Rate for Payer: Multiplan Commercial |
$555.78
|
| Rate for Payer: NAPHCARE Commercial |
$1,001.29
|
| Rate for Payer: Preferred Network Access Commercial |
$659.98
|
| Rate for Payer: Quartz Beloit One Network |
$305.68
|
| Rate for Payer: Quartz Commercial |
$395.99
|
| Rate for Payer: Quartz Medicare Advantage |
$667.52
|
| Rate for Payer: The Alliance Commercial |
$2,636.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$667.52
|
| Rate for Payer: WEA Trust Commercial |
$382.10
|
| Rate for Payer: WPS Commercial |
$2,937.11
|
|
|
MSH6
|
Facility
|
IP
|
$668.00
|
|
|
Service Code
|
CPT 81298
|
| Hospital Charge Code |
5542925
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$340.41 |
| Max. Negotiated Rate |
$639.14 |
| Rate for Payer: Aetna Commercial |
$625.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$597.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$368.20
|
| Rate for Payer: Cash Price |
$200.40
|
| Rate for Payer: Cigna Commercial |
$639.14
|
| Rate for Payer: Health EOS Commercial |
$618.30
|
| Rate for Payer: HFN Commercial |
$639.14
|
| Rate for Payer: Multiplan Commercial |
$555.78
|
| Rate for Payer: Preferred Network Access Commercial |
$639.14
|
| Rate for Payer: Quartz Beloit One Network |
$340.41
|
| Rate for Payer: Quartz Commercial |
$416.83
|
| Rate for Payer: WEA Trust Commercial |
$382.10
|
| Rate for Payer: WPS Commercial |
$514.56
|
|
|
MSH6 Dup/Del
|
Facility
|
IP
|
$668.00
|
|
|
Service Code
|
CPT 81300
|
| Hospital Charge Code |
5542926
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$340.41 |
| Max. Negotiated Rate |
$639.14 |
| Rate for Payer: Aetna Commercial |
$625.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$597.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$368.20
|
| Rate for Payer: Cash Price |
$200.40
|
| Rate for Payer: Cigna Commercial |
$639.14
|
| Rate for Payer: Health EOS Commercial |
$618.30
|
| Rate for Payer: HFN Commercial |
$639.14
|
| Rate for Payer: Multiplan Commercial |
$555.78
|
| Rate for Payer: Preferred Network Access Commercial |
$639.14
|
| Rate for Payer: Quartz Beloit One Network |
$340.41
|
| Rate for Payer: Quartz Commercial |
$416.83
|
| Rate for Payer: WEA Trust Commercial |
$382.10
|
| Rate for Payer: WPS Commercial |
$514.56
|
|
|
MSH6 Dup/Del
|
Facility
|
OP
|
$668.00
|
|
|
Service Code
|
CPT 81300
|
| Hospital Charge Code |
5542926
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$247.52 |
| Max. Negotiated Rate |
$990.08 |
| Rate for Payer: Aetna Commercial |
$625.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$597.46
|
| Rate for Payer: Aetna Managed Medicare |
$247.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$928.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$433.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$410.88
|
| Rate for Payer: Anthem Medicare Advantage |
$247.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$368.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$247.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$247.52
|
| Rate for Payer: Cash Price |
$200.40
|
| Rate for Payer: Cash Price |
$200.40
|
| Rate for Payer: Cigna Commercial |
$639.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$247.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$388.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$247.52
|
| Rate for Payer: Health EOS Commercial |
$618.30
|
| Rate for Payer: HFN Commercial |
$639.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$920.77
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$247.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$247.52
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$247.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$247.52
|
| Rate for Payer: Multiplan Commercial |
$555.78
|
| Rate for Payer: NAPHCARE Commercial |
$371.28
|
| Rate for Payer: Preferred Network Access Commercial |
$639.14
|
| Rate for Payer: Quartz Beloit One Network |
$340.41
|
| Rate for Payer: Quartz Commercial |
$451.57
|
| Rate for Payer: Quartz Medicare Advantage |
$247.52
|
| Rate for Payer: The Alliance Commercial |
$990.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$247.52
|
| Rate for Payer: United Healthcare PPO |
$521.04
|
| Rate for Payer: WEA Trust Commercial |
$382.10
|
| Rate for Payer: Wellcare Medicare |
$247.52
|
| Rate for Payer: WPS Commercial |
$514.56
|
|
|
MSH6 Dup/Del
|
Professional
|
Both
|
$668.00
|
|
|
Service Code
|
CPT 81300
|
| Hospital Charge Code |
5542926
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$247.52 |
| Max. Negotiated Rate |
$1,089.09 |
| Rate for Payer: Aetna Commercial |
$659.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$597.46
|
| Rate for Payer: Aetna Managed Medicare |
$247.52
|
| Rate for Payer: Anthem Medicare Advantage |
$247.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$247.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$247.52
|
| Rate for Payer: Cash Price |
$200.40
|
| Rate for Payer: Cash Price |
$200.40
|
| Rate for Payer: Cigna Commercial |
$659.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$347.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$247.52
|
| Rate for Payer: Health EOS Commercial |
$632.20
|
| Rate for Payer: HFN Commercial |
$659.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$873.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$873.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$247.52
|
| Rate for Payer: Multiplan Commercial |
$555.78
|
| Rate for Payer: NAPHCARE Commercial |
$371.28
|
| Rate for Payer: Preferred Network Access Commercial |
$659.98
|
| Rate for Payer: Quartz Beloit One Network |
$305.68
|
| Rate for Payer: Quartz Commercial |
$395.99
|
| Rate for Payer: Quartz Medicare Advantage |
$247.52
|
| Rate for Payer: The Alliance Commercial |
$977.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$247.52
|
| Rate for Payer: WEA Trust Commercial |
$382.10
|
| Rate for Payer: WPS Commercial |
$1,089.09
|
|
|
MSSA BC PCR
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
5239044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.49 |
| Max. Negotiated Rate |
$160.57 |
| Rate for Payer: Aetna Commercial |
$116.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$105.54
|
| Rate for Payer: Aetna Managed Medicare |
$36.49
|
| Rate for Payer: Anthem Medicare Advantage |
$36.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$36.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$36.49
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$116.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$61.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$36.49
|
| Rate for Payer: Health EOS Commercial |
$111.68
|
| Rate for Payer: HFN Commercial |
$116.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$128.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$128.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$36.49
|
| Rate for Payer: Multiplan Commercial |
$98.18
|
| Rate for Payer: NAPHCARE Commercial |
$54.74
|
| Rate for Payer: Preferred Network Access Commercial |
$116.58
|
| Rate for Payer: Quartz Beloit One Network |
$54.00
|
| Rate for Payer: Quartz Commercial |
$69.95
|
| Rate for Payer: Quartz Medicare Advantage |
$36.49
|
| Rate for Payer: The Alliance Commercial |
$144.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.49
|
| Rate for Payer: WEA Trust Commercial |
$67.50
|
| Rate for Payer: WPS Commercial |
$160.57
|
|
|
MSSA BC PCR
|
Facility
|
OP
|
$118.00
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
5239044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.49 |
| Max. Negotiated Rate |
$145.97 |
| Rate for Payer: Aetna Commercial |
$110.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$105.54
|
| Rate for Payer: Aetna Managed Medicare |
$36.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$136.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$63.86
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$60.58
|
| Rate for Payer: Anthem Medicare Advantage |
$36.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$65.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$36.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$36.49
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$112.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$36.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$68.68
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$36.49
|
| Rate for Payer: Health EOS Commercial |
$109.22
|
| Rate for Payer: HFN Commercial |
$112.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$135.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$36.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$36.49
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$36.49
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$36.49
|
| Rate for Payer: Multiplan Commercial |
$98.18
|
| Rate for Payer: NAPHCARE Commercial |
$54.74
|
| Rate for Payer: Preferred Network Access Commercial |
$112.90
|
| Rate for Payer: Quartz Beloit One Network |
$60.13
|
| Rate for Payer: Quartz Commercial |
$79.77
|
| Rate for Payer: Quartz Medicare Advantage |
$36.49
|
| Rate for Payer: The Alliance Commercial |
$145.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.49
|
| Rate for Payer: United Healthcare PPO |
$92.04
|
| Rate for Payer: WEA Trust Commercial |
$67.50
|
| Rate for Payer: Wellcare Medicare |
$36.49
|
| Rate for Payer: WPS Commercial |
$90.90
|
|
|
MSSA BC PCR
|
Facility
|
IP
|
$118.00
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
5239044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.13 |
| Max. Negotiated Rate |
$112.90 |
| Rate for Payer: Aetna Commercial |
$110.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$105.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$65.04
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$112.90
|
| Rate for Payer: Health EOS Commercial |
$109.22
|
| Rate for Payer: HFN Commercial |
$112.90
|
| Rate for Payer: Multiplan Commercial |
$98.18
|
| Rate for Payer: Preferred Network Access Commercial |
$112.90
|
| Rate for Payer: Quartz Beloit One Network |
$60.13
|
| Rate for Payer: Quartz Commercial |
$73.63
|
| Rate for Payer: WEA Trust Commercial |
$67.50
|
| Rate for Payer: WPS Commercial |
$90.90
|
|
|
MTHFR DNA Mutation Analysis
|
Facility
|
IP
|
$1,304.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
983331
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$664.52 |
| Max. Negotiated Rate |
$1,247.67 |
| Rate for Payer: Aetna Commercial |
$1,220.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,166.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$718.76
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cigna Commercial |
$1,247.67
|
| Rate for Payer: Health EOS Commercial |
$1,206.98
|
| Rate for Payer: HFN Commercial |
$1,247.67
|
| Rate for Payer: Multiplan Commercial |
$1,084.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,247.67
|
| Rate for Payer: Quartz Beloit One Network |
$664.52
|
| Rate for Payer: Quartz Commercial |
$813.70
|
| Rate for Payer: WEA Trust Commercial |
$745.89
|
| Rate for Payer: WPS Commercial |
$1,004.47
|
|
|
MTHFR DNA Mutation Analysis
|
Professional
|
Both
|
$1,304.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
983331
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$1,288.35 |
| Rate for Payer: Aetna Commercial |
$1,288.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,166.30
|
| Rate for Payer: Aetna Managed Medicare |
$67.95
|
| Rate for Payer: Anthem Medicare Advantage |
$67.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$67.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$67.95
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cigna Commercial |
$1,288.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$678.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$67.95
|
| Rate for Payer: Health EOS Commercial |
$1,234.11
|
| Rate for Payer: HFN Commercial |
$1,288.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$239.88
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$239.88
|
| Rate for Payer: Independent Care Health Plan Medicare |
$67.95
|
| Rate for Payer: Multiplan Commercial |
$1,084.93
|
| Rate for Payer: NAPHCARE Commercial |
$101.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,288.35
|
| Rate for Payer: Quartz Beloit One Network |
$596.71
|
| Rate for Payer: Quartz Commercial |
$773.01
|
| Rate for Payer: Quartz Medicare Advantage |
$67.95
|
| Rate for Payer: The Alliance Commercial |
$268.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$67.95
|
| Rate for Payer: WEA Trust Commercial |
$745.89
|
| Rate for Payer: WPS Commercial |
$299.00
|
|
|
MTHFR DNA Mutation Analysis
|
Facility
|
OP
|
$1,304.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
983331
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$1,247.67 |
| Rate for Payer: Aetna Commercial |
$1,220.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,166.30
|
| Rate for Payer: Aetna Managed Medicare |
$67.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$254.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$118.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$112.80
|
| Rate for Payer: Anthem Medicare Advantage |
$67.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$718.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$67.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$67.95
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cigna Commercial |
$1,247.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$67.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$758.93
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$67.95
|
| Rate for Payer: Health EOS Commercial |
$1,206.98
|
| Rate for Payer: HFN Commercial |
$1,247.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$252.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$67.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$67.95
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$67.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$67.95
|
| Rate for Payer: Multiplan Commercial |
$1,084.93
|
| Rate for Payer: NAPHCARE Commercial |
$101.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,247.67
|
| Rate for Payer: Quartz Beloit One Network |
$664.52
|
| Rate for Payer: Quartz Commercial |
$881.50
|
| Rate for Payer: Quartz Medicare Advantage |
$67.95
|
| Rate for Payer: The Alliance Commercial |
$271.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$67.95
|
| Rate for Payer: United Healthcare PPO |
$1,017.12
|
| Rate for Payer: WEA Trust Commercial |
$745.89
|
| Rate for Payer: Wellcare Medicare |
$67.95
|
| Rate for Payer: WPS Commercial |
$1,004.47
|
|
|
MTHFR Nucleic Acid Probe
|
Facility
|
IP
|
$79.00
|
|
| Hospital Charge Code |
2778801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$75.59 |
| Rate for Payer: Aetna Commercial |
$73.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$70.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.54
|
| Rate for Payer: Cash Price |
$23.70
|
| Rate for Payer: Cigna Commercial |
$75.59
|
| Rate for Payer: Health EOS Commercial |
$73.12
|
| Rate for Payer: HFN Commercial |
$75.59
|
| Rate for Payer: Multiplan Commercial |
$65.73
|
| Rate for Payer: Preferred Network Access Commercial |
$75.59
|
| Rate for Payer: Quartz Beloit One Network |
$40.26
|
| Rate for Payer: Quartz Commercial |
$49.30
|
| Rate for Payer: WEA Trust Commercial |
$45.19
|
| Rate for Payer: WPS Commercial |
$60.85
|
|
|
MTHFR Nucleic Acid Probe
|
Professional
|
Both
|
$79.00
|
|
| Hospital Charge Code |
2778801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$78.05 |
| Rate for Payer: Aetna Commercial |
$78.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$70.66
|
| Rate for Payer: Cash Price |
$23.70
|
| Rate for Payer: Cigna Commercial |
$78.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$49.30
|
| Rate for Payer: Health EOS Commercial |
$74.77
|
| Rate for Payer: HFN Commercial |
$78.05
|
| Rate for Payer: Multiplan Commercial |
$65.73
|
| Rate for Payer: Preferred Network Access Commercial |
$78.05
|
| Rate for Payer: Quartz Beloit One Network |
$36.15
|
| Rate for Payer: Quartz Commercial |
$46.83
|
| Rate for Payer: The Alliance Commercial |
$41.08
|
| Rate for Payer: WEA Trust Commercial |
$45.19
|
| Rate for Payer: WPS Commercial |
$60.85
|
|
|
MTHFR Nucleic Acid Probe
|
Facility
|
OP
|
$79.00
|
|
| Hospital Charge Code |
2778801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$75.59 |
| Rate for Payer: Aetna Commercial |
$73.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$70.66
|
| Rate for Payer: Aetna Managed Medicare |
$23.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$39.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.54
|
| Rate for Payer: Cash Price |
$23.70
|
| Rate for Payer: Cigna Commercial |
$75.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$45.98
|
| Rate for Payer: Health EOS Commercial |
$73.12
|
| Rate for Payer: HFN Commercial |
$75.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.62
|
| Rate for Payer: Multiplan Commercial |
$65.73
|
| Rate for Payer: NAPHCARE Commercial |
$49.30
|
| Rate for Payer: Preferred Network Access Commercial |
$75.59
|
| Rate for Payer: Quartz Beloit One Network |
$40.26
|
| Rate for Payer: Quartz Commercial |
$53.40
|
| Rate for Payer: Quartz Medicare Advantage |
$49.30
|
| Rate for Payer: The Alliance Commercial |
$41.08
|
| Rate for Payer: United Healthcare PPO |
$61.62
|
| Rate for Payer: WEA Trust Commercial |
$45.19
|
| Rate for Payer: WPS Commercial |
$60.85
|
|
|
MUELLER GEL BRACE COLD THERAPY
|
Facility
|
OP
|
$435.00
|
|
| Hospital Charge Code |
2971128
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$126.67 |
| Max. Negotiated Rate |
$416.21 |
| Rate for Payer: Aetna Commercial |
$407.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$389.06
|
| Rate for Payer: Aetna Managed Medicare |
$126.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$294.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$226.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$217.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$239.77
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cigna Commercial |
$416.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$253.17
|
| Rate for Payer: Health EOS Commercial |
$402.64
|
| Rate for Payer: HFN Commercial |
$416.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$339.30
|
| Rate for Payer: Multiplan Commercial |
$361.92
|
| Rate for Payer: NAPHCARE Commercial |
$271.44
|
| Rate for Payer: Preferred Network Access Commercial |
$416.21
|
| Rate for Payer: Quartz Beloit One Network |
$221.68
|
| Rate for Payer: Quartz Commercial |
$294.06
|
| Rate for Payer: Quartz Medicare Advantage |
$271.44
|
| Rate for Payer: The Alliance Commercial |
$226.20
|
| Rate for Payer: WEA Trust Commercial |
$248.82
|
| Rate for Payer: WPS Commercial |
$335.08
|
|
|
MUELLER GEL BRACE COLD THERAPY
|
Facility
|
IP
|
$435.00
|
|
| Hospital Charge Code |
2971128
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$221.68 |
| Max. Negotiated Rate |
$416.21 |
| Rate for Payer: Aetna Commercial |
$407.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$389.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$239.77
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cigna Commercial |
$416.21
|
| Rate for Payer: Health EOS Commercial |
$402.64
|
| Rate for Payer: HFN Commercial |
$416.21
|
| Rate for Payer: Multiplan Commercial |
$361.92
|
| Rate for Payer: Preferred Network Access Commercial |
$416.21
|
| Rate for Payer: Quartz Beloit One Network |
$221.68
|
| Rate for Payer: Quartz Commercial |
$271.44
|
| Rate for Payer: WEA Trust Commercial |
$248.82
|
| Rate for Payer: WPS Commercial |
$335.08
|
|
|
Multi Den Insert Custom Med A5513
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
HCPCS A5513
|
| Hospital Charge Code |
5290775
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$46.88 |
| Rate for Payer: Aetna Commercial |
$45.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.01
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$46.88
|
| Rate for Payer: Health EOS Commercial |
$45.35
|
| Rate for Payer: HFN Commercial |
$46.88
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: Preferred Network Access Commercial |
$46.88
|
| Rate for Payer: Quartz Beloit One Network |
$24.97
|
| Rate for Payer: Quartz Commercial |
$30.58
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$37.74
|
|
|
Multi Den Insert Custom Med A5513
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS A5513
|
| Hospital Charge Code |
5290775
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$22.42 |
| Max. Negotiated Rate |
$165.39 |
| Rate for Payer: Aetna Commercial |
$48.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Aetna Managed Medicare |
$57.37
|
| Rate for Payer: Anthem Medicare Advantage |
$57.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$57.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$57.37
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$48.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$57.37
|
| Rate for Payer: Health EOS Commercial |
$46.37
|
| Rate for Payer: HFN Commercial |
$48.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$165.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$165.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$57.37
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: NAPHCARE Commercial |
$86.05
|
| Rate for Payer: Preferred Network Access Commercial |
$48.41
|
| Rate for Payer: Quartz Beloit One Network |
$22.42
|
| Rate for Payer: Quartz Commercial |
$29.05
|
| Rate for Payer: Quartz Medicare Advantage |
$57.37
|
| Rate for Payer: The Alliance Commercial |
$157.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$57.37
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$100.39
|
|
|
Multi Den Insert Custom Med A5513
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
HCPCS A5513
|
| Hospital Charge Code |
5290775
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$14.27 |
| Max. Negotiated Rate |
$229.47 |
| Rate for Payer: Aetna Commercial |
$45.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Aetna Managed Medicare |
$14.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$35.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$35.85
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$35.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.01
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$46.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28.52
|
| Rate for Payer: Health EOS Commercial |
$45.35
|
| Rate for Payer: HFN Commercial |
$46.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$38.22
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: NAPHCARE Commercial |
$30.58
|
| Rate for Payer: Preferred Network Access Commercial |
$46.88
|
| Rate for Payer: Quartz Beloit One Network |
$24.97
|
| Rate for Payer: Quartz Commercial |
$33.12
|
| Rate for Payer: Quartz Medicare Advantage |
$30.58
|
| Rate for Payer: The Alliance Commercial |
$229.47
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$37.74
|
|
|
Multi den insert direct form A5512
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
HCPCS A5512
|
| Hospital Charge Code |
3133662
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$4.78 |
| Rate for Payer: Aetna Commercial |
$4.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2.76
|
| Rate for Payer: Cash Price |
$1.50
|
| Rate for Payer: Cigna Commercial |
$4.78
|
| Rate for Payer: Health EOS Commercial |
$4.63
|
| Rate for Payer: HFN Commercial |
$4.78
|
| Rate for Payer: Multiplan Commercial |
$4.16
|
| Rate for Payer: Preferred Network Access Commercial |
$4.78
|
| Rate for Payer: Quartz Beloit One Network |
$2.55
|
| Rate for Payer: Quartz Commercial |
$3.12
|
| Rate for Payer: WEA Trust Commercial |
$2.86
|
| Rate for Payer: WPS Commercial |
$3.85
|
|
|
Multi den insert direct form A5512
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
HCPCS A5512
|
| Hospital Charge Code |
3133662
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1.46 |
| Max. Negotiated Rate |
$153.75 |
| Rate for Payer: Aetna Commercial |
$4.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4.47
|
| Rate for Payer: Aetna Managed Medicare |
$1.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$23.95
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2.76
|
| Rate for Payer: Cash Price |
$1.50
|
| Rate for Payer: Cash Price |
$1.50
|
| Rate for Payer: Cigna Commercial |
$4.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2.91
|
| Rate for Payer: Health EOS Commercial |
$4.63
|
| Rate for Payer: HFN Commercial |
$4.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3.90
|
| Rate for Payer: Multiplan Commercial |
$4.16
|
| Rate for Payer: NAPHCARE Commercial |
$3.12
|
| Rate for Payer: Preferred Network Access Commercial |
$4.78
|
| Rate for Payer: Quartz Beloit One Network |
$2.55
|
| Rate for Payer: Quartz Commercial |
$3.38
|
| Rate for Payer: Quartz Medicare Advantage |
$3.12
|
| Rate for Payer: The Alliance Commercial |
$153.75
|
| Rate for Payer: WEA Trust Commercial |
$2.86
|
| Rate for Payer: WPS Commercial |
$3.85
|
|
|
Multi den insert direct form A5512
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS A5512
|
| Hospital Charge Code |
3133662
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$110.83 |
| Rate for Payer: Aetna Commercial |
$4.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4.47
|
| Rate for Payer: Aetna Managed Medicare |
$38.44
|
| Rate for Payer: Anthem Medicare Advantage |
$38.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$38.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$38.44
|
| Rate for Payer: Cash Price |
$1.50
|
| Rate for Payer: Cash Price |
$1.50
|
| Rate for Payer: Cigna Commercial |
$4.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$38.44
|
| Rate for Payer: Health EOS Commercial |
$4.73
|
| Rate for Payer: HFN Commercial |
$4.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$110.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$110.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$38.44
|
| Rate for Payer: Multiplan Commercial |
$4.16
|
| Rate for Payer: NAPHCARE Commercial |
$57.66
|
| Rate for Payer: Preferred Network Access Commercial |
$4.94
|
| Rate for Payer: Quartz Beloit One Network |
$2.29
|
| Rate for Payer: Quartz Commercial |
$2.96
|
| Rate for Payer: Quartz Medicare Advantage |
$38.44
|
| Rate for Payer: The Alliance Commercial |
$105.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$38.44
|
| Rate for Payer: WEA Trust Commercial |
$2.86
|
| Rate for Payer: WPS Commercial |
$67.27
|
|
|
Multihance 10 ml
|
Facility
|
OP
|
$258.00
|
|
| Hospital Charge Code |
1486806
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$75.13 |
| Max. Negotiated Rate |
$246.85 |
| Rate for Payer: Aetna Commercial |
$241.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$230.76
|
| Rate for Payer: Aetna Managed Medicare |
$75.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$174.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$134.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$128.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$142.21
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna Commercial |
$246.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$150.16
|
| Rate for Payer: Health EOS Commercial |
$238.80
|
| Rate for Payer: HFN Commercial |
$246.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$201.24
|
| Rate for Payer: Multiplan Commercial |
$214.66
|
| Rate for Payer: NAPHCARE Commercial |
$160.99
|
| Rate for Payer: Preferred Network Access Commercial |
$246.85
|
| Rate for Payer: Quartz Beloit One Network |
$131.48
|
| Rate for Payer: Quartz Commercial |
$174.41
|
| Rate for Payer: Quartz Medicare Advantage |
$160.99
|
| Rate for Payer: The Alliance Commercial |
$134.16
|
| Rate for Payer: WEA Trust Commercial |
$147.58
|
| Rate for Payer: WPS Commercial |
$198.74
|
|
