|
Pace/ICD AV + CS Leads Only
|
Facility
|
OP
|
$2,342.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
4308767
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,147.58 |
| Max. Negotiated Rate |
$33,588.76 |
| Rate for Payer: Aetna Commercial |
$2,107.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,014.12
|
| Rate for Payer: Aetna Managed Medicare |
$8,397.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$8,397.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,241.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,397.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,397.19
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,154.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,397.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,397.19
|
| Rate for Payer: Health EOS Commercial |
$2,084.38
|
| Rate for Payer: HFN Commercial |
$2,154.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31,237.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,397.19
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,397.19
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,397.19
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,397.19
|
| Rate for Payer: Multiplan Commercial |
$1,873.60
|
| Rate for Payer: NAPHCARE Commercial |
$12,595.78
|
| Rate for Payer: Preferred Network Access Commercial |
$2,154.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,147.58
|
| Rate for Payer: Quartz Commercial |
$1,522.30
|
| Rate for Payer: Quartz Medicare Advantage |
$8,397.19
|
| Rate for Payer: The Alliance Commercial |
$33,588.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,397.19
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: WEA Trust Commercial |
$1,288.10
|
| Rate for Payer: Wellcare Medicare |
$8,397.19
|
| Rate for Payer: WPS Commercial |
$1,734.72
|
|
|
Pace/ICD AV + CS Leads Only
|
Facility
|
IP
|
$2,342.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
4308767
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,147.58 |
| Max. Negotiated Rate |
$2,154.64 |
| Rate for Payer: Aetna Commercial |
$2,107.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,014.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,241.26
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,154.64
|
| Rate for Payer: Health EOS Commercial |
$2,084.38
|
| Rate for Payer: HFN Commercial |
$2,154.64
|
| Rate for Payer: Multiplan Commercial |
$1,873.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,405.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,154.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,147.58
|
| Rate for Payer: Quartz Commercial |
$1,405.20
|
| Rate for Payer: WEA Trust Commercial |
$1,288.10
|
| Rate for Payer: WPS Commercial |
$1,734.72
|
|
|
Pace/ICD CS Lead Ins, New Gen +
|
Facility
|
IP
|
$3,978.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
3052387
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,949.22 |
| Max. Negotiated Rate |
$3,659.76 |
| Rate for Payer: Aetna Commercial |
$3,580.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,421.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,108.34
|
| Rate for Payer: Cash Price |
$1,193.40
|
| Rate for Payer: Cigna Commercial |
$3,659.76
|
| Rate for Payer: Health EOS Commercial |
$3,540.42
|
| Rate for Payer: HFN Commercial |
$3,659.76
|
| Rate for Payer: Multiplan Commercial |
$3,182.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,386.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,659.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,949.22
|
| Rate for Payer: Quartz Commercial |
$2,386.80
|
| Rate for Payer: WEA Trust Commercial |
$2,187.90
|
| Rate for Payer: WPS Commercial |
$2,946.50
|
|
|
Pace/ICD CS Lead Ins, New Gen +
|
Facility
|
OP
|
$3,433.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
4294736
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$961.24 |
| Max. Negotiated Rate |
$13,732.00 |
| Rate for Payer: Aetna Commercial |
$3,089.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,952.38
|
| Rate for Payer: Aetna Managed Medicare |
$961.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,231.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,716.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,647.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,819.49
|
| Rate for Payer: Cash Price |
$1,029.90
|
| Rate for Payer: Cash Price |
$1,029.90
|
| Rate for Payer: Cigna Commercial |
$3,158.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Health EOS Commercial |
$3,055.37
|
| Rate for Payer: HFN Commercial |
$3,158.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,574.75
|
| Rate for Payer: Multiplan Commercial |
$2,746.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,059.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,158.36
|
| Rate for Payer: Quartz Beloit One Network |
$1,682.17
|
| Rate for Payer: Quartz Commercial |
$2,231.45
|
| Rate for Payer: Quartz Medicare Advantage |
$2,059.80
|
| Rate for Payer: The Alliance Commercial |
$13,732.00
|
| Rate for Payer: WEA Trust Commercial |
$1,888.15
|
| Rate for Payer: WPS Commercial |
$2,542.82
|
|
|
Pace/ICD CS Lead Ins, New Gen +
|
Facility
|
OP
|
$3,978.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
3052387
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,113.84 |
| Max. Negotiated Rate |
$15,912.00 |
| Rate for Payer: Aetna Commercial |
$3,580.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,421.08
|
| Rate for Payer: Aetna Managed Medicare |
$1,113.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,585.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,989.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,909.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,108.34
|
| Rate for Payer: Cash Price |
$1,193.40
|
| Rate for Payer: Cash Price |
$1,193.40
|
| Rate for Payer: Cigna Commercial |
$3,659.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Health EOS Commercial |
$3,540.42
|
| Rate for Payer: HFN Commercial |
$3,659.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,983.50
|
| Rate for Payer: Multiplan Commercial |
$3,182.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,386.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,659.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,949.22
|
| Rate for Payer: Quartz Commercial |
$2,585.70
|
| Rate for Payer: Quartz Medicare Advantage |
$2,386.80
|
| Rate for Payer: The Alliance Commercial |
$15,912.00
|
| Rate for Payer: WEA Trust Commercial |
$2,187.90
|
| Rate for Payer: WPS Commercial |
$2,946.50
|
|
|
Pace/ICD CS Lead Ins, New Gen +
|
Facility
|
IP
|
$3,433.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
4294736
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,682.17 |
| Max. Negotiated Rate |
$3,158.36 |
| Rate for Payer: Aetna Commercial |
$3,089.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,952.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,819.49
|
| Rate for Payer: Cash Price |
$1,029.90
|
| Rate for Payer: Cigna Commercial |
$3,158.36
|
| Rate for Payer: Health EOS Commercial |
$3,055.37
|
| Rate for Payer: HFN Commercial |
$3,158.36
|
| Rate for Payer: Multiplan Commercial |
$2,746.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,059.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,158.36
|
| Rate for Payer: Quartz Beloit One Network |
$1,682.17
|
| Rate for Payer: Quartz Commercial |
$2,059.80
|
| Rate for Payer: WEA Trust Commercial |
$1,888.15
|
| Rate for Payer: WPS Commercial |
$2,542.82
|
|
|
Pace/ICD CS Lead Repos Incl Gen Rem/Rep
|
Facility
|
IP
|
$3,030.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
4125704
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,484.70 |
| Max. Negotiated Rate |
$2,787.60 |
| Rate for Payer: Aetna Commercial |
$2,727.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,605.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,605.90
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cigna Commercial |
$2,787.60
|
| Rate for Payer: Health EOS Commercial |
$2,696.70
|
| Rate for Payer: HFN Commercial |
$2,787.60
|
| Rate for Payer: Multiplan Commercial |
$2,424.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,818.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,787.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,484.70
|
| Rate for Payer: Quartz Commercial |
$1,818.00
|
| Rate for Payer: WEA Trust Commercial |
$1,666.50
|
| Rate for Payer: WPS Commercial |
$2,244.32
|
|
|
Pace/ICD CS Lead Repos Incl Gen Rem/Rep
|
Facility
|
OP
|
$3,030.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
4125704
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,484.70 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$2,727.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,605.80
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,605.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,150.53
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cigna Commercial |
$2,787.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$2,696.70
|
| Rate for Payer: HFN Commercial |
$2,787.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,719.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,150.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,150.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,150.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,150.53
|
| Rate for Payer: Multiplan Commercial |
$2,424.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,787.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,484.70
|
| Rate for Payer: Quartz Commercial |
$1,969.50
|
| Rate for Payer: Quartz Medicare Advantage |
$3,150.53
|
| Rate for Payer: The Alliance Commercial |
$12,602.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,150.53
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$1,666.50
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$2,244.32
|
|
|
Pace/ICD Lead Only Insert Single
|
Facility
|
IP
|
$2,928.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
3052380
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,434.72 |
| Max. Negotiated Rate |
$2,693.76 |
| Rate for Payer: Aetna Commercial |
$2,635.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,518.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,551.84
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cigna Commercial |
$2,693.76
|
| Rate for Payer: Health EOS Commercial |
$2,605.92
|
| Rate for Payer: HFN Commercial |
$2,693.76
|
| Rate for Payer: Multiplan Commercial |
$2,342.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,756.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,693.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,434.72
|
| Rate for Payer: Quartz Commercial |
$1,756.80
|
| Rate for Payer: WEA Trust Commercial |
$1,610.40
|
| Rate for Payer: WPS Commercial |
$2,168.77
|
|
|
Pace/ICD Lead Only Insert Single
|
Facility
|
OP
|
$2,928.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
3052380
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,434.72 |
| Max. Negotiated Rate |
$33,588.76 |
| Rate for Payer: Aetna Commercial |
$2,635.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,518.08
|
| Rate for Payer: Aetna Managed Medicare |
$8,397.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$8,397.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,551.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,397.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,397.19
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cigna Commercial |
$2,693.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,397.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,397.19
|
| Rate for Payer: Health EOS Commercial |
$2,605.92
|
| Rate for Payer: HFN Commercial |
$2,693.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31,237.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,397.19
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,397.19
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,397.19
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,397.19
|
| Rate for Payer: Multiplan Commercial |
$2,342.40
|
| Rate for Payer: NAPHCARE Commercial |
$12,595.78
|
| Rate for Payer: Preferred Network Access Commercial |
$2,693.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,434.72
|
| Rate for Payer: Quartz Commercial |
$1,903.20
|
| Rate for Payer: Quartz Medicare Advantage |
$8,397.19
|
| Rate for Payer: The Alliance Commercial |
$33,588.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,397.19
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: WEA Trust Commercial |
$1,610.40
|
| Rate for Payer: Wellcare Medicare |
$8,397.19
|
| Rate for Payer: WPS Commercial |
$2,168.77
|
|
|
Pace/ICD Leads Only Insert Dual
|
Facility
|
OP
|
$2,342.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
3052381
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,147.58 |
| Max. Negotiated Rate |
$33,588.76 |
| Rate for Payer: Aetna Commercial |
$2,107.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,014.12
|
| Rate for Payer: Aetna Managed Medicare |
$8,397.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$8,397.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,241.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,397.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,397.19
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,154.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,397.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,397.19
|
| Rate for Payer: Health EOS Commercial |
$2,084.38
|
| Rate for Payer: HFN Commercial |
$2,154.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31,237.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,397.19
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,397.19
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,397.19
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,397.19
|
| Rate for Payer: Multiplan Commercial |
$1,873.60
|
| Rate for Payer: NAPHCARE Commercial |
$12,595.78
|
| Rate for Payer: Preferred Network Access Commercial |
$2,154.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,147.58
|
| Rate for Payer: Quartz Commercial |
$1,522.30
|
| Rate for Payer: Quartz Medicare Advantage |
$8,397.19
|
| Rate for Payer: The Alliance Commercial |
$33,588.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,397.19
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: WEA Trust Commercial |
$1,288.10
|
| Rate for Payer: Wellcare Medicare |
$8,397.19
|
| Rate for Payer: WPS Commercial |
$1,734.72
|
|
|
Pace/ICD Leads Only Insert Dual
|
Facility
|
IP
|
$2,342.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
3052381
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,147.58 |
| Max. Negotiated Rate |
$2,154.64 |
| Rate for Payer: Aetna Commercial |
$2,107.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,014.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,241.26
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,154.64
|
| Rate for Payer: Health EOS Commercial |
$2,084.38
|
| Rate for Payer: HFN Commercial |
$2,154.64
|
| Rate for Payer: Multiplan Commercial |
$1,873.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,405.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,154.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,147.58
|
| Rate for Payer: Quartz Commercial |
$1,405.20
|
| Rate for Payer: WEA Trust Commercial |
$1,288.10
|
| Rate for Payer: WPS Commercial |
$1,734.72
|
|
|
Pace/ICD LV Lead Ins, Exist Gen
|
Facility
|
IP
|
$3,854.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
3052386
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,888.46 |
| Max. Negotiated Rate |
$3,545.68 |
| Rate for Payer: Aetna Commercial |
$3,468.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,314.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,042.62
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cigna Commercial |
$3,545.68
|
| Rate for Payer: Health EOS Commercial |
$3,430.06
|
| Rate for Payer: HFN Commercial |
$3,545.68
|
| Rate for Payer: Multiplan Commercial |
$3,083.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,312.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,545.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,888.46
|
| Rate for Payer: Quartz Commercial |
$2,312.40
|
| Rate for Payer: WEA Trust Commercial |
$2,119.70
|
| Rate for Payer: WPS Commercial |
$2,854.66
|
|
|
Pace/ICD LV Lead Ins, Exist Gen
|
Facility
|
OP
|
$3,854.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
3052386
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,888.46 |
| Max. Negotiated Rate |
$42,217.88 |
| Rate for Payer: Aetna Commercial |
$3,468.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,314.44
|
| Rate for Payer: Aetna Managed Medicare |
$10,554.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$10,554.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,042.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,554.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,554.47
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cigna Commercial |
$3,545.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,554.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,554.47
|
| Rate for Payer: Health EOS Commercial |
$3,430.06
|
| Rate for Payer: HFN Commercial |
$3,545.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$39,262.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,554.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,554.47
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,554.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,554.47
|
| Rate for Payer: Multiplan Commercial |
$3,083.20
|
| Rate for Payer: NAPHCARE Commercial |
$15,831.70
|
| Rate for Payer: Preferred Network Access Commercial |
$3,545.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,888.46
|
| Rate for Payer: Quartz Commercial |
$2,505.10
|
| Rate for Payer: Quartz Medicare Advantage |
$10,554.47
|
| Rate for Payer: The Alliance Commercial |
$42,217.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,554.47
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: WEA Trust Commercial |
$2,119.70
|
| Rate for Payer: Wellcare Medicare |
$10,554.47
|
| Rate for Payer: WPS Commercial |
$2,854.66
|
|
|
Pace/ICD LV Lead Ins, Exist Gen
|
Facility
|
IP
|
$3,854.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
4308763
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,888.46 |
| Max. Negotiated Rate |
$3,545.68 |
| Rate for Payer: Aetna Commercial |
$3,468.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,314.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,042.62
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cigna Commercial |
$3,545.68
|
| Rate for Payer: Health EOS Commercial |
$3,430.06
|
| Rate for Payer: HFN Commercial |
$3,545.68
|
| Rate for Payer: Multiplan Commercial |
$3,083.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,312.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,545.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,888.46
|
| Rate for Payer: Quartz Commercial |
$2,312.40
|
| Rate for Payer: WEA Trust Commercial |
$2,119.70
|
| Rate for Payer: WPS Commercial |
$2,854.66
|
|
|
Pace/ICD LV Lead Ins, Exist Gen
|
Facility
|
OP
|
$3,854.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
4308763
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,888.46 |
| Max. Negotiated Rate |
$42,217.88 |
| Rate for Payer: Aetna Commercial |
$3,468.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,314.44
|
| Rate for Payer: Aetna Managed Medicare |
$10,554.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$10,554.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,042.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,554.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,554.47
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cigna Commercial |
$3,545.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,554.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,554.47
|
| Rate for Payer: Health EOS Commercial |
$3,430.06
|
| Rate for Payer: HFN Commercial |
$3,545.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$39,262.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,554.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,554.47
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,554.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,554.47
|
| Rate for Payer: Multiplan Commercial |
$3,083.20
|
| Rate for Payer: NAPHCARE Commercial |
$15,831.70
|
| Rate for Payer: Preferred Network Access Commercial |
$3,545.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,888.46
|
| Rate for Payer: Quartz Commercial |
$2,505.10
|
| Rate for Payer: Quartz Medicare Advantage |
$10,554.47
|
| Rate for Payer: The Alliance Commercial |
$42,217.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,554.47
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: WEA Trust Commercial |
$2,119.70
|
| Rate for Payer: Wellcare Medicare |
$10,554.47
|
| Rate for Payer: WPS Commercial |
$2,854.66
|
|
|
Pace/ICD RA/RV Lead Reposition
|
Facility
|
IP
|
$2,035.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
3052379
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$997.15 |
| Max. Negotiated Rate |
$1,872.20 |
| Rate for Payer: Aetna Commercial |
$1,831.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,750.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,078.55
|
| Rate for Payer: Cash Price |
$610.50
|
| Rate for Payer: Cigna Commercial |
$1,872.20
|
| Rate for Payer: Health EOS Commercial |
$1,811.15
|
| Rate for Payer: HFN Commercial |
$1,872.20
|
| Rate for Payer: Multiplan Commercial |
$1,628.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,221.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,872.20
|
| Rate for Payer: Quartz Beloit One Network |
$997.15
|
| Rate for Payer: Quartz Commercial |
$1,221.00
|
| Rate for Payer: WEA Trust Commercial |
$1,119.25
|
| Rate for Payer: WPS Commercial |
$1,507.32
|
|
|
Pace/ICD RA/RV Lead Reposition
|
Facility
|
OP
|
$2,035.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
3052379
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$997.15 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$1,831.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,750.10
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,078.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,150.53
|
| Rate for Payer: Cash Price |
$610.50
|
| Rate for Payer: Cash Price |
$610.50
|
| Rate for Payer: Cash Price |
$610.50
|
| Rate for Payer: Cigna Commercial |
$1,872.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$1,811.15
|
| Rate for Payer: HFN Commercial |
$1,872.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,719.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,150.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,150.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,150.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,150.53
|
| Rate for Payer: Multiplan Commercial |
$1,628.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,872.20
|
| Rate for Payer: Quartz Beloit One Network |
$997.15
|
| Rate for Payer: Quartz Commercial |
$1,322.75
|
| Rate for Payer: Quartz Medicare Advantage |
$3,150.53
|
| Rate for Payer: The Alliance Commercial |
$12,602.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,150.53
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$1,119.25
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$1,507.32
|
|
|
Pace Lead Dual Removal
|
Facility
|
IP
|
$3,999.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
4308832
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,959.51 |
| Max. Negotiated Rate |
$3,679.08 |
| Rate for Payer: Aetna Commercial |
$3,599.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,439.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,119.47
|
| Rate for Payer: Cash Price |
$1,199.70
|
| Rate for Payer: Cigna Commercial |
$3,679.08
|
| Rate for Payer: Health EOS Commercial |
$3,559.11
|
| Rate for Payer: HFN Commercial |
$3,679.08
|
| Rate for Payer: Multiplan Commercial |
$3,199.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,399.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,679.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,959.51
|
| Rate for Payer: Quartz Commercial |
$2,399.40
|
| Rate for Payer: WEA Trust Commercial |
$2,199.45
|
| Rate for Payer: WPS Commercial |
$2,962.06
|
|
|
Pace Lead Dual Removal
|
Facility
|
OP
|
$3,999.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
4308832
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,959.51 |
| Max. Negotiated Rate |
$15,525.92 |
| Rate for Payer: Aetna Commercial |
$3,599.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,439.14
|
| Rate for Payer: Aetna Managed Medicare |
$3,881.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,119.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,881.48
|
| Rate for Payer: Cash Price |
$1,199.70
|
| Rate for Payer: Cash Price |
$1,199.70
|
| Rate for Payer: Cash Price |
$1,199.70
|
| Rate for Payer: Cigna Commercial |
$3,679.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,881.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,881.48
|
| Rate for Payer: Health EOS Commercial |
$3,559.11
|
| Rate for Payer: HFN Commercial |
$3,679.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,439.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,881.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,881.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,881.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,881.48
|
| Rate for Payer: Multiplan Commercial |
$3,199.20
|
| Rate for Payer: NAPHCARE Commercial |
$5,822.22
|
| Rate for Payer: Preferred Network Access Commercial |
$3,679.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,959.51
|
| Rate for Payer: Quartz Commercial |
$2,599.35
|
| Rate for Payer: Quartz Medicare Advantage |
$3,881.48
|
| Rate for Payer: The Alliance Commercial |
$15,525.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,881.48
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$2,199.45
|
| Rate for Payer: Wellcare Medicare |
$3,881.48
|
| Rate for Payer: WPS Commercial |
$2,962.06
|
|
|
Pace Lead Dual Removal
|
Facility
|
IP
|
$4,153.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
3052395
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,034.97 |
| Max. Negotiated Rate |
$3,820.76 |
| Rate for Payer: Aetna Commercial |
$3,737.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,571.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,201.09
|
| Rate for Payer: Cash Price |
$1,245.90
|
| Rate for Payer: Cigna Commercial |
$3,820.76
|
| Rate for Payer: Health EOS Commercial |
$3,696.17
|
| Rate for Payer: HFN Commercial |
$3,820.76
|
| Rate for Payer: Multiplan Commercial |
$3,322.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,491.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,820.76
|
| Rate for Payer: Quartz Beloit One Network |
$2,034.97
|
| Rate for Payer: Quartz Commercial |
$2,491.80
|
| Rate for Payer: WEA Trust Commercial |
$2,284.15
|
| Rate for Payer: WPS Commercial |
$3,076.13
|
|
|
Pace Lead Dual Removal
|
Facility
|
OP
|
$4,153.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
3052395
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,034.97 |
| Max. Negotiated Rate |
$15,525.92 |
| Rate for Payer: Aetna Commercial |
$3,737.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,571.58
|
| Rate for Payer: Aetna Managed Medicare |
$3,881.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,201.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,881.48
|
| Rate for Payer: Cash Price |
$1,245.90
|
| Rate for Payer: Cash Price |
$1,245.90
|
| Rate for Payer: Cash Price |
$1,245.90
|
| Rate for Payer: Cigna Commercial |
$3,820.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,881.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,881.48
|
| Rate for Payer: Health EOS Commercial |
$3,696.17
|
| Rate for Payer: HFN Commercial |
$3,820.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,439.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,881.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,881.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,881.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,881.48
|
| Rate for Payer: Multiplan Commercial |
$3,322.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,822.22
|
| Rate for Payer: Preferred Network Access Commercial |
$3,820.76
|
| Rate for Payer: Quartz Beloit One Network |
$2,034.97
|
| Rate for Payer: Quartz Commercial |
$2,699.45
|
| Rate for Payer: Quartz Medicare Advantage |
$3,881.48
|
| Rate for Payer: The Alliance Commercial |
$15,525.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,881.48
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$2,284.15
|
| Rate for Payer: Wellcare Medicare |
$3,881.48
|
| Rate for Payer: WPS Commercial |
$3,076.13
|
|
|
Pace Lead Single Removal
|
Facility
|
OP
|
$3,030.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
4308817
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,484.70 |
| Max. Negotiated Rate |
$15,525.92 |
| Rate for Payer: Aetna Commercial |
$2,727.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,605.80
|
| Rate for Payer: Aetna Managed Medicare |
$3,881.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,605.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,881.48
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cigna Commercial |
$2,787.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,881.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,881.48
|
| Rate for Payer: Health EOS Commercial |
$2,696.70
|
| Rate for Payer: HFN Commercial |
$2,787.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,439.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,881.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,881.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,881.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,881.48
|
| Rate for Payer: Multiplan Commercial |
$2,424.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,822.22
|
| Rate for Payer: Preferred Network Access Commercial |
$2,787.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,484.70
|
| Rate for Payer: Quartz Commercial |
$1,969.50
|
| Rate for Payer: Quartz Medicare Advantage |
$3,881.48
|
| Rate for Payer: The Alliance Commercial |
$15,525.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,881.48
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$1,666.50
|
| Rate for Payer: Wellcare Medicare |
$3,881.48
|
| Rate for Payer: WPS Commercial |
$2,244.32
|
|
|
Pace Lead Single Removal
|
Facility
|
IP
|
$3,030.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
4308817
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,484.70 |
| Max. Negotiated Rate |
$2,787.60 |
| Rate for Payer: Aetna Commercial |
$2,727.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,605.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,605.90
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cigna Commercial |
$2,787.60
|
| Rate for Payer: Health EOS Commercial |
$2,696.70
|
| Rate for Payer: HFN Commercial |
$2,787.60
|
| Rate for Payer: Multiplan Commercial |
$2,424.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,818.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,787.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,484.70
|
| Rate for Payer: Quartz Commercial |
$1,818.00
|
| Rate for Payer: WEA Trust Commercial |
$1,666.50
|
| Rate for Payer: WPS Commercial |
$2,244.32
|
|
|
Pace Lead Single Removal
|
Facility
|
OP
|
$3,145.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
3052394
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,541.05 |
| Max. Negotiated Rate |
$15,525.92 |
| Rate for Payer: Aetna Commercial |
$2,830.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,704.70
|
| Rate for Payer: Aetna Managed Medicare |
$3,881.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,666.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,881.48
|
| Rate for Payer: Cash Price |
$943.50
|
| Rate for Payer: Cash Price |
$943.50
|
| Rate for Payer: Cash Price |
$943.50
|
| Rate for Payer: Cigna Commercial |
$2,893.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,881.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,881.48
|
| Rate for Payer: Health EOS Commercial |
$2,799.05
|
| Rate for Payer: HFN Commercial |
$2,893.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,439.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,881.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,881.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,881.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,881.48
|
| Rate for Payer: Multiplan Commercial |
$2,516.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,822.22
|
| Rate for Payer: Preferred Network Access Commercial |
$2,893.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,541.05
|
| Rate for Payer: Quartz Commercial |
$2,044.25
|
| Rate for Payer: Quartz Medicare Advantage |
$3,881.48
|
| Rate for Payer: The Alliance Commercial |
$15,525.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,881.48
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$1,729.75
|
| Rate for Payer: Wellcare Medicare |
$3,881.48
|
| Rate for Payer: WPS Commercial |
$2,329.50
|
|
