|
OPEN CRANIOTOMY FOR TRAUMA
|
Facility
|
IP
|
$47,173.51
|
|
|
Service Code
|
APR-DRG 0204
|
| Min. Negotiated Rate |
$41,902.45 |
| Max. Negotiated Rate |
$47,173.51 |
| Rate for Payer: Anthem Medicaid |
$45,171.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$45,171.23
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$45,171.23
|
| Rate for Payer: Dean Health Medicaid |
$45,171.23
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$41,902.45
|
| Rate for Payer: Managed Health Services Medicaid |
$47,173.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$45,171.23
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$45,171.23
|
| Rate for Payer: United Healthcare Medicaid |
$45,171.23
|
|
|
OPEN CRANIOTOMY FOR TRAUMA
|
Facility
|
IP
|
$22,797.61
|
|
|
Service Code
|
APR-DRG 0202
|
| Min. Negotiated Rate |
$20,250.26 |
| Max. Negotiated Rate |
$22,797.61 |
| Rate for Payer: Anthem Medicaid |
$21,829.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$21,829.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21,829.96
|
| Rate for Payer: Dean Health Medicaid |
$21,829.96
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$20,250.26
|
| Rate for Payer: Managed Health Services Medicaid |
$22,797.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$21,829.96
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$21,829.96
|
| Rate for Payer: United Healthcare Medicaid |
$21,829.96
|
|
|
OPEN CRANIOTOMY FOR TRAUMA
|
Facility
|
IP
|
$32,530.43
|
|
|
Service Code
|
APR-DRG 0203
|
| Min. Negotiated Rate |
$28,895.56 |
| Max. Negotiated Rate |
$32,530.43 |
| Rate for Payer: Anthem Medicaid |
$31,149.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$31,149.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$31,149.68
|
| Rate for Payer: Dean Health Medicaid |
$31,149.68
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$28,895.56
|
| Rate for Payer: Managed Health Services Medicaid |
$32,530.43
|
| Rate for Payer: Molina Healthcare Medicaid |
$31,149.68
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$31,149.68
|
| Rate for Payer: United Healthcare Medicaid |
$31,149.68
|
|
|
OPEN CRANIOTOMY FOR TRAUMA
|
Facility
|
IP
|
$17,624.30
|
|
|
Service Code
|
APR-DRG 0201
|
| Min. Negotiated Rate |
$15,655.01 |
| Max. Negotiated Rate |
$17,624.30 |
| Rate for Payer: Anthem Medicaid |
$16,876.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$16,876.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$16,876.24
|
| Rate for Payer: Dean Health Medicaid |
$16,876.24
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$15,655.01
|
| Rate for Payer: Managed Health Services Medicaid |
$17,624.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$16,876.24
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$16,876.24
|
| Rate for Payer: United Healthcare Medicaid |
$16,876.24
|
|
|
OPEN EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$32,705.80
|
|
|
Service Code
|
APR-DRG 0244
|
| Min. Negotiated Rate |
$29,051.33 |
| Max. Negotiated Rate |
$32,705.80 |
| Rate for Payer: Anthem Medicaid |
$31,317.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$31,317.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$31,317.60
|
| Rate for Payer: Dean Health Medicaid |
$31,317.60
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$29,051.33
|
| Rate for Payer: Managed Health Services Medicaid |
$32,705.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$31,317.60
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$31,317.60
|
| Rate for Payer: United Healthcare Medicaid |
$31,317.60
|
|
|
OPEN EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$8,855.99
|
|
|
Service Code
|
APR-DRG 0241
|
| Min. Negotiated Rate |
$7,866.45 |
| Max. Negotiated Rate |
$8,855.99 |
| Rate for Payer: Anthem Medicaid |
$8,480.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$8,480.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8,480.10
|
| Rate for Payer: Dean Health Medicaid |
$8,480.10
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,866.45
|
| Rate for Payer: Managed Health Services Medicaid |
$8,855.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,480.10
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8,480.10
|
| Rate for Payer: United Healthcare Medicaid |
$8,480.10
|
|
|
OPEN EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$11,749.54
|
|
|
Service Code
|
APR-DRG 0242
|
| Min. Negotiated Rate |
$10,436.67 |
| Max. Negotiated Rate |
$11,749.54 |
| Rate for Payer: Anthem Medicaid |
$11,250.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$11,250.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11,250.83
|
| Rate for Payer: Dean Health Medicaid |
$11,250.83
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10,436.67
|
| Rate for Payer: Managed Health Services Medicaid |
$11,749.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,250.83
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$11,250.83
|
| Rate for Payer: United Healthcare Medicaid |
$11,250.83
|
|
|
OPEN EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$20,956.26
|
|
|
Service Code
|
APR-DRG 0243
|
| Min. Negotiated Rate |
$18,614.66 |
| Max. Negotiated Rate |
$20,956.26 |
| Rate for Payer: Anthem Medicaid |
$20,066.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$20,066.77
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20,066.77
|
| Rate for Payer: Dean Health Medicaid |
$20,066.77
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,614.66
|
| Rate for Payer: Managed Health Services Medicaid |
$20,956.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$20,066.77
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$20,066.77
|
| Rate for Payer: United Healthcare Medicaid |
$20,066.77
|
|
|
Open Femoral Artery Access
|
Facility
|
IP
|
$28,139.00
|
|
|
Service Code
|
CPT 34714
|
| Hospital Charge Code |
5416677
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$14,339.63 |
| Max. Negotiated Rate |
$26,923.40 |
| Rate for Payer: Aetna Commercial |
$26,338.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$25,167.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$15,510.22
|
| Rate for Payer: Cash Price |
$8,441.70
|
| Rate for Payer: Cigna Commercial |
$26,923.40
|
| Rate for Payer: Health EOS Commercial |
$26,045.46
|
| Rate for Payer: HFN Commercial |
$26,923.40
|
| Rate for Payer: Multiplan Commercial |
$23,411.65
|
| Rate for Payer: Preferred Network Access Commercial |
$26,923.40
|
| Rate for Payer: Quartz Beloit One Network |
$14,339.63
|
| Rate for Payer: Quartz Commercial |
$17,558.74
|
| Rate for Payer: WEA Trust Commercial |
$16,095.51
|
| Rate for Payer: WPS Commercial |
$21,675.47
|
|
|
Open Femoral Artery Access
|
Facility
|
OP
|
$28,139.00
|
|
|
Service Code
|
CPT 34714
|
| Hospital Charge Code |
5416677
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$891.32 |
| Max. Negotiated Rate |
$26,923.40 |
| Rate for Payer: Aetna Commercial |
$26,338.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$25,167.52
|
| Rate for Payer: Aetna Managed Medicare |
$8,194.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,021.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14,632.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14,046.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$15,510.22
|
| Rate for Payer: Cash Price |
$8,441.70
|
| Rate for Payer: Cash Price |
$8,441.70
|
| Rate for Payer: Cigna Commercial |
$26,923.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Health EOS Commercial |
$26,045.46
|
| Rate for Payer: HFN Commercial |
$26,923.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,948.42
|
| Rate for Payer: Multiplan Commercial |
$23,411.65
|
| Rate for Payer: NAPHCARE Commercial |
$17,558.74
|
| Rate for Payer: Preferred Network Access Commercial |
$26,923.40
|
| Rate for Payer: Quartz Beloit One Network |
$14,339.63
|
| Rate for Payer: Quartz Commercial |
$19,021.96
|
| Rate for Payer: Quartz Medicare Advantage |
$17,558.74
|
| Rate for Payer: The Alliance Commercial |
$891.32
|
| Rate for Payer: WEA Trust Commercial |
$16,095.51
|
| Rate for Payer: WPS Commercial |
$21,675.47
|
|
|
OPEN INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
OP
|
$1,010.53
|
|
|
Service Code
|
EAPG 00266
|
| Min. Negotiated Rate |
$971.66 |
| Max. Negotiated Rate |
$1,010.53 |
| Rate for Payer: Anthem Medicaid |
$971.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$971.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$971.66
|
| Rate for Payer: Dean Health Medicaid |
$971.66
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$971.66
|
| Rate for Payer: Managed Health Services Medicaid |
$1,010.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$971.66
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$971.66
|
| Rate for Payer: United Healthcare Medicaid |
$971.66
|
|
|
OPEN OR PERCUTANEOUS TREATMENT OF FRACTURES
|
Facility
|
OP
|
$1,172.53
|
|
|
Service Code
|
EAPG 00043
|
| Min. Negotiated Rate |
$1,127.43 |
| Max. Negotiated Rate |
$1,172.53 |
| Rate for Payer: Anthem Medicaid |
$1,127.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$1,127.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,127.43
|
| Rate for Payer: Dean Health Medicaid |
$1,127.43
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$1,127.43
|
| Rate for Payer: Managed Health Services Medicaid |
$1,172.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,127.43
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$1,127.43
|
| Rate for Payer: United Healthcare Medicaid |
$1,127.43
|
|
|
OPEN REDUCTION INTERNAL FIXATION ALVEOLAR FRACTURE
|
Facility
|
OP
|
$4,324.00
|
|
| Hospital Charge Code |
2960281
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,259.15 |
| Max. Negotiated Rate |
$4,137.20 |
| Rate for Payer: Aetna Commercial |
$4,047.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,867.39
|
| Rate for Payer: Aetna Managed Medicare |
$1,259.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,923.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,248.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,158.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,383.39
|
| Rate for Payer: Cash Price |
$1,297.20
|
| Rate for Payer: Cigna Commercial |
$4,137.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,516.57
|
| Rate for Payer: Health EOS Commercial |
$4,002.29
|
| Rate for Payer: HFN Commercial |
$4,137.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,372.72
|
| Rate for Payer: Multiplan Commercial |
$3,597.57
|
| Rate for Payer: NAPHCARE Commercial |
$2,698.18
|
| Rate for Payer: Preferred Network Access Commercial |
$4,137.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,203.51
|
| Rate for Payer: Quartz Commercial |
$2,923.02
|
| Rate for Payer: Quartz Medicare Advantage |
$2,698.18
|
| Rate for Payer: The Alliance Commercial |
$2,248.48
|
| Rate for Payer: WEA Trust Commercial |
$2,473.33
|
| Rate for Payer: WPS Commercial |
$3,330.78
|
|
|
OPEN REDUCTION INTERNAL FIXATION ALVEOLAR FRACTURE
|
Facility
|
IP
|
$4,324.00
|
|
| Hospital Charge Code |
2960281
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,203.51 |
| Max. Negotiated Rate |
$4,137.20 |
| Rate for Payer: Aetna Commercial |
$4,047.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,867.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,383.39
|
| Rate for Payer: Cash Price |
$1,297.20
|
| Rate for Payer: Cigna Commercial |
$4,137.20
|
| Rate for Payer: Health EOS Commercial |
$4,002.29
|
| Rate for Payer: HFN Commercial |
$4,137.20
|
| Rate for Payer: Multiplan Commercial |
$3,597.57
|
| Rate for Payer: Preferred Network Access Commercial |
$4,137.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,203.51
|
| Rate for Payer: Quartz Commercial |
$2,698.18
|
| Rate for Payer: WEA Trust Commercial |
$2,473.33
|
| Rate for Payer: WPS Commercial |
$3,330.78
|
|
|
OPEN REDUCTION INTERNAL FIXATION ANKLE FRACTURE
|
Facility
|
IP
|
$5,453.00
|
|
| Hospital Charge Code |
2960262
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,778.85 |
| Max. Negotiated Rate |
$5,217.43 |
| Rate for Payer: Aetna Commercial |
$5,104.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,877.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,005.69
|
| Rate for Payer: Cash Price |
$1,635.90
|
| Rate for Payer: Cigna Commercial |
$5,217.43
|
| Rate for Payer: Health EOS Commercial |
$5,047.30
|
| Rate for Payer: HFN Commercial |
$5,217.43
|
| Rate for Payer: Multiplan Commercial |
$4,536.90
|
| Rate for Payer: Preferred Network Access Commercial |
$5,217.43
|
| Rate for Payer: Quartz Beloit One Network |
$2,778.85
|
| Rate for Payer: Quartz Commercial |
$3,402.67
|
| Rate for Payer: WEA Trust Commercial |
$3,119.12
|
| Rate for Payer: WPS Commercial |
$4,200.45
|
|
|
OPEN REDUCTION INTERNAL FIXATION ANKLE FRACTURE
|
Facility
|
OP
|
$5,453.00
|
|
| Hospital Charge Code |
2960262
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,587.91 |
| Max. Negotiated Rate |
$5,217.43 |
| Rate for Payer: Aetna Commercial |
$5,104.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,877.16
|
| Rate for Payer: Aetna Managed Medicare |
$1,587.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,686.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,835.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,722.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,005.69
|
| Rate for Payer: Cash Price |
$1,635.90
|
| Rate for Payer: Cigna Commercial |
$5,217.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,173.65
|
| Rate for Payer: Health EOS Commercial |
$5,047.30
|
| Rate for Payer: HFN Commercial |
$5,217.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,253.34
|
| Rate for Payer: Multiplan Commercial |
$4,536.90
|
| Rate for Payer: NAPHCARE Commercial |
$3,402.67
|
| Rate for Payer: Preferred Network Access Commercial |
$5,217.43
|
| Rate for Payer: Quartz Beloit One Network |
$2,778.85
|
| Rate for Payer: Quartz Commercial |
$3,686.23
|
| Rate for Payer: Quartz Medicare Advantage |
$3,402.67
|
| Rate for Payer: The Alliance Commercial |
$2,835.56
|
| Rate for Payer: WEA Trust Commercial |
$3,119.12
|
| Rate for Payer: WPS Commercial |
$4,200.45
|
|
|
OPEN REDUCTION INTERNAL FIXATION CALCANEAL FRACTURE
|
Facility
|
IP
|
$4,912.00
|
|
| Hospital Charge Code |
2960263
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,503.16 |
| Max. Negotiated Rate |
$4,699.80 |
| Rate for Payer: Aetna Commercial |
$4,597.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,393.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,707.49
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cigna Commercial |
$4,699.80
|
| Rate for Payer: Health EOS Commercial |
$4,546.55
|
| Rate for Payer: HFN Commercial |
$4,699.80
|
| Rate for Payer: Multiplan Commercial |
$4,086.78
|
| Rate for Payer: Preferred Network Access Commercial |
$4,699.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,503.16
|
| Rate for Payer: Quartz Commercial |
$3,065.09
|
| Rate for Payer: WEA Trust Commercial |
$2,809.66
|
| Rate for Payer: WPS Commercial |
$3,783.71
|
|
|
OPEN REDUCTION INTERNAL FIXATION CALCANEAL FRACTURE
|
Facility
|
OP
|
$4,912.00
|
|
| Hospital Charge Code |
2960263
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,430.37 |
| Max. Negotiated Rate |
$4,699.80 |
| Rate for Payer: Aetna Commercial |
$4,597.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,393.29
|
| Rate for Payer: Aetna Managed Medicare |
$1,430.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,320.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,554.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,452.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,707.49
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cigna Commercial |
$4,699.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,858.78
|
| Rate for Payer: Health EOS Commercial |
$4,546.55
|
| Rate for Payer: HFN Commercial |
$4,699.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,831.36
|
| Rate for Payer: Multiplan Commercial |
$4,086.78
|
| Rate for Payer: NAPHCARE Commercial |
$3,065.09
|
| Rate for Payer: Preferred Network Access Commercial |
$4,699.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,503.16
|
| Rate for Payer: Quartz Commercial |
$3,320.51
|
| Rate for Payer: Quartz Medicare Advantage |
$3,065.09
|
| Rate for Payer: The Alliance Commercial |
$2,554.24
|
| Rate for Payer: WEA Trust Commercial |
$2,809.66
|
| Rate for Payer: WPS Commercial |
$3,783.71
|
|
|
OPEN REDUCTION INTERNAL FIXATION CLAVICLE FRACTURE
|
Facility
|
IP
|
$4,657.00
|
|
| Hospital Charge Code |
2959756
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,373.21 |
| Max. Negotiated Rate |
$4,455.82 |
| Rate for Payer: Aetna Commercial |
$4,358.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,165.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,566.94
|
| Rate for Payer: Cash Price |
$1,397.10
|
| Rate for Payer: Cigna Commercial |
$4,455.82
|
| Rate for Payer: Health EOS Commercial |
$4,310.52
|
| Rate for Payer: HFN Commercial |
$4,455.82
|
| Rate for Payer: Multiplan Commercial |
$3,874.62
|
| Rate for Payer: Preferred Network Access Commercial |
$4,455.82
|
| Rate for Payer: Quartz Beloit One Network |
$2,373.21
|
| Rate for Payer: Quartz Commercial |
$2,905.97
|
| Rate for Payer: WEA Trust Commercial |
$2,663.80
|
| Rate for Payer: WPS Commercial |
$3,587.29
|
|
|
OPEN REDUCTION INTERNAL FIXATION CLAVICLE FRACTURE
|
Facility
|
OP
|
$4,657.00
|
|
| Hospital Charge Code |
2959756
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,356.12 |
| Max. Negotiated Rate |
$4,455.82 |
| Rate for Payer: Aetna Commercial |
$4,358.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,165.22
|
| Rate for Payer: Aetna Managed Medicare |
$1,356.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,148.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,421.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,324.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,566.94
|
| Rate for Payer: Cash Price |
$1,397.10
|
| Rate for Payer: Cigna Commercial |
$4,455.82
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,710.37
|
| Rate for Payer: Health EOS Commercial |
$4,310.52
|
| Rate for Payer: HFN Commercial |
$4,455.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,632.46
|
| Rate for Payer: Multiplan Commercial |
$3,874.62
|
| Rate for Payer: NAPHCARE Commercial |
$2,905.97
|
| Rate for Payer: Preferred Network Access Commercial |
$4,455.82
|
| Rate for Payer: Quartz Beloit One Network |
$2,373.21
|
| Rate for Payer: Quartz Commercial |
$3,148.13
|
| Rate for Payer: Quartz Medicare Advantage |
$2,905.97
|
| Rate for Payer: The Alliance Commercial |
$2,421.64
|
| Rate for Payer: WEA Trust Commercial |
$2,663.80
|
| Rate for Payer: WPS Commercial |
$3,587.29
|
|
|
OPEN REDUCTION INTERNAL FIXATION ELBOW FRACTURE
|
Facility
|
OP
|
$4,912.00
|
|
| Hospital Charge Code |
2960264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,430.37 |
| Max. Negotiated Rate |
$4,699.80 |
| Rate for Payer: Aetna Commercial |
$4,597.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,393.29
|
| Rate for Payer: Aetna Managed Medicare |
$1,430.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,320.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,554.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,452.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,707.49
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cigna Commercial |
$4,699.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,858.78
|
| Rate for Payer: Health EOS Commercial |
$4,546.55
|
| Rate for Payer: HFN Commercial |
$4,699.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,831.36
|
| Rate for Payer: Multiplan Commercial |
$4,086.78
|
| Rate for Payer: NAPHCARE Commercial |
$3,065.09
|
| Rate for Payer: Preferred Network Access Commercial |
$4,699.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,503.16
|
| Rate for Payer: Quartz Commercial |
$3,320.51
|
| Rate for Payer: Quartz Medicare Advantage |
$3,065.09
|
| Rate for Payer: The Alliance Commercial |
$2,554.24
|
| Rate for Payer: WEA Trust Commercial |
$2,809.66
|
| Rate for Payer: WPS Commercial |
$3,783.71
|
|
|
OPEN REDUCTION INTERNAL FIXATION ELBOW FRACTURE
|
Facility
|
IP
|
$4,912.00
|
|
| Hospital Charge Code |
2960264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,503.16 |
| Max. Negotiated Rate |
$4,699.80 |
| Rate for Payer: Aetna Commercial |
$4,597.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,393.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,707.49
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cigna Commercial |
$4,699.80
|
| Rate for Payer: Health EOS Commercial |
$4,546.55
|
| Rate for Payer: HFN Commercial |
$4,699.80
|
| Rate for Payer: Multiplan Commercial |
$4,086.78
|
| Rate for Payer: Preferred Network Access Commercial |
$4,699.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,503.16
|
| Rate for Payer: Quartz Commercial |
$3,065.09
|
| Rate for Payer: WEA Trust Commercial |
$2,809.66
|
| Rate for Payer: WPS Commercial |
$3,783.71
|
|
|
OPEN REDUCTION INTERNAL FIXATION FEMUR FRACTURE
|
Facility
|
IP
|
$4,912.00
|
|
| Hospital Charge Code |
2960265
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,503.16 |
| Max. Negotiated Rate |
$4,699.80 |
| Rate for Payer: Aetna Commercial |
$4,597.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,393.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,707.49
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cigna Commercial |
$4,699.80
|
| Rate for Payer: Health EOS Commercial |
$4,546.55
|
| Rate for Payer: HFN Commercial |
$4,699.80
|
| Rate for Payer: Multiplan Commercial |
$4,086.78
|
| Rate for Payer: Preferred Network Access Commercial |
$4,699.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,503.16
|
| Rate for Payer: Quartz Commercial |
$3,065.09
|
| Rate for Payer: WEA Trust Commercial |
$2,809.66
|
| Rate for Payer: WPS Commercial |
$3,783.71
|
|
|
OPEN REDUCTION INTERNAL FIXATION FEMUR FRACTURE
|
Facility
|
OP
|
$4,912.00
|
|
| Hospital Charge Code |
2960265
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,430.37 |
| Max. Negotiated Rate |
$4,699.80 |
| Rate for Payer: Aetna Commercial |
$4,597.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,393.29
|
| Rate for Payer: Aetna Managed Medicare |
$1,430.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,320.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,554.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,452.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,707.49
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cigna Commercial |
$4,699.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,858.78
|
| Rate for Payer: Health EOS Commercial |
$4,546.55
|
| Rate for Payer: HFN Commercial |
$4,699.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,831.36
|
| Rate for Payer: Multiplan Commercial |
$4,086.78
|
| Rate for Payer: NAPHCARE Commercial |
$3,065.09
|
| Rate for Payer: Preferred Network Access Commercial |
$4,699.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,503.16
|
| Rate for Payer: Quartz Commercial |
$3,320.51
|
| Rate for Payer: Quartz Medicare Advantage |
$3,065.09
|
| Rate for Payer: The Alliance Commercial |
$2,554.24
|
| Rate for Payer: WEA Trust Commercial |
$2,809.66
|
| Rate for Payer: WPS Commercial |
$3,783.71
|
|
|
OPEN REDUCTION INTERNAL FIXATION FINGER, HAND FRACTURE
|
Facility
|
IP
|
$4,912.00
|
|
| Hospital Charge Code |
2960270
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,503.16 |
| Max. Negotiated Rate |
$4,699.80 |
| Rate for Payer: Aetna Commercial |
$4,597.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,393.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,707.49
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cigna Commercial |
$4,699.80
|
| Rate for Payer: Health EOS Commercial |
$4,546.55
|
| Rate for Payer: HFN Commercial |
$4,699.80
|
| Rate for Payer: Multiplan Commercial |
$4,086.78
|
| Rate for Payer: Preferred Network Access Commercial |
$4,699.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,503.16
|
| Rate for Payer: Quartz Commercial |
$3,065.09
|
| Rate for Payer: WEA Trust Commercial |
$2,809.66
|
| Rate for Payer: WPS Commercial |
$3,783.71
|
|
