|
Arterial Coiling Not Hemorrhage or Tumor
|
Facility
OP
|
$18,437.00
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
4597126
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,103.72 |
| Max. Negotiated Rate |
$64,474.41 |
| Rate for Payer: Aetna Commercial |
$16,593.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$15,855.82
|
| Rate for Payer: Aetna Managed Medicare |
$17,331.83
|
| 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 |
$17,331.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,771.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17,331.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17,331.83
|
| Rate for Payer: Cash Price |
$5,531.10
|
| Rate for Payer: Cash Price |
$5,531.10
|
| Rate for Payer: Cash Price |
$5,531.10
|
| Rate for Payer: Cigna Commercial |
$16,962.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17,331.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17,331.83
|
| Rate for Payer: Health EOS Commercial |
$16,408.93
|
| Rate for Payer: HFN Commercial |
$16,962.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64,474.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17,331.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17,331.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17,331.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17,331.83
|
| Rate for Payer: Multiplan Commercial |
$14,749.60
|
| Rate for Payer: NAPHCARE Commercial |
$25,997.74
|
| Rate for Payer: Preferred Network Access Commercial |
$16,962.04
|
| Rate for Payer: Quartz Beloit One Network |
$9,034.13
|
| Rate for Payer: Quartz Commercial |
$11,984.05
|
| Rate for Payer: Quartz Medicare Advantage |
$17,331.83
|
| Rate for Payer: The Alliance Commercial |
$6,103.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,331.83
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: WEA Trust Commercial |
$10,140.35
|
| Rate for Payer: Wellcare Medicare |
$17,331.83
|
| Rate for Payer: WPS Commercial |
$13,656.29
|
|
|
Arterial Coiling Not Hemorrhage or Tumor
|
Facility
IP
|
$18,437.00
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
4597126
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,034.13 |
| Max. Negotiated Rate |
$16,962.04 |
| Rate for Payer: Aetna Commercial |
$16,593.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,771.61
|
| Rate for Payer: Cash Price |
$5,531.10
|
| Rate for Payer: Cigna Commercial |
$16,962.04
|
| Rate for Payer: Health EOS Commercial |
$16,408.93
|
| Rate for Payer: HFN Commercial |
$16,962.04
|
| Rate for Payer: Multiplan Commercial |
$14,749.60
|
| Rate for Payer: NAPHCARE Commercial |
$11,062.20
|
| Rate for Payer: Preferred Network Access Commercial |
$16,962.04
|
| Rate for Payer: Quartz Beloit One Network |
$9,034.13
|
| Rate for Payer: Quartz Commercial |
$11,062.20
|
| Rate for Payer: WEA Trust Commercial |
$10,140.35
|
| Rate for Payer: WPS Commercial |
$13,656.29
|
|
|
ARTERIAL LINE PLACEMENT
|
Facility
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959832
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$492.94 |
| Max. Negotiated Rate |
$925.52 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$603.60
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
ARTERIAL LINE PLACEMENT
|
Facility
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959832
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$281.68 |
| Max. Negotiated Rate |
$4,024.00 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| Rate for Payer: Aetna Managed Medicare |
$281.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$653.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$503.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$482.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$562.96
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$754.50
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$653.90
|
| Rate for Payer: Quartz Medicare Advantage |
$603.60
|
| Rate for Payer: The Alliance Commercial |
$4,024.00
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
Arterial Monit 3-6 Hrs
|
Facility
OP
|
$2,407.00
|
|
| Hospital Charge Code |
3101754
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$673.96 |
| Max. Negotiated Rate |
$9,628.00 |
| Rate for Payer: Aetna Commercial |
$2,166.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,070.02
|
| Rate for Payer: Aetna Managed Medicare |
$673.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,564.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,203.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,155.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,275.71
|
| Rate for Payer: Cash Price |
$722.10
|
| Rate for Payer: Cigna Commercial |
$2,214.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,346.96
|
| Rate for Payer: Health EOS Commercial |
$2,142.23
|
| Rate for Payer: HFN Commercial |
$2,214.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,805.25
|
| Rate for Payer: Multiplan Commercial |
$1,925.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,444.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,214.44
|
| Rate for Payer: Quartz Beloit One Network |
$1,179.43
|
| Rate for Payer: Quartz Commercial |
$1,564.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,444.20
|
| Rate for Payer: The Alliance Commercial |
$9,628.00
|
| Rate for Payer: WEA Trust Commercial |
$1,323.85
|
| Rate for Payer: WPS Commercial |
$1,782.86
|
|
|
Arterial Monit 3-6 Hrs
|
Facility
IP
|
$2,407.00
|
|
| Hospital Charge Code |
3101754
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,179.43 |
| Max. Negotiated Rate |
$2,214.44 |
| Rate for Payer: Aetna Commercial |
$2,166.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,275.71
|
| Rate for Payer: Cash Price |
$722.10
|
| Rate for Payer: Cigna Commercial |
$2,214.44
|
| Rate for Payer: Health EOS Commercial |
$2,142.23
|
| Rate for Payer: HFN Commercial |
$2,214.44
|
| Rate for Payer: Multiplan Commercial |
$1,925.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,444.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,214.44
|
| Rate for Payer: Quartz Beloit One Network |
$1,179.43
|
| Rate for Payer: Quartz Commercial |
$1,444.20
|
| Rate for Payer: WEA Trust Commercial |
$1,323.85
|
| Rate for Payer: WPS Commercial |
$1,782.86
|
|
|
Arterial Monitor Over 6 Hrs
|
Facility
OP
|
$3,566.00
|
|
| Hospital Charge Code |
3101755
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$998.48 |
| Max. Negotiated Rate |
$14,264.00 |
| Rate for Payer: Aetna Commercial |
$3,209.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,066.76
|
| Rate for Payer: Aetna Managed Medicare |
$998.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,317.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,783.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,711.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,889.98
|
| Rate for Payer: Cash Price |
$1,069.80
|
| Rate for Payer: Cigna Commercial |
$3,280.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,995.53
|
| Rate for Payer: Health EOS Commercial |
$3,173.74
|
| Rate for Payer: HFN Commercial |
$3,280.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,674.50
|
| Rate for Payer: Multiplan Commercial |
$2,852.80
|
| Rate for Payer: NAPHCARE Commercial |
$2,139.60
|
| Rate for Payer: Preferred Network Access Commercial |
$3,280.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,747.34
|
| Rate for Payer: Quartz Commercial |
$2,317.90
|
| Rate for Payer: Quartz Medicare Advantage |
$2,139.60
|
| Rate for Payer: The Alliance Commercial |
$14,264.00
|
| Rate for Payer: WEA Trust Commercial |
$1,961.30
|
| Rate for Payer: WPS Commercial |
$2,641.34
|
|
|
Arterial Monitor Over 6 Hrs
|
Facility
IP
|
$3,566.00
|
|
| Hospital Charge Code |
3101755
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,747.34 |
| Max. Negotiated Rate |
$3,280.72 |
| Rate for Payer: Aetna Commercial |
$3,209.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,889.98
|
| Rate for Payer: Cash Price |
$1,069.80
|
| Rate for Payer: Cigna Commercial |
$3,280.72
|
| Rate for Payer: Health EOS Commercial |
$3,173.74
|
| Rate for Payer: HFN Commercial |
$3,280.72
|
| Rate for Payer: Multiplan Commercial |
$2,852.80
|
| Rate for Payer: NAPHCARE Commercial |
$2,139.60
|
| Rate for Payer: Preferred Network Access Commercial |
$3,280.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,747.34
|
| Rate for Payer: Quartz Commercial |
$2,139.60
|
| Rate for Payer: WEA Trust Commercial |
$1,961.30
|
| Rate for Payer: WPS Commercial |
$2,641.34
|
|
|
Arterial Monit To 3Hrs
|
Facility
OP
|
$1,539.00
|
|
| Hospital Charge Code |
3101753
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$430.92 |
| Max. Negotiated Rate |
$6,156.00 |
| Rate for Payer: Aetna Commercial |
$1,385.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,323.54
|
| Rate for Payer: Aetna Managed Medicare |
$430.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,000.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$769.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$738.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$815.67
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cigna Commercial |
$1,415.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$861.22
|
| Rate for Payer: Health EOS Commercial |
$1,369.71
|
| Rate for Payer: HFN Commercial |
$1,415.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,154.25
|
| Rate for Payer: Multiplan Commercial |
$1,231.20
|
| Rate for Payer: NAPHCARE Commercial |
$923.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,415.88
|
| Rate for Payer: Quartz Beloit One Network |
$754.11
|
| Rate for Payer: Quartz Commercial |
$1,000.35
|
| Rate for Payer: Quartz Medicare Advantage |
$923.40
|
| Rate for Payer: The Alliance Commercial |
$6,156.00
|
| Rate for Payer: WEA Trust Commercial |
$846.45
|
| Rate for Payer: WPS Commercial |
$1,139.94
|
|
|
Arterial Monit To 3Hrs
|
Facility
IP
|
$1,539.00
|
|
| Hospital Charge Code |
3101753
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$754.11 |
| Max. Negotiated Rate |
$1,415.88 |
| Rate for Payer: Aetna Commercial |
$1,385.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$815.67
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cigna Commercial |
$1,415.88
|
| Rate for Payer: Health EOS Commercial |
$1,369.71
|
| Rate for Payer: HFN Commercial |
$1,415.88
|
| Rate for Payer: Multiplan Commercial |
$1,231.20
|
| Rate for Payer: NAPHCARE Commercial |
$923.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,415.88
|
| Rate for Payer: Quartz Beloit One Network |
$754.11
|
| Rate for Payer: Quartz Commercial |
$923.40
|
| Rate for Payer: WEA Trust Commercial |
$846.45
|
| Rate for Payer: WPS Commercial |
$1,139.94
|
|
|
Arterial Puncture 36600
|
Professional
|
$118.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
1188800
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$112.10 |
| Rate for Payer: Aetna Commercial |
$112.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.48
|
| Rate for Payer: Aetna Managed Medicare |
$14.28
|
| Rate for Payer: Anthem Medicare Advantage |
$14.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.28
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$112.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$59.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.28
|
| Rate for Payer: Health EOS Commercial |
$107.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$52.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$52.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.28
|
| Rate for Payer: Multiplan Commercial |
$94.40
|
| Rate for Payer: Preferred Network Access Commercial |
$112.10
|
| Rate for Payer: Quartz Beloit One Network |
$51.92
|
| Rate for Payer: Quartz Commercial |
$67.26
|
| Rate for Payer: Quartz Medicare Advantage |
$14.28
|
| Rate for Payer: The Alliance Commercial |
$60.69
|
| Rate for Payer: United Healthcare Medicaid |
$24.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.28
|
| Rate for Payer: WEA Trust Commercial |
$64.90
|
| Rate for Payer: WPS Commercial |
$64.26
|
|
|
Arterial Puncture Withdrawal Blood DX
|
Professional
|
$158.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4524643
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$150.10 |
| Rate for Payer: Aetna Commercial |
$150.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$135.88
|
| Rate for Payer: Aetna Managed Medicare |
$14.28
|
| Rate for Payer: Anthem Medicare Advantage |
$14.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.28
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cigna Commercial |
$150.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$79.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.28
|
| Rate for Payer: Health EOS Commercial |
$143.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$52.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$52.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.28
|
| Rate for Payer: Multiplan Commercial |
$126.40
|
| Rate for Payer: Preferred Network Access Commercial |
$150.10
|
| Rate for Payer: Quartz Beloit One Network |
$69.52
|
| Rate for Payer: Quartz Commercial |
$90.06
|
| Rate for Payer: Quartz Medicare Advantage |
$14.28
|
| Rate for Payer: The Alliance Commercial |
$60.69
|
| Rate for Payer: United Healthcare Medicaid |
$24.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.28
|
| Rate for Payer: WEA Trust Commercial |
$86.90
|
| Rate for Payer: WPS Commercial |
$64.26
|
|
|
Arterial Puncture Withdrawal Blood DX
|
Facility
IP
|
$158.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4524643
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$77.42 |
| Max. Negotiated Rate |
$145.36 |
| Rate for Payer: Aetna Commercial |
$142.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$83.74
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cigna Commercial |
$145.36
|
| Rate for Payer: Health EOS Commercial |
$140.62
|
| Rate for Payer: HFN Commercial |
$145.36
|
| Rate for Payer: Multiplan Commercial |
$126.40
|
| Rate for Payer: NAPHCARE Commercial |
$94.80
|
| Rate for Payer: Preferred Network Access Commercial |
$145.36
|
| Rate for Payer: Quartz Beloit One Network |
$77.42
|
| Rate for Payer: Quartz Commercial |
$94.80
|
| Rate for Payer: WEA Trust Commercial |
$86.90
|
| Rate for Payer: WPS Commercial |
$117.03
|
|
|
Arterial Puncture Withdrawal Blood DX
|
Facility
OP
|
$158.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4524643
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$75.84 |
| Max. Negotiated Rate |
$6,103.72 |
| Rate for Payer: Aetna Commercial |
$142.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$135.88
|
| Rate for Payer: Aetna Managed Medicare |
$126.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$102.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$79.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$75.84
|
| Rate for Payer: Anthem Medicare Advantage |
$126.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$83.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$126.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$126.26
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cigna Commercial |
$145.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$126.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$126.26
|
| Rate for Payer: Health EOS Commercial |
$140.62
|
| Rate for Payer: HFN Commercial |
$145.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$469.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$126.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$126.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$126.26
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$126.26
|
| Rate for Payer: Multiplan Commercial |
$126.40
|
| Rate for Payer: NAPHCARE Commercial |
$189.39
|
| Rate for Payer: Preferred Network Access Commercial |
$145.36
|
| Rate for Payer: Quartz Beloit One Network |
$77.42
|
| Rate for Payer: Quartz Commercial |
$102.70
|
| Rate for Payer: Quartz Medicare Advantage |
$126.26
|
| Rate for Payer: The Alliance Commercial |
$6,103.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.26
|
| Rate for Payer: United Healthcare PPO |
$118.50
|
| Rate for Payer: WEA Trust Commercial |
$86.90
|
| Rate for Payer: Wellcare Medicare |
$126.26
|
| Rate for Payer: WPS Commercial |
$117.03
|
|
|
Arterial/Venous Coiling for Hemorrhage
|
Facility
IP
|
$13,260.00
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
4597128
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,497.40 |
| Max. Negotiated Rate |
$12,199.20 |
| Rate for Payer: Aetna Commercial |
$11,934.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,027.80
|
| Rate for Payer: Cash Price |
$3,978.00
|
| Rate for Payer: Cigna Commercial |
$12,199.20
|
| Rate for Payer: Health EOS Commercial |
$11,801.40
|
| Rate for Payer: HFN Commercial |
$12,199.20
|
| Rate for Payer: Multiplan Commercial |
$10,608.00
|
| Rate for Payer: NAPHCARE Commercial |
$7,956.00
|
| Rate for Payer: Preferred Network Access Commercial |
$12,199.20
|
| Rate for Payer: Quartz Beloit One Network |
$6,497.40
|
| Rate for Payer: Quartz Commercial |
$7,956.00
|
| Rate for Payer: WEA Trust Commercial |
$7,293.00
|
| Rate for Payer: WPS Commercial |
$9,821.68
|
|
|
Arterial/Venous Coiling for Hemorrhage
|
Facility
OP
|
$13,260.00
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
4597128
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,103.72 |
| Max. Negotiated Rate |
$40,449.87 |
| Rate for Payer: Aetna Commercial |
$11,934.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$11,403.60
|
| Rate for Payer: Aetna Managed Medicare |
$10,873.62
|
| 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 |
$10,873.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,027.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,873.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,873.62
|
| Rate for Payer: Cash Price |
$3,978.00
|
| Rate for Payer: Cash Price |
$3,978.00
|
| Rate for Payer: Cash Price |
$3,978.00
|
| Rate for Payer: Cigna Commercial |
$12,199.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,873.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,873.62
|
| Rate for Payer: Health EOS Commercial |
$11,801.40
|
| Rate for Payer: HFN Commercial |
$12,199.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$40,449.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,873.62
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,873.62
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,873.62
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,873.62
|
| Rate for Payer: Multiplan Commercial |
$10,608.00
|
| Rate for Payer: NAPHCARE Commercial |
$16,310.43
|
| Rate for Payer: Preferred Network Access Commercial |
$12,199.20
|
| Rate for Payer: Quartz Beloit One Network |
$6,497.40
|
| Rate for Payer: Quartz Commercial |
$8,619.00
|
| Rate for Payer: Quartz Medicare Advantage |
$10,873.62
|
| Rate for Payer: The Alliance Commercial |
$6,103.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,873.62
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: WEA Trust Commercial |
$7,293.00
|
| Rate for Payer: Wellcare Medicare |
$10,873.62
|
| Rate for Payer: WPS Commercial |
$9,821.68
|
|
|
ARTERIOVENOUS ANASTOMOSIS, OPEN; BY FOREARM VEIN TRANSPOSITION
|
Facility
OP
|
$20,205.70
|
|
|
Service Code
|
CPT 36820
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,240.00 |
| Max. Negotiated Rate |
$20,205.70 |
| Rate for Payer: Aetna Managed Medicare |
$5,431.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$12,238.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10,914.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,367.00
|
| Rate for Payer: Anthem Medicare Advantage |
$5,431.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,431.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,431.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,431.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,546.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,431.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,205.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,431.64
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,431.64
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,431.64
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,431.64
|
| Rate for Payer: NAPHCARE Commercial |
$8,147.46
|
| Rate for Payer: Quartz Medicare Advantage |
$5,431.64
|
| Rate for Payer: The Alliance Commercial |
$12,148.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,431.64
|
| Rate for Payer: United Healthcare PPO |
$4,240.00
|
| Rate for Payer: Wellcare Medicare |
$5,431.64
|
|
|
ARTERIOVENOUS ANASTOMOSIS, OPEN; DIRECT, ANY SITE (EG, CIMINO TYPE) (SEPARATE PROCEDURE)
|
Facility
OP
|
$20,943.68
|
|
|
Service Code
|
CPT 36821
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,150.53 |
| Max. Negotiated Rate |
$20,943.68 |
| 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 Medicare Advantage HMO |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,150.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,546.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| 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: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Quartz Medicare Advantage |
$3,150.53
|
| Rate for Payer: The Alliance Commercial |
$20,943.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,150.53
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
|
|
ARTERIOVENOUS FISTULA/GRAFT/DECLOTTING
|
Facility
OP
|
$13,026.00
|
|
| Hospital Charge Code |
2959835
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,647.28 |
| Max. Negotiated Rate |
$52,104.00 |
| Rate for Payer: Aetna Commercial |
$11,723.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$11,202.36
|
| Rate for Payer: Aetna Managed Medicare |
$3,647.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$8,466.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6,513.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6,252.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,903.78
|
| Rate for Payer: Cash Price |
$3,907.80
|
| Rate for Payer: Cigna Commercial |
$11,983.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,289.35
|
| Rate for Payer: Health EOS Commercial |
$11,593.14
|
| Rate for Payer: HFN Commercial |
$11,983.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$9,769.50
|
| Rate for Payer: Multiplan Commercial |
$10,420.80
|
| Rate for Payer: NAPHCARE Commercial |
$7,815.60
|
| Rate for Payer: Preferred Network Access Commercial |
$11,983.92
|
| Rate for Payer: Quartz Beloit One Network |
$6,382.74
|
| Rate for Payer: Quartz Commercial |
$8,466.90
|
| Rate for Payer: Quartz Medicare Advantage |
$7,815.60
|
| Rate for Payer: The Alliance Commercial |
$52,104.00
|
| Rate for Payer: WEA Trust Commercial |
$7,164.30
|
| Rate for Payer: WPS Commercial |
$9,648.36
|
|
|
ARTERIOVENOUS FISTULA/GRAFT/DECLOTTING
|
Facility
IP
|
$13,026.00
|
|
| Hospital Charge Code |
2959835
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,382.74 |
| Max. Negotiated Rate |
$11,983.92 |
| Rate for Payer: Aetna Commercial |
$11,723.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,903.78
|
| Rate for Payer: Cash Price |
$3,907.80
|
| Rate for Payer: Cigna Commercial |
$11,983.92
|
| Rate for Payer: Health EOS Commercial |
$11,593.14
|
| Rate for Payer: HFN Commercial |
$11,983.92
|
| Rate for Payer: Multiplan Commercial |
$10,420.80
|
| Rate for Payer: NAPHCARE Commercial |
$7,815.60
|
| Rate for Payer: Preferred Network Access Commercial |
$11,983.92
|
| Rate for Payer: Quartz Beloit One Network |
$6,382.74
|
| Rate for Payer: Quartz Commercial |
$7,815.60
|
| Rate for Payer: WEA Trust Commercial |
$7,164.30
|
| Rate for Payer: WPS Commercial |
$9,648.36
|
|
|
Artery-vein nonautograft
|
Facility
IP
|
$12,095.00
|
|
|
Service Code
|
CPT 36830
|
| Hospital Charge Code |
5608014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,926.55 |
| Max. Negotiated Rate |
$11,127.40 |
| Rate for Payer: Aetna Commercial |
$10,885.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,410.35
|
| Rate for Payer: Cash Price |
$3,628.50
|
| Rate for Payer: Cigna Commercial |
$11,127.40
|
| Rate for Payer: Health EOS Commercial |
$10,764.55
|
| Rate for Payer: HFN Commercial |
$11,127.40
|
| Rate for Payer: Multiplan Commercial |
$9,676.00
|
| Rate for Payer: NAPHCARE Commercial |
$7,257.00
|
| Rate for Payer: Preferred Network Access Commercial |
$11,127.40
|
| Rate for Payer: Quartz Beloit One Network |
$5,926.55
|
| Rate for Payer: Quartz Commercial |
$7,257.00
|
| Rate for Payer: WEA Trust Commercial |
$6,652.25
|
| Rate for Payer: WPS Commercial |
$8,958.77
|
|
|
Artery-vein nonautograft
|
Facility
OP
|
$12,095.00
|
|
|
Service Code
|
CPT 36830
|
| Hospital Charge Code |
5608014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,240.00 |
| Max. Negotiated Rate |
$20,943.68 |
| Rate for Payer: Aetna Commercial |
$10,885.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,401.70
|
| Rate for Payer: Aetna Managed Medicare |
$5,431.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$12,238.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10,914.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,367.00
|
| Rate for Payer: Anthem Medicare Advantage |
$5,431.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,410.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,431.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,431.64
|
| Rate for Payer: Cash Price |
$3,628.50
|
| Rate for Payer: Cash Price |
$3,628.50
|
| Rate for Payer: Cash Price |
$3,628.50
|
| Rate for Payer: Cigna Commercial |
$11,127.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,431.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,431.64
|
| Rate for Payer: Health EOS Commercial |
$10,764.55
|
| Rate for Payer: HFN Commercial |
$11,127.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,205.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,431.64
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,431.64
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,431.64
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,431.64
|
| Rate for Payer: Multiplan Commercial |
$9,676.00
|
| Rate for Payer: NAPHCARE Commercial |
$8,147.46
|
| Rate for Payer: Preferred Network Access Commercial |
$11,127.40
|
| Rate for Payer: Quartz Beloit One Network |
$5,926.55
|
| Rate for Payer: Quartz Commercial |
$7,861.75
|
| Rate for Payer: Quartz Medicare Advantage |
$5,431.64
|
| Rate for Payer: The Alliance Commercial |
$20,943.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,431.64
|
| Rate for Payer: United Healthcare PPO |
$4,240.00
|
| Rate for Payer: WEA Trust Commercial |
$6,652.25
|
| Rate for Payer: Wellcare Medicare |
$5,431.64
|
| Rate for Payer: WPS Commercial |
$8,958.77
|
|
|
Artery X-Rays,Arms/Legs 7571626
|
Professional
|
$1,081.00
|
|
|
Service Code
|
CPT 75716 26
|
| Hospital Charge Code |
3568169
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$86.27 |
| Max. Negotiated Rate |
$1,026.95 |
| Rate for Payer: Aetna Commercial |
$1,026.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$929.66
|
| Rate for Payer: Aetna Managed Medicare |
$86.27
|
| Rate for Payer: Anthem Medicare Advantage |
$86.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$86.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$86.27
|
| Rate for Payer: Cash Price |
$324.30
|
| Rate for Payer: Cash Price |
$324.30
|
| Rate for Payer: Cigna Commercial |
$1,026.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$540.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$86.27
|
| Rate for Payer: Health EOS Commercial |
$983.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$314.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$314.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$86.27
|
| Rate for Payer: Multiplan Commercial |
$864.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,026.95
|
| Rate for Payer: Quartz Beloit One Network |
$475.64
|
| Rate for Payer: Quartz Commercial |
$616.17
|
| Rate for Payer: Quartz Medicare Advantage |
$86.27
|
| Rate for Payer: The Alliance Commercial |
$327.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$86.27
|
| Rate for Payer: WEA Trust Commercial |
$594.55
|
| Rate for Payer: WPS Commercial |
$431.35
|
|
|
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT OR BURSA (EG, TEMPOROMANDIBULAR, ACROMIOCLAVICULAR, WRIST, ELBOW OR ANKLE, OLECRANON BURSA); WITHOUT ULTRASOUND GUIDANCE
|
Facility
OP
|
$4,218.22
|
|
|
Service Code
|
CPT 20605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$110.96 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Managed Medicare |
$292.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,914.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,297.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,183.00
|
| Rate for Payer: Anthem Medicare Advantage |
$292.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$292.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$292.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$292.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$292.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,089.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$292.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$292.75
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$292.75
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$292.75
|
| Rate for Payer: NAPHCARE Commercial |
$439.12
|
| Rate for Payer: Quartz Medicare Advantage |
$292.75
|
| Rate for Payer: The Alliance Commercial |
$110.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$292.75
|
| Rate for Payer: United Healthcare PPO |
$2,257.00
|
| Rate for Payer: Wellcare Medicare |
$292.75
|
|
|
Arthrocentesis, Aspiration and/or Injection; Major Joint or Bursa
|
Professional
|
$220.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
1188962
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$41.89 |
| Max. Negotiated Rate |
$209.00 |
| Rate for Payer: Aetna Commercial |
$209.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$189.20
|
| Rate for Payer: Aetna Managed Medicare |
$41.89
|
| Rate for Payer: Anthem Medicare Advantage |
$41.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$41.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$41.89
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cigna Commercial |
$209.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$110.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$41.89
|
| Rate for Payer: Health EOS Commercial |
$200.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$150.77
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$150.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$41.89
|
| Rate for Payer: Multiplan Commercial |
$176.00
|
| Rate for Payer: Preferred Network Access Commercial |
$209.00
|
| Rate for Payer: Quartz Beloit One Network |
$96.80
|
| Rate for Payer: Quartz Commercial |
$125.40
|
| Rate for Payer: Quartz Medicare Advantage |
$41.89
|
| Rate for Payer: The Alliance Commercial |
$178.03
|
| Rate for Payer: United Healthcare Medicaid |
$64.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41.89
|
| Rate for Payer: WEA Trust Commercial |
$121.00
|
| Rate for Payer: WPS Commercial |
$188.50
|
|
