|
Osmolality Urine
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
633792
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.09 |
| Max. Negotiated Rate |
$170.92 |
| Rate for Payer: Aetna Commercial |
$170.92
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$154.73
|
| Rate for Payer: Aetna Managed Medicare |
$7.09
|
| Rate for Payer: Anthem Medicare Advantage |
$7.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.09
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cigna Commercial |
$170.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$89.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7.09
|
| Rate for Payer: Health EOS Commercial |
$163.73
|
| Rate for Payer: HFN Commercial |
$170.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$25.03
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.09
|
| Rate for Payer: Multiplan Commercial |
$143.94
|
| Rate for Payer: NAPHCARE Commercial |
$10.64
|
| Rate for Payer: Preferred Network Access Commercial |
$170.92
|
| Rate for Payer: Quartz Beloit One Network |
$79.16
|
| Rate for Payer: Quartz Commercial |
$102.55
|
| Rate for Payer: Quartz Medicare Advantage |
$7.09
|
| Rate for Payer: The Alliance Commercial |
$28.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.09
|
| Rate for Payer: WEA Trust Commercial |
$98.96
|
| Rate for Payer: WPS Commercial |
$31.21
|
|
|
Osmolality, Urine
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
5474697
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.09 |
| Max. Negotiated Rate |
$38.27 |
| Rate for Payer: Aetna Commercial |
$37.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$35.78
|
| Rate for Payer: Aetna Managed Medicare |
$7.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$26.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$12.41
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$11.77
|
| Rate for Payer: Anthem Medicare Advantage |
$7.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$22.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.09
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$38.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7.09
|
| Rate for Payer: Health EOS Commercial |
$37.02
|
| Rate for Payer: HFN Commercial |
$38.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7.09
|
| Rate for Payer: Multiplan Commercial |
$33.28
|
| Rate for Payer: NAPHCARE Commercial |
$10.64
|
| Rate for Payer: Preferred Network Access Commercial |
$38.27
|
| Rate for Payer: Quartz Beloit One Network |
$20.38
|
| Rate for Payer: Quartz Commercial |
$27.04
|
| Rate for Payer: Quartz Medicare Advantage |
$7.09
|
| Rate for Payer: The Alliance Commercial |
$28.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.09
|
| Rate for Payer: United Healthcare PPO |
$31.20
|
| Rate for Payer: WEA Trust Commercial |
$22.88
|
| Rate for Payer: Wellcare Medicare |
$7.09
|
| Rate for Payer: WPS Commercial |
$30.81
|
|
|
Osmolality, Urine
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
5474697
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.09 |
| Max. Negotiated Rate |
$39.52 |
| Rate for Payer: Aetna Commercial |
$39.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$35.78
|
| Rate for Payer: Aetna Managed Medicare |
$7.09
|
| Rate for Payer: Anthem Medicare Advantage |
$7.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.09
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$39.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7.09
|
| Rate for Payer: Health EOS Commercial |
$37.86
|
| Rate for Payer: HFN Commercial |
$39.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$25.03
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.09
|
| Rate for Payer: Multiplan Commercial |
$33.28
|
| Rate for Payer: NAPHCARE Commercial |
$10.64
|
| Rate for Payer: Preferred Network Access Commercial |
$39.52
|
| Rate for Payer: Quartz Beloit One Network |
$18.30
|
| Rate for Payer: Quartz Commercial |
$23.71
|
| Rate for Payer: Quartz Medicare Advantage |
$7.09
|
| Rate for Payer: The Alliance Commercial |
$28.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.09
|
| Rate for Payer: WEA Trust Commercial |
$22.88
|
| Rate for Payer: WPS Commercial |
$31.21
|
|
|
Osmolality, Urine
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
5474697
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.38 |
| Max. Negotiated Rate |
$38.27 |
| Rate for Payer: Aetna Commercial |
$37.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$35.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$22.05
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$38.27
|
| Rate for Payer: Health EOS Commercial |
$37.02
|
| Rate for Payer: HFN Commercial |
$38.27
|
| Rate for Payer: Multiplan Commercial |
$33.28
|
| Rate for Payer: Preferred Network Access Commercial |
$38.27
|
| Rate for Payer: Quartz Beloit One Network |
$20.38
|
| Rate for Payer: Quartz Commercial |
$24.96
|
| Rate for Payer: WEA Trust Commercial |
$22.88
|
| Rate for Payer: WPS Commercial |
$30.81
|
|
|
Osmolite 1.2 Rth 1000 mL
|
Facility
|
OP
|
$60.00
|
|
| Hospital Charge Code |
3031446
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$57.41 |
| Rate for Payer: Aetna Commercial |
$56.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$53.66
|
| Rate for Payer: Aetna Managed Medicare |
$17.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$40.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$33.07
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cigna Commercial |
$57.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$34.92
|
| Rate for Payer: Health EOS Commercial |
$55.54
|
| Rate for Payer: HFN Commercial |
$57.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.80
|
| Rate for Payer: Multiplan Commercial |
$49.92
|
| Rate for Payer: NAPHCARE Commercial |
$37.44
|
| Rate for Payer: Preferred Network Access Commercial |
$57.41
|
| Rate for Payer: Quartz Beloit One Network |
$30.58
|
| Rate for Payer: Quartz Commercial |
$40.56
|
| Rate for Payer: Quartz Medicare Advantage |
$37.44
|
| Rate for Payer: The Alliance Commercial |
$31.20
|
| Rate for Payer: WEA Trust Commercial |
$34.32
|
| Rate for Payer: WPS Commercial |
$46.22
|
|
|
Osmolite 1.2 Rth 1000 mL
|
Facility
|
IP
|
$60.00
|
|
| Hospital Charge Code |
3031446
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.58 |
| Max. Negotiated Rate |
$57.41 |
| Rate for Payer: Aetna Commercial |
$56.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$53.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$33.07
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cigna Commercial |
$57.41
|
| Rate for Payer: Health EOS Commercial |
$55.54
|
| Rate for Payer: HFN Commercial |
$57.41
|
| Rate for Payer: Multiplan Commercial |
$49.92
|
| Rate for Payer: Preferred Network Access Commercial |
$57.41
|
| Rate for Payer: Quartz Beloit One Network |
$30.58
|
| Rate for Payer: Quartz Commercial |
$37.44
|
| Rate for Payer: WEA Trust Commercial |
$34.32
|
| Rate for Payer: WPS Commercial |
$46.22
|
|
|
Osmotic Fragility, Red Blood Cell
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
978132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$148.29 |
| Max. Negotiated Rate |
$278.43 |
| Rate for Payer: Aetna Commercial |
$272.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$260.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$160.40
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Cigna Commercial |
$278.43
|
| Rate for Payer: Health EOS Commercial |
$269.35
|
| Rate for Payer: HFN Commercial |
$278.43
|
| Rate for Payer: Multiplan Commercial |
$242.11
|
| Rate for Payer: Preferred Network Access Commercial |
$278.43
|
| Rate for Payer: Quartz Beloit One Network |
$148.29
|
| Rate for Payer: Quartz Commercial |
$181.58
|
| Rate for Payer: WEA Trust Commercial |
$166.45
|
| Rate for Payer: WPS Commercial |
$224.16
|
|
|
Osmotic Fragility, Red Blood Cell
|
Facility
|
OP
|
$291.00
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
978132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.89 |
| Max. Negotiated Rate |
$278.43 |
| Rate for Payer: Aetna Commercial |
$272.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$260.27
|
| Rate for Payer: Aetna Managed Medicare |
$13.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$52.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.06
|
| Rate for Payer: Anthem Medicare Advantage |
$13.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$160.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.89
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Cigna Commercial |
$278.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$169.36
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.89
|
| Rate for Payer: Health EOS Commercial |
$269.35
|
| Rate for Payer: HFN Commercial |
$278.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$51.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.89
|
| Rate for Payer: Multiplan Commercial |
$242.11
|
| Rate for Payer: NAPHCARE Commercial |
$20.84
|
| Rate for Payer: Preferred Network Access Commercial |
$278.43
|
| Rate for Payer: Quartz Beloit One Network |
$148.29
|
| Rate for Payer: Quartz Commercial |
$196.72
|
| Rate for Payer: Quartz Medicare Advantage |
$13.89
|
| Rate for Payer: The Alliance Commercial |
$55.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.89
|
| Rate for Payer: United Healthcare PPO |
$226.98
|
| Rate for Payer: WEA Trust Commercial |
$166.45
|
| Rate for Payer: Wellcare Medicare |
$13.89
|
| Rate for Payer: WPS Commercial |
$224.16
|
|
|
Osmotic Fragility, Red Blood Cell
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
978132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.89 |
| Max. Negotiated Rate |
$287.51 |
| Rate for Payer: Aetna Commercial |
$287.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$260.27
|
| Rate for Payer: Aetna Managed Medicare |
$13.89
|
| Rate for Payer: Anthem Medicare Advantage |
$13.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.89
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Cigna Commercial |
$287.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$151.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.89
|
| Rate for Payer: Health EOS Commercial |
$275.40
|
| Rate for Payer: HFN Commercial |
$287.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$49.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$49.05
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.89
|
| Rate for Payer: Multiplan Commercial |
$242.11
|
| Rate for Payer: NAPHCARE Commercial |
$20.84
|
| Rate for Payer: Preferred Network Access Commercial |
$287.51
|
| Rate for Payer: Quartz Beloit One Network |
$133.16
|
| Rate for Payer: Quartz Commercial |
$172.50
|
| Rate for Payer: Quartz Medicare Advantage |
$13.89
|
| Rate for Payer: The Alliance Commercial |
$54.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.89
|
| Rate for Payer: WEA Trust Commercial |
$166.45
|
| Rate for Payer: WPS Commercial |
$61.14
|
|
|
OSTECTOMY, CALCANEUS;
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 28118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,107.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
OSTECTOMY, CALCANEUS; FOR SPUR, WITH OR WITHOUT PLANTAR FASCIAL RELEASE
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 28119
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,107.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
OSTECTOMY, COMPLETE EXCISION; ALL METATARSAL HEADS, WITH PARTIAL PROXIMAL PHALANGECTOMY, EXCLUDING FIRST METATARSAL (EG, CLAYTON TYPE PROCEDURE)
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 28114
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
OSTECTOMY, COMPLETE EXCISION; FIFTH METATARSAL HEAD
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 28113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
OSTECTOMY, EXCISION OF TARSAL COALITION
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 28116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL HEAD (BUNIONETTE) (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 28110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY, METATARSAL HEAD, EACH METATARSAL HEAD
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 28288
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
Ostectomy Tarsal Coalition 28116
|
Professional
|
Both
|
$3,375.00
|
|
|
Service Code
|
CPT 28116
|
| Hospital Charge Code |
4626615
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$470.08 |
| Max. Negotiated Rate |
$3,334.50 |
| Rate for Payer: Aetna Commercial |
$3,334.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,018.60
|
| Rate for Payer: Aetna Managed Medicare |
$479.70
|
| Rate for Payer: Anthem Medicare Advantage |
$479.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$479.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$479.70
|
| Rate for Payer: Cash Price |
$1,012.50
|
| Rate for Payer: Cash Price |
$1,012.50
|
| Rate for Payer: Cash Price |
$1,012.50
|
| Rate for Payer: Cigna Commercial |
$3,334.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$470.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$479.70
|
| Rate for Payer: Health EOS Commercial |
$3,194.10
|
| Rate for Payer: HFN Commercial |
$3,334.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,024.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,024.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$479.70
|
| Rate for Payer: Multiplan Commercial |
$2,808.00
|
| Rate for Payer: NAPHCARE Commercial |
$719.55
|
| Rate for Payer: Preferred Network Access Commercial |
$3,334.50
|
| Rate for Payer: Quartz Beloit One Network |
$1,544.40
|
| Rate for Payer: Quartz Commercial |
$2,000.70
|
| Rate for Payer: Quartz Medicare Advantage |
$479.70
|
| Rate for Payer: The Alliance Commercial |
$2,038.72
|
| Rate for Payer: United Healthcare Medicaid |
$470.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$479.70
|
| Rate for Payer: WEA Trust Commercial |
$1,930.50
|
| Rate for Payer: WPS Commercial |
$2,158.65
|
|
|
Osteocalcin N-MID
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
4422771
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.04 |
| Max. Negotiated Rate |
$124.18 |
| Rate for Payer: Anthem Medicare Advantage |
$31.04
|
| Rate for Payer: Aetna Commercial |
$95.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.23
|
| Rate for Payer: Aetna Managed Medicare |
$31.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$116.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$54.33
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$51.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$31.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$31.04
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$97.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$31.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$59.36
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$31.04
|
| Rate for Payer: Health EOS Commercial |
$94.41
|
| Rate for Payer: HFN Commercial |
$97.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$115.48
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$31.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$31.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$31.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$31.04
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: NAPHCARE Commercial |
$46.57
|
| Rate for Payer: Preferred Network Access Commercial |
$97.59
|
| Rate for Payer: Quartz Beloit One Network |
$51.98
|
| Rate for Payer: Quartz Commercial |
$68.95
|
| Rate for Payer: Quartz Medicare Advantage |
$31.04
|
| Rate for Payer: The Alliance Commercial |
$124.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31.04
|
| Rate for Payer: United Healthcare PPO |
$79.56
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: Wellcare Medicare |
$31.04
|
| Rate for Payer: WPS Commercial |
$78.57
|
|
|
Osteocalcin N-MID
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
4422771
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.04 |
| Max. Negotiated Rate |
$136.59 |
| Rate for Payer: Aetna Commercial |
$100.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.23
|
| Rate for Payer: Aetna Managed Medicare |
$31.04
|
| Rate for Payer: Anthem Medicare Advantage |
$31.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$31.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$31.04
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$100.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$53.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31.04
|
| Rate for Payer: Health EOS Commercial |
$96.53
|
| Rate for Payer: HFN Commercial |
$100.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$109.58
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$109.58
|
| Rate for Payer: Independent Care Health Plan Medicare |
$31.04
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: NAPHCARE Commercial |
$46.57
|
| Rate for Payer: Preferred Network Access Commercial |
$100.78
|
| Rate for Payer: Quartz Beloit One Network |
$46.68
|
| Rate for Payer: Quartz Commercial |
$60.47
|
| Rate for Payer: Quartz Medicare Advantage |
$31.04
|
| Rate for Payer: The Alliance Commercial |
$122.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31.04
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: WPS Commercial |
$136.59
|
|
|
Osteocalcin N-MID
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
4422771
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$51.98 |
| Max. Negotiated Rate |
$97.59 |
| Rate for Payer: Aetna Commercial |
$95.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.22
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$97.59
|
| Rate for Payer: Health EOS Commercial |
$94.41
|
| Rate for Payer: HFN Commercial |
$97.59
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: Preferred Network Access Commercial |
$97.59
|
| Rate for Payer: Quartz Beloit One Network |
$51.98
|
| Rate for Payer: Quartz Commercial |
$63.65
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: WPS Commercial |
$78.57
|
|
|
OSTEOCHONDRAL ALLOGRAFT, KNEE, OPEN
|
Facility
|
OP
|
$54,045.18
|
|
|
Service Code
|
CPT 27415
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,807.99 |
| Max. Negotiated Rate |
$54,045.18 |
| Rate for Payer: Aetna Managed Medicare |
$13,511.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,394.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,394.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,919.20
|
| Rate for Payer: Anthem Medicare Advantage |
$13,511.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,511.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,511.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,511.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,511.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50,262.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,511.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,511.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,511.30
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,511.30
|
| Rate for Payer: NAPHCARE Commercial |
$20,266.94
|
| Rate for Payer: Quartz Medicare Advantage |
$13,511.30
|
| Rate for Payer: The Alliance Commercial |
$54,045.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,511.30
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: Wellcare Medicare |
$13,511.30
|
|
|
OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS
|
Facility
|
IP
|
$6,488.55
|
|
|
Service Code
|
APR-DRG 3441
|
| Min. Negotiated Rate |
$5,763.53 |
| Max. Negotiated Rate |
$6,488.55 |
| Rate for Payer: Anthem Medicaid |
$6,213.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,213.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,213.14
|
| Rate for Payer: Dean Health Medicaid |
$6,213.14
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5,763.53
|
| Rate for Payer: Managed Health Services Medicaid |
$6,488.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,213.14
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,213.14
|
| Rate for Payer: United Healthcare Medicaid |
$6,213.14
|
|
|
OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS
|
Facility
|
IP
|
$20,517.85
|
|
|
Service Code
|
APR-DRG 3444
|
| Min. Negotiated Rate |
$18,225.23 |
| Max. Negotiated Rate |
$20,517.85 |
| Rate for Payer: Anthem Medicaid |
$19,646.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$19,646.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19,646.97
|
| Rate for Payer: Dean Health Medicaid |
$19,646.97
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,225.23
|
| Rate for Payer: Managed Health Services Medicaid |
$20,517.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$19,646.97
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19,646.97
|
| Rate for Payer: United Healthcare Medicaid |
$19,646.97
|
|
|
OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS
|
Facility
|
IP
|
$12,889.42
|
|
|
Service Code
|
APR-DRG 3443
|
| Min. Negotiated Rate |
$11,449.18 |
| Max. Negotiated Rate |
$12,889.42 |
| Rate for Payer: Anthem Medicaid |
$12,342.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$12,342.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12,342.33
|
| Rate for Payer: Dean Health Medicaid |
$12,342.33
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,449.18
|
| Rate for Payer: Managed Health Services Medicaid |
$12,889.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,342.33
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12,342.33
|
| Rate for Payer: United Healthcare Medicaid |
$12,342.33
|
|
|
OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS
|
Facility
|
OP
|
$33.35
|
|
|
Service Code
|
EAPG 00654
|
| Min. Negotiated Rate |
$32.06 |
| Max. Negotiated Rate |
$33.35 |
| Rate for Payer: Anthem Medicaid |
$32.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$32.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$32.06
|
| Rate for Payer: Dean Health Medicaid |
$32.06
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$32.06
|
| Rate for Payer: Managed Health Services Medicaid |
$33.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$32.06
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$32.06
|
| Rate for Payer: United Healthcare Medicaid |
$32.06
|
|
