|
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE, SUBACROMIAL BURSA); WITHOUT ULTRASOUND GUIDANCE
|
Facility
OP
|
$4,218.22
|
|
|
Service Code
|
CPT 20610
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Anthem Medicare Advantage |
$292.75
|
| 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: 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 |
$2.64
|
| 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; Medium Joint or Bursa
|
Professional
|
$231.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
1188961
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$34.41 |
| Max. Negotiated Rate |
$219.45 |
| Rate for Payer: Aetna Commercial |
$219.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$198.66
|
| Rate for Payer: Aetna Managed Medicare |
$34.41
|
| Rate for Payer: Anthem Medicare Advantage |
$34.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$34.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$34.41
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cigna Commercial |
$219.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$115.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$34.41
|
| Rate for Payer: Health EOS Commercial |
$210.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$124.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$124.19
|
| Rate for Payer: Independent Care Health Plan Medicare |
$34.41
|
| Rate for Payer: Multiplan Commercial |
$184.80
|
| Rate for Payer: Preferred Network Access Commercial |
$219.45
|
| Rate for Payer: Quartz Beloit One Network |
$101.64
|
| Rate for Payer: Quartz Commercial |
$131.67
|
| Rate for Payer: Quartz Medicare Advantage |
$34.41
|
| Rate for Payer: The Alliance Commercial |
$146.24
|
| Rate for Payer: United Healthcare Medicaid |
$49.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34.41
|
| Rate for Payer: WEA Trust Commercial |
$127.05
|
| Rate for Payer: WPS Commercial |
$154.84
|
|
|
Arthrocentesis, Aspiration and/or Injection Small Joint or Bursa
|
Professional
|
$82.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
1188960
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$149.40 |
| Rate for Payer: Aetna Commercial |
$77.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$70.52
|
| Rate for Payer: Aetna Managed Medicare |
$33.20
|
| Rate for Payer: Anthem Medicare Advantage |
$33.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$33.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$33.20
|
| Rate for Payer: Cash Price |
$24.60
|
| Rate for Payer: Cash Price |
$24.60
|
| Rate for Payer: Cigna Commercial |
$77.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$33.20
|
| Rate for Payer: Health EOS Commercial |
$74.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$119.38
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$119.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$33.20
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Preferred Network Access Commercial |
$77.90
|
| Rate for Payer: Quartz Beloit One Network |
$36.08
|
| Rate for Payer: Quartz Commercial |
$46.74
|
| Rate for Payer: Quartz Medicare Advantage |
$33.20
|
| Rate for Payer: The Alliance Commercial |
$141.10
|
| Rate for Payer: United Healthcare Medicaid |
$38.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33.20
|
| Rate for Payer: WEA Trust Commercial |
$45.10
|
| Rate for Payer: WPS Commercial |
$149.40
|
|
|
Arthrocentesis, Aspiration and/or Inj; Medium Joint or Bursa 2060550
|
Professional
|
$354.00
|
|
|
Service Code
|
CPT 20605 50
|
| Hospital Charge Code |
5454744
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.56 |
| Max. Negotiated Rate |
$336.30 |
| Rate for Payer: Aetna Commercial |
$336.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$304.44
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna Commercial |
$336.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$177.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$212.40
|
| Rate for Payer: Health EOS Commercial |
$322.14
|
| Rate for Payer: Multiplan Commercial |
$283.20
|
| Rate for Payer: Preferred Network Access Commercial |
$336.30
|
| Rate for Payer: Quartz Beloit One Network |
$155.76
|
| Rate for Payer: Quartz Commercial |
$201.78
|
| Rate for Payer: The Alliance Commercial |
$177.00
|
| Rate for Payer: United Healthcare Medicaid |
$49.56
|
| Rate for Payer: WEA Trust Commercial |
$194.70
|
| Rate for Payer: WPS Commercial |
$262.21
|
|
|
Arthrocentesis Aspir&/Inj Major 2061150
|
Professional
|
$2,125.00
|
|
|
Service Code
|
CPT 20611 50
|
| Hospital Charge Code |
5374812
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$69.94 |
| Max. Negotiated Rate |
$2,018.75 |
| Rate for Payer: Aetna Commercial |
$2,018.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,827.50
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cigna Commercial |
$2,018.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,062.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,275.00
|
| Rate for Payer: Health EOS Commercial |
$1,933.75
|
| Rate for Payer: Multiplan Commercial |
$1,700.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,018.75
|
| Rate for Payer: Quartz Beloit One Network |
$935.00
|
| Rate for Payer: Quartz Commercial |
$1,211.25
|
| Rate for Payer: The Alliance Commercial |
$1,062.50
|
| Rate for Payer: United Healthcare Medicaid |
$69.94
|
| Rate for Payer: WEA Trust Commercial |
$1,168.75
|
| Rate for Payer: WPS Commercial |
$1,573.99
|
|
|
ARTHRODESIS, ANKLE, OPEN
|
Facility
OP
|
$48,391.84
|
|
|
Service Code
|
CPT 27870
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,795.33 |
| Max. Negotiated Rate |
$48,391.84 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| 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 |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$27,265.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT
|
Facility
OP
|
$50,159.28
|
|
|
Service Code
|
CPT 28750
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,071.12 |
| Max. Negotiated Rate |
$50,159.28 |
| Rate for Payer: Aetna Managed Medicare |
$7,071.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,071.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,071.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,071.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,304.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,071.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,071.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,071.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,071.12
|
| Rate for Payer: NAPHCARE Commercial |
$10,606.68
|
| Rate for Payer: Quartz Medicare Advantage |
$7,071.12
|
| Rate for Payer: The Alliance Commercial |
$50,159.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,071.12
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$7,071.12
|
|
|
ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION;
|
Facility
OP
|
$50,159.28
|
|
|
Service Code
|
CPT 26850
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,071.12 |
| Max. Negotiated Rate |
$50,159.28 |
| Rate for Payer: NAPHCARE Commercial |
$10,606.68
|
| Rate for Payer: Aetna Managed Medicare |
$7,071.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,071.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,071.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,071.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,304.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,071.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,071.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,071.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,071.12
|
| Rate for Payer: Quartz Medicare Advantage |
$7,071.12
|
| Rate for Payer: The Alliance Commercial |
$50,159.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,071.12
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$7,071.12
|
|
|
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE;
|
Facility
OP
|
$50,159.28
|
|
|
Service Code
|
CPT 28730
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,795.33 |
| Max. Negotiated Rate |
$50,159.28 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| 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 |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$50,159.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE; WITH OSTEOTOMY (EG, FLATFOOT CORRECTION)
|
Facility
OP
|
$50,159.28
|
|
|
Service Code
|
CPT 28735
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,795.33 |
| Max. Negotiated Rate |
$50,159.28 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| 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 |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$50,159.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT
|
Facility
OP
|
$50,159.28
|
|
|
Service Code
|
CPT 28740
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,071.12 |
| Max. Negotiated Rate |
$50,159.28 |
| Rate for Payer: Aetna Managed Medicare |
$7,071.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,071.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,071.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,071.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,304.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,071.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,071.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,071.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,071.12
|
| Rate for Payer: NAPHCARE Commercial |
$10,606.68
|
| Rate for Payer: Quartz Medicare Advantage |
$7,071.12
|
| Rate for Payer: The Alliance Commercial |
$50,159.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,071.12
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$7,071.12
|
|
|
ARTHRODESIS; SUBTALAR
|
Facility
OP
|
$50,159.28
|
|
|
Service Code
|
CPT 28725
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,795.33 |
| Max. Negotiated Rate |
$50,159.28 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| 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 |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$50,159.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHRODESIS, WRIST; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)
|
Facility
OP
|
$48,391.84
|
|
|
Service Code
|
CPT 25810
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,179.00 |
| Max. Negotiated Rate |
$48,391.84 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| 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 |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,339.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$6,179.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHROEREISIS SUBTALAR 10mm
|
Facility
IP
|
$7,627.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
2967911
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,737.23 |
| Max. Negotiated Rate |
$7,016.84 |
| Rate for Payer: Aetna Commercial |
$6,864.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,042.31
|
| Rate for Payer: Cash Price |
$2,288.10
|
| Rate for Payer: Cigna Commercial |
$7,016.84
|
| Rate for Payer: Health EOS Commercial |
$6,788.03
|
| Rate for Payer: HFN Commercial |
$7,016.84
|
| Rate for Payer: Multiplan Commercial |
$6,101.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,576.20
|
| Rate for Payer: Preferred Network Access Commercial |
$7,016.84
|
| Rate for Payer: Quartz Beloit One Network |
$3,737.23
|
| Rate for Payer: Quartz Commercial |
$4,576.20
|
| Rate for Payer: WEA Trust Commercial |
$4,194.85
|
| Rate for Payer: WPS Commercial |
$5,649.32
|
|
|
ARTHROEREISIS SUBTALAR 10mm
|
Facility
OP
|
$7,627.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
2967911
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,135.56 |
| Max. Negotiated Rate |
$7,016.84 |
| Rate for Payer: Aetna Commercial |
$6,864.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,559.22
|
| Rate for Payer: Aetna Managed Medicare |
$2,135.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,957.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,813.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,660.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,042.31
|
| Rate for Payer: Cash Price |
$2,288.10
|
| Rate for Payer: Cigna Commercial |
$7,016.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,268.07
|
| Rate for Payer: Health EOS Commercial |
$6,788.03
|
| Rate for Payer: HFN Commercial |
$7,016.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,720.25
|
| Rate for Payer: Multiplan Commercial |
$6,101.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,576.20
|
| Rate for Payer: Preferred Network Access Commercial |
$7,016.84
|
| Rate for Payer: Quartz Beloit One Network |
$3,737.23
|
| Rate for Payer: Quartz Commercial |
$4,957.55
|
| Rate for Payer: Quartz Medicare Advantage |
$4,576.20
|
| Rate for Payer: WEA Trust Commercial |
$4,194.85
|
| Rate for Payer: WPS Commercial |
$5,649.32
|
|
|
ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHROPLASTY), WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT
|
Facility
OP
|
$48,391.84
|
|
|
Service Code
|
CPT 27130
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,125.32 |
| Max. Negotiated Rate |
$48,391.84 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$6,125.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHROPLASTY, ELBOW; WITH DISTAL HUMERAL PROSTHETIC REPLACEMENT
|
Facility
OP
|
$68,522.44
|
|
|
Service Code
|
CPT 24361
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,339.76 |
| Max. Negotiated Rate |
$68,522.44 |
| Rate for Payer: Aetna Managed Medicare |
$18,420.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,815.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,378.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,460.00
|
| Rate for Payer: Anthem Medicare Advantage |
$18,420.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,420.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,420.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,420.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,339.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,420.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$68,522.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,420.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,420.01
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,420.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,420.01
|
| Rate for Payer: NAPHCARE Commercial |
$27,630.02
|
| Rate for Payer: Quartz Medicare Advantage |
$18,420.01
|
| Rate for Payer: The Alliance Commercial |
$24,852.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,420.01
|
| Rate for Payer: United Healthcare PPO |
$11,078.00
|
| Rate for Payer: Wellcare Medicare |
$18,420.01
|
|
|
ARTHROPLASTY, GLENOHUMERAL JOINT; TOTAL SHOULDER (GLENOID AND PROXIMAL HUMERAL REPLACEMENT (EG, TOTAL SHOULDER))
|
Facility
OP
|
$68,522.44
|
|
|
Service Code
|
CPT 23472
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,452.00 |
| Max. Negotiated Rate |
$68,522.44 |
| Rate for Payer: Aetna Managed Medicare |
$18,420.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$18,420.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,420.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,420.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,420.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,420.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$68,522.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,420.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,420.01
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,420.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,420.01
|
| Rate for Payer: NAPHCARE Commercial |
$27,630.02
|
| Rate for Payer: Quartz Medicare Advantage |
$18,420.01
|
| Rate for Payer: The Alliance Commercial |
$14,595.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,420.01
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$18,420.01
|
|
|
ARTHROPLASTY, INTERPOSITION, INTERCARPAL OR CARPOMETACARPAL JOINTS
|
Facility
OP
|
$22,318.84
|
|
|
Service Code
|
CPT 25447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$22,318.84 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| 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 |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,339.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$22,318.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
|
ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PATELLA RESURFACING (TOTAL KNEE ARTHROPLASTY)
|
Facility
OP
|
$50,159.28
|
|
|
Service Code
|
CPT 27447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,596.00 |
| Max. Negotiated Rate |
$50,159.28 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| 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 |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$50,159.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL OR LATERAL COMPARTMENT
|
Facility
OP
|
$48,391.84
|
|
|
Service Code
|
CPT 27446
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,339.76 |
| Max. Negotiated Rate |
$48,391.84 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| 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 |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,339.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$27,265.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTION
|
Facility
OP
|
$26,304.57
|
|
|
Service Code
|
CPT 29888
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,179.00 |
| Max. Negotiated Rate |
$26,304.57 |
| Rate for Payer: Aetna Managed Medicare |
$7,071.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,071.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,071.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,071.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,304.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,071.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,071.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,071.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,071.12
|
| Rate for Payer: NAPHCARE Commercial |
$10,606.68
|
| Rate for Payer: Quartz Medicare Advantage |
$7,071.12
|
| Rate for Payer: The Alliance Commercial |
$6,179.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,071.12
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$7,071.12
|
|
|
ARTHROSCOPY
|
Facility
IP
|
$36,640.00
|
|
|
Service Code
|
MS-DRG 509
|
| Min. Negotiated Rate |
$13,179.68 |
| Max. Negotiated Rate |
$36,640.00 |
| Rate for Payer: Aetna Managed Medicare |
$13,179.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$27,903.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21,387.73
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20,319.74
|
| Rate for Payer: Anthem Medicare Advantage |
$13,179.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,179.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,179.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,179.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$22,556.77
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,179.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25,860.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,179.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,179.68
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,179.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,179.68
|
| Rate for Payer: NAPHCARE Commercial |
$19,769.52
|
| Rate for Payer: Quartz Medicare Advantage |
$13,179.68
|
| Rate for Payer: The Alliance Commercial |
$36,640.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,179.68
|
| Rate for Payer: United Healthcare PPO |
$20,133.04
|
| Rate for Payer: Wellcare Medicare |
$13,179.68
|
|
|
ARTHROSCOPY, ANKLE, SURGICAL, EXCISION OF OSTEOCHONDRAL DEFECT OF TALUS AND/OR TIBIA, INCLUDING DRILLING OF THE DEFECT
|
Facility
OP
|
$12,336.12
|
|
|
Service Code
|
CPT 29891
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,336.12 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| 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 |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,336.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
|
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, EXTENSIVE
|
Facility
OP
|
$12,336.12
|
|
|
Service Code
|
CPT 29898
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,336.12 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| 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 |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,336.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
