|
Pace Gen Removal W/O Replacement
|
Facility
|
IP
|
$1,499.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
3052393
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$763.89 |
| Max. Negotiated Rate |
$1,434.24 |
| Rate for Payer: Aetna Commercial |
$1,403.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,340.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$826.25
|
| Rate for Payer: Cash Price |
$449.70
|
| Rate for Payer: Cigna Commercial |
$1,434.24
|
| Rate for Payer: Health EOS Commercial |
$1,387.47
|
| Rate for Payer: HFN Commercial |
$1,434.24
|
| Rate for Payer: Multiplan Commercial |
$1,247.17
|
| Rate for Payer: Preferred Network Access Commercial |
$1,434.24
|
| Rate for Payer: Quartz Beloit One Network |
$763.89
|
| Rate for Payer: Quartz Commercial |
$935.38
|
| Rate for Payer: WEA Trust Commercial |
$857.43
|
| Rate for Payer: WPS Commercial |
$1,154.68
|
|
|
Pace Gen Removal W/O Replacement
|
Facility
|
OP
|
$1,499.00
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
3052393
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$763.89 |
| Max. Negotiated Rate |
$34,835.72 |
| Rate for Payer: Aetna Commercial |
$1,403.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,340.71
|
| Rate for Payer: Aetna Managed Medicare |
$8,708.93
|
| 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 |
$8,708.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$826.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,708.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,708.93
|
| Rate for Payer: Cash Price |
$449.70
|
| Rate for Payer: Cash Price |
$449.70
|
| Rate for Payer: Cash Price |
$449.70
|
| Rate for Payer: Cigna Commercial |
$1,434.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,708.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,708.93
|
| Rate for Payer: Health EOS Commercial |
$1,387.47
|
| Rate for Payer: HFN Commercial |
$1,434.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,397.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,708.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,708.93
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,708.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,708.93
|
| Rate for Payer: Multiplan Commercial |
$1,247.17
|
| Rate for Payer: NAPHCARE Commercial |
$13,063.39
|
| Rate for Payer: Preferred Network Access Commercial |
$1,434.24
|
| Rate for Payer: Quartz Beloit One Network |
$763.89
|
| Rate for Payer: Quartz Commercial |
$1,013.32
|
| Rate for Payer: Quartz Medicare Advantage |
$8,708.93
|
| Rate for Payer: The Alliance Commercial |
$34,835.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,708.93
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$857.43
|
| Rate for Payer: Wellcare Medicare |
$8,708.93
|
| Rate for Payer: WPS Commercial |
$1,154.68
|
|
|
Pace/ICD AV + CS Leads Only
|
Facility
|
IP
|
$2,342.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
4308767
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,193.48 |
| Max. Negotiated Rate |
$2,240.83 |
| Rate for Payer: Aetna Commercial |
$2,192.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,094.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,290.91
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,240.83
|
| Rate for Payer: Health EOS Commercial |
$2,167.76
|
| Rate for Payer: HFN Commercial |
$2,240.83
|
| Rate for Payer: Multiplan Commercial |
$1,948.54
|
| Rate for Payer: Preferred Network Access Commercial |
$2,240.83
|
| Rate for Payer: Quartz Beloit One Network |
$1,193.48
|
| Rate for Payer: Quartz Commercial |
$1,461.41
|
| Rate for Payer: WEA Trust Commercial |
$1,339.62
|
| Rate for Payer: WPS Commercial |
$1,804.04
|
|
|
Pace/ICD AV + CS Leads Only
|
Facility
|
OP
|
$2,342.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
4308767
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,193.48 |
| Max. Negotiated Rate |
$34,835.72 |
| Rate for Payer: Aetna Commercial |
$2,192.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,094.68
|
| Rate for Payer: Aetna Managed Medicare |
$8,708.93
|
| 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 |
$8,708.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,290.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,708.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,708.93
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,240.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,708.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,708.93
|
| Rate for Payer: Health EOS Commercial |
$2,167.76
|
| Rate for Payer: HFN Commercial |
$2,240.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,397.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,708.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,708.93
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,708.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,708.93
|
| Rate for Payer: Multiplan Commercial |
$1,948.54
|
| Rate for Payer: NAPHCARE Commercial |
$13,063.39
|
| Rate for Payer: Preferred Network Access Commercial |
$2,240.83
|
| Rate for Payer: Quartz Beloit One Network |
$1,193.48
|
| Rate for Payer: Quartz Commercial |
$1,583.19
|
| Rate for Payer: Quartz Medicare Advantage |
$8,708.93
|
| Rate for Payer: The Alliance Commercial |
$34,835.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,708.93
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$1,339.62
|
| Rate for Payer: Wellcare Medicare |
$8,708.93
|
| Rate for Payer: WPS Commercial |
$1,804.04
|
|
|
Pace/ICD CS Lead Ins, New Gen +
|
Facility
|
OP
|
$3,433.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
4294736
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$999.69 |
| Max. Negotiated Rate |
$12,349.86 |
| Rate for Payer: Aetna Commercial |
$3,213.29
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,070.48
|
| Rate for Payer: Aetna Managed Medicare |
$999.69
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,320.71
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,785.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,713.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,892.27
|
| Rate for Payer: Cash Price |
$1,029.90
|
| Rate for Payer: Cash Price |
$1,029.90
|
| Rate for Payer: Cigna Commercial |
$3,284.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Health EOS Commercial |
$3,177.58
|
| Rate for Payer: HFN Commercial |
$3,284.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,677.74
|
| Rate for Payer: Multiplan Commercial |
$2,856.26
|
| Rate for Payer: NAPHCARE Commercial |
$2,142.19
|
| Rate for Payer: Preferred Network Access Commercial |
$3,284.69
|
| Rate for Payer: Quartz Beloit One Network |
$1,749.46
|
| Rate for Payer: Quartz Commercial |
$2,320.71
|
| Rate for Payer: Quartz Medicare Advantage |
$2,142.19
|
| Rate for Payer: The Alliance Commercial |
$1,446.93
|
| Rate for Payer: WEA Trust Commercial |
$1,963.68
|
| Rate for Payer: WPS Commercial |
$2,644.44
|
|
|
Pace/ICD CS Lead Ins, New Gen +
|
Facility
|
OP
|
$3,978.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
3052387
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,158.39 |
| Max. Negotiated Rate |
$12,349.86 |
| Rate for Payer: Aetna Commercial |
$3,723.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,557.92
|
| Rate for Payer: Aetna Managed Medicare |
$1,158.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,689.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,068.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,985.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,192.67
|
| Rate for Payer: Cash Price |
$1,193.40
|
| Rate for Payer: Cash Price |
$1,193.40
|
| Rate for Payer: Cigna Commercial |
$3,806.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Health EOS Commercial |
$3,682.04
|
| Rate for Payer: HFN Commercial |
$3,806.15
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,102.84
|
| Rate for Payer: Multiplan Commercial |
$3,309.70
|
| Rate for Payer: NAPHCARE Commercial |
$2,482.27
|
| Rate for Payer: Preferred Network Access Commercial |
$3,806.15
|
| Rate for Payer: Quartz Beloit One Network |
$2,027.19
|
| Rate for Payer: Quartz Commercial |
$2,689.13
|
| Rate for Payer: Quartz Medicare Advantage |
$2,482.27
|
| Rate for Payer: The Alliance Commercial |
$1,446.93
|
| Rate for Payer: WEA Trust Commercial |
$2,275.42
|
| Rate for Payer: WPS Commercial |
$3,064.25
|
|
|
Pace/ICD CS Lead Ins, New Gen +
|
Facility
|
IP
|
$3,978.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
3052387
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,027.19 |
| Max. Negotiated Rate |
$3,806.15 |
| Rate for Payer: Aetna Commercial |
$3,723.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,557.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,192.67
|
| Rate for Payer: Cash Price |
$1,193.40
|
| Rate for Payer: Cigna Commercial |
$3,806.15
|
| Rate for Payer: Health EOS Commercial |
$3,682.04
|
| Rate for Payer: HFN Commercial |
$3,806.15
|
| Rate for Payer: Multiplan Commercial |
$3,309.70
|
| Rate for Payer: Preferred Network Access Commercial |
$3,806.15
|
| Rate for Payer: Quartz Beloit One Network |
$2,027.19
|
| Rate for Payer: Quartz Commercial |
$2,482.27
|
| Rate for Payer: WEA Trust Commercial |
$2,275.42
|
| Rate for Payer: WPS Commercial |
$3,064.25
|
|
|
Pace/ICD CS Lead Ins, New Gen +
|
Facility
|
IP
|
$3,433.00
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
4294736
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,749.46 |
| Max. Negotiated Rate |
$3,284.69 |
| Rate for Payer: Aetna Commercial |
$3,213.29
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,070.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,892.27
|
| Rate for Payer: Cash Price |
$1,029.90
|
| Rate for Payer: Cigna Commercial |
$3,284.69
|
| Rate for Payer: Health EOS Commercial |
$3,177.58
|
| Rate for Payer: HFN Commercial |
$3,284.69
|
| Rate for Payer: Multiplan Commercial |
$2,856.26
|
| Rate for Payer: Preferred Network Access Commercial |
$3,284.69
|
| Rate for Payer: Quartz Beloit One Network |
$1,749.46
|
| Rate for Payer: Quartz Commercial |
$2,142.19
|
| Rate for Payer: WEA Trust Commercial |
$1,963.68
|
| Rate for Payer: WPS Commercial |
$2,644.44
|
|
|
Pace/ICD CS Lead Repos Incl Gen Rem/Rep
|
Facility
|
IP
|
$3,030.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
4125704
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,544.09 |
| Max. Negotiated Rate |
$2,899.10 |
| Rate for Payer: Aetna Commercial |
$2,836.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,710.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,670.14
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cigna Commercial |
$2,899.10
|
| Rate for Payer: Health EOS Commercial |
$2,804.57
|
| Rate for Payer: HFN Commercial |
$2,899.10
|
| Rate for Payer: Multiplan Commercial |
$2,520.96
|
| Rate for Payer: Preferred Network Access Commercial |
$2,899.10
|
| Rate for Payer: Quartz Beloit One Network |
$1,544.09
|
| Rate for Payer: Quartz Commercial |
$1,890.72
|
| Rate for Payer: WEA Trust Commercial |
$1,733.16
|
| Rate for Payer: WPS Commercial |
$2,334.01
|
|
|
Pace/ICD CS Lead Repos Incl Gen Rem/Rep
|
Facility
|
OP
|
$3,030.00
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
4125704
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,544.09 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$2,836.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,710.03
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| 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 |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,670.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cigna Commercial |
$2,899.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$2,804.57
|
| Rate for Payer: HFN Commercial |
$2,899.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$2,520.96
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$2,899.10
|
| Rate for Payer: Quartz Beloit One Network |
$1,544.09
|
| Rate for Payer: Quartz Commercial |
$2,048.28
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$1,733.16
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$2,334.01
|
|
|
Pace/ICD Lead Only Insert Single
|
Facility
|
IP
|
$2,928.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
3052380
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,492.11 |
| Max. Negotiated Rate |
$2,801.51 |
| Rate for Payer: Aetna Commercial |
$2,740.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,618.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,613.91
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cigna Commercial |
$2,801.51
|
| Rate for Payer: Health EOS Commercial |
$2,710.16
|
| Rate for Payer: HFN Commercial |
$2,801.51
|
| Rate for Payer: Multiplan Commercial |
$2,436.10
|
| Rate for Payer: Preferred Network Access Commercial |
$2,801.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,492.11
|
| Rate for Payer: Quartz Commercial |
$1,827.07
|
| Rate for Payer: WEA Trust Commercial |
$1,674.82
|
| Rate for Payer: WPS Commercial |
$2,255.44
|
|
|
Pace/ICD Lead Only Insert Single
|
Facility
|
OP
|
$2,928.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
3052380
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,492.11 |
| Max. Negotiated Rate |
$34,835.72 |
| Rate for Payer: Aetna Commercial |
$2,740.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,618.80
|
| Rate for Payer: Aetna Managed Medicare |
$8,708.93
|
| 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 |
$8,708.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,613.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,708.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,708.93
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cigna Commercial |
$2,801.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,708.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,708.93
|
| Rate for Payer: Health EOS Commercial |
$2,710.16
|
| Rate for Payer: HFN Commercial |
$2,801.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,397.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,708.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,708.93
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,708.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,708.93
|
| Rate for Payer: Multiplan Commercial |
$2,436.10
|
| Rate for Payer: NAPHCARE Commercial |
$13,063.39
|
| Rate for Payer: Preferred Network Access Commercial |
$2,801.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,492.11
|
| Rate for Payer: Quartz Commercial |
$1,979.33
|
| Rate for Payer: Quartz Medicare Advantage |
$8,708.93
|
| Rate for Payer: The Alliance Commercial |
$34,835.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,708.93
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$1,674.82
|
| Rate for Payer: Wellcare Medicare |
$8,708.93
|
| Rate for Payer: WPS Commercial |
$2,255.44
|
|
|
Pace/ICD Leads Only Insert Dual
|
Facility
|
OP
|
$2,342.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
3052381
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,193.48 |
| Max. Negotiated Rate |
$34,835.72 |
| Rate for Payer: Aetna Commercial |
$2,192.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,094.68
|
| Rate for Payer: Aetna Managed Medicare |
$8,708.93
|
| 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 |
$8,708.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,290.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,708.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,708.93
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,240.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,708.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,708.93
|
| Rate for Payer: Health EOS Commercial |
$2,167.76
|
| Rate for Payer: HFN Commercial |
$2,240.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,397.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,708.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,708.93
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,708.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,708.93
|
| Rate for Payer: Multiplan Commercial |
$1,948.54
|
| Rate for Payer: NAPHCARE Commercial |
$13,063.39
|
| Rate for Payer: Preferred Network Access Commercial |
$2,240.83
|
| Rate for Payer: Quartz Beloit One Network |
$1,193.48
|
| Rate for Payer: Quartz Commercial |
$1,583.19
|
| Rate for Payer: Quartz Medicare Advantage |
$8,708.93
|
| Rate for Payer: The Alliance Commercial |
$34,835.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,708.93
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$1,339.62
|
| Rate for Payer: Wellcare Medicare |
$8,708.93
|
| Rate for Payer: WPS Commercial |
$1,804.04
|
|
|
Pace/ICD Leads Only Insert Dual
|
Facility
|
IP
|
$2,342.00
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
3052381
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,193.48 |
| Max. Negotiated Rate |
$2,240.83 |
| Rate for Payer: Aetna Commercial |
$2,192.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,094.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,290.91
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,240.83
|
| Rate for Payer: Health EOS Commercial |
$2,167.76
|
| Rate for Payer: HFN Commercial |
$2,240.83
|
| Rate for Payer: Multiplan Commercial |
$1,948.54
|
| Rate for Payer: Preferred Network Access Commercial |
$2,240.83
|
| Rate for Payer: Quartz Beloit One Network |
$1,193.48
|
| Rate for Payer: Quartz Commercial |
$1,461.41
|
| Rate for Payer: WEA Trust Commercial |
$1,339.62
|
| Rate for Payer: WPS Commercial |
$1,804.04
|
|
|
Pace/ICD LV Lead Ins, Exist Gen
|
Facility
|
OP
|
$3,854.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
3052386
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,964.00 |
| Max. Negotiated Rate |
$43,998.28 |
| Rate for Payer: Aetna Commercial |
$3,607.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,447.02
|
| Rate for Payer: Aetna Managed Medicare |
$10,999.57
|
| 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 |
$10,999.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,124.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,999.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,999.57
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cigna Commercial |
$3,687.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,999.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,999.57
|
| Rate for Payer: Health EOS Commercial |
$3,567.26
|
| Rate for Payer: HFN Commercial |
$3,687.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$40,918.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,999.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,999.57
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,999.57
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,999.57
|
| Rate for Payer: Multiplan Commercial |
$3,206.53
|
| Rate for Payer: NAPHCARE Commercial |
$16,499.36
|
| Rate for Payer: Preferred Network Access Commercial |
$3,687.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,964.00
|
| Rate for Payer: Quartz Commercial |
$2,605.30
|
| Rate for Payer: Quartz Medicare Advantage |
$10,999.57
|
| Rate for Payer: The Alliance Commercial |
$43,998.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,999.57
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$2,204.49
|
| Rate for Payer: Wellcare Medicare |
$10,999.57
|
| Rate for Payer: WPS Commercial |
$2,968.74
|
|
|
Pace/ICD LV Lead Ins, Exist Gen
|
Facility
|
OP
|
$3,854.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
4308763
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,964.00 |
| Max. Negotiated Rate |
$43,998.28 |
| Rate for Payer: Aetna Commercial |
$3,607.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,447.02
|
| Rate for Payer: Aetna Managed Medicare |
$10,999.57
|
| 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 |
$10,999.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,124.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,999.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,999.57
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cigna Commercial |
$3,687.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,999.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,999.57
|
| Rate for Payer: Health EOS Commercial |
$3,567.26
|
| Rate for Payer: HFN Commercial |
$3,687.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$40,918.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,999.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,999.57
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,999.57
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,999.57
|
| Rate for Payer: Multiplan Commercial |
$3,206.53
|
| Rate for Payer: NAPHCARE Commercial |
$16,499.36
|
| Rate for Payer: Preferred Network Access Commercial |
$3,687.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,964.00
|
| Rate for Payer: Quartz Commercial |
$2,605.30
|
| Rate for Payer: Quartz Medicare Advantage |
$10,999.57
|
| Rate for Payer: The Alliance Commercial |
$43,998.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,999.57
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$2,204.49
|
| Rate for Payer: Wellcare Medicare |
$10,999.57
|
| Rate for Payer: WPS Commercial |
$2,968.74
|
|
|
Pace/ICD LV Lead Ins, Exist Gen
|
Facility
|
IP
|
$3,854.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
4308763
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,964.00 |
| Max. Negotiated Rate |
$3,687.51 |
| Rate for Payer: Aetna Commercial |
$3,607.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,447.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,124.32
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cigna Commercial |
$3,687.51
|
| Rate for Payer: Health EOS Commercial |
$3,567.26
|
| Rate for Payer: HFN Commercial |
$3,687.51
|
| Rate for Payer: Multiplan Commercial |
$3,206.53
|
| Rate for Payer: Preferred Network Access Commercial |
$3,687.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,964.00
|
| Rate for Payer: Quartz Commercial |
$2,404.90
|
| Rate for Payer: WEA Trust Commercial |
$2,204.49
|
| Rate for Payer: WPS Commercial |
$2,968.74
|
|
|
Pace/ICD LV Lead Ins, Exist Gen
|
Facility
|
IP
|
$3,854.00
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
3052386
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,964.00 |
| Max. Negotiated Rate |
$3,687.51 |
| Rate for Payer: Aetna Commercial |
$3,607.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,447.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,124.32
|
| Rate for Payer: Cash Price |
$1,156.20
|
| Rate for Payer: Cigna Commercial |
$3,687.51
|
| Rate for Payer: Health EOS Commercial |
$3,567.26
|
| Rate for Payer: HFN Commercial |
$3,687.51
|
| Rate for Payer: Multiplan Commercial |
$3,206.53
|
| Rate for Payer: Preferred Network Access Commercial |
$3,687.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,964.00
|
| Rate for Payer: Quartz Commercial |
$2,404.90
|
| Rate for Payer: WEA Trust Commercial |
$2,204.49
|
| Rate for Payer: WPS Commercial |
$2,968.74
|
|
|
Pace/ICD RA/RV Lead Reposition
|
Facility
|
OP
|
$2,035.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
3052379
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,037.04 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$1,904.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,820.10
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| 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 |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,121.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$610.50
|
| Rate for Payer: Cash Price |
$610.50
|
| Rate for Payer: Cash Price |
$610.50
|
| Rate for Payer: Cigna Commercial |
$1,947.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$1,883.60
|
| Rate for Payer: HFN Commercial |
$1,947.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$1,693.12
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$1,947.09
|
| Rate for Payer: Quartz Beloit One Network |
$1,037.04
|
| Rate for Payer: Quartz Commercial |
$1,375.66
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$1,164.02
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$1,567.56
|
|
|
Pace/ICD RA/RV Lead Reposition
|
Facility
|
IP
|
$2,035.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
3052379
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,037.04 |
| Max. Negotiated Rate |
$1,947.09 |
| Rate for Payer: Aetna Commercial |
$1,904.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,820.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,121.69
|
| Rate for Payer: Cash Price |
$610.50
|
| Rate for Payer: Cigna Commercial |
$1,947.09
|
| Rate for Payer: Health EOS Commercial |
$1,883.60
|
| Rate for Payer: HFN Commercial |
$1,947.09
|
| Rate for Payer: Multiplan Commercial |
$1,693.12
|
| Rate for Payer: Preferred Network Access Commercial |
$1,947.09
|
| Rate for Payer: Quartz Beloit One Network |
$1,037.04
|
| Rate for Payer: Quartz Commercial |
$1,269.84
|
| Rate for Payer: WEA Trust Commercial |
$1,164.02
|
| Rate for Payer: WPS Commercial |
$1,567.56
|
|
|
Pace Lead Dual Removal
|
Facility
|
OP
|
$3,999.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
4308832
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,037.89 |
| Max. Negotiated Rate |
$15,730.96 |
| Rate for Payer: Aetna Commercial |
$3,743.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,576.71
|
| Rate for Payer: Aetna Managed Medicare |
$3,932.74
|
| 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 |
$3,932.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,204.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,932.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,932.74
|
| Rate for Payer: Cash Price |
$1,199.70
|
| Rate for Payer: Cash Price |
$1,199.70
|
| Rate for Payer: Cash Price |
$1,199.70
|
| Rate for Payer: Cigna Commercial |
$3,826.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,932.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,932.74
|
| Rate for Payer: Health EOS Commercial |
$3,701.47
|
| Rate for Payer: HFN Commercial |
$3,826.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,629.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,932.74
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,932.74
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,932.74
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,932.74
|
| Rate for Payer: Multiplan Commercial |
$3,327.17
|
| Rate for Payer: NAPHCARE Commercial |
$5,899.11
|
| Rate for Payer: Preferred Network Access Commercial |
$3,826.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,037.89
|
| Rate for Payer: Quartz Commercial |
$2,703.32
|
| Rate for Payer: Quartz Medicare Advantage |
$3,932.74
|
| Rate for Payer: The Alliance Commercial |
$15,730.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,932.74
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$2,287.43
|
| Rate for Payer: Wellcare Medicare |
$3,932.74
|
| Rate for Payer: WPS Commercial |
$3,080.43
|
|
|
Pace Lead Dual Removal
|
Facility
|
OP
|
$4,153.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
3052395
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,116.37 |
| Max. Negotiated Rate |
$15,730.96 |
| Rate for Payer: Aetna Commercial |
$3,887.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,714.44
|
| Rate for Payer: Aetna Managed Medicare |
$3,932.74
|
| 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 |
$3,932.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,289.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,932.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,932.74
|
| Rate for Payer: Cash Price |
$1,245.90
|
| Rate for Payer: Cash Price |
$1,245.90
|
| Rate for Payer: Cash Price |
$1,245.90
|
| Rate for Payer: Cigna Commercial |
$3,973.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,932.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,932.74
|
| Rate for Payer: Health EOS Commercial |
$3,844.02
|
| Rate for Payer: HFN Commercial |
$3,973.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,629.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,932.74
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,932.74
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,932.74
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,932.74
|
| Rate for Payer: Multiplan Commercial |
$3,455.30
|
| Rate for Payer: NAPHCARE Commercial |
$5,899.11
|
| Rate for Payer: Preferred Network Access Commercial |
$3,973.59
|
| Rate for Payer: Quartz Beloit One Network |
$2,116.37
|
| Rate for Payer: Quartz Commercial |
$2,807.43
|
| Rate for Payer: Quartz Medicare Advantage |
$3,932.74
|
| Rate for Payer: The Alliance Commercial |
$15,730.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,932.74
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$2,375.52
|
| Rate for Payer: Wellcare Medicare |
$3,932.74
|
| Rate for Payer: WPS Commercial |
$3,199.06
|
|
|
Pace Lead Dual Removal
|
Facility
|
IP
|
$3,999.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
4308832
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,037.89 |
| Max. Negotiated Rate |
$3,826.24 |
| Rate for Payer: Aetna Commercial |
$3,743.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,576.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,204.25
|
| Rate for Payer: Cash Price |
$1,199.70
|
| Rate for Payer: Cigna Commercial |
$3,826.24
|
| Rate for Payer: Health EOS Commercial |
$3,701.47
|
| Rate for Payer: HFN Commercial |
$3,826.24
|
| Rate for Payer: Multiplan Commercial |
$3,327.17
|
| Rate for Payer: Preferred Network Access Commercial |
$3,826.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,037.89
|
| Rate for Payer: Quartz Commercial |
$2,495.38
|
| Rate for Payer: WEA Trust Commercial |
$2,287.43
|
| Rate for Payer: WPS Commercial |
$3,080.43
|
|
|
Pace Lead Dual Removal
|
Facility
|
IP
|
$4,153.00
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
3052395
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,116.37 |
| Max. Negotiated Rate |
$3,973.59 |
| Rate for Payer: Aetna Commercial |
$3,887.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,714.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,289.13
|
| Rate for Payer: Cash Price |
$1,245.90
|
| Rate for Payer: Cigna Commercial |
$3,973.59
|
| Rate for Payer: Health EOS Commercial |
$3,844.02
|
| Rate for Payer: HFN Commercial |
$3,973.59
|
| Rate for Payer: Multiplan Commercial |
$3,455.30
|
| Rate for Payer: Preferred Network Access Commercial |
$3,973.59
|
| Rate for Payer: Quartz Beloit One Network |
$2,116.37
|
| Rate for Payer: Quartz Commercial |
$2,591.47
|
| Rate for Payer: WEA Trust Commercial |
$2,375.52
|
| Rate for Payer: WPS Commercial |
$3,199.06
|
|
|
Pace Lead Single Removal
|
Facility
|
OP
|
$3,145.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
3052394
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,602.69 |
| Max. Negotiated Rate |
$15,730.96 |
| Rate for Payer: Aetna Commercial |
$2,943.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,812.89
|
| Rate for Payer: Aetna Managed Medicare |
$3,932.74
|
| 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 |
$3,932.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,733.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,932.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,932.74
|
| Rate for Payer: Cash Price |
$943.50
|
| Rate for Payer: Cash Price |
$943.50
|
| Rate for Payer: Cash Price |
$943.50
|
| Rate for Payer: Cigna Commercial |
$3,009.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,932.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,932.74
|
| Rate for Payer: Health EOS Commercial |
$2,911.01
|
| Rate for Payer: HFN Commercial |
$3,009.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,629.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,932.74
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,932.74
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,932.74
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,932.74
|
| Rate for Payer: Multiplan Commercial |
$2,616.64
|
| Rate for Payer: NAPHCARE Commercial |
$5,899.11
|
| Rate for Payer: Preferred Network Access Commercial |
$3,009.14
|
| Rate for Payer: Quartz Beloit One Network |
$1,602.69
|
| Rate for Payer: Quartz Commercial |
$2,126.02
|
| Rate for Payer: Quartz Medicare Advantage |
$3,932.74
|
| Rate for Payer: The Alliance Commercial |
$15,730.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,932.74
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$1,798.94
|
| Rate for Payer: Wellcare Medicare |
$3,932.74
|
| Rate for Payer: WPS Commercial |
$2,422.59
|
|
