|
Pace Lead Single Removal
|
Facility
|
IP
|
$3,030.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
4308817
|
|
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 Lead Single Removal
|
Facility
|
OP
|
$3,030.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
4308817
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,544.09 |
| Max. Negotiated Rate |
$15,730.96 |
| Rate for Payer: Aetna Commercial |
$2,836.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,710.03
|
| Rate for Payer: Aetna Managed Medicare |
$3,932.74
|
| 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 |
$1,670.14
|
| 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 |
$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 |
$3,932.74
|
| 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 |
$2,804.57
|
| Rate for Payer: HFN Commercial |
$2,899.10
|
| 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 |
$2,520.96
|
| Rate for Payer: NAPHCARE Commercial |
$5,899.11
|
| 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 |
$3,932.74
|
| 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 |
$1,733.16
|
| Rate for Payer: Wellcare Medicare |
$3,932.74
|
| Rate for Payer: WPS Commercial |
$2,334.01
|
|
|
Pace Lead Single Removal
|
Facility
|
IP
|
$3,145.00
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
3052394
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,602.69 |
| Max. Negotiated Rate |
$3,009.14 |
| Rate for Payer: Aetna Commercial |
$2,943.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,812.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,733.52
|
| Rate for Payer: Cash Price |
$943.50
|
| Rate for Payer: Cigna Commercial |
$3,009.14
|
| Rate for Payer: Health EOS Commercial |
$2,911.01
|
| Rate for Payer: HFN Commercial |
$3,009.14
|
| Rate for Payer: Multiplan Commercial |
$2,616.64
|
| 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 |
$1,962.48
|
| Rate for Payer: WEA Trust Commercial |
$1,798.94
|
| Rate for Payer: WPS Commercial |
$2,422.59
|
|
|
Pacemaker Analysis Review And Report Double Lead
|
Professional
|
Both
|
$433.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
2982423
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.64 |
| Max. Negotiated Rate |
$427.80 |
| Rate for Payer: Aetna Commercial |
$427.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$387.28
|
| Rate for Payer: Aetna Managed Medicare |
$78.40
|
| Rate for Payer: Anthem Medicare Advantage |
$78.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$78.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$78.40
|
| Rate for Payer: Cash Price |
$129.90
|
| Rate for Payer: Cash Price |
$129.90
|
| Rate for Payer: Cash Price |
$129.90
|
| Rate for Payer: Cigna Commercial |
$427.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$51.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$78.40
|
| Rate for Payer: Health EOS Commercial |
$409.79
|
| Rate for Payer: HFN Commercial |
$427.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$277.91
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$277.91
|
| Rate for Payer: Independent Care Health Plan Medicare |
$78.40
|
| Rate for Payer: Multiplan Commercial |
$360.26
|
| Rate for Payer: NAPHCARE Commercial |
$117.59
|
| Rate for Payer: Preferred Network Access Commercial |
$427.80
|
| Rate for Payer: Quartz Beloit One Network |
$198.14
|
| Rate for Payer: Quartz Commercial |
$256.68
|
| Rate for Payer: Quartz Medicare Advantage |
$78.40
|
| Rate for Payer: The Alliance Commercial |
$297.90
|
| Rate for Payer: United Healthcare Medicaid |
$51.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$78.40
|
| Rate for Payer: WEA Trust Commercial |
$247.68
|
| Rate for Payer: WPS Commercial |
$313.58
|
|
|
Pacemaker Analysis Review And Report Double Lead
|
Facility
|
OP
|
$937.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
2982423
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$896.52 |
| Rate for Payer: Aetna Commercial |
$877.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$838.05
|
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$633.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$487.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$467.75
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$516.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.28
|
| Rate for Payer: Cash Price |
$281.10
|
| Rate for Payer: Cash Price |
$281.10
|
| Rate for Payer: Cigna Commercial |
$896.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$545.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Health EOS Commercial |
$867.29
|
| Rate for Payer: HFN Commercial |
$896.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.28
|
| Rate for Payer: Multiplan Commercial |
$779.58
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Preferred Network Access Commercial |
$896.52
|
| Rate for Payer: Quartz Beloit One Network |
$477.50
|
| Rate for Payer: Quartz Commercial |
$633.41
|
| Rate for Payer: Quartz Medicare Advantage |
$39.28
|
| Rate for Payer: The Alliance Commercial |
$157.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.28
|
| Rate for Payer: WEA Trust Commercial |
$535.96
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
| Rate for Payer: WPS Commercial |
$721.77
|
|
|
Pacemaker Analysis Review And Report Double Lead
|
Facility
|
IP
|
$937.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
2982423
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$477.50 |
| Max. Negotiated Rate |
$896.52 |
| Rate for Payer: Aetna Commercial |
$877.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$838.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$516.47
|
| Rate for Payer: Cash Price |
$281.10
|
| Rate for Payer: Cigna Commercial |
$896.52
|
| Rate for Payer: Health EOS Commercial |
$867.29
|
| Rate for Payer: HFN Commercial |
$896.52
|
| Rate for Payer: Multiplan Commercial |
$779.58
|
| Rate for Payer: Preferred Network Access Commercial |
$896.52
|
| Rate for Payer: Quartz Beloit One Network |
$477.50
|
| Rate for Payer: Quartz Commercial |
$584.69
|
| Rate for Payer: WEA Trust Commercial |
$535.96
|
| Rate for Payer: WPS Commercial |
$721.77
|
|
|
Pacemaker Analysis Review And Report, including connection, recording & disconnection
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
CPT 93288
|
| Hospital Charge Code |
2982421
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$233.91 |
| Max. Negotiated Rate |
$439.17 |
| Rate for Payer: Aetna Commercial |
$429.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$410.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$253.00
|
| Rate for Payer: Cash Price |
$137.70
|
| Rate for Payer: Cigna Commercial |
$439.17
|
| Rate for Payer: Health EOS Commercial |
$424.85
|
| Rate for Payer: HFN Commercial |
$439.17
|
| Rate for Payer: Multiplan Commercial |
$381.89
|
| Rate for Payer: Preferred Network Access Commercial |
$439.17
|
| Rate for Payer: Quartz Beloit One Network |
$233.91
|
| Rate for Payer: Quartz Commercial |
$286.42
|
| Rate for Payer: WEA Trust Commercial |
$262.55
|
| Rate for Payer: WPS Commercial |
$353.57
|
|
|
Pacemaker Analysis Review And Report, including connection, recording & disconnection
|
Facility
|
OP
|
$459.00
|
|
|
Service Code
|
CPT 93288
|
| Hospital Charge Code |
2982421
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$439.17 |
| Rate for Payer: Aetna Commercial |
$429.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$410.53
|
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$310.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$238.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$229.13
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$253.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.28
|
| Rate for Payer: Cash Price |
$137.70
|
| Rate for Payer: Cash Price |
$137.70
|
| Rate for Payer: Cigna Commercial |
$439.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$267.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Health EOS Commercial |
$424.85
|
| Rate for Payer: HFN Commercial |
$439.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.28
|
| Rate for Payer: Multiplan Commercial |
$381.89
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Preferred Network Access Commercial |
$439.17
|
| Rate for Payer: Quartz Beloit One Network |
$233.91
|
| Rate for Payer: Quartz Commercial |
$310.28
|
| Rate for Payer: Quartz Medicare Advantage |
$39.28
|
| Rate for Payer: The Alliance Commercial |
$157.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.28
|
| Rate for Payer: WEA Trust Commercial |
$262.55
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
| Rate for Payer: WPS Commercial |
$353.57
|
|
|
Pacemaker Analysis Review And Report Multiple Lead
|
Professional
|
Both
|
$578.00
|
|
|
Service Code
|
CPT 93281
|
| Hospital Charge Code |
2982424
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$60.35 |
| Max. Negotiated Rate |
$571.06 |
| Rate for Payer: Aetna Commercial |
$571.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$516.96
|
| Rate for Payer: Aetna Managed Medicare |
$82.84
|
| Rate for Payer: Anthem Medicare Advantage |
$82.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$82.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$82.84
|
| Rate for Payer: Cash Price |
$173.40
|
| Rate for Payer: Cash Price |
$173.40
|
| Rate for Payer: Cash Price |
$173.40
|
| Rate for Payer: Cigna Commercial |
$571.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$60.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$82.84
|
| Rate for Payer: Health EOS Commercial |
$547.02
|
| Rate for Payer: HFN Commercial |
$571.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$296.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$296.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$82.84
|
| Rate for Payer: Multiplan Commercial |
$480.90
|
| Rate for Payer: NAPHCARE Commercial |
$124.25
|
| Rate for Payer: Preferred Network Access Commercial |
$571.06
|
| Rate for Payer: Quartz Beloit One Network |
$264.49
|
| Rate for Payer: Quartz Commercial |
$342.64
|
| Rate for Payer: Quartz Medicare Advantage |
$82.84
|
| Rate for Payer: The Alliance Commercial |
$314.78
|
| Rate for Payer: United Healthcare Medicaid |
$60.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$82.84
|
| Rate for Payer: WEA Trust Commercial |
$330.62
|
| Rate for Payer: WPS Commercial |
$331.34
|
|
|
Pacemaker Analysis Review And Report Multiple Lead
|
Facility
|
OP
|
$1,244.00
|
|
|
Service Code
|
CPT 93281
|
| Hospital Charge Code |
2982424
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$1,190.26 |
| Rate for Payer: Aetna Commercial |
$1,164.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,112.63
|
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$840.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$646.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$621.00
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$685.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.28
|
| Rate for Payer: Cash Price |
$373.20
|
| Rate for Payer: Cash Price |
$373.20
|
| Rate for Payer: Cigna Commercial |
$1,190.26
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$724.01
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Health EOS Commercial |
$1,151.45
|
| Rate for Payer: HFN Commercial |
$1,190.26
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.28
|
| Rate for Payer: Multiplan Commercial |
$1,035.01
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Preferred Network Access Commercial |
$1,190.26
|
| Rate for Payer: Quartz Beloit One Network |
$633.94
|
| Rate for Payer: Quartz Commercial |
$840.94
|
| Rate for Payer: Quartz Medicare Advantage |
$39.28
|
| Rate for Payer: The Alliance Commercial |
$157.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.28
|
| Rate for Payer: WEA Trust Commercial |
$711.57
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
| Rate for Payer: WPS Commercial |
$958.25
|
|
|
Pacemaker Analysis Review And Report Multiple Lead
|
Facility
|
IP
|
$1,244.00
|
|
|
Service Code
|
CPT 93281
|
| Hospital Charge Code |
2982424
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$633.94 |
| Max. Negotiated Rate |
$1,190.26 |
| Rate for Payer: Aetna Commercial |
$1,164.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,112.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$685.69
|
| Rate for Payer: Cash Price |
$373.20
|
| Rate for Payer: Cigna Commercial |
$1,190.26
|
| Rate for Payer: Health EOS Commercial |
$1,151.45
|
| Rate for Payer: HFN Commercial |
$1,190.26
|
| Rate for Payer: Multiplan Commercial |
$1,035.01
|
| Rate for Payer: Preferred Network Access Commercial |
$1,190.26
|
| Rate for Payer: Quartz Beloit One Network |
$633.94
|
| Rate for Payer: Quartz Commercial |
$776.26
|
| Rate for Payer: WEA Trust Commercial |
$711.57
|
| Rate for Payer: WPS Commercial |
$958.25
|
|
|
Pacemaker Analysis Review And Report Single Lead
|
Facility
|
OP
|
$712.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
2982422
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$681.24 |
| Rate for Payer: Aetna Commercial |
$666.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$636.81
|
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$481.31
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$370.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$355.43
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$392.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.28
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cigna Commercial |
$681.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$414.38
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Health EOS Commercial |
$659.03
|
| Rate for Payer: HFN Commercial |
$681.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.28
|
| Rate for Payer: Multiplan Commercial |
$592.38
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Preferred Network Access Commercial |
$681.24
|
| Rate for Payer: Quartz Beloit One Network |
$362.84
|
| Rate for Payer: Quartz Commercial |
$481.31
|
| Rate for Payer: Quartz Medicare Advantage |
$39.28
|
| Rate for Payer: The Alliance Commercial |
$157.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.28
|
| Rate for Payer: WEA Trust Commercial |
$407.26
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
| Rate for Payer: WPS Commercial |
$548.45
|
|
|
Pacemaker Analysis Review And Report Single Lead
|
Facility
|
IP
|
$712.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
2982422
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$362.84 |
| Max. Negotiated Rate |
$681.24 |
| Rate for Payer: Aetna Commercial |
$666.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$636.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$392.45
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cigna Commercial |
$681.24
|
| Rate for Payer: Health EOS Commercial |
$659.03
|
| Rate for Payer: HFN Commercial |
$681.24
|
| Rate for Payer: Multiplan Commercial |
$592.38
|
| Rate for Payer: Preferred Network Access Commercial |
$681.24
|
| Rate for Payer: Quartz Beloit One Network |
$362.84
|
| Rate for Payer: Quartz Commercial |
$444.29
|
| Rate for Payer: WEA Trust Commercial |
$407.26
|
| Rate for Payer: WPS Commercial |
$548.45
|
|
|
Pacemaker Analysis Review And Report Single Lead
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
2982422
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$43.45 |
| Max. Negotiated Rate |
$326.04 |
| Rate for Payer: Aetna Commercial |
$326.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$295.15
|
| Rate for Payer: Aetna Managed Medicare |
$66.80
|
| Rate for Payer: Anthem Medicare Advantage |
$66.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$66.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$66.80
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cigna Commercial |
$326.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.45
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$66.80
|
| Rate for Payer: Health EOS Commercial |
$312.31
|
| Rate for Payer: HFN Commercial |
$326.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$235.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$235.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$66.80
|
| Rate for Payer: Multiplan Commercial |
$274.56
|
| Rate for Payer: NAPHCARE Commercial |
$100.20
|
| Rate for Payer: Preferred Network Access Commercial |
$326.04
|
| Rate for Payer: Quartz Beloit One Network |
$151.01
|
| Rate for Payer: Quartz Commercial |
$195.62
|
| Rate for Payer: Quartz Medicare Advantage |
$66.80
|
| Rate for Payer: The Alliance Commercial |
$253.84
|
| Rate for Payer: United Healthcare Medicaid |
$43.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$66.80
|
| Rate for Payer: WEA Trust Commercial |
$188.76
|
| Rate for Payer: WPS Commercial |
$267.20
|
|
|
PACEMAKER AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT
|
Facility
|
OP
|
$4,542.81
|
|
|
Service Code
|
EAPG 00086
|
| Min. Negotiated Rate |
$4,368.07 |
| Max. Negotiated Rate |
$4,542.81 |
| Rate for Payer: Anthem Medicaid |
$4,368.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,368.07
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,368.07
|
| Rate for Payer: Dean Health Medicaid |
$4,368.07
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,368.07
|
| Rate for Payer: Managed Health Services Medicaid |
$4,542.81
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,368.07
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,368.07
|
| Rate for Payer: United Healthcare Medicaid |
$4,368.07
|
|
|
PACEMAKER ANTI-BACTERL 3122-E
|
Facility
|
IP
|
$6,155.00
|
|
| Hospital Charge Code |
2973673
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,136.59 |
| Max. Negotiated Rate |
$5,889.10 |
| Rate for Payer: Aetna Commercial |
$5,761.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,505.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,392.64
|
| Rate for Payer: Cash Price |
$1,846.50
|
| Rate for Payer: Cigna Commercial |
$5,889.10
|
| Rate for Payer: Health EOS Commercial |
$5,697.07
|
| Rate for Payer: HFN Commercial |
$5,889.10
|
| Rate for Payer: Multiplan Commercial |
$5,120.96
|
| Rate for Payer: Preferred Network Access Commercial |
$5,889.10
|
| Rate for Payer: Quartz Beloit One Network |
$3,136.59
|
| Rate for Payer: Quartz Commercial |
$3,840.72
|
| Rate for Payer: WEA Trust Commercial |
$3,520.66
|
| Rate for Payer: WPS Commercial |
$4,741.20
|
|
|
PACEMAKER ANTI-BACTERL 3122-E
|
Facility
|
OP
|
$6,155.00
|
|
| Hospital Charge Code |
2973673
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,792.34 |
| Max. Negotiated Rate |
$5,889.10 |
| Rate for Payer: Aetna Commercial |
$5,761.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,505.03
|
| Rate for Payer: Aetna Managed Medicare |
$1,792.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,160.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,200.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,072.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,392.64
|
| Rate for Payer: Cash Price |
$1,846.50
|
| Rate for Payer: Cigna Commercial |
$5,889.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,582.21
|
| Rate for Payer: Health EOS Commercial |
$5,697.07
|
| Rate for Payer: HFN Commercial |
$5,889.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,800.90
|
| Rate for Payer: Multiplan Commercial |
$5,120.96
|
| Rate for Payer: NAPHCARE Commercial |
$3,840.72
|
| Rate for Payer: Preferred Network Access Commercial |
$5,889.10
|
| Rate for Payer: Quartz Beloit One Network |
$3,136.59
|
| Rate for Payer: Quartz Commercial |
$4,160.78
|
| Rate for Payer: Quartz Medicare Advantage |
$3,840.72
|
| Rate for Payer: The Alliance Commercial |
$3,200.60
|
| Rate for Payer: WEA Trust Commercial |
$3,520.66
|
| Rate for Payer: WPS Commercial |
$4,741.20
|
|
|
PACEMAKER ANTI-BACTERL #3133-E
|
Facility
|
IP
|
$7,373.00
|
|
| Hospital Charge Code |
2973723
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,757.28 |
| Max. Negotiated Rate |
$7,054.49 |
| Rate for Payer: Aetna Commercial |
$6,901.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,594.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,064.00
|
| Rate for Payer: Cash Price |
$2,211.90
|
| Rate for Payer: Cigna Commercial |
$7,054.49
|
| Rate for Payer: Health EOS Commercial |
$6,824.45
|
| Rate for Payer: HFN Commercial |
$7,054.49
|
| Rate for Payer: Multiplan Commercial |
$6,134.34
|
| Rate for Payer: Preferred Network Access Commercial |
$7,054.49
|
| Rate for Payer: Quartz Beloit One Network |
$3,757.28
|
| Rate for Payer: Quartz Commercial |
$4,600.75
|
| Rate for Payer: WEA Trust Commercial |
$4,217.36
|
| Rate for Payer: WPS Commercial |
$5,679.42
|
|
|
PACEMAKER ANTI-BACTERL #3133-E
|
Facility
|
OP
|
$7,373.00
|
|
| Hospital Charge Code |
2973723
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,147.02 |
| Max. Negotiated Rate |
$7,054.49 |
| Rate for Payer: Aetna Commercial |
$6,901.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,594.41
|
| Rate for Payer: Aetna Managed Medicare |
$2,147.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,984.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,833.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,680.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,064.00
|
| Rate for Payer: Cash Price |
$2,211.90
|
| Rate for Payer: Cigna Commercial |
$7,054.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,291.09
|
| Rate for Payer: Health EOS Commercial |
$6,824.45
|
| Rate for Payer: HFN Commercial |
$7,054.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,750.94
|
| Rate for Payer: Multiplan Commercial |
$6,134.34
|
| Rate for Payer: NAPHCARE Commercial |
$4,600.75
|
| Rate for Payer: Preferred Network Access Commercial |
$7,054.49
|
| Rate for Payer: Quartz Beloit One Network |
$3,757.28
|
| Rate for Payer: Quartz Commercial |
$4,984.15
|
| Rate for Payer: Quartz Medicare Advantage |
$4,600.75
|
| Rate for Payer: The Alliance Commercial |
$3,833.96
|
| Rate for Payer: WEA Trust Commercial |
$4,217.36
|
| Rate for Payer: WPS Commercial |
$5,679.42
|
|
|
Pacemaker Check In Person
|
Facility
|
IP
|
$209.00
|
|
|
Service Code
|
CPT 93288
|
| Hospital Charge Code |
3052481
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$106.51 |
| Max. Negotiated Rate |
$199.97 |
| Rate for Payer: Aetna Commercial |
$195.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$186.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$115.20
|
| Rate for Payer: Cash Price |
$62.70
|
| Rate for Payer: Cigna Commercial |
$199.97
|
| Rate for Payer: Health EOS Commercial |
$193.45
|
| Rate for Payer: HFN Commercial |
$199.97
|
| Rate for Payer: Multiplan Commercial |
$173.89
|
| Rate for Payer: Preferred Network Access Commercial |
$199.97
|
| Rate for Payer: Quartz Beloit One Network |
$106.51
|
| Rate for Payer: Quartz Commercial |
$130.42
|
| Rate for Payer: WEA Trust Commercial |
$119.55
|
| Rate for Payer: WPS Commercial |
$160.99
|
|
|
Pacemaker Check In Person
|
Facility
|
OP
|
$209.00
|
|
|
Service Code
|
CPT 93288
|
| Hospital Charge Code |
3052481
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$199.97 |
| Rate for Payer: Aetna Commercial |
$195.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$186.93
|
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$141.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$108.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$104.33
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$115.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.28
|
| Rate for Payer: Cash Price |
$62.70
|
| Rate for Payer: Cash Price |
$62.70
|
| Rate for Payer: Cigna Commercial |
$199.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$121.64
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Health EOS Commercial |
$193.45
|
| Rate for Payer: HFN Commercial |
$199.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.28
|
| Rate for Payer: Multiplan Commercial |
$173.89
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Preferred Network Access Commercial |
$199.97
|
| Rate for Payer: Quartz Beloit One Network |
$106.51
|
| Rate for Payer: Quartz Commercial |
$141.28
|
| Rate for Payer: Quartz Medicare Advantage |
$39.28
|
| Rate for Payer: The Alliance Commercial |
$157.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.28
|
| Rate for Payer: United Healthcare PPO |
$163.02
|
| Rate for Payer: WEA Trust Commercial |
$119.55
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
| Rate for Payer: WPS Commercial |
$160.99
|
|
|
Pacemaker Check Remote 90 Day
|
Facility
|
IP
|
$303.00
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
5382698
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$154.41 |
| Max. Negotiated Rate |
$289.91 |
| Rate for Payer: Aetna Commercial |
$283.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$271.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$167.01
|
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Cigna Commercial |
$289.91
|
| Rate for Payer: Health EOS Commercial |
$280.46
|
| Rate for Payer: HFN Commercial |
$289.91
|
| Rate for Payer: Multiplan Commercial |
$252.10
|
| Rate for Payer: Preferred Network Access Commercial |
$289.91
|
| Rate for Payer: Quartz Beloit One Network |
$154.41
|
| Rate for Payer: Quartz Commercial |
$189.07
|
| Rate for Payer: WEA Trust Commercial |
$173.32
|
| Rate for Payer: WPS Commercial |
$233.40
|
|
|
Pacemaker Check Remote 90 Day
|
Facility
|
OP
|
$303.00
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
5382698
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$440.09 |
| Rate for Payer: Aetna Commercial |
$283.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$271.00
|
| Rate for Payer: Aetna Managed Medicare |
$110.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$204.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$157.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$151.26
|
| Rate for Payer: Anthem Medicare Advantage |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$167.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$110.02
|
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Cigna Commercial |
$289.91
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$110.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$176.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$110.02
|
| Rate for Payer: Health EOS Commercial |
$280.46
|
| Rate for Payer: HFN Commercial |
$289.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$409.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$110.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$110.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$110.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$110.02
|
| Rate for Payer: Multiplan Commercial |
$252.10
|
| Rate for Payer: NAPHCARE Commercial |
$165.03
|
| Rate for Payer: Preferred Network Access Commercial |
$289.91
|
| Rate for Payer: Quartz Beloit One Network |
$154.41
|
| Rate for Payer: Quartz Commercial |
$204.83
|
| Rate for Payer: Quartz Medicare Advantage |
$110.02
|
| Rate for Payer: The Alliance Commercial |
$440.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110.02
|
| Rate for Payer: United Healthcare PPO |
$236.34
|
| Rate for Payer: WEA Trust Commercial |
$173.32
|
| Rate for Payer: Wellcare Medicare |
$110.02
|
| Rate for Payer: WPS Commercial |
$233.40
|
|
|
Pacemaker Check Reprogram Dual
|
Facility
|
IP
|
$393.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
3052474
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$200.27 |
| Max. Negotiated Rate |
$376.02 |
| Rate for Payer: Aetna Commercial |
$367.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$351.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$216.62
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Cigna Commercial |
$376.02
|
| Rate for Payer: Health EOS Commercial |
$363.76
|
| Rate for Payer: HFN Commercial |
$376.02
|
| Rate for Payer: Multiplan Commercial |
$326.98
|
| Rate for Payer: Preferred Network Access Commercial |
$376.02
|
| Rate for Payer: Quartz Beloit One Network |
$200.27
|
| Rate for Payer: Quartz Commercial |
$245.23
|
| Rate for Payer: WEA Trust Commercial |
$224.80
|
| Rate for Payer: WPS Commercial |
$302.73
|
|
|
Pacemaker Check Reprogram Dual
|
Facility
|
OP
|
$393.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
3052474
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$376.02 |
| Rate for Payer: Aetna Commercial |
$367.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$351.50
|
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$265.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$204.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$196.19
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$216.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.28
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Cigna Commercial |
$376.02
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$228.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Health EOS Commercial |
$363.76
|
| Rate for Payer: HFN Commercial |
$376.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.28
|
| Rate for Payer: Multiplan Commercial |
$326.98
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Preferred Network Access Commercial |
$376.02
|
| Rate for Payer: Quartz Beloit One Network |
$200.27
|
| Rate for Payer: Quartz Commercial |
$265.67
|
| Rate for Payer: Quartz Medicare Advantage |
$39.28
|
| Rate for Payer: The Alliance Commercial |
$157.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.28
|
| Rate for Payer: United Healthcare PPO |
$306.54
|
| Rate for Payer: WEA Trust Commercial |
$224.80
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
| Rate for Payer: WPS Commercial |
$302.73
|
|
