|
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
|
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
|
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
|
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 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 AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT
|
Facility
|
OP
|
$1,706.42
|
|
|
Service Code
|
EAPG 00086
|
| Min. Negotiated Rate |
$1,640.78 |
| Max. Negotiated Rate |
$1,706.42 |
| Rate for Payer: Anthem Medicaid |
$1,640.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$1,640.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,640.78
|
| Rate for Payer: Dean Health Medicaid |
$1,640.78
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$1,640.78
|
| Rate for Payer: Managed Health Services Medicaid |
$1,706.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,640.78
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$1,640.78
|
| Rate for Payer: United Healthcare Medicaid |
$1,640.78
|
|
|
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
|
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 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 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 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 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 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 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
|
|
|
Pacemaker Check Reprogram Single
|
Facility
|
OP
|
$348.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
3052473
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$332.97 |
| Rate for Payer: Aetna Commercial |
$325.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$311.25
|
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$235.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$180.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$173.72
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$191.82
|
| 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 |
$104.40
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cigna Commercial |
$332.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$202.54
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Health EOS Commercial |
$322.11
|
| Rate for Payer: HFN Commercial |
$332.97
|
| 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 |
$289.54
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Preferred Network Access Commercial |
$332.97
|
| Rate for Payer: Quartz Beloit One Network |
$177.34
|
| Rate for Payer: Quartz Commercial |
$235.25
|
| 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 |
$271.44
|
| Rate for Payer: WEA Trust Commercial |
$199.06
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
| Rate for Payer: WPS Commercial |
$268.06
|
|
|
Pacemaker Check Reprogram Single
|
Facility
|
IP
|
$348.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
3052473
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$177.34 |
| Max. Negotiated Rate |
$332.97 |
| Rate for Payer: Aetna Commercial |
$325.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$311.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$191.82
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cigna Commercial |
$332.97
|
| Rate for Payer: Health EOS Commercial |
$322.11
|
| Rate for Payer: HFN Commercial |
$332.97
|
| Rate for Payer: Multiplan Commercial |
$289.54
|
| Rate for Payer: Preferred Network Access Commercial |
$332.97
|
| Rate for Payer: Quartz Beloit One Network |
$177.34
|
| Rate for Payer: Quartz Commercial |
$217.15
|
| Rate for Payer: WEA Trust Commercial |
$199.06
|
| Rate for Payer: WPS Commercial |
$268.06
|
|
|
Pacemaker Explant Leadless-Ventricular
|
Facility
|
IP
|
$6,415.00
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
5464769
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,269.08 |
| Max. Negotiated Rate |
$6,137.87 |
| Rate for Payer: Aetna Commercial |
$6,004.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,737.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,535.95
|
| Rate for Payer: Cash Price |
$1,924.50
|
| Rate for Payer: Cigna Commercial |
$6,137.87
|
| Rate for Payer: Health EOS Commercial |
$5,937.72
|
| Rate for Payer: HFN Commercial |
$6,137.87
|
| Rate for Payer: Multiplan Commercial |
$5,337.28
|
| Rate for Payer: Preferred Network Access Commercial |
$6,137.87
|
| Rate for Payer: Quartz Beloit One Network |
$3,269.08
|
| Rate for Payer: Quartz Commercial |
$4,002.96
|
| Rate for Payer: WEA Trust Commercial |
$3,669.38
|
| Rate for Payer: WPS Commercial |
$4,941.47
|
|
|
Pacemaker Explant Leadless-Ventricular
|
Facility
|
OP
|
$6,415.00
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
5464769
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,269.08 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$6,004.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,737.58
|
| 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 |
$3,535.95
|
| 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 |
$1,924.50
|
| Rate for Payer: Cash Price |
$1,924.50
|
| Rate for Payer: Cash Price |
$1,924.50
|
| Rate for Payer: Cash Price |
$1,924.50
|
| Rate for Payer: Cigna Commercial |
$6,137.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$5,937.72
|
| Rate for Payer: HFN Commercial |
$6,137.87
|
| 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 |
$5,337.28
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$6,137.87
|
| Rate for Payer: Quartz Beloit One Network |
$3,269.08
|
| Rate for Payer: Quartz Commercial |
$4,336.54
|
| 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 |
$3,669.38
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$4,941.47
|
|
|
Pacemaker Insertion-Rep Leadless-Ventricular
|
Facility
|
OP
|
$6,050.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
5464768
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,083.08 |
| Max. Negotiated Rate |
$81,083.18 |
| Rate for Payer: Aetna Commercial |
$5,662.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,411.12
|
| Rate for Payer: Aetna Managed Medicare |
$20,270.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,607.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,113.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18,158.40
|
| Rate for Payer: Anthem Medicare Advantage |
$20,270.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,334.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20,270.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20,270.80
|
| Rate for Payer: Cash Price |
$1,815.00
|
| Rate for Payer: Cash Price |
$1,815.00
|
| Rate for Payer: Cash Price |
$1,815.00
|
| Rate for Payer: Cash Price |
$1,815.00
|
| Rate for Payer: Cigna Commercial |
$5,788.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20,270.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20,270.80
|
| Rate for Payer: Health EOS Commercial |
$5,599.88
|
| Rate for Payer: HFN Commercial |
$5,788.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$75,407.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20,270.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20,270.80
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20,270.80
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20,270.80
|
| Rate for Payer: Multiplan Commercial |
$5,033.60
|
| Rate for Payer: NAPHCARE Commercial |
$30,406.19
|
| Rate for Payer: Preferred Network Access Commercial |
$5,788.64
|
| Rate for Payer: Quartz Beloit One Network |
$3,083.08
|
| Rate for Payer: Quartz Commercial |
$4,089.80
|
| Rate for Payer: Quartz Medicare Advantage |
$20,270.80
|
| Rate for Payer: The Alliance Commercial |
$81,083.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,270.80
|
| Rate for Payer: United Healthcare PPO |
$11,521.12
|
| Rate for Payer: WEA Trust Commercial |
$3,460.60
|
| Rate for Payer: Wellcare Medicare |
$20,270.80
|
| Rate for Payer: WPS Commercial |
$4,660.31
|
|
|
Pacemaker Insertion-Rep Leadless-Ventricular
|
Facility
|
IP
|
$6,050.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
5464768
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,083.08 |
| Max. Negotiated Rate |
$5,788.64 |
| Rate for Payer: Aetna Commercial |
$5,662.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,411.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,334.76
|
| Rate for Payer: Cash Price |
$1,815.00
|
| Rate for Payer: Cigna Commercial |
$5,788.64
|
| Rate for Payer: Health EOS Commercial |
$5,599.88
|
| Rate for Payer: HFN Commercial |
$5,788.64
|
| Rate for Payer: Multiplan Commercial |
$5,033.60
|
| Rate for Payer: Preferred Network Access Commercial |
$5,788.64
|
| Rate for Payer: Quartz Beloit One Network |
$3,083.08
|
| Rate for Payer: Quartz Commercial |
$3,775.20
|
| Rate for Payer: WEA Trust Commercial |
$3,460.60
|
| Rate for Payer: WPS Commercial |
$4,660.31
|
|
|
Pacemaker Pre/Post OP Adjust
|
Facility
|
OP
|
$349.00
|
|
|
Service Code
|
CPT 93286
|
| Hospital Charge Code |
3052479
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$101.63 |
| Max. Negotiated Rate |
$333.92 |
| Rate for Payer: Aetna Commercial |
$326.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$312.15
|
| Rate for Payer: Aetna Managed Medicare |
$101.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$235.92
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$181.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$174.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$192.37
|
| Rate for Payer: Cash Price |
$104.70
|
| Rate for Payer: Cash Price |
$104.70
|
| Rate for Payer: Cigna Commercial |
$333.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$203.12
|
| Rate for Payer: Health EOS Commercial |
$323.03
|
| Rate for Payer: HFN Commercial |
$333.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$272.22
|
| Rate for Payer: Multiplan Commercial |
$290.37
|
| Rate for Payer: NAPHCARE Commercial |
$217.78
|
| Rate for Payer: Preferred Network Access Commercial |
$333.92
|
| Rate for Payer: Quartz Beloit One Network |
$177.85
|
| Rate for Payer: Quartz Commercial |
$235.92
|
| Rate for Payer: Quartz Medicare Advantage |
$217.78
|
| Rate for Payer: The Alliance Commercial |
$176.92
|
| Rate for Payer: United Healthcare PPO |
$272.22
|
| Rate for Payer: WEA Trust Commercial |
$199.63
|
| Rate for Payer: WPS Commercial |
$268.83
|
|
|
Pacemaker Pre/Post OP Adjust
|
Facility
|
IP
|
$349.00
|
|
|
Service Code
|
CPT 93286
|
| Hospital Charge Code |
3052479
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$177.85 |
| Max. Negotiated Rate |
$333.92 |
| Rate for Payer: Aetna Commercial |
$326.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$312.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$192.37
|
| Rate for Payer: Cash Price |
$104.70
|
| Rate for Payer: Cigna Commercial |
$333.92
|
| Rate for Payer: Health EOS Commercial |
$323.03
|
| Rate for Payer: HFN Commercial |
$333.92
|
| Rate for Payer: Multiplan Commercial |
$290.37
|
| Rate for Payer: Preferred Network Access Commercial |
$333.92
|
| Rate for Payer: Quartz Beloit One Network |
$177.85
|
| Rate for Payer: Quartz Commercial |
$217.78
|
| Rate for Payer: WEA Trust Commercial |
$199.63
|
| Rate for Payer: WPS Commercial |
$268.83
|
|
