|
Pertussis toxin IgA
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
CPT 86615
|
| Hospital Charge Code |
3794219
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$87.93 |
| Rate for Payer: Aetna Commercial |
$87.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Aetna Managed Medicare |
$13.72
|
| Rate for Payer: Anthem Medicare Advantage |
$13.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.72
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$87.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.72
|
| Rate for Payer: Health EOS Commercial |
$84.23
|
| Rate for Payer: HFN Commercial |
$87.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$48.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.72
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: NAPHCARE Commercial |
$20.58
|
| Rate for Payer: Preferred Network Access Commercial |
$87.93
|
| Rate for Payer: Quartz Beloit One Network |
$40.73
|
| Rate for Payer: Quartz Commercial |
$52.76
|
| Rate for Payer: Quartz Medicare Advantage |
$13.72
|
| Rate for Payer: The Alliance Commercial |
$54.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.72
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: WPS Commercial |
$60.36
|
|
|
Pertussis toxin IgA
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 86615
|
| Hospital Charge Code |
3794219
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$49.06
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$85.16
|
| Rate for Payer: Health EOS Commercial |
$82.38
|
| Rate for Payer: HFN Commercial |
$85.16
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: Preferred Network Access Commercial |
$85.16
|
| Rate for Payer: Quartz Beloit One Network |
$45.35
|
| Rate for Payer: Quartz Commercial |
$55.54
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: WPS Commercial |
$68.56
|
|
|
Pertussis toxin IgA
|
Facility
|
OP
|
$89.00
|
|
|
Service Code
|
CPT 86615
|
| Hospital Charge Code |
3794219
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Aetna Managed Medicare |
$13.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$51.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.01
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22.77
|
| Rate for Payer: Anthem Medicare Advantage |
$13.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$49.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.72
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$85.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$51.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.72
|
| Rate for Payer: Health EOS Commercial |
$82.38
|
| Rate for Payer: HFN Commercial |
$85.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$51.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.72
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.72
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.72
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: NAPHCARE Commercial |
$20.58
|
| Rate for Payer: Preferred Network Access Commercial |
$85.16
|
| Rate for Payer: Quartz Beloit One Network |
$45.35
|
| Rate for Payer: Quartz Commercial |
$60.16
|
| Rate for Payer: Quartz Medicare Advantage |
$13.72
|
| Rate for Payer: The Alliance Commercial |
$54.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.72
|
| Rate for Payer: United Healthcare PPO |
$69.42
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: Wellcare Medicare |
$13.72
|
| Rate for Payer: WPS Commercial |
$68.56
|
|
|
Pertussis toxin IgG
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 86615
|
| Hospital Charge Code |
3794218
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$49.06
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$85.16
|
| Rate for Payer: Health EOS Commercial |
$82.38
|
| Rate for Payer: HFN Commercial |
$85.16
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: Preferred Network Access Commercial |
$85.16
|
| Rate for Payer: Quartz Beloit One Network |
$45.35
|
| Rate for Payer: Quartz Commercial |
$55.54
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: WPS Commercial |
$68.56
|
|
|
Pertussis toxin IgG
|
Facility
|
OP
|
$89.00
|
|
|
Service Code
|
CPT 86615
|
| Hospital Charge Code |
3794218
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Aetna Managed Medicare |
$13.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$51.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.01
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22.77
|
| Rate for Payer: Anthem Medicare Advantage |
$13.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$49.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.72
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$85.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$51.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.72
|
| Rate for Payer: Health EOS Commercial |
$82.38
|
| Rate for Payer: HFN Commercial |
$85.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$51.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.72
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.72
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.72
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: NAPHCARE Commercial |
$20.58
|
| Rate for Payer: Preferred Network Access Commercial |
$85.16
|
| Rate for Payer: Quartz Beloit One Network |
$45.35
|
| Rate for Payer: Quartz Commercial |
$60.16
|
| Rate for Payer: Quartz Medicare Advantage |
$13.72
|
| Rate for Payer: The Alliance Commercial |
$54.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.72
|
| Rate for Payer: United Healthcare PPO |
$69.42
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: Wellcare Medicare |
$13.72
|
| Rate for Payer: WPS Commercial |
$68.56
|
|
|
Pertussis toxin IgG
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
CPT 86615
|
| Hospital Charge Code |
3794218
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$87.93 |
| Rate for Payer: Aetna Commercial |
$87.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Aetna Managed Medicare |
$13.72
|
| Rate for Payer: Anthem Medicare Advantage |
$13.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.72
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$87.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.72
|
| Rate for Payer: Health EOS Commercial |
$84.23
|
| Rate for Payer: HFN Commercial |
$87.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$48.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.72
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: NAPHCARE Commercial |
$20.58
|
| Rate for Payer: Preferred Network Access Commercial |
$87.93
|
| Rate for Payer: Quartz Beloit One Network |
$40.73
|
| Rate for Payer: Quartz Commercial |
$52.76
|
| Rate for Payer: Quartz Medicare Advantage |
$13.72
|
| Rate for Payer: The Alliance Commercial |
$54.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.72
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: WPS Commercial |
$60.36
|
|
|
Pessary, non rubber, any type A4562
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
HCPCS A4562
|
| Hospital Charge Code |
3142835
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$53.51 |
| Max. Negotiated Rate |
$100.46 |
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.88
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$100.46
|
| Rate for Payer: Health EOS Commercial |
$97.19
|
| Rate for Payer: HFN Commercial |
$100.46
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: Preferred Network Access Commercial |
$100.46
|
| Rate for Payer: Quartz Beloit One Network |
$53.51
|
| Rate for Payer: Quartz Commercial |
$65.52
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: WPS Commercial |
$80.88
|
|
|
Pessary, non rubber, any type A4562
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
HCPCS A4562
|
| Hospital Charge Code |
3142835
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$30.58 |
| Max. Negotiated Rate |
$301.89 |
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Aetna Managed Medicare |
$30.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$70.98
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$54.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$52.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.88
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$100.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$61.11
|
| Rate for Payer: Health EOS Commercial |
$97.19
|
| Rate for Payer: HFN Commercial |
$100.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$81.90
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: NAPHCARE Commercial |
$65.52
|
| Rate for Payer: Preferred Network Access Commercial |
$100.46
|
| Rate for Payer: Quartz Beloit One Network |
$53.51
|
| Rate for Payer: Quartz Commercial |
$70.98
|
| Rate for Payer: Quartz Medicare Advantage |
$65.52
|
| Rate for Payer: The Alliance Commercial |
$301.89
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: WPS Commercial |
$80.88
|
|
|
Pessary, non rubber, any type A4562
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS A4562
|
| Hospital Charge Code |
3142835
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.05 |
| Max. Negotiated Rate |
$217.63 |
| Rate for Payer: Aetna Commercial |
$103.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Aetna Managed Medicare |
$75.47
|
| Rate for Payer: Anthem Medicare Advantage |
$75.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$75.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$75.47
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$103.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$54.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$75.47
|
| Rate for Payer: Health EOS Commercial |
$99.37
|
| Rate for Payer: HFN Commercial |
$103.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$217.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$217.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$75.47
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: NAPHCARE Commercial |
$113.21
|
| Rate for Payer: Preferred Network Access Commercial |
$103.74
|
| Rate for Payer: Quartz Beloit One Network |
$48.05
|
| Rate for Payer: Quartz Commercial |
$62.24
|
| Rate for Payer: Quartz Medicare Advantage |
$75.47
|
| Rate for Payer: The Alliance Commercial |
$207.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$75.47
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: WPS Commercial |
$132.08
|
|
|
PESSARY SHAATZ/FOLD PESSARY 3-1/4 MXKPSH3-1/4
|
Facility
|
IP
|
$991.00
|
|
| Hospital Charge Code |
3072500
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$505.01 |
| Max. Negotiated Rate |
$948.19 |
| Rate for Payer: Aetna Commercial |
$927.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$886.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$546.24
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$948.19
|
| Rate for Payer: Health EOS Commercial |
$917.27
|
| Rate for Payer: HFN Commercial |
$948.19
|
| Rate for Payer: Multiplan Commercial |
$824.51
|
| Rate for Payer: Preferred Network Access Commercial |
$948.19
|
| Rate for Payer: Quartz Beloit One Network |
$505.01
|
| Rate for Payer: Quartz Commercial |
$618.38
|
| Rate for Payer: WEA Trust Commercial |
$566.85
|
| Rate for Payer: WPS Commercial |
$763.37
|
|
|
PESSARY SHAATZ/FOLD PESSARY 3-1/4 MXKPSH3-1/4
|
Facility
|
OP
|
$991.00
|
|
| Hospital Charge Code |
3072500
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$288.58 |
| Max. Negotiated Rate |
$948.19 |
| Rate for Payer: Aetna Commercial |
$927.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$886.35
|
| Rate for Payer: Aetna Managed Medicare |
$288.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$669.92
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$515.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$494.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$546.24
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$948.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$576.76
|
| Rate for Payer: Health EOS Commercial |
$917.27
|
| Rate for Payer: HFN Commercial |
$948.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$772.98
|
| Rate for Payer: Multiplan Commercial |
$824.51
|
| Rate for Payer: NAPHCARE Commercial |
$618.38
|
| Rate for Payer: Preferred Network Access Commercial |
$948.19
|
| Rate for Payer: Quartz Beloit One Network |
$505.01
|
| Rate for Payer: Quartz Commercial |
$669.92
|
| Rate for Payer: Quartz Medicare Advantage |
$618.38
|
| Rate for Payer: The Alliance Commercial |
$515.32
|
| Rate for Payer: WEA Trust Commercial |
$566.85
|
| Rate for Payer: WPS Commercial |
$763.37
|
|
|
PET Brain Imaging Metabolic Evaluation
|
Professional
|
Both
|
$3,199.00
|
|
|
Service Code
|
CPT 78608
|
| Hospital Charge Code |
2587013
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$1,463.86 |
| Max. Negotiated Rate |
$8,561.12 |
| Rate for Payer: Aetna Commercial |
$3,160.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,861.19
|
| Rate for Payer: Cash Price |
$959.70
|
| Rate for Payer: Cash Price |
$959.70
|
| Rate for Payer: Cash Price |
$959.70
|
| Rate for Payer: Cigna Commercial |
$3,160.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,663.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,996.18
|
| Rate for Payer: Health EOS Commercial |
$3,027.53
|
| Rate for Payer: HFN Commercial |
$3,160.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,561.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,561.12
|
| Rate for Payer: Multiplan Commercial |
$2,661.57
|
| Rate for Payer: Preferred Network Access Commercial |
$3,160.61
|
| Rate for Payer: Quartz Beloit One Network |
$1,463.86
|
| Rate for Payer: Quartz Commercial |
$1,896.37
|
| Rate for Payer: The Alliance Commercial |
$1,663.48
|
| Rate for Payer: WEA Trust Commercial |
$1,829.83
|
| Rate for Payer: WPS Commercial |
$2,464.19
|
|
|
PET Brain Imaging Metabolic Evaluation
|
Facility
|
OP
|
$3,199.00
|
|
|
Service Code
|
CPT 78608
|
| Hospital Charge Code |
2587013
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$1,504.86 |
| Max. Negotiated Rate |
$6,019.44 |
| Rate for Payer: Aetna Commercial |
$2,994.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,861.19
|
| Rate for Payer: Aetna Managed Medicare |
$1,504.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,242.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,583.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,403.92
|
| Rate for Payer: Anthem Medicare Advantage |
$1,504.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,763.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,504.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,504.86
|
| Rate for Payer: Cash Price |
$959.70
|
| Rate for Payer: Cash Price |
$959.70
|
| Rate for Payer: Cash Price |
$959.70
|
| Rate for Payer: Cigna Commercial |
$3,060.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,504.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,861.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,504.86
|
| Rate for Payer: Health EOS Commercial |
$2,960.99
|
| Rate for Payer: HFN Commercial |
$3,060.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,598.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,504.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,504.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,504.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,504.86
|
| Rate for Payer: Multiplan Commercial |
$2,661.57
|
| Rate for Payer: NAPHCARE Commercial |
$2,257.29
|
| Rate for Payer: Preferred Network Access Commercial |
$3,060.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,630.21
|
| Rate for Payer: Quartz Commercial |
$2,162.52
|
| Rate for Payer: Quartz Medicare Advantage |
$1,504.86
|
| Rate for Payer: The Alliance Commercial |
$6,019.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,504.86
|
| Rate for Payer: United Healthcare PPO |
$2,495.22
|
| Rate for Payer: WEA Trust Commercial |
$1,829.83
|
| Rate for Payer: Wellcare Medicare |
$1,504.86
|
| Rate for Payer: WPS Commercial |
$2,464.19
|
|
|
PET Brain Imaging Metabolic Evaluation
|
Facility
|
IP
|
$3,076.00
|
|
|
Service Code
|
CPT 78608
|
| Hospital Charge Code |
627674
|
| Min. Negotiated Rate |
$1,567.53 |
| Max. Negotiated Rate |
$2,943.12 |
| Rate for Payer: Aetna Commercial |
$2,879.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,751.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,695.49
|
| Rate for Payer: Cash Price |
$922.80
|
| Rate for Payer: Cigna Commercial |
$2,943.12
|
| Rate for Payer: Health EOS Commercial |
$2,847.15
|
| Rate for Payer: HFN Commercial |
$2,943.12
|
| Rate for Payer: Multiplan Commercial |
$2,559.23
|
| Rate for Payer: Preferred Network Access Commercial |
$2,943.12
|
| Rate for Payer: Quartz Beloit One Network |
$1,567.53
|
| Rate for Payer: Quartz Commercial |
$1,919.42
|
| Rate for Payer: WEA Trust Commercial |
$1,759.47
|
| Rate for Payer: WPS Commercial |
$2,369.44
|
|
|
PET Brain Imaging Metabolic Evaluation
|
Facility
|
OP
|
$3,076.00
|
|
|
Service Code
|
CPT 78608
|
| Hospital Charge Code |
627674
|
| Min. Negotiated Rate |
$1,504.86 |
| Max. Negotiated Rate |
$6,019.44 |
| Rate for Payer: Aetna Commercial |
$2,879.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,751.17
|
| Rate for Payer: Aetna Managed Medicare |
$1,504.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,079.38
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,599.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,535.54
|
| Rate for Payer: Anthem Medicare Advantage |
$1,504.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,695.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,504.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,504.86
|
| Rate for Payer: Cash Price |
$922.80
|
| Rate for Payer: Cash Price |
$922.80
|
| Rate for Payer: Cigna Commercial |
$2,943.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,504.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,790.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,504.86
|
| Rate for Payer: Health EOS Commercial |
$2,847.15
|
| Rate for Payer: HFN Commercial |
$2,943.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,598.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,504.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,504.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,504.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,504.86
|
| Rate for Payer: Multiplan Commercial |
$2,559.23
|
| Rate for Payer: NAPHCARE Commercial |
$2,257.29
|
| Rate for Payer: Preferred Network Access Commercial |
$2,943.12
|
| Rate for Payer: Quartz Beloit One Network |
$1,567.53
|
| Rate for Payer: Quartz Commercial |
$2,079.38
|
| Rate for Payer: Quartz Medicare Advantage |
$1,504.86
|
| Rate for Payer: The Alliance Commercial |
$6,019.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,504.86
|
| Rate for Payer: WEA Trust Commercial |
$1,759.47
|
| Rate for Payer: Wellcare Medicare |
$1,504.86
|
| Rate for Payer: WPS Commercial |
$2,369.44
|
|
|
PET Brain Imaging Metabolic Evaluation
|
Facility
|
IP
|
$3,199.00
|
|
|
Service Code
|
CPT 78608
|
| Hospital Charge Code |
2587013
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$1,630.21 |
| Max. Negotiated Rate |
$3,060.80 |
| Rate for Payer: Aetna Commercial |
$2,994.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,861.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,763.29
|
| Rate for Payer: Cash Price |
$959.70
|
| Rate for Payer: Cigna Commercial |
$3,060.80
|
| Rate for Payer: Health EOS Commercial |
$2,960.99
|
| Rate for Payer: HFN Commercial |
$3,060.80
|
| Rate for Payer: Multiplan Commercial |
$2,661.57
|
| Rate for Payer: Preferred Network Access Commercial |
$3,060.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,630.21
|
| Rate for Payer: Quartz Commercial |
$1,996.18
|
| Rate for Payer: WEA Trust Commercial |
$1,829.83
|
| Rate for Payer: WPS Commercial |
$2,464.19
|
|
|
PET Brain Imaging Metabolic Evaluation
|
Professional
|
Both
|
$3,076.00
|
|
|
Service Code
|
CPT 78608
|
| Hospital Charge Code |
627674
|
| Min. Negotiated Rate |
$1,407.58 |
| Max. Negotiated Rate |
$8,561.12 |
| Rate for Payer: Aetna Commercial |
$3,039.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,751.17
|
| Rate for Payer: Cash Price |
$922.80
|
| Rate for Payer: Cash Price |
$922.80
|
| Rate for Payer: Cash Price |
$922.80
|
| Rate for Payer: Cigna Commercial |
$3,039.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,599.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,919.42
|
| Rate for Payer: Health EOS Commercial |
$2,911.13
|
| Rate for Payer: HFN Commercial |
$3,039.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,561.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,561.12
|
| Rate for Payer: Multiplan Commercial |
$2,559.23
|
| Rate for Payer: Preferred Network Access Commercial |
$3,039.09
|
| Rate for Payer: Quartz Beloit One Network |
$1,407.58
|
| Rate for Payer: Quartz Commercial |
$1,823.45
|
| Rate for Payer: The Alliance Commercial |
$1,599.52
|
| Rate for Payer: WEA Trust Commercial |
$1,759.47
|
| Rate for Payer: WPS Commercial |
$2,369.44
|
|
|
PET/CT Axumin
|
Facility
|
OP
|
$9,448.00
|
|
|
Service Code
|
CPT 78815
|
| Hospital Charge Code |
5428942
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$1,504.86 |
| Max. Negotiated Rate |
$9,039.85 |
| Rate for Payer: Aetna Commercial |
$8,843.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,450.29
|
| Rate for Payer: Aetna Managed Medicare |
$1,504.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,242.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,583.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,403.92
|
| Rate for Payer: Anthem Medicare Advantage |
$1,504.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,207.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,504.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,504.86
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cigna Commercial |
$9,039.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,504.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,498.74
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,504.86
|
| Rate for Payer: Health EOS Commercial |
$8,745.07
|
| Rate for Payer: HFN Commercial |
$9,039.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,598.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,504.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,504.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,504.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,504.86
|
| Rate for Payer: Multiplan Commercial |
$7,860.74
|
| Rate for Payer: NAPHCARE Commercial |
$2,257.29
|
| Rate for Payer: Preferred Network Access Commercial |
$9,039.85
|
| Rate for Payer: Quartz Beloit One Network |
$4,814.70
|
| Rate for Payer: Quartz Commercial |
$6,386.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,504.86
|
| Rate for Payer: The Alliance Commercial |
$6,019.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,504.86
|
| Rate for Payer: United Healthcare PPO |
$7,369.44
|
| Rate for Payer: WEA Trust Commercial |
$5,404.26
|
| Rate for Payer: Wellcare Medicare |
$1,504.86
|
| Rate for Payer: WPS Commercial |
$7,277.79
|
|
|
PET/CT Axumin
|
Facility
|
IP
|
$9,448.00
|
|
|
Service Code
|
CPT 78815
|
| Hospital Charge Code |
5428942
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$4,814.70 |
| Max. Negotiated Rate |
$9,039.85 |
| Rate for Payer: Aetna Commercial |
$8,843.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,450.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,207.74
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cigna Commercial |
$9,039.85
|
| Rate for Payer: Health EOS Commercial |
$8,745.07
|
| Rate for Payer: HFN Commercial |
$9,039.85
|
| Rate for Payer: Multiplan Commercial |
$7,860.74
|
| Rate for Payer: Preferred Network Access Commercial |
$9,039.85
|
| Rate for Payer: Quartz Beloit One Network |
$4,814.70
|
| Rate for Payer: Quartz Commercial |
$5,895.55
|
| Rate for Payer: WEA Trust Commercial |
$5,404.26
|
| Rate for Payer: WPS Commercial |
$7,277.79
|
|
|
PET/CT Axumin
|
Professional
|
Both
|
$9,448.00
|
|
|
Service Code
|
CPT 78815
|
| Hospital Charge Code |
5428942
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$4,323.40 |
| Max. Negotiated Rate |
$10,802.06 |
| Rate for Payer: Aetna Commercial |
$9,334.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,450.29
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cigna Commercial |
$9,334.62
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,912.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,895.55
|
| Rate for Payer: Health EOS Commercial |
$8,941.59
|
| Rate for Payer: HFN Commercial |
$9,334.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,802.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,802.06
|
| Rate for Payer: Multiplan Commercial |
$7,860.74
|
| Rate for Payer: Preferred Network Access Commercial |
$9,334.62
|
| Rate for Payer: Quartz Beloit One Network |
$4,323.40
|
| Rate for Payer: Quartz Commercial |
$5,600.77
|
| Rate for Payer: The Alliance Commercial |
$4,912.96
|
| Rate for Payer: WEA Trust Commercial |
$5,404.26
|
| Rate for Payer: WPS Commercial |
$7,277.79
|
|
|
PET/CT Breast CA Initial Tx
|
Professional
|
Both
|
$8,711.00
|
|
|
Service Code
|
CPT 78815
|
| Hospital Charge Code |
675715
|
| Min. Negotiated Rate |
$3,986.15 |
| Max. Negotiated Rate |
$10,802.06 |
| Rate for Payer: Aetna Commercial |
$8,606.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,791.12
|
| Rate for Payer: Cash Price |
$2,613.30
|
| Rate for Payer: Cash Price |
$2,613.30
|
| Rate for Payer: Cash Price |
$2,613.30
|
| Rate for Payer: Cigna Commercial |
$8,606.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,529.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,435.66
|
| Rate for Payer: Health EOS Commercial |
$8,244.09
|
| Rate for Payer: HFN Commercial |
$8,606.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,802.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,802.06
|
| Rate for Payer: Multiplan Commercial |
$7,247.55
|
| Rate for Payer: Preferred Network Access Commercial |
$8,606.47
|
| Rate for Payer: Quartz Beloit One Network |
$3,986.15
|
| Rate for Payer: Quartz Commercial |
$5,163.88
|
| Rate for Payer: The Alliance Commercial |
$4,529.72
|
| Rate for Payer: WEA Trust Commercial |
$4,982.69
|
| Rate for Payer: WPS Commercial |
$6,710.08
|
|
|
PET/CT Breast CA Initial Tx
|
Facility
|
IP
|
$9,448.00
|
|
|
Service Code
|
CPT 78815
|
| Hospital Charge Code |
2587026
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$4,814.70 |
| Max. Negotiated Rate |
$9,039.85 |
| Rate for Payer: Aetna Commercial |
$8,843.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,450.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,207.74
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cigna Commercial |
$9,039.85
|
| Rate for Payer: Health EOS Commercial |
$8,745.07
|
| Rate for Payer: HFN Commercial |
$9,039.85
|
| Rate for Payer: Multiplan Commercial |
$7,860.74
|
| Rate for Payer: Preferred Network Access Commercial |
$9,039.85
|
| Rate for Payer: Quartz Beloit One Network |
$4,814.70
|
| Rate for Payer: Quartz Commercial |
$5,895.55
|
| Rate for Payer: WEA Trust Commercial |
$5,404.26
|
| Rate for Payer: WPS Commercial |
$7,277.79
|
|
|
PET/CT Breast CA Initial Tx
|
Professional
|
Both
|
$9,448.00
|
|
|
Service Code
|
CPT 78815
|
| Hospital Charge Code |
2587026
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$4,323.40 |
| Max. Negotiated Rate |
$10,802.06 |
| Rate for Payer: Aetna Commercial |
$9,334.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,450.29
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cigna Commercial |
$9,334.62
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,912.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,895.55
|
| Rate for Payer: Health EOS Commercial |
$8,941.59
|
| Rate for Payer: HFN Commercial |
$9,334.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,802.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,802.06
|
| Rate for Payer: Multiplan Commercial |
$7,860.74
|
| Rate for Payer: Preferred Network Access Commercial |
$9,334.62
|
| Rate for Payer: Quartz Beloit One Network |
$4,323.40
|
| Rate for Payer: Quartz Commercial |
$5,600.77
|
| Rate for Payer: The Alliance Commercial |
$4,912.96
|
| Rate for Payer: WEA Trust Commercial |
$5,404.26
|
| Rate for Payer: WPS Commercial |
$7,277.79
|
|
|
PET/CT Breast CA Initial Tx
|
Facility
|
IP
|
$8,711.00
|
|
|
Service Code
|
CPT 78815
|
| Hospital Charge Code |
675715
|
| Min. Negotiated Rate |
$4,439.13 |
| Max. Negotiated Rate |
$8,334.68 |
| Rate for Payer: Aetna Commercial |
$8,153.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,791.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,801.50
|
| Rate for Payer: Cash Price |
$2,613.30
|
| Rate for Payer: Cigna Commercial |
$8,334.68
|
| Rate for Payer: Health EOS Commercial |
$8,062.90
|
| Rate for Payer: HFN Commercial |
$8,334.68
|
| Rate for Payer: Multiplan Commercial |
$7,247.55
|
| Rate for Payer: Preferred Network Access Commercial |
$8,334.68
|
| Rate for Payer: Quartz Beloit One Network |
$4,439.13
|
| Rate for Payer: Quartz Commercial |
$5,435.66
|
| Rate for Payer: WEA Trust Commercial |
$4,982.69
|
| Rate for Payer: WPS Commercial |
$6,710.08
|
|
|
PET/CT Breast CA Initial Tx
|
Facility
|
OP
|
$8,711.00
|
|
|
Service Code
|
CPT 78815
|
| Hospital Charge Code |
675715
|
| Min. Negotiated Rate |
$1,504.86 |
| Max. Negotiated Rate |
$8,334.68 |
| Rate for Payer: Aetna Commercial |
$8,153.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,791.12
|
| Rate for Payer: Aetna Managed Medicare |
$1,504.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,888.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,529.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,348.53
|
| Rate for Payer: Anthem Medicare Advantage |
$1,504.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,801.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,504.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,504.86
|
| Rate for Payer: Cash Price |
$2,613.30
|
| Rate for Payer: Cash Price |
$2,613.30
|
| Rate for Payer: Cigna Commercial |
$8,334.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,504.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,069.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,504.86
|
| Rate for Payer: Health EOS Commercial |
$8,062.90
|
| Rate for Payer: HFN Commercial |
$8,334.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,598.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,504.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,504.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,504.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,504.86
|
| Rate for Payer: Multiplan Commercial |
$7,247.55
|
| Rate for Payer: NAPHCARE Commercial |
$2,257.29
|
| Rate for Payer: Preferred Network Access Commercial |
$8,334.68
|
| Rate for Payer: Quartz Beloit One Network |
$4,439.13
|
| Rate for Payer: Quartz Commercial |
$5,888.64
|
| Rate for Payer: Quartz Medicare Advantage |
$1,504.86
|
| Rate for Payer: The Alliance Commercial |
$6,019.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,504.86
|
| Rate for Payer: WEA Trust Commercial |
$4,982.69
|
| Rate for Payer: Wellcare Medicare |
$1,504.86
|
| Rate for Payer: WPS Commercial |
$6,710.08
|
|
