|
Art Bld Gas CABG
|
Facility
|
OP
|
$538.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
3059530
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.92 |
| Max. Negotiated Rate |
$514.76 |
| Rate for Payer: Aetna Commercial |
$503.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Aetna Managed Medicare |
$81.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$307.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$143.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$135.99
|
| Rate for Payer: Anthem Medicare Advantage |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$296.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$81.92
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$514.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$81.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$313.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$81.92
|
| Rate for Payer: Health EOS Commercial |
$497.97
|
| Rate for Payer: HFN Commercial |
$514.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$304.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$81.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$81.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$81.92
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$81.92
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: NAPHCARE Commercial |
$122.88
|
| Rate for Payer: Preferred Network Access Commercial |
$514.76
|
| Rate for Payer: Quartz Beloit One Network |
$274.16
|
| Rate for Payer: Quartz Commercial |
$363.69
|
| Rate for Payer: Quartz Medicare Advantage |
$81.92
|
| Rate for Payer: The Alliance Commercial |
$327.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.92
|
| Rate for Payer: United Healthcare PPO |
$419.64
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: Wellcare Medicare |
$81.92
|
| Rate for Payer: WPS Commercial |
$414.42
|
|
|
Arterial Coiling Not Hemorrhage or Tumor
|
Facility
|
OP
|
$18,437.00
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
4597126
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,395.50 |
| Max. Negotiated Rate |
$77,168.08 |
| Rate for Payer: Aetna Commercial |
$17,257.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16,490.05
|
| Rate for Payer: Aetna Managed Medicare |
$19,292.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,394.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,394.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,919.20
|
| Rate for Payer: Anthem Medicare Advantage |
$19,292.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10,162.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19,292.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19,292.02
|
| Rate for Payer: Cash Price |
$5,531.10
|
| Rate for Payer: Cash Price |
$5,531.10
|
| Rate for Payer: Cash Price |
$5,531.10
|
| Rate for Payer: Cigna Commercial |
$17,640.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$19,292.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$19,292.02
|
| Rate for Payer: Health EOS Commercial |
$17,065.29
|
| Rate for Payer: HFN Commercial |
$17,640.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$71,766.32
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19,292.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19,292.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$19,292.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$19,292.02
|
| Rate for Payer: Multiplan Commercial |
$15,339.58
|
| Rate for Payer: NAPHCARE Commercial |
$28,938.03
|
| Rate for Payer: Preferred Network Access Commercial |
$17,640.52
|
| Rate for Payer: Quartz Beloit One Network |
$9,395.50
|
| Rate for Payer: Quartz Commercial |
$12,463.41
|
| Rate for Payer: Quartz Medicare Advantage |
$19,292.02
|
| Rate for Payer: The Alliance Commercial |
$77,168.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,292.02
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$10,545.96
|
| Rate for Payer: Wellcare Medicare |
$19,292.02
|
| Rate for Payer: WPS Commercial |
$14,202.02
|
|
|
Arterial Coiling Not Hemorrhage or Tumor
|
Facility
|
IP
|
$18,437.00
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
4597126
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,395.50 |
| Max. Negotiated Rate |
$17,640.52 |
| Rate for Payer: Aetna Commercial |
$17,257.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16,490.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10,162.47
|
| Rate for Payer: Cash Price |
$5,531.10
|
| Rate for Payer: Cigna Commercial |
$17,640.52
|
| Rate for Payer: Health EOS Commercial |
$17,065.29
|
| Rate for Payer: HFN Commercial |
$17,640.52
|
| Rate for Payer: Multiplan Commercial |
$15,339.58
|
| Rate for Payer: Preferred Network Access Commercial |
$17,640.52
|
| Rate for Payer: Quartz Beloit One Network |
$9,395.50
|
| Rate for Payer: Quartz Commercial |
$11,504.69
|
| Rate for Payer: WEA Trust Commercial |
$10,545.96
|
| Rate for Payer: WPS Commercial |
$14,202.02
|
|
|
ARTERIAL LINE PLACEMENT
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959832
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$292.95 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Aetna Managed Medicare |
$292.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$680.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$523.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$502.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$585.49
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$784.68
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: NAPHCARE Commercial |
$627.74
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$680.06
|
| Rate for Payer: Quartz Medicare Advantage |
$627.74
|
| Rate for Payer: The Alliance Commercial |
$523.12
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
ARTERIAL LINE PLACEMENT
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959832
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.66 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$627.74
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
Arterial Monit 3-6 Hrs
|
Facility
|
OP
|
$2,407.00
|
|
| Hospital Charge Code |
3101754
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$700.92 |
| Max. Negotiated Rate |
$2,303.02 |
| Rate for Payer: Aetna Commercial |
$2,252.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,152.82
|
| Rate for Payer: Aetna Managed Medicare |
$700.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,627.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,251.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,201.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,326.74
|
| Rate for Payer: Cash Price |
$722.10
|
| Rate for Payer: Cigna Commercial |
$2,303.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,400.87
|
| Rate for Payer: Health EOS Commercial |
$2,227.92
|
| Rate for Payer: HFN Commercial |
$2,303.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,877.46
|
| Rate for Payer: Multiplan Commercial |
$2,002.62
|
| Rate for Payer: NAPHCARE Commercial |
$1,501.97
|
| Rate for Payer: Preferred Network Access Commercial |
$2,303.02
|
| Rate for Payer: Quartz Beloit One Network |
$1,226.61
|
| Rate for Payer: Quartz Commercial |
$1,627.13
|
| Rate for Payer: Quartz Medicare Advantage |
$1,501.97
|
| Rate for Payer: The Alliance Commercial |
$1,251.64
|
| Rate for Payer: WEA Trust Commercial |
$1,376.80
|
| Rate for Payer: WPS Commercial |
$1,854.11
|
|
|
Arterial Monit 3-6 Hrs
|
Facility
|
IP
|
$2,407.00
|
|
| Hospital Charge Code |
3101754
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,226.61 |
| Max. Negotiated Rate |
$2,303.02 |
| Rate for Payer: Aetna Commercial |
$2,252.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,152.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,326.74
|
| Rate for Payer: Cash Price |
$722.10
|
| Rate for Payer: Cigna Commercial |
$2,303.02
|
| Rate for Payer: Health EOS Commercial |
$2,227.92
|
| Rate for Payer: HFN Commercial |
$2,303.02
|
| Rate for Payer: Multiplan Commercial |
$2,002.62
|
| Rate for Payer: Preferred Network Access Commercial |
$2,303.02
|
| Rate for Payer: Quartz Beloit One Network |
$1,226.61
|
| Rate for Payer: Quartz Commercial |
$1,501.97
|
| Rate for Payer: WEA Trust Commercial |
$1,376.80
|
| Rate for Payer: WPS Commercial |
$1,854.11
|
|
|
Arterial Monitor Over 6 Hrs
|
Facility
|
IP
|
$3,566.00
|
|
| Hospital Charge Code |
3101755
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,817.23 |
| Max. Negotiated Rate |
$3,411.95 |
| Rate for Payer: Aetna Commercial |
$3,337.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,189.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,965.58
|
| Rate for Payer: Cash Price |
$1,069.80
|
| Rate for Payer: Cigna Commercial |
$3,411.95
|
| Rate for Payer: Health EOS Commercial |
$3,300.69
|
| Rate for Payer: HFN Commercial |
$3,411.95
|
| Rate for Payer: Multiplan Commercial |
$2,966.91
|
| Rate for Payer: Preferred Network Access Commercial |
$3,411.95
|
| Rate for Payer: Quartz Beloit One Network |
$1,817.23
|
| Rate for Payer: Quartz Commercial |
$2,225.18
|
| Rate for Payer: WEA Trust Commercial |
$2,039.75
|
| Rate for Payer: WPS Commercial |
$2,746.89
|
|
|
Arterial Monitor Over 6 Hrs
|
Facility
|
OP
|
$3,566.00
|
|
| Hospital Charge Code |
3101755
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,038.42 |
| Max. Negotiated Rate |
$3,411.95 |
| Rate for Payer: Aetna Commercial |
$3,337.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,189.43
|
| Rate for Payer: Aetna Managed Medicare |
$1,038.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,410.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,854.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,780.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,965.58
|
| Rate for Payer: Cash Price |
$1,069.80
|
| Rate for Payer: Cigna Commercial |
$3,411.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,075.41
|
| Rate for Payer: Health EOS Commercial |
$3,300.69
|
| Rate for Payer: HFN Commercial |
$3,411.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,781.48
|
| Rate for Payer: Multiplan Commercial |
$2,966.91
|
| Rate for Payer: NAPHCARE Commercial |
$2,225.18
|
| Rate for Payer: Preferred Network Access Commercial |
$3,411.95
|
| Rate for Payer: Quartz Beloit One Network |
$1,817.23
|
| Rate for Payer: Quartz Commercial |
$2,410.62
|
| Rate for Payer: Quartz Medicare Advantage |
$2,225.18
|
| Rate for Payer: The Alliance Commercial |
$1,854.32
|
| Rate for Payer: WEA Trust Commercial |
$2,039.75
|
| Rate for Payer: WPS Commercial |
$2,746.89
|
|
|
Arterial Monit To 3Hrs
|
Facility
|
OP
|
$1,539.00
|
|
| Hospital Charge Code |
3101753
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$448.16 |
| Max. Negotiated Rate |
$1,472.52 |
| Rate for Payer: Aetna Commercial |
$1,440.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,376.48
|
| Rate for Payer: Aetna Managed Medicare |
$448.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,040.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$800.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$768.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$848.30
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cigna Commercial |
$1,472.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$895.70
|
| Rate for Payer: Health EOS Commercial |
$1,424.50
|
| Rate for Payer: HFN Commercial |
$1,472.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,200.42
|
| Rate for Payer: Multiplan Commercial |
$1,280.45
|
| Rate for Payer: NAPHCARE Commercial |
$960.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,472.52
|
| Rate for Payer: Quartz Beloit One Network |
$784.27
|
| Rate for Payer: Quartz Commercial |
$1,040.36
|
| Rate for Payer: Quartz Medicare Advantage |
$960.34
|
| Rate for Payer: The Alliance Commercial |
$800.28
|
| Rate for Payer: WEA Trust Commercial |
$880.31
|
| Rate for Payer: WPS Commercial |
$1,185.49
|
|
|
Arterial Monit To 3Hrs
|
Facility
|
IP
|
$1,539.00
|
|
| Hospital Charge Code |
3101753
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$784.27 |
| Max. Negotiated Rate |
$1,472.52 |
| Rate for Payer: Aetna Commercial |
$1,440.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,376.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$848.30
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cigna Commercial |
$1,472.52
|
| Rate for Payer: Health EOS Commercial |
$1,424.50
|
| Rate for Payer: HFN Commercial |
$1,472.52
|
| Rate for Payer: Multiplan Commercial |
$1,280.45
|
| Rate for Payer: Preferred Network Access Commercial |
$1,472.52
|
| Rate for Payer: Quartz Beloit One Network |
$784.27
|
| Rate for Payer: Quartz Commercial |
$960.34
|
| Rate for Payer: WEA Trust Commercial |
$880.31
|
| Rate for Payer: WPS Commercial |
$1,185.49
|
|
|
Arterial Puncture 36600
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
1188800
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.98 |
| Max. Negotiated Rate |
$116.58 |
| Rate for Payer: Aetna Commercial |
$116.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$105.54
|
| Rate for Payer: Aetna Managed Medicare |
$12.98
|
| Rate for Payer: Anthem Medicare Advantage |
$12.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.98
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$116.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.98
|
| Rate for Payer: Health EOS Commercial |
$111.68
|
| Rate for Payer: HFN Commercial |
$116.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$54.59
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$54.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.98
|
| Rate for Payer: Multiplan Commercial |
$98.18
|
| Rate for Payer: NAPHCARE Commercial |
$19.47
|
| Rate for Payer: Preferred Network Access Commercial |
$116.58
|
| Rate for Payer: Quartz Beloit One Network |
$54.00
|
| Rate for Payer: Quartz Commercial |
$69.95
|
| Rate for Payer: Quartz Medicare Advantage |
$12.98
|
| Rate for Payer: The Alliance Commercial |
$55.16
|
| Rate for Payer: United Healthcare Medicaid |
$25.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.98
|
| Rate for Payer: WEA Trust Commercial |
$67.50
|
| Rate for Payer: WPS Commercial |
$58.41
|
|
|
Arterial Puncture Withdrawal Blood DX
|
Facility
|
IP
|
$158.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4524643
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$80.52 |
| Max. Negotiated Rate |
$151.17 |
| Rate for Payer: Aetna Commercial |
$147.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$141.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$87.09
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cigna Commercial |
$151.17
|
| Rate for Payer: Health EOS Commercial |
$146.24
|
| Rate for Payer: HFN Commercial |
$151.17
|
| Rate for Payer: Multiplan Commercial |
$131.46
|
| Rate for Payer: Preferred Network Access Commercial |
$151.17
|
| Rate for Payer: Quartz Beloit One Network |
$80.52
|
| Rate for Payer: Quartz Commercial |
$98.59
|
| Rate for Payer: WEA Trust Commercial |
$90.38
|
| Rate for Payer: WPS Commercial |
$121.71
|
|
|
Arterial Puncture Withdrawal Blood DX
|
Facility
|
OP
|
$158.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4524643
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$78.87 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$147.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$141.32
|
| Rate for Payer: Aetna Managed Medicare |
$140.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$106.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$82.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$78.87
|
| Rate for Payer: Anthem Medicare Advantage |
$140.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$87.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$140.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$140.02
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cigna Commercial |
$151.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$140.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$140.02
|
| Rate for Payer: Health EOS Commercial |
$146.24
|
| Rate for Payer: HFN Commercial |
$151.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$520.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$140.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$140.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$140.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$140.02
|
| Rate for Payer: Multiplan Commercial |
$131.46
|
| Rate for Payer: NAPHCARE Commercial |
$210.02
|
| Rate for Payer: Preferred Network Access Commercial |
$151.17
|
| Rate for Payer: Quartz Beloit One Network |
$80.52
|
| Rate for Payer: Quartz Commercial |
$106.81
|
| Rate for Payer: Quartz Medicare Advantage |
$140.02
|
| Rate for Payer: The Alliance Commercial |
$560.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$140.02
|
| Rate for Payer: United Healthcare PPO |
$123.24
|
| Rate for Payer: WEA Trust Commercial |
$90.38
|
| Rate for Payer: Wellcare Medicare |
$140.02
|
| Rate for Payer: WPS Commercial |
$121.71
|
|
|
Arterial Puncture Withdrawal Blood DX
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4524643
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$12.98 |
| Max. Negotiated Rate |
$156.10 |
| Rate for Payer: Aetna Commercial |
$156.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$141.32
|
| Rate for Payer: Aetna Managed Medicare |
$12.98
|
| Rate for Payer: Anthem Medicare Advantage |
$12.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.98
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cigna Commercial |
$156.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.98
|
| Rate for Payer: Health EOS Commercial |
$149.53
|
| Rate for Payer: HFN Commercial |
$156.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$54.59
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$54.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.98
|
| Rate for Payer: Multiplan Commercial |
$131.46
|
| Rate for Payer: NAPHCARE Commercial |
$19.47
|
| Rate for Payer: Preferred Network Access Commercial |
$156.10
|
| Rate for Payer: Quartz Beloit One Network |
$72.30
|
| Rate for Payer: Quartz Commercial |
$93.66
|
| Rate for Payer: Quartz Medicare Advantage |
$12.98
|
| Rate for Payer: The Alliance Commercial |
$55.16
|
| Rate for Payer: United Healthcare Medicaid |
$25.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.98
|
| Rate for Payer: WEA Trust Commercial |
$90.38
|
| Rate for Payer: WPS Commercial |
$58.41
|
|
|
Arterial/Venous Coiling for Hemorrhage
|
Facility
|
OP
|
$13,260.00
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
4597128
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,757.30 |
| Max. Negotiated Rate |
$48,595.91 |
| Rate for Payer: Aetna Commercial |
$12,411.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$11,859.74
|
| Rate for Payer: Aetna Managed Medicare |
$12,148.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,394.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,394.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,919.20
|
| Rate for Payer: Anthem Medicare Advantage |
$12,148.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,308.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,148.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,148.98
|
| Rate for Payer: Cash Price |
$3,978.00
|
| Rate for Payer: Cash Price |
$3,978.00
|
| Rate for Payer: Cash Price |
$3,978.00
|
| Rate for Payer: Cigna Commercial |
$12,687.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,148.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,148.98
|
| Rate for Payer: Health EOS Commercial |
$12,273.46
|
| Rate for Payer: HFN Commercial |
$12,687.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$45,194.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,148.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,148.98
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,148.98
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,148.98
|
| Rate for Payer: Multiplan Commercial |
$11,032.32
|
| Rate for Payer: NAPHCARE Commercial |
$18,223.47
|
| Rate for Payer: Preferred Network Access Commercial |
$12,687.17
|
| Rate for Payer: Quartz Beloit One Network |
$6,757.30
|
| Rate for Payer: Quartz Commercial |
$8,963.76
|
| Rate for Payer: Quartz Medicare Advantage |
$12,148.98
|
| Rate for Payer: The Alliance Commercial |
$48,595.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,148.98
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$7,584.72
|
| Rate for Payer: Wellcare Medicare |
$12,148.98
|
| Rate for Payer: WPS Commercial |
$10,214.18
|
|
|
Arterial/Venous Coiling for Hemorrhage
|
Facility
|
IP
|
$13,260.00
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
4597128
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,757.30 |
| Max. Negotiated Rate |
$12,687.17 |
| Rate for Payer: Aetna Commercial |
$12,411.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$11,859.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,308.91
|
| Rate for Payer: Cash Price |
$3,978.00
|
| Rate for Payer: Cigna Commercial |
$12,687.17
|
| Rate for Payer: Health EOS Commercial |
$12,273.46
|
| Rate for Payer: HFN Commercial |
$12,687.17
|
| Rate for Payer: Multiplan Commercial |
$11,032.32
|
| Rate for Payer: Preferred Network Access Commercial |
$12,687.17
|
| Rate for Payer: Quartz Beloit One Network |
$6,757.30
|
| Rate for Payer: Quartz Commercial |
$8,274.24
|
| Rate for Payer: WEA Trust Commercial |
$7,584.72
|
| Rate for Payer: WPS Commercial |
$10,214.18
|
|
|
ARTERIOVENOUS ANASTOMOSIS, OPEN; BY FOREARM VEIN TRANSPOSITION
|
Facility
|
OP
|
$23,424.04
|
|
|
Service Code
|
CPT 36820
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,409.60 |
| Max. Negotiated Rate |
$23,424.04 |
| Rate for Payer: Aetna Managed Medicare |
$5,856.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$12,727.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11,350.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,781.68
|
| Rate for Payer: Anthem Medicare Advantage |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,856.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,856.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,856.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,784.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,856.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,856.01
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,856.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,856.01
|
| Rate for Payer: NAPHCARE Commercial |
$8,784.02
|
| Rate for Payer: Quartz Medicare Advantage |
$5,856.01
|
| Rate for Payer: The Alliance Commercial |
$23,424.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,856.01
|
| Rate for Payer: United Healthcare PPO |
$4,409.60
|
| Rate for Payer: Wellcare Medicare |
$5,856.01
|
|
|
ARTERIOVENOUS ANASTOMOSIS, OPEN; DIRECT, ANY SITE (EG, CIMINO TYPE) (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$13,291.62
|
|
|
Service Code
|
CPT 36821
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| 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 Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| 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: NAPHCARE Commercial |
$4,984.36
|
| 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: Wellcare Medicare |
$3,322.90
|
|
|
ARTERIOVENOUS FISTULA CREATION OR REVISION FOR HEMODIALYSIS
|
Facility
|
OP
|
$1,814.77
|
|
|
Service Code
|
EAPG 00059
|
| Min. Negotiated Rate |
$1,744.96 |
| Max. Negotiated Rate |
$1,814.77 |
| Rate for Payer: Anthem Medicaid |
$1,744.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$1,744.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,744.96
|
| Rate for Payer: Dean Health Medicaid |
$1,744.96
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$1,744.96
|
| Rate for Payer: Managed Health Services Medicaid |
$1,814.77
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,744.96
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$1,744.96
|
| Rate for Payer: United Healthcare Medicaid |
$1,744.96
|
|
|
ARTERIOVENOUS FISTULA/GRAFT/DECLOTTING
|
Facility
|
OP
|
$13,026.00
|
|
| Hospital Charge Code |
2959835
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,793.17 |
| Max. Negotiated Rate |
$12,463.28 |
| Rate for Payer: Aetna Commercial |
$12,192.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$11,650.45
|
| Rate for Payer: Aetna Managed Medicare |
$3,793.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$8,805.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6,773.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6,502.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,179.93
|
| Rate for Payer: Cash Price |
$3,907.80
|
| Rate for Payer: Cigna Commercial |
$12,463.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,581.13
|
| Rate for Payer: Health EOS Commercial |
$12,056.87
|
| Rate for Payer: HFN Commercial |
$12,463.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,160.28
|
| Rate for Payer: Multiplan Commercial |
$10,837.63
|
| Rate for Payer: NAPHCARE Commercial |
$8,128.22
|
| Rate for Payer: Preferred Network Access Commercial |
$12,463.28
|
| Rate for Payer: Quartz Beloit One Network |
$6,638.05
|
| Rate for Payer: Quartz Commercial |
$8,805.58
|
| Rate for Payer: Quartz Medicare Advantage |
$8,128.22
|
| Rate for Payer: The Alliance Commercial |
$6,773.52
|
| Rate for Payer: WEA Trust Commercial |
$7,450.87
|
| Rate for Payer: WPS Commercial |
$10,033.93
|
|
|
ARTERIOVENOUS FISTULA/GRAFT/DECLOTTING
|
Facility
|
IP
|
$13,026.00
|
|
| Hospital Charge Code |
2959835
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,638.05 |
| Max. Negotiated Rate |
$12,463.28 |
| Rate for Payer: Aetna Commercial |
$12,192.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$11,650.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,179.93
|
| Rate for Payer: Cash Price |
$3,907.80
|
| Rate for Payer: Cigna Commercial |
$12,463.28
|
| Rate for Payer: Health EOS Commercial |
$12,056.87
|
| Rate for Payer: HFN Commercial |
$12,463.28
|
| Rate for Payer: Multiplan Commercial |
$10,837.63
|
| Rate for Payer: Preferred Network Access Commercial |
$12,463.28
|
| Rate for Payer: Quartz Beloit One Network |
$6,638.05
|
| Rate for Payer: Quartz Commercial |
$8,128.22
|
| Rate for Payer: WEA Trust Commercial |
$7,450.87
|
| Rate for Payer: WPS Commercial |
$10,033.93
|
|
|
Artery-vein nonautograft
|
Facility
|
IP
|
$12,095.00
|
|
|
Service Code
|
CPT 36830
|
| Hospital Charge Code |
5608014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,163.61 |
| Max. Negotiated Rate |
$11,572.50 |
| Rate for Payer: Aetna Commercial |
$11,320.92
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,817.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,666.76
|
| Rate for Payer: Cash Price |
$3,628.50
|
| Rate for Payer: Cigna Commercial |
$11,572.50
|
| Rate for Payer: Health EOS Commercial |
$11,195.13
|
| Rate for Payer: HFN Commercial |
$11,572.50
|
| Rate for Payer: Multiplan Commercial |
$10,063.04
|
| Rate for Payer: Preferred Network Access Commercial |
$11,572.50
|
| Rate for Payer: Quartz Beloit One Network |
$6,163.61
|
| Rate for Payer: Quartz Commercial |
$7,547.28
|
| Rate for Payer: WEA Trust Commercial |
$6,918.34
|
| Rate for Payer: WPS Commercial |
$9,316.78
|
|
|
Artery-vein nonautograft
|
Facility
|
OP
|
$12,095.00
|
|
|
Service Code
|
CPT 36830
|
| Hospital Charge Code |
5608014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,409.60 |
| Max. Negotiated Rate |
$23,424.04 |
| Rate for Payer: Aetna Commercial |
$11,320.92
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,817.77
|
| Rate for Payer: Aetna Managed Medicare |
$5,856.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$12,727.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11,350.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,781.68
|
| Rate for Payer: Anthem Medicare Advantage |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,666.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,856.01
|
| Rate for Payer: Cash Price |
$3,628.50
|
| Rate for Payer: Cash Price |
$3,628.50
|
| Rate for Payer: Cash Price |
$3,628.50
|
| Rate for Payer: Cigna Commercial |
$11,572.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,856.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,107.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,856.01
|
| Rate for Payer: Health EOS Commercial |
$11,195.13
|
| Rate for Payer: HFN Commercial |
$11,572.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,784.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,856.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,856.01
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,856.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,856.01
|
| Rate for Payer: Multiplan Commercial |
$10,063.04
|
| Rate for Payer: NAPHCARE Commercial |
$8,784.02
|
| Rate for Payer: Preferred Network Access Commercial |
$11,572.50
|
| Rate for Payer: Quartz Beloit One Network |
$6,163.61
|
| Rate for Payer: Quartz Commercial |
$8,176.22
|
| Rate for Payer: Quartz Medicare Advantage |
$5,856.01
|
| Rate for Payer: The Alliance Commercial |
$23,424.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,856.01
|
| Rate for Payer: United Healthcare PPO |
$4,409.60
|
| Rate for Payer: WEA Trust Commercial |
$6,918.34
|
| Rate for Payer: Wellcare Medicare |
$5,856.01
|
| Rate for Payer: WPS Commercial |
$9,316.78
|
|
|
Artery X-Rays,Arms/Legs 7571626
|
Professional
|
Both
|
$1,081.00
|
|
|
Service Code
|
CPT 75716 26
|
| Hospital Charge Code |
3568169
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$87.91 |
| Max. Negotiated Rate |
$1,068.03 |
| Rate for Payer: Aetna Commercial |
$1,068.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$966.85
|
| Rate for Payer: Aetna Managed Medicare |
$87.91
|
| Rate for Payer: Anthem Medicare Advantage |
$87.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$87.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$87.91
|
| Rate for Payer: Cash Price |
$324.30
|
| Rate for Payer: Cash Price |
$324.30
|
| Rate for Payer: Cash Price |
$324.30
|
| Rate for Payer: Cigna Commercial |
$1,068.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$562.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$87.91
|
| Rate for Payer: Health EOS Commercial |
$1,023.06
|
| Rate for Payer: HFN Commercial |
$1,068.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$326.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$326.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$87.91
|
| Rate for Payer: Multiplan Commercial |
$899.39
|
| Rate for Payer: NAPHCARE Commercial |
$131.87
|
| Rate for Payer: Preferred Network Access Commercial |
$1,068.03
|
| Rate for Payer: Quartz Beloit One Network |
$494.67
|
| Rate for Payer: Quartz Commercial |
$640.82
|
| Rate for Payer: Quartz Medicare Advantage |
$87.91
|
| Rate for Payer: The Alliance Commercial |
$334.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$87.91
|
| Rate for Payer: WEA Trust Commercial |
$618.33
|
| Rate for Payer: WPS Commercial |
$439.56
|
|
