|
Rh Typing
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
2952721
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.35 |
| Max. Negotiated Rate |
$105.80 |
| Rate for Payer: Aetna Commercial |
$103.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.95
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cigna Commercial |
$105.80
|
| Rate for Payer: Health EOS Commercial |
$102.35
|
| Rate for Payer: HFN Commercial |
$105.80
|
| Rate for Payer: Multiplan Commercial |
$92.00
|
| Rate for Payer: NAPHCARE Commercial |
$69.00
|
| Rate for Payer: Preferred Network Access Commercial |
$105.80
|
| Rate for Payer: Quartz Beloit One Network |
$56.35
|
| Rate for Payer: Quartz Commercial |
$69.00
|
| Rate for Payer: WEA Trust Commercial |
$63.25
|
| Rate for Payer: WPS Commercial |
$85.18
|
|
|
RHYTHM ECG WITH REPORT 93040
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
CPT 93040
|
| Hospital Charge Code |
3015357
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.70 |
| Max. Negotiated Rate |
$74.10 |
| Rate for Payer: Aetna Commercial |
$74.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.08
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$74.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$46.80
|
| Rate for Payer: Health EOS Commercial |
$70.98
|
| Rate for Payer: HFN Commercial |
$74.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$42.40
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Preferred Network Access Commercial |
$74.10
|
| Rate for Payer: Quartz Beloit One Network |
$34.32
|
| Rate for Payer: Quartz Commercial |
$44.46
|
| Rate for Payer: The Alliance Commercial |
$39.00
|
| Rate for Payer: United Healthcare Medicaid |
$13.70
|
| Rate for Payer: WEA Trust Commercial |
$42.90
|
| Rate for Payer: WPS Commercial |
$57.77
|
|
|
RHYTHM EEG - 1-3 LEADS
|
Facility
|
IP
|
$5,791.00
|
|
|
Service Code
|
CPT 95819
|
| Hospital Charge Code |
3058220
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,837.59 |
| Max. Negotiated Rate |
$5,327.72 |
| Rate for Payer: Aetna Commercial |
$5,211.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,980.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,069.23
|
| Rate for Payer: Cash Price |
$1,737.30
|
| Rate for Payer: Cigna Commercial |
$5,327.72
|
| Rate for Payer: Health EOS Commercial |
$5,153.99
|
| Rate for Payer: HFN Commercial |
$5,327.72
|
| Rate for Payer: Multiplan Commercial |
$4,632.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,474.60
|
| Rate for Payer: Preferred Network Access Commercial |
$5,327.72
|
| Rate for Payer: Quartz Beloit One Network |
$2,837.59
|
| Rate for Payer: Quartz Commercial |
$3,474.60
|
| Rate for Payer: WEA Trust Commercial |
$3,185.05
|
| Rate for Payer: WPS Commercial |
$4,289.39
|
|
|
RHYTHM EEG - 1-3 LEADS
|
Facility
|
OP
|
$5,791.00
|
|
|
Service Code
|
CPT 95819
|
| Hospital Charge Code |
3058220
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$310.24 |
| Max. Negotiated Rate |
$5,327.72 |
| Rate for Payer: Aetna Commercial |
$5,211.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,980.26
|
| Rate for Payer: Aetna Managed Medicare |
$310.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,764.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,895.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,779.68
|
| Rate for Payer: Anthem Medicare Advantage |
$310.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,069.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$310.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$310.24
|
| Rate for Payer: Cash Price |
$1,737.30
|
| Rate for Payer: Cash Price |
$1,737.30
|
| Rate for Payer: Cigna Commercial |
$5,327.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$310.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,240.64
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$310.24
|
| Rate for Payer: Health EOS Commercial |
$5,153.99
|
| Rate for Payer: HFN Commercial |
$5,327.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,154.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$310.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$310.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$310.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$310.24
|
| Rate for Payer: Multiplan Commercial |
$4,632.80
|
| Rate for Payer: NAPHCARE Commercial |
$465.36
|
| Rate for Payer: Preferred Network Access Commercial |
$5,327.72
|
| Rate for Payer: Quartz Beloit One Network |
$2,837.59
|
| Rate for Payer: Quartz Commercial |
$3,764.15
|
| Rate for Payer: Quartz Medicare Advantage |
$310.24
|
| Rate for Payer: The Alliance Commercial |
$1,240.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$310.24
|
| Rate for Payer: United Healthcare PPO |
$4,343.25
|
| Rate for Payer: WEA Trust Commercial |
$3,185.05
|
| Rate for Payer: Wellcare Medicare |
$310.24
|
| Rate for Payer: WPS Commercial |
$4,289.39
|
|
|
Ribonucleoprotein Antibody
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
978057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$95.06 |
| Max. Negotiated Rate |
$178.48 |
| Rate for Payer: Aetna Commercial |
$174.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$166.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$102.82
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Cigna Commercial |
$178.48
|
| Rate for Payer: Health EOS Commercial |
$172.66
|
| Rate for Payer: HFN Commercial |
$178.48
|
| Rate for Payer: Multiplan Commercial |
$155.20
|
| Rate for Payer: NAPHCARE Commercial |
$116.40
|
| Rate for Payer: Preferred Network Access Commercial |
$178.48
|
| Rate for Payer: Quartz Beloit One Network |
$95.06
|
| Rate for Payer: Quartz Commercial |
$116.40
|
| Rate for Payer: WEA Trust Commercial |
$106.70
|
| Rate for Payer: WPS Commercial |
$143.70
|
|
|
Ribonucleoprotein Antibody
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
978057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.29 |
| Max. Negotiated Rate |
$184.30 |
| Rate for Payer: Aetna Commercial |
$184.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$166.84
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Cigna Commercial |
$184.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$97.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$116.40
|
| Rate for Payer: Health EOS Commercial |
$176.54
|
| Rate for Payer: HFN Commercial |
$184.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.29
|
| Rate for Payer: Multiplan Commercial |
$155.20
|
| Rate for Payer: Preferred Network Access Commercial |
$184.30
|
| Rate for Payer: Quartz Beloit One Network |
$85.36
|
| Rate for Payer: Quartz Commercial |
$110.58
|
| Rate for Payer: The Alliance Commercial |
$97.00
|
| Rate for Payer: WEA Trust Commercial |
$106.70
|
| Rate for Payer: WPS Commercial |
$143.70
|
|
|
Ribonucleoprotein Antibody
|
Facility
|
OP
|
$194.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
978057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$178.48 |
| Rate for Payer: Aetna Commercial |
$174.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$166.84
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.76
|
| Rate for Payer: Anthem Medicaid |
$18.53
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$102.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Cigna Commercial |
$178.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$108.56
|
| Rate for Payer: Dean Health Medicaid |
$18.53
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$172.66
|
| Rate for Payer: HFN Commercial |
$178.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Managed Health Services Medicaid |
$19.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$155.20
|
| Rate for Payer: NAPHCARE Commercial |
$26.90
|
| Rate for Payer: Preferred Network Access Commercial |
$178.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$18.53
|
| Rate for Payer: Quartz Beloit One Network |
$95.06
|
| Rate for Payer: Quartz Commercial |
$126.10
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$71.72
|
| Rate for Payer: United Healthcare Medicaid |
$18.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Healthcare PPO |
$145.50
|
| Rate for Payer: WEA Trust Commercial |
$106.70
|
| Rate for Payer: Wellcare Medicare |
$17.93
|
| Rate for Payer: WMAP Medicaid |
$18.53
|
| Rate for Payer: WPS Commercial |
$143.70
|
|
|
Ribosomal Antibody
|
Facility
|
IP
|
$62.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
5360653
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.38 |
| Max. Negotiated Rate |
$57.04 |
| Rate for Payer: Aetna Commercial |
$55.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$53.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$32.86
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cigna Commercial |
$57.04
|
| Rate for Payer: Health EOS Commercial |
$55.18
|
| Rate for Payer: HFN Commercial |
$57.04
|
| Rate for Payer: Multiplan Commercial |
$49.60
|
| Rate for Payer: NAPHCARE Commercial |
$37.20
|
| Rate for Payer: Preferred Network Access Commercial |
$57.04
|
| Rate for Payer: Quartz Beloit One Network |
$30.38
|
| Rate for Payer: Quartz Commercial |
$37.20
|
| Rate for Payer: WEA Trust Commercial |
$34.10
|
| Rate for Payer: WPS Commercial |
$45.92
|
|
|
Ribosomal Antibody
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
5360653
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.28 |
| Max. Negotiated Rate |
$58.90 |
| Rate for Payer: Aetna Commercial |
$58.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$53.32
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cigna Commercial |
$58.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$31.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$37.20
|
| Rate for Payer: Health EOS Commercial |
$56.42
|
| Rate for Payer: HFN Commercial |
$58.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$40.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$40.70
|
| Rate for Payer: Multiplan Commercial |
$49.60
|
| Rate for Payer: Preferred Network Access Commercial |
$58.90
|
| Rate for Payer: Quartz Beloit One Network |
$27.28
|
| Rate for Payer: Quartz Commercial |
$35.34
|
| Rate for Payer: The Alliance Commercial |
$31.00
|
| Rate for Payer: WEA Trust Commercial |
$34.10
|
| Rate for Payer: WPS Commercial |
$45.92
|
|
|
Ribosomal Antibody
|
Facility
|
OP
|
$62.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
5360653
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$57.04 |
| Rate for Payer: Aetna Commercial |
$55.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$53.32
|
| Rate for Payer: Aetna Managed Medicare |
$11.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$43.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20.18
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19.14
|
| Rate for Payer: Anthem Medicaid |
$11.91
|
| Rate for Payer: Anthem Medicare Advantage |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$32.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.53
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cigna Commercial |
$57.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$34.70
|
| Rate for Payer: Dean Health Medicaid |
$11.91
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11.53
|
| Rate for Payer: Health EOS Commercial |
$55.18
|
| Rate for Payer: HFN Commercial |
$57.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11.53
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11.91
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.53
|
| Rate for Payer: Managed Health Services Medicaid |
$12.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11.53
|
| Rate for Payer: Multiplan Commercial |
$49.60
|
| Rate for Payer: NAPHCARE Commercial |
$17.30
|
| Rate for Payer: Preferred Network Access Commercial |
$57.04
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$11.91
|
| Rate for Payer: Quartz Beloit One Network |
$30.38
|
| Rate for Payer: Quartz Commercial |
$40.30
|
| Rate for Payer: Quartz Medicare Advantage |
$11.53
|
| Rate for Payer: The Alliance Commercial |
$46.12
|
| Rate for Payer: United Healthcare Medicaid |
$11.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.53
|
| Rate for Payer: United Healthcare PPO |
$46.50
|
| Rate for Payer: WEA Trust Commercial |
$34.10
|
| Rate for Payer: Wellcare Medicare |
$11.53
|
| Rate for Payer: WMAP Medicaid |
$11.91
|
| Rate for Payer: WPS Commercial |
$45.92
|
|
|
Ribosomal P Antibody
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
983391
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.70 |
| Max. Negotiated Rate |
$318.25 |
| Rate for Payer: Aetna Commercial |
$318.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$288.10
|
| Rate for Payer: Cash Price |
$100.50
|
| Rate for Payer: Cash Price |
$100.50
|
| Rate for Payer: Cigna Commercial |
$318.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$167.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$201.00
|
| Rate for Payer: Health EOS Commercial |
$304.85
|
| Rate for Payer: HFN Commercial |
$318.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$40.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$40.70
|
| Rate for Payer: Multiplan Commercial |
$268.00
|
| Rate for Payer: Preferred Network Access Commercial |
$318.25
|
| Rate for Payer: Quartz Beloit One Network |
$147.40
|
| Rate for Payer: Quartz Commercial |
$190.95
|
| Rate for Payer: The Alliance Commercial |
$167.50
|
| Rate for Payer: WEA Trust Commercial |
$184.25
|
| Rate for Payer: WPS Commercial |
$248.13
|
|
|
Ribosomal P Antibody
|
Facility
|
IP
|
$335.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
983391
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$164.15 |
| Max. Negotiated Rate |
$308.20 |
| Rate for Payer: Aetna Commercial |
$301.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$288.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$177.55
|
| Rate for Payer: Cash Price |
$100.50
|
| Rate for Payer: Cigna Commercial |
$308.20
|
| Rate for Payer: Health EOS Commercial |
$298.15
|
| Rate for Payer: HFN Commercial |
$308.20
|
| Rate for Payer: Multiplan Commercial |
$268.00
|
| Rate for Payer: NAPHCARE Commercial |
$201.00
|
| Rate for Payer: Preferred Network Access Commercial |
$308.20
|
| Rate for Payer: Quartz Beloit One Network |
$164.15
|
| Rate for Payer: Quartz Commercial |
$201.00
|
| Rate for Payer: WEA Trust Commercial |
$184.25
|
| Rate for Payer: WPS Commercial |
$248.13
|
|
|
Ribosomal P Antibody
|
Facility
|
OP
|
$335.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
983391
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$308.20 |
| Rate for Payer: Aetna Commercial |
$301.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$288.10
|
| Rate for Payer: Aetna Managed Medicare |
$11.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$43.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20.18
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19.14
|
| Rate for Payer: Anthem Medicaid |
$11.91
|
| Rate for Payer: Anthem Medicare Advantage |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$177.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.53
|
| Rate for Payer: Cash Price |
$100.50
|
| Rate for Payer: Cash Price |
$100.50
|
| Rate for Payer: Cigna Commercial |
$308.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$187.47
|
| Rate for Payer: Dean Health Medicaid |
$11.91
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11.53
|
| Rate for Payer: Health EOS Commercial |
$298.15
|
| Rate for Payer: HFN Commercial |
$308.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11.53
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11.91
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.53
|
| Rate for Payer: Managed Health Services Medicaid |
$12.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11.53
|
| Rate for Payer: Multiplan Commercial |
$268.00
|
| Rate for Payer: NAPHCARE Commercial |
$17.30
|
| Rate for Payer: Preferred Network Access Commercial |
$308.20
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$11.91
|
| Rate for Payer: Quartz Beloit One Network |
$164.15
|
| Rate for Payer: Quartz Commercial |
$217.75
|
| Rate for Payer: Quartz Medicare Advantage |
$11.53
|
| Rate for Payer: The Alliance Commercial |
$46.12
|
| Rate for Payer: United Healthcare Medicaid |
$11.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.53
|
| Rate for Payer: United Healthcare PPO |
$251.25
|
| Rate for Payer: WEA Trust Commercial |
$184.25
|
| Rate for Payer: Wellcare Medicare |
$11.53
|
| Rate for Payer: WMAP Medicaid |
$11.91
|
| Rate for Payer: WPS Commercial |
$248.13
|
|
|
RIB RESECTION
|
Facility
|
IP
|
$3,935.00
|
|
| Hospital Charge Code |
2960357
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,928.15 |
| Max. Negotiated Rate |
$3,620.20 |
| Rate for Payer: Aetna Commercial |
$3,541.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,384.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,085.55
|
| Rate for Payer: Cash Price |
$1,180.50
|
| Rate for Payer: Cigna Commercial |
$3,620.20
|
| Rate for Payer: Health EOS Commercial |
$3,502.15
|
| Rate for Payer: HFN Commercial |
$3,620.20
|
| Rate for Payer: Multiplan Commercial |
$3,148.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,361.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,620.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,928.15
|
| Rate for Payer: Quartz Commercial |
$2,361.00
|
| Rate for Payer: WEA Trust Commercial |
$2,164.25
|
| Rate for Payer: WPS Commercial |
$2,914.65
|
|
|
RIB RESECTION
|
Facility
|
OP
|
$3,935.00
|
|
| Hospital Charge Code |
2960357
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,101.80 |
| Max. Negotiated Rate |
$15,740.00 |
| Rate for Payer: Aetna Commercial |
$3,541.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,384.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,101.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,557.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,967.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,888.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,085.55
|
| Rate for Payer: Cash Price |
$1,180.50
|
| Rate for Payer: Cigna Commercial |
$3,620.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,202.03
|
| Rate for Payer: Health EOS Commercial |
$3,502.15
|
| Rate for Payer: HFN Commercial |
$3,620.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,951.25
|
| Rate for Payer: Multiplan Commercial |
$3,148.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,361.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,620.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,928.15
|
| Rate for Payer: Quartz Commercial |
$2,557.75
|
| Rate for Payer: Quartz Medicare Advantage |
$2,361.00
|
| Rate for Payer: The Alliance Commercial |
$15,740.00
|
| Rate for Payer: WEA Trust Commercial |
$2,164.25
|
| Rate for Payer: WPS Commercial |
$2,914.65
|
|
|
Right - Ear, impacted cerumen removal
|
Facility
|
IP
|
$223.00
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
4612684
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$205.16 |
| Rate for Payer: Aetna Commercial |
$200.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$191.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$118.19
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$205.16
|
| Rate for Payer: Health EOS Commercial |
$198.47
|
| Rate for Payer: HFN Commercial |
$205.16
|
| Rate for Payer: Multiplan Commercial |
$178.40
|
| Rate for Payer: NAPHCARE Commercial |
$133.80
|
| Rate for Payer: Preferred Network Access Commercial |
$205.16
|
| Rate for Payer: Quartz Beloit One Network |
$109.27
|
| Rate for Payer: Quartz Commercial |
$133.80
|
| Rate for Payer: WEA Trust Commercial |
$122.65
|
| Rate for Payer: WPS Commercial |
$165.18
|
|
|
Right - Ear, impacted cerumen removal
|
Facility
|
OP
|
$223.00
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
4612684
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$60.46 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$200.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$191.78
|
| Rate for Payer: Aetna Managed Medicare |
$60.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$144.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$111.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$107.04
|
| Rate for Payer: Anthem Medicare Advantage |
$60.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$118.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$60.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$60.46
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$205.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$60.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$60.46
|
| Rate for Payer: Health EOS Commercial |
$198.47
|
| Rate for Payer: HFN Commercial |
$205.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$224.91
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$60.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$60.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$60.46
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$60.46
|
| Rate for Payer: Multiplan Commercial |
$178.40
|
| Rate for Payer: NAPHCARE Commercial |
$90.69
|
| Rate for Payer: Preferred Network Access Commercial |
$205.16
|
| Rate for Payer: Quartz Beloit One Network |
$109.27
|
| Rate for Payer: Quartz Commercial |
$144.95
|
| Rate for Payer: Quartz Medicare Advantage |
$60.46
|
| Rate for Payer: The Alliance Commercial |
$241.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$60.46
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$122.65
|
| Rate for Payer: Wellcare Medicare |
$60.46
|
| Rate for Payer: WPS Commercial |
$165.18
|
|
|
Rigid EO wo joints L3762
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS L3762
|
| Hospital Charge Code |
4590638
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$135.52 |
| Max. Negotiated Rate |
$346.72 |
| Rate for Payer: Aetna Commercial |
$292.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$264.88
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cigna Commercial |
$292.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$154.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$184.80
|
| Rate for Payer: Health EOS Commercial |
$280.28
|
| Rate for Payer: HFN Commercial |
$292.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$346.72
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$346.72
|
| Rate for Payer: Multiplan Commercial |
$246.40
|
| Rate for Payer: Preferred Network Access Commercial |
$292.60
|
| Rate for Payer: Quartz Beloit One Network |
$135.52
|
| Rate for Payer: Quartz Commercial |
$175.56
|
| Rate for Payer: The Alliance Commercial |
$154.00
|
| Rate for Payer: WEA Trust Commercial |
$169.40
|
| Rate for Payer: WPS Commercial |
$228.14
|
|
|
Rigid EO wo joints L3762
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
HCPCS L3762
|
| Hospital Charge Code |
4590638
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$150.92 |
| Max. Negotiated Rate |
$283.36 |
| Rate for Payer: Aetna Commercial |
$277.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$264.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$163.24
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cigna Commercial |
$283.36
|
| Rate for Payer: Health EOS Commercial |
$274.12
|
| Rate for Payer: HFN Commercial |
$283.36
|
| Rate for Payer: Multiplan Commercial |
$246.40
|
| Rate for Payer: NAPHCARE Commercial |
$184.80
|
| Rate for Payer: Preferred Network Access Commercial |
$283.36
|
| Rate for Payer: Quartz Beloit One Network |
$150.92
|
| Rate for Payer: Quartz Commercial |
$184.80
|
| Rate for Payer: WEA Trust Commercial |
$169.40
|
| Rate for Payer: WPS Commercial |
$228.14
|
|
|
Rigid EO wo joints L3762
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
HCPCS L3762
|
| Hospital Charge Code |
4590638
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$1,232.00 |
| Rate for Payer: Aetna Commercial |
$277.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$264.88
|
| Rate for Payer: Aetna Managed Medicare |
$86.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$43.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.85
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$43.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$163.24
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cigna Commercial |
$283.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$172.36
|
| Rate for Payer: Health EOS Commercial |
$274.12
|
| Rate for Payer: HFN Commercial |
$283.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$231.00
|
| Rate for Payer: Multiplan Commercial |
$246.40
|
| Rate for Payer: NAPHCARE Commercial |
$184.80
|
| Rate for Payer: Preferred Network Access Commercial |
$283.36
|
| Rate for Payer: Quartz Beloit One Network |
$150.92
|
| Rate for Payer: Quartz Commercial |
$200.20
|
| Rate for Payer: Quartz Medicare Advantage |
$184.80
|
| Rate for Payer: The Alliance Commercial |
$1,232.00
|
| Rate for Payer: WEA Trust Commercial |
$169.40
|
| Rate for Payer: WPS Commercial |
$228.14
|
|
|
RIMPLATE MATRIX MIDFACE ORBITAL 12HL 0.5MM THICK TI 04.503.343
|
Facility
|
IP
|
$2,502.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5264665
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,225.98 |
| Max. Negotiated Rate |
$2,301.84 |
| Rate for Payer: Aetna Commercial |
$2,251.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,151.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,326.06
|
| Rate for Payer: Cash Price |
$750.60
|
| Rate for Payer: Cigna Commercial |
$2,301.84
|
| Rate for Payer: Health EOS Commercial |
$2,226.78
|
| Rate for Payer: HFN Commercial |
$2,301.84
|
| Rate for Payer: Multiplan Commercial |
$2,001.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,501.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,301.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,225.98
|
| Rate for Payer: Quartz Commercial |
$1,501.20
|
| Rate for Payer: WEA Trust Commercial |
$1,376.10
|
| Rate for Payer: WPS Commercial |
$1,853.23
|
|
|
RIMPLATE MATRIX MIDFACE ORBITAL 12HL 0.5MM THICK TI 04.503.343
|
Facility
|
OP
|
$2,502.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5264665
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$700.56 |
| Max. Negotiated Rate |
$10,008.00 |
| Rate for Payer: Aetna Commercial |
$2,251.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,151.72
|
| Rate for Payer: Aetna Managed Medicare |
$700.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,626.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,251.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,200.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,326.06
|
| Rate for Payer: Cash Price |
$750.60
|
| Rate for Payer: Cigna Commercial |
$2,301.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,400.12
|
| Rate for Payer: Health EOS Commercial |
$2,226.78
|
| Rate for Payer: HFN Commercial |
$2,301.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,876.50
|
| Rate for Payer: Multiplan Commercial |
$2,001.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,501.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,301.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,225.98
|
| Rate for Payer: Quartz Commercial |
$1,626.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,501.20
|
| Rate for Payer: The Alliance Commercial |
$10,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,376.10
|
| Rate for Payer: WPS Commercial |
$1,853.23
|
|
|
RIMPLATE MATRIX MIDFACE ORBITAL 12HL 0.7MM THICK TI 04.503.373
|
Facility
|
IP
|
$2,465.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5384732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,207.85 |
| Max. Negotiated Rate |
$2,267.80 |
| Rate for Payer: Aetna Commercial |
$2,218.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,119.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,306.45
|
| Rate for Payer: Cash Price |
$739.50
|
| Rate for Payer: Cigna Commercial |
$2,267.80
|
| Rate for Payer: Health EOS Commercial |
$2,193.85
|
| Rate for Payer: HFN Commercial |
$2,267.80
|
| Rate for Payer: Multiplan Commercial |
$1,972.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,479.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,267.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,207.85
|
| Rate for Payer: Quartz Commercial |
$1,479.00
|
| Rate for Payer: WEA Trust Commercial |
$1,355.75
|
| Rate for Payer: WPS Commercial |
$1,825.83
|
|
|
RIMPLATE MATRIX MIDFACE ORBITAL 12HL 0.7MM THICK TI 04.503.373
|
Facility
|
OP
|
$2,465.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5384732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$690.20 |
| Max. Negotiated Rate |
$9,860.00 |
| Rate for Payer: Aetna Commercial |
$2,218.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,119.90
|
| Rate for Payer: Aetna Managed Medicare |
$690.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,602.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,232.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,183.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,306.45
|
| Rate for Payer: Cash Price |
$739.50
|
| Rate for Payer: Cigna Commercial |
$2,267.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,379.41
|
| Rate for Payer: Health EOS Commercial |
$2,193.85
|
| Rate for Payer: HFN Commercial |
$2,267.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,848.75
|
| Rate for Payer: Multiplan Commercial |
$1,972.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,479.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,267.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,207.85
|
| Rate for Payer: Quartz Commercial |
$1,602.25
|
| Rate for Payer: Quartz Medicare Advantage |
$1,479.00
|
| Rate for Payer: The Alliance Commercial |
$9,860.00
|
| Rate for Payer: WEA Trust Commercial |
$1,355.75
|
| Rate for Payer: WPS Commercial |
$1,825.83
|
|
|
RIMPLATE MATRIX ORBITAL 12HL 0.8MM THICK TI 04.503.397
|
Facility
|
OP
|
$5,270.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6226130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,475.60 |
| Max. Negotiated Rate |
$21,080.00 |
| Rate for Payer: Aetna Commercial |
$4,743.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,532.20
|
| Rate for Payer: Aetna Managed Medicare |
$1,475.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,425.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,635.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,529.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,793.10
|
| Rate for Payer: Cash Price |
$1,581.00
|
| Rate for Payer: Cigna Commercial |
$4,848.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,949.09
|
| Rate for Payer: Health EOS Commercial |
$4,690.30
|
| Rate for Payer: HFN Commercial |
$4,848.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,952.50
|
| Rate for Payer: Multiplan Commercial |
$4,216.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,162.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,848.40
|
| Rate for Payer: Quartz Beloit One Network |
$2,582.30
|
| Rate for Payer: Quartz Commercial |
$3,425.50
|
| Rate for Payer: Quartz Medicare Advantage |
$3,162.00
|
| Rate for Payer: The Alliance Commercial |
$21,080.00
|
| Rate for Payer: WEA Trust Commercial |
$2,898.50
|
| Rate for Payer: WPS Commercial |
$3,903.49
|
|
