|
RNP/SM to TheraTest
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2778817
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$82.05 |
| Rate for Payer: Aetna Commercial |
$53.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$48.30
|
| Rate for Payer: Aetna Managed Medicare |
$18.65
|
| Rate for Payer: Anthem Medicare Advantage |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.65
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna Commercial |
$53.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$28.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18.65
|
| Rate for Payer: Health EOS Commercial |
$51.11
|
| Rate for Payer: HFN Commercial |
$53.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$65.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$44.93
|
| Rate for Payer: NAPHCARE Commercial |
$27.97
|
| Rate for Payer: Preferred Network Access Commercial |
$53.35
|
| Rate for Payer: Quartz Beloit One Network |
$24.71
|
| Rate for Payer: Quartz Commercial |
$32.01
|
| Rate for Payer: Quartz Medicare Advantage |
$18.65
|
| Rate for Payer: The Alliance Commercial |
$73.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.65
|
| Rate for Payer: WEA Trust Commercial |
$30.89
|
| Rate for Payer: WPS Commercial |
$82.05
|
|
|
Rocephin 250 mg Charge
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
2472895
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$6.92 |
| Rate for Payer: Aetna Commercial |
$6.92
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.26
|
| Rate for Payer: Aetna Managed Medicare |
$0.48
|
| Rate for Payer: Anthem Medicare Advantage |
$0.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$0.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$0.48
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna Commercial |
$6.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$0.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$0.47
|
| Rate for Payer: Health EOS Commercial |
$6.62
|
| Rate for Payer: HFN Commercial |
$6.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$0.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$0.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$0.48
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: NAPHCARE Commercial |
$0.72
|
| Rate for Payer: Preferred Network Access Commercial |
$6.92
|
| Rate for Payer: Quartz Beloit One Network |
$3.20
|
| Rate for Payer: Quartz Commercial |
$4.15
|
| Rate for Payer: Quartz Medicare Advantage |
$0.48
|
| Rate for Payer: The Alliance Commercial |
$1.32
|
| Rate for Payer: United Healthcare Medicaid |
$0.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.48
|
| Rate for Payer: WEA Trust Commercial |
$4.00
|
| Rate for Payer: WPS Commercial |
$1.18
|
|
|
Rocephin 250 mg Charge
|
Facility
|
OP
|
$7.00
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
2472895
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Aetna Commercial |
$6.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.26
|
| Rate for Payer: Aetna Managed Medicare |
$2.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4.73
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3.86
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna Commercial |
$6.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$0.62
|
| Rate for Payer: Health EOS Commercial |
$6.48
|
| Rate for Payer: HFN Commercial |
$6.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5.46
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: NAPHCARE Commercial |
$4.37
|
| Rate for Payer: Preferred Network Access Commercial |
$6.70
|
| Rate for Payer: Quartz Beloit One Network |
$3.57
|
| Rate for Payer: Quartz Commercial |
$4.73
|
| Rate for Payer: Quartz Medicare Advantage |
$4.37
|
| Rate for Payer: The Alliance Commercial |
$1.91
|
| Rate for Payer: WEA Trust Commercial |
$4.00
|
| Rate for Payer: WPS Commercial |
$1.18
|
|
|
Rocephin 250 mg Charge
|
Facility
|
IP
|
$7.00
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
2472895
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.57 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Aetna Commercial |
$6.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3.86
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna Commercial |
$6.70
|
| Rate for Payer: Health EOS Commercial |
$6.48
|
| Rate for Payer: HFN Commercial |
$6.70
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: Preferred Network Access Commercial |
$6.70
|
| Rate for Payer: Quartz Beloit One Network |
$3.57
|
| Rate for Payer: Quartz Commercial |
$4.37
|
| Rate for Payer: WEA Trust Commercial |
$4.00
|
| Rate for Payer: WPS Commercial |
$5.39
|
|
|
Rocephin JW Waste Charge
|
Facility
|
OP
|
$7.00
|
|
|
Service Code
|
HCPCS J0696 JW
|
| Hospital Charge Code |
5246657
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Aetna Commercial |
$6.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.26
|
| Rate for Payer: Aetna Managed Medicare |
$2.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4.73
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3.86
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna Commercial |
$6.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$0.62
|
| Rate for Payer: Health EOS Commercial |
$6.48
|
| Rate for Payer: HFN Commercial |
$6.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5.46
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: NAPHCARE Commercial |
$4.37
|
| Rate for Payer: Preferred Network Access Commercial |
$6.70
|
| Rate for Payer: Quartz Beloit One Network |
$3.57
|
| Rate for Payer: Quartz Commercial |
$4.73
|
| Rate for Payer: Quartz Medicare Advantage |
$4.37
|
| Rate for Payer: The Alliance Commercial |
$3.64
|
| Rate for Payer: WEA Trust Commercial |
$4.00
|
| Rate for Payer: WPS Commercial |
$1.18
|
|
|
Rocephin JW Waste Charge
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS J0696 JW
|
| Hospital Charge Code |
5246657
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$6.92 |
| Rate for Payer: Aetna Commercial |
$6.92
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.26
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna Commercial |
$6.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$0.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$0.47
|
| Rate for Payer: Health EOS Commercial |
$6.62
|
| Rate for Payer: HFN Commercial |
$6.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$0.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$0.82
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: Preferred Network Access Commercial |
$6.92
|
| Rate for Payer: Quartz Beloit One Network |
$3.20
|
| Rate for Payer: Quartz Commercial |
$4.15
|
| Rate for Payer: The Alliance Commercial |
$3.64
|
| Rate for Payer: United Healthcare Medicaid |
$0.48
|
| Rate for Payer: WEA Trust Commercial |
$4.00
|
| Rate for Payer: WPS Commercial |
$1.18
|
|
|
Rocephin JW Waste Charge
|
Facility
|
IP
|
$7.00
|
|
|
Service Code
|
HCPCS J0696 JW
|
| Hospital Charge Code |
5246657
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.57 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Aetna Commercial |
$6.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3.86
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna Commercial |
$6.70
|
| Rate for Payer: Health EOS Commercial |
$6.48
|
| Rate for Payer: HFN Commercial |
$6.70
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: Preferred Network Access Commercial |
$6.70
|
| Rate for Payer: Quartz Beloit One Network |
$3.57
|
| Rate for Payer: Quartz Commercial |
$4.37
|
| Rate for Payer: WEA Trust Commercial |
$4.00
|
| Rate for Payer: WPS Commercial |
$5.39
|
|
|
ROCKER SHOES FOR FOOT RING LONG 140/155MM HOFFMANN LIMB 4934-8-140
|
Facility
|
IP
|
$7,722.00
|
|
| Hospital Charge Code |
5685635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,935.13 |
| Max. Negotiated Rate |
$7,388.41 |
| Rate for Payer: Aetna Commercial |
$7,227.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,906.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,256.37
|
| Rate for Payer: Cash Price |
$2,316.60
|
| Rate for Payer: Cigna Commercial |
$7,388.41
|
| Rate for Payer: Health EOS Commercial |
$7,147.48
|
| Rate for Payer: HFN Commercial |
$7,388.41
|
| Rate for Payer: Multiplan Commercial |
$6,424.70
|
| Rate for Payer: Preferred Network Access Commercial |
$7,388.41
|
| Rate for Payer: Quartz Beloit One Network |
$3,935.13
|
| Rate for Payer: Quartz Commercial |
$4,818.53
|
| Rate for Payer: WEA Trust Commercial |
$4,416.98
|
| Rate for Payer: WPS Commercial |
$5,948.26
|
|
|
ROCKER SHOES FOR FOOT RING LONG 140/155MM HOFFMANN LIMB 4934-8-140
|
Facility
|
OP
|
$7,722.00
|
|
| Hospital Charge Code |
5685635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,248.65 |
| Max. Negotiated Rate |
$7,388.41 |
| Rate for Payer: Aetna Commercial |
$7,227.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,906.56
|
| Rate for Payer: Aetna Managed Medicare |
$2,248.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,220.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,015.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,854.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,256.37
|
| Rate for Payer: Cash Price |
$2,316.60
|
| Rate for Payer: Cigna Commercial |
$7,388.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,494.20
|
| Rate for Payer: Health EOS Commercial |
$7,147.48
|
| Rate for Payer: HFN Commercial |
$7,388.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,023.16
|
| Rate for Payer: Multiplan Commercial |
$6,424.70
|
| Rate for Payer: NAPHCARE Commercial |
$4,818.53
|
| Rate for Payer: Preferred Network Access Commercial |
$7,388.41
|
| Rate for Payer: Quartz Beloit One Network |
$3,935.13
|
| Rate for Payer: Quartz Commercial |
$5,220.07
|
| Rate for Payer: Quartz Medicare Advantage |
$4,818.53
|
| Rate for Payer: The Alliance Commercial |
$4,015.44
|
| Rate for Payer: WEA Trust Commercial |
$4,416.98
|
| Rate for Payer: WPS Commercial |
$5,948.26
|
|
|
ROCKER SHOES FOR FOOT RING LONG 180/120MM HOFFMANN LIMB 4934-8-180
|
Facility
|
IP
|
$8,031.00
|
|
| Hospital Charge Code |
5599712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,092.60 |
| Max. Negotiated Rate |
$7,684.06 |
| Rate for Payer: Aetna Commercial |
$7,517.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,182.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,426.69
|
| Rate for Payer: Cash Price |
$2,409.30
|
| Rate for Payer: Cigna Commercial |
$7,684.06
|
| Rate for Payer: Health EOS Commercial |
$7,433.49
|
| Rate for Payer: HFN Commercial |
$7,684.06
|
| Rate for Payer: Multiplan Commercial |
$6,681.79
|
| Rate for Payer: Preferred Network Access Commercial |
$7,684.06
|
| Rate for Payer: Quartz Beloit One Network |
$4,092.60
|
| Rate for Payer: Quartz Commercial |
$5,011.34
|
| Rate for Payer: WEA Trust Commercial |
$4,593.73
|
| Rate for Payer: WPS Commercial |
$6,186.28
|
|
|
ROCKER SHOES FOR FOOT RING LONG 180/120MM HOFFMANN LIMB 4934-8-180
|
Facility
|
OP
|
$8,031.00
|
|
| Hospital Charge Code |
5599712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,338.63 |
| Max. Negotiated Rate |
$7,684.06 |
| Rate for Payer: Aetna Commercial |
$7,517.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,182.93
|
| Rate for Payer: Aetna Managed Medicare |
$2,338.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,428.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,176.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,009.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,426.69
|
| Rate for Payer: Cash Price |
$2,409.30
|
| Rate for Payer: Cigna Commercial |
$7,684.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,674.04
|
| Rate for Payer: Health EOS Commercial |
$7,433.49
|
| Rate for Payer: HFN Commercial |
$7,684.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,264.18
|
| Rate for Payer: Multiplan Commercial |
$6,681.79
|
| Rate for Payer: NAPHCARE Commercial |
$5,011.34
|
| Rate for Payer: Preferred Network Access Commercial |
$7,684.06
|
| Rate for Payer: Quartz Beloit One Network |
$4,092.60
|
| Rate for Payer: Quartz Commercial |
$5,428.96
|
| Rate for Payer: Quartz Medicare Advantage |
$5,011.34
|
| Rate for Payer: The Alliance Commercial |
$4,176.12
|
| Rate for Payer: WEA Trust Commercial |
$4,593.73
|
| Rate for Payer: WPS Commercial |
$6,186.28
|
|
|
Rocky Mountain Spotted Fever Ab IgM
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
2942989
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$120.27 |
| Max. Negotiated Rate |
$225.80 |
| Rate for Payer: Aetna Commercial |
$220.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$211.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$130.08
|
| Rate for Payer: Cash Price |
$70.80
|
| Rate for Payer: Cigna Commercial |
$225.80
|
| Rate for Payer: Health EOS Commercial |
$218.44
|
| Rate for Payer: HFN Commercial |
$225.80
|
| Rate for Payer: Multiplan Commercial |
$196.35
|
| Rate for Payer: Preferred Network Access Commercial |
$225.80
|
| Rate for Payer: Quartz Beloit One Network |
$120.27
|
| Rate for Payer: Quartz Commercial |
$147.26
|
| Rate for Payer: WEA Trust Commercial |
$134.99
|
| Rate for Payer: WPS Commercial |
$181.79
|
|
|
Rocky Mountain Spotted Fever Ab IgM
|
Facility
|
OP
|
$236.00
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
2942989
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$225.80 |
| Rate for Payer: Aetna Commercial |
$220.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$211.08
|
| Rate for Payer: Aetna Managed Medicare |
$20.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$75.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$35.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33.41
|
| Rate for Payer: Anthem Medicare Advantage |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$130.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.12
|
| Rate for Payer: Cash Price |
$70.80
|
| Rate for Payer: Cash Price |
$70.80
|
| Rate for Payer: Cigna Commercial |
$225.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$137.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20.12
|
| Rate for Payer: Health EOS Commercial |
$218.44
|
| Rate for Payer: HFN Commercial |
$225.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$74.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20.12
|
| Rate for Payer: Multiplan Commercial |
$196.35
|
| Rate for Payer: NAPHCARE Commercial |
$30.19
|
| Rate for Payer: Preferred Network Access Commercial |
$225.80
|
| Rate for Payer: Quartz Beloit One Network |
$120.27
|
| Rate for Payer: Quartz Commercial |
$159.54
|
| Rate for Payer: Quartz Medicare Advantage |
$20.12
|
| Rate for Payer: The Alliance Commercial |
$80.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.12
|
| Rate for Payer: United Healthcare PPO |
$184.08
|
| Rate for Payer: WEA Trust Commercial |
$134.99
|
| Rate for Payer: Wellcare Medicare |
$20.12
|
| Rate for Payer: WPS Commercial |
$181.79
|
|
|
Rocky Mountain Spotted Fever Ab IgM
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
2942989
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$233.17 |
| Rate for Payer: Aetna Commercial |
$233.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$211.08
|
| Rate for Payer: Aetna Managed Medicare |
$20.12
|
| Rate for Payer: Anthem Medicare Advantage |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.12
|
| Rate for Payer: Cash Price |
$70.80
|
| Rate for Payer: Cash Price |
$70.80
|
| Rate for Payer: Cigna Commercial |
$233.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$122.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20.12
|
| Rate for Payer: Health EOS Commercial |
$223.35
|
| Rate for Payer: HFN Commercial |
$233.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$71.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$71.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.12
|
| Rate for Payer: Multiplan Commercial |
$196.35
|
| Rate for Payer: NAPHCARE Commercial |
$30.19
|
| Rate for Payer: Preferred Network Access Commercial |
$233.17
|
| Rate for Payer: Quartz Beloit One Network |
$107.99
|
| Rate for Payer: Quartz Commercial |
$139.90
|
| Rate for Payer: Quartz Medicare Advantage |
$20.12
|
| Rate for Payer: The Alliance Commercial |
$79.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.12
|
| Rate for Payer: WEA Trust Commercial |
$134.99
|
| Rate for Payer: WPS Commercial |
$88.55
|
|
|
Rocky Mountain Spotted Fever IgG & IgM
|
Facility
|
OP
|
$231.00
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
978058
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$221.02 |
| Rate for Payer: Aetna Commercial |
$216.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$206.61
|
| Rate for Payer: Aetna Managed Medicare |
$20.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$75.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$35.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33.41
|
| Rate for Payer: Anthem Medicare Advantage |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$127.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.12
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cigna Commercial |
$221.02
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$134.44
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20.12
|
| Rate for Payer: Health EOS Commercial |
$213.81
|
| Rate for Payer: HFN Commercial |
$221.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$74.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20.12
|
| Rate for Payer: Multiplan Commercial |
$192.19
|
| Rate for Payer: NAPHCARE Commercial |
$30.19
|
| Rate for Payer: Preferred Network Access Commercial |
$221.02
|
| Rate for Payer: Quartz Beloit One Network |
$117.72
|
| Rate for Payer: Quartz Commercial |
$156.16
|
| Rate for Payer: Quartz Medicare Advantage |
$20.12
|
| Rate for Payer: The Alliance Commercial |
$80.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.12
|
| Rate for Payer: United Healthcare PPO |
$180.18
|
| Rate for Payer: WEA Trust Commercial |
$132.13
|
| Rate for Payer: Wellcare Medicare |
$20.12
|
| Rate for Payer: WPS Commercial |
$177.94
|
|
|
Rocky Mountain Spotted Fever IgG & IgM
|
Facility
|
IP
|
$231.00
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
978058
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$117.72 |
| Max. Negotiated Rate |
$221.02 |
| Rate for Payer: Aetna Commercial |
$216.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$206.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$127.33
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cigna Commercial |
$221.02
|
| Rate for Payer: Health EOS Commercial |
$213.81
|
| Rate for Payer: HFN Commercial |
$221.02
|
| Rate for Payer: Multiplan Commercial |
$192.19
|
| Rate for Payer: Preferred Network Access Commercial |
$221.02
|
| Rate for Payer: Quartz Beloit One Network |
$117.72
|
| Rate for Payer: Quartz Commercial |
$144.14
|
| Rate for Payer: WEA Trust Commercial |
$132.13
|
| Rate for Payer: WPS Commercial |
$177.94
|
|
|
Rocky Mountain Spotted Fever IgG & IgM
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
978058
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$228.23 |
| Rate for Payer: Aetna Commercial |
$228.23
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$206.61
|
| Rate for Payer: Aetna Managed Medicare |
$20.12
|
| Rate for Payer: Anthem Medicare Advantage |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.12
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cigna Commercial |
$228.23
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$120.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20.12
|
| Rate for Payer: Health EOS Commercial |
$218.62
|
| Rate for Payer: HFN Commercial |
$228.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$71.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$71.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.12
|
| Rate for Payer: Multiplan Commercial |
$192.19
|
| Rate for Payer: NAPHCARE Commercial |
$30.19
|
| Rate for Payer: Preferred Network Access Commercial |
$228.23
|
| Rate for Payer: Quartz Beloit One Network |
$105.71
|
| Rate for Payer: Quartz Commercial |
$136.94
|
| Rate for Payer: Quartz Medicare Advantage |
$20.12
|
| Rate for Payer: The Alliance Commercial |
$79.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.12
|
| Rate for Payer: WEA Trust Commercial |
$132.13
|
| Rate for Payer: WPS Commercial |
$88.55
|
|
|
Rocky Mountain Spotted Fever IgG Titer
|
Facility
|
OP
|
$223.00
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
1043037
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$213.37 |
| Rate for Payer: Aetna Commercial |
$208.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$199.45
|
| Rate for Payer: Aetna Managed Medicare |
$20.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$75.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$35.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33.41
|
| Rate for Payer: Anthem Medicare Advantage |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$122.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.12
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$213.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$129.79
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20.12
|
| Rate for Payer: Health EOS Commercial |
$206.41
|
| Rate for Payer: HFN Commercial |
$213.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$74.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20.12
|
| Rate for Payer: Multiplan Commercial |
$185.54
|
| Rate for Payer: NAPHCARE Commercial |
$30.19
|
| Rate for Payer: Preferred Network Access Commercial |
$213.37
|
| Rate for Payer: Quartz Beloit One Network |
$113.64
|
| Rate for Payer: Quartz Commercial |
$150.75
|
| Rate for Payer: Quartz Medicare Advantage |
$20.12
|
| Rate for Payer: The Alliance Commercial |
$80.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.12
|
| Rate for Payer: United Healthcare PPO |
$173.94
|
| Rate for Payer: WEA Trust Commercial |
$127.56
|
| Rate for Payer: Wellcare Medicare |
$20.12
|
| Rate for Payer: WPS Commercial |
$171.78
|
|
|
Rocky Mountain Spotted Fever IgG Titer
|
Facility
|
IP
|
$223.00
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
1043037
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$113.64 |
| Max. Negotiated Rate |
$213.37 |
| Rate for Payer: Aetna Commercial |
$208.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$199.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$122.92
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$213.37
|
| Rate for Payer: Health EOS Commercial |
$206.41
|
| Rate for Payer: HFN Commercial |
$213.37
|
| Rate for Payer: Multiplan Commercial |
$185.54
|
| Rate for Payer: Preferred Network Access Commercial |
$213.37
|
| Rate for Payer: Quartz Beloit One Network |
$113.64
|
| Rate for Payer: Quartz Commercial |
$139.15
|
| Rate for Payer: WEA Trust Commercial |
$127.56
|
| Rate for Payer: WPS Commercial |
$171.78
|
|
|
Rocky Mountain Spotted Fever IgG Titer
|
Professional
|
Both
|
$223.00
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
1043037
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$199.45
|
| Rate for Payer: Aetna Managed Medicare |
$20.12
|
| Rate for Payer: Anthem Medicare Advantage |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.12
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$220.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$115.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20.12
|
| Rate for Payer: Health EOS Commercial |
$211.05
|
| Rate for Payer: HFN Commercial |
$220.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$71.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$71.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.12
|
| Rate for Payer: Multiplan Commercial |
$185.54
|
| Rate for Payer: NAPHCARE Commercial |
$30.19
|
| Rate for Payer: Preferred Network Access Commercial |
$220.32
|
| Rate for Payer: Quartz Beloit One Network |
$102.04
|
| Rate for Payer: Quartz Commercial |
$132.19
|
| Rate for Payer: Quartz Medicare Advantage |
$20.12
|
| Rate for Payer: The Alliance Commercial |
$79.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.12
|
| Rate for Payer: WEA Trust Commercial |
$127.56
|
| Rate for Payer: WPS Commercial |
$88.55
|
|
|
Rocky Mountain Spotted Fever IgM Titer
|
Facility
|
IP
|
$97.58
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
2956797
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$93.36 |
| Rate for Payer: Aetna Commercial |
$91.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$87.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$53.79
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Cigna Commercial |
$93.36
|
| Rate for Payer: Health EOS Commercial |
$90.32
|
| Rate for Payer: HFN Commercial |
$93.36
|
| Rate for Payer: Multiplan Commercial |
$81.19
|
| Rate for Payer: Preferred Network Access Commercial |
$93.36
|
| Rate for Payer: Quartz Beloit One Network |
$49.73
|
| Rate for Payer: Quartz Commercial |
$60.89
|
| Rate for Payer: WEA Trust Commercial |
$55.82
|
| Rate for Payer: WPS Commercial |
$75.17
|
|
|
Rocky Mountain Spotted Fever IgM Titer
|
Facility
|
OP
|
$97.58
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
2956797
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$93.36 |
| Rate for Payer: Aetna Commercial |
$91.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$87.28
|
| Rate for Payer: Aetna Managed Medicare |
$20.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$75.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$35.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33.41
|
| Rate for Payer: Anthem Medicare Advantage |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$53.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.12
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Cigna Commercial |
$93.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$56.79
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20.12
|
| Rate for Payer: Health EOS Commercial |
$90.32
|
| Rate for Payer: HFN Commercial |
$93.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$74.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20.12
|
| Rate for Payer: Multiplan Commercial |
$81.19
|
| Rate for Payer: NAPHCARE Commercial |
$30.19
|
| Rate for Payer: Preferred Network Access Commercial |
$93.36
|
| Rate for Payer: Quartz Beloit One Network |
$49.73
|
| Rate for Payer: Quartz Commercial |
$65.96
|
| Rate for Payer: Quartz Medicare Advantage |
$20.12
|
| Rate for Payer: The Alliance Commercial |
$80.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.12
|
| Rate for Payer: United Healthcare PPO |
$76.11
|
| Rate for Payer: WEA Trust Commercial |
$55.82
|
| Rate for Payer: Wellcare Medicare |
$20.12
|
| Rate for Payer: WPS Commercial |
$75.17
|
|
|
Rocky Mountain Spotted Fever IgM Titer
|
Professional
|
Both
|
$97.58
|
|
|
Service Code
|
CPT 86757
|
| Hospital Charge Code |
2956797
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$96.41 |
| Rate for Payer: Aetna Commercial |
$96.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$87.28
|
| Rate for Payer: Aetna Managed Medicare |
$20.12
|
| Rate for Payer: Anthem Medicare Advantage |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.12
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Cash Price |
$29.27
|
| Rate for Payer: Cigna Commercial |
$96.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$50.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20.12
|
| Rate for Payer: Health EOS Commercial |
$92.35
|
| Rate for Payer: HFN Commercial |
$96.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$71.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$71.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.12
|
| Rate for Payer: Multiplan Commercial |
$81.19
|
| Rate for Payer: NAPHCARE Commercial |
$30.19
|
| Rate for Payer: Preferred Network Access Commercial |
$96.41
|
| Rate for Payer: Quartz Beloit One Network |
$44.65
|
| Rate for Payer: Quartz Commercial |
$57.85
|
| Rate for Payer: Quartz Medicare Advantage |
$20.12
|
| Rate for Payer: The Alliance Commercial |
$79.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.12
|
| Rate for Payer: WEA Trust Commercial |
$55.82
|
| Rate for Payer: WPS Commercial |
$88.55
|
|
|
ROD ATTACHMENT FOR LARGE MULTI-PIN CLAMP 390.003
|
Facility
|
IP
|
$5,867.00
|
|
| Hospital Charge Code |
2969386
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,989.82 |
| Max. Negotiated Rate |
$5,613.55 |
| Rate for Payer: Aetna Commercial |
$5,491.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,247.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,233.89
|
| Rate for Payer: Cash Price |
$1,760.10
|
| Rate for Payer: Cigna Commercial |
$5,613.55
|
| Rate for Payer: Health EOS Commercial |
$5,430.50
|
| Rate for Payer: HFN Commercial |
$5,613.55
|
| Rate for Payer: Multiplan Commercial |
$4,881.34
|
| Rate for Payer: Preferred Network Access Commercial |
$5,613.55
|
| Rate for Payer: Quartz Beloit One Network |
$2,989.82
|
| Rate for Payer: Quartz Commercial |
$3,661.01
|
| Rate for Payer: WEA Trust Commercial |
$3,355.92
|
| Rate for Payer: WPS Commercial |
$4,519.35
|
|
|
ROD ATTACHMENT FOR LARGE MULTI-PIN CLAMP 390.003
|
Facility
|
OP
|
$5,867.00
|
|
| Hospital Charge Code |
2969386
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,708.47 |
| Max. Negotiated Rate |
$5,613.55 |
| Rate for Payer: Aetna Commercial |
$5,491.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,247.44
|
| Rate for Payer: Aetna Managed Medicare |
$1,708.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,966.09
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,050.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,928.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,233.89
|
| Rate for Payer: Cash Price |
$1,760.10
|
| Rate for Payer: Cigna Commercial |
$5,613.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,414.59
|
| Rate for Payer: Health EOS Commercial |
$5,430.50
|
| Rate for Payer: HFN Commercial |
$5,613.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,576.26
|
| Rate for Payer: Multiplan Commercial |
$4,881.34
|
| Rate for Payer: NAPHCARE Commercial |
$3,661.01
|
| Rate for Payer: Preferred Network Access Commercial |
$5,613.55
|
| Rate for Payer: Quartz Beloit One Network |
$2,989.82
|
| Rate for Payer: Quartz Commercial |
$3,966.09
|
| Rate for Payer: Quartz Medicare Advantage |
$3,661.01
|
| Rate for Payer: The Alliance Commercial |
$3,050.84
|
| Rate for Payer: WEA Trust Commercial |
$3,355.92
|
| Rate for Payer: WPS Commercial |
$4,519.35
|
|
