|
Rheumatoid Factor IgA Antibody
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2942987
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$74.48 |
| Max. Negotiated Rate |
$139.84 |
| Rate for Payer: Aetna Commercial |
$136.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$130.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$80.56
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cigna Commercial |
$139.84
|
| Rate for Payer: Health EOS Commercial |
$135.28
|
| Rate for Payer: HFN Commercial |
$139.84
|
| Rate for Payer: Multiplan Commercial |
$121.60
|
| Rate for Payer: NAPHCARE Commercial |
$91.20
|
| Rate for Payer: Preferred Network Access Commercial |
$139.84
|
| Rate for Payer: Quartz Beloit One Network |
$74.48
|
| Rate for Payer: Quartz Commercial |
$91.20
|
| Rate for Payer: WEA Trust Commercial |
$83.60
|
| Rate for Payer: WPS Commercial |
$112.59
|
|
|
Rheumatoid Factor IgA Antibody
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2942987
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.96 |
| Max. Negotiated Rate |
$144.40 |
| Rate for Payer: Aetna Commercial |
$144.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$130.72
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cigna Commercial |
$144.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$76.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$91.20
|
| Rate for Payer: Health EOS Commercial |
$138.32
|
| Rate for Payer: HFN Commercial |
$144.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$60.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$60.96
|
| Rate for Payer: Multiplan Commercial |
$121.60
|
| Rate for Payer: Preferred Network Access Commercial |
$144.40
|
| Rate for Payer: Quartz Beloit One Network |
$66.88
|
| Rate for Payer: Quartz Commercial |
$86.64
|
| Rate for Payer: The Alliance Commercial |
$76.00
|
| Rate for Payer: WEA Trust Commercial |
$83.60
|
| Rate for Payer: WPS Commercial |
$112.59
|
|
|
Rheumatoid Factor (IgA, IgG, IgM)
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
983388
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$123.48 |
| Max. Negotiated Rate |
$231.84 |
| Rate for Payer: Aetna Commercial |
$226.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$216.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$133.56
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna Commercial |
$231.84
|
| Rate for Payer: Health EOS Commercial |
$224.28
|
| Rate for Payer: HFN Commercial |
$231.84
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: NAPHCARE Commercial |
$151.20
|
| Rate for Payer: Preferred Network Access Commercial |
$231.84
|
| Rate for Payer: Quartz Beloit One Network |
$123.48
|
| Rate for Payer: Quartz Commercial |
$151.20
|
| Rate for Payer: WEA Trust Commercial |
$138.60
|
| Rate for Payer: WPS Commercial |
$186.66
|
|
|
Rheumatoid Factor (IgA, IgG, IgM)
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
983388
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.96 |
| Max. Negotiated Rate |
$239.40 |
| Rate for Payer: Aetna Commercial |
$239.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$216.72
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna Commercial |
$239.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$126.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$151.20
|
| Rate for Payer: Health EOS Commercial |
$229.32
|
| Rate for Payer: HFN Commercial |
$239.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$60.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$60.96
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: Preferred Network Access Commercial |
$239.40
|
| Rate for Payer: Quartz Beloit One Network |
$110.88
|
| Rate for Payer: Quartz Commercial |
$143.64
|
| Rate for Payer: The Alliance Commercial |
$126.00
|
| Rate for Payer: WEA Trust Commercial |
$138.60
|
| Rate for Payer: WPS Commercial |
$186.66
|
|
|
Rheumatoid Factor (IgA, IgG, IgM)
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
983388
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$231.84 |
| Rate for Payer: Aetna Commercial |
$226.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$216.72
|
| Rate for Payer: Aetna Managed Medicare |
$17.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$64.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28.67
|
| Rate for Payer: Anthem Medicaid |
$17.85
|
| Rate for Payer: Anthem Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$133.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.27
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna Commercial |
$231.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$141.02
|
| Rate for Payer: Dean Health Medicaid |
$17.85
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.27
|
| Rate for Payer: Health EOS Commercial |
$224.28
|
| Rate for Payer: HFN Commercial |
$231.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.27
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.27
|
| Rate for Payer: Managed Health Services Medicaid |
$18.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: NAPHCARE Commercial |
$25.90
|
| Rate for Payer: Preferred Network Access Commercial |
$231.84
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17.85
|
| Rate for Payer: Quartz Beloit One Network |
$123.48
|
| Rate for Payer: Quartz Commercial |
$163.80
|
| Rate for Payer: Quartz Medicare Advantage |
$17.27
|
| Rate for Payer: The Alliance Commercial |
$69.08
|
| Rate for Payer: United Healthcare Medicaid |
$17.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.27
|
| Rate for Payer: United Healthcare PPO |
$189.00
|
| Rate for Payer: WEA Trust Commercial |
$138.60
|
| Rate for Payer: Wellcare Medicare |
$17.27
|
| Rate for Payer: WMAP Medicaid |
$17.85
|
| Rate for Payer: WPS Commercial |
$186.66
|
|
|
Rheumatoid Factor IgM Antibody
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2942988
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$123.48 |
| Max. Negotiated Rate |
$231.84 |
| Rate for Payer: Aetna Commercial |
$226.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$216.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$133.56
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna Commercial |
$231.84
|
| Rate for Payer: Health EOS Commercial |
$224.28
|
| Rate for Payer: HFN Commercial |
$231.84
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: NAPHCARE Commercial |
$151.20
|
| Rate for Payer: Preferred Network Access Commercial |
$231.84
|
| Rate for Payer: Quartz Beloit One Network |
$123.48
|
| Rate for Payer: Quartz Commercial |
$151.20
|
| Rate for Payer: WEA Trust Commercial |
$138.60
|
| Rate for Payer: WPS Commercial |
$186.66
|
|
|
Rheumatoid Factor IgM Antibody
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2942988
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$231.84 |
| Rate for Payer: Aetna Commercial |
$226.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$216.72
|
| Rate for Payer: Aetna Managed Medicare |
$17.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$64.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28.67
|
| Rate for Payer: Anthem Medicaid |
$17.85
|
| Rate for Payer: Anthem Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$133.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.27
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna Commercial |
$231.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$141.02
|
| Rate for Payer: Dean Health Medicaid |
$17.85
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.27
|
| Rate for Payer: Health EOS Commercial |
$224.28
|
| Rate for Payer: HFN Commercial |
$231.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.27
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.27
|
| Rate for Payer: Managed Health Services Medicaid |
$18.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: NAPHCARE Commercial |
$25.90
|
| Rate for Payer: Preferred Network Access Commercial |
$231.84
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17.85
|
| Rate for Payer: Quartz Beloit One Network |
$123.48
|
| Rate for Payer: Quartz Commercial |
$163.80
|
| Rate for Payer: Quartz Medicare Advantage |
$17.27
|
| Rate for Payer: The Alliance Commercial |
$69.08
|
| Rate for Payer: United Healthcare Medicaid |
$17.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.27
|
| Rate for Payer: United Healthcare PPO |
$189.00
|
| Rate for Payer: WEA Trust Commercial |
$138.60
|
| Rate for Payer: Wellcare Medicare |
$17.27
|
| Rate for Payer: WMAP Medicaid |
$17.85
|
| Rate for Payer: WPS Commercial |
$186.66
|
|
|
Rheumatoid Factor IgM Antibody
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2942988
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.96 |
| Max. Negotiated Rate |
$239.40 |
| Rate for Payer: Aetna Commercial |
$239.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$216.72
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna Commercial |
$239.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$126.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$151.20
|
| Rate for Payer: Health EOS Commercial |
$229.32
|
| Rate for Payer: HFN Commercial |
$239.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$60.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$60.96
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: Preferred Network Access Commercial |
$239.40
|
| Rate for Payer: Quartz Beloit One Network |
$110.88
|
| Rate for Payer: Quartz Commercial |
$143.64
|
| Rate for Payer: The Alliance Commercial |
$126.00
|
| Rate for Payer: WEA Trust Commercial |
$138.60
|
| Rate for Payer: WPS Commercial |
$186.66
|
|
|
Rheumatoid Factor Qnt
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
5605698
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$96.60 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$90.30
|
| Rate for Payer: Aetna Managed Medicare |
$5.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$21.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.41
|
| Rate for Payer: Anthem Medicaid |
$5.86
|
| Rate for Payer: Anthem Medicare Advantage |
$5.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$55.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.67
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$96.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$58.76
|
| Rate for Payer: Dean Health Medicaid |
$5.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.67
|
| Rate for Payer: Health EOS Commercial |
$93.45
|
| Rate for Payer: HFN Commercial |
$96.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.67
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.67
|
| Rate for Payer: Managed Health Services Medicaid |
$6.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.67
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.67
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: NAPHCARE Commercial |
$8.50
|
| Rate for Payer: Preferred Network Access Commercial |
$96.60
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.86
|
| Rate for Payer: Quartz Beloit One Network |
$51.45
|
| Rate for Payer: Quartz Commercial |
$68.25
|
| Rate for Payer: Quartz Medicare Advantage |
$5.67
|
| Rate for Payer: The Alliance Commercial |
$22.68
|
| Rate for Payer: United Healthcare Medicaid |
$5.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.67
|
| Rate for Payer: United Healthcare PPO |
$78.75
|
| Rate for Payer: WEA Trust Commercial |
$57.75
|
| Rate for Payer: Wellcare Medicare |
$5.67
|
| Rate for Payer: WMAP Medicaid |
$5.86
|
| Rate for Payer: WPS Commercial |
$77.77
|
|
|
Rheumatoid Factor Qnt
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
5605698
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$99.75 |
| Rate for Payer: Aetna Commercial |
$99.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$90.30
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$99.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$52.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$63.00
|
| Rate for Payer: Health EOS Commercial |
$95.55
|
| Rate for Payer: HFN Commercial |
$99.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.02
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Preferred Network Access Commercial |
$99.75
|
| Rate for Payer: Quartz Beloit One Network |
$46.20
|
| Rate for Payer: Quartz Commercial |
$59.85
|
| Rate for Payer: The Alliance Commercial |
$52.50
|
| Rate for Payer: WEA Trust Commercial |
$57.75
|
| Rate for Payer: WPS Commercial |
$77.77
|
|
|
Rheumatoid Factor Qnt
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
5605698
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$51.45 |
| Max. Negotiated Rate |
$96.60 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$90.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$55.65
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$96.60
|
| Rate for Payer: Health EOS Commercial |
$93.45
|
| Rate for Payer: HFN Commercial |
$96.60
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: NAPHCARE Commercial |
$63.00
|
| Rate for Payer: Preferred Network Access Commercial |
$96.60
|
| Rate for Payer: Quartz Beloit One Network |
$51.45
|
| Rate for Payer: Quartz Commercial |
$63.00
|
| Rate for Payer: WEA Trust Commercial |
$57.75
|
| Rate for Payer: WPS Commercial |
$77.77
|
|
|
Rheumatoid Factor Quantitative
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
978055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.41 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$98.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.77
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cigna Commercial |
$100.28
|
| Rate for Payer: Health EOS Commercial |
$97.01
|
| Rate for Payer: HFN Commercial |
$100.28
|
| Rate for Payer: Multiplan Commercial |
$87.20
|
| Rate for Payer: NAPHCARE Commercial |
$65.40
|
| Rate for Payer: Preferred Network Access Commercial |
$100.28
|
| Rate for Payer: Quartz Beloit One Network |
$53.41
|
| Rate for Payer: Quartz Commercial |
$65.40
|
| Rate for Payer: WEA Trust Commercial |
$59.95
|
| Rate for Payer: WPS Commercial |
$80.74
|
|
|
Rheumatoid Factor Quantitative
|
Professional
|
Both
|
$109.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
978055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$103.55 |
| Rate for Payer: Aetna Commercial |
$103.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.74
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cigna Commercial |
$103.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$54.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$65.40
|
| Rate for Payer: Health EOS Commercial |
$99.19
|
| Rate for Payer: HFN Commercial |
$103.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.02
|
| Rate for Payer: Multiplan Commercial |
$87.20
|
| Rate for Payer: Preferred Network Access Commercial |
$103.55
|
| Rate for Payer: Quartz Beloit One Network |
$47.96
|
| Rate for Payer: Quartz Commercial |
$62.13
|
| Rate for Payer: The Alliance Commercial |
$54.50
|
| Rate for Payer: WEA Trust Commercial |
$59.95
|
| Rate for Payer: WPS Commercial |
$80.74
|
|
|
Rheumatoid Factor Quantitative
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
978055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$98.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.74
|
| Rate for Payer: Aetna Managed Medicare |
$5.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$21.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.41
|
| Rate for Payer: Anthem Medicaid |
$5.86
|
| Rate for Payer: Anthem Medicare Advantage |
$5.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.67
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cigna Commercial |
$100.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$61.00
|
| Rate for Payer: Dean Health Medicaid |
$5.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.67
|
| Rate for Payer: Health EOS Commercial |
$97.01
|
| Rate for Payer: HFN Commercial |
$100.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.67
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.67
|
| Rate for Payer: Managed Health Services Medicaid |
$6.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.67
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.67
|
| Rate for Payer: Multiplan Commercial |
$87.20
|
| Rate for Payer: NAPHCARE Commercial |
$8.50
|
| Rate for Payer: Preferred Network Access Commercial |
$100.28
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.86
|
| Rate for Payer: Quartz Beloit One Network |
$53.41
|
| Rate for Payer: Quartz Commercial |
$70.85
|
| Rate for Payer: Quartz Medicare Advantage |
$5.67
|
| Rate for Payer: The Alliance Commercial |
$22.68
|
| Rate for Payer: United Healthcare Medicaid |
$5.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.67
|
| Rate for Payer: United Healthcare PPO |
$81.75
|
| Rate for Payer: WEA Trust Commercial |
$59.95
|
| Rate for Payer: Wellcare Medicare |
$5.67
|
| Rate for Payer: WMAP Medicaid |
$5.86
|
| Rate for Payer: WPS Commercial |
$80.74
|
|
|
Rheumatoid Factor, Syn Fluid, Screen w/ Rfx Titer
|
Professional
|
Both
|
$134.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
983389
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$127.30 |
| Rate for Payer: Aetna Commercial |
$127.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$115.24
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$127.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$67.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$80.40
|
| Rate for Payer: Health EOS Commercial |
$121.94
|
| Rate for Payer: HFN Commercial |
$127.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.02
|
| Rate for Payer: Multiplan Commercial |
$107.20
|
| Rate for Payer: Preferred Network Access Commercial |
$127.30
|
| Rate for Payer: Quartz Beloit One Network |
$58.96
|
| Rate for Payer: Quartz Commercial |
$76.38
|
| Rate for Payer: The Alliance Commercial |
$67.00
|
| Rate for Payer: WEA Trust Commercial |
$73.70
|
| Rate for Payer: WPS Commercial |
$99.25
|
|
|
Rheumatoid Factor, Syn Fluid, Screen w/ Rfx Titer
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
983389
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.66 |
| Max. Negotiated Rate |
$123.28 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$115.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$71.02
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$123.28
|
| Rate for Payer: Health EOS Commercial |
$119.26
|
| Rate for Payer: HFN Commercial |
$123.28
|
| Rate for Payer: Multiplan Commercial |
$107.20
|
| Rate for Payer: NAPHCARE Commercial |
$80.40
|
| Rate for Payer: Preferred Network Access Commercial |
$123.28
|
| Rate for Payer: Quartz Beloit One Network |
$65.66
|
| Rate for Payer: Quartz Commercial |
$80.40
|
| Rate for Payer: WEA Trust Commercial |
$73.70
|
| Rate for Payer: WPS Commercial |
$99.25
|
|
|
Rheumatoid Factor, Syn Fluid, Screen w/ Rfx Titer
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
983389
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$123.28 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$115.24
|
| Rate for Payer: Aetna Managed Medicare |
$5.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$21.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.41
|
| Rate for Payer: Anthem Medicaid |
$5.86
|
| Rate for Payer: Anthem Medicare Advantage |
$5.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$71.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.67
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$123.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$74.99
|
| Rate for Payer: Dean Health Medicaid |
$5.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.67
|
| Rate for Payer: Health EOS Commercial |
$119.26
|
| Rate for Payer: HFN Commercial |
$123.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.67
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.67
|
| Rate for Payer: Managed Health Services Medicaid |
$6.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.67
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.67
|
| Rate for Payer: Multiplan Commercial |
$107.20
|
| Rate for Payer: NAPHCARE Commercial |
$8.50
|
| Rate for Payer: Preferred Network Access Commercial |
$123.28
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.86
|
| Rate for Payer: Quartz Beloit One Network |
$65.66
|
| Rate for Payer: Quartz Commercial |
$87.10
|
| Rate for Payer: Quartz Medicare Advantage |
$5.67
|
| Rate for Payer: The Alliance Commercial |
$22.68
|
| Rate for Payer: United Healthcare Medicaid |
$5.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.67
|
| Rate for Payer: United Healthcare PPO |
$100.50
|
| Rate for Payer: WEA Trust Commercial |
$73.70
|
| Rate for Payer: Wellcare Medicare |
$5.67
|
| Rate for Payer: WMAP Medicaid |
$5.86
|
| Rate for Payer: WPS Commercial |
$99.25
|
|
|
Rheumatoid Factor, Syn Fluid, Titer
|
Facility
|
IP
|
$93.00
|
|
|
Service Code
|
CPT 86430
|
| Hospital Charge Code |
1039098
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$45.57 |
| Max. Negotiated Rate |
$85.56 |
| Rate for Payer: Aetna Commercial |
$83.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$49.29
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Cigna Commercial |
$85.56
|
| Rate for Payer: Health EOS Commercial |
$82.77
|
| Rate for Payer: HFN Commercial |
$85.56
|
| Rate for Payer: Multiplan Commercial |
$74.40
|
| Rate for Payer: NAPHCARE Commercial |
$55.80
|
| Rate for Payer: Preferred Network Access Commercial |
$85.56
|
| Rate for Payer: Quartz Beloit One Network |
$45.57
|
| Rate for Payer: Quartz Commercial |
$55.80
|
| Rate for Payer: WEA Trust Commercial |
$51.15
|
| Rate for Payer: WPS Commercial |
$68.89
|
|
|
Rheumatoid Factor, Syn Fluid, Titer
|
Professional
|
Both
|
$93.00
|
|
|
Service Code
|
CPT 86430
|
| Hospital Charge Code |
1039098
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.67 |
| Max. Negotiated Rate |
$88.35 |
| Rate for Payer: Aetna Commercial |
$88.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.98
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Cigna Commercial |
$88.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$55.80
|
| Rate for Payer: Health EOS Commercial |
$84.63
|
| Rate for Payer: HFN Commercial |
$88.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.67
|
| Rate for Payer: Multiplan Commercial |
$74.40
|
| Rate for Payer: Preferred Network Access Commercial |
$88.35
|
| Rate for Payer: Quartz Beloit One Network |
$40.92
|
| Rate for Payer: Quartz Commercial |
$53.01
|
| Rate for Payer: The Alliance Commercial |
$46.50
|
| Rate for Payer: WEA Trust Commercial |
$51.15
|
| Rate for Payer: WPS Commercial |
$68.89
|
|
|
Rheumatoid Factor, Syn Fluid, Titer
|
Facility
|
OP
|
$93.00
|
|
|
Service Code
|
CPT 86430
|
| Hospital Charge Code |
1039098
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.14 |
| Max. Negotiated Rate |
$85.56 |
| Rate for Payer: Aetna Commercial |
$83.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.98
|
| Rate for Payer: Aetna Managed Medicare |
$6.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.74
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.19
|
| Rate for Payer: Anthem Medicaid |
$6.34
|
| Rate for Payer: Anthem Medicare Advantage |
$6.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$49.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.14
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Cigna Commercial |
$85.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$52.04
|
| Rate for Payer: Dean Health Medicaid |
$6.34
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.14
|
| Rate for Payer: Health EOS Commercial |
$82.77
|
| Rate for Payer: HFN Commercial |
$85.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.14
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.14
|
| Rate for Payer: Managed Health Services Medicaid |
$6.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.14
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.14
|
| Rate for Payer: Multiplan Commercial |
$74.40
|
| Rate for Payer: NAPHCARE Commercial |
$9.21
|
| Rate for Payer: Preferred Network Access Commercial |
$85.56
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6.34
|
| Rate for Payer: Quartz Beloit One Network |
$45.57
|
| Rate for Payer: Quartz Commercial |
$60.45
|
| Rate for Payer: Quartz Medicare Advantage |
$6.14
|
| Rate for Payer: The Alliance Commercial |
$24.56
|
| Rate for Payer: United Healthcare Medicaid |
$6.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.14
|
| Rate for Payer: United Healthcare PPO |
$69.75
|
| Rate for Payer: WEA Trust Commercial |
$51.15
|
| Rate for Payer: Wellcare Medicare |
$6.14
|
| Rate for Payer: WMAP Medicaid |
$6.34
|
| Rate for Payer: WPS Commercial |
$68.89
|
|
|
RHIG
|
Facility
|
OP
|
$509.00
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
2952700
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$105.81 |
| Max. Negotiated Rate |
$2,036.00 |
| Rate for Payer: Aetna Commercial |
$458.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$437.74
|
| Rate for Payer: Aetna Managed Medicare |
$142.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$330.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$254.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$244.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$269.77
|
| Rate for Payer: Cash Price |
$152.70
|
| Rate for Payer: Cash Price |
$152.70
|
| Rate for Payer: Cigna Commercial |
$468.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$105.81
|
| Rate for Payer: Health EOS Commercial |
$453.01
|
| Rate for Payer: HFN Commercial |
$468.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$381.75
|
| Rate for Payer: Multiplan Commercial |
$407.20
|
| Rate for Payer: NAPHCARE Commercial |
$305.40
|
| Rate for Payer: Preferred Network Access Commercial |
$468.28
|
| Rate for Payer: Quartz Beloit One Network |
$249.41
|
| Rate for Payer: Quartz Commercial |
$330.85
|
| Rate for Payer: Quartz Medicare Advantage |
$305.40
|
| Rate for Payer: The Alliance Commercial |
$2,036.00
|
| Rate for Payer: WEA Trust Commercial |
$279.95
|
| Rate for Payer: WPS Commercial |
$199.94
|
|
|
RHIG
|
Facility
|
IP
|
$509.00
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
2952700
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$249.41 |
| Max. Negotiated Rate |
$468.28 |
| Rate for Payer: Aetna Commercial |
$458.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$437.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$269.77
|
| Rate for Payer: Cash Price |
$152.70
|
| Rate for Payer: Cigna Commercial |
$468.28
|
| Rate for Payer: Health EOS Commercial |
$453.01
|
| Rate for Payer: HFN Commercial |
$468.28
|
| Rate for Payer: Multiplan Commercial |
$407.20
|
| Rate for Payer: NAPHCARE Commercial |
$305.40
|
| Rate for Payer: Preferred Network Access Commercial |
$468.28
|
| Rate for Payer: Quartz Beloit One Network |
$249.41
|
| Rate for Payer: Quartz Commercial |
$305.40
|
| Rate for Payer: WEA Trust Commercial |
$279.95
|
| Rate for Payer: WPS Commercial |
$377.02
|
|
|
RH IG, Full-Dose, IM 90384
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
CPT 90384
|
| Hospital Charge Code |
3549521
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$96.00 |
| Max. Negotiated Rate |
$356.25 |
| Rate for Payer: Aetna Commercial |
$356.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$322.50
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cigna Commercial |
$356.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$96.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$225.00
|
| Rate for Payer: Health EOS Commercial |
$341.25
|
| Rate for Payer: HFN Commercial |
$356.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$202.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$202.34
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Preferred Network Access Commercial |
$356.25
|
| Rate for Payer: Quartz Beloit One Network |
$165.00
|
| Rate for Payer: Quartz Commercial |
$213.75
|
| Rate for Payer: The Alliance Commercial |
$187.50
|
| Rate for Payer: United Healthcare Medicaid |
$96.00
|
| Rate for Payer: WEA Trust Commercial |
$206.25
|
| Rate for Payer: WPS Commercial |
$277.76
|
|
|
RH IG, Full-Dose, IM 90384
|
Facility
|
OP
|
$375.00
|
|
|
Service Code
|
CPT 90384
|
| Hospital Charge Code |
3549521
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$1,500.00 |
| Rate for Payer: Aetna Commercial |
$337.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$322.50
|
| Rate for Payer: Aetna Managed Medicare |
$105.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$243.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$187.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$198.75
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cigna Commercial |
$345.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$209.85
|
| Rate for Payer: Health EOS Commercial |
$333.75
|
| Rate for Payer: HFN Commercial |
$345.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$281.25
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: NAPHCARE Commercial |
$225.00
|
| Rate for Payer: Preferred Network Access Commercial |
$345.00
|
| Rate for Payer: Quartz Beloit One Network |
$183.75
|
| Rate for Payer: Quartz Commercial |
$243.75
|
| Rate for Payer: Quartz Medicare Advantage |
$225.00
|
| Rate for Payer: The Alliance Commercial |
$1,500.00
|
| Rate for Payer: WEA Trust Commercial |
$206.25
|
| Rate for Payer: WPS Commercial |
$277.76
|
|
|
RH IG, Full-Dose, IM 90384
|
Facility
|
IP
|
$375.00
|
|
|
Service Code
|
CPT 90384
|
| Hospital Charge Code |
3549521
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$183.75 |
| Max. Negotiated Rate |
$345.00 |
| Rate for Payer: Aetna Commercial |
$337.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$322.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$198.75
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cigna Commercial |
$345.00
|
| Rate for Payer: Health EOS Commercial |
$333.75
|
| Rate for Payer: HFN Commercial |
$345.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: NAPHCARE Commercial |
$225.00
|
| Rate for Payer: Preferred Network Access Commercial |
$345.00
|
| Rate for Payer: Quartz Beloit One Network |
$183.75
|
| Rate for Payer: Quartz Commercial |
$225.00
|
| Rate for Payer: WEA Trust Commercial |
$206.25
|
| Rate for Payer: WPS Commercial |
$277.76
|
|
