|
ASPIRATOR MECONIUM
|
Facility
IP
|
$98.00
|
|
|
Service Code
|
HCPCS A4628
|
| Hospital Charge Code |
2963172
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.02 |
| Max. Negotiated Rate |
$90.16 |
| Rate for Payer: Aetna Commercial |
$88.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$51.94
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cigna Commercial |
$90.16
|
| Rate for Payer: Health EOS Commercial |
$87.22
|
| Rate for Payer: HFN Commercial |
$90.16
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: NAPHCARE Commercial |
$58.80
|
| Rate for Payer: Preferred Network Access Commercial |
$90.16
|
| Rate for Payer: Quartz Beloit One Network |
$48.02
|
| Rate for Payer: Quartz Commercial |
$58.80
|
| Rate for Payer: WEA Trust Commercial |
$53.90
|
| Rate for Payer: WPS Commercial |
$72.59
|
|
|
ASPIRATOR MECONIUM
|
Facility
OP
|
$98.00
|
|
|
Service Code
|
HCPCS A4628
|
| Hospital Charge Code |
2963172
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$90.16 |
| Rate for Payer: Aetna Commercial |
$88.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$84.28
|
| Rate for Payer: Aetna Managed Medicare |
$27.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$63.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$49.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$47.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$51.94
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cigna Commercial |
$90.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$54.84
|
| Rate for Payer: Health EOS Commercial |
$87.22
|
| Rate for Payer: HFN Commercial |
$90.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: NAPHCARE Commercial |
$58.80
|
| Rate for Payer: Preferred Network Access Commercial |
$90.16
|
| Rate for Payer: Quartz Beloit One Network |
$48.02
|
| Rate for Payer: Quartz Commercial |
$63.70
|
| Rate for Payer: Quartz Medicare Advantage |
$58.80
|
| Rate for Payer: WEA Trust Commercial |
$53.90
|
| Rate for Payer: WPS Commercial |
$72.59
|
|
|
Aspir/Inj Major 20611 - Admin Intra-articular Injection Charge
|
Facility
IP
|
$1,652.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
4510910
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$809.48 |
| Max. Negotiated Rate |
$1,519.84 |
| Rate for Payer: Aetna Commercial |
$1,486.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$875.56
|
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: Cigna Commercial |
$1,519.84
|
| Rate for Payer: Health EOS Commercial |
$1,470.28
|
| Rate for Payer: HFN Commercial |
$1,519.84
|
| Rate for Payer: Multiplan Commercial |
$1,321.60
|
| Rate for Payer: NAPHCARE Commercial |
$991.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,519.84
|
| Rate for Payer: Quartz Beloit One Network |
$809.48
|
| Rate for Payer: Quartz Commercial |
$991.20
|
| Rate for Payer: WEA Trust Commercial |
$908.60
|
| Rate for Payer: WPS Commercial |
$1,223.64
|
|
|
Aspir/Inj Major 20611 - Admin Intra-articular Injection Charge
|
Professional
|
$1,188.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
4510910
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$1,128.60 |
| Rate for Payer: Aetna Commercial |
$1,128.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,021.68
|
| Rate for Payer: Aetna Managed Medicare |
$55.50
|
| Rate for Payer: Anthem Medicare Advantage |
$55.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$55.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$55.50
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cigna Commercial |
$1,128.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$594.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$55.50
|
| Rate for Payer: Health EOS Commercial |
$1,081.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$200.15
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$200.15
|
| Rate for Payer: Independent Care Health Plan Medicare |
$55.50
|
| Rate for Payer: Multiplan Commercial |
$950.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,128.60
|
| Rate for Payer: Quartz Beloit One Network |
$522.72
|
| Rate for Payer: Quartz Commercial |
$677.16
|
| Rate for Payer: Quartz Medicare Advantage |
$55.50
|
| Rate for Payer: The Alliance Commercial |
$235.88
|
| Rate for Payer: United Healthcare Medicaid |
$69.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$55.50
|
| Rate for Payer: WEA Trust Commercial |
$653.40
|
| Rate for Payer: WPS Commercial |
$249.75
|
|
|
Aspir/Inj Major 20611 - Admin Intra-articular Injection Charge
|
Facility
OP
|
$1,652.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
4510910
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$292.75 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$1,486.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,420.72
|
| Rate for Payer: Aetna Managed Medicare |
$292.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,073.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$826.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$792.96
|
| Rate for Payer: Anthem Medicare Advantage |
$292.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$875.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$292.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$292.75
|
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: Cigna Commercial |
$1,519.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$292.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$292.75
|
| Rate for Payer: Health EOS Commercial |
$1,470.28
|
| Rate for Payer: HFN Commercial |
$1,519.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,089.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$292.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$292.75
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$292.75
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$292.75
|
| Rate for Payer: Multiplan Commercial |
$1,321.60
|
| Rate for Payer: NAPHCARE Commercial |
$439.12
|
| Rate for Payer: Preferred Network Access Commercial |
$1,519.84
|
| Rate for Payer: Quartz Beloit One Network |
$809.48
|
| Rate for Payer: Quartz Commercial |
$1,073.80
|
| Rate for Payer: Quartz Medicare Advantage |
$292.75
|
| Rate for Payer: The Alliance Commercial |
$1,024.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$292.75
|
| Rate for Payer: WEA Trust Commercial |
$908.60
|
| Rate for Payer: Wellcare Medicare |
$292.75
|
| Rate for Payer: WPS Commercial |
$1,223.64
|
|
|
ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ - BILAT 5039050
|
Professional
|
$1,693.00
|
|
|
Service Code
|
CPT 50390 50
|
| Hospital Charge Code |
6172493
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$744.92 |
| Max. Negotiated Rate |
$1,608.35 |
| Rate for Payer: Aetna Commercial |
$1,608.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,455.98
|
| Rate for Payer: Cash Price |
$507.90
|
| Rate for Payer: Cash Price |
$507.90
|
| Rate for Payer: Cigna Commercial |
$1,608.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$846.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,015.80
|
| Rate for Payer: Health EOS Commercial |
$1,540.63
|
| Rate for Payer: Multiplan Commercial |
$1,354.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,608.35
|
| Rate for Payer: Quartz Beloit One Network |
$744.92
|
| Rate for Payer: Quartz Commercial |
$965.01
|
| Rate for Payer: The Alliance Commercial |
$846.50
|
| Rate for Payer: WEA Trust Commercial |
$931.15
|
| Rate for Payer: WPS Commercial |
$1,254.01
|
|
|
Assessment of Hearing Aid
|
Facility
OP
|
$305.00
|
|
|
Service Code
|
HCPCS V5010
|
| Hospital Charge Code |
3243550
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$85.40 |
| Max. Negotiated Rate |
$1,220.00 |
| Rate for Payer: Aetna Commercial |
$274.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.30
|
| Rate for Payer: Aetna Managed Medicare |
$85.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$198.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$152.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$146.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.65
|
| Rate for Payer: Cash Price |
$91.50
|
| Rate for Payer: Cigna Commercial |
$280.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$170.68
|
| Rate for Payer: Health EOS Commercial |
$271.45
|
| Rate for Payer: HFN Commercial |
$280.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$228.75
|
| Rate for Payer: Multiplan Commercial |
$244.00
|
| Rate for Payer: NAPHCARE Commercial |
$183.00
|
| Rate for Payer: Preferred Network Access Commercial |
$280.60
|
| Rate for Payer: Quartz Beloit One Network |
$149.45
|
| Rate for Payer: Quartz Commercial |
$198.25
|
| Rate for Payer: Quartz Medicare Advantage |
$183.00
|
| Rate for Payer: The Alliance Commercial |
$1,220.00
|
| Rate for Payer: United Healthcare PPO |
$228.75
|
| Rate for Payer: WEA Trust Commercial |
$167.75
|
| Rate for Payer: WPS Commercial |
$225.91
|
|
|
Assessment of Hearing Aid
|
Facility
IP
|
$305.00
|
|
|
Service Code
|
HCPCS V5010
|
| Hospital Charge Code |
3243550
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$149.45 |
| Max. Negotiated Rate |
$280.60 |
| Rate for Payer: Aetna Commercial |
$274.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.65
|
| Rate for Payer: Cash Price |
$91.50
|
| Rate for Payer: Cigna Commercial |
$280.60
|
| Rate for Payer: Health EOS Commercial |
$271.45
|
| Rate for Payer: HFN Commercial |
$280.60
|
| Rate for Payer: Multiplan Commercial |
$244.00
|
| Rate for Payer: NAPHCARE Commercial |
$183.00
|
| Rate for Payer: Preferred Network Access Commercial |
$280.60
|
| Rate for Payer: Quartz Beloit One Network |
$149.45
|
| Rate for Payer: Quartz Commercial |
$183.00
|
| Rate for Payer: WEA Trust Commercial |
$167.75
|
| Rate for Payer: WPS Commercial |
$225.91
|
|
|
Assessment of Hearing Aid
|
Professional
|
$305.00
|
|
|
Service Code
|
HCPCS V5010
|
| Hospital Charge Code |
3243550
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$289.75 |
| Rate for Payer: Aetna Commercial |
$289.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.30
|
| Rate for Payer: Cash Price |
$91.50
|
| Rate for Payer: Cash Price |
$91.50
|
| Rate for Payer: Cigna Commercial |
$289.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$152.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$183.00
|
| Rate for Payer: Health EOS Commercial |
$277.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$171.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$171.73
|
| Rate for Payer: Multiplan Commercial |
$244.00
|
| Rate for Payer: Preferred Network Access Commercial |
$289.75
|
| Rate for Payer: Quartz Beloit One Network |
$134.20
|
| Rate for Payer: Quartz Commercial |
$173.85
|
| Rate for Payer: The Alliance Commercial |
$152.50
|
| Rate for Payer: WEA Trust Commercial |
$167.75
|
| Rate for Payer: WPS Commercial |
$225.91
|
|
|
Assessment Of Tinnitus
|
Professional
|
$164.00
|
|
|
Service Code
|
CPT 92625
|
| Hospital Charge Code |
3203481
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$59.36 |
| Max. Negotiated Rate |
$239.79 |
| Rate for Payer: Aetna Commercial |
$155.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$141.04
|
| Rate for Payer: Aetna Managed Medicare |
$59.36
|
| Rate for Payer: Anthem Medicare Advantage |
$59.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$59.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$59.36
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cigna Commercial |
$155.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$82.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$59.36
|
| Rate for Payer: Health EOS Commercial |
$149.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$239.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$239.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$59.36
|
| Rate for Payer: Multiplan Commercial |
$131.20
|
| Rate for Payer: Preferred Network Access Commercial |
$155.80
|
| Rate for Payer: Quartz Beloit One Network |
$72.16
|
| Rate for Payer: Quartz Commercial |
$93.48
|
| Rate for Payer: Quartz Medicare Advantage |
$59.36
|
| Rate for Payer: The Alliance Commercial |
$148.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$59.36
|
| Rate for Payer: WEA Trust Commercial |
$90.20
|
| Rate for Payer: WPS Commercial |
$237.44
|
|
|
Assessment Of Tinnitus
|
Facility
OP
|
$164.00
|
|
|
Service Code
|
CPT 92625
|
| Hospital Charge Code |
3203481
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$78.72 |
| Max. Negotiated Rate |
$574.33 |
| Rate for Payer: Aetna Commercial |
$147.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$141.04
|
| Rate for Payer: Aetna Managed Medicare |
$154.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$106.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$82.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$78.72
|
| Rate for Payer: Anthem Medicare Advantage |
$154.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$86.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$154.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$154.39
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cigna Commercial |
$150.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$154.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$91.77
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$154.39
|
| Rate for Payer: Health EOS Commercial |
$145.96
|
| Rate for Payer: HFN Commercial |
$150.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$574.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$154.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$154.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$154.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$154.39
|
| Rate for Payer: Multiplan Commercial |
$131.20
|
| Rate for Payer: NAPHCARE Commercial |
$231.58
|
| Rate for Payer: Preferred Network Access Commercial |
$150.88
|
| Rate for Payer: Quartz Beloit One Network |
$80.36
|
| Rate for Payer: Quartz Commercial |
$106.60
|
| Rate for Payer: Quartz Medicare Advantage |
$154.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$154.39
|
| Rate for Payer: United Healthcare PPO |
$123.00
|
| Rate for Payer: WEA Trust Commercial |
$90.20
|
| Rate for Payer: Wellcare Medicare |
$154.39
|
| Rate for Payer: WPS Commercial |
$121.47
|
|
|
Assessment Of Tinnitus
|
Facility
IP
|
$164.00
|
|
|
Service Code
|
CPT 92625
|
| Hospital Charge Code |
3203481
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$80.36 |
| Max. Negotiated Rate |
$150.88 |
| Rate for Payer: Aetna Commercial |
$147.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$86.92
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cigna Commercial |
$150.88
|
| Rate for Payer: Health EOS Commercial |
$145.96
|
| Rate for Payer: HFN Commercial |
$150.88
|
| Rate for Payer: Multiplan Commercial |
$131.20
|
| Rate for Payer: NAPHCARE Commercial |
$98.40
|
| Rate for Payer: Preferred Network Access Commercial |
$150.88
|
| Rate for Payer: Quartz Beloit One Network |
$80.36
|
| Rate for Payer: Quartz Commercial |
$98.40
|
| Rate for Payer: WEA Trust Commercial |
$90.20
|
| Rate for Payer: WPS Commercial |
$121.47
|
|
|
AST (FS)
|
Facility
OP
|
$5.00
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
4538806
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.45 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Aetna Commercial |
$4.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4.30
|
| Rate for Payer: Aetna Managed Medicare |
$5.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.06
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.60
|
| Rate for Payer: Anthem Medicaid |
$5.35
|
| Rate for Payer: Anthem Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.18
|
| Rate for Payer: Cash Price |
$1.50
|
| Rate for Payer: Cash Price |
$1.50
|
| Rate for Payer: Cigna Commercial |
$4.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.35
|
| Rate for Payer: Dean Health Medicaid |
$5.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.18
|
| Rate for Payer: Health EOS Commercial |
$4.45
|
| Rate for Payer: HFN Commercial |
$4.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.27
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.18
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.35
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.18
|
| Rate for Payer: Managed Health Services Medicaid |
$5.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.18
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.18
|
| Rate for Payer: Multiplan Commercial |
$4.00
|
| Rate for Payer: NAPHCARE Commercial |
$7.77
|
| Rate for Payer: Preferred Network Access Commercial |
$4.60
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.35
|
| Rate for Payer: Quartz Beloit One Network |
$2.45
|
| Rate for Payer: Quartz Commercial |
$3.25
|
| Rate for Payer: Quartz Medicare Advantage |
$5.18
|
| Rate for Payer: The Alliance Commercial |
$20.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: United Healthcare PPO |
$3.75
|
| Rate for Payer: WEA Trust Commercial |
$2.75
|
| Rate for Payer: Wellcare Medicare |
$5.18
|
| Rate for Payer: WMAP Medicaid |
$5.35
|
| Rate for Payer: WPS Commercial |
$3.70
|
|
|
AST (FS)
|
Facility
IP
|
$5.00
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
4538806
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.45 |
| Max. Negotiated Rate |
$4.60 |
| Rate for Payer: Aetna Commercial |
$4.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2.65
|
| Rate for Payer: Cash Price |
$1.50
|
| Rate for Payer: Cigna Commercial |
$4.60
|
| Rate for Payer: Health EOS Commercial |
$4.45
|
| Rate for Payer: HFN Commercial |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$4.00
|
| Rate for Payer: NAPHCARE Commercial |
$3.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4.60
|
| Rate for Payer: Quartz Beloit One Network |
$2.45
|
| Rate for Payer: Quartz Commercial |
$3.00
|
| Rate for Payer: WEA Trust Commercial |
$2.75
|
| Rate for Payer: WPS Commercial |
$3.70
|
|
|
AST (FS)
|
Professional
|
$5.00
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
4538806
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$22.79 |
| Rate for Payer: Aetna Commercial |
$4.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4.30
|
| Rate for Payer: Aetna Managed Medicare |
$5.18
|
| Rate for Payer: Anthem Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.18
|
| Rate for Payer: Cash Price |
$1.50
|
| Rate for Payer: Cash Price |
$1.50
|
| Rate for Payer: Cigna Commercial |
$4.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.18
|
| Rate for Payer: Health EOS Commercial |
$4.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.18
|
| Rate for Payer: Multiplan Commercial |
$4.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4.75
|
| Rate for Payer: Quartz Beloit One Network |
$2.20
|
| Rate for Payer: Quartz Commercial |
$2.85
|
| Rate for Payer: Quartz Medicare Advantage |
$5.18
|
| Rate for Payer: The Alliance Commercial |
$20.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: WEA Trust Commercial |
$2.75
|
| Rate for Payer: WPS Commercial |
$22.79
|
|
|
Atherec/Stent/PTA Tib/Peroneal Ea Add +
|
Facility
IP
|
$4,620.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
3052456
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,263.80 |
| Max. Negotiated Rate |
$4,250.40 |
| Rate for Payer: Aetna Commercial |
$4,158.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,448.60
|
| Rate for Payer: Cash Price |
$1,386.00
|
| Rate for Payer: Cigna Commercial |
$4,250.40
|
| Rate for Payer: Health EOS Commercial |
$4,111.80
|
| Rate for Payer: HFN Commercial |
$4,250.40
|
| Rate for Payer: Multiplan Commercial |
$3,696.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,772.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,250.40
|
| Rate for Payer: Quartz Beloit One Network |
$2,263.80
|
| Rate for Payer: Quartz Commercial |
$2,772.00
|
| Rate for Payer: WEA Trust Commercial |
$2,541.00
|
| Rate for Payer: WPS Commercial |
$3,422.03
|
|
|
Atherec/Stent/PTA Tib/Peroneal Ea Add +
|
Facility
OP
|
$4,620.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
3052456
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,293.60 |
| Max. Negotiated Rate |
$20,943.68 |
| Rate for Payer: Aetna Commercial |
$4,158.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,973.20
|
| Rate for Payer: Aetna Managed Medicare |
$1,293.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,003.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,310.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,217.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,448.60
|
| Rate for Payer: Cash Price |
$1,386.00
|
| Rate for Payer: Cash Price |
$1,386.00
|
| Rate for Payer: Cigna Commercial |
$4,250.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Health EOS Commercial |
$4,111.80
|
| Rate for Payer: HFN Commercial |
$4,250.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,465.00
|
| Rate for Payer: Multiplan Commercial |
$3,696.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,772.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,250.40
|
| Rate for Payer: Quartz Beloit One Network |
$2,263.80
|
| Rate for Payer: Quartz Commercial |
$3,003.00
|
| Rate for Payer: Quartz Medicare Advantage |
$2,772.00
|
| Rate for Payer: The Alliance Commercial |
$20,943.68
|
| Rate for Payer: WEA Trust Commercial |
$2,541.00
|
| Rate for Payer: WPS Commercial |
$3,422.03
|
|
|
Atherectomy Iliac, Ea.
|
Facility
IP
|
$26,231.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
5446677
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,853.19 |
| Max. Negotiated Rate |
$24,132.52 |
| Rate for Payer: Aetna Commercial |
$23,607.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13,902.43
|
| Rate for Payer: Cash Price |
$7,869.30
|
| Rate for Payer: Cigna Commercial |
$24,132.52
|
| Rate for Payer: Health EOS Commercial |
$23,345.59
|
| Rate for Payer: HFN Commercial |
$24,132.52
|
| Rate for Payer: Multiplan Commercial |
$20,984.80
|
| Rate for Payer: NAPHCARE Commercial |
$15,738.60
|
| Rate for Payer: Preferred Network Access Commercial |
$24,132.52
|
| Rate for Payer: Quartz Beloit One Network |
$12,853.19
|
| Rate for Payer: Quartz Commercial |
$15,738.60
|
| Rate for Payer: WEA Trust Commercial |
$14,427.05
|
| Rate for Payer: WPS Commercial |
$19,429.30
|
|
|
Atherectomy Iliac, Ea.
|
Facility
OP
|
$26,231.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
5446677
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,218.22 |
| Max. Negotiated Rate |
$64,474.41 |
| Rate for Payer: Aetna Commercial |
$23,607.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22,558.66
|
| Rate for Payer: Aetna Managed Medicare |
$17,331.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,815.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,378.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,460.00
|
| Rate for Payer: Anthem Medicare Advantage |
$17,331.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13,902.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17,331.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17,331.83
|
| Rate for Payer: Cash Price |
$7,869.30
|
| Rate for Payer: Cash Price |
$7,869.30
|
| Rate for Payer: Cash Price |
$7,869.30
|
| Rate for Payer: Cigna Commercial |
$24,132.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17,331.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17,331.83
|
| Rate for Payer: Health EOS Commercial |
$23,345.59
|
| Rate for Payer: HFN Commercial |
$24,132.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64,474.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17,331.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17,331.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17,331.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17,331.83
|
| Rate for Payer: Multiplan Commercial |
$20,984.80
|
| Rate for Payer: NAPHCARE Commercial |
$25,997.74
|
| Rate for Payer: Preferred Network Access Commercial |
$24,132.52
|
| Rate for Payer: Quartz Beloit One Network |
$12,853.19
|
| Rate for Payer: Quartz Commercial |
$17,050.15
|
| Rate for Payer: Quartz Medicare Advantage |
$17,331.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,331.83
|
| Rate for Payer: United Healthcare PPO |
$11,078.00
|
| Rate for Payer: WEA Trust Commercial |
$14,427.05
|
| Rate for Payer: Wellcare Medicare |
$17,331.83
|
| Rate for Payer: WPS Commercial |
$19,429.30
|
|
|
Atherectomy Tib/Peroneal Ea Add Vessel +
|
Facility
OP
|
$3,682.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
3052454
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,030.96 |
| Max. Negotiated Rate |
$20,943.68 |
| Rate for Payer: Aetna Commercial |
$3,313.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,166.52
|
| Rate for Payer: Aetna Managed Medicare |
$1,030.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,393.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,841.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,767.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,951.46
|
| Rate for Payer: Cash Price |
$1,104.60
|
| Rate for Payer: Cash Price |
$1,104.60
|
| Rate for Payer: Cigna Commercial |
$3,387.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Health EOS Commercial |
$3,276.98
|
| Rate for Payer: HFN Commercial |
$3,387.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,761.50
|
| Rate for Payer: Multiplan Commercial |
$2,945.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,209.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,387.44
|
| Rate for Payer: Quartz Beloit One Network |
$1,804.18
|
| Rate for Payer: Quartz Commercial |
$2,393.30
|
| Rate for Payer: Quartz Medicare Advantage |
$2,209.20
|
| Rate for Payer: The Alliance Commercial |
$20,943.68
|
| Rate for Payer: WEA Trust Commercial |
$2,025.10
|
| Rate for Payer: WPS Commercial |
$2,727.26
|
|
|
Atherectomy Tib/Peroneal Ea Add Vessel +
|
Facility
IP
|
$3,682.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
3052454
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,804.18 |
| Max. Negotiated Rate |
$3,387.44 |
| Rate for Payer: Aetna Commercial |
$3,313.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,951.46
|
| Rate for Payer: Cash Price |
$1,104.60
|
| Rate for Payer: Cigna Commercial |
$3,387.44
|
| Rate for Payer: Health EOS Commercial |
$3,276.98
|
| Rate for Payer: HFN Commercial |
$3,387.44
|
| Rate for Payer: Multiplan Commercial |
$2,945.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,209.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,387.44
|
| Rate for Payer: Quartz Beloit One Network |
$1,804.18
|
| Rate for Payer: Quartz Commercial |
$2,209.20
|
| Rate for Payer: WEA Trust Commercial |
$2,025.10
|
| Rate for Payer: WPS Commercial |
$2,727.26
|
|
|
ATHEROSCLEROSIS WITH MCC
|
Facility
IP
|
$30,126.00
|
|
|
Service Code
|
MS-DRG 302
|
| Min. Negotiated Rate |
$10,836.68 |
| Max. Negotiated Rate |
$30,126.00 |
| Rate for Payer: Aetna Managed Medicare |
$10,836.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,497.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,010.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,111.36
|
| Rate for Payer: Anthem Medicare Advantage |
$10,836.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,836.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,836.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,836.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18,995.18
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,836.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,861.45
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,836.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,836.68
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,836.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,836.68
|
| Rate for Payer: NAPHCARE Commercial |
$16,255.02
|
| Rate for Payer: Quartz Medicare Advantage |
$10,836.68
|
| Rate for Payer: The Alliance Commercial |
$30,126.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,836.68
|
| Rate for Payer: United Healthcare PPO |
$17,019.42
|
| Rate for Payer: Wellcare Medicare |
$10,836.68
|
|
|
ATHEROSCLEROSIS WITHOUT MCC
|
Facility
IP
|
$17,817.00
|
|
|
Service Code
|
MS-DRG 303
|
| Min. Negotiated Rate |
$6,408.86 |
| Max. Negotiated Rate |
$17,817.00 |
| Rate for Payer: Aetna Managed Medicare |
$6,408.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$13,846.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10,613.46
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,083.48
|
| Rate for Payer: Anthem Medicare Advantage |
$6,408.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,408.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,408.86
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,408.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,193.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,408.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,832.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,408.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,408.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,408.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,408.86
|
| Rate for Payer: NAPHCARE Commercial |
$9,613.29
|
| Rate for Payer: Quartz Medicare Advantage |
$6,408.86
|
| Rate for Payer: The Alliance Commercial |
$17,817.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,408.86
|
| Rate for Payer: United Healthcare PPO |
$9,990.62
|
| Rate for Payer: Wellcare Medicare |
$6,408.86
|
|
|
Athrec/Stent/PTA Fem/Pop
|
Facility
IP
|
$9,758.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
3052448
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,781.42 |
| Max. Negotiated Rate |
$8,977.36 |
| Rate for Payer: Aetna Commercial |
$8,782.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,171.74
|
| Rate for Payer: Cash Price |
$2,927.40
|
| Rate for Payer: Cigna Commercial |
$8,977.36
|
| Rate for Payer: Health EOS Commercial |
$8,684.62
|
| Rate for Payer: HFN Commercial |
$8,977.36
|
| Rate for Payer: Multiplan Commercial |
$7,806.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,854.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,977.36
|
| Rate for Payer: Quartz Beloit One Network |
$4,781.42
|
| Rate for Payer: Quartz Commercial |
$5,854.80
|
| Rate for Payer: WEA Trust Commercial |
$5,366.90
|
| Rate for Payer: WPS Commercial |
$7,227.75
|
|
|
Athrec/Stent/PTA Fem/Pop
|
Facility
OP
|
$9,758.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
3052448
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,781.42 |
| Max. Negotiated Rate |
$64,474.41 |
| Rate for Payer: Aetna Commercial |
$8,782.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,391.88
|
| Rate for Payer: Aetna Managed Medicare |
$17,331.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,815.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,378.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,460.00
|
| Rate for Payer: Anthem Medicare Advantage |
$17,331.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,171.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17,331.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17,331.83
|
| Rate for Payer: Cash Price |
$2,927.40
|
| Rate for Payer: Cash Price |
$2,927.40
|
| Rate for Payer: Cash Price |
$2,927.40
|
| Rate for Payer: Cigna Commercial |
$8,977.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17,331.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17,331.83
|
| Rate for Payer: Health EOS Commercial |
$8,684.62
|
| Rate for Payer: HFN Commercial |
$8,977.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64,474.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17,331.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17,331.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17,331.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17,331.83
|
| Rate for Payer: Multiplan Commercial |
$7,806.40
|
| Rate for Payer: NAPHCARE Commercial |
$25,997.74
|
| Rate for Payer: Preferred Network Access Commercial |
$8,977.36
|
| Rate for Payer: Quartz Beloit One Network |
$4,781.42
|
| Rate for Payer: Quartz Commercial |
$6,342.70
|
| Rate for Payer: Quartz Medicare Advantage |
$17,331.83
|
| Rate for Payer: The Alliance Commercial |
$20,943.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,331.83
|
| Rate for Payer: United Healthcare PPO |
$11,078.00
|
| Rate for Payer: WEA Trust Commercial |
$5,366.90
|
| Rate for Payer: Wellcare Medicare |
$17,331.83
|
| Rate for Payer: WPS Commercial |
$7,227.75
|
|
