|
ASCA IgA
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2770814
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$79.03 |
| Rate for Payer: Aetna Commercial |
$71.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$64.40
|
| Rate for Payer: Aetna Managed Medicare |
$17.96
|
| Rate for Payer: Anthem Medicare Advantage |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.96
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cigna Commercial |
$71.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$37.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.96
|
| Rate for Payer: Health EOS Commercial |
$68.14
|
| Rate for Payer: HFN Commercial |
$71.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.96
|
| Rate for Payer: Multiplan Commercial |
$59.90
|
| Rate for Payer: NAPHCARE Commercial |
$26.94
|
| Rate for Payer: Preferred Network Access Commercial |
$71.14
|
| Rate for Payer: Quartz Beloit One Network |
$32.95
|
| Rate for Payer: Quartz Commercial |
$42.68
|
| Rate for Payer: Quartz Medicare Advantage |
$17.96
|
| Rate for Payer: The Alliance Commercial |
$70.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.96
|
| Rate for Payer: WEA Trust Commercial |
$41.18
|
| Rate for Payer: WPS Commercial |
$79.03
|
|
|
ASCA IgA
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2770814
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.69 |
| Max. Negotiated Rate |
$68.89 |
| Rate for Payer: Aetna Commercial |
$67.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$64.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$39.69
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cigna Commercial |
$68.89
|
| Rate for Payer: Health EOS Commercial |
$66.64
|
| Rate for Payer: HFN Commercial |
$68.89
|
| Rate for Payer: Multiplan Commercial |
$59.90
|
| Rate for Payer: Preferred Network Access Commercial |
$68.89
|
| Rate for Payer: Quartz Beloit One Network |
$36.69
|
| Rate for Payer: Quartz Commercial |
$44.93
|
| Rate for Payer: WEA Trust Commercial |
$41.18
|
| Rate for Payer: WPS Commercial |
$55.46
|
|
|
ASCA IgG
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2770815
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.69 |
| Max. Negotiated Rate |
$68.89 |
| Rate for Payer: Aetna Commercial |
$67.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$64.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$39.69
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cigna Commercial |
$68.89
|
| Rate for Payer: Health EOS Commercial |
$66.64
|
| Rate for Payer: HFN Commercial |
$68.89
|
| Rate for Payer: Multiplan Commercial |
$59.90
|
| Rate for Payer: Preferred Network Access Commercial |
$68.89
|
| Rate for Payer: Quartz Beloit One Network |
$36.69
|
| Rate for Payer: Quartz Commercial |
$44.93
|
| Rate for Payer: WEA Trust Commercial |
$41.18
|
| Rate for Payer: WPS Commercial |
$55.46
|
|
|
ASCA IgG
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2770815
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$79.03 |
| Rate for Payer: Aetna Commercial |
$71.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$64.40
|
| Rate for Payer: Aetna Managed Medicare |
$17.96
|
| Rate for Payer: Anthem Medicare Advantage |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.96
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cigna Commercial |
$71.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$37.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.96
|
| Rate for Payer: Health EOS Commercial |
$68.14
|
| Rate for Payer: HFN Commercial |
$71.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.96
|
| Rate for Payer: Multiplan Commercial |
$59.90
|
| Rate for Payer: NAPHCARE Commercial |
$26.94
|
| Rate for Payer: Preferred Network Access Commercial |
$71.14
|
| Rate for Payer: Quartz Beloit One Network |
$32.95
|
| Rate for Payer: Quartz Commercial |
$42.68
|
| Rate for Payer: Quartz Medicare Advantage |
$17.96
|
| Rate for Payer: The Alliance Commercial |
$70.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.96
|
| Rate for Payer: WEA Trust Commercial |
$41.18
|
| Rate for Payer: WPS Commercial |
$79.03
|
|
|
ASCA IgG
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2770815
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$71.84 |
| Rate for Payer: Aetna Commercial |
$67.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$64.40
|
| Rate for Payer: Aetna Managed Medicare |
$17.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.81
|
| Rate for Payer: Anthem Medicare Advantage |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$39.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.96
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cigna Commercial |
$68.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$41.90
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.96
|
| Rate for Payer: Health EOS Commercial |
$66.64
|
| Rate for Payer: HFN Commercial |
$68.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.96
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.96
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.96
|
| Rate for Payer: Multiplan Commercial |
$59.90
|
| Rate for Payer: NAPHCARE Commercial |
$26.94
|
| Rate for Payer: Preferred Network Access Commercial |
$68.89
|
| Rate for Payer: Quartz Beloit One Network |
$36.69
|
| Rate for Payer: Quartz Commercial |
$48.67
|
| Rate for Payer: Quartz Medicare Advantage |
$17.96
|
| Rate for Payer: The Alliance Commercial |
$71.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.96
|
| Rate for Payer: United Healthcare PPO |
$56.16
|
| Rate for Payer: WEA Trust Commercial |
$41.18
|
| Rate for Payer: Wellcare Medicare |
$17.96
|
| Rate for Payer: WPS Commercial |
$55.46
|
|
|
ASCA IgG Ab
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
5439032
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.81 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Aetna Commercial |
$78.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.30
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$80.37
|
| Rate for Payer: Health EOS Commercial |
$77.75
|
| Rate for Payer: HFN Commercial |
$80.37
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: Preferred Network Access Commercial |
$80.37
|
| Rate for Payer: Quartz Beloit One Network |
$42.81
|
| Rate for Payer: Quartz Commercial |
$52.42
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: WPS Commercial |
$64.71
|
|
|
ASCA IgG Ab
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
5439032
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Aetna Commercial |
$82.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Aetna Managed Medicare |
$12.74
|
| Rate for Payer: Anthem Medicare Advantage |
$12.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.74
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$82.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.74
|
| Rate for Payer: Health EOS Commercial |
$79.50
|
| Rate for Payer: HFN Commercial |
$82.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$44.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.74
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: NAPHCARE Commercial |
$19.11
|
| Rate for Payer: Preferred Network Access Commercial |
$82.99
|
| Rate for Payer: Quartz Beloit One Network |
$38.44
|
| Rate for Payer: Quartz Commercial |
$49.80
|
| Rate for Payer: Quartz Medicare Advantage |
$12.74
|
| Rate for Payer: The Alliance Commercial |
$50.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.74
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: WPS Commercial |
$56.06
|
|
|
ASCA IgG Ab
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
5439032
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Aetna Commercial |
$78.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Aetna Managed Medicare |
$12.74
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$47.77
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22.30
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21.15
|
| Rate for Payer: Anthem Medicare Advantage |
$12.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.74
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$80.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.74
|
| Rate for Payer: Health EOS Commercial |
$77.75
|
| Rate for Payer: HFN Commercial |
$80.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$47.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.74
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.74
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.74
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.74
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: NAPHCARE Commercial |
$19.11
|
| Rate for Payer: Preferred Network Access Commercial |
$80.37
|
| Rate for Payer: Quartz Beloit One Network |
$42.81
|
| Rate for Payer: Quartz Commercial |
$56.78
|
| Rate for Payer: Quartz Medicare Advantage |
$12.74
|
| Rate for Payer: The Alliance Commercial |
$50.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.74
|
| Rate for Payer: United Healthcare PPO |
$65.52
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: Wellcare Medicare |
$12.74
|
| Rate for Payer: WPS Commercial |
$64.71
|
|
|
Aspartate Aminotransferase
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
633633
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$81.33 |
| Rate for Payer: Aetna Commercial |
$79.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.02
|
| Rate for Payer: Aetna Managed Medicare |
$5.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.94
|
| Rate for Payer: Anthem Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.39
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cigna Commercial |
$81.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$49.47
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.39
|
| Rate for Payer: Health EOS Commercial |
$78.68
|
| Rate for Payer: HFN Commercial |
$81.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$70.72
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$81.33
|
| Rate for Payer: Quartz Beloit One Network |
$43.32
|
| Rate for Payer: Quartz Commercial |
$57.46
|
| Rate for Payer: Quartz Medicare Advantage |
$5.39
|
| Rate for Payer: The Alliance Commercial |
$21.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: United Healthcare PPO |
$66.30
|
| Rate for Payer: WEA Trust Commercial |
$48.62
|
| Rate for Payer: Wellcare Medicare |
$5.39
|
| Rate for Payer: WPS Commercial |
$65.48
|
|
|
Aspartate Aminotransferase
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
633633
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$83.98 |
| Rate for Payer: Aetna Commercial |
$83.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.02
|
| Rate for Payer: Aetna Managed Medicare |
$5.39
|
| Rate for Payer: Anthem Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.39
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cigna Commercial |
$83.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$44.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.39
|
| Rate for Payer: Health EOS Commercial |
$80.44
|
| Rate for Payer: HFN Commercial |
$83.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$70.72
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$83.98
|
| Rate for Payer: Quartz Beloit One Network |
$38.90
|
| Rate for Payer: Quartz Commercial |
$50.39
|
| Rate for Payer: Quartz Medicare Advantage |
$5.39
|
| Rate for Payer: The Alliance Commercial |
$21.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: WEA Trust Commercial |
$48.62
|
| Rate for Payer: WPS Commercial |
$23.70
|
|
|
Aspartate Aminotransferase
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
633633
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.32 |
| Max. Negotiated Rate |
$81.33 |
| Rate for Payer: Aetna Commercial |
$79.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.85
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cigna Commercial |
$81.33
|
| Rate for Payer: Health EOS Commercial |
$78.68
|
| Rate for Payer: HFN Commercial |
$81.33
|
| Rate for Payer: Multiplan Commercial |
$70.72
|
| Rate for Payer: Preferred Network Access Commercial |
$81.33
|
| Rate for Payer: Quartz Beloit One Network |
$43.32
|
| Rate for Payer: Quartz Commercial |
$53.04
|
| Rate for Payer: WEA Trust Commercial |
$48.62
|
| Rate for Payer: WPS Commercial |
$65.48
|
|
|
Aspergillis Niger Ab
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
5605704
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$114.82 |
| Rate for Payer: Aetna Commercial |
$112.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.33
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$58.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.98
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$114.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$69.84
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$111.07
|
| Rate for Payer: HFN Commercial |
$114.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$99.84
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$114.82
|
| Rate for Payer: Quartz Beloit One Network |
$61.15
|
| Rate for Payer: Quartz Commercial |
$81.12
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$62.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: United Healthcare PPO |
$93.60
|
| Rate for Payer: WEA Trust Commercial |
$68.64
|
| Rate for Payer: Wellcare Medicare |
$15.65
|
| Rate for Payer: WPS Commercial |
$92.44
|
|
|
Aspergillis Niger Ab
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
5605704
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$118.56 |
| Rate for Payer: Aetna Commercial |
$118.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.33
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$118.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$62.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$113.57
|
| Rate for Payer: HFN Commercial |
$118.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$55.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$55.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$99.84
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$118.56
|
| Rate for Payer: Quartz Beloit One Network |
$54.91
|
| Rate for Payer: Quartz Commercial |
$71.14
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$61.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: WEA Trust Commercial |
$68.64
|
| Rate for Payer: WPS Commercial |
$68.87
|
|
|
Aspergillis Niger Ab
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
5605704
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.15 |
| Max. Negotiated Rate |
$114.82 |
| Rate for Payer: Aetna Commercial |
$112.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.14
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$114.82
|
| Rate for Payer: Health EOS Commercial |
$111.07
|
| Rate for Payer: HFN Commercial |
$114.82
|
| Rate for Payer: Multiplan Commercial |
$99.84
|
| Rate for Payer: Preferred Network Access Commercial |
$114.82
|
| Rate for Payer: Quartz Beloit One Network |
$61.15
|
| Rate for Payer: Quartz Commercial |
$74.88
|
| Rate for Payer: WEA Trust Commercial |
$68.64
|
| Rate for Payer: WPS Commercial |
$92.44
|
|
|
Aspergillus Antibody CF
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
4392615
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$62.61 |
| Rate for Payer: Aetna Commercial |
$45.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$58.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.98
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$46.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28.52
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$45.35
|
| Rate for Payer: HFN Commercial |
$46.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$46.88
|
| Rate for Payer: Quartz Beloit One Network |
$24.97
|
| Rate for Payer: Quartz Commercial |
$33.12
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$62.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: United Healthcare PPO |
$38.22
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: Wellcare Medicare |
$15.65
|
| Rate for Payer: WPS Commercial |
$37.74
|
|
|
Aspergillus Antibody CF
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
4392615
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$68.87 |
| Rate for Payer: Aetna Commercial |
$48.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$48.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$46.37
|
| Rate for Payer: HFN Commercial |
$48.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$55.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$55.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$48.41
|
| Rate for Payer: Quartz Beloit One Network |
$22.42
|
| Rate for Payer: Quartz Commercial |
$29.05
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$61.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$68.87
|
|
|
Aspergillus Antibody CF
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
4392615
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$46.88 |
| Rate for Payer: Aetna Commercial |
$45.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.01
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$46.88
|
| Rate for Payer: Health EOS Commercial |
$45.35
|
| Rate for Payer: HFN Commercial |
$46.88
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: Preferred Network Access Commercial |
$46.88
|
| Rate for Payer: Quartz Beloit One Network |
$24.97
|
| Rate for Payer: Quartz Commercial |
$30.58
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$37.74
|
|
|
Aspergillus Antibody Panel, CF and ID
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
5582804
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.15 |
| Max. Negotiated Rate |
$114.82 |
| Rate for Payer: Aetna Commercial |
$112.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.14
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$114.82
|
| Rate for Payer: Health EOS Commercial |
$111.07
|
| Rate for Payer: HFN Commercial |
$114.82
|
| Rate for Payer: Multiplan Commercial |
$99.84
|
| Rate for Payer: Preferred Network Access Commercial |
$114.82
|
| Rate for Payer: Quartz Beloit One Network |
$61.15
|
| Rate for Payer: Quartz Commercial |
$74.88
|
| Rate for Payer: WEA Trust Commercial |
$68.64
|
| Rate for Payer: WPS Commercial |
$92.44
|
|
|
Aspergillus Antibody Panel, CF and ID
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
5582804
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$114.82 |
| Rate for Payer: Aetna Commercial |
$112.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.33
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$58.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.98
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$114.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$69.84
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$111.07
|
| Rate for Payer: HFN Commercial |
$114.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$99.84
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$114.82
|
| Rate for Payer: Quartz Beloit One Network |
$61.15
|
| Rate for Payer: Quartz Commercial |
$81.12
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$62.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: United Healthcare PPO |
$93.60
|
| Rate for Payer: WEA Trust Commercial |
$68.64
|
| Rate for Payer: Wellcare Medicare |
$15.65
|
| Rate for Payer: WPS Commercial |
$92.44
|
|
|
Aspergillus Antibody Panel, CF and ID
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
5582804
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$118.56 |
| Rate for Payer: Aetna Commercial |
$118.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.33
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$118.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$62.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$113.57
|
| Rate for Payer: HFN Commercial |
$118.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$55.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$55.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$99.84
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$118.56
|
| Rate for Payer: Quartz Beloit One Network |
$54.91
|
| Rate for Payer: Quartz Commercial |
$71.14
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$61.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: WEA Trust Commercial |
$68.64
|
| Rate for Payer: WPS Commercial |
$68.87
|
|
|
Aspergillus Antibody Screen
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
980029
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$129.17 |
| Rate for Payer: Aetna Commercial |
$126.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$120.74
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$58.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.98
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$74.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cigna Commercial |
$129.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$78.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$124.96
|
| Rate for Payer: HFN Commercial |
$129.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$112.32
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$129.17
|
| Rate for Payer: Quartz Beloit One Network |
$68.80
|
| Rate for Payer: Quartz Commercial |
$91.26
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$62.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: United Healthcare PPO |
$105.30
|
| Rate for Payer: WEA Trust Commercial |
$77.22
|
| Rate for Payer: Wellcare Medicare |
$15.65
|
| Rate for Payer: WPS Commercial |
$103.99
|
|
|
Aspergillus Antibody Screen
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
980029
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$129.17 |
| Rate for Payer: Aetna Commercial |
$126.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$120.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$74.41
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cigna Commercial |
$129.17
|
| Rate for Payer: Health EOS Commercial |
$124.96
|
| Rate for Payer: HFN Commercial |
$129.17
|
| Rate for Payer: Multiplan Commercial |
$112.32
|
| Rate for Payer: Preferred Network Access Commercial |
$129.17
|
| Rate for Payer: Quartz Beloit One Network |
$68.80
|
| Rate for Payer: Quartz Commercial |
$84.24
|
| Rate for Payer: WEA Trust Commercial |
$77.22
|
| Rate for Payer: WPS Commercial |
$103.99
|
|
|
Aspergillus Antibody Screen
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
980029
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$133.38 |
| Rate for Payer: Aetna Commercial |
$133.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$120.74
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cigna Commercial |
$133.38
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$70.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$127.76
|
| Rate for Payer: HFN Commercial |
$133.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$55.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$55.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$112.32
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$133.38
|
| Rate for Payer: Quartz Beloit One Network |
$61.78
|
| Rate for Payer: Quartz Commercial |
$80.03
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$61.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: WEA Trust Commercial |
$77.22
|
| Rate for Payer: WPS Commercial |
$68.87
|
|
|
Aspergillus Antigen
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
1037543
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.46 |
| Max. Negotiated Rate |
$254.90 |
| Rate for Payer: Aetna Commercial |
$254.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$230.76
|
| Rate for Payer: Aetna Managed Medicare |
$12.46
|
| Rate for Payer: Anthem Medicare Advantage |
$12.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.46
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna Commercial |
$254.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$134.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.46
|
| Rate for Payer: Health EOS Commercial |
$244.17
|
| Rate for Payer: HFN Commercial |
$254.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$43.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$43.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$214.66
|
| Rate for Payer: NAPHCARE Commercial |
$18.69
|
| Rate for Payer: Preferred Network Access Commercial |
$254.90
|
| Rate for Payer: Quartz Beloit One Network |
$118.06
|
| Rate for Payer: Quartz Commercial |
$152.94
|
| Rate for Payer: Quartz Medicare Advantage |
$12.46
|
| Rate for Payer: The Alliance Commercial |
$49.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.46
|
| Rate for Payer: WEA Trust Commercial |
$147.58
|
| Rate for Payer: WPS Commercial |
$54.82
|
|
|
Aspergillus Antigen
|
Facility
|
OP
|
$258.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
1037543
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.46 |
| Max. Negotiated Rate |
$246.85 |
| Rate for Payer: Aetna Commercial |
$241.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$230.76
|
| Rate for Payer: Aetna Managed Medicare |
$12.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$46.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20.68
|
| Rate for Payer: Anthem Medicare Advantage |
$12.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$142.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.46
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna Commercial |
$246.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$150.16
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.46
|
| Rate for Payer: Health EOS Commercial |
$238.80
|
| Rate for Payer: HFN Commercial |
$246.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.35
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.46
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$214.66
|
| Rate for Payer: NAPHCARE Commercial |
$18.69
|
| Rate for Payer: Preferred Network Access Commercial |
$246.85
|
| Rate for Payer: Quartz Beloit One Network |
$131.48
|
| Rate for Payer: Quartz Commercial |
$174.41
|
| Rate for Payer: Quartz Medicare Advantage |
$12.46
|
| Rate for Payer: The Alliance Commercial |
$49.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.46
|
| Rate for Payer: United Healthcare PPO |
$201.24
|
| Rate for Payer: WEA Trust Commercial |
$147.58
|
| Rate for Payer: Wellcare Medicare |
$12.46
|
| Rate for Payer: WPS Commercial |
$198.74
|
|
