|
SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC
|
Facility
IP
|
$42,425.00
|
|
|
Service Code
|
MS-DRG 905
|
| Min. Negotiated Rate |
$15,260.65 |
| Max. Negotiated Rate |
$42,425.00 |
| Rate for Payer: Aetna Managed Medicare |
$15,260.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$33,148.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25,407.98
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,139.24
|
| Rate for Payer: Anthem Medicare Advantage |
$15,260.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15,260.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15,260.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15,260.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$26,796.77
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15,260.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30,882.15
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15,260.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15,260.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15,260.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15,260.65
|
| Rate for Payer: NAPHCARE Commercial |
$22,890.98
|
| Rate for Payer: Quartz Medicare Advantage |
$15,260.65
|
| Rate for Payer: The Alliance Commercial |
$42,425.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,260.65
|
| Rate for Payer: United Healthcare PPO |
$24,042.15
|
| Rate for Payer: Wellcare Medicare |
$15,260.65
|
|
|
SKIN GRAFT, SPLIT THICKNESS
|
Facility
OP
|
$1,503.00
|
|
| Hospital Charge Code |
2960538
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$420.84 |
| Max. Negotiated Rate |
$6,012.00 |
| Rate for Payer: Aetna Commercial |
$1,352.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,292.58
|
| Rate for Payer: Aetna Managed Medicare |
$420.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$976.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$751.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$721.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$796.59
|
| Rate for Payer: Cash Price |
$450.90
|
| Rate for Payer: Cigna Commercial |
$1,382.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$841.08
|
| Rate for Payer: Health EOS Commercial |
$1,337.67
|
| Rate for Payer: HFN Commercial |
$1,382.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,127.25
|
| Rate for Payer: Multiplan Commercial |
$1,202.40
|
| Rate for Payer: NAPHCARE Commercial |
$901.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,382.76
|
| Rate for Payer: Quartz Beloit One Network |
$736.47
|
| Rate for Payer: Quartz Commercial |
$976.95
|
| Rate for Payer: Quartz Medicare Advantage |
$901.80
|
| Rate for Payer: The Alliance Commercial |
$6,012.00
|
| Rate for Payer: WEA Trust Commercial |
$826.65
|
| Rate for Payer: WPS Commercial |
$1,113.27
|
|
|
SKIN GRAFT, SPLIT THICKNESS
|
Facility
IP
|
$1,503.00
|
|
| Hospital Charge Code |
2960538
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$736.47 |
| Max. Negotiated Rate |
$1,382.76 |
| Rate for Payer: Aetna Commercial |
$1,352.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$796.59
|
| Rate for Payer: Cash Price |
$450.90
|
| Rate for Payer: Cigna Commercial |
$1,382.76
|
| Rate for Payer: Health EOS Commercial |
$1,337.67
|
| Rate for Payer: HFN Commercial |
$1,382.76
|
| Rate for Payer: Multiplan Commercial |
$1,202.40
|
| Rate for Payer: NAPHCARE Commercial |
$901.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,382.76
|
| Rate for Payer: Quartz Beloit One Network |
$736.47
|
| Rate for Payer: Quartz Commercial |
$901.80
|
| Rate for Payer: WEA Trust Commercial |
$826.65
|
| Rate for Payer: WPS Commercial |
$1,113.27
|
|
|
SKIN MARKER DEVON FINE DUAL TIP WITH RULER CAP & LABEL 31145868
|
Facility
IP
|
$51.00
|
|
| Hospital Charge Code |
3065498
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.99 |
| Max. Negotiated Rate |
$46.92 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.03
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cigna Commercial |
$46.92
|
| Rate for Payer: Health EOS Commercial |
$45.39
|
| Rate for Payer: HFN Commercial |
$46.92
|
| Rate for Payer: Multiplan Commercial |
$40.80
|
| Rate for Payer: NAPHCARE Commercial |
$30.60
|
| Rate for Payer: Preferred Network Access Commercial |
$46.92
|
| Rate for Payer: Quartz Beloit One Network |
$24.99
|
| Rate for Payer: Quartz Commercial |
$30.60
|
| Rate for Payer: WEA Trust Commercial |
$28.05
|
| Rate for Payer: WPS Commercial |
$37.78
|
|
|
SKIN MARKER DEVON FINE DUAL TIP WITH RULER CAP & LABEL 31145868
|
Facility
OP
|
$51.00
|
|
| Hospital Charge Code |
3065498
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.86
|
| Rate for Payer: Aetna Managed Medicare |
$14.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$33.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.03
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cigna Commercial |
$46.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28.54
|
| Rate for Payer: Health EOS Commercial |
$45.39
|
| Rate for Payer: HFN Commercial |
$46.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$38.25
|
| Rate for Payer: Multiplan Commercial |
$40.80
|
| Rate for Payer: NAPHCARE Commercial |
$30.60
|
| Rate for Payer: Preferred Network Access Commercial |
$46.92
|
| Rate for Payer: Quartz Beloit One Network |
$24.99
|
| Rate for Payer: Quartz Commercial |
$33.15
|
| Rate for Payer: Quartz Medicare Advantage |
$30.60
|
| Rate for Payer: The Alliance Commercial |
$204.00
|
| Rate for Payer: WEA Trust Commercial |
$28.05
|
| Rate for Payer: WPS Commercial |
$37.78
|
|
|
SKIN MARKERS FINE TIP STERILE DYNJSM03
|
Facility
OP
|
$19.00
|
|
| Hospital Charge Code |
3231470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: Aetna Commercial |
$17.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.34
|
| Rate for Payer: Aetna Managed Medicare |
$5.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$12.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10.07
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$17.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10.63
|
| Rate for Payer: Health EOS Commercial |
$16.91
|
| Rate for Payer: HFN Commercial |
$17.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.25
|
| Rate for Payer: Multiplan Commercial |
$15.20
|
| Rate for Payer: NAPHCARE Commercial |
$11.40
|
| Rate for Payer: Preferred Network Access Commercial |
$17.48
|
| Rate for Payer: Quartz Beloit One Network |
$9.31
|
| Rate for Payer: Quartz Commercial |
$12.35
|
| Rate for Payer: Quartz Medicare Advantage |
$11.40
|
| Rate for Payer: The Alliance Commercial |
$76.00
|
| Rate for Payer: WEA Trust Commercial |
$10.45
|
| Rate for Payer: WPS Commercial |
$14.07
|
|
|
SKIN MARKERS FINE TIP STERILE DYNJSM03
|
Facility
IP
|
$19.00
|
|
| Hospital Charge Code |
3231470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$17.48 |
| Rate for Payer: Aetna Commercial |
$17.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10.07
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$17.48
|
| Rate for Payer: Health EOS Commercial |
$16.91
|
| Rate for Payer: HFN Commercial |
$17.48
|
| Rate for Payer: Multiplan Commercial |
$15.20
|
| Rate for Payer: NAPHCARE Commercial |
$11.40
|
| Rate for Payer: Preferred Network Access Commercial |
$17.48
|
| Rate for Payer: Quartz Beloit One Network |
$9.31
|
| Rate for Payer: Quartz Commercial |
$11.40
|
| Rate for Payer: WEA Trust Commercial |
$10.45
|
| Rate for Payer: WPS Commercial |
$14.07
|
|
|
Skin Sensor
|
Facility
OP
|
$78.00
|
|
| Hospital Charge Code |
3101744
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$21.84 |
| Max. Negotiated Rate |
$312.00 |
| Rate for Payer: Aetna Commercial |
$70.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.08
|
| Rate for Payer: Aetna Managed Medicare |
$21.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$50.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$39.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$37.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$41.34
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$71.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$43.65
|
| Rate for Payer: Health EOS Commercial |
$69.42
|
| Rate for Payer: HFN Commercial |
$71.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.50
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: NAPHCARE Commercial |
$46.80
|
| Rate for Payer: Preferred Network Access Commercial |
$71.76
|
| Rate for Payer: Quartz Beloit One Network |
$38.22
|
| Rate for Payer: Quartz Commercial |
$50.70
|
| Rate for Payer: Quartz Medicare Advantage |
$46.80
|
| Rate for Payer: The Alliance Commercial |
$312.00
|
| Rate for Payer: WEA Trust Commercial |
$42.90
|
| Rate for Payer: WPS Commercial |
$57.77
|
|
|
Skin Sensor
|
Facility
IP
|
$78.00
|
|
| Hospital Charge Code |
3101744
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$38.22 |
| Max. Negotiated Rate |
$71.76 |
| Rate for Payer: Aetna Commercial |
$70.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$41.34
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$71.76
|
| Rate for Payer: Health EOS Commercial |
$69.42
|
| Rate for Payer: HFN Commercial |
$71.76
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: NAPHCARE Commercial |
$46.80
|
| Rate for Payer: Preferred Network Access Commercial |
$71.76
|
| Rate for Payer: Quartz Beloit One Network |
$38.22
|
| Rate for Payer: Quartz Commercial |
$46.80
|
| Rate for Payer: WEA Trust Commercial |
$42.90
|
| Rate for Payer: WPS Commercial |
$57.77
|
|
|
SKIN SPLT GRFT T/A/L, ADD-ON 15101
|
Professional
|
$795.00
|
|
|
Service Code
|
CPT 15101
|
| Hospital Charge Code |
3013634
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$101.07 |
| Max. Negotiated Rate |
$755.25 |
| Rate for Payer: Aetna Commercial |
$755.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$683.70
|
| Rate for Payer: Aetna Managed Medicare |
$101.07
|
| Rate for Payer: Anthem Medicare Advantage |
$101.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$101.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$101.07
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cigna Commercial |
$755.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$397.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$101.07
|
| Rate for Payer: Health EOS Commercial |
$723.45
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$368.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$368.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$101.07
|
| Rate for Payer: Multiplan Commercial |
$636.00
|
| Rate for Payer: Preferred Network Access Commercial |
$755.25
|
| Rate for Payer: Quartz Beloit One Network |
$349.80
|
| Rate for Payer: Quartz Commercial |
$453.15
|
| Rate for Payer: Quartz Medicare Advantage |
$101.07
|
| Rate for Payer: The Alliance Commercial |
$429.55
|
| Rate for Payer: United Healthcare Medicaid |
$214.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$101.07
|
| Rate for Payer: WEA Trust Commercial |
$437.25
|
| Rate for Payer: WPS Commercial |
$454.82
|
|
|
SKIN SPLT GRFT, TRNK/ARM/LEG 15100
|
Professional
|
$2,445.00
|
|
|
Service Code
|
CPT 15100
|
| Hospital Charge Code |
3013633
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$512.11 |
| Max. Negotiated Rate |
$2,988.50 |
| Rate for Payer: Aetna Commercial |
$2,322.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,102.70
|
| Rate for Payer: Aetna Managed Medicare |
$664.11
|
| Rate for Payer: Anthem Medicare Advantage |
$664.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$664.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$664.11
|
| Rate for Payer: Cash Price |
$733.50
|
| Rate for Payer: Cash Price |
$733.50
|
| Rate for Payer: Cigna Commercial |
$2,322.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,222.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$664.11
|
| Rate for Payer: Health EOS Commercial |
$2,224.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,350.77
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,350.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$664.11
|
| Rate for Payer: Multiplan Commercial |
$1,956.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,322.75
|
| Rate for Payer: Quartz Beloit One Network |
$1,075.80
|
| Rate for Payer: Quartz Commercial |
$1,393.65
|
| Rate for Payer: Quartz Medicare Advantage |
$664.11
|
| Rate for Payer: The Alliance Commercial |
$2,822.47
|
| Rate for Payer: United Healthcare Medicaid |
$512.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$664.11
|
| Rate for Payer: WEA Trust Commercial |
$1,344.75
|
| Rate for Payer: WPS Commercial |
$2,988.50
|
|
|
Skin Substitute Apligraft 1 Sq Cm Q4101
|
Professional
|
$173.00
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
3542168
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.42 |
| Max. Negotiated Rate |
$164.35 |
| Rate for Payer: Aetna Commercial |
$164.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$148.78
|
| Rate for Payer: Aetna Managed Medicare |
$30.42
|
| Rate for Payer: Anthem Medicare Advantage |
$30.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$30.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30.42
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cigna Commercial |
$164.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$86.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30.62
|
| Rate for Payer: Health EOS Commercial |
$157.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$107.56
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$107.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30.42
|
| Rate for Payer: Multiplan Commercial |
$138.40
|
| Rate for Payer: Preferred Network Access Commercial |
$164.35
|
| Rate for Payer: Quartz Beloit One Network |
$76.12
|
| Rate for Payer: Quartz Commercial |
$98.61
|
| Rate for Payer: Quartz Medicare Advantage |
$30.42
|
| Rate for Payer: The Alliance Commercial |
$83.66
|
| Rate for Payer: United Healthcare Medicaid |
$31.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30.42
|
| Rate for Payer: WEA Trust Commercial |
$95.15
|
| Rate for Payer: WPS Commercial |
$76.55
|
|
|
Skin Substitute Apligraft 1 Sq Cm Q4101
|
Facility
OP
|
$173.00
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
3542168
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.51 |
| Max. Negotiated Rate |
$2,042.72 |
| Rate for Payer: Aetna Commercial |
$155.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$148.78
|
| Rate for Payer: Aetna Managed Medicare |
$48.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$112.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$86.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$83.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$91.69
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cigna Commercial |
$159.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40.51
|
| Rate for Payer: Health EOS Commercial |
$153.97
|
| Rate for Payer: HFN Commercial |
$159.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$129.75
|
| Rate for Payer: Multiplan Commercial |
$138.40
|
| Rate for Payer: NAPHCARE Commercial |
$103.80
|
| Rate for Payer: Preferred Network Access Commercial |
$159.16
|
| Rate for Payer: Quartz Beloit One Network |
$84.77
|
| Rate for Payer: Quartz Commercial |
$112.45
|
| Rate for Payer: Quartz Medicare Advantage |
$103.80
|
| Rate for Payer: The Alliance Commercial |
$2,042.72
|
| Rate for Payer: WEA Trust Commercial |
$95.15
|
| Rate for Payer: WPS Commercial |
$76.55
|
|
|
Skin Substitute Apligraft 1 Sq Cm Q4101
|
Facility
IP
|
$173.00
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
3542168
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$84.77 |
| Max. Negotiated Rate |
$159.16 |
| Rate for Payer: Aetna Commercial |
$155.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$91.69
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cigna Commercial |
$159.16
|
| Rate for Payer: Health EOS Commercial |
$153.97
|
| Rate for Payer: HFN Commercial |
$159.16
|
| Rate for Payer: Multiplan Commercial |
$138.40
|
| Rate for Payer: NAPHCARE Commercial |
$103.80
|
| Rate for Payer: Preferred Network Access Commercial |
$159.16
|
| Rate for Payer: Quartz Beloit One Network |
$84.77
|
| Rate for Payer: Quartz Commercial |
$103.80
|
| Rate for Payer: WEA Trust Commercial |
$95.15
|
| Rate for Payer: WPS Commercial |
$128.14
|
|
|
SKIN TISSUE REARRANGEMENT 14000
|
Professional
|
$2,167.00
|
|
|
Service Code
|
CPT 14000
|
| Hospital Charge Code |
3013619
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$195.73 |
| Max. Negotiated Rate |
$2,117.79 |
| Rate for Payer: Aetna Commercial |
$2,058.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,863.62
|
| Rate for Payer: Aetna Managed Medicare |
$470.62
|
| Rate for Payer: Anthem Medicare Advantage |
$470.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$470.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$470.62
|
| Rate for Payer: Cash Price |
$650.10
|
| Rate for Payer: Cash Price |
$650.10
|
| Rate for Payer: Cigna Commercial |
$2,058.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,083.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$470.62
|
| Rate for Payer: Health EOS Commercial |
$1,971.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,652.92
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,652.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$470.62
|
| Rate for Payer: Multiplan Commercial |
$1,733.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,058.65
|
| Rate for Payer: Quartz Beloit One Network |
$953.48
|
| Rate for Payer: Quartz Commercial |
$1,235.19
|
| Rate for Payer: Quartz Medicare Advantage |
$470.62
|
| Rate for Payer: The Alliance Commercial |
$2,000.14
|
| Rate for Payer: United Healthcare Medicaid |
$195.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$470.62
|
| Rate for Payer: WEA Trust Commercial |
$1,191.85
|
| Rate for Payer: WPS Commercial |
$2,117.79
|
|
|
SKIN TISSUE REARRANGEMENT 14001
|
Professional
|
$1,966.00
|
|
|
Service Code
|
CPT 14001
|
| Hospital Charge Code |
3013620
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$322.56 |
| Max. Negotiated Rate |
$2,732.36 |
| Rate for Payer: Aetna Commercial |
$1,867.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,690.76
|
| Rate for Payer: Aetna Managed Medicare |
$607.19
|
| Rate for Payer: Anthem Medicare Advantage |
$607.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$607.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$607.19
|
| Rate for Payer: Cash Price |
$589.80
|
| Rate for Payer: Cash Price |
$589.80
|
| Rate for Payer: Cigna Commercial |
$1,867.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$983.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$607.19
|
| Rate for Payer: Health EOS Commercial |
$1,789.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,142.92
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,142.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$607.19
|
| Rate for Payer: Multiplan Commercial |
$1,572.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,867.70
|
| Rate for Payer: Quartz Beloit One Network |
$865.04
|
| Rate for Payer: Quartz Commercial |
$1,120.62
|
| Rate for Payer: Quartz Medicare Advantage |
$607.19
|
| Rate for Payer: The Alliance Commercial |
$2,580.56
|
| Rate for Payer: United Healthcare Medicaid |
$322.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$607.19
|
| Rate for Payer: WEA Trust Commercial |
$1,081.30
|
| Rate for Payer: WPS Commercial |
$2,732.36
|
|
|
SKIN TISSUE REARRANGEMENT 14020
|
Professional
|
$1,032.00
|
|
|
Service Code
|
CPT 14020
|
| Hospital Charge Code |
3013621
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$363.86 |
| Max. Negotiated Rate |
$2,397.15 |
| Rate for Payer: Aetna Commercial |
$980.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$887.52
|
| Rate for Payer: Aetna Managed Medicare |
$532.70
|
| Rate for Payer: Anthem Medicare Advantage |
$532.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$532.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$532.70
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cigna Commercial |
$980.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$516.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$532.70
|
| Rate for Payer: Health EOS Commercial |
$939.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,871.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,871.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$532.70
|
| Rate for Payer: Multiplan Commercial |
$825.60
|
| Rate for Payer: Preferred Network Access Commercial |
$980.40
|
| Rate for Payer: Quartz Beloit One Network |
$454.08
|
| Rate for Payer: Quartz Commercial |
$588.24
|
| Rate for Payer: Quartz Medicare Advantage |
$532.70
|
| Rate for Payer: The Alliance Commercial |
$2,263.98
|
| Rate for Payer: United Healthcare Medicaid |
$363.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$532.70
|
| Rate for Payer: WEA Trust Commercial |
$567.60
|
| Rate for Payer: WPS Commercial |
$2,397.15
|
|
|
SKIN TISSUE REARRANGEMENT 14021
|
Professional
|
$3,831.00
|
|
|
Service Code
|
CPT 14021
|
| Hospital Charge Code |
3013622
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$628.04 |
| Max. Negotiated Rate |
$3,639.45 |
| Rate for Payer: Aetna Commercial |
$3,639.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,294.66
|
| Rate for Payer: Aetna Managed Medicare |
$666.32
|
| Rate for Payer: Anthem Medicare Advantage |
$666.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$666.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$666.32
|
| Rate for Payer: Cash Price |
$1,149.30
|
| Rate for Payer: Cash Price |
$1,149.30
|
| Rate for Payer: Cigna Commercial |
$3,639.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,915.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$666.32
|
| Rate for Payer: Health EOS Commercial |
$3,486.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,349.71
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,349.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$666.32
|
| Rate for Payer: Multiplan Commercial |
$3,064.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,639.45
|
| Rate for Payer: Quartz Beloit One Network |
$1,685.64
|
| Rate for Payer: Quartz Commercial |
$2,183.67
|
| Rate for Payer: Quartz Medicare Advantage |
$666.32
|
| Rate for Payer: The Alliance Commercial |
$2,831.86
|
| Rate for Payer: United Healthcare Medicaid |
$628.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$666.32
|
| Rate for Payer: WEA Trust Commercial |
$2,107.05
|
| Rate for Payer: WPS Commercial |
$2,998.44
|
|
|
SKIN TISSUE REARRANGEMENT 14040
|
Professional
|
$3,302.00
|
|
|
Service Code
|
CPT 14040
|
| Hospital Charge Code |
3013623
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$389.77 |
| Max. Negotiated Rate |
$3,136.90 |
| Rate for Payer: Aetna Commercial |
$3,136.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,839.72
|
| Rate for Payer: Aetna Managed Medicare |
$587.72
|
| Rate for Payer: Anthem Medicare Advantage |
$587.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$587.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$587.72
|
| Rate for Payer: Cash Price |
$990.60
|
| Rate for Payer: Cash Price |
$990.60
|
| Rate for Payer: Cigna Commercial |
$3,136.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,651.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$587.72
|
| Rate for Payer: Health EOS Commercial |
$3,004.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,073.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,073.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$587.72
|
| Rate for Payer: Multiplan Commercial |
$2,641.60
|
| Rate for Payer: Preferred Network Access Commercial |
$3,136.90
|
| Rate for Payer: Quartz Beloit One Network |
$1,452.88
|
| Rate for Payer: Quartz Commercial |
$1,882.14
|
| Rate for Payer: Quartz Medicare Advantage |
$587.72
|
| Rate for Payer: The Alliance Commercial |
$2,497.81
|
| Rate for Payer: United Healthcare Medicaid |
$389.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$587.72
|
| Rate for Payer: WEA Trust Commercial |
$1,816.10
|
| Rate for Payer: WPS Commercial |
$2,644.74
|
|
|
SKIN TISSUE REARRANGEMENT 14041
|
Professional
|
$3,998.00
|
|
|
Service Code
|
CPT 14041
|
| Hospital Charge Code |
3013624
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$718.64 |
| Max. Negotiated Rate |
$3,798.10 |
| Rate for Payer: Aetna Commercial |
$3,798.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,438.28
|
| Rate for Payer: Aetna Managed Medicare |
$718.64
|
| Rate for Payer: Anthem Medicare Advantage |
$718.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$718.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$718.64
|
| Rate for Payer: Cash Price |
$1,199.40
|
| Rate for Payer: Cash Price |
$1,199.40
|
| Rate for Payer: Cigna Commercial |
$3,798.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,999.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$718.64
|
| Rate for Payer: Health EOS Commercial |
$3,638.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,537.51
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,537.51
|
| Rate for Payer: Independent Care Health Plan Medicare |
$718.64
|
| Rate for Payer: Multiplan Commercial |
$3,198.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,798.10
|
| Rate for Payer: Quartz Beloit One Network |
$1,759.12
|
| Rate for Payer: Quartz Commercial |
$2,278.86
|
| Rate for Payer: Quartz Medicare Advantage |
$718.64
|
| Rate for Payer: The Alliance Commercial |
$3,054.22
|
| Rate for Payer: United Healthcare Medicaid |
$753.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$718.64
|
| Rate for Payer: WEA Trust Commercial |
$2,198.90
|
| Rate for Payer: WPS Commercial |
$3,233.88
|
|
|
SKIN TISSUE REARRANGEMENT 14060
|
Professional
|
$4,193.00
|
|
|
Service Code
|
CPT 14060
|
| Hospital Charge Code |
3013625
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$390.81 |
| Max. Negotiated Rate |
$3,983.35 |
| Rate for Payer: Aetna Commercial |
$3,983.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,605.98
|
| Rate for Payer: Aetna Managed Medicare |
$627.95
|
| Rate for Payer: Anthem Medicare Advantage |
$627.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$627.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$627.95
|
| Rate for Payer: Cash Price |
$1,257.90
|
| Rate for Payer: Cash Price |
$1,257.90
|
| Rate for Payer: Cigna Commercial |
$3,983.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,096.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$627.95
|
| Rate for Payer: Health EOS Commercial |
$3,815.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,210.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,210.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$627.95
|
| Rate for Payer: Multiplan Commercial |
$3,354.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,983.35
|
| Rate for Payer: Quartz Beloit One Network |
$1,844.92
|
| Rate for Payer: Quartz Commercial |
$2,390.01
|
| Rate for Payer: Quartz Medicare Advantage |
$627.95
|
| Rate for Payer: The Alliance Commercial |
$2,668.79
|
| Rate for Payer: United Healthcare Medicaid |
$390.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$627.95
|
| Rate for Payer: WEA Trust Commercial |
$2,306.15
|
| Rate for Payer: WPS Commercial |
$2,825.78
|
|
|
SKIN TISSUE REARRANGEMENT 14061
|
Professional
|
$5,111.00
|
|
|
Service Code
|
CPT 14061
|
| Hospital Charge Code |
3013626
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$523.35 |
| Max. Negotiated Rate |
$4,855.45 |
| Rate for Payer: Aetna Commercial |
$4,855.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,395.46
|
| Rate for Payer: Aetna Managed Medicare |
$771.67
|
| Rate for Payer: Anthem Medicare Advantage |
$771.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$771.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$771.67
|
| Rate for Payer: Cash Price |
$1,533.30
|
| Rate for Payer: Cash Price |
$1,533.30
|
| Rate for Payer: Cigna Commercial |
$4,855.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,555.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$771.67
|
| Rate for Payer: Health EOS Commercial |
$4,651.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,722.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,722.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$771.67
|
| Rate for Payer: Multiplan Commercial |
$4,088.80
|
| Rate for Payer: Preferred Network Access Commercial |
$4,855.45
|
| Rate for Payer: Quartz Beloit One Network |
$2,248.84
|
| Rate for Payer: Quartz Commercial |
$2,913.27
|
| Rate for Payer: Quartz Medicare Advantage |
$771.67
|
| Rate for Payer: The Alliance Commercial |
$3,279.60
|
| Rate for Payer: United Healthcare Medicaid |
$523.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$771.67
|
| Rate for Payer: WEA Trust Commercial |
$2,811.05
|
| Rate for Payer: WPS Commercial |
$3,472.52
|
|
|
SKIN ULCERS WITH CC
|
Facility
IP
|
$32,487.00
|
|
|
Service Code
|
MS-DRG 593
|
| Min. Negotiated Rate |
$11,685.89 |
| Max. Negotiated Rate |
$32,487.00 |
| Rate for Payer: Aetna Managed Medicare |
$11,685.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$25,385.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,458.01
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18,486.38
|
| Rate for Payer: Anthem Medicare Advantage |
$11,685.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11,685.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11,685.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11,685.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20,521.58
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11,685.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23,593.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11,685.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11,685.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11,685.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11,685.89
|
| Rate for Payer: NAPHCARE Commercial |
$17,528.84
|
| Rate for Payer: Quartz Medicare Advantage |
$11,685.89
|
| Rate for Payer: The Alliance Commercial |
$32,487.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,685.89
|
| Rate for Payer: United Healthcare PPO |
$18,367.49
|
| Rate for Payer: Wellcare Medicare |
$11,685.89
|
|
|
SKIN ULCERS WITH MCC
|
Facility
IP
|
$55,888.00
|
|
|
Service Code
|
MS-DRG 592
|
| Min. Negotiated Rate |
$20,103.51 |
| Max. Negotiated Rate |
$55,888.00 |
| Rate for Payer: Aetna Managed Medicare |
$20,103.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$43,848.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$33,609.29
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$31,931.02
|
| Rate for Payer: Anthem Medicare Advantage |
$20,103.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20,103.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20,103.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20,103.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35,446.36
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20,103.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$40,756.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20,103.51
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20,103.51
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20,103.51
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20,103.51
|
| Rate for Payer: NAPHCARE Commercial |
$30,155.26
|
| Rate for Payer: Quartz Medicare Advantage |
$20,103.51
|
| Rate for Payer: The Alliance Commercial |
$55,888.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,103.51
|
| Rate for Payer: United Healthcare PPO |
$31,729.81
|
| Rate for Payer: Wellcare Medicare |
$20,103.51
|
|
|
SKIN ULCERS WITHOUT CC/MCC
|
Facility
IP
|
$21,254.00
|
|
|
Service Code
|
MS-DRG 594
|
| Min. Negotiated Rate |
$7,645.40 |
| Max. Negotiated Rate |
$21,254.00 |
| Rate for Payer: Aetna Managed Medicare |
$7,645.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$16,574.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$12,703.99
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12,069.62
|
| Rate for Payer: Anthem Medicare Advantage |
$7,645.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,645.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,645.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,645.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13,398.38
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,645.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15,354.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,645.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,645.40
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,645.40
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,645.40
|
| Rate for Payer: NAPHCARE Commercial |
$11,468.10
|
| Rate for Payer: Quartz Medicare Advantage |
$7,645.40
|
| Rate for Payer: The Alliance Commercial |
$21,254.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,645.40
|
| Rate for Payer: United Healthcare PPO |
$11,953.52
|
| Rate for Payer: Wellcare Medicare |
$7,645.40
|
|
