|
Special Ophthalmolgic Services: Extended Exam
|
Professional
|
$162.00
|
|
|
Service Code
|
CPT 92083
|
| Hospital Charge Code |
1188925
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$29.93 |
| Max. Negotiated Rate |
$241.16 |
| Rate for Payer: Aetna Commercial |
$153.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$139.32
|
| Rate for Payer: Aetna Managed Medicare |
$60.29
|
| Rate for Payer: Anthem Medicare Advantage |
$60.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$60.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$60.29
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cigna Commercial |
$153.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$81.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$60.29
|
| Rate for Payer: Health EOS Commercial |
$147.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$215.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$215.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$60.29
|
| Rate for Payer: Multiplan Commercial |
$129.60
|
| Rate for Payer: Preferred Network Access Commercial |
$153.90
|
| Rate for Payer: Quartz Beloit One Network |
$71.28
|
| Rate for Payer: Quartz Commercial |
$92.34
|
| Rate for Payer: Quartz Medicare Advantage |
$60.29
|
| Rate for Payer: The Alliance Commercial |
$150.72
|
| Rate for Payer: United Healthcare Medicaid |
$29.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$60.29
|
| Rate for Payer: WEA Trust Commercial |
$89.10
|
| Rate for Payer: WPS Commercial |
$241.16
|
|
|
Special Ophthalmological Services: Determination of Refractive State
|
Professional
|
$52.00
|
|
|
Service Code
|
CPT 92015
|
| Hospital Charge Code |
2634799
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.97 |
| Max. Negotiated Rate |
$66.82 |
| Rate for Payer: Aetna Commercial |
$49.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$44.72
|
| Rate for Payer: Anthem Commercial |
$20.00
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cigna Commercial |
$49.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$26.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31.20
|
| Rate for Payer: Health EOS Commercial |
$47.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$66.82
|
| Rate for Payer: Multiplan Commercial |
$41.60
|
| Rate for Payer: Preferred Network Access Commercial |
$49.40
|
| Rate for Payer: Quartz Beloit One Network |
$22.88
|
| Rate for Payer: Quartz Commercial |
$29.64
|
| Rate for Payer: The Alliance Commercial |
$26.00
|
| Rate for Payer: United Healthcare Medicaid |
$9.97
|
| Rate for Payer: WEA Trust Commercial |
$28.60
|
| Rate for Payer: WPS Commercial |
$38.52
|
|
|
Special Ophthalmological Services: Gonioscopy
|
Professional
|
$138.00
|
|
|
Service Code
|
CPT 92020
|
| Hospital Charge Code |
1188890
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.45 |
| Max. Negotiated Rate |
$131.10 |
| Rate for Payer: Aetna Commercial |
$131.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.68
|
| Rate for Payer: Aetna Managed Medicare |
$19.73
|
| Rate for Payer: Anthem Medicare Advantage |
$19.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19.73
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cigna Commercial |
$131.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$69.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19.73
|
| Rate for Payer: Health EOS Commercial |
$125.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$70.32
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$70.32
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19.73
|
| Rate for Payer: Multiplan Commercial |
$110.40
|
| Rate for Payer: Preferred Network Access Commercial |
$131.10
|
| Rate for Payer: Quartz Beloit One Network |
$60.72
|
| Rate for Payer: Quartz Commercial |
$78.66
|
| Rate for Payer: Quartz Medicare Advantage |
$19.73
|
| Rate for Payer: The Alliance Commercial |
$49.32
|
| Rate for Payer: United Healthcare Medicaid |
$13.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.73
|
| Rate for Payer: WEA Trust Commercial |
$75.90
|
| Rate for Payer: WPS Commercial |
$78.92
|
|
|
Special Ophthalmological Services: Sensorimotor Examination
|
Professional
|
$85.00
|
|
|
Service Code
|
CPT 92060
|
| Hospital Charge Code |
1188891
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$37.40 |
| Max. Negotiated Rate |
$245.04 |
| Rate for Payer: Aetna Commercial |
$80.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$73.10
|
| Rate for Payer: Aetna Managed Medicare |
$61.26
|
| Rate for Payer: Anthem Medicare Advantage |
$61.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$61.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$61.26
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cigna Commercial |
$80.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$42.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$61.26
|
| Rate for Payer: Health EOS Commercial |
$77.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$216.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$216.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$61.26
|
| Rate for Payer: Multiplan Commercial |
$68.00
|
| Rate for Payer: Preferred Network Access Commercial |
$80.75
|
| Rate for Payer: Quartz Beloit One Network |
$37.40
|
| Rate for Payer: Quartz Commercial |
$48.45
|
| Rate for Payer: Quartz Medicare Advantage |
$61.26
|
| Rate for Payer: The Alliance Commercial |
$153.15
|
| Rate for Payer: United Healthcare Medicaid |
$47.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$61.26
|
| Rate for Payer: WEA Trust Commercial |
$46.75
|
| Rate for Payer: WPS Commercial |
$245.04
|
|
|
Special Ophth Services Sensorimotor Exam 9206026
|
Professional
|
$84.00
|
|
|
Service Code
|
CPT 92060 26
|
| Hospital Charge Code |
4605871
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$142.88 |
| Rate for Payer: Aetna Commercial |
$79.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$72.24
|
| Rate for Payer: Aetna Managed Medicare |
$35.72
|
| Rate for Payer: Anthem Medicare Advantage |
$35.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35.72
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$79.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$42.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35.72
|
| Rate for Payer: Health EOS Commercial |
$76.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$128.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$128.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35.72
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: Preferred Network Access Commercial |
$79.80
|
| Rate for Payer: Quartz Beloit One Network |
$36.96
|
| Rate for Payer: Quartz Commercial |
$47.88
|
| Rate for Payer: Quartz Medicare Advantage |
$35.72
|
| Rate for Payer: The Alliance Commercial |
$89.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.72
|
| Rate for Payer: WEA Trust Commercial |
$46.20
|
| Rate for Payer: WPS Commercial |
$142.88
|
|
|
Special Physics Consultation
|
Facility
IP
|
$1,542.00
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
3040393
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$755.58 |
| Max. Negotiated Rate |
$1,418.64 |
| Rate for Payer: Aetna Commercial |
$1,387.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$817.26
|
| Rate for Payer: Cash Price |
$462.60
|
| Rate for Payer: Cigna Commercial |
$1,418.64
|
| Rate for Payer: Health EOS Commercial |
$1,372.38
|
| Rate for Payer: HFN Commercial |
$1,418.64
|
| Rate for Payer: Multiplan Commercial |
$1,233.60
|
| Rate for Payer: NAPHCARE Commercial |
$925.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,418.64
|
| Rate for Payer: Quartz Beloit One Network |
$755.58
|
| Rate for Payer: Quartz Commercial |
$925.20
|
| Rate for Payer: WEA Trust Commercial |
$848.10
|
| Rate for Payer: WPS Commercial |
$1,142.16
|
|
|
Special Physics Consultation
|
Facility
OP
|
$1,542.00
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
3040393
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$41.60 |
| Max. Negotiated Rate |
$1,418.64 |
| Rate for Payer: Aetna Commercial |
$1,387.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,326.12
|
| Rate for Payer: Aetna Managed Medicare |
$134.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$502.91
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$402.33
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$382.21
|
| Rate for Payer: Anthem Medicare Advantage |
$134.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$817.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$134.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$134.11
|
| Rate for Payer: Cash Price |
$462.60
|
| Rate for Payer: Cash Price |
$462.60
|
| Rate for Payer: Cigna Commercial |
$1,418.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$134.11
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$134.11
|
| Rate for Payer: Health EOS Commercial |
$1,372.38
|
| Rate for Payer: HFN Commercial |
$1,418.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$498.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$134.11
|
| Rate for Payer: Independent Care Health Plan Medicare |
$134.11
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$134.11
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$134.11
|
| Rate for Payer: Multiplan Commercial |
$1,233.60
|
| Rate for Payer: NAPHCARE Commercial |
$201.16
|
| Rate for Payer: Preferred Network Access Commercial |
$1,418.64
|
| Rate for Payer: Quartz Beloit One Network |
$755.58
|
| Rate for Payer: Quartz Commercial |
$1,002.30
|
| Rate for Payer: Quartz Medicare Advantage |
$134.11
|
| Rate for Payer: The Alliance Commercial |
$41.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$134.11
|
| Rate for Payer: United Healthcare PPO |
$1,156.50
|
| Rate for Payer: WEA Trust Commercial |
$848.10
|
| Rate for Payer: Wellcare Medicare |
$134.11
|
| Rate for Payer: WPS Commercial |
$1,142.16
|
|
|
Special Stain For inclusion Bodies Or Parasites
|
Professional
|
$138.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
1188853
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$131.10 |
| Rate for Payer: Aetna Commercial |
$131.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.68
|
| Rate for Payer: Aetna Managed Medicare |
$5.99
|
| Rate for Payer: Anthem Commercial |
$16.61
|
| Rate for Payer: Anthem Medicare Advantage |
$5.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.99
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cigna Commercial |
$131.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$69.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.99
|
| Rate for Payer: Health EOS Commercial |
$125.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.99
|
| Rate for Payer: Multiplan Commercial |
$110.40
|
| Rate for Payer: Preferred Network Access Commercial |
$131.10
|
| Rate for Payer: Quartz Beloit One Network |
$60.72
|
| Rate for Payer: Quartz Commercial |
$78.66
|
| Rate for Payer: Quartz Medicare Advantage |
$5.99
|
| Rate for Payer: The Alliance Commercial |
$23.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.99
|
| Rate for Payer: WEA Trust Commercial |
$75.90
|
| Rate for Payer: WPS Commercial |
$26.36
|
|
|
Special Stains 1
|
Facility
OP
|
$217.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
2778826
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.46 |
| Max. Negotiated Rate |
$226.72 |
| Rate for Payer: Aetna Commercial |
$195.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$186.62
|
| Rate for Payer: Aetna Managed Medicare |
$60.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$226.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$105.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$100.36
|
| Rate for Payer: Anthem Medicare Advantage |
$60.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$115.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$60.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$60.46
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cigna Commercial |
$199.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$60.46
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$60.46
|
| Rate for Payer: Health EOS Commercial |
$193.13
|
| Rate for Payer: HFN Commercial |
$199.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$224.91
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$60.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$60.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$60.46
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$60.46
|
| Rate for Payer: Multiplan Commercial |
$173.60
|
| Rate for Payer: NAPHCARE Commercial |
$90.69
|
| Rate for Payer: Preferred Network Access Commercial |
$199.64
|
| Rate for Payer: Quartz Beloit One Network |
$106.33
|
| Rate for Payer: Quartz Commercial |
$141.05
|
| Rate for Payer: Quartz Medicare Advantage |
$60.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$60.46
|
| Rate for Payer: United Healthcare PPO |
$162.75
|
| Rate for Payer: WEA Trust Commercial |
$119.35
|
| Rate for Payer: Wellcare Medicare |
$60.46
|
| Rate for Payer: WPS Commercial |
$160.73
|
|
|
Special Stains 1
|
Facility
IP
|
$217.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
2778826
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$106.33 |
| Max. Negotiated Rate |
$199.64 |
| Rate for Payer: Aetna Commercial |
$195.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$115.01
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cigna Commercial |
$199.64
|
| Rate for Payer: Health EOS Commercial |
$193.13
|
| Rate for Payer: HFN Commercial |
$199.64
|
| Rate for Payer: Multiplan Commercial |
$173.60
|
| Rate for Payer: NAPHCARE Commercial |
$130.20
|
| Rate for Payer: Preferred Network Access Commercial |
$199.64
|
| Rate for Payer: Quartz Beloit One Network |
$106.33
|
| Rate for Payer: Quartz Commercial |
$130.20
|
| Rate for Payer: WEA Trust Commercial |
$119.35
|
| Rate for Payer: WPS Commercial |
$160.73
|
|
|
Special Stains 1
|
Professional
|
$217.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
2778826
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.03 |
| Max. Negotiated Rate |
$345.53 |
| Rate for Payer: Aetna Commercial |
$206.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$186.62
|
| Rate for Payer: Aetna Managed Medicare |
$78.53
|
| Rate for Payer: Anthem Commercial |
$11.03
|
| Rate for Payer: Anthem Medicare Advantage |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$78.53
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cigna Commercial |
$206.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$108.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$78.53
|
| Rate for Payer: Health EOS Commercial |
$197.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$271.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$271.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$78.53
|
| Rate for Payer: Multiplan Commercial |
$173.60
|
| Rate for Payer: Preferred Network Access Commercial |
$206.15
|
| Rate for Payer: Quartz Beloit One Network |
$95.48
|
| Rate for Payer: Quartz Commercial |
$123.69
|
| Rate for Payer: Quartz Medicare Advantage |
$78.53
|
| Rate for Payer: The Alliance Commercial |
$310.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$78.53
|
| Rate for Payer: WEA Trust Commercial |
$119.35
|
| Rate for Payer: WPS Commercial |
$345.53
|
|
|
Special Stains 2
|
Professional
|
$49.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
2778830
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.03 |
| Max. Negotiated Rate |
$345.53 |
| Rate for Payer: Aetna Commercial |
$46.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$42.14
|
| Rate for Payer: Aetna Managed Medicare |
$78.53
|
| Rate for Payer: Anthem Commercial |
$11.03
|
| Rate for Payer: Anthem Medicare Advantage |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$78.53
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$46.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$24.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$78.53
|
| Rate for Payer: Health EOS Commercial |
$44.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$271.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$271.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$78.53
|
| Rate for Payer: Multiplan Commercial |
$39.20
|
| Rate for Payer: Preferred Network Access Commercial |
$46.55
|
| Rate for Payer: Quartz Beloit One Network |
$21.56
|
| Rate for Payer: Quartz Commercial |
$27.93
|
| Rate for Payer: Quartz Medicare Advantage |
$78.53
|
| Rate for Payer: The Alliance Commercial |
$310.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$78.53
|
| Rate for Payer: WEA Trust Commercial |
$26.95
|
| Rate for Payer: WPS Commercial |
$345.53
|
|
|
Special Stains 2
|
Facility
OP
|
$49.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
2778830
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.01 |
| Max. Negotiated Rate |
$226.72 |
| Rate for Payer: Aetna Commercial |
$44.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$42.14
|
| Rate for Payer: Aetna Managed Medicare |
$60.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$226.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$105.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$100.36
|
| Rate for Payer: Anthem Medicare Advantage |
$60.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$25.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$60.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$60.46
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$45.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$60.46
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$60.46
|
| Rate for Payer: Health EOS Commercial |
$43.61
|
| Rate for Payer: HFN Commercial |
$45.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$224.91
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$60.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$60.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$60.46
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$60.46
|
| Rate for Payer: Multiplan Commercial |
$39.20
|
| Rate for Payer: NAPHCARE Commercial |
$90.69
|
| Rate for Payer: Preferred Network Access Commercial |
$45.08
|
| Rate for Payer: Quartz Beloit One Network |
$24.01
|
| Rate for Payer: Quartz Commercial |
$31.85
|
| Rate for Payer: Quartz Medicare Advantage |
$60.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$60.46
|
| Rate for Payer: United Healthcare PPO |
$36.75
|
| Rate for Payer: WEA Trust Commercial |
$26.95
|
| Rate for Payer: Wellcare Medicare |
$60.46
|
| Rate for Payer: WPS Commercial |
$36.29
|
|
|
Special Stains 2
|
Facility
IP
|
$49.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
2778830
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.01 |
| Max. Negotiated Rate |
$45.08 |
| Rate for Payer: Aetna Commercial |
$44.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$25.97
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$45.08
|
| Rate for Payer: Health EOS Commercial |
$43.61
|
| Rate for Payer: HFN Commercial |
$45.08
|
| Rate for Payer: Multiplan Commercial |
$39.20
|
| Rate for Payer: NAPHCARE Commercial |
$29.40
|
| Rate for Payer: Preferred Network Access Commercial |
$45.08
|
| Rate for Payer: Quartz Beloit One Network |
$24.01
|
| Rate for Payer: Quartz Commercial |
$29.40
|
| Rate for Payer: WEA Trust Commercial |
$26.95
|
| Rate for Payer: WPS Commercial |
$36.29
|
|
|
Special Treatment Procedure
|
Facility
IP
|
$1,409.00
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
3040409
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$690.41 |
| Max. Negotiated Rate |
$1,296.28 |
| Rate for Payer: Aetna Commercial |
$1,268.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$746.77
|
| Rate for Payer: Cash Price |
$422.70
|
| Rate for Payer: Cigna Commercial |
$1,296.28
|
| Rate for Payer: Health EOS Commercial |
$1,254.01
|
| Rate for Payer: HFN Commercial |
$1,296.28
|
| Rate for Payer: Multiplan Commercial |
$1,127.20
|
| Rate for Payer: NAPHCARE Commercial |
$845.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,296.28
|
| Rate for Payer: Quartz Beloit One Network |
$690.41
|
| Rate for Payer: Quartz Commercial |
$845.40
|
| Rate for Payer: WEA Trust Commercial |
$774.95
|
| Rate for Payer: WPS Commercial |
$1,043.65
|
|
|
Special Treatment Procedure
|
Facility
OP
|
$1,409.00
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
3040409
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$212.32 |
| Max. Negotiated Rate |
$2,181.90 |
| Rate for Payer: Aetna Commercial |
$1,268.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,211.74
|
| Rate for Payer: Aetna Managed Medicare |
$581.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,181.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,745.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,658.24
|
| Rate for Payer: Anthem Medicare Advantage |
$581.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$746.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$581.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$581.84
|
| Rate for Payer: Cash Price |
$422.70
|
| Rate for Payer: Cash Price |
$422.70
|
| Rate for Payer: Cigna Commercial |
$1,296.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$581.84
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$581.84
|
| Rate for Payer: Health EOS Commercial |
$1,254.01
|
| Rate for Payer: HFN Commercial |
$1,296.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,164.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$581.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$581.84
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$581.84
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$581.84
|
| Rate for Payer: Multiplan Commercial |
$1,127.20
|
| Rate for Payer: NAPHCARE Commercial |
$872.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,296.28
|
| Rate for Payer: Quartz Beloit One Network |
$690.41
|
| Rate for Payer: Quartz Commercial |
$915.85
|
| Rate for Payer: Quartz Medicare Advantage |
$581.84
|
| Rate for Payer: The Alliance Commercial |
$212.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$581.84
|
| Rate for Payer: United Healthcare PPO |
$1,056.75
|
| Rate for Payer: WEA Trust Commercial |
$774.95
|
| Rate for Payer: Wellcare Medicare |
$581.84
|
| Rate for Payer: WPS Commercial |
$1,043.65
|
|
|
Special Treatment Procedure 77470
|
Professional
|
$505.00
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
5516739
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$134.45 |
| Max. Negotiated Rate |
$672.25 |
| Rate for Payer: Aetna Commercial |
$479.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$434.30
|
| Rate for Payer: Aetna Managed Medicare |
$134.45
|
| Rate for Payer: Anthem Medicare Advantage |
$134.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$134.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$134.45
|
| Rate for Payer: Cash Price |
$151.50
|
| Rate for Payer: Cash Price |
$151.50
|
| Rate for Payer: Cigna Commercial |
$479.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$252.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$134.45
|
| Rate for Payer: Health EOS Commercial |
$459.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$454.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$454.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$134.45
|
| Rate for Payer: Multiplan Commercial |
$404.00
|
| Rate for Payer: Preferred Network Access Commercial |
$479.75
|
| Rate for Payer: Quartz Beloit One Network |
$222.20
|
| Rate for Payer: Quartz Commercial |
$287.85
|
| Rate for Payer: Quartz Medicare Advantage |
$134.45
|
| Rate for Payer: The Alliance Commercial |
$510.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$134.45
|
| Rate for Payer: WEA Trust Commercial |
$277.75
|
| Rate for Payer: WPS Commercial |
$672.25
|
|
|
SPECIMEN TRAP STERILE 40cc
|
Facility
IP
|
$69.00
|
|
| Hospital Charge Code |
2974707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$63.48 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$36.57
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$63.48
|
| Rate for Payer: Health EOS Commercial |
$61.41
|
| Rate for Payer: HFN Commercial |
$63.48
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: NAPHCARE Commercial |
$41.40
|
| Rate for Payer: Preferred Network Access Commercial |
$63.48
|
| Rate for Payer: Quartz Beloit One Network |
$33.81
|
| Rate for Payer: Quartz Commercial |
$41.40
|
| Rate for Payer: WEA Trust Commercial |
$37.95
|
| Rate for Payer: WPS Commercial |
$51.11
|
|
|
SPECIMEN TRAP STERILE 40cc
|
Facility
OP
|
$69.00
|
|
| Hospital Charge Code |
2974707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.32 |
| Max. Negotiated Rate |
$276.00 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.34
|
| Rate for Payer: Aetna Managed Medicare |
$19.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$44.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$34.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$36.57
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$63.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$38.61
|
| Rate for Payer: Health EOS Commercial |
$61.41
|
| Rate for Payer: HFN Commercial |
$63.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$51.75
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: NAPHCARE Commercial |
$41.40
|
| Rate for Payer: Preferred Network Access Commercial |
$63.48
|
| Rate for Payer: Quartz Beloit One Network |
$33.81
|
| Rate for Payer: Quartz Commercial |
$44.85
|
| Rate for Payer: Quartz Medicare Advantage |
$41.40
|
| Rate for Payer: The Alliance Commercial |
$276.00
|
| Rate for Payer: WEA Trust Commercial |
$37.95
|
| Rate for Payer: WPS Commercial |
$51.11
|
|
|
Spec RT Port Plan Particles
|
Facility
IP
|
$1,622.00
|
|
|
Service Code
|
CPT 77321
|
| Hospital Charge Code |
3040384
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$794.78 |
| Max. Negotiated Rate |
$1,492.24 |
| Rate for Payer: Aetna Commercial |
$1,459.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$859.66
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cigna Commercial |
$1,492.24
|
| Rate for Payer: Health EOS Commercial |
$1,443.58
|
| Rate for Payer: HFN Commercial |
$1,492.24
|
| Rate for Payer: Multiplan Commercial |
$1,297.60
|
| Rate for Payer: NAPHCARE Commercial |
$973.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,492.24
|
| Rate for Payer: Quartz Beloit One Network |
$794.78
|
| Rate for Payer: Quartz Commercial |
$973.20
|
| Rate for Payer: WEA Trust Commercial |
$892.10
|
| Rate for Payer: WPS Commercial |
$1,201.42
|
|
|
Spec RT Port Plan Particles
|
Facility
OP
|
$1,622.00
|
|
|
Service Code
|
CPT 77321
|
| Hospital Charge Code |
3040384
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$261.28 |
| Max. Negotiated Rate |
$1,492.24 |
| Rate for Payer: Aetna Commercial |
$1,459.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,394.92
|
| Rate for Payer: Aetna Managed Medicare |
$365.21
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,369.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,095.63
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,040.85
|
| Rate for Payer: Anthem Medicare Advantage |
$365.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$859.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$365.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$365.21
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cigna Commercial |
$1,492.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$365.21
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$365.21
|
| Rate for Payer: Health EOS Commercial |
$1,443.58
|
| Rate for Payer: HFN Commercial |
$1,492.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,358.58
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$365.21
|
| Rate for Payer: Independent Care Health Plan Medicare |
$365.21
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$365.21
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$365.21
|
| Rate for Payer: Multiplan Commercial |
$1,297.60
|
| Rate for Payer: NAPHCARE Commercial |
$547.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,492.24
|
| Rate for Payer: Quartz Beloit One Network |
$794.78
|
| Rate for Payer: Quartz Commercial |
$1,054.30
|
| Rate for Payer: Quartz Medicare Advantage |
$365.21
|
| Rate for Payer: The Alliance Commercial |
$261.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$365.21
|
| Rate for Payer: United Healthcare PPO |
$1,216.50
|
| Rate for Payer: WEA Trust Commercial |
$892.10
|
| Rate for Payer: Wellcare Medicare |
$365.21
|
| Rate for Payer: WPS Commercial |
$1,201.42
|
|
|
Spectral Doppler Complete 93320
|
Facility
IP
|
$1,132.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
5381789
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$554.68 |
| Max. Negotiated Rate |
$1,041.44 |
| Rate for Payer: Aetna Commercial |
$1,018.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$599.96
|
| Rate for Payer: Cash Price |
$339.60
|
| Rate for Payer: Cigna Commercial |
$1,041.44
|
| Rate for Payer: Health EOS Commercial |
$1,007.48
|
| Rate for Payer: HFN Commercial |
$1,041.44
|
| Rate for Payer: Multiplan Commercial |
$905.60
|
| Rate for Payer: NAPHCARE Commercial |
$679.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,041.44
|
| Rate for Payer: Quartz Beloit One Network |
$554.68
|
| Rate for Payer: Quartz Commercial |
$679.20
|
| Rate for Payer: WEA Trust Commercial |
$622.60
|
| Rate for Payer: WPS Commercial |
$838.47
|
|
|
Spectral Doppler Complete 93320
|
Facility
OP
|
$1,132.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
5381789
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$316.96 |
| Max. Negotiated Rate |
$1,041.44 |
| Rate for Payer: Aetna Commercial |
$1,018.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$973.52
|
| Rate for Payer: Aetna Managed Medicare |
$316.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$735.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$566.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$543.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$599.96
|
| Rate for Payer: Cash Price |
$339.60
|
| Rate for Payer: Cash Price |
$339.60
|
| Rate for Payer: Cigna Commercial |
$1,041.44
|
| Rate for Payer: Health EOS Commercial |
$1,007.48
|
| Rate for Payer: HFN Commercial |
$1,041.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$849.00
|
| Rate for Payer: Multiplan Commercial |
$905.60
|
| Rate for Payer: NAPHCARE Commercial |
$679.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,041.44
|
| Rate for Payer: Quartz Beloit One Network |
$554.68
|
| Rate for Payer: Quartz Commercial |
$735.80
|
| Rate for Payer: Quartz Medicare Advantage |
$679.20
|
| Rate for Payer: United Healthcare PPO |
$849.00
|
| Rate for Payer: WEA Trust Commercial |
$622.60
|
| Rate for Payer: WPS Commercial |
$838.47
|
|
|
Spectral Doppler Limited 93321
|
Facility
OP
|
$742.00
|
|
|
Service Code
|
CPT 93321
|
| Hospital Charge Code |
5381790
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$207.76 |
| Max. Negotiated Rate |
$682.64 |
| Rate for Payer: Aetna Commercial |
$667.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$638.12
|
| Rate for Payer: Aetna Managed Medicare |
$207.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$482.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$371.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$356.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$393.26
|
| Rate for Payer: Cash Price |
$222.60
|
| Rate for Payer: Cash Price |
$222.60
|
| Rate for Payer: Cigna Commercial |
$682.64
|
| Rate for Payer: Health EOS Commercial |
$660.38
|
| Rate for Payer: HFN Commercial |
$682.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$556.50
|
| Rate for Payer: Multiplan Commercial |
$593.60
|
| Rate for Payer: NAPHCARE Commercial |
$445.20
|
| Rate for Payer: Preferred Network Access Commercial |
$682.64
|
| Rate for Payer: Quartz Beloit One Network |
$363.58
|
| Rate for Payer: Quartz Commercial |
$482.30
|
| Rate for Payer: Quartz Medicare Advantage |
$445.20
|
| Rate for Payer: United Healthcare PPO |
$556.50
|
| Rate for Payer: WEA Trust Commercial |
$408.10
|
| Rate for Payer: WPS Commercial |
$549.60
|
|
|
Spectral Doppler Limited 93321
|
Facility
IP
|
$742.00
|
|
|
Service Code
|
CPT 93321
|
| Hospital Charge Code |
5381790
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$363.58 |
| Max. Negotiated Rate |
$682.64 |
| Rate for Payer: Aetna Commercial |
$667.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$393.26
|
| Rate for Payer: Cash Price |
$222.60
|
| Rate for Payer: Cigna Commercial |
$682.64
|
| Rate for Payer: Health EOS Commercial |
$660.38
|
| Rate for Payer: HFN Commercial |
$682.64
|
| Rate for Payer: Multiplan Commercial |
$593.60
|
| Rate for Payer: NAPHCARE Commercial |
$445.20
|
| Rate for Payer: Preferred Network Access Commercial |
$682.64
|
| Rate for Payer: Quartz Beloit One Network |
$363.58
|
| Rate for Payer: Quartz Commercial |
$445.20
|
| Rate for Payer: WEA Trust Commercial |
$408.10
|
| Rate for Payer: WPS Commercial |
$549.60
|
|
