|
88309 AP Bill Surgical Pathology Level VI Complexity
|
Facility
IP
|
$1,072.00
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
295356
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$525.28 |
| Max. Negotiated Rate |
$986.24 |
| Rate for Payer: Aetna Commercial |
$964.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$568.16
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cigna Commercial |
$986.24
|
| Rate for Payer: Health EOS Commercial |
$954.08
|
| Rate for Payer: HFN Commercial |
$986.24
|
| Rate for Payer: Multiplan Commercial |
$857.60
|
| Rate for Payer: NAPHCARE Commercial |
$643.20
|
| Rate for Payer: Preferred Network Access Commercial |
$986.24
|
| Rate for Payer: Quartz Beloit One Network |
$525.28
|
| Rate for Payer: Quartz Commercial |
$643.20
|
| Rate for Payer: WEA Trust Commercial |
$589.60
|
| Rate for Payer: WPS Commercial |
$794.03
|
|
|
88309 AP Bill Surgical Pathology Level VI Complexity
|
Facility
OP
|
$1,072.00
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
295356
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$525.28 |
| Max. Negotiated Rate |
$3,187.20 |
| Rate for Payer: Aetna Commercial |
$964.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$921.92
|
| Rate for Payer: Aetna Managed Medicare |
$849.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,187.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,487.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,410.87
|
| Rate for Payer: Anthem Medicare Advantage |
$849.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$568.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$849.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$849.92
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cigna Commercial |
$986.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$849.92
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$849.92
|
| Rate for Payer: Health EOS Commercial |
$954.08
|
| Rate for Payer: HFN Commercial |
$986.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,161.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$849.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$849.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$849.92
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$849.92
|
| Rate for Payer: Multiplan Commercial |
$857.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,274.88
|
| Rate for Payer: Preferred Network Access Commercial |
$986.24
|
| Rate for Payer: Quartz Beloit One Network |
$525.28
|
| Rate for Payer: Quartz Commercial |
$696.80
|
| Rate for Payer: Quartz Medicare Advantage |
$849.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$849.92
|
| Rate for Payer: United Healthcare PPO |
$804.00
|
| Rate for Payer: WEA Trust Commercial |
$589.60
|
| Rate for Payer: Wellcare Medicare |
$849.92
|
| Rate for Payer: WPS Commercial |
$794.03
|
|
|
88311 AP Bill Decalcification
|
Facility
OP
|
$37.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
295360
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$10.36 |
| Max. Negotiated Rate |
$34.04 |
| Rate for Payer: Aetna Commercial |
$33.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$31.82
|
| Rate for Payer: Aetna Managed Medicare |
$10.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$19.61
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cigna Commercial |
$34.04
|
| Rate for Payer: Health EOS Commercial |
$32.93
|
| Rate for Payer: HFN Commercial |
$34.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$27.75
|
| Rate for Payer: Multiplan Commercial |
$29.60
|
| Rate for Payer: NAPHCARE Commercial |
$22.20
|
| Rate for Payer: Preferred Network Access Commercial |
$34.04
|
| Rate for Payer: Quartz Beloit One Network |
$18.13
|
| Rate for Payer: Quartz Commercial |
$24.05
|
| Rate for Payer: Quartz Medicare Advantage |
$22.20
|
| Rate for Payer: United Healthcare PPO |
$27.75
|
| Rate for Payer: WEA Trust Commercial |
$20.35
|
| Rate for Payer: WPS Commercial |
$27.41
|
|
|
88311 AP Bill Decalcification
|
Facility
IP
|
$37.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
295360
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.13 |
| Max. Negotiated Rate |
$34.04 |
| Rate for Payer: Aetna Commercial |
$33.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$19.61
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cigna Commercial |
$34.04
|
| Rate for Payer: Health EOS Commercial |
$32.93
|
| Rate for Payer: HFN Commercial |
$34.04
|
| Rate for Payer: Multiplan Commercial |
$29.60
|
| Rate for Payer: NAPHCARE Commercial |
$22.20
|
| Rate for Payer: Preferred Network Access Commercial |
$34.04
|
| Rate for Payer: Quartz Beloit One Network |
$18.13
|
| Rate for Payer: Quartz Commercial |
$22.20
|
| Rate for Payer: WEA Trust Commercial |
$20.35
|
| Rate for Payer: WPS Commercial |
$27.41
|
|
|
88312 AP Bill Special Stains Group I
|
Facility
IP
|
$296.00
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
295362
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$145.04 |
| Max. Negotiated Rate |
$272.32 |
| Rate for Payer: Aetna Commercial |
$266.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$156.88
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cigna Commercial |
$272.32
|
| Rate for Payer: Health EOS Commercial |
$263.44
|
| Rate for Payer: HFN Commercial |
$272.32
|
| Rate for Payer: Multiplan Commercial |
$236.80
|
| Rate for Payer: NAPHCARE Commercial |
$177.60
|
| Rate for Payer: Preferred Network Access Commercial |
$272.32
|
| Rate for Payer: Quartz Beloit One Network |
$145.04
|
| Rate for Payer: Quartz Commercial |
$177.60
|
| Rate for Payer: WEA Trust Commercial |
$162.80
|
| Rate for Payer: WPS Commercial |
$219.25
|
|
|
88312 AP Bill Special Stains Group I
|
Facility
OP
|
$296.00
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
295362
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$53.56 |
| Max. Negotiated Rate |
$272.32 |
| Rate for Payer: Aetna Commercial |
$266.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$254.56
|
| Rate for Payer: Aetna Managed Medicare |
$53.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$200.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$93.73
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$88.91
|
| Rate for Payer: Anthem Medicare Advantage |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$156.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$53.56
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cigna Commercial |
$272.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$53.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$53.56
|
| Rate for Payer: Health EOS Commercial |
$263.44
|
| Rate for Payer: HFN Commercial |
$272.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$199.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$53.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$53.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$53.56
|
| Rate for Payer: Multiplan Commercial |
$236.80
|
| Rate for Payer: NAPHCARE Commercial |
$80.34
|
| Rate for Payer: Preferred Network Access Commercial |
$272.32
|
| Rate for Payer: Quartz Beloit One Network |
$145.04
|
| Rate for Payer: Quartz Commercial |
$192.40
|
| Rate for Payer: Quartz Medicare Advantage |
$53.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.56
|
| Rate for Payer: United Healthcare PPO |
$222.00
|
| Rate for Payer: WEA Trust Commercial |
$162.80
|
| Rate for Payer: Wellcare Medicare |
$53.56
|
| Rate for Payer: WPS Commercial |
$219.25
|
|
|
88313 AP Bill Special Stains Group II
|
Facility
IP
|
$240.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
295364
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$117.60 |
| Max. Negotiated Rate |
$220.80 |
| Rate for Payer: Aetna Commercial |
$216.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$127.20
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cigna Commercial |
$220.80
|
| Rate for Payer: Health EOS Commercial |
$213.60
|
| Rate for Payer: HFN Commercial |
$220.80
|
| Rate for Payer: Multiplan Commercial |
$192.00
|
| Rate for Payer: NAPHCARE Commercial |
$144.00
|
| Rate for Payer: Preferred Network Access Commercial |
$220.80
|
| Rate for Payer: Quartz Beloit One Network |
$117.60
|
| Rate for Payer: Quartz Commercial |
$144.00
|
| Rate for Payer: WEA Trust Commercial |
$132.00
|
| Rate for Payer: WPS Commercial |
$177.77
|
|
|
88313 AP Bill Special Stains Group II
|
Facility
OP
|
$240.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
295364
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.46 |
| Max. Negotiated Rate |
$226.72 |
| Rate for Payer: Aetna Commercial |
$216.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$206.40
|
| 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 |
$127.20
|
| 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 |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cigna Commercial |
$220.80
|
| 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 |
$213.60
|
| Rate for Payer: HFN Commercial |
$220.80
|
| 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 |
$192.00
|
| Rate for Payer: NAPHCARE Commercial |
$90.69
|
| Rate for Payer: Preferred Network Access Commercial |
$220.80
|
| Rate for Payer: Quartz Beloit One Network |
$117.60
|
| Rate for Payer: Quartz Commercial |
$156.00
|
| Rate for Payer: Quartz Medicare Advantage |
$60.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$60.46
|
| Rate for Payer: United Healthcare PPO |
$180.00
|
| Rate for Payer: WEA Trust Commercial |
$132.00
|
| Rate for Payer: Wellcare Medicare |
$60.46
|
| Rate for Payer: WPS Commercial |
$177.77
|
|
|
88321 AP Bill Consultation Fee Outside slides and report
|
Facility
OP
|
$320.00
|
|
|
Service Code
|
CPT 88321
|
| Hospital Charge Code |
295358
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.64 |
| Max. Negotiated Rate |
$294.40 |
| Rate for Payer: Aetna Commercial |
$288.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$275.20
|
| Rate for Payer: Aetna Managed Medicare |
$39.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$148.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$69.37
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$65.80
|
| Rate for Payer: Anthem Medicare Advantage |
$39.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$169.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.64
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$294.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.64
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.64
|
| Rate for Payer: Health EOS Commercial |
$284.80
|
| Rate for Payer: HFN Commercial |
$294.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$147.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.64
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.64
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.64
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.64
|
| Rate for Payer: Multiplan Commercial |
$256.00
|
| Rate for Payer: NAPHCARE Commercial |
$59.46
|
| Rate for Payer: Preferred Network Access Commercial |
$294.40
|
| Rate for Payer: Quartz Beloit One Network |
$156.80
|
| Rate for Payer: Quartz Commercial |
$208.00
|
| Rate for Payer: Quartz Medicare Advantage |
$39.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.64
|
| Rate for Payer: United Healthcare PPO |
$240.00
|
| Rate for Payer: WEA Trust Commercial |
$176.00
|
| Rate for Payer: Wellcare Medicare |
$39.64
|
| Rate for Payer: WPS Commercial |
$237.02
|
|
|
88321 AP Bill Consultation Fee Outside slides and report
|
Facility
IP
|
$320.00
|
|
|
Service Code
|
CPT 88321
|
| Hospital Charge Code |
295358
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$156.80 |
| Max. Negotiated Rate |
$294.40 |
| Rate for Payer: Aetna Commercial |
$288.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$169.60
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$294.40
|
| Rate for Payer: Health EOS Commercial |
$284.80
|
| Rate for Payer: HFN Commercial |
$294.40
|
| Rate for Payer: Multiplan Commercial |
$256.00
|
| Rate for Payer: NAPHCARE Commercial |
$192.00
|
| Rate for Payer: Preferred Network Access Commercial |
$294.40
|
| Rate for Payer: Quartz Beloit One Network |
$156.80
|
| Rate for Payer: Quartz Commercial |
$192.00
|
| Rate for Payer: WEA Trust Commercial |
$176.00
|
| Rate for Payer: WPS Commercial |
$237.02
|
|
|
88323 AP Bill Consultation Fee Outside slides/report prep
|
Facility
IP
|
$136.00
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
592821
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$66.64 |
| Max. Negotiated Rate |
$125.12 |
| Rate for Payer: Aetna Commercial |
$122.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.08
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cigna Commercial |
$125.12
|
| Rate for Payer: Health EOS Commercial |
$121.04
|
| Rate for Payer: HFN Commercial |
$125.12
|
| Rate for Payer: Multiplan Commercial |
$108.80
|
| Rate for Payer: NAPHCARE Commercial |
$81.60
|
| Rate for Payer: Preferred Network Access Commercial |
$125.12
|
| Rate for Payer: Quartz Beloit One Network |
$66.64
|
| Rate for Payer: Quartz Commercial |
$81.60
|
| Rate for Payer: WEA Trust Commercial |
$74.80
|
| Rate for Payer: WPS Commercial |
$100.74
|
|
|
88323 AP Bill Consultation Fee Outside slides/report prep
|
Facility
OP
|
$136.00
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
592821
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$53.56 |
| Max. Negotiated Rate |
$200.85 |
| Rate for Payer: Aetna Commercial |
$122.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$116.96
|
| Rate for Payer: Aetna Managed Medicare |
$53.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$200.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$93.73
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$88.91
|
| Rate for Payer: Anthem Medicare Advantage |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$53.56
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cigna Commercial |
$125.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$53.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$53.56
|
| Rate for Payer: Health EOS Commercial |
$121.04
|
| Rate for Payer: HFN Commercial |
$125.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$199.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$53.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$53.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$53.56
|
| Rate for Payer: Multiplan Commercial |
$108.80
|
| Rate for Payer: NAPHCARE Commercial |
$80.34
|
| Rate for Payer: Preferred Network Access Commercial |
$125.12
|
| Rate for Payer: Quartz Beloit One Network |
$66.64
|
| Rate for Payer: Quartz Commercial |
$88.40
|
| Rate for Payer: Quartz Medicare Advantage |
$53.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.56
|
| Rate for Payer: United Healthcare PPO |
$102.00
|
| Rate for Payer: WEA Trust Commercial |
$74.80
|
| Rate for Payer: Wellcare Medicare |
$53.56
|
| Rate for Payer: WPS Commercial |
$100.74
|
|
|
88331 AP Bill Frozen single specimen
|
Facility
IP
|
$140.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
592817
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.60 |
| Max. Negotiated Rate |
$128.80 |
| Rate for Payer: Aetna Commercial |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$74.20
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cigna Commercial |
$128.80
|
| Rate for Payer: Health EOS Commercial |
$124.60
|
| Rate for Payer: HFN Commercial |
$128.80
|
| Rate for Payer: Multiplan Commercial |
$112.00
|
| Rate for Payer: NAPHCARE Commercial |
$84.00
|
| Rate for Payer: Preferred Network Access Commercial |
$128.80
|
| Rate for Payer: Quartz Beloit One Network |
$68.60
|
| Rate for Payer: Quartz Commercial |
$84.00
|
| Rate for Payer: WEA Trust Commercial |
$77.00
|
| Rate for Payer: WPS Commercial |
$103.70
|
|
|
88331 AP Bill Frozen single specimen
|
Facility
OP
|
$140.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
592817
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.60 |
| Max. Negotiated Rate |
$633.08 |
| Rate for Payer: Aetna Commercial |
$126.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$120.40
|
| Rate for Payer: Aetna Managed Medicare |
$168.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$633.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$295.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$280.24
|
| Rate for Payer: Anthem Medicare Advantage |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$74.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$168.82
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cigna Commercial |
$128.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$168.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$168.82
|
| Rate for Payer: Health EOS Commercial |
$124.60
|
| Rate for Payer: HFN Commercial |
$128.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$168.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$168.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$168.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$168.82
|
| Rate for Payer: Multiplan Commercial |
$112.00
|
| Rate for Payer: NAPHCARE Commercial |
$253.23
|
| Rate for Payer: Preferred Network Access Commercial |
$128.80
|
| Rate for Payer: Quartz Beloit One Network |
$68.60
|
| Rate for Payer: Quartz Commercial |
$91.00
|
| Rate for Payer: Quartz Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare PPO |
$105.00
|
| Rate for Payer: WEA Trust Commercial |
$77.00
|
| Rate for Payer: Wellcare Medicare |
$168.82
|
| Rate for Payer: WPS Commercial |
$103.70
|
|
|
88332 AP Bill Frozen add'l block
|
Facility
IP
|
$84.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
592815
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.16 |
| Max. Negotiated Rate |
$77.28 |
| Rate for Payer: Aetna Commercial |
$75.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$44.52
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$77.28
|
| Rate for Payer: Health EOS Commercial |
$74.76
|
| Rate for Payer: HFN Commercial |
$77.28
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: NAPHCARE Commercial |
$50.40
|
| Rate for Payer: Preferred Network Access Commercial |
$77.28
|
| Rate for Payer: Quartz Beloit One Network |
$41.16
|
| Rate for Payer: Quartz Commercial |
$50.40
|
| Rate for Payer: WEA Trust Commercial |
$46.20
|
| Rate for Payer: WPS Commercial |
$62.22
|
|
|
88332 AP Bill Frozen add'l block
|
Facility
OP
|
$84.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
592815
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.52 |
| Max. Negotiated Rate |
$77.28 |
| Rate for Payer: Aetna Commercial |
$75.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$72.24
|
| Rate for Payer: Aetna Managed Medicare |
$23.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$54.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$42.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$40.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$44.52
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$77.28
|
| Rate for Payer: Health EOS Commercial |
$74.76
|
| Rate for Payer: HFN Commercial |
$77.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: NAPHCARE Commercial |
$50.40
|
| Rate for Payer: Preferred Network Access Commercial |
$77.28
|
| Rate for Payer: Quartz Beloit One Network |
$41.16
|
| Rate for Payer: Quartz Commercial |
$54.60
|
| Rate for Payer: Quartz Medicare Advantage |
$50.40
|
| Rate for Payer: United Healthcare PPO |
$63.00
|
| Rate for Payer: WEA Trust Commercial |
$46.20
|
| Rate for Payer: WPS Commercial |
$62.22
|
|
|
88333 AP Bill Smear or Touch Prep During Intraoperative Consultation
|
Facility
OP
|
$120.00
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
5218739
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$3,187.20 |
| Rate for Payer: Aetna Commercial |
$108.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$103.20
|
| Rate for Payer: Aetna Managed Medicare |
$849.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,187.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,487.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,410.87
|
| Rate for Payer: Anthem Medicare Advantage |
$849.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$63.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$849.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$849.92
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$110.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$849.92
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$849.92
|
| Rate for Payer: Health EOS Commercial |
$106.80
|
| Rate for Payer: HFN Commercial |
$110.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,161.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$849.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$849.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$849.92
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$849.92
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,274.88
|
| Rate for Payer: Preferred Network Access Commercial |
$110.40
|
| Rate for Payer: Quartz Beloit One Network |
$58.80
|
| Rate for Payer: Quartz Commercial |
$78.00
|
| Rate for Payer: Quartz Medicare Advantage |
$849.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$849.92
|
| Rate for Payer: United Healthcare PPO |
$90.00
|
| Rate for Payer: WEA Trust Commercial |
$66.00
|
| Rate for Payer: Wellcare Medicare |
$849.92
|
| Rate for Payer: WPS Commercial |
$88.88
|
|
|
88333 AP Bill Smear or Touch Prep During Intraoperative Consultation
|
Facility
IP
|
$120.00
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
5218739
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$110.40 |
| Rate for Payer: Aetna Commercial |
$108.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$63.60
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$110.40
|
| Rate for Payer: Health EOS Commercial |
$106.80
|
| Rate for Payer: HFN Commercial |
$110.40
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: NAPHCARE Commercial |
$72.00
|
| Rate for Payer: Preferred Network Access Commercial |
$110.40
|
| Rate for Payer: Quartz Beloit One Network |
$58.80
|
| Rate for Payer: Quartz Commercial |
$72.00
|
| Rate for Payer: WEA Trust Commercial |
$66.00
|
| Rate for Payer: WPS Commercial |
$88.88
|
|
|
88333 Bill Smear or Touch Prep During Intraoperative Consultation
|
Facility
IP
|
$120.00
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
5222843
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$110.40 |
| Rate for Payer: Aetna Commercial |
$108.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$63.60
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$110.40
|
| Rate for Payer: Health EOS Commercial |
$106.80
|
| Rate for Payer: HFN Commercial |
$110.40
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: NAPHCARE Commercial |
$72.00
|
| Rate for Payer: Preferred Network Access Commercial |
$110.40
|
| Rate for Payer: Quartz Beloit One Network |
$58.80
|
| Rate for Payer: Quartz Commercial |
$72.00
|
| Rate for Payer: WEA Trust Commercial |
$66.00
|
| Rate for Payer: WPS Commercial |
$88.88
|
|
|
88333 Bill Smear or Touch Prep During Intraoperative Consultation
|
Facility
OP
|
$120.00
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
5222843
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$3,187.20 |
| Rate for Payer: Aetna Commercial |
$108.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$103.20
|
| Rate for Payer: Aetna Managed Medicare |
$849.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,187.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,487.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,410.87
|
| Rate for Payer: Anthem Medicare Advantage |
$849.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$63.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$849.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$849.92
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$110.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$849.92
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$849.92
|
| Rate for Payer: Health EOS Commercial |
$106.80
|
| Rate for Payer: HFN Commercial |
$110.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,161.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$849.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$849.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$849.92
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$849.92
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,274.88
|
| Rate for Payer: Preferred Network Access Commercial |
$110.40
|
| Rate for Payer: Quartz Beloit One Network |
$58.80
|
| Rate for Payer: Quartz Commercial |
$78.00
|
| Rate for Payer: Quartz Medicare Advantage |
$849.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$849.92
|
| Rate for Payer: United Healthcare PPO |
$90.00
|
| Rate for Payer: WEA Trust Commercial |
$66.00
|
| Rate for Payer: Wellcare Medicare |
$849.92
|
| Rate for Payer: WPS Commercial |
$88.88
|
|
|
8FR IAB-50cc
|
Facility
IP
|
$5,685.00
|
|
| Hospital Charge Code |
5184607
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,785.65 |
| Max. Negotiated Rate |
$5,230.20 |
| Rate for Payer: Aetna Commercial |
$5,116.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,013.05
|
| Rate for Payer: Cash Price |
$1,705.50
|
| Rate for Payer: Cigna Commercial |
$5,230.20
|
| Rate for Payer: Health EOS Commercial |
$5,059.65
|
| Rate for Payer: HFN Commercial |
$5,230.20
|
| Rate for Payer: Multiplan Commercial |
$4,548.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,411.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,230.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,785.65
|
| Rate for Payer: Quartz Commercial |
$3,411.00
|
| Rate for Payer: WEA Trust Commercial |
$3,126.75
|
| Rate for Payer: WPS Commercial |
$4,210.88
|
|
|
8FR IAB-50cc
|
Facility
OP
|
$5,685.00
|
|
| Hospital Charge Code |
5184607
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,591.80 |
| Max. Negotiated Rate |
$22,740.00 |
| Rate for Payer: Aetna Commercial |
$5,116.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,889.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,591.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,695.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,842.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,728.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,013.05
|
| Rate for Payer: Cash Price |
$1,705.50
|
| Rate for Payer: Cigna Commercial |
$5,230.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,181.33
|
| Rate for Payer: Health EOS Commercial |
$5,059.65
|
| Rate for Payer: HFN Commercial |
$5,230.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,263.75
|
| Rate for Payer: Multiplan Commercial |
$4,548.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,411.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,230.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,785.65
|
| Rate for Payer: Quartz Commercial |
$3,695.25
|
| Rate for Payer: Quartz Medicare Advantage |
$3,411.00
|
| Rate for Payer: The Alliance Commercial |
$22,740.00
|
| Rate for Payer: WEA Trust Commercial |
$3,126.75
|
| Rate for Payer: WPS Commercial |
$4,210.88
|
|
|
96160 Mental health consult
|
Professional
|
$153.00
|
|
|
Service Code
|
CPT 96160
|
| Hospital Charge Code |
6209684
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$145.35 |
| Rate for Payer: Aetna Commercial |
$145.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$131.58
|
| Rate for Payer: Aetna Managed Medicare |
$2.58
|
| Rate for Payer: Anthem Medicare Advantage |
$2.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2.58
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cigna Commercial |
$145.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$76.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2.58
|
| Rate for Payer: Health EOS Commercial |
$139.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$9.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2.58
|
| Rate for Payer: Multiplan Commercial |
$122.40
|
| Rate for Payer: Preferred Network Access Commercial |
$145.35
|
| Rate for Payer: Quartz Beloit One Network |
$67.32
|
| Rate for Payer: Quartz Commercial |
$87.21
|
| Rate for Payer: Quartz Medicare Advantage |
$2.58
|
| Rate for Payer: The Alliance Commercial |
$6.45
|
| Rate for Payer: United Healthcare Medicaid |
$4.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2.58
|
| Rate for Payer: WEA Trust Commercial |
$84.15
|
| Rate for Payer: WPS Commercial |
$10.32
|
|
|
96161 Postnatal consult
|
Professional
|
$78.00
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
6209685
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$74.10 |
| Rate for Payer: Aetna Commercial |
$74.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.08
|
| Rate for Payer: Aetna Managed Medicare |
$2.58
|
| Rate for Payer: Anthem Medicare Advantage |
$2.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2.58
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$74.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$39.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2.58
|
| Rate for Payer: Health EOS Commercial |
$70.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$9.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2.58
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Preferred Network Access Commercial |
$74.10
|
| Rate for Payer: Quartz Beloit One Network |
$34.32
|
| Rate for Payer: Quartz Commercial |
$44.46
|
| Rate for Payer: Quartz Medicare Advantage |
$2.58
|
| Rate for Payer: The Alliance Commercial |
$6.45
|
| Rate for Payer: United Healthcare Medicaid |
$4.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2.58
|
| Rate for Payer: WEA Trust Commercial |
$42.90
|
| Rate for Payer: WPS Commercial |
$10.32
|
|
|
99281 - Level 1 - Lynx Visit Level
|
Facility
OP
|
$228.00
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
3031290
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$87.75 |
| Max. Negotiated Rate |
$641.00 |
| Rate for Payer: Aetna Commercial |
$205.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$196.08
|
| Rate for Payer: Aetna Managed Medicare |
$87.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$641.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$459.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$436.00
|
| Rate for Payer: Anthem Medicare Advantage |
$87.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$120.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$87.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$87.75
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cigna Commercial |
$209.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$87.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$127.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$87.75
|
| Rate for Payer: Health EOS Commercial |
$202.92
|
| Rate for Payer: HFN Commercial |
$209.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$326.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$87.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$87.75
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$87.75
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$87.75
|
| Rate for Payer: Multiplan Commercial |
$182.40
|
| Rate for Payer: NAPHCARE Commercial |
$131.62
|
| Rate for Payer: Preferred Network Access Commercial |
$209.76
|
| Rate for Payer: Quartz Beloit One Network |
$111.72
|
| Rate for Payer: Quartz Commercial |
$148.20
|
| Rate for Payer: Quartz Medicare Advantage |
$87.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$87.75
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$125.40
|
| Rate for Payer: Wellcare Medicare |
$87.75
|
| Rate for Payer: WPS Commercial |
$168.88
|
|
