|
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 |
$546.29 |
| Max. Negotiated Rate |
$1,025.69 |
| Rate for Payer: Aetna Commercial |
$1,003.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$958.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$590.89
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cigna Commercial |
$1,025.69
|
| Rate for Payer: Health EOS Commercial |
$992.24
|
| Rate for Payer: HFN Commercial |
$1,025.69
|
| Rate for Payer: Multiplan Commercial |
$891.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,025.69
|
| Rate for Payer: Quartz Beloit One Network |
$546.29
|
| Rate for Payer: Quartz Commercial |
$668.93
|
| Rate for Payer: WEA Trust Commercial |
$613.18
|
| Rate for Payer: WPS Commercial |
$825.76
|
|
|
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 |
$546.29 |
| Max. Negotiated Rate |
$3,391.56 |
| Rate for Payer: Aetna Commercial |
$1,003.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$958.80
|
| Rate for Payer: Aetna Managed Medicare |
$847.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,314.69
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,546.85
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,467.30
|
| Rate for Payer: Anthem Medicare Advantage |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$590.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$847.89
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cigna Commercial |
$1,025.69
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$847.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$623.90
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$847.89
|
| Rate for Payer: Health EOS Commercial |
$992.24
|
| Rate for Payer: HFN Commercial |
$1,025.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,154.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$847.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$847.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$847.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$847.89
|
| Rate for Payer: Multiplan Commercial |
$891.90
|
| Rate for Payer: NAPHCARE Commercial |
$1,271.84
|
| Rate for Payer: Preferred Network Access Commercial |
$1,025.69
|
| Rate for Payer: Quartz Beloit One Network |
$546.29
|
| Rate for Payer: Quartz Commercial |
$724.67
|
| Rate for Payer: Quartz Medicare Advantage |
$847.89
|
| Rate for Payer: The Alliance Commercial |
$3,391.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$847.89
|
| Rate for Payer: United Healthcare PPO |
$836.16
|
| Rate for Payer: WEA Trust Commercial |
$613.18
|
| Rate for Payer: Wellcare Medicare |
$847.89
|
| Rate for Payer: WPS Commercial |
$825.76
|
|
|
88311 AP Bill Decalcification
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
295360
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.86 |
| Max. Negotiated Rate |
$35.40 |
| Rate for Payer: Aetna Commercial |
$34.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$33.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$20.39
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cigna Commercial |
$35.40
|
| Rate for Payer: Health EOS Commercial |
$34.25
|
| Rate for Payer: HFN Commercial |
$35.40
|
| Rate for Payer: Multiplan Commercial |
$30.78
|
| Rate for Payer: Preferred Network Access Commercial |
$35.40
|
| Rate for Payer: Quartz Beloit One Network |
$18.86
|
| Rate for Payer: Quartz Commercial |
$23.09
|
| Rate for Payer: WEA Trust Commercial |
$21.16
|
| Rate for Payer: WPS Commercial |
$28.50
|
|
|
88311 AP Bill Decalcification
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
295360
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$10.77 |
| Max. Negotiated Rate |
$78.08 |
| Rate for Payer: Aetna Commercial |
$34.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$33.09
|
| Rate for Payer: Aetna Managed Medicare |
$10.77
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$25.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$20.39
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cigna Commercial |
$35.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21.53
|
| Rate for Payer: Health EOS Commercial |
$34.25
|
| Rate for Payer: HFN Commercial |
$35.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28.86
|
| Rate for Payer: Multiplan Commercial |
$30.78
|
| Rate for Payer: NAPHCARE Commercial |
$23.09
|
| Rate for Payer: Preferred Network Access Commercial |
$35.40
|
| Rate for Payer: Quartz Beloit One Network |
$18.86
|
| Rate for Payer: Quartz Commercial |
$25.01
|
| Rate for Payer: Quartz Medicare Advantage |
$23.09
|
| Rate for Payer: The Alliance Commercial |
$78.08
|
| Rate for Payer: United Healthcare PPO |
$28.86
|
| Rate for Payer: WEA Trust Commercial |
$21.16
|
| Rate for Payer: WPS Commercial |
$28.50
|
|
|
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 |
$150.84 |
| Max. Negotiated Rate |
$283.21 |
| Rate for Payer: Aetna Commercial |
$277.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$264.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$163.16
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cigna Commercial |
$283.21
|
| Rate for Payer: Health EOS Commercial |
$273.98
|
| Rate for Payer: HFN Commercial |
$283.21
|
| Rate for Payer: Multiplan Commercial |
$246.27
|
| Rate for Payer: Preferred Network Access Commercial |
$283.21
|
| Rate for Payer: Quartz Beloit One Network |
$150.84
|
| Rate for Payer: Quartz Commercial |
$184.70
|
| Rate for Payer: WEA Trust Commercial |
$169.31
|
| Rate for Payer: WPS Commercial |
$228.01
|
|
|
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 |
$54.84 |
| Max. Negotiated Rate |
$283.21 |
| Rate for Payer: Aetna Commercial |
$277.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$264.74
|
| Rate for Payer: Aetna Managed Medicare |
$54.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$208.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$97.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$92.47
|
| Rate for Payer: Anthem Medicare Advantage |
$54.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$163.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$54.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$54.84
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cigna Commercial |
$283.21
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$54.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$172.27
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$54.84
|
| Rate for Payer: Health EOS Commercial |
$273.98
|
| Rate for Payer: HFN Commercial |
$283.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$204.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$54.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$54.84
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$54.84
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$54.84
|
| Rate for Payer: Multiplan Commercial |
$246.27
|
| Rate for Payer: NAPHCARE Commercial |
$82.26
|
| Rate for Payer: Preferred Network Access Commercial |
$283.21
|
| Rate for Payer: Quartz Beloit One Network |
$150.84
|
| Rate for Payer: Quartz Commercial |
$200.10
|
| Rate for Payer: Quartz Medicare Advantage |
$54.84
|
| Rate for Payer: The Alliance Commercial |
$219.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54.84
|
| Rate for Payer: United Healthcare PPO |
$230.88
|
| Rate for Payer: WEA Trust Commercial |
$169.31
|
| Rate for Payer: Wellcare Medicare |
$54.84
|
| Rate for Payer: WPS Commercial |
$228.01
|
|
|
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 |
$104.38 |
| Max. Negotiated Rate |
$560.06 |
| Rate for Payer: Aetna Commercial |
$224.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$214.66
|
| Rate for Payer: Aetna Managed Medicare |
$140.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$235.79
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$110.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$104.38
|
| Rate for Payer: Anthem Medicare Advantage |
$140.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$132.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$140.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$140.02
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cigna Commercial |
$229.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$140.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$139.68
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$140.02
|
| Rate for Payer: Health EOS Commercial |
$222.14
|
| Rate for Payer: HFN Commercial |
$229.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$520.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$140.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$140.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$140.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$140.02
|
| Rate for Payer: Multiplan Commercial |
$199.68
|
| Rate for Payer: NAPHCARE Commercial |
$210.02
|
| Rate for Payer: Preferred Network Access Commercial |
$229.63
|
| Rate for Payer: Quartz Beloit One Network |
$122.30
|
| Rate for Payer: Quartz Commercial |
$162.24
|
| Rate for Payer: Quartz Medicare Advantage |
$140.02
|
| Rate for Payer: The Alliance Commercial |
$560.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$140.02
|
| Rate for Payer: United Healthcare PPO |
$187.20
|
| Rate for Payer: WEA Trust Commercial |
$137.28
|
| Rate for Payer: Wellcare Medicare |
$140.02
|
| Rate for Payer: WPS Commercial |
$184.87
|
|
|
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 |
$122.30 |
| Max. Negotiated Rate |
$229.63 |
| Rate for Payer: Aetna Commercial |
$224.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$214.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$132.29
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cigna Commercial |
$229.63
|
| Rate for Payer: Health EOS Commercial |
$222.14
|
| Rate for Payer: HFN Commercial |
$229.63
|
| Rate for Payer: Multiplan Commercial |
$199.68
|
| Rate for Payer: Preferred Network Access Commercial |
$229.63
|
| Rate for Payer: Quartz Beloit One Network |
$122.30
|
| Rate for Payer: Quartz Commercial |
$149.76
|
| Rate for Payer: WEA Trust Commercial |
$137.28
|
| Rate for Payer: WPS Commercial |
$184.87
|
|
|
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 |
$163.07 |
| Max. Negotiated Rate |
$306.18 |
| Rate for Payer: Aetna Commercial |
$299.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$286.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$176.38
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$306.18
|
| Rate for Payer: Health EOS Commercial |
$296.19
|
| Rate for Payer: HFN Commercial |
$306.18
|
| Rate for Payer: Multiplan Commercial |
$266.24
|
| Rate for Payer: Preferred Network Access Commercial |
$306.18
|
| Rate for Payer: Quartz Beloit One Network |
$163.07
|
| Rate for Payer: Quartz Commercial |
$199.68
|
| Rate for Payer: WEA Trust Commercial |
$183.04
|
| Rate for Payer: WPS Commercial |
$246.50
|
|
|
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 |
$39.31 |
| Max. Negotiated Rate |
$306.18 |
| Rate for Payer: Aetna Commercial |
$299.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$286.21
|
| Rate for Payer: Aetna Managed Medicare |
$39.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$154.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$72.14
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$68.43
|
| Rate for Payer: Anthem Medicare Advantage |
$39.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$176.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.31
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$306.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$186.24
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.31
|
| Rate for Payer: Health EOS Commercial |
$296.19
|
| Rate for Payer: HFN Commercial |
$306.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.31
|
| Rate for Payer: Multiplan Commercial |
$266.24
|
| Rate for Payer: NAPHCARE Commercial |
$58.97
|
| Rate for Payer: Preferred Network Access Commercial |
$306.18
|
| Rate for Payer: Quartz Beloit One Network |
$163.07
|
| Rate for Payer: Quartz Commercial |
$216.32
|
| Rate for Payer: Quartz Medicare Advantage |
$39.31
|
| Rate for Payer: The Alliance Commercial |
$157.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.31
|
| Rate for Payer: United Healthcare PPO |
$249.60
|
| Rate for Payer: WEA Trust Commercial |
$183.04
|
| Rate for Payer: Wellcare Medicare |
$39.31
|
| Rate for Payer: WPS Commercial |
$246.50
|
|
|
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 |
$54.84 |
| Max. Negotiated Rate |
$219.36 |
| Rate for Payer: Aetna Commercial |
$127.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$121.64
|
| Rate for Payer: Aetna Managed Medicare |
$54.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$208.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$97.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$92.47
|
| Rate for Payer: Anthem Medicare Advantage |
$54.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$74.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$54.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$54.84
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cigna Commercial |
$130.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$54.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$79.15
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$54.84
|
| Rate for Payer: Health EOS Commercial |
$125.88
|
| Rate for Payer: HFN Commercial |
$130.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$204.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$54.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$54.84
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$54.84
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$54.84
|
| Rate for Payer: Multiplan Commercial |
$113.15
|
| Rate for Payer: NAPHCARE Commercial |
$82.26
|
| Rate for Payer: Preferred Network Access Commercial |
$130.12
|
| Rate for Payer: Quartz Beloit One Network |
$69.31
|
| Rate for Payer: Quartz Commercial |
$91.94
|
| Rate for Payer: Quartz Medicare Advantage |
$54.84
|
| Rate for Payer: The Alliance Commercial |
$219.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54.84
|
| Rate for Payer: United Healthcare PPO |
$106.08
|
| Rate for Payer: WEA Trust Commercial |
$77.79
|
| Rate for Payer: Wellcare Medicare |
$54.84
|
| Rate for Payer: WPS Commercial |
$104.76
|
|
|
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 |
$69.31 |
| Max. Negotiated Rate |
$130.12 |
| Rate for Payer: Aetna Commercial |
$127.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$121.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$74.96
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cigna Commercial |
$130.12
|
| Rate for Payer: Health EOS Commercial |
$125.88
|
| Rate for Payer: HFN Commercial |
$130.12
|
| Rate for Payer: Multiplan Commercial |
$113.15
|
| Rate for Payer: Preferred Network Access Commercial |
$130.12
|
| Rate for Payer: Quartz Beloit One Network |
$69.31
|
| Rate for Payer: Quartz Commercial |
$84.86
|
| Rate for Payer: WEA Trust Commercial |
$77.79
|
| Rate for Payer: WPS Commercial |
$104.76
|
|
|
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 |
$71.34 |
| Max. Negotiated Rate |
$717.18 |
| Rate for Payer: Aetna Commercial |
$131.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$125.22
|
| Rate for Payer: Aetna Managed Medicare |
$179.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$658.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$307.25
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$291.45
|
| Rate for Payer: Anthem Medicare Advantage |
$179.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$77.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$179.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$179.30
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cigna Commercial |
$133.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$179.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$81.48
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$179.30
|
| Rate for Payer: Health EOS Commercial |
$129.58
|
| Rate for Payer: HFN Commercial |
$133.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$666.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$179.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$179.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$179.30
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$179.30
|
| Rate for Payer: Multiplan Commercial |
$116.48
|
| Rate for Payer: NAPHCARE Commercial |
$268.94
|
| Rate for Payer: Preferred Network Access Commercial |
$133.95
|
| Rate for Payer: Quartz Beloit One Network |
$71.34
|
| Rate for Payer: Quartz Commercial |
$94.64
|
| Rate for Payer: Quartz Medicare Advantage |
$179.30
|
| Rate for Payer: The Alliance Commercial |
$717.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$179.30
|
| Rate for Payer: United Healthcare PPO |
$109.20
|
| Rate for Payer: WEA Trust Commercial |
$80.08
|
| Rate for Payer: Wellcare Medicare |
$179.30
|
| Rate for Payer: WPS Commercial |
$107.84
|
|
|
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 |
$71.34 |
| Max. Negotiated Rate |
$133.95 |
| Rate for Payer: Aetna Commercial |
$131.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$125.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$77.17
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cigna Commercial |
$133.95
|
| Rate for Payer: Health EOS Commercial |
$129.58
|
| Rate for Payer: HFN Commercial |
$133.95
|
| Rate for Payer: Multiplan Commercial |
$116.48
|
| Rate for Payer: Preferred Network Access Commercial |
$133.95
|
| Rate for Payer: Quartz Beloit One Network |
$71.34
|
| Rate for Payer: Quartz Commercial |
$87.36
|
| Rate for Payer: WEA Trust Commercial |
$80.08
|
| Rate for Payer: WPS Commercial |
$107.84
|
|
|
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 |
$42.81 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Aetna Commercial |
$78.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.30
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$80.37
|
| Rate for Payer: Health EOS Commercial |
$77.75
|
| Rate for Payer: HFN Commercial |
$80.37
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: Preferred Network Access Commercial |
$80.37
|
| Rate for Payer: Quartz Beloit One Network |
$42.81
|
| Rate for Payer: Quartz Commercial |
$52.42
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: WPS Commercial |
$64.71
|
|
|
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 |
$24.46 |
| Max. Negotiated Rate |
$214.57 |
| Rate for Payer: Aetna Commercial |
$78.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Aetna Managed Medicare |
$24.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.30
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$80.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.89
|
| Rate for Payer: Health EOS Commercial |
$77.75
|
| Rate for Payer: HFN Commercial |
$80.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.52
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: NAPHCARE Commercial |
$52.42
|
| Rate for Payer: Preferred Network Access Commercial |
$80.37
|
| Rate for Payer: Quartz Beloit One Network |
$42.81
|
| Rate for Payer: Quartz Commercial |
$56.78
|
| Rate for Payer: Quartz Medicare Advantage |
$52.42
|
| Rate for Payer: The Alliance Commercial |
$214.57
|
| Rate for Payer: United Healthcare PPO |
$65.52
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: WPS Commercial |
$64.71
|
|
|
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 |
$61.15 |
| Max. Negotiated Rate |
$3,391.56 |
| Rate for Payer: Aetna Commercial |
$112.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.33
|
| Rate for Payer: Aetna Managed Medicare |
$847.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,314.69
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,546.85
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,467.30
|
| Rate for Payer: Anthem Medicare Advantage |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$847.89
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$114.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$847.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$69.84
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$847.89
|
| Rate for Payer: Health EOS Commercial |
$111.07
|
| Rate for Payer: HFN Commercial |
$114.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,154.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$847.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$847.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$847.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$847.89
|
| Rate for Payer: Multiplan Commercial |
$99.84
|
| Rate for Payer: NAPHCARE Commercial |
$1,271.84
|
| Rate for Payer: Preferred Network Access Commercial |
$114.82
|
| Rate for Payer: Quartz Beloit One Network |
$61.15
|
| Rate for Payer: Quartz Commercial |
$81.12
|
| Rate for Payer: Quartz Medicare Advantage |
$847.89
|
| Rate for Payer: The Alliance Commercial |
$3,391.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$847.89
|
| Rate for Payer: United Healthcare PPO |
$93.60
|
| Rate for Payer: WEA Trust Commercial |
$68.64
|
| Rate for Payer: Wellcare Medicare |
$847.89
|
| Rate for Payer: WPS Commercial |
$92.44
|
|
|
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 |
$61.15 |
| Max. Negotiated Rate |
$114.82 |
| Rate for Payer: Aetna Commercial |
$112.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.14
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$114.82
|
| Rate for Payer: Health EOS Commercial |
$111.07
|
| Rate for Payer: HFN Commercial |
$114.82
|
| Rate for Payer: Multiplan Commercial |
$99.84
|
| Rate for Payer: Preferred Network Access Commercial |
$114.82
|
| Rate for Payer: Quartz Beloit One Network |
$61.15
|
| Rate for Payer: Quartz Commercial |
$74.88
|
| Rate for Payer: WEA Trust Commercial |
$68.64
|
| Rate for Payer: WPS Commercial |
$92.44
|
|
|
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 |
$61.15 |
| Max. Negotiated Rate |
$114.82 |
| Rate for Payer: Aetna Commercial |
$112.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.14
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$114.82
|
| Rate for Payer: Health EOS Commercial |
$111.07
|
| Rate for Payer: HFN Commercial |
$114.82
|
| Rate for Payer: Multiplan Commercial |
$99.84
|
| Rate for Payer: Preferred Network Access Commercial |
$114.82
|
| Rate for Payer: Quartz Beloit One Network |
$61.15
|
| Rate for Payer: Quartz Commercial |
$74.88
|
| Rate for Payer: WEA Trust Commercial |
$68.64
|
| Rate for Payer: WPS Commercial |
$92.44
|
|
|
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 |
$61.15 |
| Max. Negotiated Rate |
$3,391.56 |
| Rate for Payer: Aetna Commercial |
$112.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.33
|
| Rate for Payer: Aetna Managed Medicare |
$847.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,314.69
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,546.85
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,467.30
|
| Rate for Payer: Anthem Medicare Advantage |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$847.89
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna Commercial |
$114.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$847.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$69.84
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$847.89
|
| Rate for Payer: Health EOS Commercial |
$111.07
|
| Rate for Payer: HFN Commercial |
$114.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,154.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$847.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$847.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$847.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$847.89
|
| Rate for Payer: Multiplan Commercial |
$99.84
|
| Rate for Payer: NAPHCARE Commercial |
$1,271.84
|
| Rate for Payer: Preferred Network Access Commercial |
$114.82
|
| Rate for Payer: Quartz Beloit One Network |
$61.15
|
| Rate for Payer: Quartz Commercial |
$81.12
|
| Rate for Payer: Quartz Medicare Advantage |
$847.89
|
| Rate for Payer: The Alliance Commercial |
$3,391.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$847.89
|
| Rate for Payer: United Healthcare PPO |
$93.60
|
| Rate for Payer: WEA Trust Commercial |
$68.64
|
| Rate for Payer: Wellcare Medicare |
$847.89
|
| Rate for Payer: WPS Commercial |
$92.44
|
|
|
8FR IAB-50cc
|
Facility
|
OP
|
$5,685.00
|
|
| Hospital Charge Code |
5184607
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,655.47 |
| Max. Negotiated Rate |
$5,439.41 |
| Rate for Payer: Aetna Commercial |
$5,321.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,084.66
|
| Rate for Payer: Aetna Managed Medicare |
$1,655.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,843.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,956.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,837.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,133.57
|
| Rate for Payer: Cash Price |
$1,705.50
|
| Rate for Payer: Cigna Commercial |
$5,439.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,308.67
|
| Rate for Payer: Health EOS Commercial |
$5,262.04
|
| Rate for Payer: HFN Commercial |
$5,439.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,434.30
|
| Rate for Payer: Multiplan Commercial |
$4,729.92
|
| Rate for Payer: NAPHCARE Commercial |
$3,547.44
|
| Rate for Payer: Preferred Network Access Commercial |
$5,439.41
|
| Rate for Payer: Quartz Beloit One Network |
$2,897.08
|
| Rate for Payer: Quartz Commercial |
$3,843.06
|
| Rate for Payer: Quartz Medicare Advantage |
$3,547.44
|
| Rate for Payer: The Alliance Commercial |
$2,956.20
|
| Rate for Payer: WEA Trust Commercial |
$3,251.82
|
| Rate for Payer: WPS Commercial |
$4,379.16
|
|
|
8FR IAB-50cc
|
Facility
|
IP
|
$5,685.00
|
|
| Hospital Charge Code |
5184607
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,897.08 |
| Max. Negotiated Rate |
$5,439.41 |
| Rate for Payer: Aetna Commercial |
$5,321.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,084.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,133.57
|
| Rate for Payer: Cash Price |
$1,705.50
|
| Rate for Payer: Cigna Commercial |
$5,439.41
|
| Rate for Payer: Health EOS Commercial |
$5,262.04
|
| Rate for Payer: HFN Commercial |
$5,439.41
|
| Rate for Payer: Multiplan Commercial |
$4,729.92
|
| Rate for Payer: Preferred Network Access Commercial |
$5,439.41
|
| Rate for Payer: Quartz Beloit One Network |
$2,897.08
|
| Rate for Payer: Quartz Commercial |
$3,547.44
|
| Rate for Payer: WEA Trust Commercial |
$3,251.82
|
| Rate for Payer: WPS Commercial |
$4,379.16
|
|
|
96160 Mental health consult
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
CPT 96160
|
| Hospital Charge Code |
6209684
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$151.16 |
| Rate for Payer: Aetna Commercial |
$151.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$136.84
|
| Rate for Payer: Aetna Managed Medicare |
$3.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.00
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cigna Commercial |
$151.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3.00
|
| Rate for Payer: Health EOS Commercial |
$144.80
|
| Rate for Payer: HFN Commercial |
$151.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$9.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$127.30
|
| Rate for Payer: NAPHCARE Commercial |
$4.49
|
| Rate for Payer: Preferred Network Access Commercial |
$151.16
|
| Rate for Payer: Quartz Beloit One Network |
$70.01
|
| Rate for Payer: Quartz Commercial |
$90.70
|
| Rate for Payer: Quartz Medicare Advantage |
$3.00
|
| Rate for Payer: The Alliance Commercial |
$7.49
|
| Rate for Payer: United Healthcare Medicaid |
$4.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.00
|
| Rate for Payer: WEA Trust Commercial |
$87.52
|
| Rate for Payer: WPS Commercial |
$11.98
|
|
|
96161 Postnatal consult
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
6209685
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$77.06 |
| Rate for Payer: Aetna Commercial |
$77.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$69.76
|
| Rate for Payer: Aetna Managed Medicare |
$3.33
|
| Rate for Payer: Anthem Medicare Advantage |
$3.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.33
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$77.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3.33
|
| Rate for Payer: Health EOS Commercial |
$73.82
|
| Rate for Payer: HFN Commercial |
$77.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$9.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.33
|
| Rate for Payer: Multiplan Commercial |
$64.90
|
| Rate for Payer: NAPHCARE Commercial |
$4.99
|
| Rate for Payer: Preferred Network Access Commercial |
$77.06
|
| Rate for Payer: Quartz Beloit One Network |
$35.69
|
| Rate for Payer: Quartz Commercial |
$46.24
|
| Rate for Payer: Quartz Medicare Advantage |
$3.33
|
| Rate for Payer: The Alliance Commercial |
$8.32
|
| Rate for Payer: United Healthcare Medicaid |
$4.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.33
|
| Rate for Payer: WEA Trust Commercial |
$44.62
|
| Rate for Payer: WPS Commercial |
$13.31
|
|
|
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 |
$88.74 |
| Max. Negotiated Rate |
$666.64 |
| Rate for Payer: Aetna Commercial |
$213.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$203.92
|
| Rate for Payer: Aetna Managed Medicare |
$88.74
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$666.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$477.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$453.44
|
| Rate for Payer: Anthem Medicare Advantage |
$88.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$125.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$88.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$88.74
|
| 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 |
$218.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$88.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$132.70
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$88.74
|
| Rate for Payer: Health EOS Commercial |
$211.04
|
| Rate for Payer: HFN Commercial |
$218.15
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$330.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$88.74
|
| Rate for Payer: Independent Care Health Plan Medicare |
$88.74
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$88.74
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$88.74
|
| Rate for Payer: Multiplan Commercial |
$189.70
|
| Rate for Payer: NAPHCARE Commercial |
$133.11
|
| Rate for Payer: Preferred Network Access Commercial |
$218.15
|
| Rate for Payer: Quartz Beloit One Network |
$116.19
|
| Rate for Payer: Quartz Commercial |
$154.13
|
| Rate for Payer: Quartz Medicare Advantage |
$88.74
|
| Rate for Payer: The Alliance Commercial |
$354.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$88.74
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$130.42
|
| Rate for Payer: Wellcare Medicare |
$88.74
|
| Rate for Payer: WPS Commercial |
$175.63
|
|
