|
SUBFASCIAL ENDOSCOPIC PERFORATER SURGERY
|
Facility
|
IP
|
$6,713.00
|
|
| Hospital Charge Code |
2960369
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,420.94 |
| Max. Negotiated Rate |
$6,423.00 |
| Rate for Payer: Aetna Commercial |
$6,283.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,004.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,700.21
|
| Rate for Payer: Cash Price |
$2,013.90
|
| Rate for Payer: Cigna Commercial |
$6,423.00
|
| Rate for Payer: Health EOS Commercial |
$6,213.55
|
| Rate for Payer: HFN Commercial |
$6,423.00
|
| Rate for Payer: Multiplan Commercial |
$5,585.22
|
| Rate for Payer: Preferred Network Access Commercial |
$6,423.00
|
| Rate for Payer: Quartz Beloit One Network |
$3,420.94
|
| Rate for Payer: Quartz Commercial |
$4,188.91
|
| Rate for Payer: WEA Trust Commercial |
$3,839.84
|
| Rate for Payer: WPS Commercial |
$5,171.02
|
|
|
SUBFASCIAL ENDOSCOPIC PERFORATER SURGERY
|
Facility
|
OP
|
$6,713.00
|
|
| Hospital Charge Code |
2960369
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,954.83 |
| Max. Negotiated Rate |
$6,423.00 |
| Rate for Payer: Aetna Commercial |
$6,283.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,004.11
|
| Rate for Payer: Aetna Managed Medicare |
$1,954.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,537.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,490.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,351.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,700.21
|
| Rate for Payer: Cash Price |
$2,013.90
|
| Rate for Payer: Cigna Commercial |
$6,423.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,906.97
|
| Rate for Payer: Health EOS Commercial |
$6,213.55
|
| Rate for Payer: HFN Commercial |
$6,423.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,236.14
|
| Rate for Payer: Multiplan Commercial |
$5,585.22
|
| Rate for Payer: NAPHCARE Commercial |
$4,188.91
|
| Rate for Payer: Preferred Network Access Commercial |
$6,423.00
|
| Rate for Payer: Quartz Beloit One Network |
$3,420.94
|
| Rate for Payer: Quartz Commercial |
$4,537.99
|
| Rate for Payer: Quartz Medicare Advantage |
$4,188.91
|
| Rate for Payer: The Alliance Commercial |
$3,490.76
|
| Rate for Payer: WEA Trust Commercial |
$3,839.84
|
| Rate for Payer: WPS Commercial |
$5,171.02
|
|
|
SUBMUCOSAL INJECTION
|
Facility
|
OP
|
$917.00
|
|
| Hospital Charge Code |
4253750
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$267.03 |
| Max. Negotiated Rate |
$877.39 |
| Rate for Payer: Aetna Commercial |
$858.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$820.16
|
| Rate for Payer: Aetna Managed Medicare |
$267.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$619.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$476.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$457.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$505.45
|
| Rate for Payer: Cash Price |
$275.10
|
| Rate for Payer: Cigna Commercial |
$877.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$533.69
|
| Rate for Payer: Health EOS Commercial |
$848.78
|
| Rate for Payer: HFN Commercial |
$877.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$715.26
|
| Rate for Payer: Multiplan Commercial |
$762.94
|
| Rate for Payer: NAPHCARE Commercial |
$572.21
|
| Rate for Payer: Preferred Network Access Commercial |
$877.39
|
| Rate for Payer: Quartz Beloit One Network |
$467.30
|
| Rate for Payer: Quartz Commercial |
$619.89
|
| Rate for Payer: Quartz Medicare Advantage |
$572.21
|
| Rate for Payer: The Alliance Commercial |
$476.84
|
| Rate for Payer: WEA Trust Commercial |
$524.52
|
| Rate for Payer: WPS Commercial |
$706.37
|
|
|
SUBMUCOSAL INJECTION
|
Facility
|
IP
|
$917.00
|
|
| Hospital Charge Code |
4253750
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$467.30 |
| Max. Negotiated Rate |
$877.39 |
| Rate for Payer: Aetna Commercial |
$858.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$820.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$505.45
|
| Rate for Payer: Cash Price |
$275.10
|
| Rate for Payer: Cigna Commercial |
$877.39
|
| Rate for Payer: Health EOS Commercial |
$848.78
|
| Rate for Payer: HFN Commercial |
$877.39
|
| Rate for Payer: Multiplan Commercial |
$762.94
|
| Rate for Payer: Preferred Network Access Commercial |
$877.39
|
| Rate for Payer: Quartz Beloit One Network |
$467.30
|
| Rate for Payer: Quartz Commercial |
$572.21
|
| Rate for Payer: WEA Trust Commercial |
$524.52
|
| Rate for Payer: WPS Commercial |
$706.37
|
|
|
SUBMUCOUS RESECTION INFERIOR TURBINATE, PARTIAL OR COMPLETE, ANY METHOD
|
Facility
|
OP
|
$13,956.63
|
|
|
Service Code
|
CPT 30140
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,835.04 |
| Max. Negotiated Rate |
$13,956.63 |
| Rate for Payer: Aetna Managed Medicare |
$3,489.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$3,489.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,489.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,489.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,489.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,489.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,979.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,489.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,489.16
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,489.16
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,489.16
|
| Rate for Payer: NAPHCARE Commercial |
$5,233.74
|
| Rate for Payer: Quartz Medicare Advantage |
$3,489.16
|
| Rate for Payer: The Alliance Commercial |
$13,956.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,489.16
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$3,489.16
|
|
|
Subsequent - Chest Physiotherapy Charge
|
Facility
|
OP
|
$129.00
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
2990158
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$64.40 |
| Max. Negotiated Rate |
$560.06 |
| Rate for Payer: Aetna Commercial |
$120.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$115.38
|
| Rate for Payer: Aetna Managed Medicare |
$140.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$87.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$67.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$64.40
|
| Rate for Payer: Anthem Medicare Advantage |
$140.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$71.10
|
| 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 |
$38.70
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cigna Commercial |
$123.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$140.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$75.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$140.02
|
| Rate for Payer: Health EOS Commercial |
$119.40
|
| Rate for Payer: HFN Commercial |
$123.43
|
| 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 |
$107.33
|
| Rate for Payer: NAPHCARE Commercial |
$210.02
|
| Rate for Payer: Preferred Network Access Commercial |
$123.43
|
| Rate for Payer: Quartz Beloit One Network |
$65.74
|
| Rate for Payer: Quartz Commercial |
$87.20
|
| 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 |
$100.62
|
| Rate for Payer: WEA Trust Commercial |
$73.79
|
| Rate for Payer: Wellcare Medicare |
$140.02
|
| Rate for Payer: WPS Commercial |
$99.37
|
|
|
Subsequent - Chest Physiotherapy Charge
|
Facility
|
IP
|
$129.00
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
2990158
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$65.74 |
| Max. Negotiated Rate |
$123.43 |
| Rate for Payer: Aetna Commercial |
$120.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$115.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$71.10
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cigna Commercial |
$123.43
|
| Rate for Payer: Health EOS Commercial |
$119.40
|
| Rate for Payer: HFN Commercial |
$123.43
|
| Rate for Payer: Multiplan Commercial |
$107.33
|
| Rate for Payer: Preferred Network Access Commercial |
$123.43
|
| Rate for Payer: Quartz Beloit One Network |
$65.74
|
| Rate for Payer: Quartz Commercial |
$80.50
|
| Rate for Payer: WEA Trust Commercial |
$73.79
|
| Rate for Payer: WPS Commercial |
$99.37
|
|
|
Subsequent - Handheld Nebulizer Charge
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
2990156
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$53.58 |
| Rate for Payer: Aetna Commercial |
$52.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$30.87
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$53.58
|
| Rate for Payer: Health EOS Commercial |
$51.83
|
| Rate for Payer: HFN Commercial |
$53.58
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: Preferred Network Access Commercial |
$53.58
|
| Rate for Payer: Quartz Beloit One Network |
$28.54
|
| Rate for Payer: Quartz Commercial |
$34.94
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: WPS Commercial |
$43.14
|
|
|
Subsequent - Handheld Nebulizer Charge
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
2990156
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$27.96 |
| Max. Negotiated Rate |
$921.81 |
| Rate for Payer: Aetna Commercial |
$52.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Aetna Managed Medicare |
$230.45
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$37.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.96
|
| Rate for Payer: Anthem Medicare Advantage |
$230.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$30.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$230.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$230.45
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$53.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$230.45
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$230.45
|
| Rate for Payer: Health EOS Commercial |
$51.83
|
| Rate for Payer: HFN Commercial |
$53.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$857.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$230.45
|
| Rate for Payer: Independent Care Health Plan Medicare |
$230.45
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$230.45
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$230.45
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: NAPHCARE Commercial |
$345.68
|
| Rate for Payer: Preferred Network Access Commercial |
$53.58
|
| Rate for Payer: Quartz Beloit One Network |
$28.54
|
| Rate for Payer: Quartz Commercial |
$37.86
|
| Rate for Payer: Quartz Medicare Advantage |
$230.45
|
| Rate for Payer: The Alliance Commercial |
$921.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$230.45
|
| Rate for Payer: United Healthcare PPO |
$43.68
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: Wellcare Medicare |
$230.45
|
| Rate for Payer: WPS Commercial |
$43.14
|
|
|
Subsequent Hospital Care 99231
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 99231
|
| Hospital Charge Code |
4001096
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$129.95 |
| Max. Negotiated Rate |
$243.98 |
| Rate for Payer: Aetna Commercial |
$238.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$228.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$140.56
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna Commercial |
$243.98
|
| Rate for Payer: Health EOS Commercial |
$236.03
|
| Rate for Payer: HFN Commercial |
$243.98
|
| Rate for Payer: Multiplan Commercial |
$212.16
|
| Rate for Payer: Preferred Network Access Commercial |
$243.98
|
| Rate for Payer: Quartz Beloit One Network |
$129.95
|
| Rate for Payer: Quartz Commercial |
$159.12
|
| Rate for Payer: WEA Trust Commercial |
$145.86
|
| Rate for Payer: WPS Commercial |
$196.43
|
|
|
Subsequent Hospital Care 99231
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 99231
|
| Hospital Charge Code |
4001096
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$74.26 |
| Max. Negotiated Rate |
$243.98 |
| Rate for Payer: Aetna Commercial |
$238.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$228.07
|
| Rate for Payer: Aetna Managed Medicare |
$74.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$172.38
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$132.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$127.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$140.56
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna Commercial |
$243.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$148.41
|
| Rate for Payer: Health EOS Commercial |
$236.03
|
| Rate for Payer: HFN Commercial |
$243.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$198.90
|
| Rate for Payer: Multiplan Commercial |
$212.16
|
| Rate for Payer: NAPHCARE Commercial |
$159.12
|
| Rate for Payer: Preferred Network Access Commercial |
$243.98
|
| Rate for Payer: Quartz Beloit One Network |
$129.95
|
| Rate for Payer: Quartz Commercial |
$172.38
|
| Rate for Payer: Quartz Medicare Advantage |
$159.12
|
| Rate for Payer: The Alliance Commercial |
$174.30
|
| Rate for Payer: WEA Trust Commercial |
$145.86
|
| Rate for Payer: WPS Commercial |
$196.43
|
|
|
Subsequent Hospital Care 99232
|
Facility
|
IP
|
$360.00
|
|
|
Service Code
|
CPT 99232
|
| Hospital Charge Code |
4001097
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$183.46 |
| Max. Negotiated Rate |
$344.45 |
| Rate for Payer: Aetna Commercial |
$336.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$321.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$198.43
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cigna Commercial |
$344.45
|
| Rate for Payer: Health EOS Commercial |
$333.22
|
| Rate for Payer: HFN Commercial |
$344.45
|
| Rate for Payer: Multiplan Commercial |
$299.52
|
| Rate for Payer: Preferred Network Access Commercial |
$344.45
|
| Rate for Payer: Quartz Beloit One Network |
$183.46
|
| Rate for Payer: Quartz Commercial |
$224.64
|
| Rate for Payer: WEA Trust Commercial |
$205.92
|
| Rate for Payer: WPS Commercial |
$277.31
|
|
|
Subsequent Hospital Care 99232
|
Facility
|
OP
|
$360.00
|
|
|
Service Code
|
CPT 99232
|
| Hospital Charge Code |
4001097
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$104.83 |
| Max. Negotiated Rate |
$344.45 |
| Rate for Payer: Aetna Commercial |
$336.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$321.98
|
| Rate for Payer: Aetna Managed Medicare |
$104.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$243.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$187.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$179.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$198.43
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cigna Commercial |
$344.45
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$209.52
|
| Rate for Payer: Health EOS Commercial |
$333.22
|
| Rate for Payer: HFN Commercial |
$344.45
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$280.80
|
| Rate for Payer: Multiplan Commercial |
$299.52
|
| Rate for Payer: NAPHCARE Commercial |
$224.64
|
| Rate for Payer: Preferred Network Access Commercial |
$344.45
|
| Rate for Payer: Quartz Beloit One Network |
$183.46
|
| Rate for Payer: Quartz Commercial |
$243.36
|
| Rate for Payer: Quartz Medicare Advantage |
$224.64
|
| Rate for Payer: The Alliance Commercial |
$279.30
|
| Rate for Payer: WEA Trust Commercial |
$205.92
|
| Rate for Payer: WPS Commercial |
$277.31
|
|
|
Subsequent Hospital Care 99233
|
Facility
|
IP
|
$490.00
|
|
|
Service Code
|
CPT 99233
|
| Hospital Charge Code |
4001098
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$249.70 |
| Max. Negotiated Rate |
$468.83 |
| Rate for Payer: Aetna Commercial |
$458.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$438.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$270.09
|
| Rate for Payer: Cash Price |
$147.00
|
| Rate for Payer: Cigna Commercial |
$468.83
|
| Rate for Payer: Health EOS Commercial |
$453.54
|
| Rate for Payer: HFN Commercial |
$468.83
|
| Rate for Payer: Multiplan Commercial |
$407.68
|
| Rate for Payer: Preferred Network Access Commercial |
$468.83
|
| Rate for Payer: Quartz Beloit One Network |
$249.70
|
| Rate for Payer: Quartz Commercial |
$305.76
|
| Rate for Payer: WEA Trust Commercial |
$280.28
|
| Rate for Payer: WPS Commercial |
$377.45
|
|
|
Subsequent Hospital Care 99233
|
Facility
|
OP
|
$490.00
|
|
|
Service Code
|
CPT 99233
|
| Hospital Charge Code |
4001098
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$142.69 |
| Max. Negotiated Rate |
$468.83 |
| Rate for Payer: Aetna Commercial |
$458.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$438.26
|
| Rate for Payer: Aetna Managed Medicare |
$142.69
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$331.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$254.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$244.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$270.09
|
| Rate for Payer: Cash Price |
$147.00
|
| Rate for Payer: Cash Price |
$147.00
|
| Rate for Payer: Cigna Commercial |
$468.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$285.18
|
| Rate for Payer: Health EOS Commercial |
$453.54
|
| Rate for Payer: HFN Commercial |
$468.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$382.20
|
| Rate for Payer: Multiplan Commercial |
$407.68
|
| Rate for Payer: NAPHCARE Commercial |
$305.76
|
| Rate for Payer: Preferred Network Access Commercial |
$468.83
|
| Rate for Payer: Quartz Beloit One Network |
$249.70
|
| Rate for Payer: Quartz Commercial |
$331.24
|
| Rate for Payer: Quartz Medicare Advantage |
$305.76
|
| Rate for Payer: The Alliance Commercial |
$423.70
|
| Rate for Payer: WEA Trust Commercial |
$280.28
|
| Rate for Payer: WPS Commercial |
$377.45
|
|
|
Subsequent Skilled Nursing Facility Low
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
CPT 99308
|
| Hospital Charge Code |
1122852
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.40 |
| Max. Negotiated Rate |
$257.87 |
| Rate for Payer: Aetna Commercial |
$257.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$233.44
|
| Rate for Payer: Aetna Managed Medicare |
$67.64
|
| Rate for Payer: Anthem Medicare Advantage |
$67.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$67.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$67.64
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cigna Commercial |
$257.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$49.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$67.64
|
| Rate for Payer: Health EOS Commercial |
$247.01
|
| Rate for Payer: HFN Commercial |
$257.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$240.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$240.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$67.64
|
| Rate for Payer: Multiplan Commercial |
$217.15
|
| Rate for Payer: NAPHCARE Commercial |
$101.46
|
| Rate for Payer: Preferred Network Access Commercial |
$257.87
|
| Rate for Payer: Quartz Beloit One Network |
$119.43
|
| Rate for Payer: Quartz Commercial |
$154.72
|
| Rate for Payer: Quartz Medicare Advantage |
$67.64
|
| Rate for Payer: The Alliance Commercial |
$162.34
|
| Rate for Payer: United Healthcare Medicaid |
$49.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$67.64
|
| Rate for Payer: WEA Trust Commercial |
$149.29
|
| Rate for Payer: WPS Commercial |
$186.01
|
|
|
Subsequent Skilled Nursing Facility Minor
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
CPT 99307
|
| Hospital Charge Code |
1122851
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$29.81 |
| Max. Negotiated Rate |
$167.96 |
| Rate for Payer: Aetna Commercial |
$167.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$152.05
|
| Rate for Payer: Aetna Managed Medicare |
$36.83
|
| Rate for Payer: Anthem Medicare Advantage |
$36.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$36.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$36.83
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$167.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$29.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$36.83
|
| Rate for Payer: Health EOS Commercial |
$160.89
|
| Rate for Payer: HFN Commercial |
$167.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$153.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$153.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$36.83
|
| Rate for Payer: Multiplan Commercial |
$141.44
|
| Rate for Payer: NAPHCARE Commercial |
$55.24
|
| Rate for Payer: Preferred Network Access Commercial |
$167.96
|
| Rate for Payer: Quartz Beloit One Network |
$77.79
|
| Rate for Payer: Quartz Commercial |
$100.78
|
| Rate for Payer: Quartz Medicare Advantage |
$36.83
|
| Rate for Payer: The Alliance Commercial |
$88.38
|
| Rate for Payer: United Healthcare Medicaid |
$29.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.83
|
| Rate for Payer: WEA Trust Commercial |
$97.24
|
| Rate for Payer: WPS Commercial |
$101.27
|
|
|
successful insertion femoral artery - Arterial Line Procedure Result:
|
Facility
|
IP
|
$1,359.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
3005242
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$692.55 |
| Max. Negotiated Rate |
$1,300.29 |
| Rate for Payer: Aetna Commercial |
$1,272.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,215.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$749.08
|
| Rate for Payer: Cash Price |
$407.70
|
| Rate for Payer: Cigna Commercial |
$1,300.29
|
| Rate for Payer: Health EOS Commercial |
$1,257.89
|
| Rate for Payer: HFN Commercial |
$1,300.29
|
| Rate for Payer: Multiplan Commercial |
$1,130.69
|
| Rate for Payer: Preferred Network Access Commercial |
$1,300.29
|
| Rate for Payer: Quartz Beloit One Network |
$692.55
|
| Rate for Payer: Quartz Commercial |
$848.02
|
| Rate for Payer: WEA Trust Commercial |
$777.35
|
| Rate for Payer: WPS Commercial |
$1,046.84
|
|
|
successful insertion femoral artery - Arterial Line Procedure Result:
|
Facility
|
OP
|
$1,359.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
3005242
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.91 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$1,272.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,215.49
|
| Rate for Payer: Aetna Managed Medicare |
$395.74
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$918.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$706.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$678.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$749.08
|
| Rate for Payer: Cash Price |
$407.70
|
| Rate for Payer: Cash Price |
$407.70
|
| Rate for Payer: Cash Price |
$407.70
|
| Rate for Payer: Cigna Commercial |
$1,300.29
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Health EOS Commercial |
$1,257.89
|
| Rate for Payer: HFN Commercial |
$1,300.29
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,060.02
|
| Rate for Payer: Multiplan Commercial |
$1,130.69
|
| Rate for Payer: NAPHCARE Commercial |
$848.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,300.29
|
| Rate for Payer: Quartz Beloit One Network |
$692.55
|
| Rate for Payer: Quartz Commercial |
$918.68
|
| Rate for Payer: Quartz Medicare Advantage |
$848.02
|
| Rate for Payer: The Alliance Commercial |
$160.91
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$777.35
|
| Rate for Payer: WPS Commercial |
$1,046.84
|
|
|
successful insertion femoral site - Central IV Procedure Result:
|
Facility
|
OP
|
$1,752.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
3025907
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.04 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$1,639.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,566.99
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,184.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$911.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$874.60
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$965.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cigna Commercial |
$1,676.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$1,621.65
|
| Rate for Payer: HFN Commercial |
$1,676.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$1,457.66
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$1,676.31
|
| Rate for Payer: Quartz Beloit One Network |
$892.82
|
| Rate for Payer: Quartz Commercial |
$1,184.35
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$1,002.14
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$1,349.57
|
|
|
successful insertion femoral site - Central IV Procedure Result:
|
Facility
|
IP
|
$1,752.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
3025907
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$892.82 |
| Max. Negotiated Rate |
$1,676.31 |
| Rate for Payer: Aetna Commercial |
$1,639.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,566.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$965.70
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cigna Commercial |
$1,676.31
|
| Rate for Payer: Health EOS Commercial |
$1,621.65
|
| Rate for Payer: HFN Commercial |
$1,676.31
|
| Rate for Payer: Multiplan Commercial |
$1,457.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,676.31
|
| Rate for Payer: Quartz Beloit One Network |
$892.82
|
| Rate for Payer: Quartz Commercial |
$1,093.25
|
| Rate for Payer: WEA Trust Commercial |
$1,002.14
|
| Rate for Payer: WPS Commercial |
$1,349.57
|
|
|
successful insertion jugular site - Central IV Procedure Result:
|
Facility
|
IP
|
$1,453.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
3025906
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$740.45 |
| Max. Negotiated Rate |
$1,390.23 |
| Rate for Payer: Aetna Commercial |
$1,360.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,299.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$800.89
|
| Rate for Payer: Cash Price |
$435.90
|
| Rate for Payer: Cigna Commercial |
$1,390.23
|
| Rate for Payer: Health EOS Commercial |
$1,344.90
|
| Rate for Payer: HFN Commercial |
$1,390.23
|
| Rate for Payer: Multiplan Commercial |
$1,208.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,390.23
|
| Rate for Payer: Quartz Beloit One Network |
$740.45
|
| Rate for Payer: Quartz Commercial |
$906.67
|
| Rate for Payer: WEA Trust Commercial |
$831.12
|
| Rate for Payer: WPS Commercial |
$1,119.25
|
|
|
successful insertion jugular site - Central IV Procedure Result:
|
Facility
|
OP
|
$1,453.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
3025906
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.04 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$1,360.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,299.56
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$982.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$755.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$725.34
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$800.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$435.90
|
| Rate for Payer: Cash Price |
$435.90
|
| Rate for Payer: Cash Price |
$435.90
|
| Rate for Payer: Cigna Commercial |
$1,390.23
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$1,344.90
|
| Rate for Payer: HFN Commercial |
$1,390.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$1,208.90
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$1,390.23
|
| Rate for Payer: Quartz Beloit One Network |
$740.45
|
| Rate for Payer: Quartz Commercial |
$982.23
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$831.12
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$1,119.25
|
|
|
successful insertion Opti Q catheter - PA Line Procedure Result
|
Facility
|
IP
|
$3,832.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
3025928
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,952.79 |
| Max. Negotiated Rate |
$3,666.46 |
| Rate for Payer: Aetna Commercial |
$3,586.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,427.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,112.20
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cigna Commercial |
$3,666.46
|
| Rate for Payer: Health EOS Commercial |
$3,546.90
|
| Rate for Payer: HFN Commercial |
$3,666.46
|
| Rate for Payer: Multiplan Commercial |
$3,188.22
|
| Rate for Payer: Preferred Network Access Commercial |
$3,666.46
|
| Rate for Payer: Quartz Beloit One Network |
$1,952.79
|
| Rate for Payer: Quartz Commercial |
$2,391.17
|
| Rate for Payer: WEA Trust Commercial |
$2,191.90
|
| Rate for Payer: WPS Commercial |
$2,951.79
|
|
|
successful insertion Opti Q catheter - PA Line Procedure Result
|
Facility
|
OP
|
$3,832.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
3025928
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,656.63 |
| Max. Negotiated Rate |
$18,182.32 |
| Rate for Payer: Aetna Commercial |
$3,586.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,427.34
|
| Rate for Payer: Aetna Managed Medicare |
$1,656.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,182.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15,530.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14,753.44
|
| Rate for Payer: Anthem Medicare Advantage |
$1,656.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,112.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,656.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,656.63
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cigna Commercial |
$3,666.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,656.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,230.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,656.63
|
| Rate for Payer: Health EOS Commercial |
$3,546.90
|
| Rate for Payer: HFN Commercial |
$3,666.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,162.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,656.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,656.63
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,656.63
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,656.63
|
| Rate for Payer: Multiplan Commercial |
$3,188.22
|
| Rate for Payer: NAPHCARE Commercial |
$2,484.94
|
| Rate for Payer: Preferred Network Access Commercial |
$3,666.46
|
| Rate for Payer: Quartz Beloit One Network |
$1,952.79
|
| Rate for Payer: Quartz Commercial |
$2,590.43
|
| Rate for Payer: Quartz Medicare Advantage |
$1,656.63
|
| Rate for Payer: The Alliance Commercial |
$6,626.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,656.63
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: WEA Trust Commercial |
$2,191.90
|
| Rate for Payer: Wellcare Medicare |
$1,656.63
|
| Rate for Payer: WPS Commercial |
$2,951.79
|
|
