|
TAPE WRAP PREM WHITE #2640-10
|
Facility
|
IP
|
$902.00
|
|
| Hospital Charge Code |
2974054
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$459.66 |
| Max. Negotiated Rate |
$863.03 |
| Rate for Payer: Aetna Commercial |
$844.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$806.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$497.18
|
| Rate for Payer: Cash Price |
$270.60
|
| Rate for Payer: Cigna Commercial |
$863.03
|
| Rate for Payer: Health EOS Commercial |
$834.89
|
| Rate for Payer: HFN Commercial |
$863.03
|
| Rate for Payer: Multiplan Commercial |
$750.46
|
| Rate for Payer: Preferred Network Access Commercial |
$863.03
|
| Rate for Payer: Quartz Beloit One Network |
$459.66
|
| Rate for Payer: Quartz Commercial |
$562.85
|
| Rate for Payer: WEA Trust Commercial |
$515.94
|
| Rate for Payer: WPS Commercial |
$694.81
|
|
|
TAP FOR 3.5MM CORT SCREW GOLD/110MM 311.32
|
Facility
|
OP
|
$1,895.00
|
|
| Hospital Charge Code |
4494462
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$551.82 |
| Max. Negotiated Rate |
$1,813.14 |
| Rate for Payer: Aetna Commercial |
$1,773.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,694.89
|
| Rate for Payer: Aetna Managed Medicare |
$551.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,281.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$985.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$945.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,044.52
|
| Rate for Payer: Cash Price |
$568.50
|
| Rate for Payer: Cigna Commercial |
$1,813.14
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,102.89
|
| Rate for Payer: Health EOS Commercial |
$1,754.01
|
| Rate for Payer: HFN Commercial |
$1,813.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,478.10
|
| Rate for Payer: Multiplan Commercial |
$1,576.64
|
| Rate for Payer: NAPHCARE Commercial |
$1,182.48
|
| Rate for Payer: Preferred Network Access Commercial |
$1,813.14
|
| Rate for Payer: Quartz Beloit One Network |
$965.69
|
| Rate for Payer: Quartz Commercial |
$1,281.02
|
| Rate for Payer: Quartz Medicare Advantage |
$1,182.48
|
| Rate for Payer: The Alliance Commercial |
$985.40
|
| Rate for Payer: WEA Trust Commercial |
$1,083.94
|
| Rate for Payer: WPS Commercial |
$1,459.72
|
|
|
TAP FOR 3.5MM CORT SCREW GOLD/110MM 311.32
|
Facility
|
IP
|
$1,895.00
|
|
| Hospital Charge Code |
4494462
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$965.69 |
| Max. Negotiated Rate |
$1,813.14 |
| Rate for Payer: Aetna Commercial |
$1,773.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,694.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,044.52
|
| Rate for Payer: Cash Price |
$568.50
|
| Rate for Payer: Cigna Commercial |
$1,813.14
|
| Rate for Payer: Health EOS Commercial |
$1,754.01
|
| Rate for Payer: HFN Commercial |
$1,813.14
|
| Rate for Payer: Multiplan Commercial |
$1,576.64
|
| Rate for Payer: Preferred Network Access Commercial |
$1,813.14
|
| Rate for Payer: Quartz Beloit One Network |
$965.69
|
| Rate for Payer: Quartz Commercial |
$1,182.48
|
| Rate for Payer: WEA Trust Commercial |
$1,083.94
|
| Rate for Payer: WPS Commercial |
$1,459.72
|
|
|
TAP FOR 4.5MM CORTEX/SHAFT SCREWS 130MM/57MM TAP DEPTH 311.46
|
Facility
|
IP
|
$1,428.00
|
|
| Hospital Charge Code |
5521034
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$727.71 |
| Max. Negotiated Rate |
$1,366.31 |
| Rate for Payer: Aetna Commercial |
$1,336.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,277.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.11
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cigna Commercial |
$1,366.31
|
| Rate for Payer: Health EOS Commercial |
$1,321.76
|
| Rate for Payer: HFN Commercial |
$1,366.31
|
| Rate for Payer: Multiplan Commercial |
$1,188.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,366.31
|
| Rate for Payer: Quartz Beloit One Network |
$727.71
|
| Rate for Payer: Quartz Commercial |
$891.07
|
| Rate for Payer: WEA Trust Commercial |
$816.82
|
| Rate for Payer: WPS Commercial |
$1,099.99
|
|
|
TAP FOR 4.5MM CORTEX/SHAFT SCREWS 130MM/57MM TAP DEPTH 311.46
|
Facility
|
OP
|
$1,428.00
|
|
| Hospital Charge Code |
5521034
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$415.83 |
| Max. Negotiated Rate |
$1,366.31 |
| Rate for Payer: Aetna Commercial |
$1,336.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,277.20
|
| Rate for Payer: Aetna Managed Medicare |
$415.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$965.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$742.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$712.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.11
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cigna Commercial |
$1,366.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$831.10
|
| Rate for Payer: Health EOS Commercial |
$1,321.76
|
| Rate for Payer: HFN Commercial |
$1,366.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,113.84
|
| Rate for Payer: Multiplan Commercial |
$1,188.10
|
| Rate for Payer: NAPHCARE Commercial |
$891.07
|
| Rate for Payer: Preferred Network Access Commercial |
$1,366.31
|
| Rate for Payer: Quartz Beloit One Network |
$727.71
|
| Rate for Payer: Quartz Commercial |
$965.33
|
| Rate for Payer: Quartz Medicare Advantage |
$891.07
|
| Rate for Payer: The Alliance Commercial |
$742.56
|
| Rate for Payer: WEA Trust Commercial |
$816.82
|
| Rate for Payer: WPS Commercial |
$1,099.99
|
|
|
TARSAL TUNNEL RELEASE
|
Facility
|
IP
|
$1,337.00
|
|
| Hospital Charge Code |
2960404
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$681.34 |
| Max. Negotiated Rate |
$1,279.24 |
| Rate for Payer: Aetna Commercial |
$1,251.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,195.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$736.95
|
| Rate for Payer: Cash Price |
$401.10
|
| Rate for Payer: Cigna Commercial |
$1,279.24
|
| Rate for Payer: Health EOS Commercial |
$1,237.53
|
| Rate for Payer: HFN Commercial |
$1,279.24
|
| Rate for Payer: Multiplan Commercial |
$1,112.38
|
| Rate for Payer: Preferred Network Access Commercial |
$1,279.24
|
| Rate for Payer: Quartz Beloit One Network |
$681.34
|
| Rate for Payer: Quartz Commercial |
$834.29
|
| Rate for Payer: WEA Trust Commercial |
$764.76
|
| Rate for Payer: WPS Commercial |
$1,029.89
|
|
|
TARSAL TUNNEL RELEASE
|
Facility
|
OP
|
$1,337.00
|
|
| Hospital Charge Code |
2960404
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$389.33 |
| Max. Negotiated Rate |
$1,279.24 |
| Rate for Payer: Aetna Commercial |
$1,251.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,195.81
|
| Rate for Payer: Aetna Managed Medicare |
$389.33
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$903.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$695.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$667.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$736.95
|
| Rate for Payer: Cash Price |
$401.10
|
| Rate for Payer: Cigna Commercial |
$1,279.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$778.13
|
| Rate for Payer: Health EOS Commercial |
$1,237.53
|
| Rate for Payer: HFN Commercial |
$1,279.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,042.86
|
| Rate for Payer: Multiplan Commercial |
$1,112.38
|
| Rate for Payer: NAPHCARE Commercial |
$834.29
|
| Rate for Payer: Preferred Network Access Commercial |
$1,279.24
|
| Rate for Payer: Quartz Beloit One Network |
$681.34
|
| Rate for Payer: Quartz Commercial |
$903.81
|
| Rate for Payer: Quartz Medicare Advantage |
$834.29
|
| Rate for Payer: The Alliance Commercial |
$695.24
|
| Rate for Payer: WEA Trust Commercial |
$764.76
|
| Rate for Payer: WPS Commercial |
$1,029.89
|
|
|
TATTOO SPOT GIS45
|
Facility
|
IP
|
$471.00
|
|
|
Service Code
|
HCPCS Q9968
|
| Hospital Charge Code |
2973229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$240.02 |
| Max. Negotiated Rate |
$450.65 |
| Rate for Payer: Aetna Commercial |
$440.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$421.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$259.62
|
| Rate for Payer: Cash Price |
$141.30
|
| Rate for Payer: Cigna Commercial |
$450.65
|
| Rate for Payer: Health EOS Commercial |
$435.96
|
| Rate for Payer: HFN Commercial |
$450.65
|
| Rate for Payer: Multiplan Commercial |
$391.87
|
| Rate for Payer: Preferred Network Access Commercial |
$450.65
|
| Rate for Payer: Quartz Beloit One Network |
$240.02
|
| Rate for Payer: Quartz Commercial |
$293.90
|
| Rate for Payer: WEA Trust Commercial |
$269.41
|
| Rate for Payer: WPS Commercial |
$362.81
|
|
|
TATTOO SPOT GIS45
|
Facility
|
OP
|
$471.00
|
|
|
Service Code
|
HCPCS Q9968
|
| Hospital Charge Code |
2973229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$450.65 |
| Rate for Payer: Aetna Commercial |
$440.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$421.26
|
| Rate for Payer: Aetna Managed Medicare |
$10.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$318.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$244.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$235.12
|
| Rate for Payer: Anthem Medicare Advantage |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$259.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.20
|
| Rate for Payer: Cash Price |
$141.30
|
| Rate for Payer: Cash Price |
$141.30
|
| Rate for Payer: Cigna Commercial |
$450.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$274.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10.20
|
| Rate for Payer: Health EOS Commercial |
$435.96
|
| Rate for Payer: HFN Commercial |
$450.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10.20
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.20
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10.20
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10.20
|
| Rate for Payer: Multiplan Commercial |
$391.87
|
| Rate for Payer: NAPHCARE Commercial |
$15.30
|
| Rate for Payer: Preferred Network Access Commercial |
$450.65
|
| Rate for Payer: Quartz Beloit One Network |
$240.02
|
| Rate for Payer: Quartz Commercial |
$318.40
|
| Rate for Payer: Quartz Medicare Advantage |
$10.20
|
| Rate for Payer: The Alliance Commercial |
$40.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.20
|
| Rate for Payer: WEA Trust Commercial |
$269.41
|
| Rate for Payer: Wellcare Medicare |
$10.20
|
| Rate for Payer: WPS Commercial |
$362.81
|
|
|
Taxotere 1 mg Charge
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS J9171
|
| Hospital Charge Code |
2958947
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$186.73 |
| Rate for Payer: Aetna Commercial |
$186.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$169.04
|
| Rate for Payer: Aetna Managed Medicare |
$0.68
|
| Rate for Payer: Anthem Medicare Advantage |
$0.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$0.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$0.68
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cigna Commercial |
$186.73
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$0.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$0.91
|
| Rate for Payer: Health EOS Commercial |
$178.87
|
| Rate for Payer: HFN Commercial |
$186.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$0.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$0.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$0.68
|
| Rate for Payer: Multiplan Commercial |
$157.25
|
| Rate for Payer: NAPHCARE Commercial |
$1.01
|
| Rate for Payer: Preferred Network Access Commercial |
$186.73
|
| Rate for Payer: Quartz Beloit One Network |
$86.49
|
| Rate for Payer: Quartz Commercial |
$112.04
|
| Rate for Payer: Quartz Medicare Advantage |
$0.68
|
| Rate for Payer: The Alliance Commercial |
$1.86
|
| Rate for Payer: United Healthcare Medicaid |
$0.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$0.68
|
| Rate for Payer: WEA Trust Commercial |
$108.11
|
| Rate for Payer: WPS Commercial |
$2.26
|
|
|
Taxotere 1 mg Charge
|
Facility
|
OP
|
$189.00
|
|
|
Service Code
|
HCPCS J9171
|
| Hospital Charge Code |
2958947
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$180.84 |
| Rate for Payer: Aetna Commercial |
$176.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$169.04
|
| Rate for Payer: Aetna Managed Medicare |
$55.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$127.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$98.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$104.18
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cigna Commercial |
$180.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1.20
|
| Rate for Payer: Health EOS Commercial |
$174.94
|
| Rate for Payer: HFN Commercial |
$180.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$147.42
|
| Rate for Payer: Multiplan Commercial |
$157.25
|
| Rate for Payer: NAPHCARE Commercial |
$117.94
|
| Rate for Payer: Preferred Network Access Commercial |
$180.84
|
| Rate for Payer: Quartz Beloit One Network |
$96.31
|
| Rate for Payer: Quartz Commercial |
$127.76
|
| Rate for Payer: Quartz Medicare Advantage |
$117.94
|
| Rate for Payer: The Alliance Commercial |
$2.70
|
| Rate for Payer: WEA Trust Commercial |
$108.11
|
| Rate for Payer: WPS Commercial |
$2.26
|
|
|
Taxotere 1 mg Charge
|
Facility
|
IP
|
$189.00
|
|
|
Service Code
|
HCPCS J9171
|
| Hospital Charge Code |
2958947
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$96.31 |
| Max. Negotiated Rate |
$180.84 |
| Rate for Payer: Aetna Commercial |
$176.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$169.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$104.18
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cigna Commercial |
$180.84
|
| Rate for Payer: Health EOS Commercial |
$174.94
|
| Rate for Payer: HFN Commercial |
$180.84
|
| Rate for Payer: Multiplan Commercial |
$157.25
|
| Rate for Payer: Preferred Network Access Commercial |
$180.84
|
| Rate for Payer: Quartz Beloit One Network |
$96.31
|
| Rate for Payer: Quartz Commercial |
$117.94
|
| Rate for Payer: WEA Trust Commercial |
$108.11
|
| Rate for Payer: WPS Commercial |
$145.59
|
|
|
Tay-Sachs Disease Mutation Analysis
|
Facility
|
OP
|
$592.00
|
|
|
Service Code
|
CPT 81255
|
| Hospital Charge Code |
5619632
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.51 |
| Max. Negotiated Rate |
$566.43 |
| Rate for Payer: Aetna Commercial |
$554.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$529.48
|
| Rate for Payer: Aetna Managed Medicare |
$53.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$200.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$93.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$88.82
|
| Rate for Payer: Anthem Medicare Advantage |
$53.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$326.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$53.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$53.51
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cigna Commercial |
$566.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$53.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$344.54
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$53.51
|
| Rate for Payer: Health EOS Commercial |
$547.96
|
| Rate for Payer: HFN Commercial |
$566.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$199.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.51
|
| Rate for Payer: Independent Care Health Plan Medicare |
$53.51
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$53.51
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$53.51
|
| Rate for Payer: Multiplan Commercial |
$492.54
|
| Rate for Payer: NAPHCARE Commercial |
$80.26
|
| Rate for Payer: Preferred Network Access Commercial |
$566.43
|
| Rate for Payer: Quartz Beloit One Network |
$301.68
|
| Rate for Payer: Quartz Commercial |
$400.19
|
| Rate for Payer: Quartz Medicare Advantage |
$53.51
|
| Rate for Payer: The Alliance Commercial |
$214.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.51
|
| Rate for Payer: United Healthcare PPO |
$461.76
|
| Rate for Payer: WEA Trust Commercial |
$338.62
|
| Rate for Payer: Wellcare Medicare |
$53.51
|
| Rate for Payer: WPS Commercial |
$456.02
|
|
|
Tay-Sachs Disease Mutation Analysis
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
CPT 81255
|
| Hospital Charge Code |
5619632
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.51 |
| Max. Negotiated Rate |
$584.90 |
| Rate for Payer: Aetna Commercial |
$584.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$529.48
|
| Rate for Payer: Aetna Managed Medicare |
$53.51
|
| Rate for Payer: Anthem Medicare Advantage |
$53.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$53.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$53.51
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cigna Commercial |
$584.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$307.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$53.51
|
| Rate for Payer: Health EOS Commercial |
$560.27
|
| Rate for Payer: HFN Commercial |
$584.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$188.88
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$188.88
|
| Rate for Payer: Independent Care Health Plan Medicare |
$53.51
|
| Rate for Payer: Multiplan Commercial |
$492.54
|
| Rate for Payer: NAPHCARE Commercial |
$80.26
|
| Rate for Payer: Preferred Network Access Commercial |
$584.90
|
| Rate for Payer: Quartz Beloit One Network |
$270.90
|
| Rate for Payer: Quartz Commercial |
$350.94
|
| Rate for Payer: Quartz Medicare Advantage |
$53.51
|
| Rate for Payer: The Alliance Commercial |
$211.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.51
|
| Rate for Payer: WEA Trust Commercial |
$338.62
|
| Rate for Payer: WPS Commercial |
$235.44
|
|
|
Tay-Sachs Disease Mutation Analysis
|
Facility
|
IP
|
$592.00
|
|
|
Service Code
|
CPT 81255
|
| Hospital Charge Code |
5619632
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$301.68 |
| Max. Negotiated Rate |
$566.43 |
| Rate for Payer: Aetna Commercial |
$554.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$529.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$326.31
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cigna Commercial |
$566.43
|
| Rate for Payer: Health EOS Commercial |
$547.96
|
| Rate for Payer: HFN Commercial |
$566.43
|
| Rate for Payer: Multiplan Commercial |
$492.54
|
| Rate for Payer: Preferred Network Access Commercial |
$566.43
|
| Rate for Payer: Quartz Beloit One Network |
$301.68
|
| Rate for Payer: Quartz Commercial |
$369.41
|
| Rate for Payer: WEA Trust Commercial |
$338.62
|
| Rate for Payer: WPS Commercial |
$456.02
|
|
|
TBII (Thyrotropin-Binding Inhibitory Immunoglobulin)
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
983418
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$121.52 |
| Rate for Payer: Aetna Commercial |
$121.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.01
|
| Rate for Payer: Aetna Managed Medicare |
$17.96
|
| Rate for Payer: Anthem Medicare Advantage |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.96
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna Commercial |
$121.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$63.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.96
|
| Rate for Payer: Health EOS Commercial |
$116.41
|
| Rate for Payer: HFN Commercial |
$121.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.96
|
| Rate for Payer: Multiplan Commercial |
$102.34
|
| Rate for Payer: NAPHCARE Commercial |
$26.94
|
| Rate for Payer: Preferred Network Access Commercial |
$121.52
|
| Rate for Payer: Quartz Beloit One Network |
$56.28
|
| Rate for Payer: Quartz Commercial |
$72.91
|
| Rate for Payer: Quartz Medicare Advantage |
$17.96
|
| Rate for Payer: The Alliance Commercial |
$70.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.96
|
| Rate for Payer: WEA Trust Commercial |
$70.36
|
| Rate for Payer: WPS Commercial |
$79.03
|
|
|
TBII (Thyrotropin-Binding Inhibitory Immunoglobulin)
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
983418
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$117.69 |
| Rate for Payer: Aetna Commercial |
$115.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.01
|
| Rate for Payer: Aetna Managed Medicare |
$17.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.81
|
| Rate for Payer: Anthem Medicare Advantage |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$67.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.96
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna Commercial |
$117.69
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$71.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.96
|
| Rate for Payer: Health EOS Commercial |
$113.85
|
| Rate for Payer: HFN Commercial |
$117.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.96
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.96
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.96
|
| Rate for Payer: Multiplan Commercial |
$102.34
|
| Rate for Payer: NAPHCARE Commercial |
$26.94
|
| Rate for Payer: Preferred Network Access Commercial |
$117.69
|
| Rate for Payer: Quartz Beloit One Network |
$62.68
|
| Rate for Payer: Quartz Commercial |
$83.15
|
| Rate for Payer: Quartz Medicare Advantage |
$17.96
|
| Rate for Payer: The Alliance Commercial |
$71.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.96
|
| Rate for Payer: United Healthcare PPO |
$95.94
|
| Rate for Payer: WEA Trust Commercial |
$70.36
|
| Rate for Payer: Wellcare Medicare |
$17.96
|
| Rate for Payer: WPS Commercial |
$94.75
|
|
|
TBII (Thyrotropin-Binding Inhibitory Immunoglobulin)
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
983418
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$62.68 |
| Max. Negotiated Rate |
$117.69 |
| Rate for Payer: Aetna Commercial |
$115.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$67.80
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna Commercial |
$117.69
|
| Rate for Payer: Health EOS Commercial |
$113.85
|
| Rate for Payer: HFN Commercial |
$117.69
|
| Rate for Payer: Multiplan Commercial |
$102.34
|
| Rate for Payer: Preferred Network Access Commercial |
$117.69
|
| Rate for Payer: Quartz Beloit One Network |
$62.68
|
| Rate for Payer: Quartz Commercial |
$76.75
|
| Rate for Payer: WEA Trust Commercial |
$70.36
|
| Rate for Payer: WPS Commercial |
$94.75
|
|
|
TBIL (FSURE)
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
4538813
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.22 |
| 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 |
$5.22
|
| Rate for Payer: Anthem Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.22
|
| 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 |
$40.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$73.82
|
| Rate for Payer: HFN Commercial |
$77.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$64.90
|
| Rate for Payer: NAPHCARE Commercial |
$7.83
|
| 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 |
$5.22
|
| Rate for Payer: The Alliance Commercial |
$20.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: WEA Trust Commercial |
$44.62
|
| Rate for Payer: WPS Commercial |
$22.97
|
|
|
TBIL (FSURE)
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
4538813
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$74.63 |
| Rate for Payer: Aetna Commercial |
$73.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$69.76
|
| Rate for Payer: Aetna Managed Medicare |
$5.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.14
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.67
|
| Rate for Payer: Anthem Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$42.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.22
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$74.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$45.40
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$72.20
|
| Rate for Payer: HFN Commercial |
$74.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.22
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.22
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.22
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$64.90
|
| Rate for Payer: NAPHCARE Commercial |
$7.83
|
| Rate for Payer: Preferred Network Access Commercial |
$74.63
|
| Rate for Payer: Quartz Beloit One Network |
$39.75
|
| Rate for Payer: Quartz Commercial |
$52.73
|
| Rate for Payer: Quartz Medicare Advantage |
$5.22
|
| Rate for Payer: The Alliance Commercial |
$20.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare PPO |
$60.84
|
| Rate for Payer: WEA Trust Commercial |
$44.62
|
| Rate for Payer: Wellcare Medicare |
$5.22
|
| Rate for Payer: WPS Commercial |
$60.08
|
|
|
TBIL (FSURE)
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
4538813
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.75 |
| Max. Negotiated Rate |
$74.63 |
| Rate for Payer: Aetna Commercial |
$73.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$69.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$42.99
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$74.63
|
| Rate for Payer: Health EOS Commercial |
$72.20
|
| Rate for Payer: HFN Commercial |
$74.63
|
| Rate for Payer: Multiplan Commercial |
$64.90
|
| Rate for Payer: Preferred Network Access Commercial |
$74.63
|
| Rate for Payer: Quartz Beloit One Network |
$39.75
|
| Rate for Payer: Quartz Commercial |
$48.67
|
| Rate for Payer: WEA Trust Commercial |
$44.62
|
| Rate for Payer: WPS Commercial |
$60.08
|
|
|
TB Intradermal Test 86580
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
3382901
|
|
Hospital Revenue Code
|
300
|
| 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
|
|
|
TB Intradermal Test 86580
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
3382901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$121.76 |
| Rate for Payer: Aetna Commercial |
$52.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Aetna Managed Medicare |
$30.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$114.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$53.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$50.81
|
| Rate for Payer: Anthem Medicare Advantage |
$30.44
|
| 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 |
$30.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30.44
|
| 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 |
$30.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$30.44
|
| Rate for Payer: Health EOS Commercial |
$51.83
|
| Rate for Payer: HFN Commercial |
$53.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$113.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$30.44
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$30.44
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: NAPHCARE Commercial |
$45.66
|
| 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 |
$30.44
|
| Rate for Payer: The Alliance Commercial |
$121.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30.44
|
| Rate for Payer: United Healthcare PPO |
$43.68
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: Wellcare Medicare |
$30.44
|
| Rate for Payer: WPS Commercial |
$43.14
|
|
|
TB Intradermal Test 86580
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
3382901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.75 |
| Max. Negotiated Rate |
$55.33 |
| Rate for Payer: Aetna Commercial |
$55.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Aetna Managed Medicare |
$10.75
|
| Rate for Payer: Anthem Medicare Advantage |
$10.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.75
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$55.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$29.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10.75
|
| Rate for Payer: Health EOS Commercial |
$53.00
|
| Rate for Payer: HFN Commercial |
$55.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$34.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$34.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.75
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: NAPHCARE Commercial |
$16.13
|
| Rate for Payer: Preferred Network Access Commercial |
$55.33
|
| Rate for Payer: Quartz Beloit One Network |
$25.63
|
| Rate for Payer: Quartz Commercial |
$33.20
|
| Rate for Payer: Quartz Medicare Advantage |
$10.75
|
| Rate for Payer: The Alliance Commercial |
$42.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.75
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: WPS Commercial |
$47.32
|
|
|
TB Intradermal Test Dialysis
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
3605546
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$121.76 |
| Rate for Payer: Aetna Commercial |
$47.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$45.61
|
| Rate for Payer: Aetna Managed Medicare |
$30.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$114.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$53.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$50.81
|
| Rate for Payer: Anthem Medicare Advantage |
$30.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$28.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$30.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30.44
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cigna Commercial |
$48.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$30.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$29.68
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$30.44
|
| Rate for Payer: Health EOS Commercial |
$47.21
|
| Rate for Payer: HFN Commercial |
$48.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$113.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$30.44
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$30.44
|
| Rate for Payer: Multiplan Commercial |
$42.43
|
| Rate for Payer: NAPHCARE Commercial |
$45.66
|
| Rate for Payer: Preferred Network Access Commercial |
$48.80
|
| Rate for Payer: Quartz Beloit One Network |
$25.99
|
| Rate for Payer: Quartz Commercial |
$34.48
|
| Rate for Payer: Quartz Medicare Advantage |
$30.44
|
| Rate for Payer: The Alliance Commercial |
$121.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30.44
|
| Rate for Payer: United Healthcare PPO |
$39.78
|
| Rate for Payer: WEA Trust Commercial |
$29.17
|
| Rate for Payer: Wellcare Medicare |
$30.44
|
| Rate for Payer: WPS Commercial |
$39.29
|
|
