|
TOWEL POLY LINED #696
|
Facility
OP
|
$53.00
|
|
| Hospital Charge Code |
2972747
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$14.84 |
| Max. Negotiated Rate |
$212.00 |
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$45.58
|
| Rate for Payer: Aetna Managed Medicare |
$14.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$34.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$28.09
|
| Rate for Payer: Cash Price |
$15.90
|
| Rate for Payer: Cigna Commercial |
$48.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$29.66
|
| Rate for Payer: Health EOS Commercial |
$47.17
|
| Rate for Payer: HFN Commercial |
$48.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$39.75
|
| Rate for Payer: Multiplan Commercial |
$42.40
|
| Rate for Payer: NAPHCARE Commercial |
$31.80
|
| Rate for Payer: Preferred Network Access Commercial |
$48.76
|
| Rate for Payer: Quartz Beloit One Network |
$25.97
|
| Rate for Payer: Quartz Commercial |
$34.45
|
| Rate for Payer: Quartz Medicare Advantage |
$31.80
|
| Rate for Payer: The Alliance Commercial |
$212.00
|
| Rate for Payer: WEA Trust Commercial |
$29.15
|
| Rate for Payer: WPS Commercial |
$39.26
|
|
|
TOWEL POLY LINED #696
|
Facility
IP
|
$53.00
|
|
| Hospital Charge Code |
2972747
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.97 |
| Max. Negotiated Rate |
$48.76 |
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$28.09
|
| Rate for Payer: Cash Price |
$15.90
|
| Rate for Payer: Cigna Commercial |
$48.76
|
| Rate for Payer: Health EOS Commercial |
$47.17
|
| Rate for Payer: HFN Commercial |
$48.76
|
| Rate for Payer: Multiplan Commercial |
$42.40
|
| Rate for Payer: NAPHCARE Commercial |
$31.80
|
| Rate for Payer: Preferred Network Access Commercial |
$48.76
|
| Rate for Payer: Quartz Beloit One Network |
$25.97
|
| Rate for Payer: Quartz Commercial |
$31.80
|
| Rate for Payer: WEA Trust Commercial |
$29.15
|
| Rate for Payer: WPS Commercial |
$39.26
|
|
|
Toxicology Screen Urine
|
Professional
|
$722.00
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
993777
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.14 |
| Max. Negotiated Rate |
$685.90 |
| Rate for Payer: Aetna Commercial |
$685.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$620.92
|
| Rate for Payer: Aetna Managed Medicare |
$17.14
|
| Rate for Payer: Anthem Medicare Advantage |
$17.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.14
|
| Rate for Payer: Cash Price |
$216.60
|
| Rate for Payer: Cash Price |
$216.60
|
| Rate for Payer: Cigna Commercial |
$685.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$361.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.14
|
| Rate for Payer: Health EOS Commercial |
$657.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$60.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$60.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.14
|
| Rate for Payer: Multiplan Commercial |
$577.60
|
| Rate for Payer: Preferred Network Access Commercial |
$685.90
|
| Rate for Payer: Quartz Beloit One Network |
$317.68
|
| Rate for Payer: Quartz Commercial |
$411.54
|
| Rate for Payer: Quartz Medicare Advantage |
$17.14
|
| Rate for Payer: The Alliance Commercial |
$67.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.14
|
| Rate for Payer: WEA Trust Commercial |
$397.10
|
| Rate for Payer: WPS Commercial |
$75.42
|
|
|
Toxicology Screen Urine
|
Facility
OP
|
$722.00
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
993777
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.14 |
| Max. Negotiated Rate |
$2,888.00 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$620.92
|
| Rate for Payer: Aetna Managed Medicare |
$17.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$64.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28.45
|
| Rate for Payer: Anthem Medicaid |
$17.71
|
| Rate for Payer: Anthem Medicare Advantage |
$17.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$382.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.14
|
| Rate for Payer: Cash Price |
$216.60
|
| Rate for Payer: Cash Price |
$216.60
|
| Rate for Payer: Cigna Commercial |
$664.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17.71
|
| Rate for Payer: Dean Health Medicaid |
$17.71
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.14
|
| Rate for Payer: Health EOS Commercial |
$642.58
|
| Rate for Payer: HFN Commercial |
$664.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.14
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.14
|
| Rate for Payer: Managed Health Services Medicaid |
$18.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.14
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.14
|
| Rate for Payer: Multiplan Commercial |
$577.60
|
| Rate for Payer: NAPHCARE Commercial |
$25.71
|
| Rate for Payer: Preferred Network Access Commercial |
$664.24
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17.71
|
| Rate for Payer: Quartz Beloit One Network |
$353.78
|
| Rate for Payer: Quartz Commercial |
$469.30
|
| Rate for Payer: Quartz Medicare Advantage |
$17.14
|
| Rate for Payer: The Alliance Commercial |
$2,888.00
|
| Rate for Payer: United Healthcare Medicaid |
$17.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.14
|
| Rate for Payer: United Healthcare PPO |
$541.50
|
| Rate for Payer: WEA Trust Commercial |
$397.10
|
| Rate for Payer: Wellcare Medicare |
$17.14
|
| Rate for Payer: WMAP Medicaid |
$17.71
|
| Rate for Payer: WPS Commercial |
$534.79
|
|
|
Toxicology Screen Urine
|
Facility
IP
|
$722.00
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
993777
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$353.78 |
| Max. Negotiated Rate |
$664.24 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$382.66
|
| Rate for Payer: Cash Price |
$216.60
|
| Rate for Payer: Cigna Commercial |
$664.24
|
| Rate for Payer: Health EOS Commercial |
$642.58
|
| Rate for Payer: HFN Commercial |
$664.24
|
| Rate for Payer: Multiplan Commercial |
$577.60
|
| Rate for Payer: NAPHCARE Commercial |
$433.20
|
| Rate for Payer: Preferred Network Access Commercial |
$664.24
|
| Rate for Payer: Quartz Beloit One Network |
$353.78
|
| Rate for Payer: Quartz Commercial |
$433.20
|
| Rate for Payer: WEA Trust Commercial |
$397.10
|
| Rate for Payer: WPS Commercial |
$534.79
|
|
|
Toxocara Antibody IgG
|
Professional
|
$106.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
978081
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$100.70 |
| Rate for Payer: Aetna Commercial |
$100.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.16
|
| Rate for Payer: Aetna Managed Medicare |
$13.01
|
| Rate for Payer: Anthem Medicare Advantage |
$13.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.01
|
| Rate for Payer: Cash Price |
$31.80
|
| Rate for Payer: Cash Price |
$31.80
|
| Rate for Payer: Cigna Commercial |
$100.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$53.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.01
|
| Rate for Payer: Health EOS Commercial |
$96.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$45.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$45.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.01
|
| Rate for Payer: Multiplan Commercial |
$84.80
|
| Rate for Payer: Preferred Network Access Commercial |
$100.70
|
| Rate for Payer: Quartz Beloit One Network |
$46.64
|
| Rate for Payer: Quartz Commercial |
$60.42
|
| Rate for Payer: Quartz Medicare Advantage |
$13.01
|
| Rate for Payer: The Alliance Commercial |
$51.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.01
|
| Rate for Payer: WEA Trust Commercial |
$58.30
|
| Rate for Payer: WPS Commercial |
$57.24
|
|
|
Toxocara Antibody IgG
|
Facility
IP
|
$106.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
978081
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$51.94 |
| Max. Negotiated Rate |
$97.52 |
| Rate for Payer: Aetna Commercial |
$95.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.18
|
| Rate for Payer: Cash Price |
$31.80
|
| Rate for Payer: Cigna Commercial |
$97.52
|
| Rate for Payer: Health EOS Commercial |
$94.34
|
| Rate for Payer: HFN Commercial |
$97.52
|
| Rate for Payer: Multiplan Commercial |
$84.80
|
| Rate for Payer: NAPHCARE Commercial |
$63.60
|
| Rate for Payer: Preferred Network Access Commercial |
$97.52
|
| Rate for Payer: Quartz Beloit One Network |
$51.94
|
| Rate for Payer: Quartz Commercial |
$63.60
|
| Rate for Payer: WEA Trust Commercial |
$58.30
|
| Rate for Payer: WPS Commercial |
$78.51
|
|
|
Toxocara Antibody IgG
|
Facility
OP
|
$106.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
978081
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$424.00 |
| Rate for Payer: Aetna Commercial |
$95.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.16
|
| Rate for Payer: Aetna Managed Medicare |
$13.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$48.79
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22.77
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21.60
|
| Rate for Payer: Anthem Medicaid |
$8.17
|
| Rate for Payer: Anthem Medicare Advantage |
$13.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.01
|
| Rate for Payer: Cash Price |
$31.80
|
| Rate for Payer: Cash Price |
$31.80
|
| Rate for Payer: Cigna Commercial |
$97.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.01
|
| Rate for Payer: Health EOS Commercial |
$94.34
|
| Rate for Payer: HFN Commercial |
$97.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.01
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.01
|
| Rate for Payer: Managed Health Services Medicaid |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.01
|
| Rate for Payer: Multiplan Commercial |
$84.80
|
| Rate for Payer: NAPHCARE Commercial |
$19.52
|
| Rate for Payer: Preferred Network Access Commercial |
$97.52
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.17
|
| Rate for Payer: Quartz Beloit One Network |
$51.94
|
| Rate for Payer: Quartz Commercial |
$68.90
|
| Rate for Payer: Quartz Medicare Advantage |
$13.01
|
| Rate for Payer: The Alliance Commercial |
$424.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.01
|
| Rate for Payer: United Healthcare PPO |
$79.50
|
| Rate for Payer: WEA Trust Commercial |
$58.30
|
| Rate for Payer: Wellcare Medicare |
$13.01
|
| Rate for Payer: WMAP Medicaid |
$8.17
|
| Rate for Payer: WPS Commercial |
$78.51
|
|
|
Toxoplasma Antibody IgG
|
Facility
OP
|
$83.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
2943020
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.38
|
| Rate for Payer: Aetna Managed Medicare |
$14.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.18
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.89
|
| Rate for Payer: Anthem Medicaid |
$14.87
|
| Rate for Payer: Anthem Medicare Advantage |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.39
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$76.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14.87
|
| Rate for Payer: Dean Health Medicaid |
$14.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.39
|
| Rate for Payer: Health EOS Commercial |
$73.87
|
| Rate for Payer: HFN Commercial |
$76.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.39
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.39
|
| Rate for Payer: Managed Health Services Medicaid |
$15.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: NAPHCARE Commercial |
$21.58
|
| Rate for Payer: Preferred Network Access Commercial |
$76.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14.87
|
| Rate for Payer: Quartz Beloit One Network |
$40.67
|
| Rate for Payer: Quartz Commercial |
$53.95
|
| Rate for Payer: Quartz Medicare Advantage |
$14.39
|
| Rate for Payer: The Alliance Commercial |
$332.00
|
| Rate for Payer: United Healthcare Medicaid |
$14.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.39
|
| Rate for Payer: United Healthcare PPO |
$62.25
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: Wellcare Medicare |
$14.39
|
| Rate for Payer: WMAP Medicaid |
$14.87
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Toxoplasma Antibody IgG
|
Professional
|
$83.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
2943020
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$78.85 |
| Rate for Payer: Aetna Commercial |
$78.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.38
|
| Rate for Payer: Aetna Managed Medicare |
$14.39
|
| Rate for Payer: Anthem Medicare Advantage |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.39
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$78.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.39
|
| Rate for Payer: Health EOS Commercial |
$75.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$50.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: Preferred Network Access Commercial |
$78.85
|
| Rate for Payer: Quartz Beloit One Network |
$36.52
|
| Rate for Payer: Quartz Commercial |
$47.31
|
| Rate for Payer: Quartz Medicare Advantage |
$14.39
|
| Rate for Payer: The Alliance Commercial |
$56.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.39
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$63.32
|
|
|
Toxoplasma Antibody IgG
|
Facility
IP
|
$185.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
978082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$90.65 |
| Max. Negotiated Rate |
$170.20 |
| Rate for Payer: Aetna Commercial |
$166.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$98.05
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cigna Commercial |
$170.20
|
| Rate for Payer: Health EOS Commercial |
$164.65
|
| Rate for Payer: HFN Commercial |
$170.20
|
| Rate for Payer: Multiplan Commercial |
$148.00
|
| Rate for Payer: NAPHCARE Commercial |
$111.00
|
| Rate for Payer: Preferred Network Access Commercial |
$170.20
|
| Rate for Payer: Quartz Beloit One Network |
$90.65
|
| Rate for Payer: Quartz Commercial |
$111.00
|
| Rate for Payer: WEA Trust Commercial |
$101.75
|
| Rate for Payer: WPS Commercial |
$137.03
|
|
|
Toxoplasma Antibody IgG
|
Professional
|
$185.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
978082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$175.75 |
| Rate for Payer: Aetna Commercial |
$175.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$159.10
|
| Rate for Payer: Aetna Managed Medicare |
$14.39
|
| Rate for Payer: Anthem Medicare Advantage |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.39
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cigna Commercial |
$175.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$92.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.39
|
| Rate for Payer: Health EOS Commercial |
$168.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$50.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$148.00
|
| Rate for Payer: Preferred Network Access Commercial |
$175.75
|
| Rate for Payer: Quartz Beloit One Network |
$81.40
|
| Rate for Payer: Quartz Commercial |
$105.45
|
| Rate for Payer: Quartz Medicare Advantage |
$14.39
|
| Rate for Payer: The Alliance Commercial |
$56.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.39
|
| Rate for Payer: WEA Trust Commercial |
$101.75
|
| Rate for Payer: WPS Commercial |
$63.32
|
|
|
Toxoplasma Antibody IgG
|
Facility
OP
|
$185.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
978082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$740.00 |
| Rate for Payer: Aetna Commercial |
$166.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$159.10
|
| Rate for Payer: Aetna Managed Medicare |
$14.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.18
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.89
|
| Rate for Payer: Anthem Medicaid |
$14.87
|
| Rate for Payer: Anthem Medicare Advantage |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$98.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.39
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cigna Commercial |
$170.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14.87
|
| Rate for Payer: Dean Health Medicaid |
$14.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.39
|
| Rate for Payer: Health EOS Commercial |
$164.65
|
| Rate for Payer: HFN Commercial |
$170.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.39
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.39
|
| Rate for Payer: Managed Health Services Medicaid |
$15.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$148.00
|
| Rate for Payer: NAPHCARE Commercial |
$21.58
|
| Rate for Payer: Preferred Network Access Commercial |
$170.20
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14.87
|
| Rate for Payer: Quartz Beloit One Network |
$90.65
|
| Rate for Payer: Quartz Commercial |
$120.25
|
| Rate for Payer: Quartz Medicare Advantage |
$14.39
|
| Rate for Payer: The Alliance Commercial |
$740.00
|
| Rate for Payer: United Healthcare Medicaid |
$14.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.39
|
| Rate for Payer: United Healthcare PPO |
$138.75
|
| Rate for Payer: WEA Trust Commercial |
$101.75
|
| Rate for Payer: Wellcare Medicare |
$14.39
|
| Rate for Payer: WMAP Medicaid |
$14.87
|
| Rate for Payer: WPS Commercial |
$137.03
|
|
|
Toxoplasma Antibody IgG
|
Facility
IP
|
$83.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
2943020
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.67 |
| Max. Negotiated Rate |
$76.36 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.99
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$76.36
|
| Rate for Payer: Health EOS Commercial |
$73.87
|
| Rate for Payer: HFN Commercial |
$76.36
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: NAPHCARE Commercial |
$49.80
|
| Rate for Payer: Preferred Network Access Commercial |
$76.36
|
| Rate for Payer: Quartz Beloit One Network |
$40.67
|
| Rate for Payer: Quartz Commercial |
$49.80
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Toxoplasma Antibody IgG and IgM
|
Facility
IP
|
$125.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
978083
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.25 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$112.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.25
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: Health EOS Commercial |
$111.25
|
| Rate for Payer: HFN Commercial |
$115.00
|
| Rate for Payer: Multiplan Commercial |
$100.00
|
| Rate for Payer: NAPHCARE Commercial |
$75.00
|
| Rate for Payer: Preferred Network Access Commercial |
$115.00
|
| Rate for Payer: Quartz Beloit One Network |
$61.25
|
| Rate for Payer: Quartz Commercial |
$75.00
|
| Rate for Payer: WEA Trust Commercial |
$68.75
|
| Rate for Payer: WPS Commercial |
$92.59
|
|
|
Toxoplasma Antibody IgG and IgM
|
Facility
OP
|
$125.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
978083
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$500.00 |
| Rate for Payer: Aetna Commercial |
$112.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.50
|
| Rate for Payer: Aetna Managed Medicare |
$14.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.18
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.89
|
| Rate for Payer: Anthem Medicaid |
$14.87
|
| Rate for Payer: Anthem Medicare Advantage |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.39
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14.87
|
| Rate for Payer: Dean Health Medicaid |
$14.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.39
|
| Rate for Payer: Health EOS Commercial |
$111.25
|
| Rate for Payer: HFN Commercial |
$115.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.39
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.39
|
| Rate for Payer: Managed Health Services Medicaid |
$15.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$100.00
|
| Rate for Payer: NAPHCARE Commercial |
$21.58
|
| Rate for Payer: Preferred Network Access Commercial |
$115.00
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14.87
|
| Rate for Payer: Quartz Beloit One Network |
$61.25
|
| Rate for Payer: Quartz Commercial |
$81.25
|
| Rate for Payer: Quartz Medicare Advantage |
$14.39
|
| Rate for Payer: The Alliance Commercial |
$500.00
|
| Rate for Payer: United Healthcare Medicaid |
$14.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.39
|
| Rate for Payer: United Healthcare PPO |
$93.75
|
| Rate for Payer: WEA Trust Commercial |
$68.75
|
| Rate for Payer: Wellcare Medicare |
$14.39
|
| Rate for Payer: WMAP Medicaid |
$14.87
|
| Rate for Payer: WPS Commercial |
$92.59
|
|
|
Toxoplasma Antibody IgG and IgM
|
Professional
|
$125.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
978083
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$118.75 |
| Rate for Payer: Aetna Commercial |
$118.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.50
|
| Rate for Payer: Aetna Managed Medicare |
$14.39
|
| Rate for Payer: Anthem Medicare Advantage |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.39
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cigna Commercial |
$118.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$62.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.39
|
| Rate for Payer: Health EOS Commercial |
$113.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$50.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$100.00
|
| Rate for Payer: Preferred Network Access Commercial |
$118.75
|
| Rate for Payer: Quartz Beloit One Network |
$55.00
|
| Rate for Payer: Quartz Commercial |
$71.25
|
| Rate for Payer: Quartz Medicare Advantage |
$14.39
|
| Rate for Payer: The Alliance Commercial |
$56.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.39
|
| Rate for Payer: WEA Trust Commercial |
$68.75
|
| Rate for Payer: WPS Commercial |
$63.32
|
|
|
Toxoplasma Antibody IgM
|
Facility
IP
|
$119.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
2943021
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.31 |
| Max. Negotiated Rate |
$109.48 |
| Rate for Payer: Aetna Commercial |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$63.07
|
| Rate for Payer: Cash Price |
$35.70
|
| Rate for Payer: Cigna Commercial |
$109.48
|
| Rate for Payer: Health EOS Commercial |
$105.91
|
| Rate for Payer: HFN Commercial |
$109.48
|
| Rate for Payer: Multiplan Commercial |
$95.20
|
| Rate for Payer: NAPHCARE Commercial |
$71.40
|
| Rate for Payer: Preferred Network Access Commercial |
$109.48
|
| Rate for Payer: Quartz Beloit One Network |
$58.31
|
| Rate for Payer: Quartz Commercial |
$71.40
|
| Rate for Payer: WEA Trust Commercial |
$65.45
|
| Rate for Payer: WPS Commercial |
$88.14
|
|
|
Toxoplasma Antibody IgM
|
Professional
|
$119.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
2943021
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.41 |
| Max. Negotiated Rate |
$113.05 |
| Rate for Payer: Aetna Commercial |
$113.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$102.34
|
| Rate for Payer: Aetna Managed Medicare |
$14.41
|
| Rate for Payer: Anthem Medicare Advantage |
$14.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.41
|
| Rate for Payer: Cash Price |
$35.70
|
| Rate for Payer: Cash Price |
$35.70
|
| Rate for Payer: Cigna Commercial |
$113.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$59.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.41
|
| Rate for Payer: Health EOS Commercial |
$108.29
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$50.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.41
|
| Rate for Payer: Multiplan Commercial |
$95.20
|
| Rate for Payer: Preferred Network Access Commercial |
$113.05
|
| Rate for Payer: Quartz Beloit One Network |
$52.36
|
| Rate for Payer: Quartz Commercial |
$67.83
|
| Rate for Payer: Quartz Medicare Advantage |
$14.41
|
| Rate for Payer: The Alliance Commercial |
$56.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.41
|
| Rate for Payer: WEA Trust Commercial |
$65.45
|
| Rate for Payer: WPS Commercial |
$63.40
|
|
|
Toxoplasma Antibody IgM
|
Facility
OP
|
$119.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
2943021
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.41 |
| Max. Negotiated Rate |
$476.00 |
| Rate for Payer: Aetna Commercial |
$107.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$102.34
|
| Rate for Payer: Aetna Managed Medicare |
$14.41
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$54.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.92
|
| Rate for Payer: Anthem Medicaid |
$14.89
|
| Rate for Payer: Anthem Medicare Advantage |
$14.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$63.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.41
|
| Rate for Payer: Cash Price |
$35.70
|
| Rate for Payer: Cash Price |
$35.70
|
| Rate for Payer: Cigna Commercial |
$109.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14.89
|
| Rate for Payer: Dean Health Medicaid |
$14.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.41
|
| Rate for Payer: Health EOS Commercial |
$105.91
|
| Rate for Payer: HFN Commercial |
$109.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.41
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.41
|
| Rate for Payer: Managed Health Services Medicaid |
$15.49
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.41
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.41
|
| Rate for Payer: Multiplan Commercial |
$95.20
|
| Rate for Payer: NAPHCARE Commercial |
$21.62
|
| Rate for Payer: Preferred Network Access Commercial |
$109.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14.89
|
| Rate for Payer: Quartz Beloit One Network |
$58.31
|
| Rate for Payer: Quartz Commercial |
$77.35
|
| Rate for Payer: Quartz Medicare Advantage |
$14.41
|
| Rate for Payer: The Alliance Commercial |
$476.00
|
| Rate for Payer: United Healthcare Medicaid |
$14.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.41
|
| Rate for Payer: United Healthcare PPO |
$89.25
|
| Rate for Payer: WEA Trust Commercial |
$65.45
|
| Rate for Payer: Wellcare Medicare |
$14.41
|
| Rate for Payer: WMAP Medicaid |
$14.89
|
| Rate for Payer: WPS Commercial |
$88.14
|
|
|
Toxoplasma gondii DNA, Qual, PCR
|
Facility
OP
|
$1,028.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
983428
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$4,112.00 |
| Rate for Payer: Aetna Commercial |
$925.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$884.08
|
| Rate for Payer: Aetna Managed Medicare |
$35.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$131.59
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$61.41
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$58.25
|
| Rate for Payer: Anthem Medicaid |
$36.26
|
| Rate for Payer: Anthem Medicare Advantage |
$35.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$544.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35.09
|
| Rate for Payer: Cash Price |
$308.40
|
| Rate for Payer: Cash Price |
$308.40
|
| Rate for Payer: Cigna Commercial |
$945.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$35.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$36.26
|
| Rate for Payer: Dean Health Medicaid |
$36.26
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$35.09
|
| Rate for Payer: Health EOS Commercial |
$914.92
|
| Rate for Payer: HFN Commercial |
$945.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$130.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$35.09
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$36.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35.09
|
| Rate for Payer: Managed Health Services Medicaid |
$37.71
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$35.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$35.09
|
| Rate for Payer: Multiplan Commercial |
$822.40
|
| Rate for Payer: NAPHCARE Commercial |
$52.64
|
| Rate for Payer: Preferred Network Access Commercial |
$945.76
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$36.26
|
| Rate for Payer: Quartz Beloit One Network |
$503.72
|
| Rate for Payer: Quartz Commercial |
$668.20
|
| Rate for Payer: Quartz Medicare Advantage |
$35.09
|
| Rate for Payer: The Alliance Commercial |
$4,112.00
|
| Rate for Payer: United Healthcare Medicaid |
$36.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.09
|
| Rate for Payer: United Healthcare PPO |
$771.00
|
| Rate for Payer: WEA Trust Commercial |
$565.40
|
| Rate for Payer: Wellcare Medicare |
$35.09
|
| Rate for Payer: WMAP Medicaid |
$36.26
|
| Rate for Payer: WPS Commercial |
$761.44
|
|
|
Toxoplasma gondii DNA, Qual, PCR
|
Professional
|
$1,028.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
983428
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$976.60 |
| Rate for Payer: Aetna Commercial |
$976.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$884.08
|
| Rate for Payer: Aetna Managed Medicare |
$35.09
|
| Rate for Payer: Anthem Medicare Advantage |
$35.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35.09
|
| Rate for Payer: Cash Price |
$308.40
|
| Rate for Payer: Cash Price |
$308.40
|
| Rate for Payer: Cigna Commercial |
$976.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$514.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35.09
|
| Rate for Payer: Health EOS Commercial |
$935.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$123.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$123.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35.09
|
| Rate for Payer: Multiplan Commercial |
$822.40
|
| Rate for Payer: Preferred Network Access Commercial |
$976.60
|
| Rate for Payer: Quartz Beloit One Network |
$452.32
|
| Rate for Payer: Quartz Commercial |
$585.96
|
| Rate for Payer: Quartz Medicare Advantage |
$35.09
|
| Rate for Payer: The Alliance Commercial |
$138.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.09
|
| Rate for Payer: WEA Trust Commercial |
$565.40
|
| Rate for Payer: WPS Commercial |
$154.40
|
|
|
Toxoplasma gondii DNA, Qual, PCR
|
Facility
IP
|
$1,028.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
983428
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$503.72 |
| Max. Negotiated Rate |
$945.76 |
| Rate for Payer: Aetna Commercial |
$925.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$544.84
|
| Rate for Payer: Cash Price |
$308.40
|
| Rate for Payer: Cigna Commercial |
$945.76
|
| Rate for Payer: Health EOS Commercial |
$914.92
|
| Rate for Payer: HFN Commercial |
$945.76
|
| Rate for Payer: Multiplan Commercial |
$822.40
|
| Rate for Payer: NAPHCARE Commercial |
$616.80
|
| Rate for Payer: Preferred Network Access Commercial |
$945.76
|
| Rate for Payer: Quartz Beloit One Network |
$503.72
|
| Rate for Payer: Quartz Commercial |
$616.80
|
| Rate for Payer: WEA Trust Commercial |
$565.40
|
| Rate for Payer: WPS Commercial |
$761.44
|
|
|
Tox Scr Serum
|
Facility
OP
|
$594.00
|
|
|
Service Code
|
CPT 80329
|
| Hospital Charge Code |
979884
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$166.32 |
| Max. Negotiated Rate |
$546.48 |
| Rate for Payer: Aetna Commercial |
$534.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$510.84
|
| Rate for Payer: Aetna Managed Medicare |
$166.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$386.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$297.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$285.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$314.82
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cigna Commercial |
$546.48
|
| Rate for Payer: Health EOS Commercial |
$528.66
|
| Rate for Payer: HFN Commercial |
$546.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$445.50
|
| Rate for Payer: Multiplan Commercial |
$475.20
|
| Rate for Payer: NAPHCARE Commercial |
$356.40
|
| Rate for Payer: Preferred Network Access Commercial |
$546.48
|
| Rate for Payer: Quartz Beloit One Network |
$291.06
|
| Rate for Payer: Quartz Commercial |
$386.10
|
| Rate for Payer: Quartz Medicare Advantage |
$356.40
|
| Rate for Payer: United Healthcare PPO |
$445.50
|
| Rate for Payer: WEA Trust Commercial |
$326.70
|
| Rate for Payer: WPS Commercial |
$439.98
|
|
|
Tox Scr Serum
|
Professional
|
$594.00
|
|
|
Service Code
|
CPT 80329
|
| Hospital Charge Code |
979884
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$80.06 |
| Max. Negotiated Rate |
$564.30 |
| Rate for Payer: Aetna Commercial |
$564.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$510.84
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cigna Commercial |
$564.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$297.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$356.40
|
| Rate for Payer: Health EOS Commercial |
$540.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$80.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$80.06
|
| Rate for Payer: Multiplan Commercial |
$475.20
|
| Rate for Payer: Preferred Network Access Commercial |
$564.30
|
| Rate for Payer: Quartz Beloit One Network |
$261.36
|
| Rate for Payer: Quartz Commercial |
$338.58
|
| Rate for Payer: The Alliance Commercial |
$297.00
|
| Rate for Payer: WEA Trust Commercial |
$326.70
|
| Rate for Payer: WPS Commercial |
$439.98
|
|
