|
THUMB SUPPORT TITAN (RIGHT) #5547-66-02
|
Facility
|
IP
|
$468.00
|
|
| Hospital Charge Code |
2969692
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$238.49 |
| Max. Negotiated Rate |
$447.78 |
| Rate for Payer: Aetna Commercial |
$438.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$418.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$257.96
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cigna Commercial |
$447.78
|
| Rate for Payer: Health EOS Commercial |
$433.18
|
| Rate for Payer: HFN Commercial |
$447.78
|
| Rate for Payer: Multiplan Commercial |
$389.38
|
| Rate for Payer: Preferred Network Access Commercial |
$447.78
|
| Rate for Payer: Quartz Beloit One Network |
$238.49
|
| Rate for Payer: Quartz Commercial |
$292.03
|
| Rate for Payer: WEA Trust Commercial |
$267.70
|
| Rate for Payer: WPS Commercial |
$360.50
|
|
|
Thyroglobulin
|
Facility
|
OP
|
$347.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
2943016
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.70 |
| Max. Negotiated Rate |
$332.01 |
| Rate for Payer: Aetna Commercial |
$324.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$310.36
|
| Rate for Payer: Aetna Managed Medicare |
$16.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$62.63
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29.23
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.73
|
| Rate for Payer: Anthem Medicare Advantage |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$191.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.70
|
| Rate for Payer: Cash Price |
$104.10
|
| Rate for Payer: Cash Price |
$104.10
|
| Rate for Payer: Cigna Commercial |
$332.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$201.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.70
|
| Rate for Payer: Health EOS Commercial |
$321.18
|
| Rate for Payer: HFN Commercial |
$332.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$62.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.70
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.70
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$288.70
|
| Rate for Payer: NAPHCARE Commercial |
$25.05
|
| Rate for Payer: Preferred Network Access Commercial |
$332.01
|
| Rate for Payer: Quartz Beloit One Network |
$176.83
|
| Rate for Payer: Quartz Commercial |
$234.57
|
| Rate for Payer: Quartz Medicare Advantage |
$16.70
|
| Rate for Payer: The Alliance Commercial |
$66.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.70
|
| Rate for Payer: United Healthcare PPO |
$270.66
|
| Rate for Payer: WEA Trust Commercial |
$198.48
|
| Rate for Payer: Wellcare Medicare |
$16.70
|
| Rate for Payer: WPS Commercial |
$267.29
|
|
|
Thyroglobulin
|
Facility
|
IP
|
$347.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
2943016
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$176.83 |
| Max. Negotiated Rate |
$332.01 |
| Rate for Payer: Aetna Commercial |
$324.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$310.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$191.27
|
| Rate for Payer: Cash Price |
$104.10
|
| Rate for Payer: Cigna Commercial |
$332.01
|
| Rate for Payer: Health EOS Commercial |
$321.18
|
| Rate for Payer: HFN Commercial |
$332.01
|
| Rate for Payer: Multiplan Commercial |
$288.70
|
| Rate for Payer: Preferred Network Access Commercial |
$332.01
|
| Rate for Payer: Quartz Beloit One Network |
$176.83
|
| Rate for Payer: Quartz Commercial |
$216.53
|
| Rate for Payer: WEA Trust Commercial |
$198.48
|
| Rate for Payer: WPS Commercial |
$267.29
|
|
|
Thyroglobulin
|
Professional
|
Both
|
$347.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
2943016
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.70 |
| Max. Negotiated Rate |
$342.84 |
| Rate for Payer: Aetna Commercial |
$342.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$310.36
|
| Rate for Payer: Aetna Managed Medicare |
$16.70
|
| Rate for Payer: Anthem Medicare Advantage |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.70
|
| Rate for Payer: Cash Price |
$104.10
|
| Rate for Payer: Cash Price |
$104.10
|
| Rate for Payer: Cigna Commercial |
$342.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$180.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.70
|
| Rate for Payer: Health EOS Commercial |
$328.40
|
| Rate for Payer: HFN Commercial |
$342.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$58.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$288.70
|
| Rate for Payer: NAPHCARE Commercial |
$25.05
|
| Rate for Payer: Preferred Network Access Commercial |
$342.84
|
| Rate for Payer: Quartz Beloit One Network |
$158.79
|
| Rate for Payer: Quartz Commercial |
$205.70
|
| Rate for Payer: Quartz Medicare Advantage |
$16.70
|
| Rate for Payer: The Alliance Commercial |
$65.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.70
|
| Rate for Payer: WEA Trust Commercial |
$198.48
|
| Rate for Payer: WPS Commercial |
$73.49
|
|
|
Thyroglobulin Antibody
|
Facility
|
OP
|
$48.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
3899561
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Aetna Commercial |
$44.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$42.93
|
| Rate for Payer: Aetna Managed Medicare |
$16.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$62.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.47
|
| Rate for Payer: Anthem Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$26.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.55
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$45.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27.94
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.55
|
| Rate for Payer: Health EOS Commercial |
$44.43
|
| Rate for Payer: HFN Commercial |
$45.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$39.94
|
| Rate for Payer: NAPHCARE Commercial |
$24.82
|
| Rate for Payer: Preferred Network Access Commercial |
$45.93
|
| Rate for Payer: Quartz Beloit One Network |
$24.46
|
| Rate for Payer: Quartz Commercial |
$32.45
|
| Rate for Payer: Quartz Medicare Advantage |
$16.55
|
| Rate for Payer: The Alliance Commercial |
$66.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.55
|
| Rate for Payer: United Healthcare PPO |
$37.44
|
| Rate for Payer: WEA Trust Commercial |
$27.46
|
| Rate for Payer: Wellcare Medicare |
$16.55
|
| Rate for Payer: WPS Commercial |
$36.97
|
|
|
Thyroglobulin Antibody
|
Facility
|
IP
|
$48.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
3899561
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.46 |
| Max. Negotiated Rate |
$45.93 |
| Rate for Payer: Aetna Commercial |
$44.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$42.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$26.46
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$45.93
|
| Rate for Payer: Health EOS Commercial |
$44.43
|
| Rate for Payer: HFN Commercial |
$45.93
|
| Rate for Payer: Multiplan Commercial |
$39.94
|
| Rate for Payer: Preferred Network Access Commercial |
$45.93
|
| Rate for Payer: Quartz Beloit One Network |
$24.46
|
| Rate for Payer: Quartz Commercial |
$29.95
|
| Rate for Payer: WEA Trust Commercial |
$27.46
|
| Rate for Payer: WPS Commercial |
$36.97
|
|
|
Thyroglobulin Antibody
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
3899561
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$72.80 |
| Rate for Payer: Aetna Commercial |
$47.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$42.93
|
| Rate for Payer: Aetna Managed Medicare |
$16.55
|
| Rate for Payer: Anthem Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.55
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$47.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$24.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.55
|
| Rate for Payer: Health EOS Commercial |
$45.43
|
| Rate for Payer: HFN Commercial |
$47.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$58.41
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$39.94
|
| Rate for Payer: NAPHCARE Commercial |
$24.82
|
| Rate for Payer: Preferred Network Access Commercial |
$47.42
|
| Rate for Payer: Quartz Beloit One Network |
$21.96
|
| Rate for Payer: Quartz Commercial |
$28.45
|
| Rate for Payer: Quartz Medicare Advantage |
$16.55
|
| Rate for Payer: The Alliance Commercial |
$65.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.55
|
| Rate for Payer: WEA Trust Commercial |
$27.46
|
| Rate for Payer: WPS Commercial |
$72.80
|
|
|
Thyroglobulin Antibody
|
Professional
|
Both
|
$362.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
633841
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$357.66 |
| Rate for Payer: Aetna Commercial |
$357.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$323.77
|
| Rate for Payer: Aetna Managed Medicare |
$16.55
|
| Rate for Payer: Anthem Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.55
|
| Rate for Payer: Cash Price |
$108.60
|
| Rate for Payer: Cash Price |
$108.60
|
| Rate for Payer: Cigna Commercial |
$357.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$188.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.55
|
| Rate for Payer: Health EOS Commercial |
$342.60
|
| Rate for Payer: HFN Commercial |
$357.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$58.41
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$301.18
|
| Rate for Payer: NAPHCARE Commercial |
$24.82
|
| Rate for Payer: Preferred Network Access Commercial |
$357.66
|
| Rate for Payer: Quartz Beloit One Network |
$165.65
|
| Rate for Payer: Quartz Commercial |
$214.59
|
| Rate for Payer: Quartz Medicare Advantage |
$16.55
|
| Rate for Payer: The Alliance Commercial |
$65.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.55
|
| Rate for Payer: WEA Trust Commercial |
$207.06
|
| Rate for Payer: WPS Commercial |
$72.80
|
|
|
Thyroglobulin Antibody
|
Facility
|
IP
|
$362.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
633841
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$184.48 |
| Max. Negotiated Rate |
$346.36 |
| Rate for Payer: Aetna Commercial |
$338.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$323.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$199.53
|
| Rate for Payer: Cash Price |
$108.60
|
| Rate for Payer: Cigna Commercial |
$346.36
|
| Rate for Payer: Health EOS Commercial |
$335.07
|
| Rate for Payer: HFN Commercial |
$346.36
|
| Rate for Payer: Multiplan Commercial |
$301.18
|
| Rate for Payer: Preferred Network Access Commercial |
$346.36
|
| Rate for Payer: Quartz Beloit One Network |
$184.48
|
| Rate for Payer: Quartz Commercial |
$225.89
|
| Rate for Payer: WEA Trust Commercial |
$207.06
|
| Rate for Payer: WPS Commercial |
$278.85
|
|
|
Thyroglobulin Antibody
|
Facility
|
OP
|
$362.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
633841
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$346.36 |
| Rate for Payer: Aetna Commercial |
$338.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$323.77
|
| Rate for Payer: Aetna Managed Medicare |
$16.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$62.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.47
|
| Rate for Payer: Anthem Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$199.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.55
|
| Rate for Payer: Cash Price |
$108.60
|
| Rate for Payer: Cash Price |
$108.60
|
| Rate for Payer: Cigna Commercial |
$346.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$210.68
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.55
|
| Rate for Payer: Health EOS Commercial |
$335.07
|
| Rate for Payer: HFN Commercial |
$346.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$301.18
|
| Rate for Payer: NAPHCARE Commercial |
$24.82
|
| Rate for Payer: Preferred Network Access Commercial |
$346.36
|
| Rate for Payer: Quartz Beloit One Network |
$184.48
|
| Rate for Payer: Quartz Commercial |
$244.71
|
| Rate for Payer: Quartz Medicare Advantage |
$16.55
|
| Rate for Payer: The Alliance Commercial |
$66.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.55
|
| Rate for Payer: United Healthcare PPO |
$282.36
|
| Rate for Payer: WEA Trust Commercial |
$207.06
|
| Rate for Payer: Wellcare Medicare |
$16.55
|
| Rate for Payer: WPS Commercial |
$278.85
|
|
|
Thyroglobulin Antibody Screen
|
Professional
|
Both
|
$217.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
3764168
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$214.40 |
| Rate for Payer: Aetna Commercial |
$214.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$194.08
|
| Rate for Payer: Aetna Managed Medicare |
$16.55
|
| Rate for Payer: Anthem Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.55
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cigna Commercial |
$214.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$112.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.55
|
| Rate for Payer: Health EOS Commercial |
$205.37
|
| Rate for Payer: HFN Commercial |
$214.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$58.41
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$180.54
|
| Rate for Payer: NAPHCARE Commercial |
$24.82
|
| Rate for Payer: Preferred Network Access Commercial |
$214.40
|
| Rate for Payer: Quartz Beloit One Network |
$99.30
|
| Rate for Payer: Quartz Commercial |
$128.64
|
| Rate for Payer: Quartz Medicare Advantage |
$16.55
|
| Rate for Payer: The Alliance Commercial |
$65.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.55
|
| Rate for Payer: WEA Trust Commercial |
$124.12
|
| Rate for Payer: WPS Commercial |
$72.80
|
|
|
Thyroglobulin Antibody Screen
|
Facility
|
OP
|
$217.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
3764168
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$207.63 |
| Rate for Payer: Aetna Commercial |
$203.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$194.08
|
| Rate for Payer: Aetna Managed Medicare |
$16.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$62.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.47
|
| Rate for Payer: Anthem Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$119.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.55
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cigna Commercial |
$207.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$126.29
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.55
|
| Rate for Payer: Health EOS Commercial |
$200.86
|
| Rate for Payer: HFN Commercial |
$207.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$180.54
|
| Rate for Payer: NAPHCARE Commercial |
$24.82
|
| Rate for Payer: Preferred Network Access Commercial |
$207.63
|
| Rate for Payer: Quartz Beloit One Network |
$110.58
|
| Rate for Payer: Quartz Commercial |
$146.69
|
| Rate for Payer: Quartz Medicare Advantage |
$16.55
|
| Rate for Payer: The Alliance Commercial |
$66.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.55
|
| Rate for Payer: United Healthcare PPO |
$169.26
|
| Rate for Payer: WEA Trust Commercial |
$124.12
|
| Rate for Payer: Wellcare Medicare |
$16.55
|
| Rate for Payer: WPS Commercial |
$167.16
|
|
|
Thyroglobulin Antibody Screen
|
Facility
|
IP
|
$217.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
3764168
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$110.58 |
| Max. Negotiated Rate |
$207.63 |
| Rate for Payer: Aetna Commercial |
$203.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$194.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$119.61
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cigna Commercial |
$207.63
|
| Rate for Payer: Health EOS Commercial |
$200.86
|
| Rate for Payer: HFN Commercial |
$207.63
|
| Rate for Payer: Multiplan Commercial |
$180.54
|
| Rate for Payer: Preferred Network Access Commercial |
$207.63
|
| Rate for Payer: Quartz Beloit One Network |
$110.58
|
| Rate for Payer: Quartz Commercial |
$135.41
|
| Rate for Payer: WEA Trust Commercial |
$124.12
|
| Rate for Payer: WPS Commercial |
$167.16
|
|
|
Thyroglobulin, LC/MS/MS
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
5162612
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.70 |
| Max. Negotiated Rate |
$286.52 |
| Rate for Payer: Aetna Commercial |
$286.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$259.38
|
| Rate for Payer: Aetna Managed Medicare |
$16.70
|
| Rate for Payer: Anthem Medicare Advantage |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.70
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Cigna Commercial |
$286.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$150.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.70
|
| Rate for Payer: Health EOS Commercial |
$274.46
|
| Rate for Payer: HFN Commercial |
$286.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$58.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$241.28
|
| Rate for Payer: NAPHCARE Commercial |
$25.05
|
| Rate for Payer: Preferred Network Access Commercial |
$286.52
|
| Rate for Payer: Quartz Beloit One Network |
$132.70
|
| Rate for Payer: Quartz Commercial |
$171.91
|
| Rate for Payer: Quartz Medicare Advantage |
$16.70
|
| Rate for Payer: The Alliance Commercial |
$65.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.70
|
| Rate for Payer: WEA Trust Commercial |
$165.88
|
| Rate for Payer: WPS Commercial |
$73.49
|
|
|
Thyroglobulin, LC/MS/MS
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
5162612
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.70 |
| Max. Negotiated Rate |
$277.47 |
| Rate for Payer: Aetna Commercial |
$271.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$259.38
|
| Rate for Payer: Aetna Managed Medicare |
$16.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$62.63
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29.23
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.73
|
| Rate for Payer: Anthem Medicare Advantage |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$159.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.70
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Cigna Commercial |
$277.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$168.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.70
|
| Rate for Payer: Health EOS Commercial |
$268.42
|
| Rate for Payer: HFN Commercial |
$277.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$62.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.70
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.70
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$241.28
|
| Rate for Payer: NAPHCARE Commercial |
$25.05
|
| Rate for Payer: Preferred Network Access Commercial |
$277.47
|
| Rate for Payer: Quartz Beloit One Network |
$147.78
|
| Rate for Payer: Quartz Commercial |
$196.04
|
| Rate for Payer: Quartz Medicare Advantage |
$16.70
|
| Rate for Payer: The Alliance Commercial |
$66.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.70
|
| Rate for Payer: United Healthcare PPO |
$226.20
|
| Rate for Payer: WEA Trust Commercial |
$165.88
|
| Rate for Payer: Wellcare Medicare |
$16.70
|
| Rate for Payer: WPS Commercial |
$223.39
|
|
|
Thyroglobulin, LC/MS/MS
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
5162612
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$147.78 |
| Max. Negotiated Rate |
$277.47 |
| Rate for Payer: Aetna Commercial |
$271.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$259.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$159.85
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Cigna Commercial |
$277.47
|
| Rate for Payer: Health EOS Commercial |
$268.42
|
| Rate for Payer: HFN Commercial |
$277.47
|
| Rate for Payer: Multiplan Commercial |
$241.28
|
| Rate for Payer: Preferred Network Access Commercial |
$277.47
|
| Rate for Payer: Quartz Beloit One Network |
$147.78
|
| Rate for Payer: Quartz Commercial |
$180.96
|
| Rate for Payer: WEA Trust Commercial |
$165.88
|
| Rate for Payer: WPS Commercial |
$223.39
|
|
|
Thyroglobulin Panel
|
Facility
|
IP
|
$362.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
983423
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$184.48 |
| Max. Negotiated Rate |
$346.36 |
| Rate for Payer: Aetna Commercial |
$338.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$323.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$199.53
|
| Rate for Payer: Cash Price |
$108.60
|
| Rate for Payer: Cigna Commercial |
$346.36
|
| Rate for Payer: Health EOS Commercial |
$335.07
|
| Rate for Payer: HFN Commercial |
$346.36
|
| Rate for Payer: Multiplan Commercial |
$301.18
|
| Rate for Payer: Preferred Network Access Commercial |
$346.36
|
| Rate for Payer: Quartz Beloit One Network |
$184.48
|
| Rate for Payer: Quartz Commercial |
$225.89
|
| Rate for Payer: WEA Trust Commercial |
$207.06
|
| Rate for Payer: WPS Commercial |
$278.85
|
|
|
Thyroglobulin Panel
|
Facility
|
OP
|
$362.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
983423
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$346.36 |
| Rate for Payer: Aetna Commercial |
$338.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$323.77
|
| Rate for Payer: Aetna Managed Medicare |
$16.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$62.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.47
|
| Rate for Payer: Anthem Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$199.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.55
|
| Rate for Payer: Cash Price |
$108.60
|
| Rate for Payer: Cash Price |
$108.60
|
| Rate for Payer: Cigna Commercial |
$346.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$210.68
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.55
|
| Rate for Payer: Health EOS Commercial |
$335.07
|
| Rate for Payer: HFN Commercial |
$346.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$301.18
|
| Rate for Payer: NAPHCARE Commercial |
$24.82
|
| Rate for Payer: Preferred Network Access Commercial |
$346.36
|
| Rate for Payer: Quartz Beloit One Network |
$184.48
|
| Rate for Payer: Quartz Commercial |
$244.71
|
| Rate for Payer: Quartz Medicare Advantage |
$16.55
|
| Rate for Payer: The Alliance Commercial |
$66.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.55
|
| Rate for Payer: United Healthcare PPO |
$282.36
|
| Rate for Payer: WEA Trust Commercial |
$207.06
|
| Rate for Payer: Wellcare Medicare |
$16.55
|
| Rate for Payer: WPS Commercial |
$278.85
|
|
|
Thyroglobulin Panel
|
Professional
|
Both
|
$362.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
983423
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$357.66 |
| Rate for Payer: Aetna Commercial |
$357.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$323.77
|
| Rate for Payer: Aetna Managed Medicare |
$16.55
|
| Rate for Payer: Anthem Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.55
|
| Rate for Payer: Cash Price |
$108.60
|
| Rate for Payer: Cash Price |
$108.60
|
| Rate for Payer: Cigna Commercial |
$357.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$188.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.55
|
| Rate for Payer: Health EOS Commercial |
$342.60
|
| Rate for Payer: HFN Commercial |
$357.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$58.41
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$301.18
|
| Rate for Payer: NAPHCARE Commercial |
$24.82
|
| Rate for Payer: Preferred Network Access Commercial |
$357.66
|
| Rate for Payer: Quartz Beloit One Network |
$165.65
|
| Rate for Payer: Quartz Commercial |
$214.59
|
| Rate for Payer: Quartz Medicare Advantage |
$16.55
|
| Rate for Payer: The Alliance Commercial |
$65.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.55
|
| Rate for Payer: WEA Trust Commercial |
$207.06
|
| Rate for Payer: WPS Commercial |
$72.80
|
|
|
Thyroglobulin Quantitative
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
3959986
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$66.81 |
| Rate for Payer: Aetna Commercial |
$23.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22.36
|
| Rate for Payer: Aetna Managed Medicare |
$16.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$62.63
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29.23
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.73
|
| Rate for Payer: Anthem Medicare Advantage |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.70
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$23.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.70
|
| Rate for Payer: Health EOS Commercial |
$23.14
|
| Rate for Payer: HFN Commercial |
$23.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$62.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.70
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.70
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: NAPHCARE Commercial |
$25.05
|
| Rate for Payer: Preferred Network Access Commercial |
$23.92
|
| Rate for Payer: Quartz Beloit One Network |
$12.74
|
| Rate for Payer: Quartz Commercial |
$16.90
|
| Rate for Payer: Quartz Medicare Advantage |
$16.70
|
| Rate for Payer: The Alliance Commercial |
$66.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.70
|
| Rate for Payer: United Healthcare PPO |
$19.50
|
| Rate for Payer: WEA Trust Commercial |
$14.30
|
| Rate for Payer: Wellcare Medicare |
$16.70
|
| Rate for Payer: WPS Commercial |
$19.26
|
|
|
Thyroglobulin Quantitative
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
3959986
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$23.92 |
| Rate for Payer: Aetna Commercial |
$23.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13.78
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$23.92
|
| Rate for Payer: Health EOS Commercial |
$23.14
|
| Rate for Payer: HFN Commercial |
$23.92
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Preferred Network Access Commercial |
$23.92
|
| Rate for Payer: Quartz Beloit One Network |
$12.74
|
| Rate for Payer: Quartz Commercial |
$15.60
|
| Rate for Payer: WEA Trust Commercial |
$14.30
|
| Rate for Payer: WPS Commercial |
$19.26
|
|
|
Thyroglobulin Quantitative
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
3959986
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$73.49 |
| Rate for Payer: Aetna Commercial |
$24.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22.36
|
| Rate for Payer: Aetna Managed Medicare |
$16.70
|
| Rate for Payer: Anthem Medicare Advantage |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.70
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$24.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.70
|
| Rate for Payer: Health EOS Commercial |
$23.66
|
| Rate for Payer: HFN Commercial |
$24.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$58.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: NAPHCARE Commercial |
$25.05
|
| Rate for Payer: Preferred Network Access Commercial |
$24.70
|
| Rate for Payer: Quartz Beloit One Network |
$11.44
|
| Rate for Payer: Quartz Commercial |
$14.82
|
| Rate for Payer: Quartz Medicare Advantage |
$16.70
|
| Rate for Payer: The Alliance Commercial |
$65.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.70
|
| Rate for Payer: WEA Trust Commercial |
$14.30
|
| Rate for Payer: WPS Commercial |
$73.49
|
|
|
Thyroglobulin, Tumor Marker, Serum to Mayo
|
Facility
|
IP
|
$320.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
3756168
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$163.07 |
| Max. Negotiated Rate |
$306.18 |
| Rate for Payer: Aetna Commercial |
$299.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$286.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$176.38
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$306.18
|
| Rate for Payer: Health EOS Commercial |
$296.19
|
| Rate for Payer: HFN Commercial |
$306.18
|
| Rate for Payer: Multiplan Commercial |
$266.24
|
| Rate for Payer: Preferred Network Access Commercial |
$306.18
|
| Rate for Payer: Quartz Beloit One Network |
$163.07
|
| Rate for Payer: Quartz Commercial |
$199.68
|
| Rate for Payer: WEA Trust Commercial |
$183.04
|
| Rate for Payer: WPS Commercial |
$246.50
|
|
|
Thyroglobulin, Tumor Marker, Serum to Mayo
|
Facility
|
OP
|
$320.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
3756168
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.70 |
| Max. Negotiated Rate |
$306.18 |
| Rate for Payer: Aetna Commercial |
$299.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$286.21
|
| Rate for Payer: Aetna Managed Medicare |
$16.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$62.63
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29.23
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.73
|
| Rate for Payer: Anthem Medicare Advantage |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$176.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.70
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$306.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$186.24
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.70
|
| Rate for Payer: Health EOS Commercial |
$296.19
|
| Rate for Payer: HFN Commercial |
$306.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$62.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.70
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.70
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$266.24
|
| Rate for Payer: NAPHCARE Commercial |
$25.05
|
| Rate for Payer: Preferred Network Access Commercial |
$306.18
|
| Rate for Payer: Quartz Beloit One Network |
$163.07
|
| Rate for Payer: Quartz Commercial |
$216.32
|
| Rate for Payer: Quartz Medicare Advantage |
$16.70
|
| Rate for Payer: The Alliance Commercial |
$66.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.70
|
| Rate for Payer: United Healthcare PPO |
$249.60
|
| Rate for Payer: WEA Trust Commercial |
$183.04
|
| Rate for Payer: Wellcare Medicare |
$16.70
|
| Rate for Payer: WPS Commercial |
$246.50
|
|
|
Thyroglobulin, Tumor Marker, Serum to Mayo
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
3756168
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.70 |
| Max. Negotiated Rate |
$316.16 |
| Rate for Payer: Aetna Commercial |
$316.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$286.21
|
| Rate for Payer: Aetna Managed Medicare |
$16.70
|
| Rate for Payer: Anthem Medicare Advantage |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.70
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$316.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$166.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.70
|
| Rate for Payer: Health EOS Commercial |
$302.85
|
| Rate for Payer: HFN Commercial |
$316.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$58.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$266.24
|
| Rate for Payer: NAPHCARE Commercial |
$25.05
|
| Rate for Payer: Preferred Network Access Commercial |
$316.16
|
| Rate for Payer: Quartz Beloit One Network |
$146.43
|
| Rate for Payer: Quartz Commercial |
$189.70
|
| Rate for Payer: Quartz Medicare Advantage |
$16.70
|
| Rate for Payer: The Alliance Commercial |
$65.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.70
|
| Rate for Payer: WEA Trust Commercial |
$183.04
|
| Rate for Payer: WPS Commercial |
$73.49
|
|
