|
ThinPrep Pap & HPV mRNA w/Rfx HPV 16,18/45 #91414
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
5460757
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.67 |
| Max. Negotiated Rate |
$145.24 |
| Rate for Payer: Aetna Commercial |
$145.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$131.48
|
| Rate for Payer: Aetna Managed Medicare |
$27.67
|
| Rate for Payer: Anthem Medicare Advantage |
$27.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.67
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cigna Commercial |
$145.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$76.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27.67
|
| Rate for Payer: Health EOS Commercial |
$139.12
|
| Rate for Payer: HFN Commercial |
$145.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$97.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$97.69
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.67
|
| Rate for Payer: Multiplan Commercial |
$122.30
|
| Rate for Payer: NAPHCARE Commercial |
$41.51
|
| Rate for Payer: Preferred Network Access Commercial |
$145.24
|
| Rate for Payer: Quartz Beloit One Network |
$67.27
|
| Rate for Payer: Quartz Commercial |
$87.14
|
| Rate for Payer: Quartz Medicare Advantage |
$27.67
|
| Rate for Payer: The Alliance Commercial |
$109.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.67
|
| Rate for Payer: WEA Trust Commercial |
$84.08
|
| Rate for Payer: WPS Commercial |
$121.77
|
|
|
ThinPrep Pap w/Rfx HPV mRNA E6/E7 #90934
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
5460755
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.67 |
| Max. Negotiated Rate |
$145.24 |
| Rate for Payer: Aetna Commercial |
$145.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$131.48
|
| Rate for Payer: Aetna Managed Medicare |
$27.67
|
| Rate for Payer: Anthem Medicare Advantage |
$27.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.67
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cigna Commercial |
$145.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$76.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27.67
|
| Rate for Payer: Health EOS Commercial |
$139.12
|
| Rate for Payer: HFN Commercial |
$145.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$97.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$97.69
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.67
|
| Rate for Payer: Multiplan Commercial |
$122.30
|
| Rate for Payer: NAPHCARE Commercial |
$41.51
|
| Rate for Payer: Preferred Network Access Commercial |
$145.24
|
| Rate for Payer: Quartz Beloit One Network |
$67.27
|
| Rate for Payer: Quartz Commercial |
$87.14
|
| Rate for Payer: Quartz Medicare Advantage |
$27.67
|
| Rate for Payer: The Alliance Commercial |
$109.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.67
|
| Rate for Payer: WEA Trust Commercial |
$84.08
|
| Rate for Payer: WPS Commercial |
$121.77
|
|
|
ThinPrep Pap w/Rfx HPV mRNA E6/E7 #90934
|
Facility
|
IP
|
$147.00
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
5460755
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$74.91 |
| Max. Negotiated Rate |
$140.65 |
| Rate for Payer: Aetna Commercial |
$137.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$131.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$81.03
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cigna Commercial |
$140.65
|
| Rate for Payer: Health EOS Commercial |
$136.06
|
| Rate for Payer: HFN Commercial |
$140.65
|
| Rate for Payer: Multiplan Commercial |
$122.30
|
| Rate for Payer: Preferred Network Access Commercial |
$140.65
|
| Rate for Payer: Quartz Beloit One Network |
$74.91
|
| Rate for Payer: Quartz Commercial |
$91.73
|
| Rate for Payer: WEA Trust Commercial |
$84.08
|
| Rate for Payer: WPS Commercial |
$113.23
|
|
|
ThinPrep Pap w/Rfx HPV mRNA E6/E7 #90934
|
Facility
|
OP
|
$147.00
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
5460755
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.67 |
| Max. Negotiated Rate |
$140.65 |
| Rate for Payer: Aetna Commercial |
$137.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$131.48
|
| Rate for Payer: Aetna Managed Medicare |
$27.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$103.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$48.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$45.94
|
| Rate for Payer: Anthem Medicare Advantage |
$27.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$81.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.67
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cigna Commercial |
$140.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$27.67
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$85.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$27.67
|
| Rate for Payer: Health EOS Commercial |
$136.06
|
| Rate for Payer: HFN Commercial |
$140.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$102.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$27.67
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.67
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$27.67
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$27.67
|
| Rate for Payer: Multiplan Commercial |
$122.30
|
| Rate for Payer: NAPHCARE Commercial |
$41.51
|
| Rate for Payer: Preferred Network Access Commercial |
$140.65
|
| Rate for Payer: Quartz Beloit One Network |
$74.91
|
| Rate for Payer: Quartz Commercial |
$99.37
|
| Rate for Payer: Quartz Medicare Advantage |
$27.67
|
| Rate for Payer: The Alliance Commercial |
$110.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.67
|
| Rate for Payer: United Healthcare PPO |
$114.66
|
| Rate for Payer: WEA Trust Commercial |
$84.08
|
| Rate for Payer: Wellcare Medicare |
$27.67
|
| Rate for Payer: WPS Commercial |
$113.23
|
|
|
Thiopurine Metabolites
|
Facility
|
IP
|
$130.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
5438798
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.25 |
| Max. Negotiated Rate |
$124.38 |
| Rate for Payer: Aetna Commercial |
$121.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$116.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$71.66
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cigna Commercial |
$124.38
|
| Rate for Payer: Health EOS Commercial |
$120.33
|
| Rate for Payer: HFN Commercial |
$124.38
|
| Rate for Payer: Multiplan Commercial |
$108.16
|
| Rate for Payer: Preferred Network Access Commercial |
$124.38
|
| Rate for Payer: Quartz Beloit One Network |
$66.25
|
| Rate for Payer: Quartz Commercial |
$81.12
|
| Rate for Payer: WEA Trust Commercial |
$74.36
|
| Rate for Payer: WPS Commercial |
$100.14
|
|
|
Thiopurine Metabolites
|
Facility
|
OP
|
$130.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
5438798
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.39 |
| Max. Negotiated Rate |
$124.38 |
| Rate for Payer: Aetna Commercial |
$121.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$116.27
|
| Rate for Payer: Aetna Managed Medicare |
$19.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$72.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$33.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$32.18
|
| Rate for Payer: Anthem Medicare Advantage |
$19.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$71.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19.39
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cigna Commercial |
$124.38
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$19.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$75.66
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$19.39
|
| Rate for Payer: Health EOS Commercial |
$120.33
|
| Rate for Payer: HFN Commercial |
$124.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$72.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$19.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$19.39
|
| Rate for Payer: Multiplan Commercial |
$108.16
|
| Rate for Payer: NAPHCARE Commercial |
$29.08
|
| Rate for Payer: Preferred Network Access Commercial |
$124.38
|
| Rate for Payer: Quartz Beloit One Network |
$66.25
|
| Rate for Payer: Quartz Commercial |
$87.88
|
| Rate for Payer: Quartz Medicare Advantage |
$19.39
|
| Rate for Payer: The Alliance Commercial |
$77.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.39
|
| Rate for Payer: United Healthcare PPO |
$101.40
|
| Rate for Payer: WEA Trust Commercial |
$74.36
|
| Rate for Payer: Wellcare Medicare |
$19.39
|
| Rate for Payer: WPS Commercial |
$100.14
|
|
|
Thiopurine Metabolites
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
5438798
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.39 |
| Max. Negotiated Rate |
$128.44 |
| Rate for Payer: Aetna Commercial |
$128.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$116.27
|
| Rate for Payer: Aetna Managed Medicare |
$19.39
|
| Rate for Payer: Anthem Medicare Advantage |
$19.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19.39
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cigna Commercial |
$128.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$67.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19.39
|
| Rate for Payer: Health EOS Commercial |
$123.03
|
| Rate for Payer: HFN Commercial |
$128.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$68.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$68.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19.39
|
| Rate for Payer: Multiplan Commercial |
$108.16
|
| Rate for Payer: NAPHCARE Commercial |
$29.08
|
| Rate for Payer: Preferred Network Access Commercial |
$128.44
|
| Rate for Payer: Quartz Beloit One Network |
$59.49
|
| Rate for Payer: Quartz Commercial |
$77.06
|
| Rate for Payer: Quartz Medicare Advantage |
$19.39
|
| Rate for Payer: The Alliance Commercial |
$76.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.39
|
| Rate for Payer: WEA Trust Commercial |
$74.36
|
| Rate for Payer: WPS Commercial |
$85.30
|
|
|
Thiopurine Metabolites to Prometheus
|
Professional
|
Both
|
$301.00
|
|
| Hospital Charge Code |
2778835
|
| Min. Negotiated Rate |
$137.74 |
| Max. Negotiated Rate |
$297.39 |
| Rate for Payer: Aetna Commercial |
$297.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$269.21
|
| Rate for Payer: Cash Price |
$90.30
|
| Rate for Payer: Cigna Commercial |
$297.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$156.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$187.82
|
| Rate for Payer: Health EOS Commercial |
$284.87
|
| Rate for Payer: HFN Commercial |
$297.39
|
| Rate for Payer: Multiplan Commercial |
$250.43
|
| Rate for Payer: Preferred Network Access Commercial |
$297.39
|
| Rate for Payer: Quartz Beloit One Network |
$137.74
|
| Rate for Payer: Quartz Commercial |
$178.43
|
| Rate for Payer: The Alliance Commercial |
$156.52
|
| Rate for Payer: WEA Trust Commercial |
$172.17
|
| Rate for Payer: WPS Commercial |
$231.86
|
|
|
Thiopurine Metabolites to Prometheus
|
Facility
|
IP
|
$301.00
|
|
| Hospital Charge Code |
2778835
|
| Min. Negotiated Rate |
$153.39 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna Commercial |
$281.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$269.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$165.91
|
| Rate for Payer: Cash Price |
$90.30
|
| Rate for Payer: Cigna Commercial |
$288.00
|
| Rate for Payer: Health EOS Commercial |
$278.61
|
| Rate for Payer: HFN Commercial |
$288.00
|
| Rate for Payer: Multiplan Commercial |
$250.43
|
| Rate for Payer: Preferred Network Access Commercial |
$288.00
|
| Rate for Payer: Quartz Beloit One Network |
$153.39
|
| Rate for Payer: Quartz Commercial |
$187.82
|
| Rate for Payer: WEA Trust Commercial |
$172.17
|
| Rate for Payer: WPS Commercial |
$231.86
|
|
|
Thiopurine Metabolites to Prometheus
|
Facility
|
OP
|
$301.00
|
|
| Hospital Charge Code |
2778835
|
| Min. Negotiated Rate |
$87.65 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna Commercial |
$281.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$269.21
|
| Rate for Payer: Aetna Managed Medicare |
$87.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$203.48
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$156.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$150.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$165.91
|
| Rate for Payer: Cash Price |
$90.30
|
| Rate for Payer: Cigna Commercial |
$288.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$175.18
|
| Rate for Payer: Health EOS Commercial |
$278.61
|
| Rate for Payer: HFN Commercial |
$288.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$234.78
|
| Rate for Payer: Multiplan Commercial |
$250.43
|
| Rate for Payer: NAPHCARE Commercial |
$187.82
|
| Rate for Payer: Preferred Network Access Commercial |
$288.00
|
| Rate for Payer: Quartz Beloit One Network |
$153.39
|
| Rate for Payer: Quartz Commercial |
$203.48
|
| Rate for Payer: Quartz Medicare Advantage |
$187.82
|
| Rate for Payer: The Alliance Commercial |
$156.52
|
| Rate for Payer: WEA Trust Commercial |
$172.17
|
| Rate for Payer: WPS Commercial |
$231.86
|
|
|
Thiopurine S-Methyltransferase (TPMT) Genotype
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT 81335
|
| Hospital Charge Code |
5412828
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$727.21 |
| Rate for Payer: Aetna Commercial |
$672.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$643.07
|
| Rate for Payer: Aetna Managed Medicare |
$181.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$681.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$318.15
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$301.79
|
| Rate for Payer: Anthem Medicare Advantage |
$181.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$396.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.80
|
| Rate for Payer: Cash Price |
$215.70
|
| Rate for Payer: Cash Price |
$215.70
|
| Rate for Payer: Cigna Commercial |
$687.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$181.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$418.46
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$181.80
|
| Rate for Payer: Health EOS Commercial |
$665.51
|
| Rate for Payer: HFN Commercial |
$687.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$676.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$181.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.80
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$181.80
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$181.80
|
| Rate for Payer: Multiplan Commercial |
$598.21
|
| Rate for Payer: NAPHCARE Commercial |
$272.70
|
| Rate for Payer: Preferred Network Access Commercial |
$687.94
|
| Rate for Payer: Quartz Beloit One Network |
$366.40
|
| Rate for Payer: Quartz Commercial |
$486.04
|
| Rate for Payer: Quartz Medicare Advantage |
$181.80
|
| Rate for Payer: The Alliance Commercial |
$727.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.80
|
| Rate for Payer: United Healthcare PPO |
$560.82
|
| Rate for Payer: WEA Trust Commercial |
$411.27
|
| Rate for Payer: Wellcare Medicare |
$181.80
|
| Rate for Payer: WPS Commercial |
$553.85
|
|
|
Thiopurine S-Methyltransferase (TPMT) Genotype
|
Professional
|
Both
|
$719.00
|
|
|
Service Code
|
CPT 81335
|
| Hospital Charge Code |
5412828
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$181.80 |
| Max. Negotiated Rate |
$799.93 |
| Rate for Payer: Aetna Commercial |
$710.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$643.07
|
| Rate for Payer: Aetna Managed Medicare |
$181.80
|
| Rate for Payer: Anthem Medicare Advantage |
$181.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.80
|
| Rate for Payer: Cash Price |
$215.70
|
| Rate for Payer: Cash Price |
$215.70
|
| Rate for Payer: Cigna Commercial |
$710.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$373.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$181.80
|
| Rate for Payer: Health EOS Commercial |
$680.46
|
| Rate for Payer: HFN Commercial |
$710.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$641.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$641.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.80
|
| Rate for Payer: Multiplan Commercial |
$598.21
|
| Rate for Payer: NAPHCARE Commercial |
$272.70
|
| Rate for Payer: Preferred Network Access Commercial |
$710.37
|
| Rate for Payer: Quartz Beloit One Network |
$329.01
|
| Rate for Payer: Quartz Commercial |
$426.22
|
| Rate for Payer: Quartz Medicare Advantage |
$181.80
|
| Rate for Payer: The Alliance Commercial |
$718.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.80
|
| Rate for Payer: WEA Trust Commercial |
$411.27
|
| Rate for Payer: WPS Commercial |
$799.93
|
|
|
Thiopurine S-Methyltransferase (TPMT) Genotype
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT 81335
|
| Hospital Charge Code |
5412828
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$366.40 |
| Max. Negotiated Rate |
$687.94 |
| Rate for Payer: Aetna Commercial |
$672.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$643.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$396.31
|
| Rate for Payer: Cash Price |
$215.70
|
| Rate for Payer: Cigna Commercial |
$687.94
|
| Rate for Payer: Health EOS Commercial |
$665.51
|
| Rate for Payer: HFN Commercial |
$687.94
|
| Rate for Payer: Multiplan Commercial |
$598.21
|
| Rate for Payer: Preferred Network Access Commercial |
$687.94
|
| Rate for Payer: Quartz Beloit One Network |
$366.40
|
| Rate for Payer: Quartz Commercial |
$448.66
|
| Rate for Payer: WEA Trust Commercial |
$411.27
|
| Rate for Payer: WPS Commercial |
$553.85
|
|
|
THORACENTESIS, CHEST
|
Facility
|
OP
|
$270.00
|
|
| Hospital Charge Code |
2960431
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$78.62 |
| Max. Negotiated Rate |
$258.34 |
| Rate for Payer: Aetna Commercial |
$252.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$241.49
|
| Rate for Payer: Aetna Managed Medicare |
$78.62
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$182.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$140.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$134.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$148.82
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cigna Commercial |
$258.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$157.14
|
| Rate for Payer: Health EOS Commercial |
$249.91
|
| Rate for Payer: HFN Commercial |
$258.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$210.60
|
| Rate for Payer: Multiplan Commercial |
$224.64
|
| Rate for Payer: NAPHCARE Commercial |
$168.48
|
| Rate for Payer: Preferred Network Access Commercial |
$258.34
|
| Rate for Payer: Quartz Beloit One Network |
$137.59
|
| Rate for Payer: Quartz Commercial |
$182.52
|
| Rate for Payer: Quartz Medicare Advantage |
$168.48
|
| Rate for Payer: The Alliance Commercial |
$140.40
|
| Rate for Payer: WEA Trust Commercial |
$154.44
|
| Rate for Payer: WPS Commercial |
$207.98
|
|
|
THORACENTESIS, CHEST
|
Facility
|
IP
|
$270.00
|
|
| Hospital Charge Code |
2960431
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$137.59 |
| Max. Negotiated Rate |
$258.34 |
| Rate for Payer: Aetna Commercial |
$252.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$241.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$148.82
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cigna Commercial |
$258.34
|
| Rate for Payer: Health EOS Commercial |
$249.91
|
| Rate for Payer: HFN Commercial |
$258.34
|
| Rate for Payer: Multiplan Commercial |
$224.64
|
| Rate for Payer: Preferred Network Access Commercial |
$258.34
|
| Rate for Payer: Quartz Beloit One Network |
$137.59
|
| Rate for Payer: Quartz Commercial |
$168.48
|
| Rate for Payer: WEA Trust Commercial |
$154.44
|
| Rate for Payer: WPS Commercial |
$207.98
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING, BILAT 32554-50
|
Professional
|
Both
|
$3,158.00
|
|
|
Service Code
|
CPT 32554 50
|
| Hospital Charge Code |
6174317
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$94.00 |
| Max. Negotiated Rate |
$3,120.10 |
| Rate for Payer: Aetna Commercial |
$3,120.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,824.52
|
| Rate for Payer: Cash Price |
$947.40
|
| Rate for Payer: Cash Price |
$947.40
|
| Rate for Payer: Cash Price |
$947.40
|
| Rate for Payer: Cigna Commercial |
$3,120.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$94.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,970.59
|
| Rate for Payer: Health EOS Commercial |
$2,988.73
|
| Rate for Payer: HFN Commercial |
$3,120.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$312.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$312.75
|
| Rate for Payer: Multiplan Commercial |
$2,627.46
|
| Rate for Payer: Preferred Network Access Commercial |
$3,120.10
|
| Rate for Payer: Quartz Beloit One Network |
$1,445.10
|
| Rate for Payer: Quartz Commercial |
$1,872.06
|
| Rate for Payer: The Alliance Commercial |
$1,642.16
|
| Rate for Payer: United Healthcare Medicaid |
$94.00
|
| Rate for Payer: WEA Trust Commercial |
$1,806.38
|
| Rate for Payer: WPS Commercial |
$2,432.61
|
|
|
THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE; WITH IMAGING GUIDANCE
|
Facility
|
OP
|
$4,386.95
|
|
|
Service Code
|
CPT 32555
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$660.17 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Managed Medicare |
$660.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,030.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,388.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,270.32
|
| Rate for Payer: Anthem Medicare Advantage |
$660.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$660.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$660.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$660.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$660.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,455.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$660.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$660.17
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$660.17
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$660.17
|
| Rate for Payer: NAPHCARE Commercial |
$990.26
|
| Rate for Payer: Quartz Medicare Advantage |
$660.17
|
| Rate for Payer: The Alliance Commercial |
$2,640.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$660.17
|
| Rate for Payer: United Healthcare PPO |
$2,347.28
|
| Rate for Payer: Wellcare Medicare |
$660.17
|
|
|
Thoracentesis Performed By
|
Facility
|
IP
|
$1,162.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
2844884
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$592.16 |
| Max. Negotiated Rate |
$1,111.80 |
| Rate for Payer: Aetna Commercial |
$1,087.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,039.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$640.49
|
| Rate for Payer: Cash Price |
$348.60
|
| Rate for Payer: Cigna Commercial |
$1,111.80
|
| Rate for Payer: Health EOS Commercial |
$1,075.55
|
| Rate for Payer: HFN Commercial |
$1,111.80
|
| Rate for Payer: Multiplan Commercial |
$966.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,111.80
|
| Rate for Payer: Quartz Beloit One Network |
$592.16
|
| Rate for Payer: Quartz Commercial |
$725.09
|
| Rate for Payer: WEA Trust Commercial |
$664.66
|
| Rate for Payer: WPS Commercial |
$895.09
|
|
|
Thoracentesis Performed By
|
Facility
|
OP
|
$1,162.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
2844884
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.04 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$1,087.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,039.29
|
| Rate for Payer: Aetna Managed Medicare |
$660.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$785.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$604.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$580.07
|
| Rate for Payer: Anthem Medicare Advantage |
$660.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$640.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$660.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$660.17
|
| Rate for Payer: Cash Price |
$348.60
|
| Rate for Payer: Cash Price |
$348.60
|
| Rate for Payer: Cash Price |
$348.60
|
| Rate for Payer: Cigna Commercial |
$1,111.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$660.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$660.17
|
| Rate for Payer: Health EOS Commercial |
$1,075.55
|
| Rate for Payer: HFN Commercial |
$1,111.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,455.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$660.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$660.17
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$660.17
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$660.17
|
| Rate for Payer: Multiplan Commercial |
$966.78
|
| Rate for Payer: NAPHCARE Commercial |
$990.26
|
| Rate for Payer: Preferred Network Access Commercial |
$1,111.80
|
| Rate for Payer: Quartz Beloit One Network |
$592.16
|
| Rate for Payer: Quartz Commercial |
$785.51
|
| Rate for Payer: Quartz Medicare Advantage |
$660.17
|
| Rate for Payer: The Alliance Commercial |
$2,640.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$660.17
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$664.66
|
| Rate for Payer: Wellcare Medicare |
$660.17
|
| Rate for Payer: WPS Commercial |
$895.09
|
|
|
THORACENTESIS, RELATED BIOPSY AND PLEURAL DRAINAGE PROCEDURES
|
Facility
|
OP
|
$217.81
|
|
|
Service Code
|
EAPG 00068
|
| Min. Negotiated Rate |
$209.43 |
| Max. Negotiated Rate |
$217.81 |
| Rate for Payer: Anthem Medicaid |
$209.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$209.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$209.43
|
| Rate for Payer: Dean Health Medicaid |
$209.43
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$209.43
|
| Rate for Payer: Managed Health Services Medicaid |
$217.81
|
| Rate for Payer: Molina Healthcare Medicaid |
$209.43
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$209.43
|
| Rate for Payer: United Healthcare Medicaid |
$209.43
|
|
|
Thoracentesis w/Imag 32555
|
Professional
|
Both
|
$1,860.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
3157536
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$91.77 |
| Max. Negotiated Rate |
$1,837.68 |
| Rate for Payer: Aetna Commercial |
$1,837.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,663.58
|
| Rate for Payer: Aetna Managed Medicare |
$91.77
|
| Rate for Payer: Anthem Medicare Advantage |
$91.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$91.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$91.77
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Cigna Commercial |
$1,837.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$94.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$91.77
|
| Rate for Payer: Health EOS Commercial |
$1,760.30
|
| Rate for Payer: HFN Commercial |
$1,837.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$388.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$388.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$91.77
|
| Rate for Payer: Multiplan Commercial |
$1,547.52
|
| Rate for Payer: NAPHCARE Commercial |
$137.65
|
| Rate for Payer: Preferred Network Access Commercial |
$1,837.68
|
| Rate for Payer: Quartz Beloit One Network |
$851.14
|
| Rate for Payer: Quartz Commercial |
$1,102.61
|
| Rate for Payer: Quartz Medicare Advantage |
$91.77
|
| Rate for Payer: The Alliance Commercial |
$390.02
|
| Rate for Payer: United Healthcare Medicaid |
$94.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.77
|
| Rate for Payer: WEA Trust Commercial |
$1,063.92
|
| Rate for Payer: WPS Commercial |
$412.96
|
|
|
Thoracentesis w/Imaging
|
Facility
|
OP
|
$2,361.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
5605764
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.04 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$2,209.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,111.68
|
| Rate for Payer: Aetna Managed Medicare |
$660.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,596.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,227.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,178.61
|
| Rate for Payer: Anthem Medicare Advantage |
$660.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,301.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$660.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$660.17
|
| Rate for Payer: Cash Price |
$708.30
|
| Rate for Payer: Cash Price |
$708.30
|
| Rate for Payer: Cash Price |
$708.30
|
| Rate for Payer: Cigna Commercial |
$2,259.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$660.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$660.17
|
| Rate for Payer: Health EOS Commercial |
$2,185.34
|
| Rate for Payer: HFN Commercial |
$2,259.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,455.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$660.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$660.17
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$660.17
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$660.17
|
| Rate for Payer: Multiplan Commercial |
$1,964.35
|
| Rate for Payer: NAPHCARE Commercial |
$990.26
|
| Rate for Payer: Preferred Network Access Commercial |
$2,259.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,203.17
|
| Rate for Payer: Quartz Commercial |
$1,596.04
|
| Rate for Payer: Quartz Medicare Advantage |
$660.17
|
| Rate for Payer: The Alliance Commercial |
$2,640.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$660.17
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$1,350.49
|
| Rate for Payer: Wellcare Medicare |
$660.17
|
| Rate for Payer: WPS Commercial |
$1,818.68
|
|
|
Thoracentesis w/Imaging
|
Facility
|
IP
|
$2,361.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
5605764
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,203.17 |
| Max. Negotiated Rate |
$2,259.00 |
| Rate for Payer: Aetna Commercial |
$2,209.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,111.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,301.38
|
| Rate for Payer: Cash Price |
$708.30
|
| Rate for Payer: Cigna Commercial |
$2,259.00
|
| Rate for Payer: Health EOS Commercial |
$2,185.34
|
| Rate for Payer: HFN Commercial |
$2,259.00
|
| Rate for Payer: Multiplan Commercial |
$1,964.35
|
| Rate for Payer: Preferred Network Access Commercial |
$2,259.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,203.17
|
| Rate for Payer: Quartz Commercial |
$1,473.26
|
| Rate for Payer: WEA Trust Commercial |
$1,350.49
|
| Rate for Payer: WPS Commercial |
$1,818.68
|
|
|
Thoracentesis w/o Img 32554
|
Professional
|
Both
|
$1,579.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
3127501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$76.71 |
| Max. Negotiated Rate |
$1,560.05 |
| Rate for Payer: Aetna Commercial |
$1,560.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,412.26
|
| Rate for Payer: Aetna Managed Medicare |
$76.71
|
| Rate for Payer: Anthem Medicare Advantage |
$76.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$76.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$76.71
|
| Rate for Payer: Cash Price |
$473.70
|
| Rate for Payer: Cash Price |
$473.70
|
| Rate for Payer: Cash Price |
$473.70
|
| Rate for Payer: Cigna Commercial |
$1,560.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$94.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$76.71
|
| Rate for Payer: Health EOS Commercial |
$1,494.37
|
| Rate for Payer: HFN Commercial |
$1,560.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$312.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$312.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$76.71
|
| Rate for Payer: Multiplan Commercial |
$1,313.73
|
| Rate for Payer: NAPHCARE Commercial |
$115.07
|
| Rate for Payer: Preferred Network Access Commercial |
$1,560.05
|
| Rate for Payer: Quartz Beloit One Network |
$722.55
|
| Rate for Payer: Quartz Commercial |
$936.03
|
| Rate for Payer: Quartz Medicare Advantage |
$76.71
|
| Rate for Payer: The Alliance Commercial |
$326.02
|
| Rate for Payer: United Healthcare Medicaid |
$94.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$76.71
|
| Rate for Payer: WEA Trust Commercial |
$903.19
|
| Rate for Payer: WPS Commercial |
$345.20
|
|
|
Thoracic Gas Volume - Pulmonary Function Test Charge
|
Facility
|
OP
|
$944.00
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
3006991
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$392.70 |
| Max. Negotiated Rate |
$1,570.82 |
| Rate for Payer: Aetna Commercial |
$883.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$844.31
|
| Rate for Payer: Aetna Managed Medicare |
$392.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$638.14
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$490.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$471.24
|
| Rate for Payer: Anthem Medicare Advantage |
$392.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$520.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$392.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$392.70
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cigna Commercial |
$903.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$392.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$549.41
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$392.70
|
| Rate for Payer: Health EOS Commercial |
$873.77
|
| Rate for Payer: HFN Commercial |
$903.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,460.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$392.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$392.70
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$392.70
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$392.70
|
| Rate for Payer: Multiplan Commercial |
$785.41
|
| Rate for Payer: NAPHCARE Commercial |
$589.06
|
| Rate for Payer: Preferred Network Access Commercial |
$903.22
|
| Rate for Payer: Quartz Beloit One Network |
$481.06
|
| Rate for Payer: Quartz Commercial |
$638.14
|
| Rate for Payer: Quartz Medicare Advantage |
$392.70
|
| Rate for Payer: The Alliance Commercial |
$1,570.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$392.70
|
| Rate for Payer: United Healthcare PPO |
$736.32
|
| Rate for Payer: WEA Trust Commercial |
$539.97
|
| Rate for Payer: Wellcare Medicare |
$392.70
|
| Rate for Payer: WPS Commercial |
$727.16
|
|
