|
Thrombolytic Therapy Art/Vein F/U
|
Facility
|
IP
|
$7,299.00
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
3052439
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,719.57 |
| Max. Negotiated Rate |
$6,983.68 |
| Rate for Payer: Aetna Commercial |
$6,831.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,528.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,023.21
|
| Rate for Payer: Cash Price |
$2,189.70
|
| Rate for Payer: Cigna Commercial |
$6,983.68
|
| Rate for Payer: Health EOS Commercial |
$6,755.95
|
| Rate for Payer: HFN Commercial |
$6,983.68
|
| Rate for Payer: Multiplan Commercial |
$6,072.77
|
| Rate for Payer: Preferred Network Access Commercial |
$6,983.68
|
| Rate for Payer: Quartz Beloit One Network |
$3,719.57
|
| Rate for Payer: Quartz Commercial |
$4,554.58
|
| Rate for Payer: WEA Trust Commercial |
$4,175.03
|
| Rate for Payer: WPS Commercial |
$5,622.42
|
|
|
Thrombolytic Therapy Cessation
|
Facility
|
OP
|
$1,708.00
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
3052440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$870.40 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$1,598.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,527.64
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$941.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$512.40
|
| Rate for Payer: Cash Price |
$512.40
|
| Rate for Payer: Cash Price |
$512.40
|
| Rate for Payer: Cigna Commercial |
$1,634.21
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$1,580.92
|
| Rate for Payer: HFN Commercial |
$1,634.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$1,421.06
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$1,634.21
|
| Rate for Payer: Quartz Beloit One Network |
$870.40
|
| Rate for Payer: Quartz Commercial |
$1,154.61
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: WEA Trust Commercial |
$976.98
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$1,315.67
|
|
|
Thrombolytic Therapy Cessation
|
Facility
|
IP
|
$1,708.00
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
3052440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$870.40 |
| Max. Negotiated Rate |
$1,634.21 |
| Rate for Payer: Aetna Commercial |
$1,598.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,527.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$941.45
|
| Rate for Payer: Cash Price |
$512.40
|
| Rate for Payer: Cigna Commercial |
$1,634.21
|
| Rate for Payer: Health EOS Commercial |
$1,580.92
|
| Rate for Payer: HFN Commercial |
$1,634.21
|
| Rate for Payer: Multiplan Commercial |
$1,421.06
|
| Rate for Payer: Preferred Network Access Commercial |
$1,634.21
|
| Rate for Payer: Quartz Beloit One Network |
$870.40
|
| Rate for Payer: Quartz Commercial |
$1,065.79
|
| Rate for Payer: WEA Trust Commercial |
$976.98
|
| Rate for Payer: WPS Commercial |
$1,315.67
|
|
|
Thrombolytic Therapy Venous Initial
|
Facility
|
IP
|
$6,812.00
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
3052438
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,471.40 |
| Max. Negotiated Rate |
$6,517.72 |
| Rate for Payer: Aetna Commercial |
$6,376.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,092.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,754.77
|
| Rate for Payer: Cash Price |
$2,043.60
|
| Rate for Payer: Cigna Commercial |
$6,517.72
|
| Rate for Payer: Health EOS Commercial |
$6,305.19
|
| Rate for Payer: HFN Commercial |
$6,517.72
|
| Rate for Payer: Multiplan Commercial |
$5,667.58
|
| Rate for Payer: Preferred Network Access Commercial |
$6,517.72
|
| Rate for Payer: Quartz Beloit One Network |
$3,471.40
|
| Rate for Payer: Quartz Commercial |
$4,250.69
|
| Rate for Payer: WEA Trust Commercial |
$3,896.46
|
| Rate for Payer: WPS Commercial |
$5,247.28
|
|
|
Thrombolytic Therapy Venous Initial
|
Facility
|
OP
|
$6,812.00
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
3052438
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$6,376.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,092.65
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,754.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$2,043.60
|
| Rate for Payer: Cash Price |
$2,043.60
|
| Rate for Payer: Cash Price |
$2,043.60
|
| Rate for Payer: Cigna Commercial |
$6,517.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$6,305.19
|
| Rate for Payer: HFN Commercial |
$6,517.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$5,667.58
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$6,517.72
|
| Rate for Payer: Quartz Beloit One Network |
$3,471.40
|
| Rate for Payer: Quartz Commercial |
$4,604.91
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$3,896.46
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$5,247.28
|
|
|
Thromboplastin time, partial (PTT); plasma or whole blood
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 85730
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna Managed Medicare |
$6.25
|
| Rate for Payer: Anthem Medicare Advantage |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.25
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.25
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.25
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.25
|
| Rate for Payer: NAPHCARE Commercial |
$9.38
|
| Rate for Payer: Quartz Medicare Advantage |
$6.25
|
| Rate for Payer: The Alliance Commercial |
$25.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.25
|
| Rate for Payer: Wellcare Medicare |
$6.25
|
|
|
Thromboplastin time, partial (PTT); plasma or whole blood
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 85730
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna Managed Medicare |
$6.25
|
| Rate for Payer: Anthem Medicare Advantage |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.25
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.25
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.25
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.25
|
| Rate for Payer: NAPHCARE Commercial |
$9.38
|
| Rate for Payer: Quartz Medicare Advantage |
$6.25
|
| Rate for Payer: The Alliance Commercial |
$25.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.25
|
| Rate for Payer: Wellcare Medicare |
$6.25
|
|
|
Thrombosis Hypercoagulability Panel
|
Facility
|
IP
|
$323.00
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
5486694
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$164.60 |
| Max. Negotiated Rate |
$309.05 |
| Rate for Payer: Aetna Commercial |
$302.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$288.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$178.04
|
| Rate for Payer: Cash Price |
$96.90
|
| Rate for Payer: Cigna Commercial |
$309.05
|
| Rate for Payer: Health EOS Commercial |
$298.97
|
| Rate for Payer: HFN Commercial |
$309.05
|
| Rate for Payer: Multiplan Commercial |
$268.74
|
| Rate for Payer: Preferred Network Access Commercial |
$309.05
|
| Rate for Payer: Quartz Beloit One Network |
$164.60
|
| Rate for Payer: Quartz Commercial |
$201.55
|
| Rate for Payer: WEA Trust Commercial |
$184.76
|
| Rate for Payer: WPS Commercial |
$248.81
|
|
|
Thrombosis Hypercoagulability Panel
|
Professional
|
Both
|
$323.00
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
5486694
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$319.12 |
| Rate for Payer: Aetna Commercial |
$319.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$288.89
|
| Rate for Payer: Aetna Managed Medicare |
$6.25
|
| Rate for Payer: Anthem Medicare Advantage |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.25
|
| Rate for Payer: Cash Price |
$96.90
|
| Rate for Payer: Cash Price |
$96.90
|
| Rate for Payer: Cigna Commercial |
$319.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$167.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.25
|
| Rate for Payer: Health EOS Commercial |
$305.69
|
| Rate for Payer: HFN Commercial |
$319.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.25
|
| Rate for Payer: Multiplan Commercial |
$268.74
|
| Rate for Payer: NAPHCARE Commercial |
$9.38
|
| Rate for Payer: Preferred Network Access Commercial |
$319.12
|
| Rate for Payer: Quartz Beloit One Network |
$147.80
|
| Rate for Payer: Quartz Commercial |
$191.47
|
| Rate for Payer: Quartz Medicare Advantage |
$6.25
|
| Rate for Payer: The Alliance Commercial |
$24.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.25
|
| Rate for Payer: WEA Trust Commercial |
$184.76
|
| Rate for Payer: WPS Commercial |
$27.50
|
|
|
Thrombosis Hypercoagulability Panel
|
Facility
|
OP
|
$323.00
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
5486694
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$309.05 |
| Rate for Payer: Aetna Commercial |
$302.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$288.89
|
| Rate for Payer: Aetna Managed Medicare |
$6.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.94
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.38
|
| Rate for Payer: Anthem Medicare Advantage |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$178.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.25
|
| Rate for Payer: Cash Price |
$96.90
|
| Rate for Payer: Cash Price |
$96.90
|
| Rate for Payer: Cigna Commercial |
$309.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$187.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.25
|
| Rate for Payer: Health EOS Commercial |
$298.97
|
| Rate for Payer: HFN Commercial |
$309.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.25
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.25
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.25
|
| Rate for Payer: Multiplan Commercial |
$268.74
|
| Rate for Payer: NAPHCARE Commercial |
$9.38
|
| Rate for Payer: Preferred Network Access Commercial |
$309.05
|
| Rate for Payer: Quartz Beloit One Network |
$164.60
|
| Rate for Payer: Quartz Commercial |
$218.35
|
| Rate for Payer: Quartz Medicare Advantage |
$6.25
|
| Rate for Payer: The Alliance Commercial |
$25.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.25
|
| Rate for Payer: United Healthcare PPO |
$251.94
|
| Rate for Payer: WEA Trust Commercial |
$184.76
|
| Rate for Payer: Wellcare Medicare |
$6.25
|
| Rate for Payer: WPS Commercial |
$248.81
|
|
|
Thrombospondin Type 1 7A Antibodies
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
5613547
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$178.36 |
| Max. Negotiated Rate |
$334.88 |
| Rate for Payer: Aetna Commercial |
$327.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$313.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$192.92
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$334.88
|
| Rate for Payer: Health EOS Commercial |
$323.96
|
| Rate for Payer: HFN Commercial |
$334.88
|
| Rate for Payer: Multiplan Commercial |
$291.20
|
| Rate for Payer: Preferred Network Access Commercial |
$334.88
|
| Rate for Payer: Quartz Beloit One Network |
$178.36
|
| Rate for Payer: Quartz Commercial |
$218.40
|
| Rate for Payer: WEA Trust Commercial |
$200.20
|
| Rate for Payer: WPS Commercial |
$269.61
|
|
|
Thrombospondin Type 1 7A Antibodies
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
5613547
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.53 |
| Max. Negotiated Rate |
$334.88 |
| Rate for Payer: Aetna Commercial |
$327.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$313.04
|
| Rate for Payer: Aetna Managed Medicare |
$12.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$46.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21.93
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20.80
|
| Rate for Payer: Anthem Medicare Advantage |
$12.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$192.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.53
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$334.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$203.70
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.53
|
| Rate for Payer: Health EOS Commercial |
$323.96
|
| Rate for Payer: HFN Commercial |
$334.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.53
|
| Rate for Payer: Multiplan Commercial |
$291.20
|
| Rate for Payer: NAPHCARE Commercial |
$18.80
|
| Rate for Payer: Preferred Network Access Commercial |
$334.88
|
| Rate for Payer: Quartz Beloit One Network |
$178.36
|
| Rate for Payer: Quartz Commercial |
$236.60
|
| Rate for Payer: Quartz Medicare Advantage |
$12.53
|
| Rate for Payer: The Alliance Commercial |
$50.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.53
|
| Rate for Payer: United Healthcare PPO |
$273.00
|
| Rate for Payer: WEA Trust Commercial |
$200.20
|
| Rate for Payer: Wellcare Medicare |
$12.53
|
| Rate for Payer: WPS Commercial |
$269.61
|
|
|
Thrombospondin Type 1 7A Antibodies
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
5613547
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.53 |
| Max. Negotiated Rate |
$345.80 |
| Rate for Payer: Aetna Commercial |
$345.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$313.04
|
| Rate for Payer: Aetna Managed Medicare |
$12.53
|
| Rate for Payer: Anthem Commercial |
$17.27
|
| Rate for Payer: Anthem Medicare Advantage |
$12.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.53
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$345.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$182.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.53
|
| Rate for Payer: Health EOS Commercial |
$331.24
|
| Rate for Payer: HFN Commercial |
$345.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$44.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.53
|
| Rate for Payer: Multiplan Commercial |
$291.20
|
| Rate for Payer: NAPHCARE Commercial |
$18.80
|
| Rate for Payer: Preferred Network Access Commercial |
$345.80
|
| Rate for Payer: Quartz Beloit One Network |
$160.16
|
| Rate for Payer: Quartz Commercial |
$207.48
|
| Rate for Payer: Quartz Medicare Advantage |
$12.53
|
| Rate for Payer: The Alliance Commercial |
$49.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.53
|
| Rate for Payer: WEA Trust Commercial |
$200.20
|
| Rate for Payer: WPS Commercial |
$55.14
|
|
|
THUMB REPAIR, GAMEKEEPER
|
Facility
|
IP
|
$1,242.00
|
|
| Hospital Charge Code |
2960082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$632.92 |
| Max. Negotiated Rate |
$1,188.35 |
| Rate for Payer: Aetna Commercial |
$1,162.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,110.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$684.59
|
| Rate for Payer: Cash Price |
$372.60
|
| Rate for Payer: Cigna Commercial |
$1,188.35
|
| Rate for Payer: Health EOS Commercial |
$1,149.60
|
| Rate for Payer: HFN Commercial |
$1,188.35
|
| Rate for Payer: Multiplan Commercial |
$1,033.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,188.35
|
| Rate for Payer: Quartz Beloit One Network |
$632.92
|
| Rate for Payer: Quartz Commercial |
$775.01
|
| Rate for Payer: WEA Trust Commercial |
$710.42
|
| Rate for Payer: WPS Commercial |
$956.71
|
|
|
THUMB REPAIR, GAMEKEEPER
|
Facility
|
OP
|
$1,242.00
|
|
| Hospital Charge Code |
2960082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$361.67 |
| Max. Negotiated Rate |
$1,188.35 |
| Rate for Payer: Aetna Commercial |
$1,162.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,110.84
|
| Rate for Payer: Aetna Managed Medicare |
$361.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$839.59
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$645.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$620.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$684.59
|
| Rate for Payer: Cash Price |
$372.60
|
| Rate for Payer: Cigna Commercial |
$1,188.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$722.84
|
| Rate for Payer: Health EOS Commercial |
$1,149.60
|
| Rate for Payer: HFN Commercial |
$1,188.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$968.76
|
| Rate for Payer: Multiplan Commercial |
$1,033.34
|
| Rate for Payer: NAPHCARE Commercial |
$775.01
|
| Rate for Payer: Preferred Network Access Commercial |
$1,188.35
|
| Rate for Payer: Quartz Beloit One Network |
$632.92
|
| Rate for Payer: Quartz Commercial |
$839.59
|
| Rate for Payer: Quartz Medicare Advantage |
$775.01
|
| Rate for Payer: The Alliance Commercial |
$645.84
|
| Rate for Payer: WEA Trust Commercial |
$710.42
|
| Rate for Payer: WPS Commercial |
$956.71
|
|
|
THUMB SUPPORT LEFT TITAN #5547-66-01
|
Facility
|
OP
|
$468.00
|
|
| Hospital Charge Code |
2969693
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$136.28 |
| Max. Negotiated Rate |
$447.78 |
| Rate for Payer: Aetna Commercial |
$438.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$418.58
|
| Rate for Payer: Aetna Managed Medicare |
$136.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$316.37
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$243.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$233.63
|
| 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: Dean Health DHI/DHP/ASO |
$272.38
|
| Rate for Payer: Health EOS Commercial |
$433.18
|
| Rate for Payer: HFN Commercial |
$447.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$365.04
|
| Rate for Payer: Multiplan Commercial |
$389.38
|
| Rate for Payer: NAPHCARE Commercial |
$292.03
|
| Rate for Payer: Preferred Network Access Commercial |
$447.78
|
| Rate for Payer: Quartz Beloit One Network |
$238.49
|
| Rate for Payer: Quartz Commercial |
$316.37
|
| Rate for Payer: Quartz Medicare Advantage |
$292.03
|
| Rate for Payer: The Alliance Commercial |
$243.36
|
| Rate for Payer: WEA Trust Commercial |
$267.70
|
| Rate for Payer: WPS Commercial |
$360.50
|
|
|
THUMB SUPPORT LEFT TITAN #5547-66-01
|
Facility
|
IP
|
$468.00
|
|
| Hospital Charge Code |
2969693
|
|
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
|
|
|
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
|
|
|
THUMB SUPPORT TITAN (RIGHT) #5547-66-02
|
Facility
|
OP
|
$468.00
|
|
| Hospital Charge Code |
2969692
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$136.28 |
| Max. Negotiated Rate |
$447.78 |
| Rate for Payer: Aetna Commercial |
$438.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$418.58
|
| Rate for Payer: Aetna Managed Medicare |
$136.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$316.37
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$243.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$233.63
|
| 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: Dean Health DHI/DHP/ASO |
$272.38
|
| Rate for Payer: Health EOS Commercial |
$433.18
|
| Rate for Payer: HFN Commercial |
$447.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$365.04
|
| Rate for Payer: Multiplan Commercial |
$389.38
|
| Rate for Payer: NAPHCARE Commercial |
$292.03
|
| Rate for Payer: Preferred Network Access Commercial |
$447.78
|
| Rate for Payer: Quartz Beloit One Network |
$238.49
|
| Rate for Payer: Quartz Commercial |
$316.37
|
| Rate for Payer: Quartz Medicare Advantage |
$292.03
|
| Rate for Payer: The Alliance Commercial |
$243.36
|
| Rate for Payer: WEA Trust Commercial |
$267.70
|
| Rate for Payer: WPS Commercial |
$360.50
|
|
|
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
|
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 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
|
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
|
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
|
|
