|
THYROID DISORDERS
|
Facility
|
IP
|
$4,822.57
|
|
|
Service Code
|
APR-DRG 4271
|
| Min. Negotiated Rate |
$4,283.71 |
| Max. Negotiated Rate |
$4,822.57 |
| Rate for Payer: Anthem Medicaid |
$4,617.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,617.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,617.88
|
| Rate for Payer: Dean Health Medicaid |
$4,617.88
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,283.71
|
| Rate for Payer: Managed Health Services Medicaid |
$4,822.57
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,617.88
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,617.88
|
| Rate for Payer: United Healthcare Medicaid |
$4,617.88
|
|
|
THYROID DISORDERS
|
Facility
|
IP
|
$10,609.66
|
|
|
Service Code
|
APR-DRG 4273
|
| Min. Negotiated Rate |
$9,424.16 |
| Max. Negotiated Rate |
$10,609.66 |
| Rate for Payer: Anthem Medicaid |
$10,159.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$10,159.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10,159.33
|
| Rate for Payer: Dean Health Medicaid |
$10,159.33
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9,424.16
|
| Rate for Payer: Managed Health Services Medicaid |
$10,609.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,159.33
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10,159.33
|
| Rate for Payer: United Healthcare Medicaid |
$10,159.33
|
|
|
THYROID DISORDERS
|
Facility
|
IP
|
$19,114.92
|
|
|
Service Code
|
APR-DRG 4274
|
| Min. Negotiated Rate |
$16,979.06 |
| Max. Negotiated Rate |
$19,114.92 |
| Rate for Payer: Anthem Medicaid |
$18,303.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$18,303.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18,303.59
|
| Rate for Payer: Dean Health Medicaid |
$18,303.59
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,979.06
|
| Rate for Payer: Managed Health Services Medicaid |
$19,114.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$18,303.59
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$18,303.59
|
| Rate for Payer: United Healthcare Medicaid |
$18,303.59
|
|
|
THYROID DISORDERS
|
Facility
|
IP
|
$6,488.55
|
|
|
Service Code
|
APR-DRG 4272
|
| Min. Negotiated Rate |
$5,763.53 |
| Max. Negotiated Rate |
$6,488.55 |
| Rate for Payer: Anthem Medicaid |
$6,213.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,213.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,213.14
|
| Rate for Payer: Dean Health Medicaid |
$6,213.14
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5,763.53
|
| Rate for Payer: Managed Health Services Medicaid |
$6,488.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,213.14
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,213.14
|
| Rate for Payer: United Healthcare Medicaid |
$6,213.14
|
|
|
THYROIDECTOMY/PARATHRYOIDECTOMY/THYROIDOPLASTY
|
Facility
|
IP
|
$4,238.00
|
|
| Hospital Charge Code |
2960435
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,159.68 |
| Max. Negotiated Rate |
$4,054.92 |
| Rate for Payer: Aetna Commercial |
$3,966.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,790.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,335.99
|
| Rate for Payer: Cash Price |
$1,271.40
|
| Rate for Payer: Cigna Commercial |
$4,054.92
|
| Rate for Payer: Health EOS Commercial |
$3,922.69
|
| Rate for Payer: HFN Commercial |
$4,054.92
|
| Rate for Payer: Multiplan Commercial |
$3,526.02
|
| Rate for Payer: Preferred Network Access Commercial |
$4,054.92
|
| Rate for Payer: Quartz Beloit One Network |
$2,159.68
|
| Rate for Payer: Quartz Commercial |
$2,644.51
|
| Rate for Payer: WEA Trust Commercial |
$2,424.14
|
| Rate for Payer: WPS Commercial |
$3,264.53
|
|
|
THYROIDECTOMY/PARATHRYOIDECTOMY/THYROIDOPLASTY
|
Facility
|
OP
|
$4,238.00
|
|
| Hospital Charge Code |
2960435
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,234.11 |
| Max. Negotiated Rate |
$4,054.92 |
| Rate for Payer: Aetna Commercial |
$3,966.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,790.47
|
| Rate for Payer: Aetna Managed Medicare |
$1,234.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,864.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,203.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,115.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,335.99
|
| Rate for Payer: Cash Price |
$1,271.40
|
| Rate for Payer: Cigna Commercial |
$4,054.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,466.52
|
| Rate for Payer: Health EOS Commercial |
$3,922.69
|
| Rate for Payer: HFN Commercial |
$4,054.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,305.64
|
| Rate for Payer: Multiplan Commercial |
$3,526.02
|
| Rate for Payer: NAPHCARE Commercial |
$2,644.51
|
| Rate for Payer: Preferred Network Access Commercial |
$4,054.92
|
| Rate for Payer: Quartz Beloit One Network |
$2,159.68
|
| Rate for Payer: Quartz Commercial |
$2,864.89
|
| Rate for Payer: Quartz Medicare Advantage |
$2,644.51
|
| Rate for Payer: The Alliance Commercial |
$2,203.76
|
| Rate for Payer: WEA Trust Commercial |
$2,424.14
|
| Rate for Payer: WPS Commercial |
$3,264.53
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$39,545.08
|
|
|
Service Code
|
APR-DRG 4044
|
| Min. Negotiated Rate |
$35,126.41 |
| Max. Negotiated Rate |
$39,545.08 |
| Rate for Payer: Anthem Medicaid |
$37,866.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$37,866.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$37,866.59
|
| Rate for Payer: Dean Health Medicaid |
$37,866.59
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$35,126.41
|
| Rate for Payer: Managed Health Services Medicaid |
$39,545.08
|
| Rate for Payer: Molina Healthcare Medicaid |
$37,866.59
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$37,866.59
|
| Rate for Payer: United Healthcare Medicaid |
$37,866.59
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$13,853.93
|
|
|
Service Code
|
APR-DRG 4042
|
| Min. Negotiated Rate |
$12,305.92 |
| Max. Negotiated Rate |
$13,853.93 |
| Rate for Payer: Anthem Medicaid |
$13,265.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$13,265.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13,265.90
|
| Rate for Payer: Dean Health Medicaid |
$13,265.90
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$12,305.92
|
| Rate for Payer: Managed Health Services Medicaid |
$13,853.93
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,265.90
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$13,265.90
|
| Rate for Payer: United Healthcare Medicaid |
$13,265.90
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$22,885.29
|
|
|
Service Code
|
APR-DRG 4043
|
| Min. Negotiated Rate |
$20,328.14 |
| Max. Negotiated Rate |
$22,885.29 |
| Rate for Payer: Anthem Medicaid |
$21,913.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$21,913.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21,913.93
|
| Rate for Payer: Dean Health Medicaid |
$21,913.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$20,328.14
|
| Rate for Payer: Managed Health Services Medicaid |
$22,885.29
|
| Rate for Payer: Molina Healthcare Medicaid |
$21,913.93
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$21,913.93
|
| Rate for Payer: United Healthcare Medicaid |
$21,913.93
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$9,820.51
|
|
|
Service Code
|
APR-DRG 4041
|
| Min. Negotiated Rate |
$8,723.19 |
| Max. Negotiated Rate |
$9,820.51 |
| Rate for Payer: Anthem Medicaid |
$9,403.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$9,403.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9,403.68
|
| Rate for Payer: Dean Health Medicaid |
$9,403.68
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8,723.19
|
| Rate for Payer: Managed Health Services Medicaid |
$9,820.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,403.68
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$9,403.68
|
| Rate for Payer: United Healthcare Medicaid |
$9,403.68
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC
|
Facility
|
IP
|
$41,583.36
|
|
|
Service Code
|
MSDRG 626
|
| Min. Negotiated Rate |
$11,989.47 |
| Max. Negotiated Rate |
$41,583.36 |
| Rate for Payer: Aetna Managed Medicare |
$11,989.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$32,715.71
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25,076.33
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23,824.15
|
| Rate for Payer: Anthem Medicare Advantage |
$11,989.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11,989.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11,989.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11,989.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$26,446.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11,989.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30,255.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11,989.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11,989.47
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11,989.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11,989.47
|
| Rate for Payer: NAPHCARE Commercial |
$17,984.21
|
| Rate for Payer: Quartz Medicare Advantage |
$11,989.47
|
| Rate for Payer: The Alliance Commercial |
$41,583.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,989.47
|
| Rate for Payer: United Healthcare PPO |
$23,554.47
|
| Rate for Payer: Wellcare Medicare |
$11,989.47
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$81,102.32
|
|
|
Service Code
|
MSDRG 625
|
| Min. Negotiated Rate |
$23,635.30 |
| Max. Negotiated Rate |
$81,102.32 |
| Rate for Payer: Aetna Managed Medicare |
$23,635.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$65,896.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$50,508.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$47,986.73
|
| Rate for Payer: Anthem Medicare Advantage |
$23,635.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23,635.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23,635.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23,635.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$53,269.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23,635.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$59,241.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23,635.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23,635.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23,635.30
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23,635.30
|
| Rate for Payer: NAPHCARE Commercial |
$35,452.95
|
| Rate for Payer: Quartz Medicare Advantage |
$23,635.30
|
| Rate for Payer: The Alliance Commercial |
$81,102.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,635.30
|
| Rate for Payer: United Healthcare PPO |
$46,120.61
|
| Rate for Payer: Wellcare Medicare |
$23,635.30
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$34,508.24
|
|
|
Service Code
|
MSDRG 627
|
| Min. Negotiated Rate |
$10,679.16 |
| Max. Negotiated Rate |
$34,508.24 |
| Rate for Payer: Aetna Managed Medicare |
$10,679.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$28,982.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22,214.81
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21,105.52
|
| Rate for Payer: Anthem Medicare Advantage |
$10,679.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,679.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,679.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,679.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23,429.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,679.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25,066.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,679.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,679.16
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,679.16
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,679.16
|
| Rate for Payer: NAPHCARE Commercial |
$16,018.74
|
| Rate for Payer: Quartz Medicare Advantage |
$10,679.16
|
| Rate for Payer: The Alliance Commercial |
$34,508.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,679.16
|
| Rate for Payer: United Healthcare PPO |
$19,514.27
|
| Rate for Payer: Wellcare Medicare |
$10,679.16
|
|
|
Thyroid Peroxidase Antibody
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
3899562
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.29 |
| Max. Negotiated Rate |
$28.70 |
| Rate for Payer: Aetna Commercial |
$28.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$26.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$16.54
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$28.70
|
| Rate for Payer: Health EOS Commercial |
$27.77
|
| Rate for Payer: HFN Commercial |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$24.96
|
| Rate for Payer: Preferred Network Access Commercial |
$28.70
|
| Rate for Payer: Quartz Beloit One Network |
$15.29
|
| Rate for Payer: Quartz Commercial |
$18.72
|
| Rate for Payer: WEA Trust Commercial |
$17.16
|
| Rate for Payer: WPS Commercial |
$23.11
|
|
|
Thyroid Peroxidase Antibody
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
983424
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$189.70 |
| Rate for Payer: Aetna Commercial |
$189.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$171.72
|
| Rate for Payer: Aetna Managed Medicare |
$15.13
|
| Rate for Payer: Anthem Medicare Advantage |
$15.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.13
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cigna Commercial |
$189.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$99.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.13
|
| Rate for Payer: Health EOS Commercial |
$181.71
|
| Rate for Payer: HFN Commercial |
$189.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.41
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.13
|
| Rate for Payer: Multiplan Commercial |
$159.74
|
| Rate for Payer: NAPHCARE Commercial |
$22.70
|
| Rate for Payer: Preferred Network Access Commercial |
$189.70
|
| Rate for Payer: Quartz Beloit One Network |
$87.86
|
| Rate for Payer: Quartz Commercial |
$113.82
|
| Rate for Payer: Quartz Medicare Advantage |
$15.13
|
| Rate for Payer: The Alliance Commercial |
$59.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.13
|
| Rate for Payer: WEA Trust Commercial |
$109.82
|
| Rate for Payer: WPS Commercial |
$66.58
|
|
|
Thyroid Peroxidase Antibody
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
983424
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$183.71 |
| Rate for Payer: Aetna Commercial |
$179.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$171.72
|
| Rate for Payer: Aetna Managed Medicare |
$15.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.12
|
| Rate for Payer: Anthem Medicare Advantage |
$15.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$105.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.13
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cigna Commercial |
$183.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$111.74
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.13
|
| Rate for Payer: Health EOS Commercial |
$177.72
|
| Rate for Payer: HFN Commercial |
$183.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$56.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.13
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.13
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.13
|
| Rate for Payer: Multiplan Commercial |
$159.74
|
| Rate for Payer: NAPHCARE Commercial |
$22.70
|
| Rate for Payer: Preferred Network Access Commercial |
$183.71
|
| Rate for Payer: Quartz Beloit One Network |
$97.84
|
| Rate for Payer: Quartz Commercial |
$129.79
|
| Rate for Payer: Quartz Medicare Advantage |
$15.13
|
| Rate for Payer: The Alliance Commercial |
$60.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.13
|
| Rate for Payer: United Healthcare PPO |
$149.76
|
| Rate for Payer: WEA Trust Commercial |
$109.82
|
| Rate for Payer: Wellcare Medicare |
$15.13
|
| Rate for Payer: WPS Commercial |
$147.90
|
|
|
Thyroid Peroxidase Antibody
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
3899562
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.73 |
| Max. Negotiated Rate |
$66.58 |
| Rate for Payer: Aetna Commercial |
$29.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$26.83
|
| Rate for Payer: Aetna Managed Medicare |
$15.13
|
| Rate for Payer: Anthem Medicare Advantage |
$15.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.13
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$29.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$15.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.13
|
| Rate for Payer: Health EOS Commercial |
$28.39
|
| Rate for Payer: HFN Commercial |
$29.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.41
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.13
|
| Rate for Payer: Multiplan Commercial |
$24.96
|
| Rate for Payer: NAPHCARE Commercial |
$22.70
|
| Rate for Payer: Preferred Network Access Commercial |
$29.64
|
| Rate for Payer: Quartz Beloit One Network |
$13.73
|
| Rate for Payer: Quartz Commercial |
$17.78
|
| Rate for Payer: Quartz Medicare Advantage |
$15.13
|
| Rate for Payer: The Alliance Commercial |
$59.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.13
|
| Rate for Payer: WEA Trust Commercial |
$17.16
|
| Rate for Payer: WPS Commercial |
$66.58
|
|
|
Thyroid Peroxidase Antibody
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
3899562
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$60.53 |
| Rate for Payer: Aetna Commercial |
$28.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$26.83
|
| Rate for Payer: Aetna Managed Medicare |
$15.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.12
|
| Rate for Payer: Anthem Medicare Advantage |
$15.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$16.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.13
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$28.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.46
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.13
|
| Rate for Payer: Health EOS Commercial |
$27.77
|
| Rate for Payer: HFN Commercial |
$28.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$56.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.13
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.13
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.13
|
| Rate for Payer: Multiplan Commercial |
$24.96
|
| Rate for Payer: NAPHCARE Commercial |
$22.70
|
| Rate for Payer: Preferred Network Access Commercial |
$28.70
|
| Rate for Payer: Quartz Beloit One Network |
$15.29
|
| Rate for Payer: Quartz Commercial |
$20.28
|
| Rate for Payer: Quartz Medicare Advantage |
$15.13
|
| Rate for Payer: The Alliance Commercial |
$60.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.13
|
| Rate for Payer: United Healthcare PPO |
$23.40
|
| Rate for Payer: WEA Trust Commercial |
$17.16
|
| Rate for Payer: Wellcare Medicare |
$15.13
|
| Rate for Payer: WPS Commercial |
$23.11
|
|
|
Thyroid Peroxidase Antibody
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
983424
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$97.84 |
| Max. Negotiated Rate |
$183.71 |
| Rate for Payer: Aetna Commercial |
$179.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$171.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$105.83
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cigna Commercial |
$183.71
|
| Rate for Payer: Health EOS Commercial |
$177.72
|
| Rate for Payer: HFN Commercial |
$183.71
|
| Rate for Payer: Multiplan Commercial |
$159.74
|
| Rate for Payer: Preferred Network Access Commercial |
$183.71
|
| Rate for Payer: Quartz Beloit One Network |
$97.84
|
| Rate for Payer: Quartz Commercial |
$119.81
|
| Rate for Payer: WEA Trust Commercial |
$109.82
|
| Rate for Payer: WPS Commercial |
$147.90
|
|
|
Thyroid Peroxidase & Thyroglobulin Antibodies
|
Facility
|
OP
|
$49.61
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
3899560
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.45 |
| Max. Negotiated Rate |
$100.51 |
| Rate for Payer: Aetna Commercial |
$46.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$44.37
|
| Rate for Payer: Aetna Managed Medicare |
$14.45
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$33.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.35
|
| Rate for Payer: Cash Price |
$14.88
|
| Rate for Payer: Cash Price |
$14.88
|
| Rate for Payer: Cigna Commercial |
$47.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28.87
|
| Rate for Payer: Health EOS Commercial |
$45.92
|
| Rate for Payer: HFN Commercial |
$47.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$38.70
|
| Rate for Payer: Multiplan Commercial |
$41.28
|
| Rate for Payer: NAPHCARE Commercial |
$30.96
|
| Rate for Payer: Preferred Network Access Commercial |
$47.47
|
| Rate for Payer: Quartz Beloit One Network |
$25.28
|
| Rate for Payer: Quartz Commercial |
$33.54
|
| Rate for Payer: Quartz Medicare Advantage |
$30.96
|
| Rate for Payer: The Alliance Commercial |
$100.51
|
| Rate for Payer: United Healthcare PPO |
$38.70
|
| Rate for Payer: WEA Trust Commercial |
$28.38
|
| Rate for Payer: WPS Commercial |
$38.21
|
|
|
Thyroid Peroxidase & Thyroglobulin Antibodies
|
Facility
|
IP
|
$49.61
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
3899560
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.28 |
| Max. Negotiated Rate |
$47.47 |
| Rate for Payer: Aetna Commercial |
$46.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$44.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.35
|
| Rate for Payer: Cash Price |
$14.88
|
| Rate for Payer: Cigna Commercial |
$47.47
|
| Rate for Payer: Health EOS Commercial |
$45.92
|
| Rate for Payer: HFN Commercial |
$47.47
|
| Rate for Payer: Multiplan Commercial |
$41.28
|
| Rate for Payer: Preferred Network Access Commercial |
$47.47
|
| Rate for Payer: Quartz Beloit One Network |
$25.28
|
| Rate for Payer: Quartz Commercial |
$30.96
|
| Rate for Payer: WEA Trust Commercial |
$28.38
|
| Rate for Payer: WPS Commercial |
$38.21
|
|
|
Thyroid Peroxidase & Thyroglobulin Antibodies
|
Professional
|
Both
|
$49.61
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
3899560
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.70 |
| Max. Negotiated Rate |
$125.63 |
| Rate for Payer: Aetna Commercial |
$49.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$44.37
|
| Rate for Payer: Aetna Managed Medicare |
$25.13
|
| Rate for Payer: Anthem Medicare Advantage |
$25.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$25.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$25.13
|
| Rate for Payer: Cash Price |
$14.88
|
| Rate for Payer: Cash Price |
$14.88
|
| Rate for Payer: Cash Price |
$14.88
|
| Rate for Payer: Cigna Commercial |
$49.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$25.13
|
| Rate for Payer: Health EOS Commercial |
$46.95
|
| Rate for Payer: HFN Commercial |
$49.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$79.48
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$79.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$25.13
|
| Rate for Payer: Multiplan Commercial |
$41.28
|
| Rate for Payer: NAPHCARE Commercial |
$37.69
|
| Rate for Payer: Preferred Network Access Commercial |
$49.01
|
| Rate for Payer: Quartz Beloit One Network |
$22.70
|
| Rate for Payer: Quartz Commercial |
$29.41
|
| Rate for Payer: Quartz Medicare Advantage |
$25.13
|
| Rate for Payer: The Alliance Commercial |
$95.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.13
|
| Rate for Payer: WEA Trust Commercial |
$28.38
|
| Rate for Payer: WPS Commercial |
$125.63
|
|
|
Thyroid Stimulating Hormone
|
Professional
|
Both
|
$298.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
633844
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$294.42 |
| Rate for Payer: Aetna Commercial |
$294.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$266.53
|
| Rate for Payer: Aetna Managed Medicare |
$17.47
|
| Rate for Payer: Anthem Medicare Advantage |
$17.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.47
|
| Rate for Payer: Cash Price |
$89.40
|
| Rate for Payer: Cash Price |
$89.40
|
| Rate for Payer: Cigna Commercial |
$294.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$154.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.47
|
| Rate for Payer: Health EOS Commercial |
$282.03
|
| Rate for Payer: HFN Commercial |
$294.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$61.67
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.47
|
| Rate for Payer: Multiplan Commercial |
$247.94
|
| Rate for Payer: NAPHCARE Commercial |
$26.21
|
| Rate for Payer: Preferred Network Access Commercial |
$294.42
|
| Rate for Payer: Quartz Beloit One Network |
$136.36
|
| Rate for Payer: Quartz Commercial |
$176.65
|
| Rate for Payer: Quartz Medicare Advantage |
$17.47
|
| Rate for Payer: The Alliance Commercial |
$69.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.47
|
| Rate for Payer: WEA Trust Commercial |
$170.46
|
| Rate for Payer: WPS Commercial |
$76.88
|
|
|
Thyroid Stimulating Hormone
|
Facility
|
OP
|
$298.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
633844
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$285.13 |
| Rate for Payer: Aetna Commercial |
$278.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$266.53
|
| Rate for Payer: Aetna Managed Medicare |
$17.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$65.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.58
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.00
|
| Rate for Payer: Anthem Medicare Advantage |
$17.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$164.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.47
|
| Rate for Payer: Cash Price |
$89.40
|
| Rate for Payer: Cash Price |
$89.40
|
| Rate for Payer: Cigna Commercial |
$285.13
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$173.44
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.47
|
| Rate for Payer: Health EOS Commercial |
$275.83
|
| Rate for Payer: HFN Commercial |
$285.13
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.47
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.47
|
| Rate for Payer: Multiplan Commercial |
$247.94
|
| Rate for Payer: NAPHCARE Commercial |
$26.21
|
| Rate for Payer: Preferred Network Access Commercial |
$285.13
|
| Rate for Payer: Quartz Beloit One Network |
$151.86
|
| Rate for Payer: Quartz Commercial |
$201.45
|
| Rate for Payer: Quartz Medicare Advantage |
$17.47
|
| Rate for Payer: The Alliance Commercial |
$69.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.47
|
| Rate for Payer: United Healthcare PPO |
$232.44
|
| Rate for Payer: WEA Trust Commercial |
$170.46
|
| Rate for Payer: Wellcare Medicare |
$17.47
|
| Rate for Payer: WPS Commercial |
$229.55
|
|
|
Thyroid Stimulating Hormone
|
Facility
|
IP
|
$298.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
633844
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$151.86 |
| Max. Negotiated Rate |
$285.13 |
| Rate for Payer: Aetna Commercial |
$278.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$266.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$164.26
|
| Rate for Payer: Cash Price |
$89.40
|
| Rate for Payer: Cigna Commercial |
$285.13
|
| Rate for Payer: Health EOS Commercial |
$275.83
|
| Rate for Payer: HFN Commercial |
$285.13
|
| Rate for Payer: Multiplan Commercial |
$247.94
|
| Rate for Payer: Preferred Network Access Commercial |
$285.13
|
| Rate for Payer: Quartz Beloit One Network |
$151.86
|
| Rate for Payer: Quartz Commercial |
$185.95
|
| Rate for Payer: WEA Trust Commercial |
$170.46
|
| Rate for Payer: WPS Commercial |
$229.55
|
|
