|
URETHRAL STRICTURE
|
Facility
IP
|
$29,913.00
|
|
|
Service Code
|
MS-DRG 697
|
| Min. Negotiated Rate |
$10,760.17 |
| Max. Negotiated Rate |
$29,913.00 |
| Rate for Payer: Aetna Managed Medicare |
$10,760.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,287.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17,849.91
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16,958.58
|
| Rate for Payer: Anthem Medicare Advantage |
$10,760.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,760.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,760.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,760.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18,825.58
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,760.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,705.45
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,760.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,760.17
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,760.17
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,760.17
|
| Rate for Payer: NAPHCARE Commercial |
$16,140.26
|
| Rate for Payer: Quartz Medicare Advantage |
$10,760.17
|
| Rate for Payer: The Alliance Commercial |
$29,913.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,760.17
|
| Rate for Payer: United Healthcare PPO |
$16,897.97
|
| Rate for Payer: Wellcare Medicare |
$10,760.17
|
|
|
URETHROMEATOPLASTY, WITH MUCOSAL ADVANCEMENT
|
Facility
OP
|
$39,231.04
|
|
|
Service Code
|
CPT 53450
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,726.00 |
| Max. Negotiated Rate |
$39,231.04 |
| Rate for Payer: Aetna Managed Medicare |
$3,445.74
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,445.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,445.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,445.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,445.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,445.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,818.15
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,445.74
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,445.74
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,445.74
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,445.74
|
| Rate for Payer: NAPHCARE Commercial |
$5,168.61
|
| Rate for Payer: Quartz Medicare Advantage |
$3,445.74
|
| Rate for Payer: The Alliance Commercial |
$39,231.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,445.74
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$3,445.74
|
|
|
URETHROPLASTY
|
Facility
OP
|
$3,935.00
|
|
| Hospital Charge Code |
2960480
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,101.80 |
| Max. Negotiated Rate |
$15,740.00 |
| Rate for Payer: Aetna Commercial |
$3,541.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,384.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,101.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,557.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,967.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,888.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,085.55
|
| Rate for Payer: Cash Price |
$1,180.50
|
| Rate for Payer: Cigna Commercial |
$3,620.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,202.03
|
| Rate for Payer: Health EOS Commercial |
$3,502.15
|
| Rate for Payer: HFN Commercial |
$3,620.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,951.25
|
| Rate for Payer: Multiplan Commercial |
$3,148.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,361.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,620.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,928.15
|
| Rate for Payer: Quartz Commercial |
$2,557.75
|
| Rate for Payer: Quartz Medicare Advantage |
$2,361.00
|
| Rate for Payer: The Alliance Commercial |
$15,740.00
|
| Rate for Payer: WEA Trust Commercial |
$2,164.25
|
| Rate for Payer: WPS Commercial |
$2,914.65
|
|
|
URETHROPLASTY
|
Facility
IP
|
$3,935.00
|
|
| Hospital Charge Code |
2960480
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,928.15 |
| Max. Negotiated Rate |
$3,620.20 |
| Rate for Payer: Aetna Commercial |
$3,541.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,085.55
|
| Rate for Payer: Cash Price |
$1,180.50
|
| Rate for Payer: Cigna Commercial |
$3,620.20
|
| Rate for Payer: Health EOS Commercial |
$3,502.15
|
| Rate for Payer: HFN Commercial |
$3,620.20
|
| Rate for Payer: Multiplan Commercial |
$3,148.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,361.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,620.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,928.15
|
| Rate for Payer: Quartz Commercial |
$2,361.00
|
| Rate for Payer: WEA Trust Commercial |
$2,164.25
|
| Rate for Payer: WPS Commercial |
$2,914.65
|
|
|
URETHROSCOPY
|
Facility
IP
|
$4,383.00
|
|
| Hospital Charge Code |
2960481
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,147.67 |
| Max. Negotiated Rate |
$4,032.36 |
| Rate for Payer: Aetna Commercial |
$3,944.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,322.99
|
| Rate for Payer: Cash Price |
$1,314.90
|
| Rate for Payer: Cigna Commercial |
$4,032.36
|
| Rate for Payer: Health EOS Commercial |
$3,900.87
|
| Rate for Payer: HFN Commercial |
$4,032.36
|
| Rate for Payer: Multiplan Commercial |
$3,506.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,629.80
|
| Rate for Payer: Preferred Network Access Commercial |
$4,032.36
|
| Rate for Payer: Quartz Beloit One Network |
$2,147.67
|
| Rate for Payer: Quartz Commercial |
$2,629.80
|
| Rate for Payer: WEA Trust Commercial |
$2,410.65
|
| Rate for Payer: WPS Commercial |
$3,246.49
|
|
|
URETHROSCOPY
|
Facility
OP
|
$4,383.00
|
|
| Hospital Charge Code |
2960481
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,227.24 |
| Max. Negotiated Rate |
$17,532.00 |
| Rate for Payer: Aetna Commercial |
$3,944.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,769.38
|
| Rate for Payer: Aetna Managed Medicare |
$1,227.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,848.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,191.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,103.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,322.99
|
| Rate for Payer: Cash Price |
$1,314.90
|
| Rate for Payer: Cigna Commercial |
$4,032.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,452.73
|
| Rate for Payer: Health EOS Commercial |
$3,900.87
|
| Rate for Payer: HFN Commercial |
$4,032.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,287.25
|
| Rate for Payer: Multiplan Commercial |
$3,506.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,629.80
|
| Rate for Payer: Preferred Network Access Commercial |
$4,032.36
|
| Rate for Payer: Quartz Beloit One Network |
$2,147.67
|
| Rate for Payer: Quartz Commercial |
$2,848.95
|
| Rate for Payer: Quartz Medicare Advantage |
$2,629.80
|
| Rate for Payer: The Alliance Commercial |
$17,532.00
|
| Rate for Payer: WEA Trust Commercial |
$2,410.65
|
| Rate for Payer: WPS Commercial |
$3,246.49
|
|
|
URETHROTOMY
|
Facility
OP
|
$4,238.00
|
|
| Hospital Charge Code |
2960479
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,186.64 |
| Max. Negotiated Rate |
$16,952.00 |
| Rate for Payer: Aetna Commercial |
$3,814.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,644.68
|
| Rate for Payer: Aetna Managed Medicare |
$1,186.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,754.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,119.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,034.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,246.14
|
| Rate for Payer: Cash Price |
$1,271.40
|
| Rate for Payer: Cigna Commercial |
$3,898.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,371.58
|
| Rate for Payer: Health EOS Commercial |
$3,771.82
|
| Rate for Payer: HFN Commercial |
$3,898.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,178.50
|
| Rate for Payer: Multiplan Commercial |
$3,390.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,542.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,898.96
|
| Rate for Payer: Quartz Beloit One Network |
$2,076.62
|
| Rate for Payer: Quartz Commercial |
$2,754.70
|
| Rate for Payer: Quartz Medicare Advantage |
$2,542.80
|
| Rate for Payer: The Alliance Commercial |
$16,952.00
|
| Rate for Payer: WEA Trust Commercial |
$2,330.90
|
| Rate for Payer: WPS Commercial |
$3,139.09
|
|
|
URETHROTOMY
|
Facility
IP
|
$4,238.00
|
|
| Hospital Charge Code |
2960479
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,076.62 |
| Max. Negotiated Rate |
$3,898.96 |
| Rate for Payer: Aetna Commercial |
$3,814.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,246.14
|
| Rate for Payer: Cash Price |
$1,271.40
|
| Rate for Payer: Cigna Commercial |
$3,898.96
|
| Rate for Payer: Health EOS Commercial |
$3,771.82
|
| Rate for Payer: HFN Commercial |
$3,898.96
|
| Rate for Payer: Multiplan Commercial |
$3,390.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,542.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,898.96
|
| Rate for Payer: Quartz Beloit One Network |
$2,076.62
|
| Rate for Payer: Quartz Commercial |
$2,542.80
|
| Rate for Payer: WEA Trust Commercial |
$2,330.90
|
| Rate for Payer: WPS Commercial |
$3,139.09
|
|
|
Uric Acid
|
Facility
IP
|
$82.00
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
633858
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.18 |
| Max. Negotiated Rate |
$75.44 |
| Rate for Payer: Aetna Commercial |
$73.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.46
|
| Rate for Payer: Cash Price |
$24.60
|
| Rate for Payer: Cigna Commercial |
$75.44
|
| Rate for Payer: Health EOS Commercial |
$72.98
|
| Rate for Payer: HFN Commercial |
$75.44
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: NAPHCARE Commercial |
$49.20
|
| Rate for Payer: Preferred Network Access Commercial |
$75.44
|
| Rate for Payer: Quartz Beloit One Network |
$40.18
|
| Rate for Payer: Quartz Commercial |
$49.20
|
| Rate for Payer: WEA Trust Commercial |
$45.10
|
| Rate for Payer: WPS Commercial |
$60.74
|
|
|
Uric Acid
|
Professional
|
$82.00
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
633858
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$77.90 |
| Rate for Payer: Aetna Commercial |
$77.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$70.52
|
| Rate for Payer: Aetna Managed Medicare |
$4.52
|
| Rate for Payer: Anthem Medicare Advantage |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.52
|
| Rate for Payer: Cash Price |
$24.60
|
| Rate for Payer: Cash Price |
$24.60
|
| Rate for Payer: Cigna Commercial |
$77.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.52
|
| Rate for Payer: Health EOS Commercial |
$74.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.52
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Preferred Network Access Commercial |
$77.90
|
| Rate for Payer: Quartz Beloit One Network |
$36.08
|
| Rate for Payer: Quartz Commercial |
$46.74
|
| Rate for Payer: Quartz Medicare Advantage |
$4.52
|
| Rate for Payer: The Alliance Commercial |
$17.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.52
|
| Rate for Payer: WEA Trust Commercial |
$45.10
|
| Rate for Payer: WPS Commercial |
$19.89
|
|
|
Uric Acid
|
Facility
OP
|
$82.00
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
633858
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$328.00 |
| Rate for Payer: Aetna Commercial |
$73.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$70.52
|
| Rate for Payer: Aetna Managed Medicare |
$4.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$16.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.91
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7.50
|
| Rate for Payer: Anthem Medicaid |
$4.67
|
| Rate for Payer: Anthem Medicare Advantage |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.52
|
| Rate for Payer: Cash Price |
$24.60
|
| Rate for Payer: Cash Price |
$24.60
|
| Rate for Payer: Cigna Commercial |
$75.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.67
|
| Rate for Payer: Dean Health Medicaid |
$4.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.52
|
| Rate for Payer: Health EOS Commercial |
$72.98
|
| Rate for Payer: HFN Commercial |
$75.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$16.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.52
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.67
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.52
|
| Rate for Payer: Managed Health Services Medicaid |
$4.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.52
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: NAPHCARE Commercial |
$6.78
|
| Rate for Payer: Preferred Network Access Commercial |
$75.44
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.67
|
| Rate for Payer: Quartz Beloit One Network |
$40.18
|
| Rate for Payer: Quartz Commercial |
$53.30
|
| Rate for Payer: Quartz Medicare Advantage |
$4.52
|
| Rate for Payer: The Alliance Commercial |
$328.00
|
| Rate for Payer: United Healthcare Medicaid |
$4.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.52
|
| Rate for Payer: United Healthcare PPO |
$61.50
|
| Rate for Payer: WEA Trust Commercial |
$45.10
|
| Rate for Payer: Wellcare Medicare |
$4.52
|
| Rate for Payer: WMAP Medicaid |
$4.67
|
| Rate for Payer: WPS Commercial |
$60.74
|
|
|
Uric Acid 24 Hour Urine
|
Professional
|
$56.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
633859
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$53.20 |
| Rate for Payer: Aetna Commercial |
$53.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$48.16
|
| Rate for Payer: Aetna Managed Medicare |
$5.08
|
| Rate for Payer: Anthem Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.08
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$53.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$28.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.08
|
| Rate for Payer: Health EOS Commercial |
$50.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$44.80
|
| Rate for Payer: Preferred Network Access Commercial |
$53.20
|
| Rate for Payer: Quartz Beloit One Network |
$24.64
|
| Rate for Payer: Quartz Commercial |
$31.92
|
| Rate for Payer: Quartz Medicare Advantage |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$20.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: WEA Trust Commercial |
$30.80
|
| Rate for Payer: WPS Commercial |
$22.35
|
|
|
Uric Acid 24 Hour Urine
|
Facility
OP
|
$56.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
633859
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$224.00 |
| Rate for Payer: Aetna Commercial |
$50.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$48.16
|
| Rate for Payer: Aetna Managed Medicare |
$5.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.89
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.43
|
| Rate for Payer: Anthem Medicaid |
$5.25
|
| Rate for Payer: Anthem Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$29.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.08
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$51.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.25
|
| Rate for Payer: Dean Health Medicaid |
$5.25
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.08
|
| Rate for Payer: Health EOS Commercial |
$49.84
|
| Rate for Payer: HFN Commercial |
$51.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.08
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.08
|
| Rate for Payer: Managed Health Services Medicaid |
$5.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$44.80
|
| Rate for Payer: NAPHCARE Commercial |
$7.62
|
| Rate for Payer: Preferred Network Access Commercial |
$51.52
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.25
|
| Rate for Payer: Quartz Beloit One Network |
$27.44
|
| Rate for Payer: Quartz Commercial |
$36.40
|
| Rate for Payer: Quartz Medicare Advantage |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$224.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: United Healthcare PPO |
$42.00
|
| Rate for Payer: WEA Trust Commercial |
$30.80
|
| Rate for Payer: Wellcare Medicare |
$5.08
|
| Rate for Payer: WMAP Medicaid |
$5.25
|
| Rate for Payer: WPS Commercial |
$41.48
|
|
|
Uric Acid 24 Hour Urine
|
Facility
IP
|
$56.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
633859
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$51.52 |
| Rate for Payer: Aetna Commercial |
$50.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$29.68
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$51.52
|
| Rate for Payer: Health EOS Commercial |
$49.84
|
| Rate for Payer: HFN Commercial |
$51.52
|
| Rate for Payer: Multiplan Commercial |
$44.80
|
| Rate for Payer: NAPHCARE Commercial |
$33.60
|
| Rate for Payer: Preferred Network Access Commercial |
$51.52
|
| Rate for Payer: Quartz Beloit One Network |
$27.44
|
| Rate for Payer: Quartz Commercial |
$33.60
|
| Rate for Payer: WEA Trust Commercial |
$30.80
|
| Rate for Payer: WPS Commercial |
$41.48
|
|
|
Uric Acid Random Urine
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
3304823
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$16.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$15.48
|
| Rate for Payer: Aetna Managed Medicare |
$5.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.89
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.43
|
| Rate for Payer: Anthem Medicaid |
$5.25
|
| Rate for Payer: Anthem Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.08
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna Commercial |
$16.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.25
|
| Rate for Payer: Dean Health Medicaid |
$5.25
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.08
|
| Rate for Payer: Health EOS Commercial |
$16.02
|
| Rate for Payer: HFN Commercial |
$16.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.08
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.08
|
| Rate for Payer: Managed Health Services Medicaid |
$5.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: NAPHCARE Commercial |
$7.62
|
| Rate for Payer: Preferred Network Access Commercial |
$16.56
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.25
|
| Rate for Payer: Quartz Beloit One Network |
$8.82
|
| Rate for Payer: Quartz Commercial |
$11.70
|
| Rate for Payer: Quartz Medicare Advantage |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$72.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: United Healthcare PPO |
$13.50
|
| Rate for Payer: WEA Trust Commercial |
$9.90
|
| Rate for Payer: Wellcare Medicare |
$5.08
|
| Rate for Payer: WMAP Medicaid |
$5.25
|
| Rate for Payer: WPS Commercial |
$13.33
|
|
|
Uric Acid Random Urine
|
Facility
IP
|
$18.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
3304823
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$16.56 |
| Rate for Payer: Aetna Commercial |
$16.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9.54
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna Commercial |
$16.56
|
| Rate for Payer: Health EOS Commercial |
$16.02
|
| Rate for Payer: HFN Commercial |
$16.56
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: NAPHCARE Commercial |
$10.80
|
| Rate for Payer: Preferred Network Access Commercial |
$16.56
|
| Rate for Payer: Quartz Beloit One Network |
$8.82
|
| Rate for Payer: Quartz Commercial |
$10.80
|
| Rate for Payer: WEA Trust Commercial |
$9.90
|
| Rate for Payer: WPS Commercial |
$13.33
|
|
|
Uric Acid Random Urine
|
Professional
|
$18.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
3304823
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$22.35 |
| Rate for Payer: Aetna Commercial |
$17.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$15.48
|
| Rate for Payer: Aetna Managed Medicare |
$5.08
|
| Rate for Payer: Anthem Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.08
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna Commercial |
$17.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.08
|
| Rate for Payer: Health EOS Commercial |
$16.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: Preferred Network Access Commercial |
$17.10
|
| Rate for Payer: Quartz Beloit One Network |
$7.92
|
| Rate for Payer: Quartz Commercial |
$10.26
|
| Rate for Payer: Quartz Medicare Advantage |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$20.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: WEA Trust Commercial |
$9.90
|
| Rate for Payer: WPS Commercial |
$22.35
|
|
|
Uric Acid, Synovial Fluid
|
Facility
OP
|
$46.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
3154855
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$184.00 |
| Rate for Payer: Aetna Commercial |
$41.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$39.56
|
| Rate for Payer: Aetna Managed Medicare |
$5.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.89
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.43
|
| Rate for Payer: Anthem Medicaid |
$5.25
|
| Rate for Payer: Anthem Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$24.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.08
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cigna Commercial |
$42.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.25
|
| Rate for Payer: Dean Health Medicaid |
$5.25
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.08
|
| Rate for Payer: Health EOS Commercial |
$40.94
|
| Rate for Payer: HFN Commercial |
$42.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.08
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.08
|
| Rate for Payer: Managed Health Services Medicaid |
$5.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$36.80
|
| Rate for Payer: NAPHCARE Commercial |
$7.62
|
| Rate for Payer: Preferred Network Access Commercial |
$42.32
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.25
|
| Rate for Payer: Quartz Beloit One Network |
$22.54
|
| Rate for Payer: Quartz Commercial |
$29.90
|
| Rate for Payer: Quartz Medicare Advantage |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$184.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: United Healthcare PPO |
$34.50
|
| Rate for Payer: WEA Trust Commercial |
$25.30
|
| Rate for Payer: Wellcare Medicare |
$5.08
|
| Rate for Payer: WMAP Medicaid |
$5.25
|
| Rate for Payer: WPS Commercial |
$34.07
|
|
|
Uric Acid, Synovial Fluid
|
Professional
|
$46.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
3154855
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Aetna Commercial |
$43.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$39.56
|
| Rate for Payer: Aetna Managed Medicare |
$5.08
|
| Rate for Payer: Anthem Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.08
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cigna Commercial |
$43.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$23.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.08
|
| Rate for Payer: Health EOS Commercial |
$41.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$36.80
|
| Rate for Payer: Preferred Network Access Commercial |
$43.70
|
| Rate for Payer: Quartz Beloit One Network |
$20.24
|
| Rate for Payer: Quartz Commercial |
$26.22
|
| Rate for Payer: Quartz Medicare Advantage |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$20.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: WEA Trust Commercial |
$25.30
|
| Rate for Payer: WPS Commercial |
$22.35
|
|
|
Uric Acid, Synovial Fluid
|
Facility
IP
|
$46.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
3154855
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.54 |
| Max. Negotiated Rate |
$42.32 |
| Rate for Payer: Aetna Commercial |
$41.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$24.38
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cigna Commercial |
$42.32
|
| Rate for Payer: Health EOS Commercial |
$40.94
|
| Rate for Payer: HFN Commercial |
$42.32
|
| Rate for Payer: Multiplan Commercial |
$36.80
|
| Rate for Payer: NAPHCARE Commercial |
$27.60
|
| Rate for Payer: Preferred Network Access Commercial |
$42.32
|
| Rate for Payer: Quartz Beloit One Network |
$22.54
|
| Rate for Payer: Quartz Commercial |
$27.60
|
| Rate for Payer: WEA Trust Commercial |
$25.30
|
| Rate for Payer: WPS Commercial |
$34.07
|
|
|
Uric Acid, Urine
|
Facility
OP
|
$28.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
5474695
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$112.00 |
| Rate for Payer: Aetna Commercial |
$25.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$24.08
|
| Rate for Payer: Aetna Managed Medicare |
$5.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.89
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.43
|
| Rate for Payer: Anthem Medicaid |
$5.25
|
| Rate for Payer: Anthem Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.08
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cigna Commercial |
$25.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.25
|
| Rate for Payer: Dean Health Medicaid |
$5.25
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.08
|
| Rate for Payer: Health EOS Commercial |
$24.92
|
| Rate for Payer: HFN Commercial |
$25.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.08
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.08
|
| Rate for Payer: Managed Health Services Medicaid |
$5.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$22.40
|
| Rate for Payer: NAPHCARE Commercial |
$7.62
|
| Rate for Payer: Preferred Network Access Commercial |
$25.76
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.25
|
| Rate for Payer: Quartz Beloit One Network |
$13.72
|
| Rate for Payer: Quartz Commercial |
$18.20
|
| Rate for Payer: Quartz Medicare Advantage |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$112.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: United Healthcare PPO |
$21.00
|
| Rate for Payer: WEA Trust Commercial |
$15.40
|
| Rate for Payer: Wellcare Medicare |
$5.08
|
| Rate for Payer: WMAP Medicaid |
$5.25
|
| Rate for Payer: WPS Commercial |
$20.74
|
|
|
Uric Acid, Urine
|
Facility
IP
|
$28.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
5474695
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$25.76 |
| Rate for Payer: Aetna Commercial |
$25.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14.84
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cigna Commercial |
$25.76
|
| Rate for Payer: Health EOS Commercial |
$24.92
|
| Rate for Payer: HFN Commercial |
$25.76
|
| Rate for Payer: Multiplan Commercial |
$22.40
|
| Rate for Payer: NAPHCARE Commercial |
$16.80
|
| Rate for Payer: Preferred Network Access Commercial |
$25.76
|
| Rate for Payer: Quartz Beloit One Network |
$13.72
|
| Rate for Payer: Quartz Commercial |
$16.80
|
| Rate for Payer: WEA Trust Commercial |
$15.40
|
| Rate for Payer: WPS Commercial |
$20.74
|
|
|
Uric Acid, Urine
|
Professional
|
$28.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
5474695
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$26.60 |
| Rate for Payer: Aetna Commercial |
$26.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$24.08
|
| Rate for Payer: Aetna Managed Medicare |
$5.08
|
| Rate for Payer: Anthem Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.08
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cigna Commercial |
$26.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.08
|
| Rate for Payer: Health EOS Commercial |
$25.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$22.40
|
| Rate for Payer: Preferred Network Access Commercial |
$26.60
|
| Rate for Payer: Quartz Beloit One Network |
$12.32
|
| Rate for Payer: Quartz Commercial |
$15.96
|
| Rate for Payer: Quartz Medicare Advantage |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$20.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: WEA Trust Commercial |
$15.40
|
| Rate for Payer: WPS Commercial |
$22.35
|
|
|
Urinal
|
Facility
IP
|
$1.00
|
|
| Hospital Charge Code |
3040328
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.49 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$0.53
|
| Rate for Payer: Cash Price |
$0.30
|
| Rate for Payer: Cigna Commercial |
$0.92
|
| Rate for Payer: Health EOS Commercial |
$0.89
|
| Rate for Payer: HFN Commercial |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$0.80
|
| Rate for Payer: NAPHCARE Commercial |
$0.60
|
| Rate for Payer: Preferred Network Access Commercial |
$0.92
|
| Rate for Payer: Quartz Beloit One Network |
$0.49
|
| Rate for Payer: Quartz Commercial |
$0.60
|
| Rate for Payer: WEA Trust Commercial |
$0.55
|
| Rate for Payer: WPS Commercial |
$0.74
|
|
|
Urinal
|
Facility
OP
|
$1.00
|
|
| Hospital Charge Code |
3040328
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$0.86
|
| Rate for Payer: Aetna Managed Medicare |
$0.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$0.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$0.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$0.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$0.53
|
| Rate for Payer: Cash Price |
$0.30
|
| Rate for Payer: Cigna Commercial |
$0.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$0.56
|
| Rate for Payer: Health EOS Commercial |
$0.89
|
| Rate for Payer: HFN Commercial |
$0.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$0.75
|
| Rate for Payer: Multiplan Commercial |
$0.80
|
| Rate for Payer: NAPHCARE Commercial |
$0.60
|
| Rate for Payer: Preferred Network Access Commercial |
$0.92
|
| Rate for Payer: Quartz Beloit One Network |
$0.49
|
| Rate for Payer: Quartz Commercial |
$0.65
|
| Rate for Payer: Quartz Medicare Advantage |
$0.60
|
| Rate for Payer: The Alliance Commercial |
$4.00
|
| Rate for Payer: WEA Trust Commercial |
$0.55
|
| Rate for Payer: WPS Commercial |
$0.74
|
|
