|
Urine 24 Hour Protein, Total
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
2942978
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$38.70
|
| Rate for Payer: Aetna Managed Medicare |
$3.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$13.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.42
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.09
|
| Rate for Payer: Anthem Medicaid |
$3.79
|
| Rate for Payer: Anthem Medicare Advantage |
$3.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$23.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.67
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna Commercial |
$41.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3.79
|
| Rate for Payer: Dean Health Medicaid |
$3.79
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.67
|
| Rate for Payer: Health EOS Commercial |
$40.05
|
| Rate for Payer: HFN Commercial |
$41.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.67
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$3.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.67
|
| Rate for Payer: Managed Health Services Medicaid |
$3.94
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.67
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.67
|
| Rate for Payer: Multiplan Commercial |
$36.00
|
| Rate for Payer: NAPHCARE Commercial |
$5.50
|
| Rate for Payer: Preferred Network Access Commercial |
$41.40
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$3.79
|
| Rate for Payer: Quartz Beloit One Network |
$22.05
|
| Rate for Payer: Quartz Commercial |
$29.25
|
| Rate for Payer: Quartz Medicare Advantage |
$3.67
|
| Rate for Payer: The Alliance Commercial |
$180.00
|
| Rate for Payer: United Healthcare Medicaid |
$3.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.67
|
| Rate for Payer: United Healthcare PPO |
$33.75
|
| Rate for Payer: WEA Trust Commercial |
$24.75
|
| Rate for Payer: Wellcare Medicare |
$3.67
|
| Rate for Payer: WMAP Medicaid |
$3.79
|
| Rate for Payer: WPS Commercial |
$33.33
|
|
|
Urine 24 Hour Protein, Total
|
Facility
IP
|
$45.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
2942978
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.05 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$23.85
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna Commercial |
$41.40
|
| Rate for Payer: Health EOS Commercial |
$40.05
|
| Rate for Payer: HFN Commercial |
$41.40
|
| Rate for Payer: Multiplan Commercial |
$36.00
|
| Rate for Payer: NAPHCARE Commercial |
$27.00
|
| Rate for Payer: Preferred Network Access Commercial |
$41.40
|
| Rate for Payer: Quartz Beloit One Network |
$22.05
|
| Rate for Payer: Quartz Commercial |
$27.00
|
| Rate for Payer: WEA Trust Commercial |
$24.75
|
| Rate for Payer: WPS Commercial |
$33.33
|
|
|
Urine Ammonium
|
Facility
IP
|
$131.00
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
2942998
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$64.19 |
| Max. Negotiated Rate |
$120.52 |
| Rate for Payer: Aetna Commercial |
$117.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$69.43
|
| Rate for Payer: Cash Price |
$39.30
|
| Rate for Payer: Cigna Commercial |
$120.52
|
| Rate for Payer: Health EOS Commercial |
$116.59
|
| Rate for Payer: HFN Commercial |
$120.52
|
| Rate for Payer: Multiplan Commercial |
$104.80
|
| Rate for Payer: NAPHCARE Commercial |
$78.60
|
| Rate for Payer: Preferred Network Access Commercial |
$120.52
|
| Rate for Payer: Quartz Beloit One Network |
$64.19
|
| Rate for Payer: Quartz Commercial |
$78.60
|
| Rate for Payer: WEA Trust Commercial |
$72.05
|
| Rate for Payer: WPS Commercial |
$97.03
|
|
|
Urine Ammonium
|
Professional
|
$131.00
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
2942998
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.57 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Aetna Commercial |
$124.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$112.66
|
| Rate for Payer: Aetna Managed Medicare |
$14.57
|
| Rate for Payer: Anthem Medicare Advantage |
$14.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.57
|
| Rate for Payer: Cash Price |
$39.30
|
| Rate for Payer: Cash Price |
$39.30
|
| Rate for Payer: Cigna Commercial |
$124.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$65.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.57
|
| Rate for Payer: Health EOS Commercial |
$119.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$51.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$51.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.57
|
| Rate for Payer: Multiplan Commercial |
$104.80
|
| Rate for Payer: Preferred Network Access Commercial |
$124.45
|
| Rate for Payer: Quartz Beloit One Network |
$57.64
|
| Rate for Payer: Quartz Commercial |
$74.67
|
| Rate for Payer: Quartz Medicare Advantage |
$14.57
|
| Rate for Payer: The Alliance Commercial |
$57.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.57
|
| Rate for Payer: WEA Trust Commercial |
$72.05
|
| Rate for Payer: WPS Commercial |
$64.11
|
|
|
Urine Ammonium
|
Facility
OP
|
$131.00
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
2942998
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.57 |
| Max. Negotiated Rate |
$524.00 |
| Rate for Payer: Aetna Commercial |
$117.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$112.66
|
| Rate for Payer: Aetna Managed Medicare |
$14.57
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$54.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24.19
|
| Rate for Payer: Anthem Medicaid |
$15.06
|
| Rate for Payer: Anthem Medicare Advantage |
$14.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$69.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.57
|
| Rate for Payer: Cash Price |
$39.30
|
| Rate for Payer: Cash Price |
$39.30
|
| Rate for Payer: Cigna Commercial |
$120.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$15.06
|
| Rate for Payer: Dean Health Medicaid |
$15.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.57
|
| Rate for Payer: Health EOS Commercial |
$116.59
|
| Rate for Payer: HFN Commercial |
$120.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$54.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.57
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$15.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.57
|
| Rate for Payer: Managed Health Services Medicaid |
$15.66
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.57
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.57
|
| Rate for Payer: Multiplan Commercial |
$104.80
|
| Rate for Payer: NAPHCARE Commercial |
$21.86
|
| Rate for Payer: Preferred Network Access Commercial |
$120.52
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$15.06
|
| Rate for Payer: Quartz Beloit One Network |
$64.19
|
| Rate for Payer: Quartz Commercial |
$85.15
|
| Rate for Payer: Quartz Medicare Advantage |
$14.57
|
| Rate for Payer: The Alliance Commercial |
$524.00
|
| Rate for Payer: United Healthcare Medicaid |
$15.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.57
|
| Rate for Payer: United Healthcare PPO |
$98.25
|
| Rate for Payer: WEA Trust Commercial |
$72.05
|
| Rate for Payer: Wellcare Medicare |
$14.57
|
| Rate for Payer: WMAP Medicaid |
$15.06
|
| Rate for Payer: WPS Commercial |
$97.03
|
|
|
Urine Arsenic Random
|
Professional
|
$83.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3986159
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.97 |
| Max. Negotiated Rate |
$83.47 |
| Rate for Payer: Aetna Commercial |
$78.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.38
|
| Rate for Payer: Aetna Managed Medicare |
$18.97
|
| Rate for Payer: Anthem Medicare Advantage |
$18.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.97
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$78.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18.97
|
| Rate for Payer: Health EOS Commercial |
$75.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$66.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.97
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: Preferred Network Access Commercial |
$78.85
|
| Rate for Payer: Quartz Beloit One Network |
$36.52
|
| Rate for Payer: Quartz Commercial |
$47.31
|
| Rate for Payer: Quartz Medicare Advantage |
$18.97
|
| Rate for Payer: The Alliance Commercial |
$74.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.97
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$83.47
|
|
|
Urine Arsenic Random
|
Facility
IP
|
$83.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3986159
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.67 |
| Max. Negotiated Rate |
$76.36 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.99
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$76.36
|
| Rate for Payer: Health EOS Commercial |
$73.87
|
| Rate for Payer: HFN Commercial |
$76.36
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: NAPHCARE Commercial |
$49.80
|
| Rate for Payer: Preferred Network Access Commercial |
$76.36
|
| Rate for Payer: Quartz Beloit One Network |
$40.67
|
| Rate for Payer: Quartz Commercial |
$49.80
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Urine Arsenic Random
|
Facility
OP
|
$83.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3986159
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.97 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.38
|
| Rate for Payer: Aetna Managed Medicare |
$18.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$71.14
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$33.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$31.49
|
| Rate for Payer: Anthem Medicaid |
$19.60
|
| Rate for Payer: Anthem Medicare Advantage |
$18.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.97
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$76.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19.60
|
| Rate for Payer: Dean Health Medicaid |
$19.60
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18.97
|
| Rate for Payer: Health EOS Commercial |
$73.87
|
| Rate for Payer: HFN Commercial |
$76.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$70.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.97
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$19.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.97
|
| Rate for Payer: Managed Health Services Medicaid |
$20.38
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18.97
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18.97
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: NAPHCARE Commercial |
$28.46
|
| Rate for Payer: Preferred Network Access Commercial |
$76.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19.60
|
| Rate for Payer: Quartz Beloit One Network |
$40.67
|
| Rate for Payer: Quartz Commercial |
$53.95
|
| Rate for Payer: Quartz Medicare Advantage |
$18.97
|
| Rate for Payer: The Alliance Commercial |
$332.00
|
| Rate for Payer: United Healthcare Medicaid |
$19.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.97
|
| Rate for Payer: United Healthcare PPO |
$62.25
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: Wellcare Medicare |
$18.97
|
| Rate for Payer: WMAP Medicaid |
$19.60
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Urine Cadmium Level
|
Facility
IP
|
$636.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
2942906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$311.64 |
| Max. Negotiated Rate |
$585.12 |
| Rate for Payer: Aetna Commercial |
$572.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$337.08
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cigna Commercial |
$585.12
|
| Rate for Payer: Health EOS Commercial |
$566.04
|
| Rate for Payer: HFN Commercial |
$585.12
|
| Rate for Payer: Multiplan Commercial |
$508.80
|
| Rate for Payer: NAPHCARE Commercial |
$381.60
|
| Rate for Payer: Preferred Network Access Commercial |
$585.12
|
| Rate for Payer: Quartz Beloit One Network |
$311.64
|
| Rate for Payer: Quartz Commercial |
$381.60
|
| Rate for Payer: WEA Trust Commercial |
$349.80
|
| Rate for Payer: WPS Commercial |
$471.09
|
|
|
Urine Cadmium Level
|
Professional
|
$83.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
3986166
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$104.02 |
| Rate for Payer: Aetna Commercial |
$78.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.38
|
| Rate for Payer: Aetna Managed Medicare |
$23.64
|
| Rate for Payer: Anthem Medicare Advantage |
$23.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.64
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$78.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.64
|
| Rate for Payer: Health EOS Commercial |
$75.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$83.45
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$83.45
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.64
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: Preferred Network Access Commercial |
$78.85
|
| Rate for Payer: Quartz Beloit One Network |
$36.52
|
| Rate for Payer: Quartz Commercial |
$47.31
|
| Rate for Payer: Quartz Medicare Advantage |
$23.64
|
| Rate for Payer: The Alliance Commercial |
$93.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.64
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$104.02
|
|
|
Urine Cadmium Level
|
Facility
IP
|
$83.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
3986166
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.67 |
| Max. Negotiated Rate |
$76.36 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.99
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$76.36
|
| Rate for Payer: Health EOS Commercial |
$73.87
|
| Rate for Payer: HFN Commercial |
$76.36
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: NAPHCARE Commercial |
$49.80
|
| Rate for Payer: Preferred Network Access Commercial |
$76.36
|
| Rate for Payer: Quartz Beloit One Network |
$40.67
|
| Rate for Payer: Quartz Commercial |
$49.80
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Urine Cadmium Level
|
Facility
OP
|
$636.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
2942906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$2,544.00 |
| Rate for Payer: Aetna Commercial |
$572.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$546.96
|
| Rate for Payer: Aetna Managed Medicare |
$23.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$88.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41.37
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$39.24
|
| Rate for Payer: Anthem Medicaid |
$24.43
|
| Rate for Payer: Anthem Medicare Advantage |
$23.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$337.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.64
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cigna Commercial |
$585.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$24.43
|
| Rate for Payer: Dean Health Medicaid |
$24.43
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23.64
|
| Rate for Payer: Health EOS Commercial |
$566.04
|
| Rate for Payer: HFN Commercial |
$585.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$87.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.64
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$24.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.64
|
| Rate for Payer: Managed Health Services Medicaid |
$25.41
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23.64
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23.64
|
| Rate for Payer: Multiplan Commercial |
$508.80
|
| Rate for Payer: NAPHCARE Commercial |
$35.46
|
| Rate for Payer: Preferred Network Access Commercial |
$585.12
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$24.43
|
| Rate for Payer: Quartz Beloit One Network |
$311.64
|
| Rate for Payer: Quartz Commercial |
$413.40
|
| Rate for Payer: Quartz Medicare Advantage |
$23.64
|
| Rate for Payer: The Alliance Commercial |
$2,544.00
|
| Rate for Payer: United Healthcare Medicaid |
$24.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.64
|
| Rate for Payer: United Healthcare PPO |
$477.00
|
| Rate for Payer: WEA Trust Commercial |
$349.80
|
| Rate for Payer: Wellcare Medicare |
$23.64
|
| Rate for Payer: WMAP Medicaid |
$24.43
|
| Rate for Payer: WPS Commercial |
$471.09
|
|
|
Urine Cadmium Level
|
Professional
|
$636.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
2942906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$604.20 |
| Rate for Payer: Aetna Commercial |
$604.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$546.96
|
| Rate for Payer: Aetna Managed Medicare |
$23.64
|
| Rate for Payer: Anthem Medicare Advantage |
$23.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.64
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cigna Commercial |
$604.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$318.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.64
|
| Rate for Payer: Health EOS Commercial |
$578.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$83.45
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$83.45
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.64
|
| Rate for Payer: Multiplan Commercial |
$508.80
|
| Rate for Payer: Preferred Network Access Commercial |
$604.20
|
| Rate for Payer: Quartz Beloit One Network |
$279.84
|
| Rate for Payer: Quartz Commercial |
$362.52
|
| Rate for Payer: Quartz Medicare Advantage |
$23.64
|
| Rate for Payer: The Alliance Commercial |
$93.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.64
|
| Rate for Payer: WEA Trust Commercial |
$349.80
|
| Rate for Payer: WPS Commercial |
$104.02
|
|
|
Urine Cadmium Level
|
Facility
OP
|
$83.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
3986166
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.38
|
| Rate for Payer: Aetna Managed Medicare |
$23.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$88.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41.37
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$39.24
|
| Rate for Payer: Anthem Medicaid |
$24.43
|
| Rate for Payer: Anthem Medicare Advantage |
$23.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.64
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$76.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$24.43
|
| Rate for Payer: Dean Health Medicaid |
$24.43
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23.64
|
| Rate for Payer: Health EOS Commercial |
$73.87
|
| Rate for Payer: HFN Commercial |
$76.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$87.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.64
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$24.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.64
|
| Rate for Payer: Managed Health Services Medicaid |
$25.41
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23.64
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23.64
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: NAPHCARE Commercial |
$35.46
|
| Rate for Payer: Preferred Network Access Commercial |
$76.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$24.43
|
| Rate for Payer: Quartz Beloit One Network |
$40.67
|
| Rate for Payer: Quartz Commercial |
$53.95
|
| Rate for Payer: Quartz Medicare Advantage |
$23.64
|
| Rate for Payer: The Alliance Commercial |
$332.00
|
| Rate for Payer: United Healthcare Medicaid |
$24.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.64
|
| Rate for Payer: United Healthcare PPO |
$62.25
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: Wellcare Medicare |
$23.64
|
| Rate for Payer: WMAP Medicaid |
$24.43
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Urine Calcium
|
Facility
IP
|
$21.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
3813057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.29 |
| Max. Negotiated Rate |
$19.32 |
| Rate for Payer: Aetna Commercial |
$18.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.13
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$19.32
|
| Rate for Payer: Health EOS Commercial |
$18.69
|
| Rate for Payer: HFN Commercial |
$19.32
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: NAPHCARE Commercial |
$12.60
|
| Rate for Payer: Preferred Network Access Commercial |
$19.32
|
| Rate for Payer: Quartz Beloit One Network |
$10.29
|
| Rate for Payer: Quartz Commercial |
$12.60
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: WPS Commercial |
$15.55
|
|
|
Urine Calcium
|
Professional
|
$21.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
3813057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$19.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.06
|
| Rate for Payer: Aetna Managed Medicare |
$6.03
|
| Rate for Payer: Anthem Medicare Advantage |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.03
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$19.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.03
|
| Rate for Payer: Health EOS Commercial |
$19.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.03
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: Preferred Network Access Commercial |
$19.95
|
| Rate for Payer: Quartz Beloit One Network |
$9.24
|
| Rate for Payer: Quartz Commercial |
$11.97
|
| Rate for Payer: Quartz Medicare Advantage |
$6.03
|
| Rate for Payer: The Alliance Commercial |
$23.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: WPS Commercial |
$26.53
|
|
|
Urine Calcium
|
Facility
OP
|
$21.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
3813057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna Commercial |
$18.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.06
|
| Rate for Payer: Aetna Managed Medicare |
$6.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.55
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.01
|
| Rate for Payer: Anthem Medicaid |
$6.23
|
| Rate for Payer: Anthem Medicare Advantage |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.03
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$19.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6.23
|
| Rate for Payer: Dean Health Medicaid |
$6.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.03
|
| Rate for Payer: Health EOS Commercial |
$18.69
|
| Rate for Payer: HFN Commercial |
$19.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.03
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.03
|
| Rate for Payer: Managed Health Services Medicaid |
$6.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.03
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.03
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: NAPHCARE Commercial |
$9.04
|
| Rate for Payer: Preferred Network Access Commercial |
$19.32
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6.23
|
| Rate for Payer: Quartz Beloit One Network |
$10.29
|
| Rate for Payer: Quartz Commercial |
$13.65
|
| Rate for Payer: Quartz Medicare Advantage |
$6.03
|
| Rate for Payer: The Alliance Commercial |
$84.00
|
| Rate for Payer: United Healthcare Medicaid |
$6.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: United Healthcare PPO |
$15.75
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: Wellcare Medicare |
$6.03
|
| Rate for Payer: WMAP Medicaid |
$6.23
|
| Rate for Payer: WPS Commercial |
$15.55
|
|
|
Urine Citrate
|
Facility
IP
|
$237.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
2942992
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$116.13 |
| Max. Negotiated Rate |
$218.04 |
| Rate for Payer: Aetna Commercial |
$213.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$125.61
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cigna Commercial |
$218.04
|
| Rate for Payer: Health EOS Commercial |
$210.93
|
| Rate for Payer: HFN Commercial |
$218.04
|
| Rate for Payer: Multiplan Commercial |
$189.60
|
| Rate for Payer: NAPHCARE Commercial |
$142.20
|
| Rate for Payer: Preferred Network Access Commercial |
$218.04
|
| Rate for Payer: Quartz Beloit One Network |
$116.13
|
| Rate for Payer: Quartz Commercial |
$142.20
|
| Rate for Payer: WEA Trust Commercial |
$130.35
|
| Rate for Payer: WPS Commercial |
$175.55
|
|
|
Urine Citrate
|
Facility
OP
|
$237.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
2942992
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.80 |
| Max. Negotiated Rate |
$948.00 |
| Rate for Payer: Aetna Commercial |
$213.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$203.82
|
| Rate for Payer: Aetna Managed Medicare |
$27.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$104.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$48.65
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$46.15
|
| Rate for Payer: Anthem Medicaid |
$28.73
|
| Rate for Payer: Anthem Medicare Advantage |
$27.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$125.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.80
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cigna Commercial |
$218.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$27.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$28.73
|
| Rate for Payer: Dean Health Medicaid |
$28.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$27.80
|
| Rate for Payer: Health EOS Commercial |
$210.93
|
| Rate for Payer: HFN Commercial |
$218.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$103.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$27.80
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$28.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.80
|
| Rate for Payer: Managed Health Services Medicaid |
$29.88
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$27.80
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$27.80
|
| Rate for Payer: Multiplan Commercial |
$189.60
|
| Rate for Payer: NAPHCARE Commercial |
$41.70
|
| Rate for Payer: Preferred Network Access Commercial |
$218.04
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$28.73
|
| Rate for Payer: Quartz Beloit One Network |
$116.13
|
| Rate for Payer: Quartz Commercial |
$154.05
|
| Rate for Payer: Quartz Medicare Advantage |
$27.80
|
| Rate for Payer: The Alliance Commercial |
$948.00
|
| Rate for Payer: United Healthcare Medicaid |
$28.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.80
|
| Rate for Payer: United Healthcare PPO |
$177.75
|
| Rate for Payer: WEA Trust Commercial |
$130.35
|
| Rate for Payer: Wellcare Medicare |
$27.80
|
| Rate for Payer: WMAP Medicaid |
$28.73
|
| Rate for Payer: WPS Commercial |
$175.55
|
|
|
Urine Citrate
|
Professional
|
$237.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
2942992
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.80 |
| Max. Negotiated Rate |
$225.15 |
| Rate for Payer: Aetna Commercial |
$225.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$203.82
|
| Rate for Payer: Aetna Managed Medicare |
$27.80
|
| Rate for Payer: Anthem Medicare Advantage |
$27.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.80
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cigna Commercial |
$225.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$118.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27.80
|
| Rate for Payer: Health EOS Commercial |
$215.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$98.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$98.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.80
|
| Rate for Payer: Multiplan Commercial |
$189.60
|
| Rate for Payer: Preferred Network Access Commercial |
$225.15
|
| Rate for Payer: Quartz Beloit One Network |
$104.28
|
| Rate for Payer: Quartz Commercial |
$135.09
|
| Rate for Payer: Quartz Medicare Advantage |
$27.80
|
| Rate for Payer: The Alliance Commercial |
$109.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.80
|
| Rate for Payer: WEA Trust Commercial |
$130.35
|
| Rate for Payer: WPS Commercial |
$122.32
|
|
|
Urine Citrate
|
Facility
OP
|
$21.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
3813060
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.29 |
| Max. Negotiated Rate |
$104.25 |
| Rate for Payer: Aetna Commercial |
$18.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.06
|
| Rate for Payer: Aetna Managed Medicare |
$27.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$104.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$48.65
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$46.15
|
| Rate for Payer: Anthem Medicaid |
$28.73
|
| Rate for Payer: Anthem Medicare Advantage |
$27.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.80
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$19.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$27.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$28.73
|
| Rate for Payer: Dean Health Medicaid |
$28.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$27.80
|
| Rate for Payer: Health EOS Commercial |
$18.69
|
| Rate for Payer: HFN Commercial |
$19.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$103.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$27.80
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$28.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.80
|
| Rate for Payer: Managed Health Services Medicaid |
$29.88
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$27.80
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$27.80
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: NAPHCARE Commercial |
$41.70
|
| Rate for Payer: Preferred Network Access Commercial |
$19.32
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$28.73
|
| Rate for Payer: Quartz Beloit One Network |
$10.29
|
| Rate for Payer: Quartz Commercial |
$13.65
|
| Rate for Payer: Quartz Medicare Advantage |
$27.80
|
| Rate for Payer: The Alliance Commercial |
$84.00
|
| Rate for Payer: United Healthcare Medicaid |
$28.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.80
|
| Rate for Payer: United Healthcare PPO |
$15.75
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: Wellcare Medicare |
$27.80
|
| Rate for Payer: WMAP Medicaid |
$28.73
|
| Rate for Payer: WPS Commercial |
$15.55
|
|
|
Urine Citrate
|
Facility
IP
|
$21.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
3813060
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.29 |
| Max. Negotiated Rate |
$19.32 |
| Rate for Payer: Aetna Commercial |
$18.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.13
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$19.32
|
| Rate for Payer: Health EOS Commercial |
$18.69
|
| Rate for Payer: HFN Commercial |
$19.32
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: NAPHCARE Commercial |
$12.60
|
| Rate for Payer: Preferred Network Access Commercial |
$19.32
|
| Rate for Payer: Quartz Beloit One Network |
$10.29
|
| Rate for Payer: Quartz Commercial |
$12.60
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: WPS Commercial |
$15.55
|
|
|
Urine Citrate
|
Professional
|
$21.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
3813060
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.24 |
| Max. Negotiated Rate |
$122.32 |
| Rate for Payer: Aetna Commercial |
$19.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.06
|
| Rate for Payer: Aetna Managed Medicare |
$27.80
|
| Rate for Payer: Anthem Medicare Advantage |
$27.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.80
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$19.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27.80
|
| Rate for Payer: Health EOS Commercial |
$19.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$98.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$98.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.80
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: Preferred Network Access Commercial |
$19.95
|
| Rate for Payer: Quartz Beloit One Network |
$9.24
|
| Rate for Payer: Quartz Commercial |
$11.97
|
| Rate for Payer: Quartz Medicare Advantage |
$27.80
|
| Rate for Payer: The Alliance Commercial |
$109.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.80
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: WPS Commercial |
$122.32
|
|
|
Urine Creatinine
|
Facility
IP
|
$21.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
3813067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.29 |
| Max. Negotiated Rate |
$19.32 |
| Rate for Payer: Aetna Commercial |
$18.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.13
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$19.32
|
| Rate for Payer: Health EOS Commercial |
$18.69
|
| Rate for Payer: HFN Commercial |
$19.32
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: NAPHCARE Commercial |
$12.60
|
| Rate for Payer: Preferred Network Access Commercial |
$19.32
|
| Rate for Payer: Quartz Beloit One Network |
$10.29
|
| Rate for Payer: Quartz Commercial |
$12.60
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: WPS Commercial |
$15.55
|
|
|
Urine Creatinine
|
Professional
|
$126.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
982625
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Aetna Commercial |
$119.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$108.36
|
| Rate for Payer: Aetna Managed Medicare |
$5.18
|
| Rate for Payer: Anthem Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.18
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cigna Commercial |
$119.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$63.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.18
|
| Rate for Payer: Health EOS Commercial |
$114.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.18
|
| Rate for Payer: Multiplan Commercial |
$100.80
|
| Rate for Payer: Preferred Network Access Commercial |
$119.70
|
| Rate for Payer: Quartz Beloit One Network |
$55.44
|
| Rate for Payer: Quartz Commercial |
$71.82
|
| Rate for Payer: Quartz Medicare Advantage |
$5.18
|
| Rate for Payer: The Alliance Commercial |
$20.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: WEA Trust Commercial |
$69.30
|
| Rate for Payer: WPS Commercial |
$22.79
|
|
