|
Urine Potassium
|
Facility
IP
|
$53.00
|
|
|
Service Code
|
CPT 84133
|
| Hospital Charge Code |
2942999
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.97 |
| Max. Negotiated Rate |
$48.76 |
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$28.09
|
| Rate for Payer: Cash Price |
$15.90
|
| Rate for Payer: Cigna Commercial |
$48.76
|
| Rate for Payer: Health EOS Commercial |
$47.17
|
| Rate for Payer: HFN Commercial |
$48.76
|
| Rate for Payer: Multiplan Commercial |
$42.40
|
| Rate for Payer: NAPHCARE Commercial |
$31.80
|
| Rate for Payer: Preferred Network Access Commercial |
$48.76
|
| Rate for Payer: Quartz Beloit One Network |
$25.97
|
| Rate for Payer: Quartz Commercial |
$31.80
|
| Rate for Payer: WEA Trust Commercial |
$29.15
|
| Rate for Payer: WPS Commercial |
$39.26
|
|
|
Urine Potassium
|
Facility
OP
|
$21.00
|
|
|
Service Code
|
CPT 84133
|
| Hospital Charge Code |
3813066
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.73 |
| 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 |
$4.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7.85
|
| Rate for Payer: Anthem Medicaid |
$4.89
|
| Rate for Payer: Anthem Medicare Advantage |
$4.73
|
| 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 |
$4.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.73
|
| 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 |
$4.73
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.89
|
| Rate for Payer: Dean Health Medicaid |
$4.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.73
|
| Rate for Payer: Health EOS Commercial |
$18.69
|
| Rate for Payer: HFN Commercial |
$19.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.73
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.73
|
| Rate for Payer: Managed Health Services Medicaid |
$5.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.73
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.73
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: NAPHCARE Commercial |
$7.10
|
| Rate for Payer: Preferred Network Access Commercial |
$19.32
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.89
|
| Rate for Payer: Quartz Beloit One Network |
$10.29
|
| Rate for Payer: Quartz Commercial |
$13.65
|
| Rate for Payer: Quartz Medicare Advantage |
$4.73
|
| Rate for Payer: The Alliance Commercial |
$84.00
|
| Rate for Payer: United Healthcare Medicaid |
$4.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.73
|
| Rate for Payer: United Healthcare PPO |
$15.75
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: Wellcare Medicare |
$4.73
|
| Rate for Payer: WMAP Medicaid |
$4.89
|
| Rate for Payer: WPS Commercial |
$15.55
|
|
|
Urine Pregnancy Test POC
|
Facility
OP
|
$168.00
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
3996783
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$672.00 |
| Rate for Payer: Aetna Commercial |
$151.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$144.48
|
| Rate for Payer: Aetna Managed Medicare |
$8.61
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$32.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15.07
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14.29
|
| Rate for Payer: Anthem Medicaid |
$8.90
|
| Rate for Payer: Anthem Medicare Advantage |
$8.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$89.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.61
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna Commercial |
$154.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.90
|
| Rate for Payer: Dean Health Medicaid |
$8.90
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8.61
|
| Rate for Payer: Health EOS Commercial |
$149.52
|
| Rate for Payer: HFN Commercial |
$154.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.61
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.61
|
| Rate for Payer: Managed Health Services Medicaid |
$9.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8.61
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8.61
|
| Rate for Payer: Multiplan Commercial |
$134.40
|
| Rate for Payer: NAPHCARE Commercial |
$12.92
|
| Rate for Payer: Preferred Network Access Commercial |
$154.56
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.90
|
| Rate for Payer: Quartz Beloit One Network |
$82.32
|
| Rate for Payer: Quartz Commercial |
$109.20
|
| Rate for Payer: Quartz Medicare Advantage |
$8.61
|
| Rate for Payer: The Alliance Commercial |
$672.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.61
|
| Rate for Payer: United Healthcare PPO |
$126.00
|
| Rate for Payer: WEA Trust Commercial |
$92.40
|
| Rate for Payer: Wellcare Medicare |
$8.61
|
| Rate for Payer: WMAP Medicaid |
$8.90
|
| Rate for Payer: WPS Commercial |
$124.44
|
|
|
Urine Pregnancy Test POC
|
Facility
IP
|
$168.00
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
3996783
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$82.32 |
| Max. Negotiated Rate |
$154.56 |
| Rate for Payer: Aetna Commercial |
$151.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$89.04
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna Commercial |
$154.56
|
| Rate for Payer: Health EOS Commercial |
$149.52
|
| Rate for Payer: HFN Commercial |
$154.56
|
| Rate for Payer: Multiplan Commercial |
$134.40
|
| Rate for Payer: NAPHCARE Commercial |
$100.80
|
| Rate for Payer: Preferred Network Access Commercial |
$154.56
|
| Rate for Payer: Quartz Beloit One Network |
$82.32
|
| Rate for Payer: Quartz Commercial |
$100.80
|
| Rate for Payer: WEA Trust Commercial |
$92.40
|
| Rate for Payer: WPS Commercial |
$124.44
|
|
|
Urine Pregnancy Test POC
|
Professional
|
$168.00
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
3996783
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$159.60 |
| Rate for Payer: Aetna Commercial |
$159.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$144.48
|
| Rate for Payer: Aetna Managed Medicare |
$8.61
|
| Rate for Payer: Anthem Medicare Advantage |
$8.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.61
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna Commercial |
$159.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$84.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.61
|
| Rate for Payer: Health EOS Commercial |
$152.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.61
|
| Rate for Payer: Multiplan Commercial |
$134.40
|
| Rate for Payer: Preferred Network Access Commercial |
$159.60
|
| Rate for Payer: Quartz Beloit One Network |
$73.92
|
| Rate for Payer: Quartz Commercial |
$95.76
|
| Rate for Payer: Quartz Medicare Advantage |
$8.61
|
| Rate for Payer: The Alliance Commercial |
$34.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.61
|
| Rate for Payer: WEA Trust Commercial |
$92.40
|
| Rate for Payer: WPS Commercial |
$37.88
|
|
|
Urine Protein
|
Professional
|
$77.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
982777
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$73.15 |
| Rate for Payer: Aetna Commercial |
$73.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.22
|
| Rate for Payer: Aetna Managed Medicare |
$3.67
|
| Rate for Payer: Anthem Medicare Advantage |
$3.67
|
| 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 |
$23.10
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Cigna Commercial |
$73.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$38.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3.67
|
| Rate for Payer: Health EOS Commercial |
$70.07
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.67
|
| Rate for Payer: Multiplan Commercial |
$61.60
|
| Rate for Payer: Preferred Network Access Commercial |
$73.15
|
| Rate for Payer: Quartz Beloit One Network |
$33.88
|
| Rate for Payer: Quartz Commercial |
$43.89
|
| Rate for Payer: Quartz Medicare Advantage |
$3.67
|
| Rate for Payer: The Alliance Commercial |
$14.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.67
|
| Rate for Payer: WEA Trust Commercial |
$42.35
|
| Rate for Payer: WPS Commercial |
$16.15
|
|
|
Urine Protein
|
Facility
IP
|
$77.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
982777
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.73 |
| Max. Negotiated Rate |
$70.84 |
| Rate for Payer: Aetna Commercial |
$69.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$40.81
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Cigna Commercial |
$70.84
|
| Rate for Payer: Health EOS Commercial |
$68.53
|
| Rate for Payer: HFN Commercial |
$70.84
|
| Rate for Payer: Multiplan Commercial |
$61.60
|
| Rate for Payer: NAPHCARE Commercial |
$46.20
|
| Rate for Payer: Preferred Network Access Commercial |
$70.84
|
| Rate for Payer: Quartz Beloit One Network |
$37.73
|
| Rate for Payer: Quartz Commercial |
$46.20
|
| Rate for Payer: WEA Trust Commercial |
$42.35
|
| Rate for Payer: WPS Commercial |
$57.03
|
|
|
Urine Protein
|
Facility
OP
|
$52.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
3119373
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$208.00 |
| Rate for Payer: Aetna Commercial |
$46.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$44.72
|
| 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 |
$27.56
|
| 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 |
$15.60
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cigna Commercial |
$47.84
|
| 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 |
$46.28
|
| Rate for Payer: HFN Commercial |
$47.84
|
| 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 |
$41.60
|
| Rate for Payer: NAPHCARE Commercial |
$5.50
|
| Rate for Payer: Preferred Network Access Commercial |
$47.84
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$3.79
|
| Rate for Payer: Quartz Beloit One Network |
$25.48
|
| Rate for Payer: Quartz Commercial |
$33.80
|
| Rate for Payer: Quartz Medicare Advantage |
$3.67
|
| Rate for Payer: The Alliance Commercial |
$208.00
|
| Rate for Payer: United Healthcare Medicaid |
$3.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.67
|
| Rate for Payer: United Healthcare PPO |
$39.00
|
| Rate for Payer: WEA Trust Commercial |
$28.60
|
| Rate for Payer: Wellcare Medicare |
$3.67
|
| Rate for Payer: WMAP Medicaid |
$3.79
|
| Rate for Payer: WPS Commercial |
$38.52
|
|
|
Urine Protein
|
Facility
IP
|
$52.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
3119373
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.48 |
| Max. Negotiated Rate |
$47.84 |
| Rate for Payer: Aetna Commercial |
$46.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.56
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cigna Commercial |
$47.84
|
| Rate for Payer: Health EOS Commercial |
$46.28
|
| Rate for Payer: HFN Commercial |
$47.84
|
| Rate for Payer: Multiplan Commercial |
$41.60
|
| Rate for Payer: NAPHCARE Commercial |
$31.20
|
| Rate for Payer: Preferred Network Access Commercial |
$47.84
|
| Rate for Payer: Quartz Beloit One Network |
$25.48
|
| Rate for Payer: Quartz Commercial |
$31.20
|
| Rate for Payer: WEA Trust Commercial |
$28.60
|
| Rate for Payer: WPS Commercial |
$38.52
|
|
|
Urine Protein
|
Facility
OP
|
$77.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
982777
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$308.00 |
| Rate for Payer: Aetna Commercial |
$69.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.22
|
| 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 |
$40.81
|
| 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 |
$23.10
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Cigna Commercial |
$70.84
|
| 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 |
$68.53
|
| Rate for Payer: HFN Commercial |
$70.84
|
| 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 |
$61.60
|
| Rate for Payer: NAPHCARE Commercial |
$5.50
|
| Rate for Payer: Preferred Network Access Commercial |
$70.84
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$3.79
|
| Rate for Payer: Quartz Beloit One Network |
$37.73
|
| Rate for Payer: Quartz Commercial |
$50.05
|
| Rate for Payer: Quartz Medicare Advantage |
$3.67
|
| Rate for Payer: The Alliance Commercial |
$308.00
|
| Rate for Payer: United Healthcare Medicaid |
$3.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.67
|
| Rate for Payer: United Healthcare PPO |
$57.75
|
| Rate for Payer: WEA Trust Commercial |
$42.35
|
| Rate for Payer: Wellcare Medicare |
$3.67
|
| Rate for Payer: WMAP Medicaid |
$3.79
|
| Rate for Payer: WPS Commercial |
$57.03
|
|
|
Urine Protein
|
Professional
|
$52.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
3119373
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$49.40 |
| Rate for Payer: Aetna Commercial |
$49.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$44.72
|
| Rate for Payer: Aetna Managed Medicare |
$3.67
|
| Rate for Payer: Anthem Medicare Advantage |
$3.67
|
| 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 |
$15.60
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cigna Commercial |
$49.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$26.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3.67
|
| Rate for Payer: Health EOS Commercial |
$47.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.67
|
| Rate for Payer: Multiplan Commercial |
$41.60
|
| Rate for Payer: Preferred Network Access Commercial |
$49.40
|
| Rate for Payer: Quartz Beloit One Network |
$22.88
|
| Rate for Payer: Quartz Commercial |
$29.64
|
| Rate for Payer: Quartz Medicare Advantage |
$3.67
|
| Rate for Payer: The Alliance Commercial |
$14.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.67
|
| Rate for Payer: WEA Trust Commercial |
$28.60
|
| Rate for Payer: WPS Commercial |
$16.15
|
|
|
Urine Sodium
|
Facility
IP
|
$100.00
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
2942994
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$49.00 |
| Max. Negotiated Rate |
$92.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$53.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cigna Commercial |
$92.00
|
| Rate for Payer: Health EOS Commercial |
$89.00
|
| Rate for Payer: HFN Commercial |
$92.00
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: NAPHCARE Commercial |
$60.00
|
| Rate for Payer: Preferred Network Access Commercial |
$92.00
|
| Rate for Payer: Quartz Beloit One Network |
$49.00
|
| Rate for Payer: Quartz Commercial |
$60.00
|
| Rate for Payer: WEA Trust Commercial |
$55.00
|
| Rate for Payer: WPS Commercial |
$74.07
|
|
|
Urine Sodium
|
Professional
|
$21.00
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
3813062
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$22.26 |
| Rate for Payer: Aetna Commercial |
$19.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.06
|
| Rate for Payer: Aetna Managed Medicare |
$5.06
|
| Rate for Payer: Anthem Medicare Advantage |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.06
|
| 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 |
$5.06
|
| Rate for Payer: Health EOS Commercial |
$19.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.06
|
| 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 |
$5.06
|
| Rate for Payer: The Alliance Commercial |
$19.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.06
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: WPS Commercial |
$22.26
|
|
|
Urine Sodium
|
Facility
OP
|
$100.00
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
2942994
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.00
|
| Rate for Payer: Aetna Managed Medicare |
$5.06
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18.98
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.86
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.40
|
| Rate for Payer: Anthem Medicaid |
$5.23
|
| Rate for Payer: Anthem Medicare Advantage |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$53.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.06
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cigna Commercial |
$92.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.23
|
| Rate for Payer: Dean Health Medicaid |
$5.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.06
|
| Rate for Payer: Health EOS Commercial |
$89.00
|
| Rate for Payer: HFN Commercial |
$92.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.06
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.06
|
| Rate for Payer: Managed Health Services Medicaid |
$5.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.06
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.06
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: NAPHCARE Commercial |
$7.59
|
| Rate for Payer: Preferred Network Access Commercial |
$92.00
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.23
|
| Rate for Payer: Quartz Beloit One Network |
$49.00
|
| Rate for Payer: Quartz Commercial |
$65.00
|
| Rate for Payer: Quartz Medicare Advantage |
$5.06
|
| Rate for Payer: The Alliance Commercial |
$400.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.06
|
| Rate for Payer: United Healthcare PPO |
$75.00
|
| Rate for Payer: WEA Trust Commercial |
$55.00
|
| Rate for Payer: Wellcare Medicare |
$5.06
|
| Rate for Payer: WMAP Medicaid |
$5.23
|
| Rate for Payer: WPS Commercial |
$74.07
|
|
|
Urine Sodium
|
Facility
IP
|
$21.00
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
3813062
|
|
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 Sodium
|
Facility
OP
|
$21.00
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
3813062
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.06 |
| 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 |
$5.06
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18.98
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.86
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.40
|
| Rate for Payer: Anthem Medicaid |
$5.23
|
| Rate for Payer: Anthem Medicare Advantage |
$5.06
|
| 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 |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.06
|
| 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 |
$5.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.23
|
| Rate for Payer: Dean Health Medicaid |
$5.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.06
|
| Rate for Payer: Health EOS Commercial |
$18.69
|
| Rate for Payer: HFN Commercial |
$19.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.06
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.06
|
| Rate for Payer: Managed Health Services Medicaid |
$5.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.06
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.06
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: NAPHCARE Commercial |
$7.59
|
| Rate for Payer: Preferred Network Access Commercial |
$19.32
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.23
|
| Rate for Payer: Quartz Beloit One Network |
$10.29
|
| Rate for Payer: Quartz Commercial |
$13.65
|
| Rate for Payer: Quartz Medicare Advantage |
$5.06
|
| Rate for Payer: The Alliance Commercial |
$84.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.06
|
| Rate for Payer: United Healthcare PPO |
$15.75
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: Wellcare Medicare |
$5.06
|
| Rate for Payer: WMAP Medicaid |
$5.23
|
| Rate for Payer: WPS Commercial |
$15.55
|
|
|
Urine Sodium
|
Professional
|
$100.00
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
2942994
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$95.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.00
|
| Rate for Payer: Aetna Managed Medicare |
$5.06
|
| Rate for Payer: Anthem Medicare Advantage |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.06
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$50.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.06
|
| Rate for Payer: Health EOS Commercial |
$91.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.06
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: Preferred Network Access Commercial |
$95.00
|
| Rate for Payer: Quartz Beloit One Network |
$44.00
|
| Rate for Payer: Quartz Commercial |
$57.00
|
| Rate for Payer: Quartz Medicare Advantage |
$5.06
|
| Rate for Payer: The Alliance Commercial |
$19.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.06
|
| Rate for Payer: WEA Trust Commercial |
$55.00
|
| Rate for Payer: WPS Commercial |
$22.26
|
|
|
Urine Sulfate
|
Facility
OP
|
$55.00
|
|
|
Service Code
|
CPT 84392
|
| Hospital Charge Code |
2942995
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.49 |
| Max. Negotiated Rate |
$220.00 |
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$47.30
|
| Rate for Payer: Aetna Managed Medicare |
$5.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.59
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.61
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.11
|
| Rate for Payer: Anthem Medicaid |
$5.67
|
| Rate for Payer: Anthem Medicare Advantage |
$5.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$29.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.49
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cigna Commercial |
$50.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.67
|
| Rate for Payer: Dean Health Medicaid |
$5.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.49
|
| Rate for Payer: Health EOS Commercial |
$48.95
|
| Rate for Payer: HFN Commercial |
$50.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.49
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.67
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.49
|
| Rate for Payer: Managed Health Services Medicaid |
$5.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.49
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.49
|
| Rate for Payer: Multiplan Commercial |
$44.00
|
| Rate for Payer: NAPHCARE Commercial |
$8.24
|
| Rate for Payer: Preferred Network Access Commercial |
$50.60
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.67
|
| Rate for Payer: Quartz Beloit One Network |
$26.95
|
| Rate for Payer: Quartz Commercial |
$35.75
|
| Rate for Payer: Quartz Medicare Advantage |
$5.49
|
| Rate for Payer: The Alliance Commercial |
$220.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.49
|
| Rate for Payer: United Healthcare PPO |
$41.25
|
| Rate for Payer: WEA Trust Commercial |
$30.25
|
| Rate for Payer: Wellcare Medicare |
$5.49
|
| Rate for Payer: WMAP Medicaid |
$5.67
|
| Rate for Payer: WPS Commercial |
$40.74
|
|
|
Urine Sulfate
|
Professional
|
$55.00
|
|
|
Service Code
|
CPT 84392
|
| Hospital Charge Code |
2942995
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.49 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Aetna Commercial |
$52.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$47.30
|
| Rate for Payer: Aetna Managed Medicare |
$5.49
|
| Rate for Payer: Anthem Medicare Advantage |
$5.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.49
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cigna Commercial |
$52.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$27.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.49
|
| Rate for Payer: Health EOS Commercial |
$50.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.38
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.49
|
| Rate for Payer: Multiplan Commercial |
$44.00
|
| Rate for Payer: Preferred Network Access Commercial |
$52.25
|
| Rate for Payer: Quartz Beloit One Network |
$24.20
|
| Rate for Payer: Quartz Commercial |
$31.35
|
| Rate for Payer: Quartz Medicare Advantage |
$5.49
|
| Rate for Payer: The Alliance Commercial |
$21.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.49
|
| Rate for Payer: WEA Trust Commercial |
$30.25
|
| Rate for Payer: WPS Commercial |
$24.16
|
|
|
Urine Sulfate
|
Facility
IP
|
$55.00
|
|
|
Service Code
|
CPT 84392
|
| Hospital Charge Code |
2942995
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.95 |
| Max. Negotiated Rate |
$50.60 |
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$29.15
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cigna Commercial |
$50.60
|
| Rate for Payer: Health EOS Commercial |
$48.95
|
| Rate for Payer: HFN Commercial |
$50.60
|
| Rate for Payer: Multiplan Commercial |
$44.00
|
| Rate for Payer: NAPHCARE Commercial |
$33.00
|
| Rate for Payer: Preferred Network Access Commercial |
$50.60
|
| Rate for Payer: Quartz Beloit One Network |
$26.95
|
| Rate for Payer: Quartz Commercial |
$33.00
|
| Rate for Payer: WEA Trust Commercial |
$30.25
|
| Rate for Payer: WPS Commercial |
$40.74
|
|
|
Urine Uric Acid
|
Professional
|
$62.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
2942991
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$58.90 |
| Rate for Payer: Aetna Commercial |
$58.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$53.32
|
| 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 |
$18.60
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cigna Commercial |
$58.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$31.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.08
|
| Rate for Payer: Health EOS Commercial |
$56.42
|
| 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 |
$49.60
|
| Rate for Payer: Preferred Network Access Commercial |
$58.90
|
| Rate for Payer: Quartz Beloit One Network |
$27.28
|
| Rate for Payer: Quartz Commercial |
$35.34
|
| 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 |
$34.10
|
| Rate for Payer: WPS Commercial |
$22.35
|
|
|
Urine Uric Acid
|
Facility
OP
|
$62.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
2942991
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$248.00 |
| Rate for Payer: Aetna Commercial |
$55.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$53.32
|
| 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 |
$32.86
|
| 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 |
$18.60
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cigna Commercial |
$57.04
|
| 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 |
$55.18
|
| Rate for Payer: HFN Commercial |
$57.04
|
| 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 |
$49.60
|
| Rate for Payer: NAPHCARE Commercial |
$7.62
|
| Rate for Payer: Preferred Network Access Commercial |
$57.04
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.25
|
| Rate for Payer: Quartz Beloit One Network |
$30.38
|
| Rate for Payer: Quartz Commercial |
$40.30
|
| Rate for Payer: Quartz Medicare Advantage |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$248.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: United Healthcare PPO |
$46.50
|
| Rate for Payer: WEA Trust Commercial |
$34.10
|
| Rate for Payer: Wellcare Medicare |
$5.08
|
| Rate for Payer: WMAP Medicaid |
$5.25
|
| Rate for Payer: WPS Commercial |
$45.92
|
|
|
Urine Uric Acid
|
Facility
IP
|
$62.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
2942991
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.38 |
| Max. Negotiated Rate |
$57.04 |
| Rate for Payer: Aetna Commercial |
$55.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$32.86
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cigna Commercial |
$57.04
|
| Rate for Payer: Health EOS Commercial |
$55.18
|
| Rate for Payer: HFN Commercial |
$57.04
|
| Rate for Payer: Multiplan Commercial |
$49.60
|
| Rate for Payer: NAPHCARE Commercial |
$37.20
|
| Rate for Payer: Preferred Network Access Commercial |
$57.04
|
| Rate for Payer: Quartz Beloit One Network |
$30.38
|
| Rate for Payer: Quartz Commercial |
$37.20
|
| Rate for Payer: WEA Trust Commercial |
$34.10
|
| Rate for Payer: WPS Commercial |
$45.92
|
|
|
Urine Uric Acid
|
Facility
OP
|
$21.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
3813071
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| 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 |
$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 |
$11.13
|
| 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 |
$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 |
$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 |
$18.69
|
| Rate for Payer: HFN Commercial |
$19.32
|
| 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 |
$16.80
|
| Rate for Payer: NAPHCARE Commercial |
$7.62
|
| Rate for Payer: Preferred Network Access Commercial |
$19.32
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.25
|
| Rate for Payer: Quartz Beloit One Network |
$10.29
|
| Rate for Payer: Quartz Commercial |
$13.65
|
| Rate for Payer: Quartz Medicare Advantage |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$84.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: United Healthcare PPO |
$15.75
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: Wellcare Medicare |
$5.08
|
| Rate for Payer: WMAP Medicaid |
$5.25
|
| Rate for Payer: WPS Commercial |
$15.55
|
|
|
Urine Uric Acid
|
Facility
IP
|
$21.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
3813071
|
|
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
|
|
