|
Urine Uric Acid
|
Professional
|
$21.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
3813071
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$22.35 |
| Rate for Payer: Aetna Commercial |
$19.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.06
|
| 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 |
$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 |
$5.08
|
| Rate for Payer: Health EOS Commercial |
$19.11
|
| 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 |
$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 |
$5.08
|
| Rate for Payer: The Alliance Commercial |
$20.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: WEA Trust Commercial |
$11.55
|
| Rate for Payer: WPS Commercial |
$22.35
|
|
|
Urine Vanillylmandelic Acid
|
Facility
IP
|
$36.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
4076085
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.64 |
| Max. Negotiated Rate |
$33.12 |
| Rate for Payer: Aetna Commercial |
$32.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$19.08
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cigna Commercial |
$33.12
|
| Rate for Payer: Health EOS Commercial |
$32.04
|
| Rate for Payer: HFN Commercial |
$33.12
|
| Rate for Payer: Multiplan Commercial |
$28.80
|
| Rate for Payer: NAPHCARE Commercial |
$21.60
|
| Rate for Payer: Preferred Network Access Commercial |
$33.12
|
| Rate for Payer: Quartz Beloit One Network |
$17.64
|
| Rate for Payer: Quartz Commercial |
$21.60
|
| Rate for Payer: WEA Trust Commercial |
$19.80
|
| Rate for Payer: WPS Commercial |
$26.67
|
|
|
Urine Vanillylmandelic Acid
|
Professional
|
$36.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
4076085
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.50 |
| Max. Negotiated Rate |
$68.20 |
| Rate for Payer: Aetna Commercial |
$34.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$30.96
|
| Rate for Payer: Aetna Managed Medicare |
$15.50
|
| Rate for Payer: Anthem Medicare Advantage |
$15.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.50
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cigna Commercial |
$34.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.50
|
| Rate for Payer: Health EOS Commercial |
$32.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$54.72
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$54.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.50
|
| Rate for Payer: Multiplan Commercial |
$28.80
|
| Rate for Payer: Preferred Network Access Commercial |
$34.20
|
| Rate for Payer: Quartz Beloit One Network |
$15.84
|
| Rate for Payer: Quartz Commercial |
$20.52
|
| Rate for Payer: Quartz Medicare Advantage |
$15.50
|
| Rate for Payer: The Alliance Commercial |
$61.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.50
|
| Rate for Payer: WEA Trust Commercial |
$19.80
|
| Rate for Payer: WPS Commercial |
$68.20
|
|
|
Urine Vanillylmandelic Acid
|
Facility
OP
|
$36.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
4076085
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.50 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$32.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$30.96
|
| Rate for Payer: Aetna Managed Medicare |
$15.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$58.12
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.73
|
| Rate for Payer: Anthem Medicaid |
$16.02
|
| Rate for Payer: Anthem Medicare Advantage |
$15.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$19.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.50
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cigna Commercial |
$33.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$16.02
|
| Rate for Payer: Dean Health Medicaid |
$16.02
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.50
|
| Rate for Payer: Health EOS Commercial |
$32.04
|
| Rate for Payer: HFN Commercial |
$33.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$57.66
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.50
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.50
|
| Rate for Payer: Managed Health Services Medicaid |
$16.66
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.50
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.50
|
| Rate for Payer: Multiplan Commercial |
$28.80
|
| Rate for Payer: NAPHCARE Commercial |
$23.25
|
| Rate for Payer: Preferred Network Access Commercial |
$33.12
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$16.02
|
| Rate for Payer: Quartz Beloit One Network |
$17.64
|
| Rate for Payer: Quartz Commercial |
$23.40
|
| Rate for Payer: Quartz Medicare Advantage |
$15.50
|
| Rate for Payer: The Alliance Commercial |
$144.00
|
| Rate for Payer: United Healthcare Medicaid |
$16.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.50
|
| Rate for Payer: United Healthcare PPO |
$27.00
|
| Rate for Payer: WEA Trust Commercial |
$19.80
|
| Rate for Payer: Wellcare Medicare |
$15.50
|
| Rate for Payer: WMAP Medicaid |
$16.02
|
| Rate for Payer: WPS Commercial |
$26.67
|
|
|
URO Flow Testing
|
Facility
OP
|
$227.00
|
|
|
Service Code
|
CPT 51741
|
| Hospital Charge Code |
3005560
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$108.96 |
| Max. Negotiated Rate |
$28,833.64 |
| Rate for Payer: Aetna Commercial |
$204.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$195.22
|
| Rate for Payer: Aetna Managed Medicare |
$310.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$147.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$113.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$108.96
|
| Rate for Payer: Anthem Medicare Advantage |
$310.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$120.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$310.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$310.24
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cigna Commercial |
$208.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$310.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$310.24
|
| Rate for Payer: Health EOS Commercial |
$202.03
|
| Rate for Payer: HFN Commercial |
$208.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,154.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$310.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$310.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$310.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$310.24
|
| Rate for Payer: Multiplan Commercial |
$181.60
|
| Rate for Payer: NAPHCARE Commercial |
$465.36
|
| Rate for Payer: Preferred Network Access Commercial |
$208.84
|
| Rate for Payer: Quartz Beloit One Network |
$111.23
|
| Rate for Payer: Quartz Commercial |
$147.55
|
| Rate for Payer: Quartz Medicare Advantage |
$310.24
|
| Rate for Payer: The Alliance Commercial |
$28,833.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$310.24
|
| Rate for Payer: United Healthcare PPO |
$170.25
|
| Rate for Payer: WEA Trust Commercial |
$124.85
|
| Rate for Payer: Wellcare Medicare |
$310.24
|
| Rate for Payer: WPS Commercial |
$168.14
|
|
|
URO Flow Testing
|
Facility
IP
|
$227.00
|
|
|
Service Code
|
CPT 51741
|
| Hospital Charge Code |
3005560
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$111.23 |
| Max. Negotiated Rate |
$208.84 |
| Rate for Payer: Aetna Commercial |
$204.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$120.31
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cigna Commercial |
$208.84
|
| Rate for Payer: Health EOS Commercial |
$202.03
|
| Rate for Payer: HFN Commercial |
$208.84
|
| Rate for Payer: Multiplan Commercial |
$181.60
|
| Rate for Payer: NAPHCARE Commercial |
$136.20
|
| Rate for Payer: Preferred Network Access Commercial |
$208.84
|
| Rate for Payer: Quartz Beloit One Network |
$111.23
|
| Rate for Payer: Quartz Commercial |
$136.20
|
| Rate for Payer: WEA Trust Commercial |
$124.85
|
| Rate for Payer: WPS Commercial |
$168.14
|
|
|
UROSTOMY STERILE KIT 19252
|
Facility
OP
|
$217.00
|
|
| Hospital Charge Code |
2963705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.76 |
| Max. Negotiated Rate |
$868.00 |
| Rate for Payer: Aetna Commercial |
$195.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$186.62
|
| Rate for Payer: Aetna Managed Medicare |
$60.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$141.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$108.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$104.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$115.01
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cigna Commercial |
$199.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$121.43
|
| Rate for Payer: Health EOS Commercial |
$193.13
|
| Rate for Payer: HFN Commercial |
$199.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$162.75
|
| Rate for Payer: Multiplan Commercial |
$173.60
|
| Rate for Payer: NAPHCARE Commercial |
$130.20
|
| Rate for Payer: Preferred Network Access Commercial |
$199.64
|
| Rate for Payer: Quartz Beloit One Network |
$106.33
|
| Rate for Payer: Quartz Commercial |
$141.05
|
| Rate for Payer: Quartz Medicare Advantage |
$130.20
|
| Rate for Payer: The Alliance Commercial |
$868.00
|
| Rate for Payer: WEA Trust Commercial |
$119.35
|
| Rate for Payer: WPS Commercial |
$160.73
|
|
|
UROSTOMY STERILE KIT 19252
|
Facility
IP
|
$217.00
|
|
| Hospital Charge Code |
2963705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.33 |
| Max. Negotiated Rate |
$199.64 |
| Rate for Payer: Aetna Commercial |
$195.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$115.01
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cigna Commercial |
$199.64
|
| Rate for Payer: Health EOS Commercial |
$193.13
|
| Rate for Payer: HFN Commercial |
$199.64
|
| Rate for Payer: Multiplan Commercial |
$173.60
|
| Rate for Payer: NAPHCARE Commercial |
$130.20
|
| Rate for Payer: Preferred Network Access Commercial |
$199.64
|
| Rate for Payer: Quartz Beloit One Network |
$106.33
|
| Rate for Payer: Quartz Commercial |
$130.20
|
| Rate for Payer: WEA Trust Commercial |
$119.35
|
| Rate for Payer: WPS Commercial |
$160.73
|
|
|
UroVysion, Detection of Bladder Cancer
|
Facility
OP
|
$1,997.00
|
|
|
Service Code
|
CPT 88120
|
| Hospital Charge Code |
5543245
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$168.82 |
| Max. Negotiated Rate |
$1,837.24 |
| Rate for Payer: Aetna Commercial |
$1,797.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,717.42
|
| Rate for Payer: Aetna Managed Medicare |
$168.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$633.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$295.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$280.24
|
| Rate for Payer: Anthem Medicare Advantage |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,058.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$168.82
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cigna Commercial |
$1,837.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$168.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$168.82
|
| Rate for Payer: Health EOS Commercial |
$1,777.33
|
| Rate for Payer: HFN Commercial |
$1,837.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$168.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$168.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$168.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$168.82
|
| Rate for Payer: Multiplan Commercial |
$1,597.60
|
| Rate for Payer: NAPHCARE Commercial |
$253.23
|
| Rate for Payer: Preferred Network Access Commercial |
$1,837.24
|
| Rate for Payer: Quartz Beloit One Network |
$978.53
|
| Rate for Payer: Quartz Commercial |
$1,298.05
|
| Rate for Payer: Quartz Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare PPO |
$1,497.75
|
| Rate for Payer: WEA Trust Commercial |
$1,098.35
|
| Rate for Payer: Wellcare Medicare |
$168.82
|
| Rate for Payer: WPS Commercial |
$1,479.18
|
|
|
UroVysion, Detection of Bladder Cancer
|
Professional
|
$1,997.00
|
|
|
Service Code
|
CPT 88120
|
| Hospital Charge Code |
5543245
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.27 |
| Max. Negotiated Rate |
$2,527.45 |
| Rate for Payer: Aetna Commercial |
$1,897.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,717.42
|
| Rate for Payer: Aetna Managed Medicare |
$574.42
|
| Rate for Payer: Anthem Commercial |
$38.27
|
| Rate for Payer: Anthem Medicare Advantage |
$574.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$574.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$574.42
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cigna Commercial |
$1,897.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$998.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$574.42
|
| Rate for Payer: Health EOS Commercial |
$1,817.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,110.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,110.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$574.42
|
| Rate for Payer: Multiplan Commercial |
$1,597.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,897.15
|
| Rate for Payer: Quartz Beloit One Network |
$878.68
|
| Rate for Payer: Quartz Commercial |
$1,138.29
|
| Rate for Payer: Quartz Medicare Advantage |
$574.42
|
| Rate for Payer: The Alliance Commercial |
$2,268.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$574.42
|
| Rate for Payer: WEA Trust Commercial |
$1,098.35
|
| Rate for Payer: WPS Commercial |
$2,527.45
|
|
|
UroVysion, Detection of Bladder Cancer
|
Facility
IP
|
$1,997.00
|
|
|
Service Code
|
CPT 88120
|
| Hospital Charge Code |
5543245
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$978.53 |
| Max. Negotiated Rate |
$1,837.24 |
| Rate for Payer: Aetna Commercial |
$1,797.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,058.41
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cigna Commercial |
$1,837.24
|
| Rate for Payer: Health EOS Commercial |
$1,777.33
|
| Rate for Payer: HFN Commercial |
$1,837.24
|
| Rate for Payer: Multiplan Commercial |
$1,597.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,198.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,837.24
|
| Rate for Payer: Quartz Beloit One Network |
$978.53
|
| Rate for Payer: Quartz Commercial |
$1,198.20
|
| Rate for Payer: WEA Trust Commercial |
$1,098.35
|
| Rate for Payer: WPS Commercial |
$1,479.18
|
|
|
US Abdomen Complete
|
Professional
|
$1,427.00
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
625608
|
| Min. Negotiated Rate |
$113.29 |
| Max. Negotiated Rate |
$1,355.65 |
| Rate for Payer: Aetna Commercial |
$1,355.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,227.22
|
| Rate for Payer: Aetna Managed Medicare |
$113.29
|
| Rate for Payer: Anthem Medicare Advantage |
$113.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$113.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$113.29
|
| Rate for Payer: Cash Price |
$428.10
|
| Rate for Payer: Cash Price |
$428.10
|
| Rate for Payer: Cigna Commercial |
$1,355.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$713.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$113.29
|
| Rate for Payer: Health EOS Commercial |
$1,298.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$416.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$416.05
|
| Rate for Payer: Independent Care Health Plan Medicare |
$113.29
|
| Rate for Payer: Multiplan Commercial |
$1,141.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,355.65
|
| Rate for Payer: Quartz Beloit One Network |
$627.88
|
| Rate for Payer: Quartz Commercial |
$813.39
|
| Rate for Payer: Quartz Medicare Advantage |
$113.29
|
| Rate for Payer: The Alliance Commercial |
$430.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$113.29
|
| Rate for Payer: WEA Trust Commercial |
$784.85
|
| Rate for Payer: WPS Commercial |
$566.45
|
|
|
US Abdomen Complete
|
Facility
OP
|
$1,427.00
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
625608
|
| Min. Negotiated Rate |
$29.68 |
| Max. Negotiated Rate |
$1,312.84 |
| Rate for Payer: Aetna Commercial |
$1,284.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,227.22
|
| Rate for Payer: Aetna Managed Medicare |
$108.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$927.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$713.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$684.96
|
| Rate for Payer: Anthem Medicare Advantage |
$108.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$756.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$108.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$108.67
|
| Rate for Payer: Cash Price |
$428.10
|
| Rate for Payer: Cash Price |
$428.10
|
| Rate for Payer: Cigna Commercial |
$1,312.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$108.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$108.67
|
| Rate for Payer: Health EOS Commercial |
$1,270.03
|
| Rate for Payer: HFN Commercial |
$1,312.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$404.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$108.67
|
| Rate for Payer: Independent Care Health Plan Medicare |
$108.67
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$108.67
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$108.67
|
| Rate for Payer: Multiplan Commercial |
$1,141.60
|
| Rate for Payer: NAPHCARE Commercial |
$163.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,312.84
|
| Rate for Payer: Quartz Beloit One Network |
$699.23
|
| Rate for Payer: Quartz Commercial |
$927.55
|
| Rate for Payer: Quartz Medicare Advantage |
$108.67
|
| Rate for Payer: The Alliance Commercial |
$29.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$108.67
|
| Rate for Payer: WEA Trust Commercial |
$784.85
|
| Rate for Payer: Wellcare Medicare |
$108.67
|
| Rate for Payer: WPS Commercial |
$1,056.98
|
|
|
US Abdomen Complete
|
Facility
IP
|
$1,739.00
|
|
|
Service Code
|
CPT 76700 TC
|
| Hospital Charge Code |
2430801
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$852.11 |
| Max. Negotiated Rate |
$1,599.88 |
| Rate for Payer: Aetna Commercial |
$1,565.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$921.67
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cigna Commercial |
$1,599.88
|
| Rate for Payer: Health EOS Commercial |
$1,547.71
|
| Rate for Payer: HFN Commercial |
$1,599.88
|
| Rate for Payer: Multiplan Commercial |
$1,391.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,043.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,599.88
|
| Rate for Payer: Quartz Beloit One Network |
$852.11
|
| Rate for Payer: Quartz Commercial |
$1,043.40
|
| Rate for Payer: WEA Trust Commercial |
$956.45
|
| Rate for Payer: WPS Commercial |
$1,288.08
|
|
|
US Abdomen Complete
|
Facility
OP
|
$1,739.00
|
|
|
Service Code
|
CPT 76700 TC
|
| Hospital Charge Code |
3072696
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$486.92 |
| Max. Negotiated Rate |
$6,956.00 |
| Rate for Payer: Aetna Commercial |
$1,565.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,495.54
|
| Rate for Payer: Aetna Managed Medicare |
$486.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$816.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$689.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$655.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$921.67
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cigna Commercial |
$1,599.88
|
| Rate for Payer: Health EOS Commercial |
$1,547.71
|
| Rate for Payer: HFN Commercial |
$1,599.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,304.25
|
| Rate for Payer: Multiplan Commercial |
$1,391.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,043.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,599.88
|
| Rate for Payer: Quartz Beloit One Network |
$852.11
|
| Rate for Payer: Quartz Commercial |
$1,130.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,043.40
|
| Rate for Payer: The Alliance Commercial |
$6,956.00
|
| Rate for Payer: United Healthcare PPO |
$574.00
|
| Rate for Payer: WEA Trust Commercial |
$956.45
|
| Rate for Payer: WPS Commercial |
$1,288.08
|
|
|
US Abdomen Complete
|
Professional
|
$1,739.00
|
|
|
Service Code
|
CPT 76700 TC
|
| Hospital Charge Code |
3072696
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.08 |
| Max. Negotiated Rate |
$1,652.05 |
| Rate for Payer: Aetna Commercial |
$1,652.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,495.54
|
| Rate for Payer: Aetna Managed Medicare |
$76.08
|
| Rate for Payer: Anthem Medicare Advantage |
$76.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$76.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$76.08
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cigna Commercial |
$1,652.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$869.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$76.08
|
| Rate for Payer: Health EOS Commercial |
$1,582.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$281.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$281.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$76.08
|
| Rate for Payer: Multiplan Commercial |
$1,391.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,652.05
|
| Rate for Payer: Quartz Beloit One Network |
$765.16
|
| Rate for Payer: Quartz Commercial |
$991.23
|
| Rate for Payer: Quartz Medicare Advantage |
$76.08
|
| Rate for Payer: The Alliance Commercial |
$289.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$76.08
|
| Rate for Payer: WEA Trust Commercial |
$956.45
|
| Rate for Payer: WPS Commercial |
$380.40
|
|
|
US Abdomen Complete
|
Facility
IP
|
$1,739.00
|
|
|
Service Code
|
CPT 76700 TC
|
| Hospital Charge Code |
3072696
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$852.11 |
| Max. Negotiated Rate |
$1,599.88 |
| Rate for Payer: Aetna Commercial |
$1,565.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$921.67
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cigna Commercial |
$1,599.88
|
| Rate for Payer: Health EOS Commercial |
$1,547.71
|
| Rate for Payer: HFN Commercial |
$1,599.88
|
| Rate for Payer: Multiplan Commercial |
$1,391.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,043.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,599.88
|
| Rate for Payer: Quartz Beloit One Network |
$852.11
|
| Rate for Payer: Quartz Commercial |
$1,043.40
|
| Rate for Payer: WEA Trust Commercial |
$956.45
|
| Rate for Payer: WPS Commercial |
$1,288.08
|
|
|
US Abdomen Complete
|
Facility
OP
|
$1,739.00
|
|
|
Service Code
|
CPT 76700 TC
|
| Hospital Charge Code |
2430801
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$486.92 |
| Max. Negotiated Rate |
$6,956.00 |
| Rate for Payer: Aetna Commercial |
$1,565.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,495.54
|
| Rate for Payer: Aetna Managed Medicare |
$486.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$816.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$689.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$655.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$921.67
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cigna Commercial |
$1,599.88
|
| Rate for Payer: Health EOS Commercial |
$1,547.71
|
| Rate for Payer: HFN Commercial |
$1,599.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,304.25
|
| Rate for Payer: Multiplan Commercial |
$1,391.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,043.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,599.88
|
| Rate for Payer: Quartz Beloit One Network |
$852.11
|
| Rate for Payer: Quartz Commercial |
$1,130.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,043.40
|
| Rate for Payer: The Alliance Commercial |
$6,956.00
|
| Rate for Payer: United Healthcare PPO |
$574.00
|
| Rate for Payer: WEA Trust Commercial |
$956.45
|
| Rate for Payer: WPS Commercial |
$1,288.08
|
|
|
US Abdomen Complete
|
Facility
IP
|
$1,427.00
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
625608
|
| Min. Negotiated Rate |
$699.23 |
| Max. Negotiated Rate |
$1,312.84 |
| Rate for Payer: Aetna Commercial |
$1,284.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$756.31
|
| Rate for Payer: Cash Price |
$428.10
|
| Rate for Payer: Cigna Commercial |
$1,312.84
|
| Rate for Payer: Health EOS Commercial |
$1,270.03
|
| Rate for Payer: HFN Commercial |
$1,312.84
|
| Rate for Payer: Multiplan Commercial |
$1,141.60
|
| Rate for Payer: NAPHCARE Commercial |
$856.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,312.84
|
| Rate for Payer: Quartz Beloit One Network |
$699.23
|
| Rate for Payer: Quartz Commercial |
$856.20
|
| Rate for Payer: WEA Trust Commercial |
$784.85
|
| Rate for Payer: WPS Commercial |
$1,056.98
|
|
|
US Abdomen Complete
|
Professional
|
$1,739.00
|
|
|
Service Code
|
CPT 76700 TC
|
| Hospital Charge Code |
2430801
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.08 |
| Max. Negotiated Rate |
$1,652.05 |
| Rate for Payer: Aetna Commercial |
$1,652.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,495.54
|
| Rate for Payer: Aetna Managed Medicare |
$76.08
|
| Rate for Payer: Anthem Medicare Advantage |
$76.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$76.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$76.08
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cash Price |
$521.70
|
| Rate for Payer: Cigna Commercial |
$1,652.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$869.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$76.08
|
| Rate for Payer: Health EOS Commercial |
$1,582.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$281.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$281.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$76.08
|
| Rate for Payer: Multiplan Commercial |
$1,391.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,652.05
|
| Rate for Payer: Quartz Beloit One Network |
$765.16
|
| Rate for Payer: Quartz Commercial |
$991.23
|
| Rate for Payer: Quartz Medicare Advantage |
$76.08
|
| Rate for Payer: The Alliance Commercial |
$289.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$76.08
|
| Rate for Payer: WEA Trust Commercial |
$956.45
|
| Rate for Payer: WPS Commercial |
$380.40
|
|
|
US Abdomen Limited
|
Professional
|
$1,763.00
|
|
|
Service Code
|
CPT 76705 TC
|
| Hospital Charge Code |
2430803
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$58.05 |
| Max. Negotiated Rate |
$1,674.85 |
| Rate for Payer: Aetna Commercial |
$1,674.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,516.18
|
| Rate for Payer: Aetna Managed Medicare |
$58.05
|
| Rate for Payer: Anthem Medicare Advantage |
$58.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$58.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$58.05
|
| Rate for Payer: Cash Price |
$528.90
|
| Rate for Payer: Cash Price |
$528.90
|
| Rate for Payer: Cigna Commercial |
$1,674.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$881.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$58.05
|
| Rate for Payer: Health EOS Commercial |
$1,604.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$211.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$211.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$58.05
|
| Rate for Payer: Multiplan Commercial |
$1,410.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,674.85
|
| Rate for Payer: Quartz Beloit One Network |
$775.72
|
| Rate for Payer: Quartz Commercial |
$1,004.91
|
| Rate for Payer: Quartz Medicare Advantage |
$58.05
|
| Rate for Payer: The Alliance Commercial |
$220.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$58.05
|
| Rate for Payer: WEA Trust Commercial |
$969.65
|
| Rate for Payer: WPS Commercial |
$290.25
|
|
|
US Abdomen Limited
|
Professional
|
$1,499.00
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
625610
|
| Min. Negotiated Rate |
$85.23 |
| Max. Negotiated Rate |
$1,424.05 |
| Rate for Payer: Aetna Commercial |
$1,424.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,289.14
|
| Rate for Payer: Aetna Managed Medicare |
$85.23
|
| Rate for Payer: Anthem Medicare Advantage |
$85.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$85.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$85.23
|
| Rate for Payer: Cash Price |
$449.70
|
| Rate for Payer: Cash Price |
$449.70
|
| Rate for Payer: Cigna Commercial |
$1,424.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$749.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$85.23
|
| Rate for Payer: Health EOS Commercial |
$1,364.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$310.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$310.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$85.23
|
| Rate for Payer: Multiplan Commercial |
$1,199.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,424.05
|
| Rate for Payer: Quartz Beloit One Network |
$659.56
|
| Rate for Payer: Quartz Commercial |
$854.43
|
| Rate for Payer: Quartz Medicare Advantage |
$85.23
|
| Rate for Payer: The Alliance Commercial |
$323.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$85.23
|
| Rate for Payer: WEA Trust Commercial |
$824.45
|
| Rate for Payer: WPS Commercial |
$426.15
|
|
|
US Abdomen Limited
|
Facility
OP
|
$1,499.00
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
625610
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$1,379.08 |
| Rate for Payer: Aetna Commercial |
$1,349.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,289.14
|
| Rate for Payer: Aetna Managed Medicare |
$108.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$974.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$749.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$719.52
|
| Rate for Payer: Anthem Medicare Advantage |
$108.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$794.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$108.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$108.67
|
| Rate for Payer: Cash Price |
$449.70
|
| Rate for Payer: Cash Price |
$449.70
|
| Rate for Payer: Cigna Commercial |
$1,379.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$108.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$108.67
|
| Rate for Payer: Health EOS Commercial |
$1,334.11
|
| Rate for Payer: HFN Commercial |
$1,379.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$404.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$108.67
|
| Rate for Payer: Independent Care Health Plan Medicare |
$108.67
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$108.67
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$108.67
|
| Rate for Payer: Multiplan Commercial |
$1,199.20
|
| Rate for Payer: NAPHCARE Commercial |
$163.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,379.08
|
| Rate for Payer: Quartz Beloit One Network |
$734.51
|
| Rate for Payer: Quartz Commercial |
$974.35
|
| Rate for Payer: Quartz Medicare Advantage |
$108.67
|
| Rate for Payer: The Alliance Commercial |
$13.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$108.67
|
| Rate for Payer: WEA Trust Commercial |
$824.45
|
| Rate for Payer: Wellcare Medicare |
$108.67
|
| Rate for Payer: WPS Commercial |
$1,110.31
|
|
|
US Abdomen Limited
|
Facility
IP
|
$1,763.00
|
|
|
Service Code
|
CPT 76705 TC
|
| Hospital Charge Code |
2430803
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$863.87 |
| Max. Negotiated Rate |
$1,621.96 |
| Rate for Payer: Aetna Commercial |
$1,586.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$934.39
|
| Rate for Payer: Cash Price |
$528.90
|
| Rate for Payer: Cigna Commercial |
$1,621.96
|
| Rate for Payer: Health EOS Commercial |
$1,569.07
|
| Rate for Payer: HFN Commercial |
$1,621.96
|
| Rate for Payer: Multiplan Commercial |
$1,410.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,057.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,621.96
|
| Rate for Payer: Quartz Beloit One Network |
$863.87
|
| Rate for Payer: Quartz Commercial |
$1,057.80
|
| Rate for Payer: WEA Trust Commercial |
$969.65
|
| Rate for Payer: WPS Commercial |
$1,305.85
|
|
|
US Abdomen Limited
|
Facility
IP
|
$1,499.00
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
625610
|
| Min. Negotiated Rate |
$734.51 |
| Max. Negotiated Rate |
$1,379.08 |
| Rate for Payer: Aetna Commercial |
$1,349.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$794.47
|
| Rate for Payer: Cash Price |
$449.70
|
| Rate for Payer: Cigna Commercial |
$1,379.08
|
| Rate for Payer: Health EOS Commercial |
$1,334.11
|
| Rate for Payer: HFN Commercial |
$1,379.08
|
| Rate for Payer: Multiplan Commercial |
$1,199.20
|
| Rate for Payer: NAPHCARE Commercial |
$899.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,379.08
|
| Rate for Payer: Quartz Beloit One Network |
$734.51
|
| Rate for Payer: Quartz Commercial |
$899.40
|
| Rate for Payer: WEA Trust Commercial |
$824.45
|
| Rate for Payer: WPS Commercial |
$1,110.31
|
|
