|
TREATMENT OF PENIS LESION 54200
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
CPT 54200
|
| Hospital Charge Code |
3015027
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.31 |
| Max. Negotiated Rate |
$468.31 |
| Rate for Payer: Aetna Commercial |
$468.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$423.95
|
| Rate for Payer: Aetna Managed Medicare |
$81.61
|
| Rate for Payer: Anthem Medicare Advantage |
$81.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$81.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$81.61
|
| Rate for Payer: Cash Price |
$142.20
|
| Rate for Payer: Cash Price |
$142.20
|
| Rate for Payer: Cash Price |
$142.20
|
| Rate for Payer: Cigna Commercial |
$468.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$31.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$81.61
|
| Rate for Payer: Health EOS Commercial |
$448.59
|
| Rate for Payer: HFN Commercial |
$468.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$297.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$297.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$81.61
|
| Rate for Payer: Multiplan Commercial |
$394.37
|
| Rate for Payer: NAPHCARE Commercial |
$122.41
|
| Rate for Payer: Preferred Network Access Commercial |
$468.31
|
| Rate for Payer: Quartz Beloit One Network |
$216.90
|
| Rate for Payer: Quartz Commercial |
$280.99
|
| Rate for Payer: Quartz Medicare Advantage |
$81.61
|
| Rate for Payer: The Alliance Commercial |
$346.84
|
| Rate for Payer: United Healthcare Medicaid |
$31.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.61
|
| Rate for Payer: WEA Trust Commercial |
$271.13
|
| Rate for Payer: WPS Commercial |
$367.24
|
|
|
TREATMENT OF PENIS LESION 54220
|
Professional
|
Both
|
$795.00
|
|
|
Service Code
|
CPT 54220
|
| Hospital Charge Code |
3015028
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$122.86 |
| Max. Negotiated Rate |
$785.46 |
| Rate for Payer: Aetna Commercial |
$785.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$711.05
|
| Rate for Payer: Aetna Managed Medicare |
$122.86
|
| Rate for Payer: Anthem Medicare Advantage |
$122.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$122.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$122.86
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cash Price |
$238.50
|
| Rate for Payer: Cigna Commercial |
$785.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$348.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$122.86
|
| Rate for Payer: Health EOS Commercial |
$752.39
|
| Rate for Payer: HFN Commercial |
$785.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$457.58
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$457.58
|
| Rate for Payer: Independent Care Health Plan Medicare |
$122.86
|
| Rate for Payer: Multiplan Commercial |
$661.44
|
| Rate for Payer: NAPHCARE Commercial |
$184.28
|
| Rate for Payer: Preferred Network Access Commercial |
$785.46
|
| Rate for Payer: Quartz Beloit One Network |
$363.79
|
| Rate for Payer: Quartz Commercial |
$471.28
|
| Rate for Payer: Quartz Medicare Advantage |
$122.86
|
| Rate for Payer: The Alliance Commercial |
$522.13
|
| Rate for Payer: United Healthcare Medicaid |
$348.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.86
|
| Rate for Payer: WEA Trust Commercial |
$454.74
|
| Rate for Payer: WPS Commercial |
$552.85
|
|
|
TREATMENT OF RIB FRACTURE 21800
|
Professional
|
Both
|
$277.00
|
|
| Hospital Charge Code |
3013743
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$126.76 |
| Max. Negotiated Rate |
$273.68 |
| Rate for Payer: Aetna Commercial |
$273.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$247.75
|
| Rate for Payer: Cash Price |
$83.10
|
| Rate for Payer: Cigna Commercial |
$273.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$144.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$172.85
|
| Rate for Payer: Health EOS Commercial |
$262.15
|
| Rate for Payer: HFN Commercial |
$273.68
|
| Rate for Payer: Multiplan Commercial |
$230.46
|
| Rate for Payer: Preferred Network Access Commercial |
$273.68
|
| Rate for Payer: Quartz Beloit One Network |
$126.76
|
| Rate for Payer: Quartz Commercial |
$164.21
|
| Rate for Payer: The Alliance Commercial |
$144.04
|
| Rate for Payer: WEA Trust Commercial |
$158.44
|
| Rate for Payer: WPS Commercial |
$213.37
|
|
|
Treatment of superficial wound dehiscence; simple closure
|
Facility
|
OP
|
$4,386.95
|
|
|
Service Code
|
CPT 12020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$777.80 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Managed Medicare |
$777.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,030.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,388.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,270.32
|
| Rate for Payer: Anthem Medicare Advantage |
$777.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$777.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$777.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$777.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$777.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,893.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$777.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$777.80
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$777.80
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$777.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,166.69
|
| Rate for Payer: Quartz Medicare Advantage |
$777.80
|
| Rate for Payer: The Alliance Commercial |
$3,111.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$777.80
|
| Rate for Payer: United Healthcare PPO |
$2,347.28
|
| Rate for Payer: Wellcare Medicare |
$777.80
|
|
|
TREATMENT OF THIGH FRACTURE 27500
|
Professional
|
Both
|
$2,166.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
3014081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$442.61 |
| Max. Negotiated Rate |
$2,140.01 |
| Rate for Payer: Aetna Commercial |
$2,140.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,937.27
|
| Rate for Payer: Aetna Managed Medicare |
$442.61
|
| Rate for Payer: Anthem Medicare Advantage |
$442.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$442.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$442.61
|
| Rate for Payer: Cash Price |
$649.80
|
| Rate for Payer: Cash Price |
$649.80
|
| Rate for Payer: Cash Price |
$649.80
|
| Rate for Payer: Cigna Commercial |
$2,140.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$626.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$442.61
|
| Rate for Payer: Health EOS Commercial |
$2,049.90
|
| Rate for Payer: HFN Commercial |
$2,140.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,662.91
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,662.91
|
| Rate for Payer: Independent Care Health Plan Medicare |
$442.61
|
| Rate for Payer: Multiplan Commercial |
$1,802.11
|
| Rate for Payer: NAPHCARE Commercial |
$663.92
|
| Rate for Payer: Preferred Network Access Commercial |
$2,140.01
|
| Rate for Payer: Quartz Beloit One Network |
$991.16
|
| Rate for Payer: Quartz Commercial |
$1,284.00
|
| Rate for Payer: Quartz Medicare Advantage |
$442.61
|
| Rate for Payer: The Alliance Commercial |
$1,881.11
|
| Rate for Payer: United Healthcare Medicaid |
$626.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$442.61
|
| Rate for Payer: WEA Trust Commercial |
$1,238.95
|
| Rate for Payer: WPS Commercial |
$1,991.76
|
|
|
TREATMENT OF THIGH FRACTURE 27501
|
Professional
|
Both
|
$2,622.00
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
3014082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$457.25 |
| Max. Negotiated Rate |
$2,590.54 |
| Rate for Payer: Aetna Commercial |
$2,590.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,345.12
|
| Rate for Payer: Aetna Managed Medicare |
$457.25
|
| Rate for Payer: Anthem Medicare Advantage |
$457.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$457.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$457.25
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Cigna Commercial |
$2,590.54
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$460.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$457.25
|
| Rate for Payer: Health EOS Commercial |
$2,481.46
|
| Rate for Payer: HFN Commercial |
$2,590.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,721.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,721.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$457.25
|
| Rate for Payer: Multiplan Commercial |
$2,181.50
|
| Rate for Payer: NAPHCARE Commercial |
$685.87
|
| Rate for Payer: Preferred Network Access Commercial |
$2,590.54
|
| Rate for Payer: Quartz Beloit One Network |
$1,199.83
|
| Rate for Payer: Quartz Commercial |
$1,554.32
|
| Rate for Payer: Quartz Medicare Advantage |
$457.25
|
| Rate for Payer: The Alliance Commercial |
$1,943.30
|
| Rate for Payer: United Healthcare Medicaid |
$460.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$457.25
|
| Rate for Payer: WEA Trust Commercial |
$1,499.78
|
| Rate for Payer: WPS Commercial |
$2,057.61
|
|
|
TREATMENT OF THIGH FRACTURE 27508
|
Professional
|
Both
|
$1,800.00
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
3014086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$466.78 |
| Max. Negotiated Rate |
$2,100.52 |
| Rate for Payer: Aetna Commercial |
$1,778.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,609.92
|
| Rate for Payer: Aetna Managed Medicare |
$466.78
|
| Rate for Payer: Anthem Medicare Advantage |
$466.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$466.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$466.78
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cigna Commercial |
$1,778.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$626.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$466.78
|
| Rate for Payer: Health EOS Commercial |
$1,703.52
|
| Rate for Payer: HFN Commercial |
$1,778.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,727.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,727.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$466.78
|
| Rate for Payer: Multiplan Commercial |
$1,497.60
|
| Rate for Payer: NAPHCARE Commercial |
$700.17
|
| Rate for Payer: Preferred Network Access Commercial |
$1,778.40
|
| Rate for Payer: Quartz Beloit One Network |
$823.68
|
| Rate for Payer: Quartz Commercial |
$1,067.04
|
| Rate for Payer: Quartz Medicare Advantage |
$466.78
|
| Rate for Payer: The Alliance Commercial |
$1,983.83
|
| Rate for Payer: United Healthcare Medicaid |
$626.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$466.78
|
| Rate for Payer: WEA Trust Commercial |
$1,029.60
|
| Rate for Payer: WPS Commercial |
$2,100.52
|
|
|
TREATMENT OF TIBIA FRACTURE 27752
|
Professional
|
Both
|
$1,973.00
|
|
|
Service Code
|
CPT 27752
|
| Hospital Charge Code |
3014140
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$477.50 |
| Max. Negotiated Rate |
$2,148.73 |
| Rate for Payer: Aetna Commercial |
$1,949.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,764.65
|
| Rate for Payer: Aetna Managed Medicare |
$477.50
|
| Rate for Payer: Anthem Medicare Advantage |
$477.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$477.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$477.50
|
| Rate for Payer: Cash Price |
$591.90
|
| Rate for Payer: Cash Price |
$591.90
|
| Rate for Payer: Cash Price |
$591.90
|
| Rate for Payer: Cigna Commercial |
$1,949.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$511.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$477.50
|
| Rate for Payer: Health EOS Commercial |
$1,867.25
|
| Rate for Payer: HFN Commercial |
$1,949.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,702.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,702.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$477.50
|
| Rate for Payer: Multiplan Commercial |
$1,641.54
|
| Rate for Payer: NAPHCARE Commercial |
$716.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,949.32
|
| Rate for Payer: Quartz Beloit One Network |
$902.84
|
| Rate for Payer: Quartz Commercial |
$1,169.59
|
| Rate for Payer: Quartz Medicare Advantage |
$477.50
|
| Rate for Payer: The Alliance Commercial |
$2,029.35
|
| Rate for Payer: United Healthcare Medicaid |
$511.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$477.50
|
| Rate for Payer: WEA Trust Commercial |
$1,128.56
|
| Rate for Payer: WPS Commercial |
$2,148.73
|
|
|
TREATMENT OF TOE FRACTURE 28515
|
Professional
|
Both
|
$341.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
3014261
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.34 |
| Max. Negotiated Rate |
$641.63 |
| Rate for Payer: Aetna Commercial |
$336.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$304.99
|
| Rate for Payer: Aetna Managed Medicare |
$142.58
|
| Rate for Payer: Anthem Medicare Advantage |
$142.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$142.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$142.58
|
| Rate for Payer: Cash Price |
$102.30
|
| Rate for Payer: Cash Price |
$102.30
|
| Rate for Payer: Cash Price |
$102.30
|
| Rate for Payer: Cigna Commercial |
$336.91
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$78.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$142.58
|
| Rate for Payer: Health EOS Commercial |
$322.72
|
| Rate for Payer: HFN Commercial |
$336.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$497.92
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$497.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$142.58
|
| Rate for Payer: Multiplan Commercial |
$283.71
|
| Rate for Payer: NAPHCARE Commercial |
$213.88
|
| Rate for Payer: Preferred Network Access Commercial |
$336.91
|
| Rate for Payer: Quartz Beloit One Network |
$156.04
|
| Rate for Payer: Quartz Commercial |
$202.14
|
| Rate for Payer: Quartz Medicare Advantage |
$142.58
|
| Rate for Payer: The Alliance Commercial |
$605.98
|
| Rate for Payer: United Healthcare Medicaid |
$78.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$142.58
|
| Rate for Payer: WEA Trust Commercial |
$195.05
|
| Rate for Payer: WPS Commercial |
$641.63
|
|
|
TREATMENT OF URETHRA LESION 53260
|
Professional
|
Both
|
$675.00
|
|
|
Service Code
|
CPT 53260
|
| Hospital Charge Code |
3015011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.34 |
| Max. Negotiated Rate |
$718.43 |
| Rate for Payer: Aetna Commercial |
$666.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$603.72
|
| Rate for Payer: Aetna Managed Medicare |
$159.65
|
| Rate for Payer: Anthem Medicare Advantage |
$159.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$159.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$159.65
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Cigna Commercial |
$666.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$78.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$159.65
|
| Rate for Payer: Health EOS Commercial |
$638.82
|
| Rate for Payer: HFN Commercial |
$666.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$628.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$159.65
|
| Rate for Payer: Multiplan Commercial |
$561.60
|
| Rate for Payer: NAPHCARE Commercial |
$239.48
|
| Rate for Payer: Preferred Network Access Commercial |
$666.90
|
| Rate for Payer: Quartz Beloit One Network |
$308.88
|
| Rate for Payer: Quartz Commercial |
$400.14
|
| Rate for Payer: Quartz Medicare Advantage |
$159.65
|
| Rate for Payer: The Alliance Commercial |
$678.51
|
| Rate for Payer: United Healthcare Medicaid |
$78.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$159.65
|
| Rate for Payer: WEA Trust Commercial |
$386.10
|
| Rate for Payer: WPS Commercial |
$718.43
|
|
|
TREATMENT OF URETHRA LESION 53265
|
Professional
|
Both
|
$1,290.00
|
|
|
Service Code
|
CPT 53265
|
| Hospital Charge Code |
3015012
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$109.67 |
| Max. Negotiated Rate |
$1,274.52 |
| Rate for Payer: Aetna Commercial |
$1,274.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,153.78
|
| Rate for Payer: Aetna Managed Medicare |
$163.84
|
| Rate for Payer: Anthem Medicare Advantage |
$163.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$163.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$163.84
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cigna Commercial |
$1,274.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$109.67
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$163.84
|
| Rate for Payer: Health EOS Commercial |
$1,220.86
|
| Rate for Payer: HFN Commercial |
$1,274.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$652.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$652.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$163.84
|
| Rate for Payer: Multiplan Commercial |
$1,073.28
|
| Rate for Payer: NAPHCARE Commercial |
$245.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,274.52
|
| Rate for Payer: Quartz Beloit One Network |
$590.30
|
| Rate for Payer: Quartz Commercial |
$764.71
|
| Rate for Payer: Quartz Medicare Advantage |
$163.84
|
| Rate for Payer: The Alliance Commercial |
$696.33
|
| Rate for Payer: United Healthcare Medicaid |
$109.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$163.84
|
| Rate for Payer: WEA Trust Commercial |
$737.88
|
| Rate for Payer: WPS Commercial |
$737.29
|
|
|
TREAT METACARPAL FRACTURE 26605
|
Professional
|
Both
|
$672.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
3013970
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$239.78 |
| Max. Negotiated Rate |
$1,356.08 |
| Rate for Payer: Aetna Commercial |
$663.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$601.04
|
| Rate for Payer: Aetna Managed Medicare |
$301.35
|
| Rate for Payer: Anthem Medicare Advantage |
$301.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$301.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$301.35
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cigna Commercial |
$663.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$239.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$301.35
|
| Rate for Payer: Health EOS Commercial |
$635.98
|
| Rate for Payer: HFN Commercial |
$663.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,037.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,037.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$301.35
|
| Rate for Payer: Multiplan Commercial |
$559.10
|
| Rate for Payer: NAPHCARE Commercial |
$452.03
|
| Rate for Payer: Preferred Network Access Commercial |
$663.94
|
| Rate for Payer: Quartz Beloit One Network |
$307.51
|
| Rate for Payer: Quartz Commercial |
$398.36
|
| Rate for Payer: Quartz Medicare Advantage |
$301.35
|
| Rate for Payer: The Alliance Commercial |
$1,280.74
|
| Rate for Payer: United Healthcare Medicaid |
$239.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$301.35
|
| Rate for Payer: WEA Trust Commercial |
$384.38
|
| Rate for Payer: WPS Commercial |
$1,356.08
|
|
|
Treat Radius Fracture 2465050
|
Professional
|
Both
|
$1,295.00
|
|
|
Service Code
|
CPT 24650 50
|
| Hospital Charge Code |
5454900
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$198.19 |
| Max. Negotiated Rate |
$1,279.46 |
| Rate for Payer: Aetna Commercial |
$1,279.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,158.25
|
| Rate for Payer: Cash Price |
$388.50
|
| Rate for Payer: Cash Price |
$388.50
|
| Rate for Payer: Cash Price |
$388.50
|
| Rate for Payer: Cigna Commercial |
$1,279.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$198.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$808.08
|
| Rate for Payer: Health EOS Commercial |
$1,225.59
|
| Rate for Payer: HFN Commercial |
$1,279.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$859.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$859.25
|
| Rate for Payer: Multiplan Commercial |
$1,077.44
|
| Rate for Payer: Preferred Network Access Commercial |
$1,279.46
|
| Rate for Payer: Quartz Beloit One Network |
$592.59
|
| Rate for Payer: Quartz Commercial |
$767.68
|
| Rate for Payer: The Alliance Commercial |
$673.40
|
| Rate for Payer: United Healthcare Medicaid |
$198.19
|
| Rate for Payer: WEA Trust Commercial |
$740.74
|
| Rate for Payer: WPS Commercial |
$997.54
|
|
|
TREAT SESAMOID BONE FRACTURE 28530
|
Professional
|
Both
|
$770.00
|
|
|
Service Code
|
CPT 28530
|
| Hospital Charge Code |
3014263
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$62.24 |
| Max. Negotiated Rate |
$760.76 |
| Rate for Payer: Aetna Commercial |
$760.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$688.69
|
| Rate for Payer: Aetna Managed Medicare |
$101.69
|
| Rate for Payer: Anthem Medicare Advantage |
$101.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$101.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$101.69
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cigna Commercial |
$760.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$62.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$101.69
|
| Rate for Payer: Health EOS Commercial |
$728.73
|
| Rate for Payer: HFN Commercial |
$760.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$350.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$350.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$101.69
|
| Rate for Payer: Multiplan Commercial |
$640.64
|
| Rate for Payer: NAPHCARE Commercial |
$152.54
|
| Rate for Payer: Preferred Network Access Commercial |
$760.76
|
| Rate for Payer: Quartz Beloit One Network |
$352.35
|
| Rate for Payer: Quartz Commercial |
$456.46
|
| Rate for Payer: Quartz Medicare Advantage |
$101.69
|
| Rate for Payer: The Alliance Commercial |
$432.19
|
| Rate for Payer: United Healthcare Medicaid |
$62.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$101.69
|
| Rate for Payer: WEA Trust Commercial |
$440.44
|
| Rate for Payer: WPS Commercial |
$457.61
|
|
|
TREAT SHOULDER BLADE FX 23570
|
Professional
|
Both
|
$644.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
3013787
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$103.63 |
| Max. Negotiated Rate |
$1,100.97 |
| Rate for Payer: Aetna Commercial |
$636.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$575.99
|
| Rate for Payer: Aetna Managed Medicare |
$244.66
|
| Rate for Payer: Anthem Medicare Advantage |
$244.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$244.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$244.66
|
| Rate for Payer: Cash Price |
$193.20
|
| Rate for Payer: Cash Price |
$193.20
|
| Rate for Payer: Cash Price |
$193.20
|
| Rate for Payer: Cigna Commercial |
$636.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$103.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$244.66
|
| Rate for Payer: Health EOS Commercial |
$609.48
|
| Rate for Payer: HFN Commercial |
$636.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$846.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$846.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$244.66
|
| Rate for Payer: Multiplan Commercial |
$535.81
|
| Rate for Payer: NAPHCARE Commercial |
$366.99
|
| Rate for Payer: Preferred Network Access Commercial |
$636.27
|
| Rate for Payer: Quartz Beloit One Network |
$294.69
|
| Rate for Payer: Quartz Commercial |
$381.76
|
| Rate for Payer: Quartz Medicare Advantage |
$244.66
|
| Rate for Payer: The Alliance Commercial |
$1,039.81
|
| Rate for Payer: United Healthcare Medicaid |
$103.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$244.66
|
| Rate for Payer: WEA Trust Commercial |
$368.37
|
| Rate for Payer: WPS Commercial |
$1,100.97
|
|
|
TREAT SHOULDER DISLOCATION 23650
|
Professional
|
Both
|
$967.00
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
3013796
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$196.21 |
| Max. Negotiated Rate |
$1,588.02 |
| Rate for Payer: Aetna Commercial |
$955.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$864.88
|
| Rate for Payer: Aetna Managed Medicare |
$352.89
|
| Rate for Payer: Anthem Medicare Advantage |
$352.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$352.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$352.89
|
| Rate for Payer: Cash Price |
$290.10
|
| Rate for Payer: Cash Price |
$290.10
|
| Rate for Payer: Cash Price |
$290.10
|
| Rate for Payer: Cigna Commercial |
$955.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$196.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$352.89
|
| Rate for Payer: Health EOS Commercial |
$915.17
|
| Rate for Payer: HFN Commercial |
$955.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,018.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,018.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$352.89
|
| Rate for Payer: Multiplan Commercial |
$804.54
|
| Rate for Payer: NAPHCARE Commercial |
$529.34
|
| Rate for Payer: Preferred Network Access Commercial |
$955.40
|
| Rate for Payer: Quartz Beloit One Network |
$442.50
|
| Rate for Payer: Quartz Commercial |
$573.24
|
| Rate for Payer: Quartz Medicare Advantage |
$352.89
|
| Rate for Payer: The Alliance Commercial |
$1,499.79
|
| Rate for Payer: United Healthcare Medicaid |
$196.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$352.89
|
| Rate for Payer: WEA Trust Commercial |
$553.12
|
| Rate for Payer: WPS Commercial |
$1,588.02
|
|
|
TREAT SPINE FRACTURE 22310
|
Professional
|
Both
|
$1,714.00
|
|
|
Service Code
|
CPT 22310
|
| Hospital Charge Code |
3013751
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$277.59 |
| Max. Negotiated Rate |
$1,693.43 |
| Rate for Payer: Aetna Commercial |
$1,693.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,533.00
|
| Rate for Payer: Aetna Managed Medicare |
$277.59
|
| Rate for Payer: Anthem Medicare Advantage |
$277.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$277.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$277.59
|
| Rate for Payer: Cash Price |
$514.20
|
| Rate for Payer: Cash Price |
$514.20
|
| Rate for Payer: Cash Price |
$514.20
|
| Rate for Payer: Cigna Commercial |
$1,693.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$470.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$277.59
|
| Rate for Payer: Health EOS Commercial |
$1,622.13
|
| Rate for Payer: HFN Commercial |
$1,693.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,016.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,016.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$277.59
|
| Rate for Payer: Multiplan Commercial |
$1,426.05
|
| Rate for Payer: NAPHCARE Commercial |
$416.38
|
| Rate for Payer: Preferred Network Access Commercial |
$1,693.43
|
| Rate for Payer: Quartz Beloit One Network |
$784.33
|
| Rate for Payer: Quartz Commercial |
$1,016.06
|
| Rate for Payer: Quartz Medicare Advantage |
$277.59
|
| Rate for Payer: The Alliance Commercial |
$1,179.74
|
| Rate for Payer: United Healthcare Medicaid |
$470.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$277.59
|
| Rate for Payer: WEA Trust Commercial |
$980.41
|
| Rate for Payer: WPS Commercial |
$1,249.14
|
|
|
TREAT SPINE FRACTURE 22315
|
Professional
|
Both
|
$2,834.00
|
|
|
Service Code
|
CPT 22315
|
| Hospital Charge Code |
3013752
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$470.08 |
| Max. Negotiated Rate |
$3,195.50 |
| Rate for Payer: Aetna Commercial |
$2,799.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,534.73
|
| Rate for Payer: Aetna Managed Medicare |
$710.11
|
| Rate for Payer: Anthem Medicare Advantage |
$710.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$710.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$710.11
|
| Rate for Payer: Cash Price |
$850.20
|
| Rate for Payer: Cash Price |
$850.20
|
| Rate for Payer: Cash Price |
$850.20
|
| Rate for Payer: Cigna Commercial |
$2,799.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$470.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$710.11
|
| Rate for Payer: Health EOS Commercial |
$2,682.10
|
| Rate for Payer: HFN Commercial |
$2,799.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,636.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,636.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$710.11
|
| Rate for Payer: Multiplan Commercial |
$2,357.89
|
| Rate for Payer: NAPHCARE Commercial |
$1,065.17
|
| Rate for Payer: Preferred Network Access Commercial |
$2,799.99
|
| Rate for Payer: Quartz Beloit One Network |
$1,296.84
|
| Rate for Payer: Quartz Commercial |
$1,680.00
|
| Rate for Payer: Quartz Medicare Advantage |
$710.11
|
| Rate for Payer: The Alliance Commercial |
$3,017.98
|
| Rate for Payer: United Healthcare Medicaid |
$470.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$710.11
|
| Rate for Payer: WEA Trust Commercial |
$1,621.05
|
| Rate for Payer: WPS Commercial |
$3,195.50
|
|
|
TREAT STERNUM FRACTURE 21820
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
CPT 21820
|
| Hospital Charge Code |
3013744
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$142.20 |
| Max. Negotiated Rate |
$737.01 |
| Rate for Payer: Aetna Commercial |
$640.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$579.57
|
| Rate for Payer: Aetna Managed Medicare |
$163.78
|
| Rate for Payer: Anthem Medicare Advantage |
$163.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$163.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$163.78
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cigna Commercial |
$640.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$142.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$163.78
|
| Rate for Payer: Health EOS Commercial |
$613.27
|
| Rate for Payer: HFN Commercial |
$640.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$508.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$508.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$163.78
|
| Rate for Payer: Multiplan Commercial |
$539.14
|
| Rate for Payer: NAPHCARE Commercial |
$245.67
|
| Rate for Payer: Preferred Network Access Commercial |
$640.22
|
| Rate for Payer: Quartz Beloit One Network |
$296.52
|
| Rate for Payer: Quartz Commercial |
$384.13
|
| Rate for Payer: Quartz Medicare Advantage |
$163.78
|
| Rate for Payer: The Alliance Commercial |
$696.06
|
| Rate for Payer: United Healthcare Medicaid |
$142.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$163.78
|
| Rate for Payer: WEA Trust Commercial |
$370.66
|
| Rate for Payer: WPS Commercial |
$737.01
|
|
|
TREAT TAIL BONE FRACTURE 27200
|
Professional
|
Both
|
$518.00
|
|
|
Service Code
|
CPT 27200
|
| Hospital Charge Code |
3014027
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$156.69 |
| Max. Negotiated Rate |
$872.63 |
| Rate for Payer: Aetna Commercial |
$511.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$463.30
|
| Rate for Payer: Aetna Managed Medicare |
$193.92
|
| Rate for Payer: Anthem Medicare Advantage |
$193.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$193.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$193.92
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cigna Commercial |
$511.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$156.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$193.92
|
| Rate for Payer: Health EOS Commercial |
$490.24
|
| Rate for Payer: HFN Commercial |
$511.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$653.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$653.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$193.92
|
| Rate for Payer: Multiplan Commercial |
$430.98
|
| Rate for Payer: NAPHCARE Commercial |
$290.88
|
| Rate for Payer: Preferred Network Access Commercial |
$511.78
|
| Rate for Payer: Quartz Beloit One Network |
$237.04
|
| Rate for Payer: Quartz Commercial |
$307.07
|
| Rate for Payer: Quartz Medicare Advantage |
$193.92
|
| Rate for Payer: The Alliance Commercial |
$824.15
|
| Rate for Payer: United Healthcare Medicaid |
$156.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$193.92
|
| Rate for Payer: WEA Trust Commercial |
$296.30
|
| Rate for Payer: WPS Commercial |
$872.63
|
|
|
TREAT THIGH FRACTURE 27230
|
Professional
|
Both
|
$1,961.00
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
3014029
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$451.93 |
| Max. Negotiated Rate |
$2,033.69 |
| Rate for Payer: Aetna Commercial |
$1,937.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,753.92
|
| Rate for Payer: Aetna Managed Medicare |
$451.93
|
| Rate for Payer: Anthem Medicare Advantage |
$451.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$451.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$451.93
|
| Rate for Payer: Cash Price |
$588.30
|
| Rate for Payer: Cash Price |
$588.30
|
| Rate for Payer: Cash Price |
$588.30
|
| Rate for Payer: Cigna Commercial |
$1,937.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$548.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$451.93
|
| Rate for Payer: Health EOS Commercial |
$1,855.89
|
| Rate for Payer: HFN Commercial |
$1,937.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,653.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,653.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$451.93
|
| Rate for Payer: Multiplan Commercial |
$1,631.55
|
| Rate for Payer: NAPHCARE Commercial |
$677.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,937.47
|
| Rate for Payer: Quartz Beloit One Network |
$897.35
|
| Rate for Payer: Quartz Commercial |
$1,162.48
|
| Rate for Payer: Quartz Medicare Advantage |
$451.93
|
| Rate for Payer: The Alliance Commercial |
$1,920.71
|
| Rate for Payer: United Healthcare Medicaid |
$548.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$451.93
|
| Rate for Payer: WEA Trust Commercial |
$1,121.69
|
| Rate for Payer: WPS Commercial |
$2,033.69
|
|
|
TREAT THIGH FRACTURE 27246
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
3014035
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$313.36 |
| Max. Negotiated Rate |
$1,620.50 |
| Rate for Payer: Aetna Commercial |
$979.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$886.35
|
| Rate for Payer: Aetna Managed Medicare |
$360.11
|
| Rate for Payer: Anthem Medicare Advantage |
$360.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$360.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$360.11
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$979.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$313.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$360.11
|
| Rate for Payer: Health EOS Commercial |
$937.88
|
| Rate for Payer: HFN Commercial |
$979.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,338.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,338.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$360.11
|
| Rate for Payer: Multiplan Commercial |
$824.51
|
| Rate for Payer: NAPHCARE Commercial |
$540.17
|
| Rate for Payer: Preferred Network Access Commercial |
$979.11
|
| Rate for Payer: Quartz Beloit One Network |
$453.48
|
| Rate for Payer: Quartz Commercial |
$587.46
|
| Rate for Payer: Quartz Medicare Advantage |
$360.11
|
| Rate for Payer: The Alliance Commercial |
$1,530.47
|
| Rate for Payer: United Healthcare Medicaid |
$313.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$360.11
|
| Rate for Payer: WEA Trust Commercial |
$566.85
|
| Rate for Payer: WPS Commercial |
$1,620.50
|
|
|
TREAT THIGH FX GROWTH PLATE 27516
|
Professional
|
Both
|
$2,001.00
|
|
|
Service Code
|
CPT 27516
|
| Hospital Charge Code |
3014091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$457.41 |
| Max. Negotiated Rate |
$2,058.36 |
| Rate for Payer: Aetna Commercial |
$1,976.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,789.69
|
| Rate for Payer: Aetna Managed Medicare |
$457.41
|
| Rate for Payer: Anthem Medicare Advantage |
$457.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$457.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$457.41
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Cigna Commercial |
$1,976.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$470.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$457.41
|
| Rate for Payer: Health EOS Commercial |
$1,893.75
|
| Rate for Payer: HFN Commercial |
$1,976.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,678.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,678.03
|
| Rate for Payer: Independent Care Health Plan Medicare |
$457.41
|
| Rate for Payer: Multiplan Commercial |
$1,664.83
|
| Rate for Payer: NAPHCARE Commercial |
$686.12
|
| Rate for Payer: Preferred Network Access Commercial |
$1,976.99
|
| Rate for Payer: Quartz Beloit One Network |
$915.66
|
| Rate for Payer: Quartz Commercial |
$1,186.19
|
| Rate for Payer: Quartz Medicare Advantage |
$457.41
|
| Rate for Payer: The Alliance Commercial |
$1,944.00
|
| Rate for Payer: United Healthcare Medicaid |
$470.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$457.41
|
| Rate for Payer: WEA Trust Commercial |
$1,144.57
|
| Rate for Payer: WPS Commercial |
$2,058.36
|
|
|
TREAT TOE DISLOCATION 28635
|
Professional
|
Both
|
$620.00
|
|
|
Service Code
|
CPT 28635
|
| Hospital Charge Code |
3014270
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$109.67 |
| Max. Negotiated Rate |
$612.56 |
| Rate for Payer: Aetna Commercial |
$612.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$554.53
|
| Rate for Payer: Aetna Managed Medicare |
$120.29
|
| Rate for Payer: Anthem Medicare Advantage |
$120.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$120.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$120.29
|
| Rate for Payer: Cash Price |
$186.00
|
| Rate for Payer: Cash Price |
$186.00
|
| Rate for Payer: Cash Price |
$186.00
|
| Rate for Payer: Cigna Commercial |
$612.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$109.67
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$120.29
|
| Rate for Payer: Health EOS Commercial |
$586.77
|
| Rate for Payer: HFN Commercial |
$612.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$470.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$470.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$120.29
|
| Rate for Payer: Multiplan Commercial |
$515.84
|
| Rate for Payer: NAPHCARE Commercial |
$180.43
|
| Rate for Payer: Preferred Network Access Commercial |
$612.56
|
| Rate for Payer: Quartz Beloit One Network |
$283.71
|
| Rate for Payer: Quartz Commercial |
$367.54
|
| Rate for Payer: Quartz Medicare Advantage |
$120.29
|
| Rate for Payer: The Alliance Commercial |
$511.22
|
| Rate for Payer: United Healthcare Medicaid |
$109.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$120.29
|
| Rate for Payer: WEA Trust Commercial |
$354.64
|
| Rate for Payer: WPS Commercial |
$541.29
|
|
|
TREAT TOE DISLOCATION 28636
|
Professional
|
Both
|
$1,132.00
|
|
|
Service Code
|
CPT 28636
|
| Hospital Charge Code |
3014271
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$207.71 |
| Max. Negotiated Rate |
$1,118.42 |
| Rate for Payer: Aetna Commercial |
$1,118.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,012.46
|
| Rate for Payer: Aetna Managed Medicare |
$207.71
|
| Rate for Payer: Anthem Medicare Advantage |
$207.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$207.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$207.71
|
| Rate for Payer: Cash Price |
$339.60
|
| Rate for Payer: Cash Price |
$339.60
|
| Rate for Payer: Cash Price |
$339.60
|
| Rate for Payer: Cigna Commercial |
$1,118.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$221.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$207.71
|
| Rate for Payer: Health EOS Commercial |
$1,071.32
|
| Rate for Payer: HFN Commercial |
$1,118.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$689.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$689.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$207.71
|
| Rate for Payer: Multiplan Commercial |
$941.82
|
| Rate for Payer: NAPHCARE Commercial |
$311.56
|
| Rate for Payer: Preferred Network Access Commercial |
$1,118.42
|
| Rate for Payer: Quartz Beloit One Network |
$518.00
|
| Rate for Payer: Quartz Commercial |
$671.05
|
| Rate for Payer: Quartz Medicare Advantage |
$207.71
|
| Rate for Payer: The Alliance Commercial |
$882.76
|
| Rate for Payer: United Healthcare Medicaid |
$221.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$207.71
|
| Rate for Payer: WEA Trust Commercial |
$647.50
|
| Rate for Payer: WPS Commercial |
$934.69
|
|
