|
UNCOMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$38,992.72
|
|
|
Service Code
|
MSDRG 383
|
| Min. Negotiated Rate |
$11,080.46 |
| Max. Negotiated Rate |
$38,992.72 |
| Rate for Payer: Aetna Managed Medicare |
$11,080.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$30,125.77
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$23,091.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21,938.11
|
| Rate for Payer: Anthem Medicare Advantage |
$11,080.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11,080.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11,080.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11,080.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24,353.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11,080.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28,355.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11,080.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11,080.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11,080.46
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11,080.46
|
| Rate for Payer: NAPHCARE Commercial |
$16,620.69
|
| Rate for Payer: Quartz Medicare Advantage |
$11,080.46
|
| Rate for Payer: The Alliance Commercial |
$38,992.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,080.46
|
| Rate for Payer: United Healthcare PPO |
$22,075.11
|
| Rate for Payer: Wellcare Medicare |
$11,080.46
|
|
|
UNCOMPLICATED PEPTIC ULCER WITHOUT MCC
|
Facility
|
IP
|
$24,546.08
|
|
|
Service Code
|
MSDRG 384
|
| Min. Negotiated Rate |
$7,053.01 |
| Max. Negotiated Rate |
$24,546.08 |
| Rate for Payer: Aetna Managed Medicare |
$7,053.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,651.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14,295.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$13,582.02
|
| Rate for Payer: Anthem Medicare Advantage |
$7,053.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,053.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,053.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,053.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15,077.29
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,053.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17,759.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,053.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,053.01
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,053.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,053.01
|
| Rate for Payer: NAPHCARE Commercial |
$10,579.51
|
| Rate for Payer: Quartz Medicare Advantage |
$7,053.01
|
| Rate for Payer: The Alliance Commercial |
$24,546.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,053.01
|
| Rate for Payer: United Healthcare PPO |
$13,825.76
|
| Rate for Payer: Wellcare Medicare |
$7,053.01
|
|
|
UNDERWEAR DISP PULL UP XL #1625
|
Facility
|
OP
|
$27.00
|
|
| Hospital Charge Code |
2974518
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$25.83 |
| Rate for Payer: Aetna Commercial |
$25.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$24.15
|
| Rate for Payer: Aetna Managed Medicare |
$7.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$13.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14.88
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cigna Commercial |
$25.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.71
|
| Rate for Payer: Health EOS Commercial |
$24.99
|
| Rate for Payer: HFN Commercial |
$25.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.06
|
| Rate for Payer: Multiplan Commercial |
$22.46
|
| Rate for Payer: NAPHCARE Commercial |
$16.85
|
| Rate for Payer: Preferred Network Access Commercial |
$25.83
|
| Rate for Payer: Quartz Beloit One Network |
$13.76
|
| Rate for Payer: Quartz Commercial |
$18.25
|
| Rate for Payer: Quartz Medicare Advantage |
$16.85
|
| Rate for Payer: The Alliance Commercial |
$14.04
|
| Rate for Payer: WEA Trust Commercial |
$15.44
|
| Rate for Payer: WPS Commercial |
$20.80
|
|
|
UNDERWEAR DISP PULL UP XL #1625
|
Facility
|
IP
|
$27.00
|
|
| Hospital Charge Code |
2974518
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$25.83 |
| Rate for Payer: Aetna Commercial |
$25.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$24.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14.88
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cigna Commercial |
$25.83
|
| Rate for Payer: Health EOS Commercial |
$24.99
|
| Rate for Payer: HFN Commercial |
$25.83
|
| Rate for Payer: Multiplan Commercial |
$22.46
|
| Rate for Payer: Preferred Network Access Commercial |
$25.83
|
| Rate for Payer: Quartz Beloit One Network |
$13.76
|
| Rate for Payer: Quartz Commercial |
$16.85
|
| Rate for Payer: WEA Trust Commercial |
$15.44
|
| Rate for Payer: WPS Commercial |
$20.80
|
|
|
UNI COMPARTMENTAL KNEE ARTHROPLASTY
|
Facility
|
OP
|
$13,291.00
|
|
| Hospital Charge Code |
4524686
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,870.34 |
| Max. Negotiated Rate |
$12,716.83 |
| Rate for Payer: Aetna Commercial |
$12,440.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$11,887.47
|
| Rate for Payer: Aetna Managed Medicare |
$3,870.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$8,984.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6,911.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6,634.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,326.00
|
| Rate for Payer: Cash Price |
$3,987.30
|
| Rate for Payer: Cigna Commercial |
$12,716.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,735.36
|
| Rate for Payer: Health EOS Commercial |
$12,302.15
|
| Rate for Payer: HFN Commercial |
$12,716.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,366.98
|
| Rate for Payer: Multiplan Commercial |
$11,058.11
|
| Rate for Payer: NAPHCARE Commercial |
$8,293.58
|
| Rate for Payer: Preferred Network Access Commercial |
$12,716.83
|
| Rate for Payer: Quartz Beloit One Network |
$6,773.09
|
| Rate for Payer: Quartz Commercial |
$8,984.72
|
| Rate for Payer: Quartz Medicare Advantage |
$8,293.58
|
| Rate for Payer: The Alliance Commercial |
$6,911.32
|
| Rate for Payer: WEA Trust Commercial |
$7,602.45
|
| Rate for Payer: WPS Commercial |
$10,238.06
|
|
|
UNI COMPARTMENTAL KNEE ARTHROPLASTY
|
Facility
|
IP
|
$13,291.00
|
|
| Hospital Charge Code |
4524686
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,773.09 |
| Max. Negotiated Rate |
$12,716.83 |
| Rate for Payer: Aetna Commercial |
$12,440.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$11,887.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,326.00
|
| Rate for Payer: Cash Price |
$3,987.30
|
| Rate for Payer: Cigna Commercial |
$12,716.83
|
| Rate for Payer: Health EOS Commercial |
$12,302.15
|
| Rate for Payer: HFN Commercial |
$12,716.83
|
| Rate for Payer: Multiplan Commercial |
$11,058.11
|
| Rate for Payer: Preferred Network Access Commercial |
$12,716.83
|
| Rate for Payer: Quartz Beloit One Network |
$6,773.09
|
| Rate for Payer: Quartz Commercial |
$8,293.58
|
| Rate for Payer: WEA Trust Commercial |
$7,602.45
|
| Rate for Payer: WPS Commercial |
$10,238.06
|
|
|
UNIVERSAL JOINT FOR TWO TUBES 393.71
|
Facility
|
OP
|
$4,057.00
|
|
| Hospital Charge Code |
5811628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,181.40 |
| Max. Negotiated Rate |
$3,881.74 |
| Rate for Payer: Aetna Commercial |
$3,797.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,628.58
|
| Rate for Payer: Aetna Managed Medicare |
$1,181.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,742.53
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,109.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,025.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,236.22
|
| Rate for Payer: Cash Price |
$1,217.10
|
| Rate for Payer: Cigna Commercial |
$3,881.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,361.17
|
| Rate for Payer: Health EOS Commercial |
$3,755.16
|
| Rate for Payer: HFN Commercial |
$3,881.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,164.46
|
| Rate for Payer: Multiplan Commercial |
$3,375.42
|
| Rate for Payer: NAPHCARE Commercial |
$2,531.57
|
| Rate for Payer: Preferred Network Access Commercial |
$3,881.74
|
| Rate for Payer: Quartz Beloit One Network |
$2,067.45
|
| Rate for Payer: Quartz Commercial |
$2,742.53
|
| Rate for Payer: Quartz Medicare Advantage |
$2,531.57
|
| Rate for Payer: The Alliance Commercial |
$2,109.64
|
| Rate for Payer: WEA Trust Commercial |
$2,320.60
|
| Rate for Payer: WPS Commercial |
$3,125.11
|
|
|
UNIVERSAL JOINT FOR TWO TUBES 393.71
|
Facility
|
IP
|
$4,057.00
|
|
| Hospital Charge Code |
5811628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,067.45 |
| Max. Negotiated Rate |
$3,881.74 |
| Rate for Payer: Aetna Commercial |
$3,797.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,628.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,236.22
|
| Rate for Payer: Cash Price |
$1,217.10
|
| Rate for Payer: Cigna Commercial |
$3,881.74
|
| Rate for Payer: Health EOS Commercial |
$3,755.16
|
| Rate for Payer: HFN Commercial |
$3,881.74
|
| Rate for Payer: Multiplan Commercial |
$3,375.42
|
| Rate for Payer: Preferred Network Access Commercial |
$3,881.74
|
| Rate for Payer: Quartz Beloit One Network |
$2,067.45
|
| Rate for Payer: Quartz Commercial |
$2,531.57
|
| Rate for Payer: WEA Trust Commercial |
$2,320.60
|
| Rate for Payer: WPS Commercial |
$3,125.11
|
|
|
UNLISTED LAPAROSCOPIC PROCEDURE, LIVER
|
Facility
|
OP
|
$25,449.01
|
|
|
Service Code
|
CPT 47379
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,476.64 |
| Max. Negotiated Rate |
$25,449.01 |
| Rate for Payer: Aetna Managed Medicare |
$6,362.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15,758.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$13,140.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12,483.12
|
| Rate for Payer: Anthem Medicare Advantage |
$6,362.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,362.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,362.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,362.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,490.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,362.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23,667.58
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,362.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,362.25
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,362.25
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,362.25
|
| Rate for Payer: NAPHCARE Commercial |
$9,543.38
|
| Rate for Payer: Quartz Medicare Advantage |
$6,362.25
|
| Rate for Payer: The Alliance Commercial |
$25,449.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,362.25
|
| Rate for Payer: United Healthcare PPO |
$5,476.64
|
| Rate for Payer: Wellcare Medicare |
$6,362.25
|
|
|
UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM
|
Facility
|
OP
|
$25,449.01
|
|
|
Service Code
|
CPT 49329
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,476.64 |
| Max. Negotiated Rate |
$25,449.01 |
| Rate for Payer: Aetna Managed Medicare |
$6,362.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15,758.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$13,140.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12,483.12
|
| Rate for Payer: Anthem Medicare Advantage |
$6,362.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,362.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,362.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,362.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,490.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,362.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23,667.58
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,362.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,362.25
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,362.25
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,362.25
|
| Rate for Payer: NAPHCARE Commercial |
$9,543.38
|
| Rate for Payer: Quartz Medicare Advantage |
$6,362.25
|
| Rate for Payer: The Alliance Commercial |
$25,449.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,362.25
|
| Rate for Payer: United Healthcare PPO |
$5,476.64
|
| Rate for Payer: Wellcare Medicare |
$6,362.25
|
|
|
Unlisted Magnetic Resonance 7649872195
|
Facility
|
OP
|
$5,056.00
|
|
|
Service Code
|
CPT 76498
|
| Hospital Charge Code |
5518689
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$91.58 |
| Max. Negotiated Rate |
$4,837.58 |
| Rate for Payer: Aetna Commercial |
$4,732.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,522.09
|
| Rate for Payer: Aetna Managed Medicare |
$91.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$91.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,786.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$91.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$91.58
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cigna Commercial |
$4,837.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$91.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,942.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$91.58
|
| Rate for Payer: Health EOS Commercial |
$4,679.83
|
| Rate for Payer: HFN Commercial |
$4,837.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$340.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$91.58
|
| Rate for Payer: Independent Care Health Plan Medicare |
$91.58
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$91.58
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$91.58
|
| Rate for Payer: Multiplan Commercial |
$4,206.59
|
| Rate for Payer: NAPHCARE Commercial |
$137.37
|
| Rate for Payer: Preferred Network Access Commercial |
$4,837.58
|
| Rate for Payer: Quartz Beloit One Network |
$2,576.54
|
| Rate for Payer: Quartz Commercial |
$3,417.86
|
| Rate for Payer: Quartz Medicare Advantage |
$91.58
|
| Rate for Payer: The Alliance Commercial |
$366.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.58
|
| Rate for Payer: United Healthcare PPO |
$3,142.88
|
| Rate for Payer: WEA Trust Commercial |
$2,892.03
|
| Rate for Payer: Wellcare Medicare |
$91.58
|
| Rate for Payer: WPS Commercial |
$3,894.64
|
|
|
Unlisted Magnetic Resonance 7649872195
|
Facility
|
IP
|
$5,056.00
|
|
|
Service Code
|
CPT 76498
|
| Hospital Charge Code |
5518689
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,576.54 |
| Max. Negotiated Rate |
$4,837.58 |
| Rate for Payer: Aetna Commercial |
$4,732.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,522.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,786.87
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cigna Commercial |
$4,837.58
|
| Rate for Payer: Health EOS Commercial |
$4,679.83
|
| Rate for Payer: HFN Commercial |
$4,837.58
|
| Rate for Payer: Multiplan Commercial |
$4,206.59
|
| Rate for Payer: Preferred Network Access Commercial |
$4,837.58
|
| Rate for Payer: Quartz Beloit One Network |
$2,576.54
|
| Rate for Payer: Quartz Commercial |
$3,154.94
|
| Rate for Payer: WEA Trust Commercial |
$2,892.03
|
| Rate for Payer: WPS Commercial |
$3,894.64
|
|
|
UNLISTED PROCEDURE, ABDOMEN, MUSCULOSKELETAL SYSTEM
|
Facility
|
OP
|
$29,092.96
|
|
|
Service Code
|
CPT 22999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$259.59 |
| Max. Negotiated Rate |
$29,092.96 |
| Rate for Payer: Aetna Managed Medicare |
$259.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29,092.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,282.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,968.32
|
| Rate for Payer: Anthem Medicare Advantage |
$259.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$259.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$259.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$259.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$259.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$965.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$259.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$259.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$259.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$259.59
|
| Rate for Payer: NAPHCARE Commercial |
$389.39
|
| Rate for Payer: Quartz Medicare Advantage |
$259.59
|
| Rate for Payer: The Alliance Commercial |
$1,038.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.59
|
| Rate for Payer: United Healthcare PPO |
$14,223.04
|
| Rate for Payer: Wellcare Medicare |
$259.59
|
|
|
UNLISTED PROCEDURE, ANUS
|
Facility
|
OP
|
$29,092.96
|
|
|
Service Code
|
CPT 46999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$978.68 |
| Max. Negotiated Rate |
$29,092.96 |
| Rate for Payer: Aetna Managed Medicare |
$978.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29,092.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,282.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,968.32
|
| Rate for Payer: Anthem Medicare Advantage |
$978.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$978.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$978.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$978.68
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$978.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,640.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$978.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$978.68
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$978.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$978.68
|
| Rate for Payer: NAPHCARE Commercial |
$1,468.02
|
| Rate for Payer: Quartz Medicare Advantage |
$978.68
|
| Rate for Payer: The Alliance Commercial |
$3,914.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$978.68
|
| Rate for Payer: United Healthcare PPO |
$14,223.04
|
| Rate for Payer: Wellcare Medicare |
$978.68
|
|
|
UNLISTED PROCEDURE, ARTHROSCOPY
|
Facility
|
OP
|
$29,092.96
|
|
|
Service Code
|
CPT 29999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$259.59 |
| Max. Negotiated Rate |
$29,092.96 |
| Rate for Payer: Aetna Managed Medicare |
$259.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29,092.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,282.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,968.32
|
| Rate for Payer: Anthem Medicare Advantage |
$259.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$259.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$259.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$259.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$259.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$965.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$259.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$259.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$259.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$259.59
|
| Rate for Payer: NAPHCARE Commercial |
$389.39
|
| Rate for Payer: Quartz Medicare Advantage |
$259.59
|
| Rate for Payer: The Alliance Commercial |
$1,038.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.59
|
| Rate for Payer: United Healthcare PPO |
$14,223.04
|
| Rate for Payer: Wellcare Medicare |
$259.59
|
|
|
UNLISTED PROCEDURE, LEG OR ANKLE
|
Facility
|
OP
|
$29,092.96
|
|
|
Service Code
|
CPT 27899
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$259.59 |
| Max. Negotiated Rate |
$29,092.96 |
| Rate for Payer: Aetna Managed Medicare |
$259.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29,092.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,282.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,968.32
|
| Rate for Payer: Anthem Medicare Advantage |
$259.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$259.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$259.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$259.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$259.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$965.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$259.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$259.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$259.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$259.59
|
| Rate for Payer: NAPHCARE Commercial |
$389.39
|
| Rate for Payer: Quartz Medicare Advantage |
$259.59
|
| Rate for Payer: The Alliance Commercial |
$1,038.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$259.59
|
| Rate for Payer: United Healthcare PPO |
$14,223.04
|
| Rate for Payer: Wellcare Medicare |
$259.59
|
|
|
UNLISTED PROCEDURE, PHARYNX, ADENOIDS, OR TONSILS
|
Facility
|
OP
|
$29,092.96
|
|
|
Service Code
|
CPT 42999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$249.26 |
| Max. Negotiated Rate |
$29,092.96 |
| Rate for Payer: Aetna Managed Medicare |
$249.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29,092.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,282.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,968.32
|
| Rate for Payer: Anthem Medicare Advantage |
$249.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$249.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$249.26
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$249.26
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$249.26
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$927.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$249.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$249.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$249.26
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$249.26
|
| Rate for Payer: NAPHCARE Commercial |
$373.89
|
| Rate for Payer: Quartz Medicare Advantage |
$249.26
|
| Rate for Payer: The Alliance Commercial |
$997.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$249.26
|
| Rate for Payer: United Healthcare PPO |
$14,223.04
|
| Rate for Payer: Wellcare Medicare |
$249.26
|
|
|
UNLISTED PROCEDURE STOMACH 43999-43762
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
CPT 43999
|
| Hospital Charge Code |
5609741
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$93.35 |
| Max. Negotiated Rate |
$201.55 |
| Rate for Payer: Aetna Commercial |
$201.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$182.46
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$201.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$106.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$127.30
|
| Rate for Payer: Health EOS Commercial |
$193.07
|
| Rate for Payer: HFN Commercial |
$201.55
|
| Rate for Payer: Multiplan Commercial |
$169.73
|
| Rate for Payer: Preferred Network Access Commercial |
$201.55
|
| Rate for Payer: Quartz Beloit One Network |
$93.35
|
| Rate for Payer: Quartz Commercial |
$120.93
|
| Rate for Payer: The Alliance Commercial |
$106.08
|
| Rate for Payer: WEA Trust Commercial |
$116.69
|
| Rate for Payer: WPS Commercial |
$157.14
|
|
|
UNLISTED PROCEDURE, VASCULAR SURGERY
|
Facility
|
OP
|
$29,092.96
|
|
|
Service Code
|
CPT 37799
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$660.17 |
| Max. Negotiated Rate |
$29,092.96 |
| Rate for Payer: Aetna Managed Medicare |
$660.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29,092.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,282.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,968.32
|
| Rate for Payer: Anthem Medicare Advantage |
$660.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$660.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$660.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$660.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$660.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,455.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$660.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$660.17
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$660.17
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$660.17
|
| Rate for Payer: NAPHCARE Commercial |
$990.26
|
| Rate for Payer: Quartz Medicare Advantage |
$660.17
|
| Rate for Payer: The Alliance Commercial |
$2,640.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$660.17
|
| Rate for Payer: United Healthcare PPO |
$14,223.04
|
| Rate for Payer: Wellcare Medicare |
$660.17
|
|
|
Unna Boot
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
2572822
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.02 |
| Max. Negotiated Rate |
$179.82 |
| Rate for Payer: Aetna Commercial |
$179.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$162.78
|
| Rate for Payer: Aetna Managed Medicare |
$22.51
|
| Rate for Payer: Anthem Medicare Advantage |
$22.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$22.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$22.51
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$179.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$22.51
|
| Rate for Payer: Health EOS Commercial |
$172.24
|
| Rate for Payer: HFN Commercial |
$179.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$92.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$92.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$22.51
|
| Rate for Payer: Multiplan Commercial |
$151.42
|
| Rate for Payer: NAPHCARE Commercial |
$33.76
|
| Rate for Payer: Preferred Network Access Commercial |
$179.82
|
| Rate for Payer: Quartz Beloit One Network |
$83.28
|
| Rate for Payer: Quartz Commercial |
$107.89
|
| Rate for Payer: Quartz Medicare Advantage |
$22.51
|
| Rate for Payer: The Alliance Commercial |
$95.65
|
| Rate for Payer: United Healthcare Medicaid |
$21.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22.51
|
| Rate for Payer: WEA Trust Commercial |
$104.10
|
| Rate for Payer: WPS Commercial |
$101.28
|
|
|
Unna Boot 29580PP
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
3133515
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.02 |
| Max. Negotiated Rate |
$296.40 |
| Rate for Payer: Aetna Commercial |
$296.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$268.32
|
| Rate for Payer: Aetna Managed Medicare |
$22.51
|
| Rate for Payer: Anthem Medicare Advantage |
$22.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$22.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$22.51
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cigna Commercial |
$296.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$22.51
|
| Rate for Payer: Health EOS Commercial |
$283.92
|
| Rate for Payer: HFN Commercial |
$296.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$92.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$92.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$22.51
|
| Rate for Payer: Multiplan Commercial |
$249.60
|
| Rate for Payer: NAPHCARE Commercial |
$33.76
|
| Rate for Payer: Preferred Network Access Commercial |
$296.40
|
| Rate for Payer: Quartz Beloit One Network |
$137.28
|
| Rate for Payer: Quartz Commercial |
$177.84
|
| Rate for Payer: Quartz Medicare Advantage |
$22.51
|
| Rate for Payer: The Alliance Commercial |
$95.65
|
| Rate for Payer: United Healthcare Medicaid |
$21.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22.51
|
| Rate for Payer: WEA Trust Commercial |
$171.60
|
| Rate for Payer: WPS Commercial |
$101.28
|
|
|
Unscheduled dialysis for an ESRD patient
|
Facility
|
IP
|
$1,331.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
5164612
|
|
Hospital Revenue Code
|
821
|
| Min. Negotiated Rate |
$678.28 |
| Max. Negotiated Rate |
$1,273.50 |
| Rate for Payer: Aetna Commercial |
$1,245.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,190.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$733.65
|
| Rate for Payer: Cash Price |
$399.30
|
| Rate for Payer: Cigna Commercial |
$1,273.50
|
| Rate for Payer: Health EOS Commercial |
$1,231.97
|
| Rate for Payer: HFN Commercial |
$1,273.50
|
| Rate for Payer: Multiplan Commercial |
$1,107.39
|
| Rate for Payer: Preferred Network Access Commercial |
$1,273.50
|
| Rate for Payer: Quartz Beloit One Network |
$678.28
|
| Rate for Payer: Quartz Commercial |
$830.54
|
| Rate for Payer: WEA Trust Commercial |
$761.33
|
| Rate for Payer: WPS Commercial |
$1,025.27
|
|
|
Unscheduled dialysis for an ESRD patient
|
Facility
|
OP
|
$1,331.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
5164612
|
|
Hospital Revenue Code
|
821
|
| Min. Negotiated Rate |
$678.28 |
| Max. Negotiated Rate |
$2,889.08 |
| Rate for Payer: Aetna Commercial |
$1,245.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,190.45
|
| Rate for Payer: Aetna Managed Medicare |
$722.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,332.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,194.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,134.64
|
| Rate for Payer: Anthem Medicare Advantage |
$722.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$733.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$722.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$722.27
|
| Rate for Payer: Cash Price |
$399.30
|
| Rate for Payer: Cash Price |
$399.30
|
| Rate for Payer: Cash Price |
$399.30
|
| Rate for Payer: Cigna Commercial |
$1,273.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$722.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$774.64
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$722.27
|
| Rate for Payer: Health EOS Commercial |
$1,231.97
|
| Rate for Payer: HFN Commercial |
$1,273.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,686.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$722.27
|
| Rate for Payer: Independent Care Health Plan Medicare |
$722.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$722.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$722.27
|
| Rate for Payer: Multiplan Commercial |
$1,107.39
|
| Rate for Payer: NAPHCARE Commercial |
$1,083.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,273.50
|
| Rate for Payer: Quartz Beloit One Network |
$678.28
|
| Rate for Payer: Quartz Commercial |
$899.76
|
| Rate for Payer: Quartz Medicare Advantage |
$722.27
|
| Rate for Payer: The Alliance Commercial |
$2,889.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$722.27
|
| Rate for Payer: United Healthcare PPO |
$1,038.18
|
| Rate for Payer: WEA Trust Commercial |
$761.33
|
| Rate for Payer: Wellcare Medicare |
$722.27
|
| Rate for Payer: WPS Commercial |
$1,025.27
|
|
|
UPEP Interpretation
|
Facility
|
IP
|
$237.00
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
2942979
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$120.78 |
| Max. Negotiated Rate |
$226.76 |
| Rate for Payer: Aetna Commercial |
$221.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$211.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$130.63
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cigna Commercial |
$226.76
|
| Rate for Payer: Health EOS Commercial |
$219.37
|
| Rate for Payer: HFN Commercial |
$226.76
|
| Rate for Payer: Multiplan Commercial |
$197.18
|
| Rate for Payer: Preferred Network Access Commercial |
$226.76
|
| Rate for Payer: Quartz Beloit One Network |
$120.78
|
| Rate for Payer: Quartz Commercial |
$147.89
|
| Rate for Payer: WEA Trust Commercial |
$135.56
|
| Rate for Payer: WPS Commercial |
$182.56
|
|
|
UPEP Interpretation
|
Facility
|
OP
|
$237.00
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
2942979
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.54 |
| Max. Negotiated Rate |
$226.76 |
| Rate for Payer: Aetna Commercial |
$221.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$211.97
|
| Rate for Payer: Aetna Managed Medicare |
$18.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$69.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$32.45
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30.78
|
| Rate for Payer: Anthem Medicare Advantage |
$18.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$130.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.54
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cigna Commercial |
$226.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$137.93
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18.54
|
| Rate for Payer: Health EOS Commercial |
$219.37
|
| Rate for Payer: HFN Commercial |
$226.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$68.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.54
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.54
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18.54
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18.54
|
| Rate for Payer: Multiplan Commercial |
$197.18
|
| Rate for Payer: NAPHCARE Commercial |
$27.81
|
| Rate for Payer: Preferred Network Access Commercial |
$226.76
|
| Rate for Payer: Quartz Beloit One Network |
$120.78
|
| Rate for Payer: Quartz Commercial |
$160.21
|
| Rate for Payer: Quartz Medicare Advantage |
$18.54
|
| Rate for Payer: The Alliance Commercial |
$74.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.54
|
| Rate for Payer: United Healthcare PPO |
$184.86
|
| Rate for Payer: WEA Trust Commercial |
$135.56
|
| Rate for Payer: Wellcare Medicare |
$18.54
|
| Rate for Payer: WPS Commercial |
$182.56
|
|
