|
Urine 24 Hour Protein, Total
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
2942978
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$44.46 |
| Rate for Payer: Aetna Commercial |
$44.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$40.25
|
| Rate for Payer: Aetna Managed Medicare |
$3.82
|
| Rate for Payer: Anthem Medicare Advantage |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.82
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna Commercial |
$44.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$23.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3.82
|
| Rate for Payer: Health EOS Commercial |
$42.59
|
| Rate for Payer: HFN Commercial |
$44.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.48
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.82
|
| Rate for Payer: Multiplan Commercial |
$37.44
|
| Rate for Payer: NAPHCARE Commercial |
$5.73
|
| Rate for Payer: Preferred Network Access Commercial |
$44.46
|
| Rate for Payer: Quartz Beloit One Network |
$20.59
|
| Rate for Payer: Quartz Commercial |
$26.68
|
| Rate for Payer: Quartz Medicare Advantage |
$3.82
|
| Rate for Payer: The Alliance Commercial |
$15.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.82
|
| Rate for Payer: WEA Trust Commercial |
$25.74
|
| Rate for Payer: WPS Commercial |
$16.79
|
|
|
Urine 24 Hour Protein, Total
|
Facility
|
IP
|
$45.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
2942978
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.93 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna Commercial |
$42.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$40.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$24.80
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna Commercial |
$43.06
|
| Rate for Payer: Health EOS Commercial |
$41.65
|
| Rate for Payer: HFN Commercial |
$43.06
|
| Rate for Payer: Multiplan Commercial |
$37.44
|
| Rate for Payer: Preferred Network Access Commercial |
$43.06
|
| Rate for Payer: Quartz Beloit One Network |
$22.93
|
| Rate for Payer: Quartz Commercial |
$28.08
|
| Rate for Payer: WEA Trust Commercial |
$25.74
|
| Rate for Payer: WPS Commercial |
$34.66
|
|
|
Urine Ammonium
|
Facility
|
IP
|
$131.00
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
2942998
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.76 |
| Max. Negotiated Rate |
$125.34 |
| Rate for Payer: Aetna Commercial |
$122.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$117.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.21
|
| Rate for Payer: Cash Price |
$39.30
|
| Rate for Payer: Cigna Commercial |
$125.34
|
| Rate for Payer: Health EOS Commercial |
$121.25
|
| Rate for Payer: HFN Commercial |
$125.34
|
| Rate for Payer: Multiplan Commercial |
$108.99
|
| Rate for Payer: Preferred Network Access Commercial |
$125.34
|
| Rate for Payer: Quartz Beloit One Network |
$66.76
|
| Rate for Payer: Quartz Commercial |
$81.74
|
| Rate for Payer: WEA Trust Commercial |
$74.93
|
| Rate for Payer: WPS Commercial |
$100.91
|
|
|
Urine Ammonium
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
2942998
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$129.43 |
| Rate for Payer: Aetna Commercial |
$129.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$117.17
|
| Rate for Payer: Aetna Managed Medicare |
$15.15
|
| Rate for Payer: Anthem Medicare Advantage |
$15.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.15
|
| Rate for Payer: Cash Price |
$39.30
|
| Rate for Payer: Cash Price |
$39.30
|
| Rate for Payer: Cigna Commercial |
$129.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$68.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.15
|
| Rate for Payer: Health EOS Commercial |
$123.98
|
| Rate for Payer: HFN Commercial |
$129.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.15
|
| Rate for Payer: Multiplan Commercial |
$108.99
|
| Rate for Payer: NAPHCARE Commercial |
$22.73
|
| Rate for Payer: Preferred Network Access Commercial |
$129.43
|
| Rate for Payer: Quartz Beloit One Network |
$59.95
|
| Rate for Payer: Quartz Commercial |
$77.66
|
| Rate for Payer: Quartz Medicare Advantage |
$15.15
|
| Rate for Payer: The Alliance Commercial |
$59.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.15
|
| Rate for Payer: WEA Trust Commercial |
$74.93
|
| Rate for Payer: WPS Commercial |
$66.67
|
|
|
Urine Ammonium
|
Facility
|
OP
|
$131.00
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
2942998
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$125.34 |
| Rate for Payer: Aetna Commercial |
$122.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$117.17
|
| Rate for Payer: Aetna Managed Medicare |
$15.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.15
|
| Rate for Payer: Anthem Medicare Advantage |
$15.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.15
|
| Rate for Payer: Cash Price |
$39.30
|
| Rate for Payer: Cash Price |
$39.30
|
| Rate for Payer: Cigna Commercial |
$125.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.15
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$76.24
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.15
|
| Rate for Payer: Health EOS Commercial |
$121.25
|
| Rate for Payer: HFN Commercial |
$125.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$56.37
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.15
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.15
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.15
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.15
|
| Rate for Payer: Multiplan Commercial |
$108.99
|
| Rate for Payer: NAPHCARE Commercial |
$22.73
|
| Rate for Payer: Preferred Network Access Commercial |
$125.34
|
| Rate for Payer: Quartz Beloit One Network |
$66.76
|
| Rate for Payer: Quartz Commercial |
$88.56
|
| Rate for Payer: Quartz Medicare Advantage |
$15.15
|
| Rate for Payer: The Alliance Commercial |
$60.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.15
|
| Rate for Payer: United Healthcare PPO |
$102.18
|
| Rate for Payer: WEA Trust Commercial |
$74.93
|
| Rate for Payer: Wellcare Medicare |
$15.15
|
| Rate for Payer: WPS Commercial |
$100.91
|
|
|
Urine Arsenic Random
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3986159
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$51.79
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Urine Arsenic Random
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3986159
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.73 |
| Max. Negotiated Rate |
$86.81 |
| Rate for Payer: Aetna Commercial |
$82.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$19.73
|
| Rate for Payer: Anthem Medicare Advantage |
$19.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19.73
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$82.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19.73
|
| Rate for Payer: Health EOS Commercial |
$78.55
|
| Rate for Payer: HFN Commercial |
$82.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$69.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$69.64
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19.73
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$29.59
|
| Rate for Payer: Preferred Network Access Commercial |
$82.00
|
| Rate for Payer: Quartz Beloit One Network |
$37.98
|
| Rate for Payer: Quartz Commercial |
$49.20
|
| Rate for Payer: Quartz Medicare Advantage |
$19.73
|
| Rate for Payer: The Alliance Commercial |
$77.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.73
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$86.81
|
|
|
Urine Arsenic Random
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3986159
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.73 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$19.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$73.98
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$34.53
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$32.75
|
| Rate for Payer: Anthem Medicare Advantage |
$19.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19.73
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$19.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$19.73
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$73.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19.73
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$19.73
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$19.73
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$29.59
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$56.11
|
| Rate for Payer: Quartz Medicare Advantage |
$19.73
|
| Rate for Payer: The Alliance Commercial |
$78.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.73
|
| Rate for Payer: United Healthcare PPO |
$64.74
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: Wellcare Medicare |
$19.73
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Urine Cadmium Level
|
Facility
|
IP
|
$636.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
2942906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$324.11 |
| Max. Negotiated Rate |
$608.52 |
| Rate for Payer: Aetna Commercial |
$595.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$568.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$350.56
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cigna Commercial |
$608.52
|
| Rate for Payer: Health EOS Commercial |
$588.68
|
| Rate for Payer: HFN Commercial |
$608.52
|
| Rate for Payer: Multiplan Commercial |
$529.15
|
| Rate for Payer: Preferred Network Access Commercial |
$608.52
|
| Rate for Payer: Quartz Beloit One Network |
$324.11
|
| Rate for Payer: Quartz Commercial |
$396.86
|
| Rate for Payer: WEA Trust Commercial |
$363.79
|
| Rate for Payer: WPS Commercial |
$489.91
|
|
|
Urine Cadmium Level
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
3986166
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$51.79
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Urine Cadmium Level
|
Professional
|
Both
|
$636.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
2942906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.59 |
| Max. Negotiated Rate |
$628.37 |
| Rate for Payer: Aetna Commercial |
$628.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$568.84
|
| Rate for Payer: Aetna Managed Medicare |
$24.59
|
| Rate for Payer: Anthem Medicare Advantage |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.59
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cigna Commercial |
$628.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$330.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24.59
|
| Rate for Payer: Health EOS Commercial |
$601.91
|
| Rate for Payer: HFN Commercial |
$628.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$86.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$86.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.59
|
| Rate for Payer: Multiplan Commercial |
$529.15
|
| Rate for Payer: NAPHCARE Commercial |
$36.88
|
| Rate for Payer: Preferred Network Access Commercial |
$628.37
|
| Rate for Payer: Quartz Beloit One Network |
$291.03
|
| Rate for Payer: Quartz Commercial |
$377.02
|
| Rate for Payer: Quartz Medicare Advantage |
$24.59
|
| Rate for Payer: The Alliance Commercial |
$97.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.59
|
| Rate for Payer: WEA Trust Commercial |
$363.79
|
| Rate for Payer: WPS Commercial |
$108.18
|
|
|
Urine Cadmium Level
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
3986166
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.59 |
| Max. Negotiated Rate |
$108.18 |
| Rate for Payer: Aetna Commercial |
$82.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$24.59
|
| Rate for Payer: Anthem Medicare Advantage |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.59
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$82.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24.59
|
| Rate for Payer: Health EOS Commercial |
$78.55
|
| Rate for Payer: HFN Commercial |
$82.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$86.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$86.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.59
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$36.88
|
| Rate for Payer: Preferred Network Access Commercial |
$82.00
|
| Rate for Payer: Quartz Beloit One Network |
$37.98
|
| Rate for Payer: Quartz Commercial |
$49.20
|
| Rate for Payer: Quartz Medicare Advantage |
$24.59
|
| Rate for Payer: The Alliance Commercial |
$97.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.59
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$108.18
|
|
|
Urine Cadmium Level
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
3986166
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.59 |
| Max. Negotiated Rate |
$98.34 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$24.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$92.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.02
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$40.81
|
| Rate for Payer: Anthem Medicare Advantage |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.59
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$24.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$24.59
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$91.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$24.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$24.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$24.59
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$36.88
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$56.11
|
| Rate for Payer: Quartz Medicare Advantage |
$24.59
|
| Rate for Payer: The Alliance Commercial |
$98.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.59
|
| Rate for Payer: United Healthcare PPO |
$64.74
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: Wellcare Medicare |
$24.59
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Urine Cadmium Level
|
Facility
|
OP
|
$636.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
2942906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.59 |
| Max. Negotiated Rate |
$608.52 |
| Rate for Payer: Aetna Commercial |
$595.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$568.84
|
| Rate for Payer: Aetna Managed Medicare |
$24.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$92.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.02
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$40.81
|
| Rate for Payer: Anthem Medicare Advantage |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$350.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.59
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cigna Commercial |
$608.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$24.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$370.15
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$24.59
|
| Rate for Payer: Health EOS Commercial |
$588.68
|
| Rate for Payer: HFN Commercial |
$608.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$91.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$24.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$24.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$24.59
|
| Rate for Payer: Multiplan Commercial |
$529.15
|
| Rate for Payer: NAPHCARE Commercial |
$36.88
|
| Rate for Payer: Preferred Network Access Commercial |
$608.52
|
| Rate for Payer: Quartz Beloit One Network |
$324.11
|
| Rate for Payer: Quartz Commercial |
$429.94
|
| Rate for Payer: Quartz Medicare Advantage |
$24.59
|
| Rate for Payer: The Alliance Commercial |
$98.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.59
|
| Rate for Payer: United Healthcare PPO |
$496.08
|
| Rate for Payer: WEA Trust Commercial |
$363.79
|
| Rate for Payer: Wellcare Medicare |
$24.59
|
| Rate for Payer: WPS Commercial |
$489.91
|
|
|
Urine Calcium
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
3813057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$25.08 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.78
|
| Rate for Payer: Aetna Managed Medicare |
$6.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.97
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.41
|
| Rate for Payer: Anthem Medicare Advantage |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.27
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$20.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.27
|
| Rate for Payer: Health EOS Commercial |
$19.44
|
| Rate for Payer: HFN Commercial |
$20.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.27
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.27
|
| Rate for Payer: Multiplan Commercial |
$17.47
|
| Rate for Payer: NAPHCARE Commercial |
$9.41
|
| Rate for Payer: Preferred Network Access Commercial |
$20.09
|
| Rate for Payer: Quartz Beloit One Network |
$10.70
|
| Rate for Payer: Quartz Commercial |
$14.20
|
| Rate for Payer: Quartz Medicare Advantage |
$6.27
|
| Rate for Payer: The Alliance Commercial |
$25.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.27
|
| Rate for Payer: United Healthcare PPO |
$16.38
|
| Rate for Payer: WEA Trust Commercial |
$12.01
|
| Rate for Payer: Wellcare Medicare |
$6.27
|
| Rate for Payer: WPS Commercial |
$16.18
|
|
|
Urine Calcium
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
3813057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.70 |
| Max. Negotiated Rate |
$20.09 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.58
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$20.09
|
| Rate for Payer: Health EOS Commercial |
$19.44
|
| Rate for Payer: HFN Commercial |
$20.09
|
| Rate for Payer: Multiplan Commercial |
$17.47
|
| Rate for Payer: Preferred Network Access Commercial |
$20.09
|
| Rate for Payer: Quartz Beloit One Network |
$10.70
|
| Rate for Payer: Quartz Commercial |
$13.10
|
| Rate for Payer: WEA Trust Commercial |
$12.01
|
| Rate for Payer: WPS Commercial |
$16.18
|
|
|
Urine Calcium
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
3813057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$27.59 |
| Rate for Payer: Aetna Commercial |
$20.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.78
|
| Rate for Payer: Aetna Managed Medicare |
$6.27
|
| Rate for Payer: Anthem Medicare Advantage |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.27
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$20.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.27
|
| Rate for Payer: Health EOS Commercial |
$19.87
|
| Rate for Payer: HFN Commercial |
$20.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.27
|
| Rate for Payer: Multiplan Commercial |
$17.47
|
| Rate for Payer: NAPHCARE Commercial |
$9.41
|
| Rate for Payer: Preferred Network Access Commercial |
$20.75
|
| Rate for Payer: Quartz Beloit One Network |
$9.61
|
| Rate for Payer: Quartz Commercial |
$12.45
|
| Rate for Payer: Quartz Medicare Advantage |
$6.27
|
| Rate for Payer: The Alliance Commercial |
$24.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.27
|
| Rate for Payer: WEA Trust Commercial |
$12.01
|
| Rate for Payer: WPS Commercial |
$27.59
|
|
|
Urine Citrate
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
3813060
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$127.21 |
| Rate for Payer: Aetna Commercial |
$20.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.78
|
| Rate for Payer: Aetna Managed Medicare |
$28.91
|
| Rate for Payer: Anthem Medicare Advantage |
$28.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$28.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$28.91
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$20.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28.91
|
| Rate for Payer: Health EOS Commercial |
$19.87
|
| Rate for Payer: HFN Commercial |
$20.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$102.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$102.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$28.91
|
| Rate for Payer: Multiplan Commercial |
$17.47
|
| Rate for Payer: NAPHCARE Commercial |
$43.37
|
| Rate for Payer: Preferred Network Access Commercial |
$20.75
|
| Rate for Payer: Quartz Beloit One Network |
$9.61
|
| Rate for Payer: Quartz Commercial |
$12.45
|
| Rate for Payer: Quartz Medicare Advantage |
$28.91
|
| Rate for Payer: The Alliance Commercial |
$114.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.91
|
| Rate for Payer: WEA Trust Commercial |
$12.01
|
| Rate for Payer: WPS Commercial |
$127.21
|
|
|
Urine Citrate
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
3813060
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.70 |
| Max. Negotiated Rate |
$115.65 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.78
|
| Rate for Payer: Aetna Managed Medicare |
$28.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$108.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$50.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$47.99
|
| Rate for Payer: Anthem Medicare Advantage |
$28.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$28.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$28.91
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$20.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$28.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$28.91
|
| Rate for Payer: Health EOS Commercial |
$19.44
|
| Rate for Payer: HFN Commercial |
$20.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$107.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$28.91
|
| Rate for Payer: Independent Care Health Plan Medicare |
$28.91
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$28.91
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$28.91
|
| Rate for Payer: Multiplan Commercial |
$17.47
|
| Rate for Payer: NAPHCARE Commercial |
$43.37
|
| Rate for Payer: Preferred Network Access Commercial |
$20.09
|
| Rate for Payer: Quartz Beloit One Network |
$10.70
|
| Rate for Payer: Quartz Commercial |
$14.20
|
| Rate for Payer: Quartz Medicare Advantage |
$28.91
|
| Rate for Payer: The Alliance Commercial |
$115.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.91
|
| Rate for Payer: United Healthcare PPO |
$16.38
|
| Rate for Payer: WEA Trust Commercial |
$12.01
|
| Rate for Payer: Wellcare Medicare |
$28.91
|
| Rate for Payer: WPS Commercial |
$16.18
|
|
|
Urine Citrate
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
3813060
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.70 |
| Max. Negotiated Rate |
$20.09 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.58
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$20.09
|
| Rate for Payer: Health EOS Commercial |
$19.44
|
| Rate for Payer: HFN Commercial |
$20.09
|
| Rate for Payer: Multiplan Commercial |
$17.47
|
| Rate for Payer: Preferred Network Access Commercial |
$20.09
|
| Rate for Payer: Quartz Beloit One Network |
$10.70
|
| Rate for Payer: Quartz Commercial |
$13.10
|
| Rate for Payer: WEA Trust Commercial |
$12.01
|
| Rate for Payer: WPS Commercial |
$16.18
|
|
|
Urine Citrate
|
Facility
|
OP
|
$237.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
2942992
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.91 |
| 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 |
$28.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$108.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$50.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$47.99
|
| Rate for Payer: Anthem Medicare Advantage |
$28.91
|
| 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 |
$28.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$28.91
|
| 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 |
$28.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$137.93
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$28.91
|
| Rate for Payer: Health EOS Commercial |
$219.37
|
| Rate for Payer: HFN Commercial |
$226.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$107.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$28.91
|
| Rate for Payer: Independent Care Health Plan Medicare |
$28.91
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$28.91
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$28.91
|
| Rate for Payer: Multiplan Commercial |
$197.18
|
| Rate for Payer: NAPHCARE Commercial |
$43.37
|
| 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 |
$28.91
|
| Rate for Payer: The Alliance Commercial |
$115.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.91
|
| Rate for Payer: United Healthcare PPO |
$184.86
|
| Rate for Payer: WEA Trust Commercial |
$135.56
|
| Rate for Payer: Wellcare Medicare |
$28.91
|
| Rate for Payer: WPS Commercial |
$182.56
|
|
|
Urine Citrate
|
Facility
|
IP
|
$237.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
2942992
|
|
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
|
|
|
Urine Citrate
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
2942992
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.91 |
| Max. Negotiated Rate |
$234.16 |
| Rate for Payer: Aetna Commercial |
$234.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$211.97
|
| Rate for Payer: Aetna Managed Medicare |
$28.91
|
| Rate for Payer: Anthem Medicare Advantage |
$28.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$28.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$28.91
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cigna Commercial |
$234.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$123.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28.91
|
| Rate for Payer: Health EOS Commercial |
$224.30
|
| Rate for Payer: HFN Commercial |
$234.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$102.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$102.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$28.91
|
| Rate for Payer: Multiplan Commercial |
$197.18
|
| Rate for Payer: NAPHCARE Commercial |
$43.37
|
| Rate for Payer: Preferred Network Access Commercial |
$234.16
|
| Rate for Payer: Quartz Beloit One Network |
$108.45
|
| Rate for Payer: Quartz Commercial |
$140.49
|
| Rate for Payer: Quartz Medicare Advantage |
$28.91
|
| Rate for Payer: The Alliance Commercial |
$114.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.91
|
| Rate for Payer: WEA Trust Commercial |
$135.56
|
| Rate for Payer: WPS Commercial |
$127.21
|
|
|
Urine Creatinine
|
Facility
|
OP
|
$126.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
982625
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$120.56 |
| Rate for Payer: Aetna Commercial |
$117.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$112.69
|
| Rate for Payer: Aetna Managed Medicare |
$5.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.94
|
| Rate for Payer: Anthem Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$69.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.39
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cigna Commercial |
$120.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$73.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.39
|
| Rate for Payer: Health EOS Commercial |
$116.63
|
| Rate for Payer: HFN Commercial |
$120.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$104.83
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$120.56
|
| Rate for Payer: Quartz Beloit One Network |
$64.21
|
| Rate for Payer: Quartz Commercial |
$85.18
|
| Rate for Payer: Quartz Medicare Advantage |
$5.39
|
| Rate for Payer: The Alliance Commercial |
$21.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: United Healthcare PPO |
$98.28
|
| Rate for Payer: WEA Trust Commercial |
$72.07
|
| Rate for Payer: Wellcare Medicare |
$5.39
|
| Rate for Payer: WPS Commercial |
$97.06
|
|
|
Urine Creatinine
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
3813067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$21.55 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.78
|
| Rate for Payer: Aetna Managed Medicare |
$5.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.94
|
| Rate for Payer: Anthem Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.39
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna Commercial |
$20.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.39
|
| Rate for Payer: Health EOS Commercial |
$19.44
|
| Rate for Payer: HFN Commercial |
$20.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$17.47
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$20.09
|
| Rate for Payer: Quartz Beloit One Network |
$10.70
|
| Rate for Payer: Quartz Commercial |
$14.20
|
| Rate for Payer: Quartz Medicare Advantage |
$5.39
|
| Rate for Payer: The Alliance Commercial |
$21.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: United Healthcare PPO |
$16.38
|
| Rate for Payer: WEA Trust Commercial |
$12.01
|
| Rate for Payer: Wellcare Medicare |
$5.39
|
| Rate for Payer: WPS Commercial |
$16.18
|
|
