|
Urine Creatinine, Stone Risk Diagnostic Profile
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2943038
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$51.98 |
| Max. Negotiated Rate |
$97.59 |
| Rate for Payer: Aetna Commercial |
$95.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.22
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$97.59
|
| Rate for Payer: Health EOS Commercial |
$94.41
|
| Rate for Payer: HFN Commercial |
$97.59
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: Preferred Network Access Commercial |
$97.59
|
| Rate for Payer: Quartz Beloit One Network |
$51.98
|
| Rate for Payer: Quartz Commercial |
$63.65
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: WPS Commercial |
$78.57
|
|
|
Urine Creatinine, Stone Risk Diagnostic Profile
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2943038
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$100.78 |
| Rate for Payer: Aetna Commercial |
$100.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.23
|
| Rate for Payer: Aetna Managed Medicare |
$5.39
|
| Rate for Payer: Anthem Medicare Advantage |
$5.39
|
| 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 |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$100.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$53.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.39
|
| Rate for Payer: Health EOS Commercial |
$96.53
|
| Rate for Payer: HFN Commercial |
$100.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$100.78
|
| Rate for Payer: Quartz Beloit One Network |
$46.68
|
| Rate for Payer: Quartz Commercial |
$60.47
|
| Rate for Payer: Quartz Medicare Advantage |
$5.39
|
| Rate for Payer: The Alliance Commercial |
$21.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: WPS Commercial |
$23.70
|
|
|
Urine Creatinine, Stone Risk Diagnostic Profile
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2943038
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$97.59 |
| Rate for Payer: Aetna Commercial |
$95.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.23
|
| 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 |
$56.22
|
| 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 |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$97.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$59.36
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.39
|
| Rate for Payer: Health EOS Commercial |
$94.41
|
| Rate for Payer: HFN Commercial |
$97.59
|
| 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 |
$84.86
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$97.59
|
| Rate for Payer: Quartz Beloit One Network |
$51.98
|
| Rate for Payer: Quartz Commercial |
$68.95
|
| 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 |
$79.56
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: Wellcare Medicare |
$5.39
|
| Rate for Payer: WPS Commercial |
$78.57
|
|
|
Urine Culture
|
Facility
|
OP
|
$201.00
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
633907
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.39 |
| Max. Negotiated Rate |
$192.32 |
| Rate for Payer: Aetna Commercial |
$188.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$179.77
|
| Rate for Payer: Aetna Managed Medicare |
$8.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14.69
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$13.93
|
| Rate for Payer: Anthem Medicare Advantage |
$8.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$110.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.39
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cigna Commercial |
$192.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$116.98
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8.39
|
| Rate for Payer: Health EOS Commercial |
$186.05
|
| Rate for Payer: HFN Commercial |
$192.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8.39
|
| Rate for Payer: Multiplan Commercial |
$167.23
|
| Rate for Payer: NAPHCARE Commercial |
$12.59
|
| Rate for Payer: Preferred Network Access Commercial |
$192.32
|
| Rate for Payer: Quartz Beloit One Network |
$102.43
|
| Rate for Payer: Quartz Commercial |
$135.88
|
| Rate for Payer: Quartz Medicare Advantage |
$8.39
|
| Rate for Payer: The Alliance Commercial |
$33.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.39
|
| Rate for Payer: United Healthcare PPO |
$156.78
|
| Rate for Payer: WEA Trust Commercial |
$114.97
|
| Rate for Payer: Wellcare Medicare |
$8.39
|
| Rate for Payer: WPS Commercial |
$154.83
|
|
|
Urine Culture
|
Facility
|
IP
|
$201.00
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
633907
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$102.43 |
| Max. Negotiated Rate |
$192.32 |
| Rate for Payer: Aetna Commercial |
$188.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$179.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$110.79
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cigna Commercial |
$192.32
|
| Rate for Payer: Health EOS Commercial |
$186.05
|
| Rate for Payer: HFN Commercial |
$192.32
|
| Rate for Payer: Multiplan Commercial |
$167.23
|
| Rate for Payer: Preferred Network Access Commercial |
$192.32
|
| Rate for Payer: Quartz Beloit One Network |
$102.43
|
| Rate for Payer: Quartz Commercial |
$125.42
|
| Rate for Payer: WEA Trust Commercial |
$114.97
|
| Rate for Payer: WPS Commercial |
$154.83
|
|
|
Urine Culture
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
633907
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.39 |
| Max. Negotiated Rate |
$198.59 |
| Rate for Payer: Aetna Commercial |
$198.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$179.77
|
| Rate for Payer: Aetna Managed Medicare |
$8.39
|
| Rate for Payer: Anthem Medicare Advantage |
$8.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.39
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cigna Commercial |
$198.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$104.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.39
|
| Rate for Payer: Health EOS Commercial |
$190.23
|
| Rate for Payer: HFN Commercial |
$198.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$29.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.39
|
| Rate for Payer: Multiplan Commercial |
$167.23
|
| Rate for Payer: NAPHCARE Commercial |
$12.59
|
| Rate for Payer: Preferred Network Access Commercial |
$198.59
|
| Rate for Payer: Quartz Beloit One Network |
$91.98
|
| Rate for Payer: Quartz Commercial |
$119.15
|
| Rate for Payer: Quartz Medicare Advantage |
$8.39
|
| Rate for Payer: The Alliance Commercial |
$33.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.39
|
| Rate for Payer: WEA Trust Commercial |
$114.97
|
| Rate for Payer: WPS Commercial |
$36.93
|
|
|
Urine Cytology to US Labs
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
1043295
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.57 |
| Max. Negotiated Rate |
$378.40 |
| Rate for Payer: Aetna Commercial |
$378.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$342.56
|
| Rate for Payer: Aetna Managed Medicare |
$65.57
|
| Rate for Payer: Anthem Commercial |
$66.36
|
| Rate for Payer: Anthem Medicare Advantage |
$65.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$65.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$65.57
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cigna Commercial |
$378.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$199.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$65.57
|
| Rate for Payer: Health EOS Commercial |
$362.47
|
| Rate for Payer: HFN Commercial |
$378.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$236.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$236.61
|
| Rate for Payer: Independent Care Health Plan Medicare |
$65.57
|
| Rate for Payer: Multiplan Commercial |
$318.66
|
| Rate for Payer: NAPHCARE Commercial |
$98.36
|
| Rate for Payer: Preferred Network Access Commercial |
$378.40
|
| Rate for Payer: Quartz Beloit One Network |
$175.26
|
| Rate for Payer: Quartz Commercial |
$227.04
|
| Rate for Payer: Quartz Medicare Advantage |
$65.57
|
| Rate for Payer: The Alliance Commercial |
$259.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$65.57
|
| Rate for Payer: WEA Trust Commercial |
$219.08
|
| Rate for Payer: WPS Commercial |
$288.52
|
|
|
Urine Cytology to US Labs
|
Facility
|
OP
|
$383.00
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
1043295
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.84 |
| Max. Negotiated Rate |
$366.45 |
| Rate for Payer: Aetna Commercial |
$358.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$342.56
|
| Rate for Payer: Aetna Managed Medicare |
$54.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$208.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$97.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$92.47
|
| Rate for Payer: Anthem Medicare Advantage |
$54.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$211.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$54.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$54.84
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cigna Commercial |
$366.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$54.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$222.91
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$54.84
|
| Rate for Payer: Health EOS Commercial |
$354.50
|
| Rate for Payer: HFN Commercial |
$366.45
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$204.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$54.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$54.84
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$54.84
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$54.84
|
| Rate for Payer: Multiplan Commercial |
$318.66
|
| Rate for Payer: NAPHCARE Commercial |
$82.26
|
| Rate for Payer: Preferred Network Access Commercial |
$366.45
|
| Rate for Payer: Quartz Beloit One Network |
$195.18
|
| Rate for Payer: Quartz Commercial |
$258.91
|
| Rate for Payer: Quartz Medicare Advantage |
$54.84
|
| Rate for Payer: The Alliance Commercial |
$219.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54.84
|
| Rate for Payer: United Healthcare PPO |
$298.74
|
| Rate for Payer: WEA Trust Commercial |
$219.08
|
| Rate for Payer: Wellcare Medicare |
$54.84
|
| Rate for Payer: WPS Commercial |
$295.02
|
|
|
Urine Cytology to US Labs
|
Facility
|
IP
|
$383.00
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
1043295
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$195.18 |
| Max. Negotiated Rate |
$366.45 |
| Rate for Payer: Aetna Commercial |
$358.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$342.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$211.11
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cigna Commercial |
$366.45
|
| Rate for Payer: Health EOS Commercial |
$354.50
|
| Rate for Payer: HFN Commercial |
$366.45
|
| Rate for Payer: Multiplan Commercial |
$318.66
|
| Rate for Payer: Preferred Network Access Commercial |
$366.45
|
| Rate for Payer: Quartz Beloit One Network |
$195.18
|
| Rate for Payer: Quartz Commercial |
$238.99
|
| Rate for Payer: WEA Trust Commercial |
$219.08
|
| Rate for Payer: WPS Commercial |
$295.02
|
|
|
Urine Dipstick POC Amb
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
1190880
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$84.97 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.92
|
| Rate for Payer: Aetna Managed Medicare |
$2.34
|
| Rate for Payer: Anthem Medicare Advantage |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2.34
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$84.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$44.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2.34
|
| Rate for Payer: Health EOS Commercial |
$81.39
|
| Rate for Payer: HFN Commercial |
$84.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2.34
|
| Rate for Payer: Multiplan Commercial |
$71.55
|
| Rate for Payer: NAPHCARE Commercial |
$3.51
|
| Rate for Payer: Preferred Network Access Commercial |
$84.97
|
| Rate for Payer: Quartz Beloit One Network |
$39.35
|
| Rate for Payer: Quartz Commercial |
$50.98
|
| Rate for Payer: Quartz Medicare Advantage |
$2.34
|
| Rate for Payer: The Alliance Commercial |
$9.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2.34
|
| Rate for Payer: WEA Trust Commercial |
$49.19
|
| Rate for Payer: WPS Commercial |
$10.30
|
|
|
Urine Dipstick POC Amb
|
Facility
|
IP
|
$86.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
1190880
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.83 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Aetna Commercial |
$80.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$47.40
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$82.28
|
| Rate for Payer: Health EOS Commercial |
$79.60
|
| Rate for Payer: HFN Commercial |
$82.28
|
| Rate for Payer: Multiplan Commercial |
$71.55
|
| Rate for Payer: Preferred Network Access Commercial |
$82.28
|
| Rate for Payer: Quartz Beloit One Network |
$43.83
|
| Rate for Payer: Quartz Commercial |
$53.66
|
| Rate for Payer: WEA Trust Commercial |
$49.19
|
| Rate for Payer: WPS Commercial |
$66.25
|
|
|
Urine Dipstick POC Amb
|
Facility
|
OP
|
$86.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
1190880
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Aetna Commercial |
$80.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.92
|
| Rate for Payer: Aetna Managed Medicare |
$2.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$8.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4.09
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3.88
|
| Rate for Payer: Anthem Medicare Advantage |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$47.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2.34
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$82.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$50.05
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2.34
|
| Rate for Payer: Health EOS Commercial |
$79.60
|
| Rate for Payer: HFN Commercial |
$82.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2.34
|
| Rate for Payer: Multiplan Commercial |
$71.55
|
| Rate for Payer: NAPHCARE Commercial |
$3.51
|
| Rate for Payer: Preferred Network Access Commercial |
$82.28
|
| Rate for Payer: Quartz Beloit One Network |
$43.83
|
| Rate for Payer: Quartz Commercial |
$58.14
|
| Rate for Payer: Quartz Medicare Advantage |
$2.34
|
| Rate for Payer: The Alliance Commercial |
$9.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2.34
|
| Rate for Payer: United Healthcare PPO |
$67.08
|
| Rate for Payer: WEA Trust Commercial |
$49.19
|
| Rate for Payer: Wellcare Medicare |
$2.34
|
| Rate for Payer: WPS Commercial |
$66.25
|
|
|
Urine Drug Screen POC Amb
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
6187008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.90 |
| Max. Negotiated Rate |
$57.66 |
| Rate for Payer: Aetna Commercial |
$25.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$23.25
|
| Rate for Payer: Aetna Managed Medicare |
$13.10
|
| Rate for Payer: Anthem Medicare Advantage |
$13.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.10
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cigna Commercial |
$25.69
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.10
|
| Rate for Payer: Health EOS Commercial |
$24.61
|
| Rate for Payer: HFN Commercial |
$25.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$46.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.10
|
| Rate for Payer: Multiplan Commercial |
$21.63
|
| Rate for Payer: NAPHCARE Commercial |
$19.66
|
| Rate for Payer: Preferred Network Access Commercial |
$25.69
|
| Rate for Payer: Quartz Beloit One Network |
$11.90
|
| Rate for Payer: Quartz Commercial |
$15.41
|
| Rate for Payer: Quartz Medicare Advantage |
$13.10
|
| Rate for Payer: The Alliance Commercial |
$51.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.10
|
| Rate for Payer: WEA Trust Commercial |
$14.87
|
| Rate for Payer: WPS Commercial |
$57.66
|
|
|
Urine Drug Screen POC Amb
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
6187008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$52.42 |
| Rate for Payer: Aetna Commercial |
$24.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$23.25
|
| Rate for Payer: Aetna Managed Medicare |
$13.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$49.14
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22.93
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21.75
|
| Rate for Payer: Anthem Medicare Advantage |
$13.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.10
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cigna Commercial |
$24.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.13
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.10
|
| Rate for Payer: Health EOS Commercial |
$24.07
|
| Rate for Payer: HFN Commercial |
$24.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.10
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.10
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.10
|
| Rate for Payer: Multiplan Commercial |
$21.63
|
| Rate for Payer: NAPHCARE Commercial |
$19.66
|
| Rate for Payer: Preferred Network Access Commercial |
$24.88
|
| Rate for Payer: Quartz Beloit One Network |
$13.25
|
| Rate for Payer: Quartz Commercial |
$17.58
|
| Rate for Payer: Quartz Medicare Advantage |
$13.10
|
| Rate for Payer: The Alliance Commercial |
$52.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.10
|
| Rate for Payer: United Healthcare PPO |
$20.28
|
| Rate for Payer: WEA Trust Commercial |
$14.87
|
| Rate for Payer: Wellcare Medicare |
$13.10
|
| Rate for Payer: WPS Commercial |
$20.03
|
|
|
Urine Drug Screen POC Amb
|
Facility
|
IP
|
$26.00
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
6187008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.25 |
| Max. Negotiated Rate |
$24.88 |
| Rate for Payer: Aetna Commercial |
$24.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$23.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14.33
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cigna Commercial |
$24.88
|
| Rate for Payer: Health EOS Commercial |
$24.07
|
| Rate for Payer: HFN Commercial |
$24.88
|
| Rate for Payer: Multiplan Commercial |
$21.63
|
| Rate for Payer: Preferred Network Access Commercial |
$24.88
|
| Rate for Payer: Quartz Beloit One Network |
$13.25
|
| Rate for Payer: Quartz Commercial |
$16.22
|
| Rate for Payer: WEA Trust Commercial |
$14.87
|
| Rate for Payer: WPS Commercial |
$20.03
|
|
|
Urine Homovanillic Acid
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
4076081
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.31 |
| Max. Negotiated Rate |
$121.52 |
| Rate for Payer: Aetna Commercial |
$121.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.01
|
| Rate for Payer: Aetna Managed Medicare |
$23.31
|
| Rate for Payer: Anthem Medicare Advantage |
$23.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.31
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna Commercial |
$121.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$63.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.31
|
| Rate for Payer: Health EOS Commercial |
$116.41
|
| Rate for Payer: HFN Commercial |
$121.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$82.27
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$82.27
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.31
|
| Rate for Payer: Multiplan Commercial |
$102.34
|
| Rate for Payer: NAPHCARE Commercial |
$34.96
|
| Rate for Payer: Preferred Network Access Commercial |
$121.52
|
| Rate for Payer: Quartz Beloit One Network |
$56.28
|
| Rate for Payer: Quartz Commercial |
$72.91
|
| Rate for Payer: Quartz Medicare Advantage |
$23.31
|
| Rate for Payer: The Alliance Commercial |
$92.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.31
|
| Rate for Payer: WEA Trust Commercial |
$70.36
|
| Rate for Payer: WPS Commercial |
$102.55
|
|
|
Urine Homovanillic Acid
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
4076081
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$62.68 |
| Max. Negotiated Rate |
$117.69 |
| Rate for Payer: Aetna Commercial |
$115.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$67.80
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna Commercial |
$117.69
|
| Rate for Payer: Health EOS Commercial |
$113.85
|
| Rate for Payer: HFN Commercial |
$117.69
|
| Rate for Payer: Multiplan Commercial |
$102.34
|
| Rate for Payer: Preferred Network Access Commercial |
$117.69
|
| Rate for Payer: Quartz Beloit One Network |
$62.68
|
| Rate for Payer: Quartz Commercial |
$76.75
|
| Rate for Payer: WEA Trust Commercial |
$70.36
|
| Rate for Payer: WPS Commercial |
$94.75
|
|
|
Urine Homovanillic Acid
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
4076081
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.31 |
| Max. Negotiated Rate |
$117.69 |
| Rate for Payer: Aetna Commercial |
$115.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.01
|
| Rate for Payer: Aetna Managed Medicare |
$23.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$87.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$40.79
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$38.69
|
| Rate for Payer: Anthem Medicare Advantage |
$23.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$67.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.31
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna Commercial |
$117.69
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$71.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23.31
|
| Rate for Payer: Health EOS Commercial |
$113.85
|
| Rate for Payer: HFN Commercial |
$117.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$86.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23.31
|
| Rate for Payer: Multiplan Commercial |
$102.34
|
| Rate for Payer: NAPHCARE Commercial |
$34.96
|
| Rate for Payer: Preferred Network Access Commercial |
$117.69
|
| Rate for Payer: Quartz Beloit One Network |
$62.68
|
| Rate for Payer: Quartz Commercial |
$83.15
|
| Rate for Payer: Quartz Medicare Advantage |
$23.31
|
| Rate for Payer: The Alliance Commercial |
$93.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.31
|
| Rate for Payer: United Healthcare PPO |
$95.94
|
| Rate for Payer: WEA Trust Commercial |
$70.36
|
| Rate for Payer: Wellcare Medicare |
$23.31
|
| Rate for Payer: WPS Commercial |
$94.75
|
|
|
Urine Lambda Light Chain
|
Professional
|
Both
|
$186.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
2942948
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.14 |
| Max. Negotiated Rate |
$183.77 |
| Rate for Payer: Aetna Commercial |
$183.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$166.36
|
| Rate for Payer: Aetna Managed Medicare |
$14.14
|
| Rate for Payer: Anthem Medicare Advantage |
$14.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.14
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cigna Commercial |
$183.77
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$96.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.14
|
| Rate for Payer: Health EOS Commercial |
$176.03
|
| Rate for Payer: HFN Commercial |
$183.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$49.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$49.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.14
|
| Rate for Payer: Multiplan Commercial |
$154.75
|
| Rate for Payer: NAPHCARE Commercial |
$21.22
|
| Rate for Payer: Preferred Network Access Commercial |
$183.77
|
| Rate for Payer: Quartz Beloit One Network |
$85.11
|
| Rate for Payer: Quartz Commercial |
$110.26
|
| Rate for Payer: Quartz Medicare Advantage |
$14.14
|
| Rate for Payer: The Alliance Commercial |
$55.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.14
|
| Rate for Payer: WEA Trust Commercial |
$106.39
|
| Rate for Payer: WPS Commercial |
$62.23
|
|
|
Urine Lambda Light Chain
|
Facility
|
OP
|
$186.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
2942948
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.14 |
| Max. Negotiated Rate |
$177.96 |
| Rate for Payer: Aetna Commercial |
$174.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$166.36
|
| Rate for Payer: Aetna Managed Medicare |
$14.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.75
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.48
|
| Rate for Payer: Anthem Medicare Advantage |
$14.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$102.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.14
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cigna Commercial |
$177.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14.14
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$108.25
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.14
|
| Rate for Payer: Health EOS Commercial |
$172.16
|
| Rate for Payer: HFN Commercial |
$177.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$52.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.14
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.14
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.14
|
| Rate for Payer: Multiplan Commercial |
$154.75
|
| Rate for Payer: NAPHCARE Commercial |
$21.22
|
| Rate for Payer: Preferred Network Access Commercial |
$177.96
|
| Rate for Payer: Quartz Beloit One Network |
$94.79
|
| Rate for Payer: Quartz Commercial |
$125.74
|
| Rate for Payer: Quartz Medicare Advantage |
$14.14
|
| Rate for Payer: The Alliance Commercial |
$56.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.14
|
| Rate for Payer: United Healthcare PPO |
$145.08
|
| Rate for Payer: WEA Trust Commercial |
$106.39
|
| Rate for Payer: Wellcare Medicare |
$14.14
|
| Rate for Payer: WPS Commercial |
$143.28
|
|
|
Urine Lambda Light Chain
|
Facility
|
IP
|
$186.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
2942948
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$177.96 |
| Rate for Payer: Aetna Commercial |
$174.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$166.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$102.52
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cigna Commercial |
$177.96
|
| Rate for Payer: Health EOS Commercial |
$172.16
|
| Rate for Payer: HFN Commercial |
$177.96
|
| Rate for Payer: Multiplan Commercial |
$154.75
|
| Rate for Payer: Preferred Network Access Commercial |
$177.96
|
| Rate for Payer: Quartz Beloit One Network |
$94.79
|
| Rate for Payer: Quartz Commercial |
$116.06
|
| Rate for Payer: WEA Trust Commercial |
$106.39
|
| Rate for Payer: WPS Commercial |
$143.28
|
|
|
Urine Lead Level
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
3986162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$82.00 |
| Rate for Payer: Aetna Commercial |
$82.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$12.59
|
| Rate for Payer: Anthem Medicare Advantage |
$12.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.59
|
| 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 |
$12.59
|
| Rate for Payer: Health EOS Commercial |
$78.55
|
| Rate for Payer: HFN Commercial |
$82.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$44.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.59
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$18.89
|
| 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 |
$12.59
|
| Rate for Payer: The Alliance Commercial |
$49.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.59
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$55.42
|
|
|
Urine Lead Level
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
3986162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.59 |
| 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 |
$12.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$47.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20.91
|
| Rate for Payer: Anthem Medicare Advantage |
$12.59
|
| 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 |
$12.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.59
|
| 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 |
$12.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.59
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.59
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$18.89
|
| 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 |
$12.59
|
| Rate for Payer: The Alliance Commercial |
$50.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.59
|
| Rate for Payer: United Healthcare PPO |
$64.74
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: Wellcare Medicare |
$12.59
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Urine Lead Level
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
3986162
|
|
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 Lead Level
|
Professional
|
Both
|
$622.00
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
2942907
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$614.54 |
| Rate for Payer: Aetna Commercial |
$614.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$556.32
|
| Rate for Payer: Aetna Managed Medicare |
$12.59
|
| Rate for Payer: Anthem Medicare Advantage |
$12.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.59
|
| Rate for Payer: Cash Price |
$186.60
|
| Rate for Payer: Cash Price |
$186.60
|
| Rate for Payer: Cigna Commercial |
$614.54
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$323.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.59
|
| Rate for Payer: Health EOS Commercial |
$588.66
|
| Rate for Payer: HFN Commercial |
$614.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$44.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.59
|
| Rate for Payer: Multiplan Commercial |
$517.50
|
| Rate for Payer: NAPHCARE Commercial |
$18.89
|
| Rate for Payer: Preferred Network Access Commercial |
$614.54
|
| Rate for Payer: Quartz Beloit One Network |
$284.63
|
| Rate for Payer: Quartz Commercial |
$368.72
|
| Rate for Payer: Quartz Medicare Advantage |
$12.59
|
| Rate for Payer: The Alliance Commercial |
$49.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.59
|
| Rate for Payer: WEA Trust Commercial |
$355.78
|
| Rate for Payer: WPS Commercial |
$55.42
|
|
