|
US Needle Placement Renal Right
|
Facility
|
IP
|
$1,927.00
|
|
|
Service Code
|
CPT 76942 TC,RT
|
| Hospital Charge Code |
2980121
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$982.00 |
| Max. Negotiated Rate |
$1,843.75 |
| Rate for Payer: Aetna Commercial |
$1,803.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,723.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,062.16
|
| Rate for Payer: Cash Price |
$578.10
|
| Rate for Payer: Cigna Commercial |
$1,843.75
|
| Rate for Payer: Health EOS Commercial |
$1,783.63
|
| Rate for Payer: HFN Commercial |
$1,843.75
|
| Rate for Payer: Multiplan Commercial |
$1,603.26
|
| Rate for Payer: Preferred Network Access Commercial |
$1,843.75
|
| Rate for Payer: Quartz Beloit One Network |
$982.00
|
| Rate for Payer: Quartz Commercial |
$1,202.45
|
| Rate for Payer: WEA Trust Commercial |
$1,102.24
|
| Rate for Payer: WPS Commercial |
$1,484.37
|
|
|
US Needle Placement Renal Right
|
Facility
|
OP
|
$1,927.00
|
|
|
Service Code
|
CPT 76942 RT
|
| Hospital Charge Code |
2544934
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$561.14 |
| Max. Negotiated Rate |
$1,843.75 |
| Rate for Payer: Aetna Commercial |
$1,803.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,723.51
|
| Rate for Payer: Aetna Managed Medicare |
$561.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$848.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$716.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$681.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,062.16
|
| Rate for Payer: Cash Price |
$578.10
|
| Rate for Payer: Cash Price |
$578.10
|
| Rate for Payer: Cash Price |
$578.10
|
| Rate for Payer: Cigna Commercial |
$1,843.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,121.51
|
| Rate for Payer: Health EOS Commercial |
$1,783.63
|
| Rate for Payer: HFN Commercial |
$1,843.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,503.06
|
| Rate for Payer: Multiplan Commercial |
$1,603.26
|
| Rate for Payer: NAPHCARE Commercial |
$1,202.45
|
| Rate for Payer: Preferred Network Access Commercial |
$1,843.75
|
| Rate for Payer: Quartz Beloit One Network |
$982.00
|
| Rate for Payer: Quartz Commercial |
$1,302.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,202.45
|
| Rate for Payer: The Alliance Commercial |
$1,002.04
|
| Rate for Payer: United Healthcare PPO |
$596.96
|
| Rate for Payer: WEA Trust Commercial |
$1,102.24
|
| Rate for Payer: WPS Commercial |
$1,484.37
|
|
|
US Non OB Tranvaginal
|
Facility
|
IP
|
$1,168.00
|
|
|
Service Code
|
CPT 76830 TC
|
| Hospital Charge Code |
4500658
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$595.21 |
| Max. Negotiated Rate |
$1,117.54 |
| Rate for Payer: Aetna Commercial |
$1,093.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,044.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$643.80
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cigna Commercial |
$1,117.54
|
| Rate for Payer: Health EOS Commercial |
$1,081.10
|
| Rate for Payer: HFN Commercial |
$1,117.54
|
| Rate for Payer: Multiplan Commercial |
$971.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,117.54
|
| Rate for Payer: Quartz Beloit One Network |
$595.21
|
| Rate for Payer: Quartz Commercial |
$728.83
|
| Rate for Payer: WEA Trust Commercial |
$668.10
|
| Rate for Payer: WPS Commercial |
$899.71
|
|
|
US Non OB Tranvaginal
|
Facility
|
OP
|
$1,168.00
|
|
|
Service Code
|
CPT 76830 TC
|
| Hospital Charge Code |
4500658
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$337.63 |
| Max. Negotiated Rate |
$1,117.54 |
| Rate for Payer: Aetna Commercial |
$1,093.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,044.66
|
| Rate for Payer: Aetna Managed Medicare |
$340.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$848.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$716.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$681.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$643.80
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cigna Commercial |
$1,117.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$679.78
|
| Rate for Payer: Health EOS Commercial |
$1,081.10
|
| Rate for Payer: HFN Commercial |
$1,117.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$911.04
|
| Rate for Payer: Multiplan Commercial |
$971.78
|
| Rate for Payer: NAPHCARE Commercial |
$728.83
|
| Rate for Payer: Preferred Network Access Commercial |
$1,117.54
|
| Rate for Payer: Quartz Beloit One Network |
$595.21
|
| Rate for Payer: Quartz Commercial |
$789.57
|
| Rate for Payer: Quartz Medicare Advantage |
$728.83
|
| Rate for Payer: The Alliance Commercial |
$337.63
|
| Rate for Payer: United Healthcare PPO |
$596.96
|
| Rate for Payer: WEA Trust Commercial |
$668.10
|
| Rate for Payer: WPS Commercial |
$899.71
|
|
|
US Non OB Tranvaginal
|
Professional
|
Both
|
$1,168.00
|
|
|
Service Code
|
CPT 76830 TC
|
| Hospital Charge Code |
4500658
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$84.41 |
| Max. Negotiated Rate |
$1,153.98 |
| Rate for Payer: Aetna Commercial |
$1,153.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,044.66
|
| Rate for Payer: Aetna Managed Medicare |
$84.41
|
| Rate for Payer: Anthem Medicare Advantage |
$84.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$84.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$84.41
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cigna Commercial |
$1,153.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$607.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$84.41
|
| Rate for Payer: Health EOS Commercial |
$1,105.40
|
| Rate for Payer: HFN Commercial |
$1,153.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$320.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$320.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$84.41
|
| Rate for Payer: Multiplan Commercial |
$971.78
|
| Rate for Payer: NAPHCARE Commercial |
$126.61
|
| Rate for Payer: Preferred Network Access Commercial |
$1,153.98
|
| Rate for Payer: Quartz Beloit One Network |
$534.48
|
| Rate for Payer: Quartz Commercial |
$692.39
|
| Rate for Payer: Quartz Medicare Advantage |
$84.41
|
| Rate for Payer: The Alliance Commercial |
$320.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$84.41
|
| Rate for Payer: WEA Trust Commercial |
$668.10
|
| Rate for Payer: WPS Commercial |
$422.03
|
|
|
US OR Guidance
|
Professional
|
Both
|
$1,993.00
|
|
|
Service Code
|
CPT 76998
|
| Hospital Charge Code |
6179833
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$394.88 |
| Max. Negotiated Rate |
$1,969.08 |
| Rate for Payer: Aetna Commercial |
$1,969.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,782.54
|
| Rate for Payer: Cash Price |
$597.90
|
| Rate for Payer: Cash Price |
$597.90
|
| Rate for Payer: Cash Price |
$597.90
|
| Rate for Payer: Cigna Commercial |
$1,969.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,036.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,243.63
|
| Rate for Payer: Health EOS Commercial |
$1,886.18
|
| Rate for Payer: HFN Commercial |
$1,969.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$394.88
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$394.88
|
| Rate for Payer: Multiplan Commercial |
$1,658.18
|
| Rate for Payer: Preferred Network Access Commercial |
$1,969.08
|
| Rate for Payer: Quartz Beloit One Network |
$912.00
|
| Rate for Payer: Quartz Commercial |
$1,181.45
|
| Rate for Payer: The Alliance Commercial |
$1,036.36
|
| Rate for Payer: WEA Trust Commercial |
$1,140.00
|
| Rate for Payer: WPS Commercial |
$1,535.21
|
|
|
US OR Guidance
|
Facility
|
OP
|
$1,993.00
|
|
|
Service Code
|
CPT 76998
|
| Hospital Charge Code |
6179833
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$580.36 |
| Max. Negotiated Rate |
$1,906.90 |
| Rate for Payer: Aetna Commercial |
$1,865.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,782.54
|
| Rate for Payer: Aetna Managed Medicare |
$580.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$848.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$716.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$681.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,098.54
|
| Rate for Payer: Cash Price |
$597.90
|
| Rate for Payer: Cash Price |
$597.90
|
| Rate for Payer: Cash Price |
$597.90
|
| Rate for Payer: Cigna Commercial |
$1,906.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,159.93
|
| Rate for Payer: Health EOS Commercial |
$1,844.72
|
| Rate for Payer: HFN Commercial |
$1,906.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,554.54
|
| Rate for Payer: Multiplan Commercial |
$1,658.18
|
| Rate for Payer: NAPHCARE Commercial |
$1,243.63
|
| Rate for Payer: Preferred Network Access Commercial |
$1,906.90
|
| Rate for Payer: Quartz Beloit One Network |
$1,015.63
|
| Rate for Payer: Quartz Commercial |
$1,347.27
|
| Rate for Payer: Quartz Medicare Advantage |
$1,243.63
|
| Rate for Payer: The Alliance Commercial |
$1,036.36
|
| Rate for Payer: United Healthcare PPO |
$596.96
|
| Rate for Payer: WEA Trust Commercial |
$1,140.00
|
| Rate for Payer: WPS Commercial |
$1,535.21
|
|
|
US OR Guidance
|
Facility
|
IP
|
$1,993.00
|
|
|
Service Code
|
CPT 76998
|
| Hospital Charge Code |
6179833
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,015.63 |
| Max. Negotiated Rate |
$1,906.90 |
| Rate for Payer: Aetna Commercial |
$1,865.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,782.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,098.54
|
| Rate for Payer: Cash Price |
$597.90
|
| Rate for Payer: Cigna Commercial |
$1,906.90
|
| Rate for Payer: Health EOS Commercial |
$1,844.72
|
| Rate for Payer: HFN Commercial |
$1,906.90
|
| Rate for Payer: Multiplan Commercial |
$1,658.18
|
| Rate for Payer: Preferred Network Access Commercial |
$1,906.90
|
| Rate for Payer: Quartz Beloit One Network |
$1,015.63
|
| Rate for Payer: Quartz Commercial |
$1,243.63
|
| Rate for Payer: WEA Trust Commercial |
$1,140.00
|
| Rate for Payer: WPS Commercial |
$1,535.21
|
|
|
US Pancreas
|
Professional
|
Both
|
$1,571.00
|
|
|
Service Code
|
CPT 76775
|
| Hospital Charge Code |
2552809
|
| Min. Negotiated Rate |
$60.50 |
| Max. Negotiated Rate |
$1,552.15 |
| Rate for Payer: Aetna Commercial |
$1,552.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,405.10
|
| Rate for Payer: Aetna Managed Medicare |
$60.50
|
| Rate for Payer: Anthem Medicare Advantage |
$60.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$60.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$60.50
|
| Rate for Payer: Cash Price |
$471.30
|
| Rate for Payer: Cash Price |
$471.30
|
| Rate for Payer: Cash Price |
$471.30
|
| Rate for Payer: Cigna Commercial |
$1,552.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$816.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$60.50
|
| Rate for Payer: Health EOS Commercial |
$1,486.79
|
| Rate for Payer: HFN Commercial |
$1,552.15
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$207.72
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$207.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$60.50
|
| Rate for Payer: Multiplan Commercial |
$1,307.07
|
| Rate for Payer: NAPHCARE Commercial |
$90.75
|
| Rate for Payer: Preferred Network Access Commercial |
$1,552.15
|
| Rate for Payer: Quartz Beloit One Network |
$718.89
|
| Rate for Payer: Quartz Commercial |
$931.29
|
| Rate for Payer: Quartz Medicare Advantage |
$60.50
|
| Rate for Payer: The Alliance Commercial |
$229.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$60.50
|
| Rate for Payer: WEA Trust Commercial |
$898.61
|
| Rate for Payer: WPS Commercial |
$302.48
|
|
|
US Pancreas
|
Facility
|
OP
|
$1,571.00
|
|
|
Service Code
|
CPT 76775
|
| Hospital Charge Code |
2552809
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$1,503.13 |
| Rate for Payer: Aetna Commercial |
$1,470.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,405.10
|
| Rate for Payer: Aetna Managed Medicare |
$110.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,062.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$816.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$784.24
|
| Rate for Payer: Anthem Medicare Advantage |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$865.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$110.02
|
| Rate for Payer: Cash Price |
$471.30
|
| Rate for Payer: Cash Price |
$471.30
|
| Rate for Payer: Cigna Commercial |
$1,503.13
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$110.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$914.32
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$110.02
|
| Rate for Payer: Health EOS Commercial |
$1,454.12
|
| Rate for Payer: HFN Commercial |
$1,503.13
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$409.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$110.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$110.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$110.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$110.02
|
| Rate for Payer: Multiplan Commercial |
$1,307.07
|
| Rate for Payer: NAPHCARE Commercial |
$165.03
|
| Rate for Payer: Preferred Network Access Commercial |
$1,503.13
|
| Rate for Payer: Quartz Beloit One Network |
$800.58
|
| Rate for Payer: Quartz Commercial |
$1,062.00
|
| Rate for Payer: Quartz Medicare Advantage |
$110.02
|
| Rate for Payer: The Alliance Commercial |
$440.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110.02
|
| Rate for Payer: WEA Trust Commercial |
$898.61
|
| Rate for Payer: Wellcare Medicare |
$110.02
|
| Rate for Payer: WPS Commercial |
$1,210.14
|
|
|
US Pancreas
|
Professional
|
Both
|
$2,044.00
|
|
|
Service Code
|
CPT 76775 TC
|
| Hospital Charge Code |
2587175
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$2,019.47 |
| Rate for Payer: Aetna Commercial |
$2,019.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,828.15
|
| Rate for Payer: Aetna Managed Medicare |
$33.38
|
| Rate for Payer: Anthem Medicare Advantage |
$33.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$33.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$33.38
|
| Rate for Payer: Cash Price |
$613.20
|
| Rate for Payer: Cash Price |
$613.20
|
| Rate for Payer: Cash Price |
$613.20
|
| Rate for Payer: Cigna Commercial |
$2,019.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,062.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$33.38
|
| Rate for Payer: Health EOS Commercial |
$1,934.44
|
| Rate for Payer: HFN Commercial |
$2,019.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$106.58
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$106.58
|
| Rate for Payer: Independent Care Health Plan Medicare |
$33.38
|
| Rate for Payer: Multiplan Commercial |
$1,700.61
|
| Rate for Payer: NAPHCARE Commercial |
$50.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,019.47
|
| Rate for Payer: Quartz Beloit One Network |
$935.33
|
| Rate for Payer: Quartz Commercial |
$1,211.68
|
| Rate for Payer: Quartz Medicare Advantage |
$33.38
|
| Rate for Payer: The Alliance Commercial |
$126.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33.38
|
| Rate for Payer: WEA Trust Commercial |
$1,169.17
|
| Rate for Payer: WPS Commercial |
$166.92
|
|
|
US Pancreas
|
Facility
|
OP
|
$2,044.00
|
|
|
Service Code
|
CPT 76775 TC
|
| Hospital Charge Code |
2587175
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$133.54 |
| Max. Negotiated Rate |
$1,955.70 |
| Rate for Payer: Aetna Commercial |
$1,913.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,828.15
|
| Rate for Payer: Aetna Managed Medicare |
$595.21
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$848.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$716.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$681.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,126.65
|
| Rate for Payer: Cash Price |
$613.20
|
| Rate for Payer: Cash Price |
$613.20
|
| Rate for Payer: Cash Price |
$613.20
|
| Rate for Payer: Cigna Commercial |
$1,955.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,189.61
|
| Rate for Payer: Health EOS Commercial |
$1,891.93
|
| Rate for Payer: HFN Commercial |
$1,955.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,594.32
|
| Rate for Payer: Multiplan Commercial |
$1,700.61
|
| Rate for Payer: NAPHCARE Commercial |
$1,275.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,955.70
|
| Rate for Payer: Quartz Beloit One Network |
$1,041.62
|
| Rate for Payer: Quartz Commercial |
$1,381.74
|
| Rate for Payer: Quartz Medicare Advantage |
$1,275.46
|
| Rate for Payer: The Alliance Commercial |
$133.54
|
| Rate for Payer: United Healthcare PPO |
$596.96
|
| Rate for Payer: WEA Trust Commercial |
$1,169.17
|
| Rate for Payer: WPS Commercial |
$1,574.49
|
|
|
US Pancreas
|
Facility
|
IP
|
$1,571.00
|
|
|
Service Code
|
CPT 76775
|
| Hospital Charge Code |
2552809
|
| Min. Negotiated Rate |
$800.58 |
| Max. Negotiated Rate |
$1,503.13 |
| Rate for Payer: Aetna Commercial |
$1,470.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,405.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$865.94
|
| Rate for Payer: Cash Price |
$471.30
|
| Rate for Payer: Cigna Commercial |
$1,503.13
|
| Rate for Payer: Health EOS Commercial |
$1,454.12
|
| Rate for Payer: HFN Commercial |
$1,503.13
|
| Rate for Payer: Multiplan Commercial |
$1,307.07
|
| Rate for Payer: Preferred Network Access Commercial |
$1,503.13
|
| Rate for Payer: Quartz Beloit One Network |
$800.58
|
| Rate for Payer: Quartz Commercial |
$980.30
|
| Rate for Payer: WEA Trust Commercial |
$898.61
|
| Rate for Payer: WPS Commercial |
$1,210.14
|
|
|
US Pancreas
|
Facility
|
IP
|
$2,044.00
|
|
|
Service Code
|
CPT 76775 TC
|
| Hospital Charge Code |
2587175
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,041.62 |
| Max. Negotiated Rate |
$1,955.70 |
| Rate for Payer: Aetna Commercial |
$1,913.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,828.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,126.65
|
| Rate for Payer: Cash Price |
$613.20
|
| Rate for Payer: Cigna Commercial |
$1,955.70
|
| Rate for Payer: Health EOS Commercial |
$1,891.93
|
| Rate for Payer: HFN Commercial |
$1,955.70
|
| Rate for Payer: Multiplan Commercial |
$1,700.61
|
| Rate for Payer: Preferred Network Access Commercial |
$1,955.70
|
| Rate for Payer: Quartz Beloit One Network |
$1,041.62
|
| Rate for Payer: Quartz Commercial |
$1,275.46
|
| Rate for Payer: WEA Trust Commercial |
$1,169.17
|
| Rate for Payer: WPS Commercial |
$1,574.49
|
|
|
US Paracentesis
|
Facility
|
OP
|
$1,754.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
661684
|
| Min. Negotiated Rate |
$875.60 |
| Max. Negotiated Rate |
$4,947.89 |
| Rate for Payer: Aetna Commercial |
$1,641.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,568.78
|
| Rate for Payer: Aetna Managed Medicare |
$954.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,185.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$912.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$875.60
|
| Rate for Payer: Anthem Medicare Advantage |
$954.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$966.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$954.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$954.50
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cigna Commercial |
$1,678.23
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$954.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$954.50
|
| Rate for Payer: Health EOS Commercial |
$1,623.50
|
| Rate for Payer: HFN Commercial |
$1,678.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,550.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$954.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$954.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$954.50
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$954.50
|
| Rate for Payer: Multiplan Commercial |
$1,459.33
|
| Rate for Payer: NAPHCARE Commercial |
$1,431.75
|
| Rate for Payer: Preferred Network Access Commercial |
$1,678.23
|
| Rate for Payer: Quartz Beloit One Network |
$893.84
|
| Rate for Payer: Quartz Commercial |
$1,185.70
|
| Rate for Payer: Quartz Medicare Advantage |
$954.50
|
| Rate for Payer: The Alliance Commercial |
$3,818.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$954.50
|
| Rate for Payer: WEA Trust Commercial |
$1,003.29
|
| Rate for Payer: Wellcare Medicare |
$954.50
|
| Rate for Payer: WPS Commercial |
$1,351.11
|
|
|
US Paracentesis
|
Professional
|
Both
|
$2,281.00
|
|
|
Service Code
|
CPT 49083 TC
|
| Hospital Charge Code |
2544936
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$246.11 |
| Max. Negotiated Rate |
$2,253.63 |
| Rate for Payer: Aetna Commercial |
$2,253.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,040.13
|
| Rate for Payer: Cash Price |
$684.30
|
| Rate for Payer: Cash Price |
$684.30
|
| Rate for Payer: Cash Price |
$684.30
|
| Rate for Payer: Cigna Commercial |
$2,253.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$246.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,423.34
|
| Rate for Payer: Health EOS Commercial |
$2,158.74
|
| Rate for Payer: HFN Commercial |
$2,253.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$372.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$372.44
|
| Rate for Payer: Multiplan Commercial |
$1,897.79
|
| Rate for Payer: Preferred Network Access Commercial |
$2,253.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,043.79
|
| Rate for Payer: Quartz Commercial |
$1,352.18
|
| Rate for Payer: The Alliance Commercial |
$1,186.12
|
| Rate for Payer: United Healthcare Medicaid |
$246.11
|
| Rate for Payer: WEA Trust Commercial |
$1,304.73
|
| Rate for Payer: WPS Commercial |
$1,757.05
|
|
|
US Paracentesis
|
Facility
|
IP
|
$2,281.00
|
|
|
Service Code
|
CPT 49083 TC
|
| Hospital Charge Code |
2544936
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,162.40 |
| Max. Negotiated Rate |
$2,182.46 |
| Rate for Payer: Aetna Commercial |
$2,135.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,040.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,257.29
|
| Rate for Payer: Cash Price |
$684.30
|
| Rate for Payer: Cigna Commercial |
$2,182.46
|
| Rate for Payer: Health EOS Commercial |
$2,111.29
|
| Rate for Payer: HFN Commercial |
$2,182.46
|
| Rate for Payer: Multiplan Commercial |
$1,897.79
|
| Rate for Payer: Preferred Network Access Commercial |
$2,182.46
|
| Rate for Payer: Quartz Beloit One Network |
$1,162.40
|
| Rate for Payer: Quartz Commercial |
$1,423.34
|
| Rate for Payer: WEA Trust Commercial |
$1,304.73
|
| Rate for Payer: WPS Commercial |
$1,757.05
|
|
|
US Paracentesis
|
Facility
|
IP
|
$1,754.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
661684
|
| Min. Negotiated Rate |
$893.84 |
| Max. Negotiated Rate |
$1,678.23 |
| Rate for Payer: Aetna Commercial |
$1,641.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,568.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$966.80
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cigna Commercial |
$1,678.23
|
| Rate for Payer: Health EOS Commercial |
$1,623.50
|
| Rate for Payer: HFN Commercial |
$1,678.23
|
| Rate for Payer: Multiplan Commercial |
$1,459.33
|
| Rate for Payer: Preferred Network Access Commercial |
$1,678.23
|
| Rate for Payer: Quartz Beloit One Network |
$893.84
|
| Rate for Payer: Quartz Commercial |
$1,094.50
|
| Rate for Payer: WEA Trust Commercial |
$1,003.29
|
| Rate for Payer: WPS Commercial |
$1,351.11
|
|
|
US Paracentesis
|
Facility
|
OP
|
$2,281.00
|
|
|
Service Code
|
CPT 49083 TC
|
| Hospital Charge Code |
2544936
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$596.96 |
| Max. Negotiated Rate |
$4,947.89 |
| Rate for Payer: Aetna Commercial |
$2,135.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,040.13
|
| Rate for Payer: Aetna Managed Medicare |
$664.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$848.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$716.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$681.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,257.29
|
| Rate for Payer: Cash Price |
$684.30
|
| Rate for Payer: Cash Price |
$684.30
|
| Rate for Payer: Cash Price |
$684.30
|
| Rate for Payer: Cigna Commercial |
$2,182.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Health EOS Commercial |
$2,111.29
|
| Rate for Payer: HFN Commercial |
$2,182.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,779.18
|
| Rate for Payer: Multiplan Commercial |
$1,897.79
|
| Rate for Payer: NAPHCARE Commercial |
$1,423.34
|
| Rate for Payer: Preferred Network Access Commercial |
$2,182.46
|
| Rate for Payer: Quartz Beloit One Network |
$1,162.40
|
| Rate for Payer: Quartz Commercial |
$1,541.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,423.34
|
| Rate for Payer: The Alliance Commercial |
$1,186.12
|
| Rate for Payer: United Healthcare PPO |
$596.96
|
| Rate for Payer: WEA Trust Commercial |
$1,304.73
|
| Rate for Payer: WPS Commercial |
$1,757.05
|
|
|
US Paracentesis
|
Professional
|
Both
|
$1,754.00
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
661684
|
| Min. Negotiated Rate |
$90.62 |
| Max. Negotiated Rate |
$1,732.95 |
| Rate for Payer: Aetna Commercial |
$1,732.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,568.78
|
| Rate for Payer: Aetna Managed Medicare |
$90.62
|
| Rate for Payer: Anthem Medicare Advantage |
$90.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$90.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$90.62
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cigna Commercial |
$1,732.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$246.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$90.62
|
| Rate for Payer: Health EOS Commercial |
$1,659.99
|
| Rate for Payer: HFN Commercial |
$1,732.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$372.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$372.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$90.62
|
| Rate for Payer: Multiplan Commercial |
$1,459.33
|
| Rate for Payer: NAPHCARE Commercial |
$135.92
|
| Rate for Payer: Preferred Network Access Commercial |
$1,732.95
|
| Rate for Payer: Quartz Beloit One Network |
$802.63
|
| Rate for Payer: Quartz Commercial |
$1,039.77
|
| Rate for Payer: Quartz Medicare Advantage |
$90.62
|
| Rate for Payer: The Alliance Commercial |
$385.11
|
| Rate for Payer: United Healthcare Medicaid |
$246.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$90.62
|
| Rate for Payer: WEA Trust Commercial |
$1,003.29
|
| Rate for Payer: WPS Commercial |
$407.77
|
|
|
US Parathyroid
|
Facility
|
OP
|
$1,429.00
|
|
|
Service Code
|
CPT 76536 TC
|
| Hospital Charge Code |
2544938
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$326.56 |
| Max. Negotiated Rate |
$1,367.27 |
| Rate for Payer: Aetna Commercial |
$1,337.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.10
|
| Rate for Payer: Aetna Managed Medicare |
$416.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$848.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$716.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$681.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$831.68
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,114.62
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: NAPHCARE Commercial |
$891.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$966.00
|
| Rate for Payer: Quartz Medicare Advantage |
$891.70
|
| Rate for Payer: The Alliance Commercial |
$326.56
|
| Rate for Payer: United Healthcare PPO |
$596.96
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
US Parathyroid
|
Facility
|
OP
|
$1,374.00
|
|
|
Service Code
|
CPT 76536
|
| Hospital Charge Code |
631481
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$1,314.64 |
| Rate for Payer: Aetna Commercial |
$1,286.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.91
|
| Rate for Payer: Aetna Managed Medicare |
$110.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$928.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$714.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$685.90
|
| Rate for Payer: Anthem Medicare Advantage |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$757.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$110.02
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Cigna Commercial |
$1,314.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$110.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$799.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$110.02
|
| Rate for Payer: Health EOS Commercial |
$1,271.77
|
| Rate for Payer: HFN Commercial |
$1,314.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$409.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$110.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$110.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$110.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$110.02
|
| Rate for Payer: Multiplan Commercial |
$1,143.17
|
| Rate for Payer: NAPHCARE Commercial |
$165.03
|
| Rate for Payer: Preferred Network Access Commercial |
$1,314.64
|
| Rate for Payer: Quartz Beloit One Network |
$700.19
|
| Rate for Payer: Quartz Commercial |
$928.82
|
| Rate for Payer: Quartz Medicare Advantage |
$110.02
|
| Rate for Payer: The Alliance Commercial |
$440.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110.02
|
| Rate for Payer: WEA Trust Commercial |
$785.93
|
| Rate for Payer: Wellcare Medicare |
$110.02
|
| Rate for Payer: WPS Commercial |
$1,058.39
|
|
|
US Parathyroid
|
Professional
|
Both
|
$1,429.00
|
|
|
Service Code
|
CPT 76536 TC
|
| Hospital Charge Code |
2544938
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$81.64 |
| Max. Negotiated Rate |
$1,411.85 |
| Rate for Payer: Aetna Commercial |
$1,411.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.10
|
| Rate for Payer: Aetna Managed Medicare |
$81.64
|
| Rate for Payer: Anthem Medicare Advantage |
$81.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$81.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$81.64
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,411.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$743.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$81.64
|
| Rate for Payer: Health EOS Commercial |
$1,352.41
|
| Rate for Payer: HFN Commercial |
$1,411.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$314.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$314.11
|
| Rate for Payer: Independent Care Health Plan Medicare |
$81.64
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: NAPHCARE Commercial |
$122.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,411.85
|
| Rate for Payer: Quartz Beloit One Network |
$653.91
|
| Rate for Payer: Quartz Commercial |
$847.11
|
| Rate for Payer: Quartz Medicare Advantage |
$81.64
|
| Rate for Payer: The Alliance Commercial |
$310.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.64
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$408.20
|
|
|
US Parathyroid
|
Professional
|
Both
|
$1,374.00
|
|
|
Service Code
|
CPT 76536
|
| Hospital Charge Code |
631481
|
| Min. Negotiated Rate |
$108.06 |
| Max. Negotiated Rate |
$1,357.51 |
| Rate for Payer: Aetna Commercial |
$1,357.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.91
|
| Rate for Payer: Aetna Managed Medicare |
$108.06
|
| Rate for Payer: Anthem Medicare Advantage |
$108.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$108.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$108.06
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Cigna Commercial |
$1,357.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$714.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$108.06
|
| Rate for Payer: Health EOS Commercial |
$1,300.35
|
| Rate for Payer: HFN Commercial |
$1,357.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$412.71
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$412.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$108.06
|
| Rate for Payer: Multiplan Commercial |
$1,143.17
|
| Rate for Payer: NAPHCARE Commercial |
$162.08
|
| Rate for Payer: Preferred Network Access Commercial |
$1,357.51
|
| Rate for Payer: Quartz Beloit One Network |
$628.74
|
| Rate for Payer: Quartz Commercial |
$814.51
|
| Rate for Payer: Quartz Medicare Advantage |
$108.06
|
| Rate for Payer: The Alliance Commercial |
$410.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$108.06
|
| Rate for Payer: WEA Trust Commercial |
$785.93
|
| Rate for Payer: WPS Commercial |
$540.28
|
|
|
US Parathyroid
|
Facility
|
IP
|
$1,374.00
|
|
|
Service Code
|
CPT 76536
|
| Hospital Charge Code |
631481
|
| Min. Negotiated Rate |
$700.19 |
| Max. Negotiated Rate |
$1,314.64 |
| Rate for Payer: Aetna Commercial |
$1,286.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$757.35
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Cigna Commercial |
$1,314.64
|
| Rate for Payer: Health EOS Commercial |
$1,271.77
|
| Rate for Payer: HFN Commercial |
$1,314.64
|
| Rate for Payer: Multiplan Commercial |
$1,143.17
|
| Rate for Payer: Preferred Network Access Commercial |
$1,314.64
|
| Rate for Payer: Quartz Beloit One Network |
$700.19
|
| Rate for Payer: Quartz Commercial |
$857.38
|
| Rate for Payer: WEA Trust Commercial |
$785.93
|
| Rate for Payer: WPS Commercial |
$1,058.39
|
|
