|
US Parathyroid
|
Facility
|
IP
|
$1,429.00
|
|
|
Service Code
|
CPT 76536 TC
|
| Hospital Charge Code |
2544938
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$728.22 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$891.70
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
US Parotid
|
Facility
|
OP
|
$1,374.00
|
|
|
Service Code
|
CPT 76536
|
| Hospital Charge Code |
631477
|
| 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 Parotid
|
Facility
|
IP
|
$1,374.00
|
|
|
Service Code
|
CPT 76536
|
| Hospital Charge Code |
631477
|
| 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
|
|
|
US Parotid
|
Professional
|
Both
|
$1,374.00
|
|
|
Service Code
|
CPT 76536
|
| Hospital Charge Code |
631477
|
| 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 Parotid
|
Facility
|
IP
|
$1,429.00
|
|
|
Service Code
|
CPT 76536 TC
|
| Hospital Charge Code |
2544940
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$728.22 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$891.70
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
US Parotid
|
Professional
|
Both
|
$1,429.00
|
|
|
Service Code
|
CPT 76536 TC
|
| Hospital Charge Code |
2544940
|
|
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 Parotid
|
Facility
|
OP
|
$1,429.00
|
|
|
Service Code
|
CPT 76536 TC
|
| Hospital Charge Code |
2544940
|
|
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 Pelvis Non-Ob Complete
|
Facility
|
IP
|
$1,789.00
|
|
|
Service Code
|
CPT 76856 TC
|
| Hospital Charge Code |
3072733
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$911.67 |
| Max. Negotiated Rate |
$1,711.72 |
| Rate for Payer: Aetna Commercial |
$1,674.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,600.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$986.10
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cigna Commercial |
$1,711.72
|
| Rate for Payer: Health EOS Commercial |
$1,655.90
|
| Rate for Payer: HFN Commercial |
$1,711.72
|
| Rate for Payer: Multiplan Commercial |
$1,488.45
|
| Rate for Payer: Preferred Network Access Commercial |
$1,711.72
|
| Rate for Payer: Quartz Beloit One Network |
$911.67
|
| Rate for Payer: Quartz Commercial |
$1,116.34
|
| Rate for Payer: WEA Trust Commercial |
$1,023.31
|
| Rate for Payer: WPS Commercial |
$1,378.07
|
|
|
US Pelvis Non-Ob Complete
|
Professional
|
Both
|
$1,789.00
|
|
|
Service Code
|
CPT 76856 TC
|
| Hospital Charge Code |
3072733
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.32 |
| Max. Negotiated Rate |
$1,767.53 |
| Rate for Payer: Aetna Commercial |
$1,767.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,600.08
|
| Rate for Payer: Aetna Managed Medicare |
$72.32
|
| Rate for Payer: Anthem Medicare Advantage |
$72.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$72.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$72.32
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cigna Commercial |
$1,767.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$930.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$72.32
|
| Rate for Payer: Health EOS Commercial |
$1,693.11
|
| Rate for Payer: HFN Commercial |
$1,767.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$269.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$269.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$72.32
|
| Rate for Payer: Multiplan Commercial |
$1,488.45
|
| Rate for Payer: NAPHCARE Commercial |
$108.48
|
| Rate for Payer: Preferred Network Access Commercial |
$1,767.53
|
| Rate for Payer: Quartz Beloit One Network |
$818.65
|
| Rate for Payer: Quartz Commercial |
$1,060.52
|
| Rate for Payer: Quartz Medicare Advantage |
$72.32
|
| Rate for Payer: The Alliance Commercial |
$274.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$72.32
|
| Rate for Payer: WEA Trust Commercial |
$1,023.31
|
| Rate for Payer: WPS Commercial |
$361.61
|
|
|
US Pelvis Non-Ob Complete
|
Facility
|
OP
|
$1,789.00
|
|
|
Service Code
|
CPT 76856 TC
|
| Hospital Charge Code |
3072733
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$289.29 |
| Max. Negotiated Rate |
$1,711.72 |
| Rate for Payer: Aetna Commercial |
$1,674.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,600.08
|
| Rate for Payer: Aetna Managed Medicare |
$520.96
|
| 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 |
$986.10
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cigna Commercial |
$1,711.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,041.20
|
| Rate for Payer: Health EOS Commercial |
$1,655.90
|
| Rate for Payer: HFN Commercial |
$1,711.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,395.42
|
| Rate for Payer: Multiplan Commercial |
$1,488.45
|
| Rate for Payer: NAPHCARE Commercial |
$1,116.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,711.72
|
| Rate for Payer: Quartz Beloit One Network |
$911.67
|
| Rate for Payer: Quartz Commercial |
$1,209.36
|
| Rate for Payer: Quartz Medicare Advantage |
$1,116.34
|
| Rate for Payer: The Alliance Commercial |
$289.29
|
| Rate for Payer: United Healthcare PPO |
$596.96
|
| Rate for Payer: WEA Trust Commercial |
$1,023.31
|
| Rate for Payer: WPS Commercial |
$1,378.07
|
|
|
US Pelvis Non-OB Complete
|
Facility
|
IP
|
$1,789.00
|
|
|
Service Code
|
CPT 76856 TC
|
| Hospital Charge Code |
2544942
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$911.67 |
| Max. Negotiated Rate |
$1,711.72 |
| Rate for Payer: Aetna Commercial |
$1,674.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,600.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$986.10
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cigna Commercial |
$1,711.72
|
| Rate for Payer: Health EOS Commercial |
$1,655.90
|
| Rate for Payer: HFN Commercial |
$1,711.72
|
| Rate for Payer: Multiplan Commercial |
$1,488.45
|
| Rate for Payer: Preferred Network Access Commercial |
$1,711.72
|
| Rate for Payer: Quartz Beloit One Network |
$911.67
|
| Rate for Payer: Quartz Commercial |
$1,116.34
|
| Rate for Payer: WEA Trust Commercial |
$1,023.31
|
| Rate for Payer: WPS Commercial |
$1,378.07
|
|
|
US Pelvis Non-OB Complete
|
Facility
|
OP
|
$1,513.00
|
|
|
Service Code
|
CPT 76856
|
| Hospital Charge Code |
630929
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$1,447.64 |
| Rate for Payer: Aetna Commercial |
$1,416.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,353.23
|
| Rate for Payer: Aetna Managed Medicare |
$110.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,022.79
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$786.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$755.29
|
| Rate for Payer: Anthem Medicare Advantage |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$833.97
|
| 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 |
$453.90
|
| Rate for Payer: Cash Price |
$453.90
|
| Rate for Payer: Cigna Commercial |
$1,447.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$110.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$880.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$110.02
|
| Rate for Payer: Health EOS Commercial |
$1,400.43
|
| Rate for Payer: HFN Commercial |
$1,447.64
|
| 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 |
$1,258.82
|
| Rate for Payer: NAPHCARE Commercial |
$165.03
|
| Rate for Payer: Preferred Network Access Commercial |
$1,447.64
|
| Rate for Payer: Quartz Beloit One Network |
$771.02
|
| Rate for Payer: Quartz Commercial |
$1,022.79
|
| 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 |
$865.44
|
| Rate for Payer: Wellcare Medicare |
$110.02
|
| Rate for Payer: WPS Commercial |
$1,165.46
|
|
|
US Pelvis Non-OB Complete
|
Professional
|
Both
|
$1,789.00
|
|
|
Service Code
|
CPT 76856 TC
|
| Hospital Charge Code |
2544942
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.32 |
| Max. Negotiated Rate |
$1,767.53 |
| Rate for Payer: Aetna Commercial |
$1,767.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,600.08
|
| Rate for Payer: Aetna Managed Medicare |
$72.32
|
| Rate for Payer: Anthem Medicare Advantage |
$72.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$72.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$72.32
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cigna Commercial |
$1,767.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$930.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$72.32
|
| Rate for Payer: Health EOS Commercial |
$1,693.11
|
| Rate for Payer: HFN Commercial |
$1,767.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$269.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$269.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$72.32
|
| Rate for Payer: Multiplan Commercial |
$1,488.45
|
| Rate for Payer: NAPHCARE Commercial |
$108.48
|
| Rate for Payer: Preferred Network Access Commercial |
$1,767.53
|
| Rate for Payer: Quartz Beloit One Network |
$818.65
|
| Rate for Payer: Quartz Commercial |
$1,060.52
|
| Rate for Payer: Quartz Medicare Advantage |
$72.32
|
| Rate for Payer: The Alliance Commercial |
$274.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$72.32
|
| Rate for Payer: WEA Trust Commercial |
$1,023.31
|
| Rate for Payer: WPS Commercial |
$361.61
|
|
|
US Pelvis Non-OB Complete
|
Facility
|
IP
|
$1,513.00
|
|
|
Service Code
|
CPT 76856
|
| Hospital Charge Code |
630929
|
| Min. Negotiated Rate |
$771.02 |
| Max. Negotiated Rate |
$1,447.64 |
| Rate for Payer: Aetna Commercial |
$1,416.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,353.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$833.97
|
| Rate for Payer: Cash Price |
$453.90
|
| Rate for Payer: Cigna Commercial |
$1,447.64
|
| Rate for Payer: Health EOS Commercial |
$1,400.43
|
| Rate for Payer: HFN Commercial |
$1,447.64
|
| Rate for Payer: Multiplan Commercial |
$1,258.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,447.64
|
| Rate for Payer: Quartz Beloit One Network |
$771.02
|
| Rate for Payer: Quartz Commercial |
$944.11
|
| Rate for Payer: WEA Trust Commercial |
$865.44
|
| Rate for Payer: WPS Commercial |
$1,165.46
|
|
|
US Pelvis Non-OB Complete
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
CPT 76856
|
| Hospital Charge Code |
630929
|
| Min. Negotiated Rate |
$104.68 |
| Max. Negotiated Rate |
$1,494.84 |
| Rate for Payer: Aetna Commercial |
$1,494.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,353.23
|
| Rate for Payer: Aetna Managed Medicare |
$104.68
|
| Rate for Payer: Anthem Medicare Advantage |
$104.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$104.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$104.68
|
| Rate for Payer: Cash Price |
$453.90
|
| Rate for Payer: Cash Price |
$453.90
|
| Rate for Payer: Cash Price |
$453.90
|
| Rate for Payer: Cigna Commercial |
$1,494.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$786.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$104.68
|
| Rate for Payer: Health EOS Commercial |
$1,431.90
|
| Rate for Payer: HFN Commercial |
$1,494.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$389.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$389.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$104.68
|
| Rate for Payer: Multiplan Commercial |
$1,258.82
|
| Rate for Payer: NAPHCARE Commercial |
$157.01
|
| Rate for Payer: Preferred Network Access Commercial |
$1,494.84
|
| Rate for Payer: Quartz Beloit One Network |
$692.35
|
| Rate for Payer: Quartz Commercial |
$896.91
|
| Rate for Payer: Quartz Medicare Advantage |
$104.68
|
| Rate for Payer: The Alliance Commercial |
$397.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$104.68
|
| Rate for Payer: WEA Trust Commercial |
$865.44
|
| Rate for Payer: WPS Commercial |
$523.38
|
|
|
US Pelvis Non-OB Complete
|
Facility
|
OP
|
$1,789.00
|
|
|
Service Code
|
CPT 76856 TC
|
| Hospital Charge Code |
2544942
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$289.29 |
| Max. Negotiated Rate |
$1,711.72 |
| Rate for Payer: Aetna Commercial |
$1,674.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,600.08
|
| Rate for Payer: Aetna Managed Medicare |
$520.96
|
| 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 |
$986.10
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cigna Commercial |
$1,711.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,041.20
|
| Rate for Payer: Health EOS Commercial |
$1,655.90
|
| Rate for Payer: HFN Commercial |
$1,711.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,395.42
|
| Rate for Payer: Multiplan Commercial |
$1,488.45
|
| Rate for Payer: NAPHCARE Commercial |
$1,116.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,711.72
|
| Rate for Payer: Quartz Beloit One Network |
$911.67
|
| Rate for Payer: Quartz Commercial |
$1,209.36
|
| Rate for Payer: Quartz Medicare Advantage |
$1,116.34
|
| Rate for Payer: The Alliance Commercial |
$289.29
|
| Rate for Payer: United Healthcare PPO |
$596.96
|
| Rate for Payer: WEA Trust Commercial |
$1,023.31
|
| Rate for Payer: WPS Commercial |
$1,378.07
|
|
|
US Pelvis Non-OB Limited
|
Facility
|
IP
|
$1,221.00
|
|
|
Service Code
|
CPT 76857 TC
|
| Hospital Charge Code |
2544944
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$622.22 |
| Max. Negotiated Rate |
$1,168.25 |
| Rate for Payer: Aetna Commercial |
$1,142.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,092.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$673.02
|
| Rate for Payer: Cash Price |
$366.30
|
| Rate for Payer: Cigna Commercial |
$1,168.25
|
| Rate for Payer: Health EOS Commercial |
$1,130.16
|
| Rate for Payer: HFN Commercial |
$1,168.25
|
| Rate for Payer: Multiplan Commercial |
$1,015.87
|
| Rate for Payer: Preferred Network Access Commercial |
$1,168.25
|
| Rate for Payer: Quartz Beloit One Network |
$622.22
|
| Rate for Payer: Quartz Commercial |
$761.90
|
| Rate for Payer: WEA Trust Commercial |
$698.41
|
| Rate for Payer: WPS Commercial |
$940.54
|
|
|
US Pelvis Non-OB Limited
|
Facility
|
IP
|
$1,144.00
|
|
|
Service Code
|
CPT 76857
|
| Hospital Charge Code |
630925
|
| Min. Negotiated Rate |
$582.98 |
| Max. Negotiated Rate |
$1,094.58 |
| Rate for Payer: Aetna Commercial |
$1,070.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,023.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$630.57
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cigna Commercial |
$1,094.58
|
| Rate for Payer: Health EOS Commercial |
$1,058.89
|
| Rate for Payer: HFN Commercial |
$1,094.58
|
| Rate for Payer: Multiplan Commercial |
$951.81
|
| Rate for Payer: Preferred Network Access Commercial |
$1,094.58
|
| Rate for Payer: Quartz Beloit One Network |
$582.98
|
| Rate for Payer: Quartz Commercial |
$713.86
|
| Rate for Payer: WEA Trust Commercial |
$654.37
|
| Rate for Payer: WPS Commercial |
$881.22
|
|
|
US Pelvis Non-OB Limited
|
Professional
|
Both
|
$1,221.00
|
|
|
Service Code
|
CPT 76857 TC
|
| Hospital Charge Code |
2544944
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$27.06 |
| Max. Negotiated Rate |
$1,206.35 |
| Rate for Payer: Aetna Commercial |
$1,206.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,092.06
|
| Rate for Payer: Aetna Managed Medicare |
$27.06
|
| Rate for Payer: Anthem Medicare Advantage |
$27.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.06
|
| Rate for Payer: Cash Price |
$366.30
|
| Rate for Payer: Cash Price |
$366.30
|
| Rate for Payer: Cash Price |
$366.30
|
| Rate for Payer: Cigna Commercial |
$1,206.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$634.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27.06
|
| Rate for Payer: Health EOS Commercial |
$1,155.55
|
| Rate for Payer: HFN Commercial |
$1,206.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$84.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$84.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.06
|
| Rate for Payer: Multiplan Commercial |
$1,015.87
|
| Rate for Payer: NAPHCARE Commercial |
$40.59
|
| Rate for Payer: Preferred Network Access Commercial |
$1,206.35
|
| Rate for Payer: Quartz Beloit One Network |
$558.73
|
| Rate for Payer: Quartz Commercial |
$723.81
|
| Rate for Payer: Quartz Medicare Advantage |
$27.06
|
| Rate for Payer: The Alliance Commercial |
$102.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.06
|
| Rate for Payer: WEA Trust Commercial |
$698.41
|
| Rate for Payer: WPS Commercial |
$135.30
|
|
|
US Pelvis Non-OB Limited
|
Facility
|
OP
|
$1,144.00
|
|
|
Service Code
|
CPT 76857
|
| Hospital Charge Code |
630925
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$1,094.58 |
| Rate for Payer: Aetna Commercial |
$1,070.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,023.19
|
| Rate for Payer: Aetna Managed Medicare |
$110.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$773.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$594.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$571.08
|
| Rate for Payer: Anthem Medicare Advantage |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$630.57
|
| 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 |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cigna Commercial |
$1,094.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$110.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$665.81
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$110.02
|
| Rate for Payer: Health EOS Commercial |
$1,058.89
|
| Rate for Payer: HFN Commercial |
$1,094.58
|
| 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 |
$951.81
|
| Rate for Payer: NAPHCARE Commercial |
$165.03
|
| Rate for Payer: Preferred Network Access Commercial |
$1,094.58
|
| Rate for Payer: Quartz Beloit One Network |
$582.98
|
| Rate for Payer: Quartz Commercial |
$773.34
|
| 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 |
$654.37
|
| Rate for Payer: Wellcare Medicare |
$110.02
|
| Rate for Payer: WPS Commercial |
$881.22
|
|
|
US Pelvis Non-OB Limited
|
Professional
|
Both
|
$1,144.00
|
|
|
Service Code
|
CPT 76857
|
| Hospital Charge Code |
630925
|
| Min. Negotiated Rate |
$50.73 |
| Max. Negotiated Rate |
$1,130.27 |
| Rate for Payer: Aetna Commercial |
$1,130.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,023.19
|
| Rate for Payer: Aetna Managed Medicare |
$50.73
|
| Rate for Payer: Anthem Medicare Advantage |
$50.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$50.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$50.73
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cigna Commercial |
$1,130.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$594.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$50.73
|
| Rate for Payer: Health EOS Commercial |
$1,082.68
|
| Rate for Payer: HFN Commercial |
$1,130.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$170.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$170.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$50.73
|
| Rate for Payer: Multiplan Commercial |
$951.81
|
| Rate for Payer: NAPHCARE Commercial |
$76.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,130.27
|
| Rate for Payer: Quartz Beloit One Network |
$523.49
|
| Rate for Payer: Quartz Commercial |
$678.16
|
| Rate for Payer: Quartz Medicare Advantage |
$50.73
|
| Rate for Payer: The Alliance Commercial |
$192.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$50.73
|
| Rate for Payer: WEA Trust Commercial |
$654.37
|
| Rate for Payer: WPS Commercial |
$253.66
|
|
|
US Pelvis Non-OB Limited
|
Facility
|
OP
|
$1,221.00
|
|
|
Service Code
|
CPT 76857 TC
|
| Hospital Charge Code |
2544944
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$108.24 |
| Max. Negotiated Rate |
$1,168.25 |
| Rate for Payer: Aetna Commercial |
$1,142.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,092.06
|
| Rate for Payer: Aetna Managed Medicare |
$355.56
|
| 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 |
$673.02
|
| Rate for Payer: Cash Price |
$366.30
|
| Rate for Payer: Cash Price |
$366.30
|
| Rate for Payer: Cash Price |
$366.30
|
| Rate for Payer: Cigna Commercial |
$1,168.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$710.62
|
| Rate for Payer: Health EOS Commercial |
$1,130.16
|
| Rate for Payer: HFN Commercial |
$1,168.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$952.38
|
| Rate for Payer: Multiplan Commercial |
$1,015.87
|
| Rate for Payer: NAPHCARE Commercial |
$761.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,168.25
|
| Rate for Payer: Quartz Beloit One Network |
$622.22
|
| Rate for Payer: Quartz Commercial |
$825.40
|
| Rate for Payer: Quartz Medicare Advantage |
$761.90
|
| Rate for Payer: The Alliance Commercial |
$108.24
|
| Rate for Payer: United Healthcare PPO |
$596.96
|
| Rate for Payer: WEA Trust Commercial |
$698.41
|
| Rate for Payer: WPS Commercial |
$940.54
|
|
|
US Pelvis, Transvaginal
|
Facility
|
IP
|
$1,789.00
|
|
|
Service Code
|
CPT 76856 TC
|
| Hospital Charge Code |
2587178
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$911.67 |
| Max. Negotiated Rate |
$1,711.72 |
| Rate for Payer: Aetna Commercial |
$1,674.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,600.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$986.10
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cigna Commercial |
$1,711.72
|
| Rate for Payer: Health EOS Commercial |
$1,655.90
|
| Rate for Payer: HFN Commercial |
$1,711.72
|
| Rate for Payer: Multiplan Commercial |
$1,488.45
|
| Rate for Payer: Preferred Network Access Commercial |
$1,711.72
|
| Rate for Payer: Quartz Beloit One Network |
$911.67
|
| Rate for Payer: Quartz Commercial |
$1,116.34
|
| Rate for Payer: WEA Trust Commercial |
$1,023.31
|
| Rate for Payer: WPS Commercial |
$1,378.07
|
|
|
US Pelvis, Transvaginal
|
Facility
|
OP
|
$1,789.00
|
|
|
Service Code
|
CPT 76856 TC
|
| Hospital Charge Code |
2587178
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$289.29 |
| Max. Negotiated Rate |
$1,711.72 |
| Rate for Payer: Aetna Commercial |
$1,674.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,600.08
|
| Rate for Payer: Aetna Managed Medicare |
$520.96
|
| 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 |
$986.10
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cigna Commercial |
$1,711.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,041.20
|
| Rate for Payer: Health EOS Commercial |
$1,655.90
|
| Rate for Payer: HFN Commercial |
$1,711.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,395.42
|
| Rate for Payer: Multiplan Commercial |
$1,488.45
|
| Rate for Payer: NAPHCARE Commercial |
$1,116.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,711.72
|
| Rate for Payer: Quartz Beloit One Network |
$911.67
|
| Rate for Payer: Quartz Commercial |
$1,209.36
|
| Rate for Payer: Quartz Medicare Advantage |
$1,116.34
|
| Rate for Payer: The Alliance Commercial |
$289.29
|
| Rate for Payer: United Healthcare PPO |
$596.96
|
| Rate for Payer: WEA Trust Commercial |
$1,023.31
|
| Rate for Payer: WPS Commercial |
$1,378.07
|
|
|
US Pelvis, Transvaginal
|
Professional
|
Both
|
$1,789.00
|
|
|
Service Code
|
CPT 76856 TC
|
| Hospital Charge Code |
2587178
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.32 |
| Max. Negotiated Rate |
$1,767.53 |
| Rate for Payer: Aetna Commercial |
$1,767.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,600.08
|
| Rate for Payer: Aetna Managed Medicare |
$72.32
|
| Rate for Payer: Anthem Medicare Advantage |
$72.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$72.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$72.32
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cigna Commercial |
$1,767.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$930.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$72.32
|
| Rate for Payer: Health EOS Commercial |
$1,693.11
|
| Rate for Payer: HFN Commercial |
$1,767.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$269.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$269.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$72.32
|
| Rate for Payer: Multiplan Commercial |
$1,488.45
|
| Rate for Payer: NAPHCARE Commercial |
$108.48
|
| Rate for Payer: Preferred Network Access Commercial |
$1,767.53
|
| Rate for Payer: Quartz Beloit One Network |
$818.65
|
| Rate for Payer: Quartz Commercial |
$1,060.52
|
| Rate for Payer: Quartz Medicare Advantage |
$72.32
|
| Rate for Payer: The Alliance Commercial |
$274.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$72.32
|
| Rate for Payer: WEA Trust Commercial |
$1,023.31
|
| Rate for Payer: WPS Commercial |
$361.61
|
|
