|
X-RAY Thoracic Spine 2 View 7207026
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
CPT 72070 26
|
| Hospital Charge Code |
3238180
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$34.28 |
| Max. Negotiated Rate |
$89.30 |
| Rate for Payer: Aetna Commercial |
$89.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$80.84
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cigna Commercial |
$89.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$47.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$56.40
|
| Rate for Payer: Health EOS Commercial |
$85.54
|
| Rate for Payer: HFN Commercial |
$89.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$34.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$34.28
|
| Rate for Payer: Multiplan Commercial |
$75.20
|
| Rate for Payer: Preferred Network Access Commercial |
$89.30
|
| Rate for Payer: Quartz Beloit One Network |
$41.36
|
| Rate for Payer: Quartz Commercial |
$53.58
|
| Rate for Payer: The Alliance Commercial |
$47.00
|
| Rate for Payer: WEA Trust Commercial |
$51.70
|
| Rate for Payer: WPS Commercial |
$69.63
|
|
|
X-RAY Thoracic Spine 3 View 72072
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
3238191
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$44.00 |
| Max. Negotiated Rate |
$132.34 |
| Rate for Payer: Aetna Commercial |
$95.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$50.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$60.00
|
| Rate for Payer: Health EOS Commercial |
$91.00
|
| Rate for Payer: HFN Commercial |
$95.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$132.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$132.34
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: Preferred Network Access Commercial |
$95.00
|
| Rate for Payer: Quartz Beloit One Network |
$44.00
|
| Rate for Payer: Quartz Commercial |
$57.00
|
| Rate for Payer: The Alliance Commercial |
$50.00
|
| Rate for Payer: WEA Trust Commercial |
$55.00
|
| Rate for Payer: WPS Commercial |
$74.07
|
|
|
X-RAY Thoracic Spine 3 View 7207226
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
CPT 72072 26
|
| Hospital Charge Code |
3238192
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$37.98 |
| Max. Negotiated Rate |
$112.10 |
| Rate for Payer: Aetna Commercial |
$112.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.48
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$112.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$59.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$70.80
|
| Rate for Payer: Health EOS Commercial |
$107.38
|
| Rate for Payer: HFN Commercial |
$112.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$37.98
|
| Rate for Payer: Multiplan Commercial |
$94.40
|
| Rate for Payer: Preferred Network Access Commercial |
$112.10
|
| Rate for Payer: Quartz Beloit One Network |
$51.92
|
| Rate for Payer: Quartz Commercial |
$67.26
|
| Rate for Payer: The Alliance Commercial |
$59.00
|
| Rate for Payer: WEA Trust Commercial |
$64.90
|
| Rate for Payer: WPS Commercial |
$87.40
|
|
|
X-RAY Thoracolumbar 7208026
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
CPT 72080 26
|
| Hospital Charge Code |
3238203
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.51 |
| Max. Negotiated Rate |
$82.65 |
| Rate for Payer: Aetna Commercial |
$82.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.82
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna Commercial |
$82.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$52.20
|
| Rate for Payer: Health EOS Commercial |
$79.17
|
| Rate for Payer: HFN Commercial |
$82.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35.51
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$35.51
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: Preferred Network Access Commercial |
$82.65
|
| Rate for Payer: Quartz Beloit One Network |
$38.28
|
| Rate for Payer: Quartz Commercial |
$49.59
|
| Rate for Payer: The Alliance Commercial |
$43.50
|
| Rate for Payer: WEA Trust Commercial |
$47.85
|
| Rate for Payer: WPS Commercial |
$64.44
|
|
|
XR Babygram
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
CPT 71045 TC
|
| Hospital Charge Code |
5724181
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.82 |
| Max. Negotiated Rate |
$445.28 |
| Rate for Payer: Aetna Commercial |
$435.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.24
|
| Rate for Payer: Aetna Managed Medicare |
$89.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$336.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$269.46
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$255.99
|
| Rate for Payer: Anthem Medicare Advantage |
$89.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$89.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$89.82
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cigna Commercial |
$445.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$89.82
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$270.85
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$89.82
|
| Rate for Payer: Health EOS Commercial |
$430.76
|
| Rate for Payer: HFN Commercial |
$445.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$334.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$89.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$89.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$89.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$89.82
|
| Rate for Payer: Multiplan Commercial |
$387.20
|
| Rate for Payer: NAPHCARE Commercial |
$134.73
|
| Rate for Payer: Preferred Network Access Commercial |
$445.28
|
| Rate for Payer: Quartz Beloit One Network |
$237.16
|
| Rate for Payer: Quartz Commercial |
$314.60
|
| Rate for Payer: Quartz Medicare Advantage |
$89.82
|
| Rate for Payer: The Alliance Commercial |
$359.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$89.82
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$266.20
|
| Rate for Payer: Wellcare Medicare |
$89.82
|
| Rate for Payer: WPS Commercial |
$358.50
|
|
|
XR Babygram
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
CPT 71045 TC
|
| Hospital Charge Code |
5724181
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$237.16 |
| Max. Negotiated Rate |
$445.28 |
| Rate for Payer: Aetna Commercial |
$435.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.52
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cigna Commercial |
$445.28
|
| Rate for Payer: Health EOS Commercial |
$430.76
|
| Rate for Payer: HFN Commercial |
$445.28
|
| Rate for Payer: Multiplan Commercial |
$387.20
|
| Rate for Payer: NAPHCARE Commercial |
$290.40
|
| Rate for Payer: Preferred Network Access Commercial |
$445.28
|
| Rate for Payer: Quartz Beloit One Network |
$237.16
|
| Rate for Payer: Quartz Commercial |
$290.40
|
| Rate for Payer: WEA Trust Commercial |
$266.20
|
| Rate for Payer: WPS Commercial |
$358.50
|
|
|
XR Babygram
|
Professional
|
Both
|
$484.00
|
|
|
Service Code
|
CPT 71045 TC
|
| Hospital Charge Code |
5724181
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$56.09 |
| Max. Negotiated Rate |
$459.80 |
| Rate for Payer: Aetna Commercial |
$459.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.24
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cigna Commercial |
$459.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$242.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$290.40
|
| Rate for Payer: Health EOS Commercial |
$440.44
|
| Rate for Payer: HFN Commercial |
$459.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$56.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$56.09
|
| Rate for Payer: Multiplan Commercial |
$387.20
|
| Rate for Payer: Preferred Network Access Commercial |
$459.80
|
| Rate for Payer: Quartz Beloit One Network |
$212.96
|
| Rate for Payer: Quartz Commercial |
$275.88
|
| Rate for Payer: The Alliance Commercial |
$242.00
|
| Rate for Payer: WEA Trust Commercial |
$266.20
|
| Rate for Payer: WPS Commercial |
$358.50
|
|
|
XR Barium Enema Complete
|
Professional
|
Both
|
$1,387.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
1536879
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$543.34 |
| Max. Negotiated Rate |
$1,317.65 |
| Rate for Payer: Aetna Commercial |
$1,317.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,192.82
|
| Rate for Payer: Cash Price |
$416.10
|
| Rate for Payer: Cash Price |
$416.10
|
| Rate for Payer: Cash Price |
$416.10
|
| Rate for Payer: Cigna Commercial |
$1,317.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$693.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.20
|
| Rate for Payer: Health EOS Commercial |
$1,262.17
|
| Rate for Payer: HFN Commercial |
$1,317.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$543.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$543.34
|
| Rate for Payer: Multiplan Commercial |
$1,109.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,317.65
|
| Rate for Payer: Quartz Beloit One Network |
$610.28
|
| Rate for Payer: Quartz Commercial |
$790.59
|
| Rate for Payer: The Alliance Commercial |
$693.50
|
| Rate for Payer: WEA Trust Commercial |
$762.85
|
| Rate for Payer: WPS Commercial |
$1,027.35
|
|
|
XR Barium Enema Complete
|
Facility
|
OP
|
$1,286.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
627608
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$1,183.12 |
| Rate for Payer: Aetna Commercial |
$1,157.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,105.96
|
| Rate for Payer: Aetna Managed Medicare |
$181.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$835.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$643.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$617.28
|
| Rate for Payer: Anthem Medicare Advantage |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$681.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.60
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cigna Commercial |
$1,183.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$181.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$719.65
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$181.60
|
| Rate for Payer: Health EOS Commercial |
$1,144.54
|
| Rate for Payer: HFN Commercial |
$1,183.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$675.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$181.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$181.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$181.60
|
| Rate for Payer: Multiplan Commercial |
$1,028.80
|
| Rate for Payer: NAPHCARE Commercial |
$272.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,183.12
|
| Rate for Payer: Quartz Beloit One Network |
$630.14
|
| Rate for Payer: Quartz Commercial |
$835.90
|
| Rate for Payer: Quartz Medicare Advantage |
$181.60
|
| Rate for Payer: The Alliance Commercial |
$726.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.60
|
| Rate for Payer: WEA Trust Commercial |
$707.30
|
| Rate for Payer: Wellcare Medicare |
$181.60
|
| Rate for Payer: WPS Commercial |
$952.54
|
|
|
XR Barium Enema Complete
|
Professional
|
Both
|
$1,286.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
627608
|
| Min. Negotiated Rate |
$543.34 |
| Max. Negotiated Rate |
$1,221.70 |
| Rate for Payer: Aetna Commercial |
$1,221.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,105.96
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cigna Commercial |
$1,221.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$643.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$771.60
|
| Rate for Payer: Health EOS Commercial |
$1,170.26
|
| Rate for Payer: HFN Commercial |
$1,221.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$543.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$543.34
|
| Rate for Payer: Multiplan Commercial |
$1,028.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,221.70
|
| Rate for Payer: Quartz Beloit One Network |
$565.84
|
| Rate for Payer: Quartz Commercial |
$733.02
|
| Rate for Payer: The Alliance Commercial |
$643.00
|
| Rate for Payer: WEA Trust Commercial |
$707.30
|
| Rate for Payer: WPS Commercial |
$952.54
|
|
|
XR Barium Enema Complete
|
Facility
|
IP
|
$1,387.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
1536879
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$679.63 |
| Max. Negotiated Rate |
$1,276.04 |
| Rate for Payer: Aetna Commercial |
$1,248.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,192.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$735.11
|
| Rate for Payer: Cash Price |
$416.10
|
| Rate for Payer: Cigna Commercial |
$1,276.04
|
| Rate for Payer: Health EOS Commercial |
$1,234.43
|
| Rate for Payer: HFN Commercial |
$1,276.04
|
| Rate for Payer: Multiplan Commercial |
$1,109.60
|
| Rate for Payer: NAPHCARE Commercial |
$832.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,276.04
|
| Rate for Payer: Quartz Beloit One Network |
$679.63
|
| Rate for Payer: Quartz Commercial |
$832.20
|
| Rate for Payer: WEA Trust Commercial |
$762.85
|
| Rate for Payer: WPS Commercial |
$1,027.35
|
|
|
XR Barium Enema Complete
|
Facility
|
OP
|
$1,387.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
1536879
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$1,276.04 |
| Rate for Payer: Aetna Commercial |
$1,248.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,192.82
|
| Rate for Payer: Aetna Managed Medicare |
$181.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$681.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$544.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$517.56
|
| Rate for Payer: Anthem Medicare Advantage |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$735.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.60
|
| Rate for Payer: Cash Price |
$416.10
|
| Rate for Payer: Cash Price |
$416.10
|
| Rate for Payer: Cash Price |
$416.10
|
| Rate for Payer: Cigna Commercial |
$1,276.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$181.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$776.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$181.60
|
| Rate for Payer: Health EOS Commercial |
$1,234.43
|
| Rate for Payer: HFN Commercial |
$1,276.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$675.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$181.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$181.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$181.60
|
| Rate for Payer: Multiplan Commercial |
$1,109.60
|
| Rate for Payer: NAPHCARE Commercial |
$272.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,276.04
|
| Rate for Payer: Quartz Beloit One Network |
$679.63
|
| Rate for Payer: Quartz Commercial |
$901.55
|
| Rate for Payer: Quartz Medicare Advantage |
$181.60
|
| Rate for Payer: The Alliance Commercial |
$726.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.60
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$762.85
|
| Rate for Payer: Wellcare Medicare |
$181.60
|
| Rate for Payer: WPS Commercial |
$1,027.35
|
|
|
XR Barium Enema Complete
|
Facility
|
IP
|
$1,286.00
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
627608
|
| Min. Negotiated Rate |
$630.14 |
| Max. Negotiated Rate |
$1,183.12 |
| Rate for Payer: Aetna Commercial |
$1,157.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,105.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$681.58
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cigna Commercial |
$1,183.12
|
| Rate for Payer: Health EOS Commercial |
$1,144.54
|
| Rate for Payer: HFN Commercial |
$1,183.12
|
| Rate for Payer: Multiplan Commercial |
$1,028.80
|
| Rate for Payer: NAPHCARE Commercial |
$771.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,183.12
|
| Rate for Payer: Quartz Beloit One Network |
$630.14
|
| Rate for Payer: Quartz Commercial |
$771.60
|
| Rate for Payer: WEA Trust Commercial |
$707.30
|
| Rate for Payer: WPS Commercial |
$952.54
|
|
|
XR Barium Enema Therapeutic
|
Facility
|
OP
|
$1,527.00
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
1536881
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$1,404.84 |
| Rate for Payer: Aetna Commercial |
$1,374.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,313.22
|
| Rate for Payer: Aetna Managed Medicare |
$181.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$681.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$544.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$517.56
|
| Rate for Payer: Anthem Medicare Advantage |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$809.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.60
|
| Rate for Payer: Cash Price |
$458.10
|
| Rate for Payer: Cash Price |
$458.10
|
| Rate for Payer: Cash Price |
$458.10
|
| Rate for Payer: Cigna Commercial |
$1,404.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$181.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$854.51
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$181.60
|
| Rate for Payer: Health EOS Commercial |
$1,359.03
|
| Rate for Payer: HFN Commercial |
$1,404.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$675.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$181.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$181.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$181.60
|
| Rate for Payer: Multiplan Commercial |
$1,221.60
|
| Rate for Payer: NAPHCARE Commercial |
$272.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,404.84
|
| Rate for Payer: Quartz Beloit One Network |
$748.23
|
| Rate for Payer: Quartz Commercial |
$992.55
|
| Rate for Payer: Quartz Medicare Advantage |
$181.60
|
| Rate for Payer: The Alliance Commercial |
$726.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.60
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$839.85
|
| Rate for Payer: Wellcare Medicare |
$181.60
|
| Rate for Payer: WPS Commercial |
$1,131.05
|
|
|
XR Barium Enema Therapeutic
|
Facility
|
IP
|
$1,468.00
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
627610
|
| Min. Negotiated Rate |
$719.32 |
| Max. Negotiated Rate |
$1,350.56 |
| Rate for Payer: Aetna Commercial |
$1,321.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,262.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$778.04
|
| Rate for Payer: Cash Price |
$440.40
|
| Rate for Payer: Cigna Commercial |
$1,350.56
|
| Rate for Payer: Health EOS Commercial |
$1,306.52
|
| Rate for Payer: HFN Commercial |
$1,350.56
|
| Rate for Payer: Multiplan Commercial |
$1,174.40
|
| Rate for Payer: NAPHCARE Commercial |
$880.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,350.56
|
| Rate for Payer: Quartz Beloit One Network |
$719.32
|
| Rate for Payer: Quartz Commercial |
$880.80
|
| Rate for Payer: WEA Trust Commercial |
$807.40
|
| Rate for Payer: WPS Commercial |
$1,087.35
|
|
|
XR Barium Enema Therapeutic
|
Professional
|
Both
|
$1,527.00
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
1536881
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$671.88 |
| Max. Negotiated Rate |
$1,450.65 |
| Rate for Payer: Aetna Commercial |
$1,450.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,313.22
|
| Rate for Payer: Cash Price |
$458.10
|
| Rate for Payer: Cash Price |
$458.10
|
| Rate for Payer: Cash Price |
$458.10
|
| Rate for Payer: Cigna Commercial |
$1,450.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$763.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$916.20
|
| Rate for Payer: Health EOS Commercial |
$1,389.57
|
| Rate for Payer: HFN Commercial |
$1,450.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$903.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$903.36
|
| Rate for Payer: Multiplan Commercial |
$1,221.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,450.65
|
| Rate for Payer: Quartz Beloit One Network |
$671.88
|
| Rate for Payer: Quartz Commercial |
$870.39
|
| Rate for Payer: The Alliance Commercial |
$763.50
|
| Rate for Payer: WEA Trust Commercial |
$839.85
|
| Rate for Payer: WPS Commercial |
$1,131.05
|
|
|
XR Barium Enema Therapeutic
|
Facility
|
OP
|
$1,468.00
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
627610
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$1,350.56 |
| Rate for Payer: Aetna Commercial |
$1,321.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,262.48
|
| Rate for Payer: Aetna Managed Medicare |
$181.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$954.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$734.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$704.64
|
| Rate for Payer: Anthem Medicare Advantage |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$778.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.60
|
| Rate for Payer: Cash Price |
$440.40
|
| Rate for Payer: Cash Price |
$440.40
|
| Rate for Payer: Cigna Commercial |
$1,350.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$181.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$821.49
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$181.60
|
| Rate for Payer: Health EOS Commercial |
$1,306.52
|
| Rate for Payer: HFN Commercial |
$1,350.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$675.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$181.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$181.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$181.60
|
| Rate for Payer: Multiplan Commercial |
$1,174.40
|
| Rate for Payer: NAPHCARE Commercial |
$272.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,350.56
|
| Rate for Payer: Quartz Beloit One Network |
$719.32
|
| Rate for Payer: Quartz Commercial |
$954.20
|
| Rate for Payer: Quartz Medicare Advantage |
$181.60
|
| Rate for Payer: The Alliance Commercial |
$726.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.60
|
| Rate for Payer: WEA Trust Commercial |
$807.40
|
| Rate for Payer: Wellcare Medicare |
$181.60
|
| Rate for Payer: WPS Commercial |
$1,087.35
|
|
|
XR Barium Enema Therapeutic
|
Professional
|
Both
|
$1,468.00
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
627610
|
| Min. Negotiated Rate |
$645.92 |
| Max. Negotiated Rate |
$1,394.60 |
| Rate for Payer: Aetna Commercial |
$1,394.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,262.48
|
| Rate for Payer: Cash Price |
$440.40
|
| Rate for Payer: Cash Price |
$440.40
|
| Rate for Payer: Cash Price |
$440.40
|
| Rate for Payer: Cigna Commercial |
$1,394.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$734.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$880.80
|
| Rate for Payer: Health EOS Commercial |
$1,335.88
|
| Rate for Payer: HFN Commercial |
$1,394.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$903.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$903.36
|
| Rate for Payer: Multiplan Commercial |
$1,174.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,394.60
|
| Rate for Payer: Quartz Beloit One Network |
$645.92
|
| Rate for Payer: Quartz Commercial |
$836.76
|
| Rate for Payer: The Alliance Commercial |
$734.00
|
| Rate for Payer: WEA Trust Commercial |
$807.40
|
| Rate for Payer: WPS Commercial |
$1,087.35
|
|
|
XR Barium Enema Therapeutic
|
Facility
|
IP
|
$1,527.00
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
1536881
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$748.23 |
| Max. Negotiated Rate |
$1,404.84 |
| Rate for Payer: Aetna Commercial |
$1,374.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,313.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$809.31
|
| Rate for Payer: Cash Price |
$458.10
|
| Rate for Payer: Cigna Commercial |
$1,404.84
|
| Rate for Payer: Health EOS Commercial |
$1,359.03
|
| Rate for Payer: HFN Commercial |
$1,404.84
|
| Rate for Payer: Multiplan Commercial |
$1,221.60
|
| Rate for Payer: NAPHCARE Commercial |
$916.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,404.84
|
| Rate for Payer: Quartz Beloit One Network |
$748.23
|
| Rate for Payer: Quartz Commercial |
$916.20
|
| Rate for Payer: WEA Trust Commercial |
$839.85
|
| Rate for Payer: WPS Commercial |
$1,131.05
|
|
|
XR Barium Enema w/ Air Complete
|
Facility
|
IP
|
$1,683.00
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
627612
|
| Min. Negotiated Rate |
$824.67 |
| Max. Negotiated Rate |
$1,548.36 |
| Rate for Payer: Aetna Commercial |
$1,514.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,447.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$891.99
|
| Rate for Payer: Cash Price |
$504.90
|
| Rate for Payer: Cigna Commercial |
$1,548.36
|
| Rate for Payer: Health EOS Commercial |
$1,497.87
|
| Rate for Payer: HFN Commercial |
$1,548.36
|
| Rate for Payer: Multiplan Commercial |
$1,346.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,009.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,548.36
|
| Rate for Payer: Quartz Beloit One Network |
$824.67
|
| Rate for Payer: Quartz Commercial |
$1,009.80
|
| Rate for Payer: WEA Trust Commercial |
$925.65
|
| Rate for Payer: WPS Commercial |
$1,246.60
|
|
|
XR Barium Enema w/ Air Complete
|
Facility
|
OP
|
$1,818.00
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
1536883
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$1,672.56 |
| Rate for Payer: Aetna Commercial |
$1,636.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,563.48
|
| Rate for Payer: Aetna Managed Medicare |
$181.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$681.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$544.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$517.56
|
| Rate for Payer: Anthem Medicare Advantage |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$963.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.60
|
| Rate for Payer: Cash Price |
$545.40
|
| Rate for Payer: Cash Price |
$545.40
|
| Rate for Payer: Cash Price |
$545.40
|
| Rate for Payer: Cigna Commercial |
$1,672.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$181.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,017.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$181.60
|
| Rate for Payer: Health EOS Commercial |
$1,618.02
|
| Rate for Payer: HFN Commercial |
$1,672.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$675.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$181.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$181.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$181.60
|
| Rate for Payer: Multiplan Commercial |
$1,454.40
|
| Rate for Payer: NAPHCARE Commercial |
$272.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,672.56
|
| Rate for Payer: Quartz Beloit One Network |
$890.82
|
| Rate for Payer: Quartz Commercial |
$1,181.70
|
| Rate for Payer: Quartz Medicare Advantage |
$181.60
|
| Rate for Payer: The Alliance Commercial |
$726.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.60
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$999.90
|
| Rate for Payer: Wellcare Medicare |
$181.60
|
| Rate for Payer: WPS Commercial |
$1,346.59
|
|
|
XR Barium Enema w/ Air Complete
|
Facility
|
IP
|
$1,818.00
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
1536883
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$890.82 |
| Max. Negotiated Rate |
$1,672.56 |
| Rate for Payer: Aetna Commercial |
$1,636.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,563.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$963.54
|
| Rate for Payer: Cash Price |
$545.40
|
| Rate for Payer: Cigna Commercial |
$1,672.56
|
| Rate for Payer: Health EOS Commercial |
$1,618.02
|
| Rate for Payer: HFN Commercial |
$1,672.56
|
| Rate for Payer: Multiplan Commercial |
$1,454.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,090.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,672.56
|
| Rate for Payer: Quartz Beloit One Network |
$890.82
|
| Rate for Payer: Quartz Commercial |
$1,090.80
|
| Rate for Payer: WEA Trust Commercial |
$999.90
|
| Rate for Payer: WPS Commercial |
$1,346.59
|
|
|
XR Barium Enema w/ Air Complete
|
Professional
|
Both
|
$1,683.00
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
627612
|
| Min. Negotiated Rate |
$740.52 |
| Max. Negotiated Rate |
$1,598.85 |
| Rate for Payer: Aetna Commercial |
$1,598.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,447.38
|
| Rate for Payer: Cash Price |
$504.90
|
| Rate for Payer: Cash Price |
$504.90
|
| Rate for Payer: Cash Price |
$504.90
|
| Rate for Payer: Cigna Commercial |
$1,598.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$841.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,009.80
|
| Rate for Payer: Health EOS Commercial |
$1,531.53
|
| Rate for Payer: HFN Commercial |
$1,598.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$785.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$785.11
|
| Rate for Payer: Multiplan Commercial |
$1,346.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,598.85
|
| Rate for Payer: Quartz Beloit One Network |
$740.52
|
| Rate for Payer: Quartz Commercial |
$959.31
|
| Rate for Payer: The Alliance Commercial |
$841.50
|
| Rate for Payer: WEA Trust Commercial |
$925.65
|
| Rate for Payer: WPS Commercial |
$1,246.60
|
|
|
XR Barium Enema w/ Air Complete
|
Professional
|
Both
|
$1,818.00
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
1536883
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$785.11 |
| Max. Negotiated Rate |
$1,727.10 |
| Rate for Payer: Aetna Commercial |
$1,727.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,563.48
|
| Rate for Payer: Cash Price |
$545.40
|
| Rate for Payer: Cash Price |
$545.40
|
| Rate for Payer: Cash Price |
$545.40
|
| Rate for Payer: Cigna Commercial |
$1,727.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$909.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,090.80
|
| Rate for Payer: Health EOS Commercial |
$1,654.38
|
| Rate for Payer: HFN Commercial |
$1,727.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$785.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$785.11
|
| Rate for Payer: Multiplan Commercial |
$1,454.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,727.10
|
| Rate for Payer: Quartz Beloit One Network |
$799.92
|
| Rate for Payer: Quartz Commercial |
$1,036.26
|
| Rate for Payer: The Alliance Commercial |
$909.00
|
| Rate for Payer: WEA Trust Commercial |
$999.90
|
| Rate for Payer: WPS Commercial |
$1,346.59
|
|
|
XR Barium Enema w/ Air Complete
|
Facility
|
OP
|
$1,683.00
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
627612
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$1,548.36 |
| Rate for Payer: Aetna Commercial |
$1,514.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,447.38
|
| Rate for Payer: Aetna Managed Medicare |
$181.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,093.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$841.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$807.84
|
| Rate for Payer: Anthem Medicare Advantage |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$891.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.60
|
| Rate for Payer: Cash Price |
$504.90
|
| Rate for Payer: Cash Price |
$504.90
|
| Rate for Payer: Cigna Commercial |
$1,548.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$181.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$941.81
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$181.60
|
| Rate for Payer: Health EOS Commercial |
$1,497.87
|
| Rate for Payer: HFN Commercial |
$1,548.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$675.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$181.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$181.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$181.60
|
| Rate for Payer: Multiplan Commercial |
$1,346.40
|
| Rate for Payer: NAPHCARE Commercial |
$272.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,548.36
|
| Rate for Payer: Quartz Beloit One Network |
$824.67
|
| Rate for Payer: Quartz Commercial |
$1,093.95
|
| Rate for Payer: Quartz Medicare Advantage |
$181.60
|
| Rate for Payer: The Alliance Commercial |
$726.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.60
|
| Rate for Payer: WEA Trust Commercial |
$925.65
|
| Rate for Payer: Wellcare Medicare |
$181.60
|
| Rate for Payer: WPS Commercial |
$1,246.60
|
|
