|
VDRL with Reflex Titer, CSF
|
Facility
|
OP
|
$89.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
5364667
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Aetna Managed Medicare |
$4.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$16.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.77
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7.37
|
| Rate for Payer: Anthem Medicare Advantage |
$4.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$49.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.44
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$85.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$51.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.44
|
| Rate for Payer: Health EOS Commercial |
$82.38
|
| Rate for Payer: HFN Commercial |
$85.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$16.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.44
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.44
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: NAPHCARE Commercial |
$6.66
|
| Rate for Payer: Preferred Network Access Commercial |
$85.16
|
| Rate for Payer: Quartz Beloit One Network |
$45.35
|
| Rate for Payer: Quartz Commercial |
$60.16
|
| Rate for Payer: Quartz Medicare Advantage |
$4.44
|
| Rate for Payer: The Alliance Commercial |
$17.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.44
|
| Rate for Payer: United Healthcare PPO |
$69.42
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: Wellcare Medicare |
$4.44
|
| Rate for Payer: WPS Commercial |
$68.56
|
|
|
VDRL with Reflex Titer, CSF
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
5364667
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$87.93 |
| Rate for Payer: Aetna Commercial |
$87.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Aetna Managed Medicare |
$4.44
|
| Rate for Payer: Anthem Medicare Advantage |
$4.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.44
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$87.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.44
|
| Rate for Payer: Health EOS Commercial |
$84.23
|
| Rate for Payer: HFN Commercial |
$87.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.67
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.44
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: NAPHCARE Commercial |
$6.66
|
| Rate for Payer: Preferred Network Access Commercial |
$87.93
|
| Rate for Payer: Quartz Beloit One Network |
$40.73
|
| Rate for Payer: Quartz Commercial |
$52.76
|
| Rate for Payer: Quartz Medicare Advantage |
$4.44
|
| Rate for Payer: The Alliance Commercial |
$17.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.44
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: WPS Commercial |
$19.54
|
|
|
VE 1st Order
|
Facility
|
IP
|
$1,956.00
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
3052559
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$996.78 |
| Max. Negotiated Rate |
$1,871.50 |
| Rate for Payer: Aetna Commercial |
$1,830.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,749.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,078.15
|
| Rate for Payer: Cash Price |
$586.80
|
| Rate for Payer: Cigna Commercial |
$1,871.50
|
| Rate for Payer: Health EOS Commercial |
$1,810.47
|
| Rate for Payer: HFN Commercial |
$1,871.50
|
| Rate for Payer: Multiplan Commercial |
$1,627.39
|
| Rate for Payer: Preferred Network Access Commercial |
$1,871.50
|
| Rate for Payer: Quartz Beloit One Network |
$996.78
|
| Rate for Payer: Quartz Commercial |
$1,220.54
|
| Rate for Payer: WEA Trust Commercial |
$1,118.83
|
| Rate for Payer: WPS Commercial |
$1,506.71
|
|
|
VE 1st Order
|
Facility
|
OP
|
$1,956.00
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
3052559
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$569.59 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$1,830.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,749.45
|
| Rate for Payer: Aetna Managed Medicare |
$569.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,322.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,017.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$976.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,078.15
|
| Rate for Payer: Cash Price |
$586.80
|
| Rate for Payer: Cash Price |
$586.80
|
| Rate for Payer: Cigna Commercial |
$1,871.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Health EOS Commercial |
$1,810.47
|
| Rate for Payer: HFN Commercial |
$1,871.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,525.68
|
| Rate for Payer: Multiplan Commercial |
$1,627.39
|
| Rate for Payer: NAPHCARE Commercial |
$1,220.54
|
| Rate for Payer: Preferred Network Access Commercial |
$1,871.50
|
| Rate for Payer: Quartz Beloit One Network |
$996.78
|
| Rate for Payer: Quartz Commercial |
$1,322.26
|
| Rate for Payer: Quartz Medicare Advantage |
$1,220.54
|
| Rate for Payer: The Alliance Commercial |
$717.18
|
| Rate for Payer: WEA Trust Commercial |
$1,118.83
|
| Rate for Payer: WPS Commercial |
$1,506.71
|
|
|
VE 2nd Order
|
Facility
|
OP
|
$2,490.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
3052560
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$725.09 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$2,330.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,227.06
|
| Rate for Payer: Aetna Managed Medicare |
$725.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,683.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,294.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,243.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,372.49
|
| Rate for Payer: Cash Price |
$747.00
|
| Rate for Payer: Cash Price |
$747.00
|
| Rate for Payer: Cigna Commercial |
$2,382.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Health EOS Commercial |
$2,304.74
|
| Rate for Payer: HFN Commercial |
$2,382.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,942.20
|
| Rate for Payer: Multiplan Commercial |
$2,071.68
|
| Rate for Payer: NAPHCARE Commercial |
$1,553.76
|
| Rate for Payer: Preferred Network Access Commercial |
$2,382.43
|
| Rate for Payer: Quartz Beloit One Network |
$1,268.90
|
| Rate for Payer: Quartz Commercial |
$1,683.24
|
| Rate for Payer: Quartz Medicare Advantage |
$1,553.76
|
| Rate for Payer: The Alliance Commercial |
$898.31
|
| Rate for Payer: WEA Trust Commercial |
$1,424.28
|
| Rate for Payer: WPS Commercial |
$1,918.05
|
|
|
VE 2nd Order
|
Facility
|
IP
|
$2,490.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
3052560
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,268.90 |
| Max. Negotiated Rate |
$2,382.43 |
| Rate for Payer: Aetna Commercial |
$2,330.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,227.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,372.49
|
| Rate for Payer: Cash Price |
$747.00
|
| Rate for Payer: Cigna Commercial |
$2,382.43
|
| Rate for Payer: Health EOS Commercial |
$2,304.74
|
| Rate for Payer: HFN Commercial |
$2,382.43
|
| Rate for Payer: Multiplan Commercial |
$2,071.68
|
| Rate for Payer: Preferred Network Access Commercial |
$2,382.43
|
| Rate for Payer: Quartz Beloit One Network |
$1,268.90
|
| Rate for Payer: Quartz Commercial |
$1,553.76
|
| Rate for Payer: WEA Trust Commercial |
$1,424.28
|
| Rate for Payer: WPS Commercial |
$1,918.05
|
|
|
VE 3rd Order
|
Facility
|
IP
|
$2,889.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
3052561
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,472.23 |
| Max. Negotiated Rate |
$2,764.20 |
| Rate for Payer: Aetna Commercial |
$2,704.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,583.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,592.42
|
| Rate for Payer: Cash Price |
$866.70
|
| Rate for Payer: Cigna Commercial |
$2,764.20
|
| Rate for Payer: Health EOS Commercial |
$2,674.06
|
| Rate for Payer: HFN Commercial |
$2,764.20
|
| Rate for Payer: Multiplan Commercial |
$2,403.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,764.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,472.23
|
| Rate for Payer: Quartz Commercial |
$1,802.74
|
| Rate for Payer: WEA Trust Commercial |
$1,652.51
|
| Rate for Payer: WPS Commercial |
$2,225.40
|
|
|
VE 3rd Order
|
Facility
|
OP
|
$2,889.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
3052561
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$841.28 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$2,704.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,583.92
|
| Rate for Payer: Aetna Managed Medicare |
$841.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,952.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,502.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,442.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,592.42
|
| Rate for Payer: Cash Price |
$866.70
|
| Rate for Payer: Cash Price |
$866.70
|
| Rate for Payer: Cigna Commercial |
$2,764.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Health EOS Commercial |
$2,674.06
|
| Rate for Payer: HFN Commercial |
$2,764.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,253.42
|
| Rate for Payer: Multiplan Commercial |
$2,403.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,802.74
|
| Rate for Payer: Preferred Network Access Commercial |
$2,764.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,472.23
|
| Rate for Payer: Quartz Commercial |
$1,952.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,802.74
|
| Rate for Payer: The Alliance Commercial |
$1,099.57
|
| Rate for Payer: WEA Trust Commercial |
$1,652.51
|
| Rate for Payer: WPS Commercial |
$2,225.40
|
|
|
VE Add Vessel +
|
Facility
|
IP
|
$618.00
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
4125621
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$314.93 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Aetna Commercial |
$578.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$552.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$340.64
|
| Rate for Payer: Cash Price |
$185.40
|
| Rate for Payer: Cigna Commercial |
$591.30
|
| Rate for Payer: Health EOS Commercial |
$572.02
|
| Rate for Payer: HFN Commercial |
$591.30
|
| Rate for Payer: Multiplan Commercial |
$514.18
|
| Rate for Payer: Preferred Network Access Commercial |
$591.30
|
| Rate for Payer: Quartz Beloit One Network |
$314.93
|
| Rate for Payer: Quartz Commercial |
$385.63
|
| Rate for Payer: WEA Trust Commercial |
$353.50
|
| Rate for Payer: WPS Commercial |
$476.05
|
|
|
VE Add Vessel +
|
Facility
|
OP
|
$618.00
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
4125621
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$171.77 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$578.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$552.74
|
| Rate for Payer: Aetna Managed Medicare |
$179.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$417.77
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$321.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$308.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$340.64
|
| Rate for Payer: Cash Price |
$185.40
|
| Rate for Payer: Cash Price |
$185.40
|
| Rate for Payer: Cigna Commercial |
$591.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Health EOS Commercial |
$572.02
|
| Rate for Payer: HFN Commercial |
$591.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$482.04
|
| Rate for Payer: Multiplan Commercial |
$514.18
|
| Rate for Payer: NAPHCARE Commercial |
$385.63
|
| Rate for Payer: Preferred Network Access Commercial |
$591.30
|
| Rate for Payer: Quartz Beloit One Network |
$314.93
|
| Rate for Payer: Quartz Commercial |
$417.77
|
| Rate for Payer: Quartz Medicare Advantage |
$385.63
|
| Rate for Payer: The Alliance Commercial |
$171.77
|
| Rate for Payer: WEA Trust Commercial |
$353.50
|
| Rate for Payer: WPS Commercial |
$476.05
|
|
|
Vectibix 5 mg Charge
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
HCPCS J9303
|
| Hospital Charge Code |
2958964
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$103.33 |
| Max. Negotiated Rate |
$722.47 |
| Rate for Payer: Aetna Commercial |
$193.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$185.14
|
| Rate for Payer: Aetna Managed Medicare |
$180.62
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$139.93
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$107.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$103.33
|
| Rate for Payer: Anthem Medicare Advantage |
$180.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$114.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$180.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$180.62
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Cigna Commercial |
$198.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$180.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$208.09
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$180.62
|
| Rate for Payer: Health EOS Commercial |
$191.60
|
| Rate for Payer: HFN Commercial |
$198.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$671.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$180.62
|
| Rate for Payer: Independent Care Health Plan Medicare |
$180.62
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$180.62
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$180.62
|
| Rate for Payer: Multiplan Commercial |
$172.22
|
| Rate for Payer: NAPHCARE Commercial |
$270.93
|
| Rate for Payer: Preferred Network Access Commercial |
$198.06
|
| Rate for Payer: Quartz Beloit One Network |
$105.49
|
| Rate for Payer: Quartz Commercial |
$139.93
|
| Rate for Payer: Quartz Medicare Advantage |
$180.62
|
| Rate for Payer: The Alliance Commercial |
$722.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$180.62
|
| Rate for Payer: WEA Trust Commercial |
$118.40
|
| Rate for Payer: Wellcare Medicare |
$180.62
|
| Rate for Payer: WPS Commercial |
$393.22
|
|
|
Vectibix 5 mg Charge
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS J9303
|
| Hospital Charge Code |
2958964
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$94.72 |
| Max. Negotiated Rate |
$496.70 |
| Rate for Payer: Aetna Commercial |
$204.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$185.14
|
| Rate for Payer: Aetna Managed Medicare |
$180.62
|
| Rate for Payer: Anthem Medicare Advantage |
$180.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$180.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$180.62
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Cigna Commercial |
$204.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$180.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$157.29
|
| Rate for Payer: Health EOS Commercial |
$195.90
|
| Rate for Payer: HFN Commercial |
$204.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$188.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$188.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$180.62
|
| Rate for Payer: Multiplan Commercial |
$172.22
|
| Rate for Payer: NAPHCARE Commercial |
$270.93
|
| Rate for Payer: Preferred Network Access Commercial |
$204.52
|
| Rate for Payer: Quartz Beloit One Network |
$94.72
|
| Rate for Payer: Quartz Commercial |
$122.71
|
| Rate for Payer: Quartz Medicare Advantage |
$180.62
|
| Rate for Payer: The Alliance Commercial |
$496.70
|
| Rate for Payer: United Healthcare Medicaid |
$180.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$180.62
|
| Rate for Payer: WEA Trust Commercial |
$118.40
|
| Rate for Payer: WPS Commercial |
$393.22
|
|
|
Vectibix 5 mg Charge
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
HCPCS J9303
|
| Hospital Charge Code |
2958964
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$105.49 |
| Max. Negotiated Rate |
$198.06 |
| Rate for Payer: Aetna Commercial |
$193.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$185.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$114.10
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Cigna Commercial |
$198.06
|
| Rate for Payer: Health EOS Commercial |
$191.60
|
| Rate for Payer: HFN Commercial |
$198.06
|
| Rate for Payer: Multiplan Commercial |
$172.22
|
| Rate for Payer: Preferred Network Access Commercial |
$198.06
|
| Rate for Payer: Quartz Beloit One Network |
$105.49
|
| Rate for Payer: Quartz Commercial |
$129.17
|
| Rate for Payer: WEA Trust Commercial |
$118.40
|
| Rate for Payer: WPS Commercial |
$159.45
|
|
|
Vedolizumab Antibody Quantitation
|
Facility
|
IP
|
$1,152.00
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
5619661
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$587.06 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$718.85
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
Vedolizumab Antibody Quantitation
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
5619661
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$1,138.18 |
| Rate for Payer: Aetna Commercial |
$1,138.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Aetna Managed Medicare |
$40.11
|
| Rate for Payer: Anthem Medicare Advantage |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$40.11
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,138.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$599.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40.11
|
| Rate for Payer: Health EOS Commercial |
$1,090.25
|
| Rate for Payer: HFN Commercial |
$1,138.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$141.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$141.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$40.11
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: NAPHCARE Commercial |
$60.17
|
| Rate for Payer: Preferred Network Access Commercial |
$1,138.18
|
| Rate for Payer: Quartz Beloit One Network |
$527.16
|
| Rate for Payer: Quartz Commercial |
$682.91
|
| Rate for Payer: Quartz Medicare Advantage |
$40.11
|
| Rate for Payer: The Alliance Commercial |
$158.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.11
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$176.50
|
|
|
Vedolizumab Antibody Quantitation
|
Facility
|
OP
|
$1,152.00
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
5619661
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Aetna Managed Medicare |
$40.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$150.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$70.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$66.59
|
| Rate for Payer: Anthem Medicare Advantage |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$40.11
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$40.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$670.46
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$40.11
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$149.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$40.11
|
| Rate for Payer: Independent Care Health Plan Medicare |
$40.11
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$40.11
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$40.11
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: NAPHCARE Commercial |
$60.17
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$778.75
|
| Rate for Payer: Quartz Medicare Advantage |
$40.11
|
| Rate for Payer: The Alliance Commercial |
$160.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.11
|
| Rate for Payer: United Healthcare PPO |
$898.56
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: Wellcare Medicare |
$40.11
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
VEGA TOTAL KNEE IMPLANTS (FEMUR,TIBIA PLATEAU,PATELLA,GLIDING SURFACE- CONSTRUCT)
|
Facility
|
OP
|
$29,506.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
5659643
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,592.15 |
| Max. Negotiated Rate |
$28,231.34 |
| Rate for Payer: Aetna Commercial |
$27,617.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$26,390.17
|
| Rate for Payer: Aetna Managed Medicare |
$8,592.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,946.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15,343.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14,729.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$16,263.71
|
| Rate for Payer: Cash Price |
$8,851.80
|
| Rate for Payer: Cigna Commercial |
$28,231.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17,172.49
|
| Rate for Payer: Health EOS Commercial |
$27,310.75
|
| Rate for Payer: HFN Commercial |
$28,231.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23,014.68
|
| Rate for Payer: Multiplan Commercial |
$24,548.99
|
| Rate for Payer: NAPHCARE Commercial |
$18,411.74
|
| Rate for Payer: Preferred Network Access Commercial |
$28,231.34
|
| Rate for Payer: Quartz Beloit One Network |
$15,036.26
|
| Rate for Payer: Quartz Commercial |
$19,946.06
|
| Rate for Payer: Quartz Medicare Advantage |
$18,411.74
|
| Rate for Payer: The Alliance Commercial |
$15,343.12
|
| Rate for Payer: WEA Trust Commercial |
$16,877.43
|
| Rate for Payer: WPS Commercial |
$22,728.47
|
|
|
VEGA TOTAL KNEE IMPLANTS (FEMUR,TIBIA PLATEAU,PATELLA,GLIDING SURFACE- CONSTRUCT)
|
Facility
|
IP
|
$29,506.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
5659643
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15,036.26 |
| Max. Negotiated Rate |
$28,231.34 |
| Rate for Payer: Aetna Commercial |
$27,617.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$26,390.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$16,263.71
|
| Rate for Payer: Cash Price |
$8,851.80
|
| Rate for Payer: Cigna Commercial |
$28,231.34
|
| Rate for Payer: Health EOS Commercial |
$27,310.75
|
| Rate for Payer: HFN Commercial |
$28,231.34
|
| Rate for Payer: Multiplan Commercial |
$24,548.99
|
| Rate for Payer: Preferred Network Access Commercial |
$28,231.34
|
| Rate for Payer: Quartz Beloit One Network |
$15,036.26
|
| Rate for Payer: Quartz Commercial |
$18,411.74
|
| Rate for Payer: WEA Trust Commercial |
$16,877.43
|
| Rate for Payer: WPS Commercial |
$22,728.47
|
|
|
VEIN ACCESS CUTDOWN OVER 1 YR 36425
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
3014524
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.99 |
| Max. Negotiated Rate |
$223.29 |
| Rate for Payer: Aetna Commercial |
$223.29
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$202.13
|
| Rate for Payer: Aetna Managed Medicare |
$31.99
|
| Rate for Payer: Anthem Medicare Advantage |
$31.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$31.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$31.99
|
| Rate for Payer: Cash Price |
$67.80
|
| Rate for Payer: Cash Price |
$67.80
|
| Rate for Payer: Cash Price |
$67.80
|
| Rate for Payer: Cigna Commercial |
$223.29
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$42.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31.99
|
| Rate for Payer: Health EOS Commercial |
$213.89
|
| Rate for Payer: HFN Commercial |
$223.29
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$139.77
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$139.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$31.99
|
| Rate for Payer: Multiplan Commercial |
$188.03
|
| Rate for Payer: NAPHCARE Commercial |
$47.99
|
| Rate for Payer: Preferred Network Access Commercial |
$223.29
|
| Rate for Payer: Quartz Beloit One Network |
$103.42
|
| Rate for Payer: Quartz Commercial |
$133.97
|
| Rate for Payer: Quartz Medicare Advantage |
$31.99
|
| Rate for Payer: The Alliance Commercial |
$135.96
|
| Rate for Payer: United Healthcare Medicaid |
$42.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31.99
|
| Rate for Payer: WEA Trust Commercial |
$129.27
|
| Rate for Payer: WPS Commercial |
$143.96
|
|
|
VEIN LIGATION AND STRIPPING
|
Facility
|
IP
|
$78,448.24
|
|
|
Service Code
|
MSDRG 263
|
| Min. Negotiated Rate |
$23,920.96 |
| Max. Negotiated Rate |
$78,448.24 |
| Rate for Payer: Aetna Managed Medicare |
$23,920.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$66,710.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$51,132.69
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$48,579.40
|
| Rate for Payer: Anthem Medicare Advantage |
$23,920.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23,920.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23,920.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23,920.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$53,927.58
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23,920.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$57,295.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23,920.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23,920.96
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23,920.96
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23,920.96
|
| Rate for Payer: NAPHCARE Commercial |
$35,881.44
|
| Rate for Payer: Quartz Medicare Advantage |
$23,920.96
|
| Rate for Payer: The Alliance Commercial |
$78,448.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,920.96
|
| Rate for Payer: United Healthcare PPO |
$44,604.93
|
| Rate for Payer: Wellcare Medicare |
$23,920.96
|
|
|
VEIN STRIPPER DORMO-STRIP SYMMETRY DISP STERILE VE-022
|
Facility
|
IP
|
$157.00
|
|
| Hospital Charge Code |
5178752
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.01 |
| Max. Negotiated Rate |
$150.22 |
| Rate for Payer: Aetna Commercial |
$146.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$140.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$86.54
|
| Rate for Payer: Cash Price |
$47.10
|
| Rate for Payer: Cigna Commercial |
$150.22
|
| Rate for Payer: Health EOS Commercial |
$145.32
|
| Rate for Payer: HFN Commercial |
$150.22
|
| Rate for Payer: Multiplan Commercial |
$130.62
|
| Rate for Payer: Preferred Network Access Commercial |
$150.22
|
| Rate for Payer: Quartz Beloit One Network |
$80.01
|
| Rate for Payer: Quartz Commercial |
$97.97
|
| Rate for Payer: WEA Trust Commercial |
$89.80
|
| Rate for Payer: WPS Commercial |
$120.94
|
|
|
VEIN STRIPPER DORMO-STRIP SYMMETRY DISP STERILE VE-022
|
Facility
|
OP
|
$157.00
|
|
| Hospital Charge Code |
5178752
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.72 |
| Max. Negotiated Rate |
$150.22 |
| Rate for Payer: Aetna Commercial |
$146.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$140.42
|
| Rate for Payer: Aetna Managed Medicare |
$45.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$106.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$81.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$78.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$86.54
|
| Rate for Payer: Cash Price |
$47.10
|
| Rate for Payer: Cigna Commercial |
$150.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$91.37
|
| Rate for Payer: Health EOS Commercial |
$145.32
|
| Rate for Payer: HFN Commercial |
$150.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$122.46
|
| Rate for Payer: Multiplan Commercial |
$130.62
|
| Rate for Payer: NAPHCARE Commercial |
$97.97
|
| Rate for Payer: Preferred Network Access Commercial |
$150.22
|
| Rate for Payer: Quartz Beloit One Network |
$80.01
|
| Rate for Payer: Quartz Commercial |
$106.13
|
| Rate for Payer: Quartz Medicare Advantage |
$97.97
|
| Rate for Payer: The Alliance Commercial |
$81.64
|
| Rate for Payer: WEA Trust Commercial |
$89.80
|
| Rate for Payer: WPS Commercial |
$120.94
|
|
|
VEIN X-RAY, ARM/LEG 7582026
|
Professional
|
Both
|
$1,144.00
|
|
|
Service Code
|
CPT 75820 26
|
| Hospital Charge Code |
3015293
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$47.60 |
| 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 |
$47.60
|
| Rate for Payer: Anthem Medicare Advantage |
$47.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$47.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$47.60
|
| 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 |
$47.60
|
| 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 |
$178.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$178.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$47.60
|
| Rate for Payer: Multiplan Commercial |
$951.81
|
| Rate for Payer: NAPHCARE Commercial |
$71.40
|
| 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 |
$47.60
|
| Rate for Payer: The Alliance Commercial |
$180.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$47.60
|
| Rate for Payer: WEA Trust Commercial |
$654.37
|
| Rate for Payer: WPS Commercial |
$238.00
|
|
|
Velban 1 mg Charge
|
Facility
|
IP
|
$10.00
|
|
|
Service Code
|
HCPCS J9360
|
| Hospital Charge Code |
2958983
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$9.57 |
| Rate for Payer: Aetna Commercial |
$9.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5.51
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$9.57
|
| Rate for Payer: Health EOS Commercial |
$9.26
|
| Rate for Payer: HFN Commercial |
$9.57
|
| Rate for Payer: Multiplan Commercial |
$8.32
|
| Rate for Payer: Preferred Network Access Commercial |
$9.57
|
| Rate for Payer: Quartz Beloit One Network |
$5.10
|
| Rate for Payer: Quartz Commercial |
$6.24
|
| Rate for Payer: WEA Trust Commercial |
$5.72
|
| Rate for Payer: WPS Commercial |
$7.70
|
|
|
Velban 1 mg Charge
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J9360
|
| Hospital Charge Code |
2958983
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$14.81 |
| Rate for Payer: Aetna Commercial |
$9.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8.94
|
| Rate for Payer: Aetna Managed Medicare |
$5.39
|
| Rate for Payer: Anthem Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.39
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$9.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$9.46
|
| Rate for Payer: HFN Commercial |
$9.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$8.32
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$9.88
|
| Rate for Payer: Quartz Beloit One Network |
$4.58
|
| Rate for Payer: Quartz Commercial |
$5.93
|
| Rate for Payer: Quartz Medicare Advantage |
$5.39
|
| Rate for Payer: The Alliance Commercial |
$14.81
|
| Rate for Payer: United Healthcare Medicaid |
$5.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: WEA Trust Commercial |
$5.72
|
| Rate for Payer: WPS Commercial |
$13.06
|
|
