|
VISI-WIPE 581047
|
Facility
|
OP
|
$84.00
|
|
| Hospital Charge Code |
2964800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.46 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Aetna Commercial |
$78.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Aetna Managed Medicare |
$24.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.30
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$80.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.89
|
| Rate for Payer: Health EOS Commercial |
$77.75
|
| Rate for Payer: HFN Commercial |
$80.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.52
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: NAPHCARE Commercial |
$52.42
|
| Rate for Payer: Preferred Network Access Commercial |
$80.37
|
| Rate for Payer: Quartz Beloit One Network |
$42.81
|
| Rate for Payer: Quartz Commercial |
$56.78
|
| Rate for Payer: Quartz Medicare Advantage |
$52.42
|
| Rate for Payer: The Alliance Commercial |
$43.68
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: WPS Commercial |
$64.71
|
|
|
VISI-WIPE 581047
|
Facility
|
IP
|
$84.00
|
|
| Hospital Charge Code |
2964800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.81 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Aetna Commercial |
$78.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.30
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$80.37
|
| Rate for Payer: Health EOS Commercial |
$77.75
|
| Rate for Payer: HFN Commercial |
$80.37
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: Preferred Network Access Commercial |
$80.37
|
| Rate for Payer: Quartz Beloit One Network |
$42.81
|
| Rate for Payer: Quartz Commercial |
$52.42
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: WPS Commercial |
$64.71
|
|
|
Vistaril 25 mg Charge
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS J3410
|
| Hospital Charge Code |
2958853
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$37.18 |
| Rate for Payer: Aetna Commercial |
$6.92
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.26
|
| Rate for Payer: Aetna Managed Medicare |
$13.52
|
| Rate for Payer: Anthem Medicare Advantage |
$13.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.52
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna Commercial |
$6.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.42
|
| Rate for Payer: Health EOS Commercial |
$6.62
|
| Rate for Payer: HFN Commercial |
$6.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.52
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: NAPHCARE Commercial |
$20.28
|
| Rate for Payer: Preferred Network Access Commercial |
$6.92
|
| Rate for Payer: Quartz Beloit One Network |
$3.20
|
| Rate for Payer: Quartz Commercial |
$4.15
|
| Rate for Payer: Quartz Medicare Advantage |
$13.52
|
| Rate for Payer: The Alliance Commercial |
$37.18
|
| Rate for Payer: United Healthcare Medicaid |
$13.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.52
|
| Rate for Payer: WEA Trust Commercial |
$4.00
|
| Rate for Payer: WPS Commercial |
$36.06
|
|
|
Vistaril 25 mg Charge
|
Facility
|
OP
|
$7.00
|
|
|
Service Code
|
HCPCS J3410
|
| Hospital Charge Code |
2958853
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$54.08 |
| Rate for Payer: Aetna Commercial |
$6.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.26
|
| Rate for Payer: Aetna Managed Medicare |
$2.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4.73
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3.86
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna Commercial |
$6.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19.08
|
| Rate for Payer: Health EOS Commercial |
$6.48
|
| Rate for Payer: HFN Commercial |
$6.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5.46
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: NAPHCARE Commercial |
$4.37
|
| Rate for Payer: Preferred Network Access Commercial |
$6.70
|
| Rate for Payer: Quartz Beloit One Network |
$3.57
|
| Rate for Payer: Quartz Commercial |
$4.73
|
| Rate for Payer: Quartz Medicare Advantage |
$4.37
|
| Rate for Payer: The Alliance Commercial |
$54.08
|
| Rate for Payer: WEA Trust Commercial |
$4.00
|
| Rate for Payer: WPS Commercial |
$36.06
|
|
|
Vistaril 25 mg Charge
|
Facility
|
IP
|
$7.00
|
|
|
Service Code
|
HCPCS J3410
|
| Hospital Charge Code |
2958853
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.57 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Aetna Commercial |
$6.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3.86
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna Commercial |
$6.70
|
| Rate for Payer: Health EOS Commercial |
$6.48
|
| Rate for Payer: HFN Commercial |
$6.70
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: Preferred Network Access Commercial |
$6.70
|
| Rate for Payer: Quartz Beloit One Network |
$3.57
|
| Rate for Payer: Quartz Commercial |
$4.37
|
| Rate for Payer: WEA Trust Commercial |
$4.00
|
| Rate for Payer: WPS Commercial |
$5.39
|
|
|
VISUAL FIELD EXAMINATION(S) 92082
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
CPT 92082
|
| Hospital Charge Code |
3015325
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$30.66 |
| Max. Negotiated Rate |
$189.49 |
| Rate for Payer: Aetna Commercial |
$66.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.92
|
| Rate for Payer: Aetna Managed Medicare |
$47.37
|
| Rate for Payer: Anthem Medicare Advantage |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$47.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$47.37
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$66.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$57.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$47.37
|
| Rate for Payer: Health EOS Commercial |
$63.41
|
| Rate for Payer: HFN Commercial |
$66.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$167.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$167.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$47.37
|
| Rate for Payer: Multiplan Commercial |
$55.74
|
| Rate for Payer: NAPHCARE Commercial |
$71.06
|
| Rate for Payer: Preferred Network Access Commercial |
$66.20
|
| Rate for Payer: Quartz Beloit One Network |
$30.66
|
| Rate for Payer: Quartz Commercial |
$39.72
|
| Rate for Payer: Quartz Medicare Advantage |
$47.37
|
| Rate for Payer: The Alliance Commercial |
$118.43
|
| Rate for Payer: United Healthcare Medicaid |
$57.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$47.37
|
| Rate for Payer: WEA Trust Commercial |
$38.32
|
| Rate for Payer: WPS Commercial |
$189.49
|
|
|
Visual Field Examination(s) 9208226
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
CPT 92082 26
|
| Hospital Charge Code |
4616612
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$82.58 |
| Rate for Payer: Aetna Commercial |
$66.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.92
|
| Rate for Payer: Aetna Managed Medicare |
$20.64
|
| Rate for Payer: Anthem Medicare Advantage |
$20.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.64
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$66.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$22.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20.64
|
| Rate for Payer: Health EOS Commercial |
$63.41
|
| Rate for Payer: HFN Commercial |
$66.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$75.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$75.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$55.74
|
| Rate for Payer: NAPHCARE Commercial |
$30.97
|
| Rate for Payer: Preferred Network Access Commercial |
$66.20
|
| Rate for Payer: Quartz Beloit One Network |
$30.66
|
| Rate for Payer: Quartz Commercial |
$39.72
|
| Rate for Payer: Quartz Medicare Advantage |
$20.64
|
| Rate for Payer: The Alliance Commercial |
$51.61
|
| Rate for Payer: United Healthcare Medicaid |
$22.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.64
|
| Rate for Payer: WEA Trust Commercial |
$38.32
|
| Rate for Payer: WPS Commercial |
$82.58
|
|
|
Visual Field Examinations (S) 92083
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
CPT 92083
|
| Hospital Charge Code |
3713512
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$426.82 |
| Rate for Payer: Aetna Commercial |
$426.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$386.38
|
| Rate for Payer: Aetna Managed Medicare |
$63.82
|
| Rate for Payer: Anthem Medicare Advantage |
$63.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$63.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$63.82
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cigna Commercial |
$426.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$31.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$63.82
|
| Rate for Payer: Health EOS Commercial |
$408.84
|
| Rate for Payer: HFN Commercial |
$426.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$224.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$224.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$63.82
|
| Rate for Payer: Multiplan Commercial |
$359.42
|
| Rate for Payer: NAPHCARE Commercial |
$95.74
|
| Rate for Payer: Preferred Network Access Commercial |
$426.82
|
| Rate for Payer: Quartz Beloit One Network |
$197.68
|
| Rate for Payer: Quartz Commercial |
$256.09
|
| Rate for Payer: Quartz Medicare Advantage |
$63.82
|
| Rate for Payer: The Alliance Commercial |
$159.56
|
| Rate for Payer: United Healthcare Medicaid |
$31.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$63.82
|
| Rate for Payer: WEA Trust Commercial |
$247.10
|
| Rate for Payer: WPS Commercial |
$255.30
|
|
|
Visual Field Exam (S) 9208326
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
CPT 92083 26
|
| Hospital Charge Code |
3147511
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.92 |
| Max. Negotiated Rate |
$426.82 |
| Rate for Payer: Aetna Commercial |
$426.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$386.38
|
| Rate for Payer: Aetna Managed Medicare |
$26.78
|
| Rate for Payer: Anthem Medicare Advantage |
$26.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$26.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$26.78
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cigna Commercial |
$426.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$26.78
|
| Rate for Payer: Health EOS Commercial |
$408.84
|
| Rate for Payer: HFN Commercial |
$426.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$96.99
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$96.99
|
| Rate for Payer: Independent Care Health Plan Medicare |
$26.78
|
| Rate for Payer: Multiplan Commercial |
$359.42
|
| Rate for Payer: NAPHCARE Commercial |
$40.17
|
| Rate for Payer: Preferred Network Access Commercial |
$426.82
|
| Rate for Payer: Quartz Beloit One Network |
$197.68
|
| Rate for Payer: Quartz Commercial |
$256.09
|
| Rate for Payer: Quartz Medicare Advantage |
$26.78
|
| Rate for Payer: The Alliance Commercial |
$66.95
|
| Rate for Payer: United Healthcare Medicaid |
$19.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26.78
|
| Rate for Payer: WEA Trust Commercial |
$247.10
|
| Rate for Payer: WPS Commercial |
$107.12
|
|
|
VISUAL FIELD XM UNI/BI W/INTERPRET LIMITED EXAM - 92081
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
CPT 92081
|
| Hospital Charge Code |
5785967
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.58 |
| Max. Negotiated Rate |
$151.16 |
| Rate for Payer: Aetna Commercial |
$151.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$136.84
|
| Rate for Payer: Aetna Managed Medicare |
$33.58
|
| Rate for Payer: Anthem Medicare Advantage |
$33.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$33.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$33.58
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cigna Commercial |
$151.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$44.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$33.58
|
| Rate for Payer: Health EOS Commercial |
$144.80
|
| Rate for Payer: HFN Commercial |
$151.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$118.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$118.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$33.58
|
| Rate for Payer: Multiplan Commercial |
$127.30
|
| Rate for Payer: NAPHCARE Commercial |
$50.37
|
| Rate for Payer: Preferred Network Access Commercial |
$151.16
|
| Rate for Payer: Quartz Beloit One Network |
$70.01
|
| Rate for Payer: Quartz Commercial |
$90.70
|
| Rate for Payer: Quartz Medicare Advantage |
$33.58
|
| Rate for Payer: The Alliance Commercial |
$83.95
|
| Rate for Payer: United Healthcare Medicaid |
$44.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33.58
|
| Rate for Payer: WEA Trust Commercial |
$87.52
|
| Rate for Payer: WPS Commercial |
$134.33
|
|
|
VISUALIZATION OF WINDPIPE 31615
|
Professional
|
Both
|
$1,397.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
3014397
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$98.47 |
| Max. Negotiated Rate |
$1,380.24 |
| Rate for Payer: Aetna Commercial |
$1,380.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,249.48
|
| Rate for Payer: Aetna Managed Medicare |
$98.47
|
| Rate for Payer: Anthem Medicare Advantage |
$98.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$98.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$98.47
|
| Rate for Payer: Cash Price |
$419.10
|
| Rate for Payer: Cash Price |
$419.10
|
| Rate for Payer: Cash Price |
$419.10
|
| Rate for Payer: Cigna Commercial |
$1,380.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$164.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$98.47
|
| Rate for Payer: Health EOS Commercial |
$1,322.12
|
| Rate for Payer: HFN Commercial |
$1,380.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$394.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$394.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$98.47
|
| Rate for Payer: Multiplan Commercial |
$1,162.30
|
| Rate for Payer: NAPHCARE Commercial |
$147.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,380.24
|
| Rate for Payer: Quartz Beloit One Network |
$639.27
|
| Rate for Payer: Quartz Commercial |
$828.14
|
| Rate for Payer: Quartz Medicare Advantage |
$98.47
|
| Rate for Payer: The Alliance Commercial |
$418.49
|
| Rate for Payer: United Healthcare Medicaid |
$164.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$98.47
|
| Rate for Payer: WEA Trust Commercial |
$799.08
|
| Rate for Payer: WPS Commercial |
$443.10
|
|
|
VISUALIZATION SYSTEM CLEARIFY 21-345
|
Facility
|
OP
|
$646.00
|
|
| Hospital Charge Code |
4493782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.12 |
| Max. Negotiated Rate |
$618.09 |
| Rate for Payer: Aetna Commercial |
$604.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$577.78
|
| Rate for Payer: Aetna Managed Medicare |
$188.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$436.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$335.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$322.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$356.08
|
| Rate for Payer: Cash Price |
$193.80
|
| Rate for Payer: Cigna Commercial |
$618.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$375.97
|
| Rate for Payer: Health EOS Commercial |
$597.94
|
| Rate for Payer: HFN Commercial |
$618.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$503.88
|
| Rate for Payer: Multiplan Commercial |
$537.47
|
| Rate for Payer: NAPHCARE Commercial |
$403.10
|
| Rate for Payer: Preferred Network Access Commercial |
$618.09
|
| Rate for Payer: Quartz Beloit One Network |
$329.20
|
| Rate for Payer: Quartz Commercial |
$436.70
|
| Rate for Payer: Quartz Medicare Advantage |
$403.10
|
| Rate for Payer: The Alliance Commercial |
$335.92
|
| Rate for Payer: WEA Trust Commercial |
$369.51
|
| Rate for Payer: WPS Commercial |
$497.61
|
|
|
VISUALIZATION SYSTEM CLEARIFY 21-345
|
Facility
|
IP
|
$646.00
|
|
| Hospital Charge Code |
4493782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$329.20 |
| Max. Negotiated Rate |
$618.09 |
| Rate for Payer: Aetna Commercial |
$604.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$577.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$356.08
|
| Rate for Payer: Cash Price |
$193.80
|
| Rate for Payer: Cigna Commercial |
$618.09
|
| Rate for Payer: Health EOS Commercial |
$597.94
|
| Rate for Payer: HFN Commercial |
$618.09
|
| Rate for Payer: Multiplan Commercial |
$537.47
|
| Rate for Payer: Preferred Network Access Commercial |
$618.09
|
| Rate for Payer: Quartz Beloit One Network |
$329.20
|
| Rate for Payer: Quartz Commercial |
$403.10
|
| Rate for Payer: WEA Trust Commercial |
$369.51
|
| Rate for Payer: WPS Commercial |
$497.61
|
|
|
Visual Reinforcement Audiometry
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
1188814
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$41.43 |
| Max. Negotiated Rate |
$908.96 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$227.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41.43
|
| Rate for Payer: Anthem Medicare Advantage |
$227.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$227.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$227.24
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$227.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$227.24
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$845.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$227.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$227.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$227.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$227.24
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$340.86
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$56.11
|
| Rate for Payer: Quartz Medicare Advantage |
$227.24
|
| Rate for Payer: The Alliance Commercial |
$908.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$227.24
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: Wellcare Medicare |
$227.24
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Visual Reinforcement Audiometry
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
1188814
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$51.79
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Visual Reinforcement Audiometry
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
1188814
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$30.39 |
| Max. Negotiated Rate |
$135.83 |
| Rate for Payer: Aetna Commercial |
$82.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$30.39
|
| Rate for Payer: Anthem Medicare Advantage |
$30.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$30.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30.39
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$82.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30.39
|
| Rate for Payer: Health EOS Commercial |
$78.55
|
| Rate for Payer: HFN Commercial |
$82.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$135.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$135.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30.39
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$45.58
|
| Rate for Payer: Preferred Network Access Commercial |
$82.00
|
| Rate for Payer: Quartz Beloit One Network |
$37.98
|
| Rate for Payer: Quartz Commercial |
$49.20
|
| Rate for Payer: Quartz Medicare Advantage |
$30.39
|
| Rate for Payer: The Alliance Commercial |
$75.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30.39
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$121.56
|
|
|
Visual Reinforcement Audiomety
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
3203506
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$51.79
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Visual Reinforcement Audiomety
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
3203506
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$30.39 |
| Max. Negotiated Rate |
$135.83 |
| Rate for Payer: Aetna Commercial |
$82.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$30.39
|
| Rate for Payer: Anthem Medicare Advantage |
$30.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$30.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30.39
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$82.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30.39
|
| Rate for Payer: Health EOS Commercial |
$78.55
|
| Rate for Payer: HFN Commercial |
$82.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$135.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$135.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30.39
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$45.58
|
| Rate for Payer: Preferred Network Access Commercial |
$82.00
|
| Rate for Payer: Quartz Beloit One Network |
$37.98
|
| Rate for Payer: Quartz Commercial |
$49.20
|
| Rate for Payer: Quartz Medicare Advantage |
$30.39
|
| Rate for Payer: The Alliance Commercial |
$75.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30.39
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$121.56
|
|
|
Visual Reinforcement Audiomety
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
3203506
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$41.43 |
| Max. Negotiated Rate |
$908.96 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$227.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41.43
|
| Rate for Payer: Anthem Medicare Advantage |
$227.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$227.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$227.24
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$227.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$227.24
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$845.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$227.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$227.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$227.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$227.24
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$340.86
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$56.11
|
| Rate for Payer: Quartz Medicare Advantage |
$227.24
|
| Rate for Payer: The Alliance Commercial |
$908.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$227.24
|
| Rate for Payer: United Healthcare PPO |
$64.74
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: Wellcare Medicare |
$227.24
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Vital 1.0
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
HCPCS B4153
|
| Hospital Charge Code |
3031455
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$22.42 |
| Max. Negotiated Rate |
$73.67 |
| Rate for Payer: Aetna Commercial |
$72.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$68.87
|
| Rate for Payer: Aetna Managed Medicare |
$22.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$52.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$40.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$38.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$42.44
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Cigna Commercial |
$73.67
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$44.81
|
| Rate for Payer: Health EOS Commercial |
$71.27
|
| Rate for Payer: HFN Commercial |
$73.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$60.06
|
| Rate for Payer: Multiplan Commercial |
$64.06
|
| Rate for Payer: NAPHCARE Commercial |
$48.05
|
| Rate for Payer: Preferred Network Access Commercial |
$73.67
|
| Rate for Payer: Quartz Beloit One Network |
$39.24
|
| Rate for Payer: Quartz Commercial |
$52.05
|
| Rate for Payer: Quartz Medicare Advantage |
$48.05
|
| Rate for Payer: The Alliance Commercial |
$40.04
|
| Rate for Payer: WEA Trust Commercial |
$44.04
|
| Rate for Payer: WPS Commercial |
$59.31
|
|
|
Vital 1.0
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
HCPCS B4153
|
| Hospital Charge Code |
3031455
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$73.67 |
| Rate for Payer: Aetna Commercial |
$72.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$68.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$42.44
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Cigna Commercial |
$73.67
|
| Rate for Payer: Health EOS Commercial |
$71.27
|
| Rate for Payer: HFN Commercial |
$73.67
|
| Rate for Payer: Multiplan Commercial |
$64.06
|
| Rate for Payer: Preferred Network Access Commercial |
$73.67
|
| Rate for Payer: Quartz Beloit One Network |
$39.24
|
| Rate for Payer: Quartz Commercial |
$48.05
|
| Rate for Payer: WEA Trust Commercial |
$44.04
|
| Rate for Payer: WPS Commercial |
$59.31
|
|
|
VITAL CAPACITY TEST 94150
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
3015454
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.07 |
| Max. Negotiated Rate |
$86.98 |
| Rate for Payer: Aetna Commercial |
$21.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$19.68
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$21.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.73
|
| Rate for Payer: Health EOS Commercial |
$20.82
|
| Rate for Payer: HFN Commercial |
$21.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$86.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$86.98
|
| Rate for Payer: Multiplan Commercial |
$18.30
|
| Rate for Payer: Preferred Network Access Commercial |
$21.74
|
| Rate for Payer: Quartz Beloit One Network |
$10.07
|
| Rate for Payer: Quartz Commercial |
$13.04
|
| Rate for Payer: The Alliance Commercial |
$11.44
|
| Rate for Payer: United Healthcare Medicaid |
$19.92
|
| Rate for Payer: WEA Trust Commercial |
$12.58
|
| Rate for Payer: WPS Commercial |
$16.95
|
|
|
Vital Signs Monitor Dymap
|
Facility
|
IP
|
$371.00
|
|
| Hospital Charge Code |
3101752
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$189.06 |
| Max. Negotiated Rate |
$354.97 |
| Rate for Payer: Aetna Commercial |
$347.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$331.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$204.50
|
| Rate for Payer: Cash Price |
$111.30
|
| Rate for Payer: Cigna Commercial |
$354.97
|
| Rate for Payer: Health EOS Commercial |
$343.40
|
| Rate for Payer: HFN Commercial |
$354.97
|
| Rate for Payer: Multiplan Commercial |
$308.67
|
| Rate for Payer: Preferred Network Access Commercial |
$354.97
|
| Rate for Payer: Quartz Beloit One Network |
$189.06
|
| Rate for Payer: Quartz Commercial |
$231.50
|
| Rate for Payer: WEA Trust Commercial |
$212.21
|
| Rate for Payer: WPS Commercial |
$285.78
|
|
|
Vital Signs Monitor Dymap
|
Facility
|
OP
|
$371.00
|
|
| Hospital Charge Code |
3101752
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$108.04 |
| Max. Negotiated Rate |
$354.97 |
| Rate for Payer: Aetna Commercial |
$347.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$331.82
|
| Rate for Payer: Aetna Managed Medicare |
$108.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$250.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$192.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$185.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$204.50
|
| Rate for Payer: Cash Price |
$111.30
|
| Rate for Payer: Cigna Commercial |
$354.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$215.92
|
| Rate for Payer: Health EOS Commercial |
$343.40
|
| Rate for Payer: HFN Commercial |
$354.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$289.38
|
| Rate for Payer: Multiplan Commercial |
$308.67
|
| Rate for Payer: NAPHCARE Commercial |
$231.50
|
| Rate for Payer: Preferred Network Access Commercial |
$354.97
|
| Rate for Payer: Quartz Beloit One Network |
$189.06
|
| Rate for Payer: Quartz Commercial |
$250.80
|
| Rate for Payer: Quartz Medicare Advantage |
$231.50
|
| Rate for Payer: The Alliance Commercial |
$192.92
|
| Rate for Payer: WEA Trust Commercial |
$212.21
|
| Rate for Payer: WPS Commercial |
$285.78
|
|
|
Vitamin A Level
|
Facility
|
OP
|
$219.00
|
|
|
Service Code
|
CPT 84590
|
| Hospital Charge Code |
978090
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$209.54 |
| Rate for Payer: Aetna Commercial |
$204.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$195.87
|
| Rate for Payer: Aetna Managed Medicare |
$12.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$45.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21.13
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20.04
|
| Rate for Payer: Anthem Medicare Advantage |
$12.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$120.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.07
|
| Rate for Payer: Cash Price |
$65.70
|
| Rate for Payer: Cash Price |
$65.70
|
| Rate for Payer: Cigna Commercial |
$209.54
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$127.46
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.07
|
| Rate for Payer: Health EOS Commercial |
$202.71
|
| Rate for Payer: HFN Commercial |
$209.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.92
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.07
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.07
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.07
|
| Rate for Payer: Multiplan Commercial |
$182.21
|
| Rate for Payer: NAPHCARE Commercial |
$18.11
|
| Rate for Payer: Preferred Network Access Commercial |
$209.54
|
| Rate for Payer: Quartz Beloit One Network |
$111.60
|
| Rate for Payer: Quartz Commercial |
$148.04
|
| Rate for Payer: Quartz Medicare Advantage |
$12.07
|
| Rate for Payer: The Alliance Commercial |
$48.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.07
|
| Rate for Payer: United Healthcare PPO |
$170.82
|
| Rate for Payer: WEA Trust Commercial |
$125.27
|
| Rate for Payer: Wellcare Medicare |
$12.07
|
| Rate for Payer: WPS Commercial |
$168.70
|
|
