|
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
|
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
|
|
|
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
|
|
|
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
|
OP
|
$10.00
|
|
|
Service Code
|
HCPCS J9360
|
| Hospital Charge Code |
2958983
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$23.34 |
| Rate for Payer: Aetna Commercial |
$9.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8.94
|
| Rate for Payer: Aetna Managed Medicare |
$2.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5.51
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$9.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.91
|
| Rate for Payer: Health EOS Commercial |
$9.26
|
| Rate for Payer: HFN Commercial |
$9.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7.80
|
| Rate for Payer: Multiplan Commercial |
$8.32
|
| Rate for Payer: NAPHCARE Commercial |
$6.24
|
| Rate for Payer: Preferred Network Access Commercial |
$9.57
|
| Rate for Payer: Quartz Beloit One Network |
$5.10
|
| Rate for Payer: Quartz Commercial |
$6.76
|
| Rate for Payer: Quartz Medicare Advantage |
$6.24
|
| Rate for Payer: The Alliance Commercial |
$23.34
|
| Rate for Payer: WEA Trust Commercial |
$5.72
|
| Rate for Payer: WPS Commercial |
$13.06
|
|
|
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 |
$16.04 |
| Rate for Payer: Aetna Commercial |
$9.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8.94
|
| Rate for Payer: Aetna Managed Medicare |
$5.83
|
| Rate for Payer: Anthem Medicare Advantage |
$5.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.83
|
| 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 |
$5.83
|
| Rate for Payer: Multiplan Commercial |
$8.32
|
| Rate for Payer: NAPHCARE Commercial |
$8.75
|
| 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 |
$5.83
|
| Rate for Payer: The Alliance Commercial |
$16.04
|
| Rate for Payer: United Healthcare Medicaid |
$5.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.83
|
| Rate for Payer: WEA Trust Commercial |
$5.72
|
| Rate for Payer: WPS Commercial |
$13.06
|
|
|
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
|
|
|
Velcade 0.1 mg Charge
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
HCPCS J9041
|
| Hospital Charge Code |
2958967
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$63.19 |
| Max. Negotiated Rate |
$118.64 |
| Rate for Payer: Aetna Commercial |
$116.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$68.35
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Cigna Commercial |
$118.64
|
| Rate for Payer: Health EOS Commercial |
$114.77
|
| Rate for Payer: HFN Commercial |
$118.64
|
| Rate for Payer: Multiplan Commercial |
$103.17
|
| Rate for Payer: Preferred Network Access Commercial |
$118.64
|
| Rate for Payer: Quartz Beloit One Network |
$63.19
|
| Rate for Payer: Quartz Commercial |
$77.38
|
| Rate for Payer: WEA Trust Commercial |
$70.93
|
| Rate for Payer: WPS Commercial |
$95.52
|
|
|
Velcade 0.1 mg Charge
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS J9041
|
| Hospital Charge Code |
2958967
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$122.51 |
| Rate for Payer: Aetna Commercial |
$122.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.91
|
| Rate for Payer: Aetna Managed Medicare |
$2.12
|
| Rate for Payer: Anthem Medicare Advantage |
$2.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2.12
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Cigna Commercial |
$122.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2.79
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2.15
|
| Rate for Payer: Health EOS Commercial |
$117.35
|
| Rate for Payer: HFN Commercial |
$122.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$68.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$68.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2.12
|
| Rate for Payer: Multiplan Commercial |
$103.17
|
| Rate for Payer: NAPHCARE Commercial |
$3.18
|
| Rate for Payer: Preferred Network Access Commercial |
$122.51
|
| Rate for Payer: Quartz Beloit One Network |
$56.74
|
| Rate for Payer: Quartz Commercial |
$73.51
|
| Rate for Payer: Quartz Medicare Advantage |
$2.12
|
| Rate for Payer: The Alliance Commercial |
$5.83
|
| Rate for Payer: United Healthcare Medicaid |
$2.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2.12
|
| Rate for Payer: WEA Trust Commercial |
$70.93
|
| Rate for Payer: WPS Commercial |
$5.38
|
|
|
Velcade 0.1 mg Charge
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
HCPCS J9041
|
| Hospital Charge Code |
2958967
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.85 |
| Max. Negotiated Rate |
$118.64 |
| Rate for Payer: Aetna Commercial |
$116.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.91
|
| Rate for Payer: Aetna Managed Medicare |
$36.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$83.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$64.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$61.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$68.35
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Cigna Commercial |
$118.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2.85
|
| Rate for Payer: Health EOS Commercial |
$114.77
|
| Rate for Payer: HFN Commercial |
$118.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$96.72
|
| Rate for Payer: Multiplan Commercial |
$103.17
|
| Rate for Payer: NAPHCARE Commercial |
$77.38
|
| Rate for Payer: Preferred Network Access Commercial |
$118.64
|
| Rate for Payer: Quartz Beloit One Network |
$63.19
|
| Rate for Payer: Quartz Commercial |
$83.82
|
| Rate for Payer: Quartz Medicare Advantage |
$77.38
|
| Rate for Payer: The Alliance Commercial |
$8.49
|
| Rate for Payer: WEA Trust Commercial |
$70.93
|
| Rate for Payer: WPS Commercial |
$5.38
|
|
|
Vena Cava Filter Insertion
|
Facility
|
IP
|
$8,784.00
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
3529588
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,476.33 |
| Max. Negotiated Rate |
$8,404.53 |
| Rate for Payer: Aetna Commercial |
$8,221.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,856.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,841.74
|
| Rate for Payer: Cash Price |
$2,635.20
|
| Rate for Payer: Cigna Commercial |
$8,404.53
|
| Rate for Payer: Health EOS Commercial |
$8,130.47
|
| Rate for Payer: HFN Commercial |
$8,404.53
|
| Rate for Payer: Multiplan Commercial |
$7,308.29
|
| Rate for Payer: Preferred Network Access Commercial |
$8,404.53
|
| Rate for Payer: Quartz Beloit One Network |
$4,476.33
|
| Rate for Payer: Quartz Commercial |
$5,481.22
|
| Rate for Payer: WEA Trust Commercial |
$5,024.45
|
| Rate for Payer: WPS Commercial |
$6,766.32
|
|
|
Vena Cava Filter Insertion
|
Facility
|
OP
|
$8,784.00
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
3529588
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,409.60 |
| Max. Negotiated Rate |
$23,424.04 |
| Rate for Payer: Aetna Commercial |
$8,221.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,856.41
|
| Rate for Payer: Aetna Managed Medicare |
$5,856.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$12,727.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11,350.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,781.68
|
| Rate for Payer: Anthem Medicare Advantage |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,841.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,856.01
|
| Rate for Payer: Cash Price |
$2,635.20
|
| Rate for Payer: Cash Price |
$2,635.20
|
| Rate for Payer: Cash Price |
$2,635.20
|
| Rate for Payer: Cigna Commercial |
$8,404.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,856.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,856.01
|
| Rate for Payer: Health EOS Commercial |
$8,130.47
|
| Rate for Payer: HFN Commercial |
$8,404.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,784.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,856.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,856.01
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,856.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,856.01
|
| Rate for Payer: Multiplan Commercial |
$7,308.29
|
| Rate for Payer: NAPHCARE Commercial |
$8,784.02
|
| Rate for Payer: Preferred Network Access Commercial |
$8,404.53
|
| Rate for Payer: Quartz Beloit One Network |
$4,476.33
|
| Rate for Payer: Quartz Commercial |
$5,937.98
|
| Rate for Payer: Quartz Medicare Advantage |
$5,856.01
|
| Rate for Payer: The Alliance Commercial |
$23,424.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,856.01
|
| Rate for Payer: United Healthcare PPO |
$4,409.60
|
| Rate for Payer: WEA Trust Commercial |
$5,024.45
|
| Rate for Payer: Wellcare Medicare |
$5,856.01
|
| Rate for Payer: WPS Commercial |
$6,766.32
|
|
|
Vena Cava Filter Removal
|
Facility
|
OP
|
$6,795.00
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
3052432
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$12,361.20 |
| Rate for Payer: Aetna Commercial |
$6,360.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,077.45
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,745.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$2,038.50
|
| Rate for Payer: Cash Price |
$2,038.50
|
| Rate for Payer: Cash Price |
$2,038.50
|
| Rate for Payer: Cigna Commercial |
$6,501.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$6,289.45
|
| Rate for Payer: HFN Commercial |
$6,501.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$5,653.44
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$6,501.46
|
| Rate for Payer: Quartz Beloit One Network |
$3,462.73
|
| Rate for Payer: Quartz Commercial |
$4,593.42
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$5,648.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$3,886.74
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$5,234.19
|
|
|
Vena Cava Filter Removal
|
Facility
|
IP
|
$6,795.00
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
3052432
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,462.73 |
| Max. Negotiated Rate |
$6,501.46 |
| Rate for Payer: Aetna Commercial |
$6,360.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,077.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,745.40
|
| Rate for Payer: Cash Price |
$2,038.50
|
| Rate for Payer: Cigna Commercial |
$6,501.46
|
| Rate for Payer: Health EOS Commercial |
$6,289.45
|
| Rate for Payer: HFN Commercial |
$6,501.46
|
| Rate for Payer: Multiplan Commercial |
$5,653.44
|
| Rate for Payer: Preferred Network Access Commercial |
$6,501.46
|
| Rate for Payer: Quartz Beloit One Network |
$3,462.73
|
| Rate for Payer: Quartz Commercial |
$4,240.08
|
| Rate for Payer: WEA Trust Commercial |
$3,886.74
|
| Rate for Payer: WPS Commercial |
$5,234.19
|
|
|
Vena Cava Filter Reposition
|
Facility
|
IP
|
$5,685.00
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
3052431
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,897.08 |
| Max. Negotiated Rate |
$5,439.41 |
| Rate for Payer: Aetna Commercial |
$5,321.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,084.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,133.57
|
| Rate for Payer: Cash Price |
$1,705.50
|
| Rate for Payer: Cigna Commercial |
$5,439.41
|
| Rate for Payer: Health EOS Commercial |
$5,262.04
|
| Rate for Payer: HFN Commercial |
$5,439.41
|
| Rate for Payer: Multiplan Commercial |
$4,729.92
|
| Rate for Payer: Preferred Network Access Commercial |
$5,439.41
|
| Rate for Payer: Quartz Beloit One Network |
$2,897.08
|
| Rate for Payer: Quartz Commercial |
$3,547.44
|
| Rate for Payer: WEA Trust Commercial |
$3,251.82
|
| Rate for Payer: WPS Commercial |
$4,379.16
|
|
|
Vena Cava Filter Reposition
|
Facility
|
OP
|
$5,685.00
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
3052431
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,897.08 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$5,321.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,084.66
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,133.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$1,705.50
|
| Rate for Payer: Cash Price |
$1,705.50
|
| Rate for Payer: Cash Price |
$1,705.50
|
| Rate for Payer: Cigna Commercial |
$5,439.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$5,262.04
|
| Rate for Payer: HFN Commercial |
$5,439.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$4,729.92
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$5,439.41
|
| Rate for Payer: Quartz Beloit One Network |
$2,897.08
|
| Rate for Payer: Quartz Commercial |
$3,843.06
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$3,251.82
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$4,379.16
|
|
|
VENACAVAL FILTER
|
Facility
|
OP
|
$16,700.00
|
|
| Hospital Charge Code |
2960499
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,863.04 |
| Max. Negotiated Rate |
$15,978.56 |
| Rate for Payer: Aetna Commercial |
$15,631.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$14,936.48
|
| Rate for Payer: Aetna Managed Medicare |
$4,863.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$11,289.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,684.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8,336.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,205.04
|
| Rate for Payer: Cash Price |
$5,010.00
|
| Rate for Payer: Cigna Commercial |
$15,978.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,719.40
|
| Rate for Payer: Health EOS Commercial |
$15,457.52
|
| Rate for Payer: HFN Commercial |
$15,978.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13,026.00
|
| Rate for Payer: Multiplan Commercial |
$13,894.40
|
| Rate for Payer: NAPHCARE Commercial |
$10,420.80
|
| Rate for Payer: Preferred Network Access Commercial |
$15,978.56
|
| Rate for Payer: Quartz Beloit One Network |
$8,510.32
|
| Rate for Payer: Quartz Commercial |
$11,289.20
|
| Rate for Payer: Quartz Medicare Advantage |
$10,420.80
|
| Rate for Payer: The Alliance Commercial |
$8,684.00
|
| Rate for Payer: WEA Trust Commercial |
$9,552.40
|
| Rate for Payer: WPS Commercial |
$12,864.01
|
|
|
VENACAVAL FILTER
|
Facility
|
IP
|
$16,700.00
|
|
| Hospital Charge Code |
2960499
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,510.32 |
| Max. Negotiated Rate |
$15,978.56 |
| Rate for Payer: Aetna Commercial |
$15,631.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$14,936.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,205.04
|
| Rate for Payer: Cash Price |
$5,010.00
|
| Rate for Payer: Cigna Commercial |
$15,978.56
|
| Rate for Payer: Health EOS Commercial |
$15,457.52
|
| Rate for Payer: HFN Commercial |
$15,978.56
|
| Rate for Payer: Multiplan Commercial |
$13,894.40
|
| Rate for Payer: Preferred Network Access Commercial |
$15,978.56
|
| Rate for Payer: Quartz Beloit One Network |
$8,510.32
|
| Rate for Payer: Quartz Commercial |
$10,420.80
|
| Rate for Payer: WEA Trust Commercial |
$9,552.40
|
| Rate for Payer: WPS Commercial |
$12,864.01
|
|
|
Venofer 1 mg Charge
|
Facility
|
OP
|
$3.00
|
|
|
Service Code
|
HCPCS J1756
|
| Hospital Charge Code |
2958932
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$2.87 |
| Rate for Payer: Aetna Commercial |
$2.81
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2.68
|
| Rate for Payer: Aetna Managed Medicare |
$0.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2.03
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1.65
|
| Rate for Payer: Cash Price |
$0.90
|
| Rate for Payer: Cash Price |
$0.90
|
| Rate for Payer: Cigna Commercial |
$2.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$0.32
|
| Rate for Payer: Health EOS Commercial |
$2.78
|
| Rate for Payer: HFN Commercial |
$2.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2.34
|
| Rate for Payer: Multiplan Commercial |
$2.50
|
| Rate for Payer: NAPHCARE Commercial |
$1.87
|
| Rate for Payer: Preferred Network Access Commercial |
$2.87
|
| Rate for Payer: Quartz Beloit One Network |
$1.53
|
| Rate for Payer: Quartz Commercial |
$2.03
|
| Rate for Payer: Quartz Medicare Advantage |
$1.87
|
| Rate for Payer: The Alliance Commercial |
$0.96
|
| Rate for Payer: WEA Trust Commercial |
$1.72
|
| Rate for Payer: WPS Commercial |
$0.60
|
|
