|
Voiding Pressure Any Technique
|
Facility
|
IP
|
$1,130.00
|
|
|
Service Code
|
CPT 51728
|
| Hospital Charge Code |
3005558
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$575.85 |
| Max. Negotiated Rate |
$1,081.18 |
| Rate for Payer: Aetna Commercial |
$1,057.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,010.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$622.86
|
| Rate for Payer: Cash Price |
$339.00
|
| Rate for Payer: Cigna Commercial |
$1,081.18
|
| Rate for Payer: Health EOS Commercial |
$1,045.93
|
| Rate for Payer: HFN Commercial |
$1,081.18
|
| Rate for Payer: Multiplan Commercial |
$940.16
|
| Rate for Payer: Preferred Network Access Commercial |
$1,081.18
|
| Rate for Payer: Quartz Beloit One Network |
$575.85
|
| Rate for Payer: Quartz Commercial |
$705.12
|
| Rate for Payer: WEA Trust Commercial |
$646.36
|
| Rate for Payer: WPS Commercial |
$870.44
|
|
|
Voiding Pressure Any Technique
|
Facility
|
OP
|
$1,130.00
|
|
|
Service Code
|
CPT 51728
|
| Hospital Charge Code |
3005558
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$564.10 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$1,057.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,010.67
|
| Rate for Payer: Aetna Managed Medicare |
$733.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$763.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$587.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$564.10
|
| Rate for Payer: Anthem Medicare Advantage |
$733.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$622.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$733.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$733.82
|
| Rate for Payer: Cash Price |
$339.00
|
| Rate for Payer: Cash Price |
$339.00
|
| Rate for Payer: Cigna Commercial |
$1,081.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$733.82
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$733.82
|
| Rate for Payer: Health EOS Commercial |
$1,045.93
|
| Rate for Payer: HFN Commercial |
$1,081.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,729.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$733.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$733.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$733.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$733.82
|
| Rate for Payer: Multiplan Commercial |
$940.16
|
| Rate for Payer: NAPHCARE Commercial |
$1,100.74
|
| Rate for Payer: Preferred Network Access Commercial |
$1,081.18
|
| Rate for Payer: Quartz Beloit One Network |
$575.85
|
| Rate for Payer: Quartz Commercial |
$763.88
|
| Rate for Payer: Quartz Medicare Advantage |
$733.82
|
| Rate for Payer: The Alliance Commercial |
$2,935.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$733.82
|
| Rate for Payer: United Healthcare PPO |
$881.40
|
| Rate for Payer: WEA Trust Commercial |
$646.36
|
| Rate for Payer: Wellcare Medicare |
$733.82
|
| Rate for Payer: WPS Commercial |
$870.44
|
|
|
Volatile and Halocarbon Intoxicants, Blood
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
6173262
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.93 |
| Max. Negotiated Rate |
$94.85 |
| Rate for Payer: Aetna Commercial |
$94.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$85.86
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cigna Commercial |
$94.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$49.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$59.90
|
| Rate for Payer: Health EOS Commercial |
$90.85
|
| Rate for Payer: HFN Commercial |
$94.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$83.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$83.26
|
| Rate for Payer: Multiplan Commercial |
$79.87
|
| Rate for Payer: Preferred Network Access Commercial |
$94.85
|
| Rate for Payer: Quartz Beloit One Network |
$43.93
|
| Rate for Payer: Quartz Commercial |
$56.91
|
| Rate for Payer: The Alliance Commercial |
$49.92
|
| Rate for Payer: WEA Trust Commercial |
$54.91
|
| Rate for Payer: WPS Commercial |
$73.95
|
|
|
Volatile and Halocarbon Intoxicants, Blood
|
Facility
|
IP
|
$96.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
6173262
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.92 |
| Max. Negotiated Rate |
$91.85 |
| Rate for Payer: Aetna Commercial |
$89.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$85.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$52.92
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cigna Commercial |
$91.85
|
| Rate for Payer: Health EOS Commercial |
$88.86
|
| Rate for Payer: HFN Commercial |
$91.85
|
| Rate for Payer: Multiplan Commercial |
$79.87
|
| Rate for Payer: Preferred Network Access Commercial |
$91.85
|
| Rate for Payer: Quartz Beloit One Network |
$48.92
|
| Rate for Payer: Quartz Commercial |
$59.90
|
| Rate for Payer: WEA Trust Commercial |
$54.91
|
| Rate for Payer: WPS Commercial |
$73.95
|
|
|
Volatile and Halocarbon Intoxicants, Blood
|
Facility
|
OP
|
$96.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
6173262
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.96 |
| Max. Negotiated Rate |
$91.85 |
| Rate for Payer: Aetna Commercial |
$89.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$85.86
|
| Rate for Payer: Aetna Managed Medicare |
$27.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$64.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$49.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$47.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$52.92
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cigna Commercial |
$91.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$55.87
|
| Rate for Payer: Health EOS Commercial |
$88.86
|
| Rate for Payer: HFN Commercial |
$91.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$74.88
|
| Rate for Payer: Multiplan Commercial |
$79.87
|
| Rate for Payer: NAPHCARE Commercial |
$59.90
|
| Rate for Payer: Preferred Network Access Commercial |
$91.85
|
| Rate for Payer: Quartz Beloit One Network |
$48.92
|
| Rate for Payer: Quartz Commercial |
$64.90
|
| Rate for Payer: Quartz Medicare Advantage |
$59.90
|
| Rate for Payer: The Alliance Commercial |
$49.92
|
| Rate for Payer: United Healthcare PPO |
$74.88
|
| Rate for Payer: WEA Trust Commercial |
$54.91
|
| Rate for Payer: WPS Commercial |
$73.95
|
|
|
Volatile Screen
|
Professional
|
Both
|
$48.00
|
|
| Hospital Charge Code |
2942883
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.96 |
| Max. Negotiated Rate |
$47.42 |
| Rate for Payer: Aetna Commercial |
$47.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$42.93
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$47.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$24.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$29.95
|
| Rate for Payer: Health EOS Commercial |
$45.43
|
| Rate for Payer: HFN Commercial |
$47.42
|
| Rate for Payer: Multiplan Commercial |
$39.94
|
| Rate for Payer: Preferred Network Access Commercial |
$47.42
|
| Rate for Payer: Quartz Beloit One Network |
$21.96
|
| Rate for Payer: Quartz Commercial |
$28.45
|
| Rate for Payer: The Alliance Commercial |
$24.96
|
| Rate for Payer: WEA Trust Commercial |
$27.46
|
| Rate for Payer: WPS Commercial |
$36.97
|
|
|
Volatile Screen
|
Facility
|
IP
|
$48.00
|
|
| Hospital Charge Code |
2942883
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.46 |
| Max. Negotiated Rate |
$45.93 |
| Rate for Payer: Aetna Commercial |
$44.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$42.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$26.46
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$45.93
|
| Rate for Payer: Health EOS Commercial |
$44.43
|
| Rate for Payer: HFN Commercial |
$45.93
|
| Rate for Payer: Multiplan Commercial |
$39.94
|
| Rate for Payer: Preferred Network Access Commercial |
$45.93
|
| Rate for Payer: Quartz Beloit One Network |
$24.46
|
| Rate for Payer: Quartz Commercial |
$29.95
|
| Rate for Payer: WEA Trust Commercial |
$27.46
|
| Rate for Payer: WPS Commercial |
$36.97
|
|
|
Volatile Screen
|
Facility
|
OP
|
$48.00
|
|
| Hospital Charge Code |
2942883
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.98 |
| Max. Negotiated Rate |
$45.93 |
| Rate for Payer: Aetna Commercial |
$44.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$42.93
|
| Rate for Payer: Aetna Managed Medicare |
$13.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$32.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$26.46
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$45.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27.94
|
| Rate for Payer: Health EOS Commercial |
$44.43
|
| Rate for Payer: HFN Commercial |
$45.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37.44
|
| Rate for Payer: Multiplan Commercial |
$39.94
|
| Rate for Payer: NAPHCARE Commercial |
$29.95
|
| Rate for Payer: Preferred Network Access Commercial |
$45.93
|
| Rate for Payer: Quartz Beloit One Network |
$24.46
|
| Rate for Payer: Quartz Commercial |
$32.45
|
| Rate for Payer: Quartz Medicare Advantage |
$29.95
|
| Rate for Payer: The Alliance Commercial |
$24.96
|
| Rate for Payer: United Healthcare PPO |
$37.44
|
| Rate for Payer: WEA Trust Commercial |
$27.46
|
| Rate for Payer: WPS Commercial |
$36.97
|
|
|
Volcano Atherectomy Device
|
Facility
|
OP
|
$10,752.00
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
5273129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,130.98 |
| Max. Negotiated Rate |
$10,287.51 |
| Rate for Payer: Aetna Commercial |
$10,063.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,616.59
|
| Rate for Payer: Aetna Managed Medicare |
$3,130.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,268.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,591.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,367.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,926.50
|
| Rate for Payer: Cash Price |
$3,225.60
|
| Rate for Payer: Cigna Commercial |
$10,287.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,257.66
|
| Rate for Payer: Health EOS Commercial |
$9,952.05
|
| Rate for Payer: HFN Commercial |
$10,287.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,386.56
|
| Rate for Payer: Multiplan Commercial |
$8,945.66
|
| Rate for Payer: NAPHCARE Commercial |
$6,709.25
|
| Rate for Payer: Preferred Network Access Commercial |
$10,287.51
|
| Rate for Payer: Quartz Beloit One Network |
$5,479.22
|
| Rate for Payer: Quartz Commercial |
$7,268.35
|
| Rate for Payer: Quartz Medicare Advantage |
$6,709.25
|
| Rate for Payer: The Alliance Commercial |
$5,591.04
|
| Rate for Payer: WEA Trust Commercial |
$6,150.14
|
| Rate for Payer: WPS Commercial |
$8,282.27
|
|
|
Volcano Atherectomy Device
|
Facility
|
IP
|
$10,752.00
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
5273129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,479.22 |
| Max. Negotiated Rate |
$10,287.51 |
| Rate for Payer: Aetna Commercial |
$10,063.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,616.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,926.50
|
| Rate for Payer: Cash Price |
$3,225.60
|
| Rate for Payer: Cigna Commercial |
$10,287.51
|
| Rate for Payer: Health EOS Commercial |
$9,952.05
|
| Rate for Payer: HFN Commercial |
$10,287.51
|
| Rate for Payer: Multiplan Commercial |
$8,945.66
|
| Rate for Payer: Preferred Network Access Commercial |
$10,287.51
|
| Rate for Payer: Quartz Beloit One Network |
$5,479.22
|
| Rate for Payer: Quartz Commercial |
$6,709.25
|
| Rate for Payer: WEA Trust Commercial |
$6,150.14
|
| Rate for Payer: WPS Commercial |
$8,282.27
|
|
|
von Hippel-Lindau Sequencing
|
Professional
|
Both
|
$1,008.00
|
|
|
Service Code
|
CPT 81404
|
| Hospital Charge Code |
4526743
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$285.82 |
| Max. Negotiated Rate |
$1,257.62 |
| Rate for Payer: Aetna Commercial |
$995.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$901.56
|
| Rate for Payer: Aetna Managed Medicare |
$285.82
|
| Rate for Payer: Anthem Medicare Advantage |
$285.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$285.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$285.82
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cigna Commercial |
$995.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$524.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$285.82
|
| Rate for Payer: Health EOS Commercial |
$953.97
|
| Rate for Payer: HFN Commercial |
$995.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,008.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,008.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$285.82
|
| Rate for Payer: Multiplan Commercial |
$838.66
|
| Rate for Payer: NAPHCARE Commercial |
$428.73
|
| Rate for Payer: Preferred Network Access Commercial |
$995.90
|
| Rate for Payer: Quartz Beloit One Network |
$461.26
|
| Rate for Payer: Quartz Commercial |
$597.54
|
| Rate for Payer: Quartz Medicare Advantage |
$285.82
|
| Rate for Payer: The Alliance Commercial |
$1,129.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$285.82
|
| Rate for Payer: WEA Trust Commercial |
$576.58
|
| Rate for Payer: WPS Commercial |
$1,257.62
|
|
|
von Hippel-Lindau Sequencing
|
Facility
|
IP
|
$1,008.00
|
|
|
Service Code
|
CPT 81404
|
| Hospital Charge Code |
4526743
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$513.68 |
| Max. Negotiated Rate |
$964.45 |
| Rate for Payer: Aetna Commercial |
$943.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$901.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$555.61
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cigna Commercial |
$964.45
|
| Rate for Payer: Health EOS Commercial |
$933.00
|
| Rate for Payer: HFN Commercial |
$964.45
|
| Rate for Payer: Multiplan Commercial |
$838.66
|
| Rate for Payer: Preferred Network Access Commercial |
$964.45
|
| Rate for Payer: Quartz Beloit One Network |
$513.68
|
| Rate for Payer: Quartz Commercial |
$628.99
|
| Rate for Payer: WEA Trust Commercial |
$576.58
|
| Rate for Payer: WPS Commercial |
$776.46
|
|
|
von Hippel-Lindau Sequencing
|
Facility
|
OP
|
$1,008.00
|
|
|
Service Code
|
CPT 81404
|
| Hospital Charge Code |
4526743
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$285.82 |
| Max. Negotiated Rate |
$1,143.29 |
| Rate for Payer: Aetna Commercial |
$943.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$901.56
|
| Rate for Payer: Aetna Managed Medicare |
$285.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,071.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$500.19
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$474.47
|
| Rate for Payer: Anthem Medicare Advantage |
$285.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$555.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$285.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$285.82
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cigna Commercial |
$964.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$285.82
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$586.66
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$285.82
|
| Rate for Payer: Health EOS Commercial |
$933.00
|
| Rate for Payer: HFN Commercial |
$964.45
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,063.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$285.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$285.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$285.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$285.82
|
| Rate for Payer: Multiplan Commercial |
$838.66
|
| Rate for Payer: NAPHCARE Commercial |
$428.73
|
| Rate for Payer: Preferred Network Access Commercial |
$964.45
|
| Rate for Payer: Quartz Beloit One Network |
$513.68
|
| Rate for Payer: Quartz Commercial |
$681.41
|
| Rate for Payer: Quartz Medicare Advantage |
$285.82
|
| Rate for Payer: The Alliance Commercial |
$1,143.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$285.82
|
| Rate for Payer: United Healthcare PPO |
$786.24
|
| Rate for Payer: WEA Trust Commercial |
$576.58
|
| Rate for Payer: Wellcare Medicare |
$285.82
|
| Rate for Payer: WPS Commercial |
$776.46
|
|
|
von Willebrand Comprehensive Panel
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
983439
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$145.43 |
| Rate for Payer: Aetna Commercial |
$142.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$135.95
|
| Rate for Payer: Aetna Managed Medicare |
$6.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.94
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.38
|
| Rate for Payer: Anthem Medicare Advantage |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$83.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.25
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cigna Commercial |
$145.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$88.46
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.25
|
| Rate for Payer: Health EOS Commercial |
$140.69
|
| Rate for Payer: HFN Commercial |
$145.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.25
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.25
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.25
|
| Rate for Payer: Multiplan Commercial |
$126.46
|
| Rate for Payer: NAPHCARE Commercial |
$9.38
|
| Rate for Payer: Preferred Network Access Commercial |
$145.43
|
| Rate for Payer: Quartz Beloit One Network |
$77.46
|
| Rate for Payer: Quartz Commercial |
$102.75
|
| Rate for Payer: Quartz Medicare Advantage |
$6.25
|
| Rate for Payer: The Alliance Commercial |
$25.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.25
|
| Rate for Payer: United Healthcare PPO |
$118.56
|
| Rate for Payer: WEA Trust Commercial |
$86.94
|
| Rate for Payer: Wellcare Medicare |
$6.25
|
| Rate for Payer: WPS Commercial |
$117.09
|
|
|
von Willebrand Comprehensive Panel
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
983439
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$150.18 |
| Rate for Payer: Aetna Commercial |
$150.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$135.95
|
| Rate for Payer: Aetna Managed Medicare |
$6.25
|
| Rate for Payer: Anthem Medicare Advantage |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.25
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cigna Commercial |
$150.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$79.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.25
|
| Rate for Payer: Health EOS Commercial |
$143.85
|
| Rate for Payer: HFN Commercial |
$150.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.25
|
| Rate for Payer: Multiplan Commercial |
$126.46
|
| Rate for Payer: NAPHCARE Commercial |
$9.38
|
| Rate for Payer: Preferred Network Access Commercial |
$150.18
|
| Rate for Payer: Quartz Beloit One Network |
$69.56
|
| Rate for Payer: Quartz Commercial |
$90.11
|
| Rate for Payer: Quartz Medicare Advantage |
$6.25
|
| Rate for Payer: The Alliance Commercial |
$24.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.25
|
| Rate for Payer: WEA Trust Commercial |
$86.94
|
| Rate for Payer: WPS Commercial |
$27.50
|
|
|
von Willebrand Comprehensive Panel
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
983439
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$77.46 |
| Max. Negotiated Rate |
$145.43 |
| Rate for Payer: Aetna Commercial |
$142.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$135.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$83.78
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cigna Commercial |
$145.43
|
| Rate for Payer: Health EOS Commercial |
$140.69
|
| Rate for Payer: HFN Commercial |
$145.43
|
| Rate for Payer: Multiplan Commercial |
$126.46
|
| Rate for Payer: Preferred Network Access Commercial |
$145.43
|
| Rate for Payer: Quartz Beloit One Network |
$77.46
|
| Rate for Payer: Quartz Commercial |
$94.85
|
| Rate for Payer: WEA Trust Commercial |
$86.94
|
| Rate for Payer: WPS Commercial |
$117.09
|
|
|
Von Willebrand Factor Antigen
|
Professional
|
Both
|
$729.00
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
978096
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$720.25 |
| Rate for Payer: Aetna Commercial |
$720.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$652.02
|
| Rate for Payer: Aetna Managed Medicare |
$23.86
|
| Rate for Payer: Anthem Medicare Advantage |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.86
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Cigna Commercial |
$720.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$379.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.86
|
| Rate for Payer: Health EOS Commercial |
$689.93
|
| Rate for Payer: HFN Commercial |
$720.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$84.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$84.22
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.86
|
| Rate for Payer: Multiplan Commercial |
$606.53
|
| Rate for Payer: NAPHCARE Commercial |
$35.79
|
| Rate for Payer: Preferred Network Access Commercial |
$720.25
|
| Rate for Payer: Quartz Beloit One Network |
$333.59
|
| Rate for Payer: Quartz Commercial |
$432.15
|
| Rate for Payer: Quartz Medicare Advantage |
$23.86
|
| Rate for Payer: The Alliance Commercial |
$94.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.86
|
| Rate for Payer: WEA Trust Commercial |
$416.99
|
| Rate for Payer: WPS Commercial |
$104.97
|
|
|
Von Willebrand Factor Antigen
|
Professional
|
Both
|
$743.00
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
2943027
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$734.08 |
| Rate for Payer: Aetna Commercial |
$734.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$664.54
|
| Rate for Payer: Aetna Managed Medicare |
$23.86
|
| Rate for Payer: Anthem Medicare Advantage |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.86
|
| Rate for Payer: Cash Price |
$222.90
|
| Rate for Payer: Cash Price |
$222.90
|
| Rate for Payer: Cigna Commercial |
$734.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$386.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.86
|
| Rate for Payer: Health EOS Commercial |
$703.18
|
| Rate for Payer: HFN Commercial |
$734.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$84.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$84.22
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.86
|
| Rate for Payer: Multiplan Commercial |
$618.18
|
| Rate for Payer: NAPHCARE Commercial |
$35.79
|
| Rate for Payer: Preferred Network Access Commercial |
$734.08
|
| Rate for Payer: Quartz Beloit One Network |
$340.00
|
| Rate for Payer: Quartz Commercial |
$440.45
|
| Rate for Payer: Quartz Medicare Advantage |
$23.86
|
| Rate for Payer: The Alliance Commercial |
$94.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.86
|
| Rate for Payer: WEA Trust Commercial |
$425.00
|
| Rate for Payer: WPS Commercial |
$104.97
|
|
|
Von Willebrand Factor Antigen
|
Facility
|
OP
|
$743.00
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
2943027
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$710.90 |
| Rate for Payer: Aetna Commercial |
$695.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$664.54
|
| Rate for Payer: Aetna Managed Medicare |
$23.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$89.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41.75
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$39.60
|
| Rate for Payer: Anthem Medicare Advantage |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$409.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.86
|
| Rate for Payer: Cash Price |
$222.90
|
| Rate for Payer: Cash Price |
$222.90
|
| Rate for Payer: Cigna Commercial |
$710.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$432.43
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23.86
|
| Rate for Payer: Health EOS Commercial |
$687.72
|
| Rate for Payer: HFN Commercial |
$710.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$88.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23.86
|
| Rate for Payer: Multiplan Commercial |
$618.18
|
| Rate for Payer: NAPHCARE Commercial |
$35.79
|
| Rate for Payer: Preferred Network Access Commercial |
$710.90
|
| Rate for Payer: Quartz Beloit One Network |
$378.63
|
| Rate for Payer: Quartz Commercial |
$502.27
|
| Rate for Payer: Quartz Medicare Advantage |
$23.86
|
| Rate for Payer: The Alliance Commercial |
$95.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.86
|
| Rate for Payer: United Healthcare PPO |
$579.54
|
| Rate for Payer: WEA Trust Commercial |
$425.00
|
| Rate for Payer: Wellcare Medicare |
$23.86
|
| Rate for Payer: WPS Commercial |
$572.33
|
|
|
Von Willebrand Factor Antigen
|
Facility
|
IP
|
$743.00
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
2943027
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$378.63 |
| Max. Negotiated Rate |
$710.90 |
| Rate for Payer: Aetna Commercial |
$695.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$664.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$409.54
|
| Rate for Payer: Cash Price |
$222.90
|
| Rate for Payer: Cigna Commercial |
$710.90
|
| Rate for Payer: Health EOS Commercial |
$687.72
|
| Rate for Payer: HFN Commercial |
$710.90
|
| Rate for Payer: Multiplan Commercial |
$618.18
|
| Rate for Payer: Preferred Network Access Commercial |
$710.90
|
| Rate for Payer: Quartz Beloit One Network |
$378.63
|
| Rate for Payer: Quartz Commercial |
$463.63
|
| Rate for Payer: WEA Trust Commercial |
$425.00
|
| Rate for Payer: WPS Commercial |
$572.33
|
|
|
Von Willebrand Factor Antigen
|
Facility
|
OP
|
$729.00
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
978096
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$697.51 |
| Rate for Payer: Aetna Commercial |
$682.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$652.02
|
| Rate for Payer: Aetna Managed Medicare |
$23.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$89.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41.75
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$39.60
|
| Rate for Payer: Anthem Medicare Advantage |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$401.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.86
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Cigna Commercial |
$697.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$424.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23.86
|
| Rate for Payer: Health EOS Commercial |
$674.76
|
| Rate for Payer: HFN Commercial |
$697.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$88.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23.86
|
| Rate for Payer: Multiplan Commercial |
$606.53
|
| Rate for Payer: NAPHCARE Commercial |
$35.79
|
| Rate for Payer: Preferred Network Access Commercial |
$697.51
|
| Rate for Payer: Quartz Beloit One Network |
$371.50
|
| Rate for Payer: Quartz Commercial |
$492.80
|
| Rate for Payer: Quartz Medicare Advantage |
$23.86
|
| Rate for Payer: The Alliance Commercial |
$95.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.86
|
| Rate for Payer: United Healthcare PPO |
$568.62
|
| Rate for Payer: WEA Trust Commercial |
$416.99
|
| Rate for Payer: Wellcare Medicare |
$23.86
|
| Rate for Payer: WPS Commercial |
$561.55
|
|
|
Von Willebrand Factor Antigen
|
Facility
|
IP
|
$729.00
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
978096
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$371.50 |
| Max. Negotiated Rate |
$697.51 |
| Rate for Payer: Aetna Commercial |
$682.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$652.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$401.82
|
| Rate for Payer: Cash Price |
$218.70
|
| Rate for Payer: Cigna Commercial |
$697.51
|
| Rate for Payer: Health EOS Commercial |
$674.76
|
| Rate for Payer: HFN Commercial |
$697.51
|
| Rate for Payer: Multiplan Commercial |
$606.53
|
| Rate for Payer: Preferred Network Access Commercial |
$697.51
|
| Rate for Payer: Quartz Beloit One Network |
$371.50
|
| Rate for Payer: Quartz Commercial |
$454.90
|
| Rate for Payer: WEA Trust Commercial |
$416.99
|
| Rate for Payer: WPS Commercial |
$561.55
|
|
|
Von Willebrand Factor Multimer Assay
|
Facility
|
IP
|
$781.00
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
978097
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$398.00 |
| Max. Negotiated Rate |
$747.26 |
| Rate for Payer: Aetna Commercial |
$731.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$698.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$430.49
|
| Rate for Payer: Cash Price |
$234.30
|
| Rate for Payer: Cigna Commercial |
$747.26
|
| Rate for Payer: Health EOS Commercial |
$722.89
|
| Rate for Payer: HFN Commercial |
$747.26
|
| Rate for Payer: Multiplan Commercial |
$649.79
|
| Rate for Payer: Preferred Network Access Commercial |
$747.26
|
| Rate for Payer: Quartz Beloit One Network |
$398.00
|
| Rate for Payer: Quartz Commercial |
$487.34
|
| Rate for Payer: WEA Trust Commercial |
$446.73
|
| Rate for Payer: WPS Commercial |
$601.60
|
|
|
Von Willebrand Factor Multimer Assay
|
Facility
|
OP
|
$826.00
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
2943028
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$790.32 |
| Rate for Payer: Aetna Commercial |
$773.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$738.77
|
| Rate for Payer: Aetna Managed Medicare |
$23.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$89.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41.75
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$39.60
|
| Rate for Payer: Anthem Medicare Advantage |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$455.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.86
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cigna Commercial |
$790.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$480.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23.86
|
| Rate for Payer: Health EOS Commercial |
$764.55
|
| Rate for Payer: HFN Commercial |
$790.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$88.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23.86
|
| Rate for Payer: Multiplan Commercial |
$687.23
|
| Rate for Payer: NAPHCARE Commercial |
$35.79
|
| Rate for Payer: Preferred Network Access Commercial |
$790.32
|
| Rate for Payer: Quartz Beloit One Network |
$420.93
|
| Rate for Payer: Quartz Commercial |
$558.38
|
| Rate for Payer: Quartz Medicare Advantage |
$23.86
|
| Rate for Payer: The Alliance Commercial |
$95.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.86
|
| Rate for Payer: United Healthcare PPO |
$644.28
|
| Rate for Payer: WEA Trust Commercial |
$472.47
|
| Rate for Payer: Wellcare Medicare |
$23.86
|
| Rate for Payer: WPS Commercial |
$636.27
|
|
|
Von Willebrand Factor Multimer Assay
|
Professional
|
Both
|
$781.00
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
978097
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$771.63 |
| Rate for Payer: Aetna Commercial |
$771.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$698.53
|
| Rate for Payer: Aetna Managed Medicare |
$23.86
|
| Rate for Payer: Anthem Medicare Advantage |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.86
|
| Rate for Payer: Cash Price |
$234.30
|
| Rate for Payer: Cash Price |
$234.30
|
| Rate for Payer: Cigna Commercial |
$771.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$406.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.86
|
| Rate for Payer: Health EOS Commercial |
$739.14
|
| Rate for Payer: HFN Commercial |
$771.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$84.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$84.22
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.86
|
| Rate for Payer: Multiplan Commercial |
$649.79
|
| Rate for Payer: NAPHCARE Commercial |
$35.79
|
| Rate for Payer: Preferred Network Access Commercial |
$771.63
|
| Rate for Payer: Quartz Beloit One Network |
$357.39
|
| Rate for Payer: Quartz Commercial |
$462.98
|
| Rate for Payer: Quartz Medicare Advantage |
$23.86
|
| Rate for Payer: The Alliance Commercial |
$94.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.86
|
| Rate for Payer: WEA Trust Commercial |
$446.73
|
| Rate for Payer: WPS Commercial |
$104.97
|
|
