|
X-ray Exam of Foot Complete 7363026
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
CPT 73630 26
|
| Hospital Charge Code |
3171497
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.01 |
| Max. Negotiated Rate |
$156.10 |
| Rate for Payer: Aetna Commercial |
$156.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$141.32
|
| Rate for Payer: Aetna Managed Medicare |
$8.01
|
| Rate for Payer: Anthem Medicare Advantage |
$8.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.01
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cigna Commercial |
$156.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$82.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.01
|
| Rate for Payer: Health EOS Commercial |
$149.53
|
| Rate for Payer: HFN Commercial |
$156.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$29.41
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.01
|
| Rate for Payer: Multiplan Commercial |
$131.46
|
| Rate for Payer: NAPHCARE Commercial |
$12.01
|
| Rate for Payer: Preferred Network Access Commercial |
$156.10
|
| Rate for Payer: Quartz Beloit One Network |
$72.30
|
| Rate for Payer: Quartz Commercial |
$93.66
|
| Rate for Payer: Quartz Medicare Advantage |
$8.01
|
| Rate for Payer: The Alliance Commercial |
$30.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.01
|
| Rate for Payer: WEA Trust Commercial |
$90.38
|
| Rate for Payer: WPS Commercial |
$40.04
|
|
|
X-ray Exam of Foot Complete 736302650
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
CPT 73630 26,50
|
| Hospital Charge Code |
5578004
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$120.27 |
| Max. Negotiated Rate |
$312.21 |
| Rate for Payer: Aetna Commercial |
$312.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$282.63
|
| Rate for Payer: Cash Price |
$94.80
|
| Rate for Payer: Cash Price |
$94.80
|
| Rate for Payer: Cash Price |
$94.80
|
| Rate for Payer: Cigna Commercial |
$312.21
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$164.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$197.18
|
| Rate for Payer: Health EOS Commercial |
$299.06
|
| Rate for Payer: HFN Commercial |
$312.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$120.27
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$120.27
|
| Rate for Payer: Multiplan Commercial |
$262.91
|
| Rate for Payer: Preferred Network Access Commercial |
$312.21
|
| Rate for Payer: Quartz Beloit One Network |
$144.60
|
| Rate for Payer: Quartz Commercial |
$187.32
|
| Rate for Payer: The Alliance Commercial |
$164.32
|
| Rate for Payer: WEA Trust Commercial |
$180.75
|
| Rate for Payer: WPS Commercial |
$243.41
|
|
|
X-ray Exam of Hand Min Three 73130
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
3171543
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$32.03 |
| Max. Negotiated Rate |
$188.66 |
| Rate for Payer: Aetna Commercial |
$69.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$62.61
|
| Rate for Payer: Aetna Managed Medicare |
$37.73
|
| Rate for Payer: Anthem Medicare Advantage |
$37.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$37.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$37.73
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$69.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$36.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$37.73
|
| Rate for Payer: Health EOS Commercial |
$66.25
|
| Rate for Payer: HFN Commercial |
$69.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$127.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$127.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$37.73
|
| Rate for Payer: Multiplan Commercial |
$58.24
|
| Rate for Payer: NAPHCARE Commercial |
$56.60
|
| Rate for Payer: Preferred Network Access Commercial |
$69.16
|
| Rate for Payer: Quartz Beloit One Network |
$32.03
|
| Rate for Payer: Quartz Commercial |
$41.50
|
| Rate for Payer: Quartz Medicare Advantage |
$37.73
|
| Rate for Payer: The Alliance Commercial |
$143.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$37.73
|
| Rate for Payer: WEA Trust Commercial |
$40.04
|
| Rate for Payer: WPS Commercial |
$188.66
|
|
|
X-ray Exam of Hand Min Three 7313026
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
CPT 73130 26
|
| Hospital Charge Code |
3171548
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.67 |
| Max. Negotiated Rate |
$104.73 |
| Rate for Payer: Aetna Commercial |
$104.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$94.81
|
| Rate for Payer: Aetna Managed Medicare |
$8.67
|
| Rate for Payer: Anthem Medicare Advantage |
$8.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.67
|
| Rate for Payer: Cash Price |
$31.80
|
| Rate for Payer: Cash Price |
$31.80
|
| Rate for Payer: Cash Price |
$31.80
|
| Rate for Payer: Cigna Commercial |
$104.73
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$55.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.67
|
| Rate for Payer: Health EOS Commercial |
$100.32
|
| Rate for Payer: HFN Commercial |
$104.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30.62
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$88.19
|
| Rate for Payer: NAPHCARE Commercial |
$13.01
|
| Rate for Payer: Preferred Network Access Commercial |
$104.73
|
| Rate for Payer: Quartz Beloit One Network |
$48.51
|
| Rate for Payer: Quartz Commercial |
$62.84
|
| Rate for Payer: Quartz Medicare Advantage |
$8.67
|
| Rate for Payer: The Alliance Commercial |
$32.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.67
|
| Rate for Payer: WEA Trust Commercial |
$60.63
|
| Rate for Payer: WPS Commercial |
$43.37
|
|
|
X-RAY Exam of Heel 7365026
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
CPT 73650 26
|
| Hospital Charge Code |
3206253
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$88.92 |
| Rate for Payer: Aetna Commercial |
$88.92
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$80.50
|
| Rate for Payer: Aetna Managed Medicare |
$7.66
|
| Rate for Payer: Anthem Medicare Advantage |
$7.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.66
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cigna Commercial |
$88.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7.66
|
| Rate for Payer: Health EOS Commercial |
$85.18
|
| Rate for Payer: HFN Commercial |
$88.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$28.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.66
|
| Rate for Payer: Multiplan Commercial |
$74.88
|
| Rate for Payer: NAPHCARE Commercial |
$11.50
|
| Rate for Payer: Preferred Network Access Commercial |
$88.92
|
| Rate for Payer: Quartz Beloit One Network |
$41.18
|
| Rate for Payer: Quartz Commercial |
$53.35
|
| Rate for Payer: Quartz Medicare Advantage |
$7.66
|
| Rate for Payer: The Alliance Commercial |
$29.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.66
|
| Rate for Payer: WEA Trust Commercial |
$51.48
|
| Rate for Payer: WPS Commercial |
$38.32
|
|
|
X-ray Exam of Knee, 3 View 73562
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
3171475
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.69 |
| Max. Negotiated Rate |
$210.39 |
| Rate for Payer: Aetna Commercial |
$77.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$69.76
|
| Rate for Payer: Aetna Managed Medicare |
$42.08
|
| Rate for Payer: Anthem Medicare Advantage |
$42.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$42.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$42.08
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$77.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$40.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$42.08
|
| Rate for Payer: Health EOS Commercial |
$73.82
|
| Rate for Payer: HFN Commercial |
$77.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$142.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$142.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$42.08
|
| Rate for Payer: Multiplan Commercial |
$64.90
|
| Rate for Payer: NAPHCARE Commercial |
$63.12
|
| Rate for Payer: Preferred Network Access Commercial |
$77.06
|
| Rate for Payer: Quartz Beloit One Network |
$35.69
|
| Rate for Payer: Quartz Commercial |
$46.24
|
| Rate for Payer: Quartz Medicare Advantage |
$42.08
|
| Rate for Payer: The Alliance Commercial |
$159.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42.08
|
| Rate for Payer: WEA Trust Commercial |
$44.62
|
| Rate for Payer: WPS Commercial |
$210.39
|
|
|
X-ray Exam of Knee, 3 View 7356226
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
CPT 73562 26
|
| Hospital Charge Code |
3171480
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$109.67 |
| Rate for Payer: Aetna Commercial |
$109.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$99.28
|
| Rate for Payer: Aetna Managed Medicare |
$9.35
|
| Rate for Payer: Anthem Medicare Advantage |
$9.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.35
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cigna Commercial |
$109.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$57.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.35
|
| Rate for Payer: Health EOS Commercial |
$105.05
|
| Rate for Payer: HFN Commercial |
$109.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$33.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$33.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.35
|
| Rate for Payer: Multiplan Commercial |
$92.35
|
| Rate for Payer: NAPHCARE Commercial |
$14.02
|
| Rate for Payer: Preferred Network Access Commercial |
$109.67
|
| Rate for Payer: Quartz Beloit One Network |
$50.79
|
| Rate for Payer: Quartz Commercial |
$65.80
|
| Rate for Payer: Quartz Medicare Advantage |
$9.35
|
| Rate for Payer: The Alliance Commercial |
$35.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.35
|
| Rate for Payer: WEA Trust Commercial |
$63.49
|
| Rate for Payer: WPS Commercial |
$46.75
|
|
|
X-Ray Exam of Lower Spine 7211426
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
CPT 72114 26
|
| Hospital Charge Code |
3451597
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$241.07 |
| Rate for Payer: Aetna Commercial |
$241.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$218.23
|
| Rate for Payer: Aetna Managed Medicare |
$14.28
|
| Rate for Payer: Anthem Medicare Advantage |
$14.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.28
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$241.07
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$126.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.28
|
| Rate for Payer: Health EOS Commercial |
$230.92
|
| Rate for Payer: HFN Commercial |
$241.07
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53.31
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.28
|
| Rate for Payer: Multiplan Commercial |
$203.01
|
| Rate for Payer: NAPHCARE Commercial |
$21.42
|
| Rate for Payer: Preferred Network Access Commercial |
$241.07
|
| Rate for Payer: Quartz Beloit One Network |
$111.65
|
| Rate for Payer: Quartz Commercial |
$144.64
|
| Rate for Payer: Quartz Medicare Advantage |
$14.28
|
| Rate for Payer: The Alliance Commercial |
$54.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.28
|
| Rate for Payer: WEA Trust Commercial |
$139.57
|
| Rate for Payer: WPS Commercial |
$71.40
|
|
|
X-ray Exam of Shoulder Complete 73030
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
3171509
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$32.03 |
| Max. Negotiated Rate |
$177.11 |
| Rate for Payer: Aetna Commercial |
$69.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$62.61
|
| Rate for Payer: Aetna Managed Medicare |
$35.42
|
| Rate for Payer: Anthem Medicare Advantage |
$35.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35.42
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$69.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$36.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35.42
|
| Rate for Payer: Health EOS Commercial |
$66.25
|
| Rate for Payer: HFN Commercial |
$69.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$120.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$120.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35.42
|
| Rate for Payer: Multiplan Commercial |
$58.24
|
| Rate for Payer: NAPHCARE Commercial |
$53.13
|
| Rate for Payer: Preferred Network Access Commercial |
$69.16
|
| Rate for Payer: Quartz Beloit One Network |
$32.03
|
| Rate for Payer: Quartz Commercial |
$41.50
|
| Rate for Payer: Quartz Medicare Advantage |
$35.42
|
| Rate for Payer: The Alliance Commercial |
$134.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.42
|
| Rate for Payer: WEA Trust Commercial |
$40.04
|
| Rate for Payer: WPS Commercial |
$177.11
|
|
|
X-ray Exam of Shoulder Min 7303026
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
CPT 73030 26
|
| Hospital Charge Code |
3171514
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$116.58 |
| Rate for Payer: Aetna Commercial |
$116.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$105.54
|
| Rate for Payer: Aetna Managed Medicare |
$9.02
|
| Rate for Payer: Anthem Medicare Advantage |
$9.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.02
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$116.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$61.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.02
|
| Rate for Payer: Health EOS Commercial |
$111.68
|
| Rate for Payer: HFN Commercial |
$116.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$33.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$33.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.02
|
| Rate for Payer: Multiplan Commercial |
$98.18
|
| Rate for Payer: NAPHCARE Commercial |
$13.53
|
| Rate for Payer: Preferred Network Access Commercial |
$116.58
|
| Rate for Payer: Quartz Beloit One Network |
$54.00
|
| Rate for Payer: Quartz Commercial |
$69.95
|
| Rate for Payer: Quartz Medicare Advantage |
$9.02
|
| Rate for Payer: The Alliance Commercial |
$34.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.02
|
| Rate for Payer: WEA Trust Commercial |
$67.50
|
| Rate for Payer: WPS Commercial |
$45.08
|
|
|
X-Ray Exam of Sinuses Waters View Only 70210
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
3811616
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$32.07 |
| Max. Negotiated Rate |
$161.04 |
| Rate for Payer: Aetna Commercial |
$161.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$145.79
|
| Rate for Payer: Aetna Managed Medicare |
$32.07
|
| Rate for Payer: Anthem Medicare Advantage |
$32.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$32.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$32.07
|
| Rate for Payer: Cash Price |
$48.90
|
| Rate for Payer: Cash Price |
$48.90
|
| Rate for Payer: Cash Price |
$48.90
|
| Rate for Payer: Cigna Commercial |
$161.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$84.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32.07
|
| Rate for Payer: Health EOS Commercial |
$154.26
|
| Rate for Payer: HFN Commercial |
$161.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$113.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$113.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$32.07
|
| Rate for Payer: Multiplan Commercial |
$135.62
|
| Rate for Payer: NAPHCARE Commercial |
$48.11
|
| Rate for Payer: Preferred Network Access Commercial |
$161.04
|
| Rate for Payer: Quartz Beloit One Network |
$74.59
|
| Rate for Payer: Quartz Commercial |
$96.63
|
| Rate for Payer: Quartz Medicare Advantage |
$32.07
|
| Rate for Payer: The Alliance Commercial |
$121.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32.07
|
| Rate for Payer: WEA Trust Commercial |
$93.24
|
| Rate for Payer: WPS Commercial |
$160.37
|
|
|
X-RAY Exam of Sinuses Waters View Only 7021026
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
CPT 70210 26
|
| Hospital Charge Code |
3814462
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.34 |
| Max. Negotiated Rate |
$161.04 |
| Rate for Payer: Aetna Commercial |
$161.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$145.79
|
| Rate for Payer: Aetna Managed Medicare |
$8.34
|
| Rate for Payer: Anthem Medicare Advantage |
$8.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.34
|
| Rate for Payer: Cash Price |
$48.90
|
| Rate for Payer: Cash Price |
$48.90
|
| Rate for Payer: Cash Price |
$48.90
|
| Rate for Payer: Cigna Commercial |
$161.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$84.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.34
|
| Rate for Payer: Health EOS Commercial |
$154.26
|
| Rate for Payer: HFN Commercial |
$161.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30.62
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.34
|
| Rate for Payer: Multiplan Commercial |
$135.62
|
| Rate for Payer: NAPHCARE Commercial |
$12.51
|
| Rate for Payer: Preferred Network Access Commercial |
$161.04
|
| Rate for Payer: Quartz Beloit One Network |
$74.59
|
| Rate for Payer: Quartz Commercial |
$96.63
|
| Rate for Payer: Quartz Medicare Advantage |
$8.34
|
| Rate for Payer: The Alliance Commercial |
$31.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.34
|
| Rate for Payer: WEA Trust Commercial |
$93.24
|
| Rate for Payer: WPS Commercial |
$41.70
|
|
|
X-RAY Exam of Sternum 7112026
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
CPT 71120 26
|
| Hospital Charge Code |
3238214
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$111.64 |
| Rate for Payer: Aetna Commercial |
$111.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.07
|
| Rate for Payer: Aetna Managed Medicare |
$9.38
|
| Rate for Payer: Anthem Medicare Advantage |
$9.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.38
|
| Rate for Payer: Cash Price |
$33.90
|
| Rate for Payer: Cash Price |
$33.90
|
| Rate for Payer: Cash Price |
$33.90
|
| Rate for Payer: Cigna Commercial |
$111.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$58.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.38
|
| Rate for Payer: Health EOS Commercial |
$106.94
|
| Rate for Payer: HFN Commercial |
$111.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$34.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$34.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.38
|
| Rate for Payer: Multiplan Commercial |
$94.02
|
| Rate for Payer: NAPHCARE Commercial |
$14.07
|
| Rate for Payer: Preferred Network Access Commercial |
$111.64
|
| Rate for Payer: Quartz Beloit One Network |
$51.71
|
| Rate for Payer: Quartz Commercial |
$66.99
|
| Rate for Payer: Quartz Medicare Advantage |
$9.38
|
| Rate for Payer: The Alliance Commercial |
$35.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.38
|
| Rate for Payer: WEA Trust Commercial |
$64.64
|
| Rate for Payer: WPS Commercial |
$46.90
|
|
|
X-RAY Exam of Toe(S) 7366026
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
CPT 73660 26
|
| Hospital Charge Code |
3238236
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Aetna Commercial |
$82.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Aetna Managed Medicare |
$6.28
|
| Rate for Payer: Anthem Medicare Advantage |
$6.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.28
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$82.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.28
|
| Rate for Payer: Health EOS Commercial |
$79.50
|
| Rate for Payer: HFN Commercial |
$82.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.28
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: NAPHCARE Commercial |
$9.42
|
| Rate for Payer: Preferred Network Access Commercial |
$82.99
|
| Rate for Payer: Quartz Beloit One Network |
$38.44
|
| Rate for Payer: Quartz Commercial |
$49.80
|
| Rate for Payer: Quartz Medicare Advantage |
$6.28
|
| Rate for Payer: The Alliance Commercial |
$23.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.28
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: WPS Commercial |
$31.41
|
|
|
X-ray Exam of Wrist Complete 73110
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
3149484
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$211.95 |
| Rate for Payer: Aetna Commercial |
$58.29
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$52.77
|
| Rate for Payer: Aetna Managed Medicare |
$42.39
|
| Rate for Payer: Anthem Medicare Advantage |
$42.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$42.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$42.39
|
| Rate for Payer: Cash Price |
$17.70
|
| Rate for Payer: Cash Price |
$17.70
|
| Rate for Payer: Cash Price |
$17.70
|
| Rate for Payer: Cigna Commercial |
$58.29
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$30.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$42.39
|
| Rate for Payer: Health EOS Commercial |
$55.84
|
| Rate for Payer: HFN Commercial |
$58.29
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$142.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$142.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$42.39
|
| Rate for Payer: Multiplan Commercial |
$49.09
|
| Rate for Payer: NAPHCARE Commercial |
$63.59
|
| Rate for Payer: Preferred Network Access Commercial |
$58.29
|
| Rate for Payer: Quartz Beloit One Network |
$27.00
|
| Rate for Payer: Quartz Commercial |
$34.98
|
| Rate for Payer: Quartz Medicare Advantage |
$42.39
|
| Rate for Payer: The Alliance Commercial |
$161.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42.39
|
| Rate for Payer: WEA Trust Commercial |
$33.75
|
| Rate for Payer: WPS Commercial |
$211.95
|
|
|
X-ray Exam of Wrist Complete 7311026
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
CPT 73110 26
|
| Hospital Charge Code |
3149490
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.67 |
| Max. Negotiated Rate |
$99.79 |
| Rate for Payer: Aetna Commercial |
$99.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$90.33
|
| Rate for Payer: Aetna Managed Medicare |
$8.67
|
| Rate for Payer: Anthem Medicare Advantage |
$8.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.67
|
| Rate for Payer: Cash Price |
$30.30
|
| Rate for Payer: Cash Price |
$30.30
|
| Rate for Payer: Cash Price |
$30.30
|
| Rate for Payer: Cigna Commercial |
$99.79
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$52.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.67
|
| Rate for Payer: Health EOS Commercial |
$95.59
|
| Rate for Payer: HFN Commercial |
$99.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30.62
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$84.03
|
| Rate for Payer: NAPHCARE Commercial |
$13.01
|
| Rate for Payer: Preferred Network Access Commercial |
$99.79
|
| Rate for Payer: Quartz Beloit One Network |
$46.22
|
| Rate for Payer: Quartz Commercial |
$59.87
|
| Rate for Payer: Quartz Medicare Advantage |
$8.67
|
| Rate for Payer: The Alliance Commercial |
$32.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.67
|
| Rate for Payer: WEA Trust Commercial |
$57.77
|
| Rate for Payer: WPS Commercial |
$43.37
|
|
|
X-RAY Femur 73552
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
4605772
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.42 |
| Max. Negotiated Rate |
$177.11 |
| Rate for Payer: Aetna Commercial |
$79.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.55
|
| Rate for Payer: Aetna Managed Medicare |
$35.42
|
| Rate for Payer: Anthem Medicare Advantage |
$35.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35.42
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cigna Commercial |
$79.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35.42
|
| Rate for Payer: Health EOS Commercial |
$75.71
|
| Rate for Payer: HFN Commercial |
$79.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$123.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$123.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35.42
|
| Rate for Payer: Multiplan Commercial |
$66.56
|
| Rate for Payer: NAPHCARE Commercial |
$53.13
|
| Rate for Payer: Preferred Network Access Commercial |
$79.04
|
| Rate for Payer: Quartz Beloit One Network |
$36.61
|
| Rate for Payer: Quartz Commercial |
$47.42
|
| Rate for Payer: Quartz Medicare Advantage |
$35.42
|
| Rate for Payer: The Alliance Commercial |
$134.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.42
|
| Rate for Payer: WEA Trust Commercial |
$45.76
|
| Rate for Payer: WPS Commercial |
$177.11
|
|
|
X-RAY Femur 7355226
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
CPT 73552 26
|
| Hospital Charge Code |
4605773
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.68 |
| Max. Negotiated Rate |
$79.04 |
| Rate for Payer: Aetna Commercial |
$79.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.55
|
| Rate for Payer: Aetna Managed Medicare |
$8.68
|
| Rate for Payer: Anthem Medicare Advantage |
$8.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.68
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cigna Commercial |
$79.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.68
|
| Rate for Payer: Health EOS Commercial |
$75.71
|
| Rate for Payer: HFN Commercial |
$79.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$31.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$66.56
|
| Rate for Payer: NAPHCARE Commercial |
$13.03
|
| Rate for Payer: Preferred Network Access Commercial |
$79.04
|
| Rate for Payer: Quartz Beloit One Network |
$36.61
|
| Rate for Payer: Quartz Commercial |
$47.42
|
| Rate for Payer: Quartz Medicare Advantage |
$8.68
|
| Rate for Payer: The Alliance Commercial |
$33.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.68
|
| Rate for Payer: WEA Trust Commercial |
$45.76
|
| Rate for Payer: WPS Commercial |
$43.42
|
|
|
X-RAY Finger(S) 73140
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
3209515
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.30 |
| Max. Negotiated Rate |
$195.05 |
| Rate for Payer: Aetna Commercial |
$39.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$35.78
|
| Rate for Payer: Aetna Managed Medicare |
$39.01
|
| Rate for Payer: Anthem Medicare Advantage |
$39.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.01
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$39.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$39.01
|
| Rate for Payer: Health EOS Commercial |
$37.86
|
| Rate for Payer: HFN Commercial |
$39.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$130.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$130.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.01
|
| Rate for Payer: Multiplan Commercial |
$33.28
|
| Rate for Payer: NAPHCARE Commercial |
$58.52
|
| Rate for Payer: Preferred Network Access Commercial |
$39.52
|
| Rate for Payer: Quartz Beloit One Network |
$18.30
|
| Rate for Payer: Quartz Commercial |
$23.71
|
| Rate for Payer: Quartz Medicare Advantage |
$39.01
|
| Rate for Payer: The Alliance Commercial |
$148.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.01
|
| Rate for Payer: WEA Trust Commercial |
$22.88
|
| Rate for Payer: WPS Commercial |
$195.05
|
|
|
X-RAY Finger(S) 7314026
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
CPT 73140 26
|
| Hospital Charge Code |
3209520
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$100.78 |
| Rate for Payer: Aetna Commercial |
$100.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.23
|
| Rate for Payer: Aetna Managed Medicare |
$6.61
|
| Rate for Payer: Anthem Medicare Advantage |
$6.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.61
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$100.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$53.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.61
|
| Rate for Payer: Health EOS Commercial |
$96.53
|
| Rate for Payer: HFN Commercial |
$100.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$24.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.61
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: NAPHCARE Commercial |
$9.92
|
| Rate for Payer: Preferred Network Access Commercial |
$100.78
|
| Rate for Payer: Quartz Beloit One Network |
$46.68
|
| Rate for Payer: Quartz Commercial |
$60.47
|
| Rate for Payer: Quartz Medicare Advantage |
$6.61
|
| Rate for Payer: The Alliance Commercial |
$25.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.61
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: WPS Commercial |
$33.07
|
|
|
X-RAY Foot 2 View 73620
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
3209527
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.96 |
| Max. Negotiated Rate |
$142.01 |
| Rate for Payer: Aetna Commercial |
$47.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$42.93
|
| Rate for Payer: Aetna Managed Medicare |
$28.40
|
| Rate for Payer: Anthem Medicare Advantage |
$28.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$28.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$28.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| 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 |
$28.40
|
| Rate for Payer: Health EOS Commercial |
$45.43
|
| Rate for Payer: HFN Commercial |
$47.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$99.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$99.67
|
| Rate for Payer: Independent Care Health Plan Medicare |
$28.40
|
| Rate for Payer: Multiplan Commercial |
$39.94
|
| Rate for Payer: NAPHCARE Commercial |
$42.60
|
| 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: Quartz Medicare Advantage |
$28.40
|
| Rate for Payer: The Alliance Commercial |
$107.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.40
|
| Rate for Payer: WEA Trust Commercial |
$27.46
|
| Rate for Payer: WPS Commercial |
$142.01
|
|
|
X-RAY Foot 2 View 7362026
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
CPT 73620 26
|
| Hospital Charge Code |
3209532
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$74.10 |
| Rate for Payer: Aetna Commercial |
$74.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.08
|
| Rate for Payer: Aetna Managed Medicare |
$7.66
|
| Rate for Payer: Anthem Medicare Advantage |
$7.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.66
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna Commercial |
$74.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$39.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7.66
|
| Rate for Payer: Health EOS Commercial |
$70.98
|
| Rate for Payer: HFN Commercial |
$74.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$26.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.66
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: NAPHCARE Commercial |
$11.50
|
| Rate for Payer: Preferred Network Access Commercial |
$74.10
|
| Rate for Payer: Quartz Beloit One Network |
$34.32
|
| Rate for Payer: Quartz Commercial |
$44.46
|
| Rate for Payer: Quartz Medicare Advantage |
$7.66
|
| Rate for Payer: The Alliance Commercial |
$29.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.66
|
| Rate for Payer: WEA Trust Commercial |
$42.90
|
| Rate for Payer: WPS Commercial |
$38.32
|
|
|
X-RAY Forearm 2 View Complete 73090
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
3209540
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$25.63 |
| Max. Negotiated Rate |
$143.68 |
| Rate for Payer: Aetna Commercial |
$55.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Aetna Managed Medicare |
$28.74
|
| Rate for Payer: Anthem Medicare Advantage |
$28.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$28.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$28.74
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$55.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$29.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28.74
|
| Rate for Payer: Health EOS Commercial |
$53.00
|
| Rate for Payer: HFN Commercial |
$55.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$102.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$102.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$28.74
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: NAPHCARE Commercial |
$43.10
|
| Rate for Payer: Preferred Network Access Commercial |
$55.33
|
| Rate for Payer: Quartz Beloit One Network |
$25.63
|
| Rate for Payer: Quartz Commercial |
$33.20
|
| Rate for Payer: Quartz Medicare Advantage |
$28.74
|
| Rate for Payer: The Alliance Commercial |
$109.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.74
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: WPS Commercial |
$143.68
|
|
|
X-RAY Forearm 2 View Complete 7309026
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
CPT 73090 26
|
| Hospital Charge Code |
3209545
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$95.84 |
| Rate for Payer: Aetna Commercial |
$95.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.76
|
| Rate for Payer: Aetna Managed Medicare |
$7.66
|
| Rate for Payer: Anthem Medicare Advantage |
$7.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.66
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$95.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$50.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7.66
|
| Rate for Payer: Health EOS Commercial |
$91.80
|
| Rate for Payer: HFN Commercial |
$95.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$28.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.66
|
| Rate for Payer: Multiplan Commercial |
$80.70
|
| Rate for Payer: NAPHCARE Commercial |
$11.50
|
| Rate for Payer: Preferred Network Access Commercial |
$95.84
|
| Rate for Payer: Quartz Beloit One Network |
$44.39
|
| Rate for Payer: Quartz Commercial |
$57.50
|
| Rate for Payer: Quartz Medicare Advantage |
$7.66
|
| Rate for Payer: The Alliance Commercial |
$29.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.66
|
| Rate for Payer: WEA Trust Commercial |
$55.48
|
| Rate for Payer: WPS Commercial |
$38.32
|
|
|
X-RAY Hand 2 Views 73120
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
3209551
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.22 |
| Max. Negotiated Rate |
$155.32 |
| Rate for Payer: Aetna Commercial |
$41.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$37.56
|
| Rate for Payer: Aetna Managed Medicare |
$31.06
|
| Rate for Payer: Anthem Medicare Advantage |
$31.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$31.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$31.06
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cigna Commercial |
$41.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31.06
|
| Rate for Payer: Health EOS Commercial |
$39.75
|
| Rate for Payer: HFN Commercial |
$41.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$109.32
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$109.32
|
| Rate for Payer: Independent Care Health Plan Medicare |
$31.06
|
| Rate for Payer: Multiplan Commercial |
$34.94
|
| Rate for Payer: NAPHCARE Commercial |
$46.60
|
| Rate for Payer: Preferred Network Access Commercial |
$41.50
|
| Rate for Payer: Quartz Beloit One Network |
$19.22
|
| Rate for Payer: Quartz Commercial |
$24.90
|
| Rate for Payer: Quartz Medicare Advantage |
$31.06
|
| Rate for Payer: The Alliance Commercial |
$118.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31.06
|
| Rate for Payer: WEA Trust Commercial |
$24.02
|
| Rate for Payer: WPS Commercial |
$155.32
|
|
