|
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
|
|
|
X-RAY Hand 2 Views 7312026
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
CPT 73120 26
|
| Hospital Charge Code |
3209556
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$68.17 |
| Rate for Payer: Aetna Commercial |
$68.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$61.71
|
| Rate for Payer: Aetna Managed Medicare |
$8.00
|
| Rate for Payer: Anthem Medicare Advantage |
$8.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.00
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$68.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$35.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.00
|
| Rate for Payer: Health EOS Commercial |
$65.30
|
| Rate for Payer: HFN Commercial |
$68.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$29.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.00
|
| Rate for Payer: Multiplan Commercial |
$57.41
|
| Rate for Payer: NAPHCARE Commercial |
$12.00
|
| Rate for Payer: Preferred Network Access Commercial |
$68.17
|
| Rate for Payer: Quartz Beloit One Network |
$31.57
|
| Rate for Payer: Quartz Commercial |
$40.90
|
| Rate for Payer: Quartz Medicare Advantage |
$8.00
|
| Rate for Payer: The Alliance Commercial |
$30.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.00
|
| Rate for Payer: WEA Trust Commercial |
$39.47
|
| Rate for Payer: WPS Commercial |
$39.99
|
|
|
X-RAY Hip 2 Views 73502
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
4605766
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$30.66 |
| Max. Negotiated Rate |
$242.22 |
| Rate for Payer: Aetna Commercial |
$66.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.92
|
| Rate for Payer: Aetna Managed Medicare |
$48.44
|
| Rate for Payer: Anthem Medicare Advantage |
$48.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$48.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$48.44
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$66.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$34.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.44
|
| Rate for Payer: Health EOS Commercial |
$63.41
|
| Rate for Payer: HFN Commercial |
$66.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$164.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$164.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$48.44
|
| Rate for Payer: Multiplan Commercial |
$55.74
|
| Rate for Payer: NAPHCARE Commercial |
$72.66
|
| Rate for Payer: Preferred Network Access Commercial |
$66.20
|
| Rate for Payer: Quartz Beloit One Network |
$30.66
|
| Rate for Payer: Quartz Commercial |
$39.72
|
| Rate for Payer: Quartz Medicare Advantage |
$48.44
|
| Rate for Payer: The Alliance Commercial |
$184.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48.44
|
| Rate for Payer: WEA Trust Commercial |
$38.32
|
| Rate for Payer: WPS Commercial |
$242.22
|
|
|
X-RAY Hip 2 Views 7350226
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
CPT 73502 26
|
| Hospital Charge Code |
4605767
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$66.20 |
| Rate for Payer: Aetna Commercial |
$66.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.92
|
| Rate for Payer: Aetna Managed Medicare |
$10.73
|
| Rate for Payer: Anthem Medicare Advantage |
$10.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.73
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$66.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$34.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10.73
|
| Rate for Payer: Health EOS Commercial |
$63.41
|
| Rate for Payer: HFN Commercial |
$66.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$39.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$55.74
|
| Rate for Payer: NAPHCARE Commercial |
$16.10
|
| Rate for Payer: Preferred Network Access Commercial |
$66.20
|
| Rate for Payer: Quartz Beloit One Network |
$30.66
|
| Rate for Payer: Quartz Commercial |
$39.72
|
| Rate for Payer: Quartz Medicare Advantage |
$10.73
|
| Rate for Payer: The Alliance Commercial |
$40.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.73
|
| Rate for Payer: WEA Trust Commercial |
$38.32
|
| Rate for Payer: WPS Commercial |
$53.66
|
|
|
X-RAY Hips-AP Pelvis & 2V Hips 73521
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
CPT 73521
|
| Hospital Charge Code |
4605769
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$40.27 |
| Max. Negotiated Rate |
$207.27 |
| Rate for Payer: Aetna Commercial |
$86.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$78.71
|
| Rate for Payer: Aetna Managed Medicare |
$41.45
|
| Rate for Payer: Anthem Medicare Advantage |
$41.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$41.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$41.45
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cigna Commercial |
$86.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$45.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$41.45
|
| Rate for Payer: Health EOS Commercial |
$83.28
|
| Rate for Payer: HFN Commercial |
$86.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$144.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$144.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$41.45
|
| Rate for Payer: Multiplan Commercial |
$73.22
|
| Rate for Payer: NAPHCARE Commercial |
$62.18
|
| Rate for Payer: Preferred Network Access Commercial |
$86.94
|
| Rate for Payer: Quartz Beloit One Network |
$40.27
|
| Rate for Payer: Quartz Commercial |
$52.17
|
| Rate for Payer: Quartz Medicare Advantage |
$41.45
|
| Rate for Payer: The Alliance Commercial |
$157.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41.45
|
| Rate for Payer: WEA Trust Commercial |
$50.34
|
| Rate for Payer: WPS Commercial |
$207.27
|
|
|
X-RAY Hips-AP Pelvis & 2V Hips 7352126
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
CPT 73521 26
|
| Hospital Charge Code |
4605770
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$86.94 |
| Rate for Payer: Aetna Commercial |
$86.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$78.71
|
| Rate for Payer: Aetna Managed Medicare |
$10.73
|
| Rate for Payer: Anthem Medicare Advantage |
$10.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.73
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cigna Commercial |
$86.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$45.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10.73
|
| Rate for Payer: Health EOS Commercial |
$83.28
|
| Rate for Payer: HFN Commercial |
$86.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$39.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$73.22
|
| Rate for Payer: NAPHCARE Commercial |
$16.10
|
| Rate for Payer: Preferred Network Access Commercial |
$86.94
|
| Rate for Payer: Quartz Beloit One Network |
$40.27
|
| Rate for Payer: Quartz Commercial |
$52.17
|
| Rate for Payer: Quartz Medicare Advantage |
$10.73
|
| Rate for Payer: The Alliance Commercial |
$40.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.73
|
| Rate for Payer: WEA Trust Commercial |
$50.34
|
| Rate for Payer: WPS Commercial |
$53.66
|
|
|
X-RAY Hip Unilateral 1 View 73501
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
4605763
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.43 |
| Max. Negotiated Rate |
$167.13 |
| Rate for Payer: Aetna Commercial |
$78.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$70.66
|
| Rate for Payer: Aetna Managed Medicare |
$33.43
|
| Rate for Payer: Anthem Medicare Advantage |
$33.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$33.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$33.43
|
| Rate for Payer: Cash Price |
$23.70
|
| Rate for Payer: Cash Price |
$23.70
|
| Rate for Payer: Cash Price |
$23.70
|
| Rate for Payer: Cigna Commercial |
$78.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$33.43
|
| Rate for Payer: Health EOS Commercial |
$74.77
|
| Rate for Payer: HFN Commercial |
$78.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$113.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$113.11
|
| Rate for Payer: Independent Care Health Plan Medicare |
$33.43
|
| Rate for Payer: Multiplan Commercial |
$65.73
|
| Rate for Payer: NAPHCARE Commercial |
$50.14
|
| Rate for Payer: Preferred Network Access Commercial |
$78.05
|
| Rate for Payer: Quartz Beloit One Network |
$36.15
|
| Rate for Payer: Quartz Commercial |
$46.83
|
| Rate for Payer: Quartz Medicare Advantage |
$33.43
|
| Rate for Payer: The Alliance Commercial |
$127.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33.43
|
| Rate for Payer: WEA Trust Commercial |
$45.19
|
| Rate for Payer: WPS Commercial |
$167.13
|
|
|
X-RAY Hip Unilateral 1 View 7350126
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
CPT 73501 26
|
| Hospital Charge Code |
4605764
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$78.05 |
| Rate for Payer: Aetna Commercial |
$78.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$70.66
|
| 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 |
$23.70
|
| Rate for Payer: Cash Price |
$23.70
|
| Rate for Payer: Cash Price |
$23.70
|
| Rate for Payer: Cigna Commercial |
$78.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.02
|
| Rate for Payer: Health EOS Commercial |
$74.77
|
| Rate for Payer: HFN Commercial |
$78.05
|
| 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 |
$65.73
|
| Rate for Payer: NAPHCARE Commercial |
$13.53
|
| Rate for Payer: Preferred Network Access Commercial |
$78.05
|
| Rate for Payer: Quartz Beloit One Network |
$36.15
|
| Rate for Payer: Quartz Commercial |
$46.83
|
| 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 |
$45.19
|
| Rate for Payer: WPS Commercial |
$45.08
|
|
|
X-RAY Humerus Min 2 Views 73060
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
3209590
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.73 |
| Max. Negotiated Rate |
$158.65 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.92
|
| Rate for Payer: Aetna Managed Medicare |
$31.73
|
| Rate for Payer: Anthem Medicare Advantage |
$31.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$31.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$31.73
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$84.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$44.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31.73
|
| Rate for Payer: Health EOS Commercial |
$81.39
|
| Rate for Payer: HFN Commercial |
$84.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$112.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$112.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$31.73
|
| Rate for Payer: Multiplan Commercial |
$71.55
|
| Rate for Payer: NAPHCARE Commercial |
$47.60
|
| Rate for Payer: Preferred Network Access Commercial |
$84.97
|
| Rate for Payer: Quartz Beloit One Network |
$39.35
|
| Rate for Payer: Quartz Commercial |
$50.98
|
| Rate for Payer: Quartz Medicare Advantage |
$31.73
|
| Rate for Payer: The Alliance Commercial |
$120.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31.73
|
| Rate for Payer: WEA Trust Commercial |
$49.19
|
| Rate for Payer: WPS Commercial |
$158.65
|
|
|
X-RAY Humerus Min 2 Views 7306026
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
CPT 73060 26
|
| Hospital Charge Code |
3209595
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.00 |
| 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 |
$8.00
|
| Rate for Payer: Anthem Medicare Advantage |
$8.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.00
|
| 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 |
$8.00
|
| Rate for Payer: Health EOS Commercial |
$91.80
|
| Rate for Payer: HFN Commercial |
$95.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$29.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.00
|
| Rate for Payer: Multiplan Commercial |
$80.70
|
| Rate for Payer: NAPHCARE Commercial |
$12.00
|
| 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 |
$8.00
|
| Rate for Payer: The Alliance Commercial |
$30.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.00
|
| Rate for Payer: WEA Trust Commercial |
$55.48
|
| Rate for Payer: WPS Commercial |
$39.99
|
|
|
X-RAY Knee, 2 Views 73560
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
3236181
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$28.83 |
| Max. Negotiated Rate |
$170.30 |
| Rate for Payer: Aetna Commercial |
$62.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$56.35
|
| Rate for Payer: Aetna Managed Medicare |
$34.06
|
| Rate for Payer: Anthem Medicare Advantage |
$34.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$34.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$34.06
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cigna Commercial |
$62.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$32.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$34.06
|
| Rate for Payer: Health EOS Commercial |
$59.62
|
| Rate for Payer: HFN Commercial |
$62.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$120.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$120.19
|
| Rate for Payer: Independent Care Health Plan Medicare |
$34.06
|
| Rate for Payer: Multiplan Commercial |
$52.42
|
| Rate for Payer: NAPHCARE Commercial |
$51.09
|
| Rate for Payer: Preferred Network Access Commercial |
$62.24
|
| Rate for Payer: Quartz Beloit One Network |
$28.83
|
| Rate for Payer: Quartz Commercial |
$37.35
|
| Rate for Payer: Quartz Medicare Advantage |
$34.06
|
| Rate for Payer: The Alliance Commercial |
$129.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34.06
|
| Rate for Payer: WEA Trust Commercial |
$36.04
|
| Rate for Payer: WPS Commercial |
$170.30
|
|
|
X-RAY Knee, 2 Views 7356026
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
CPT 73560 26
|
| Hospital Charge Code |
3236182
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.00 |
| 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 |
$8.00
|
| Rate for Payer: Anthem Medicare Advantage |
$8.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.00
|
| 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 |
$8.00
|
| Rate for Payer: Health EOS Commercial |
$96.53
|
| Rate for Payer: HFN Commercial |
$100.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$29.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.00
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: NAPHCARE Commercial |
$12.00
|
| 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 |
$8.00
|
| Rate for Payer: The Alliance Commercial |
$30.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.00
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: WPS Commercial |
$39.99
|
|
|
X-RAY Knee 4 or More 73564
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
3236192
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.11 |
| Max. Negotiated Rate |
$245.54 |
| Rate for Payer: Aetna Commercial |
$109.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$99.28
|
| Rate for Payer: Aetna Managed Medicare |
$49.11
|
| Rate for Payer: Anthem Medicare Advantage |
$49.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$49.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$49.11
|
| 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 |
$49.11
|
| Rate for Payer: Health EOS Commercial |
$105.05
|
| Rate for Payer: HFN Commercial |
$109.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$161.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$161.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$49.11
|
| Rate for Payer: Multiplan Commercial |
$92.35
|
| Rate for Payer: NAPHCARE Commercial |
$73.66
|
| 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 |
$49.11
|
| Rate for Payer: The Alliance Commercial |
$186.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$49.11
|
| Rate for Payer: WEA Trust Commercial |
$63.49
|
| Rate for Payer: WPS Commercial |
$245.54
|
|
