|
zzCV Angiogram Pelvis
|
Facility
|
OP
|
$7,023.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
630356
|
| Min. Negotiated Rate |
$3,371.04 |
| Max. Negotiated Rate |
$21,726.56 |
| Rate for Payer: Aetna Commercial |
$6,320.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,039.78
|
| Rate for Payer: Aetna Managed Medicare |
$5,431.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,564.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,511.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,371.04
|
| Rate for Payer: Anthem Medicare Advantage |
$5,431.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,722.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,431.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,431.64
|
| Rate for Payer: Cash Price |
$2,106.90
|
| Rate for Payer: Cash Price |
$2,106.90
|
| Rate for Payer: Cigna Commercial |
$6,461.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,431.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,930.07
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,431.64
|
| Rate for Payer: Health EOS Commercial |
$6,250.47
|
| Rate for Payer: HFN Commercial |
$6,461.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,205.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,431.64
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,431.64
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,431.64
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,431.64
|
| Rate for Payer: Multiplan Commercial |
$5,618.40
|
| Rate for Payer: NAPHCARE Commercial |
$8,147.46
|
| Rate for Payer: Preferred Network Access Commercial |
$6,461.16
|
| Rate for Payer: Quartz Beloit One Network |
$3,441.27
|
| Rate for Payer: Quartz Commercial |
$4,564.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,431.64
|
| Rate for Payer: The Alliance Commercial |
$21,726.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,431.64
|
| Rate for Payer: WEA Trust Commercial |
$3,862.65
|
| Rate for Payer: Wellcare Medicare |
$5,431.64
|
| Rate for Payer: WPS Commercial |
$5,201.94
|
|
|
zzCV Angiogram Renal Bilateral
|
Facility
|
IP
|
$8,165.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
630375
|
| Min. Negotiated Rate |
$4,000.85 |
| Max. Negotiated Rate |
$7,511.80 |
| Rate for Payer: Aetna Commercial |
$7,348.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,021.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,327.45
|
| Rate for Payer: Cash Price |
$2,449.50
|
| Rate for Payer: Cigna Commercial |
$7,511.80
|
| Rate for Payer: Health EOS Commercial |
$7,266.85
|
| Rate for Payer: HFN Commercial |
$7,511.80
|
| Rate for Payer: Multiplan Commercial |
$6,532.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,899.00
|
| Rate for Payer: Preferred Network Access Commercial |
$7,511.80
|
| Rate for Payer: Quartz Beloit One Network |
$4,000.85
|
| Rate for Payer: Quartz Commercial |
$4,899.00
|
| Rate for Payer: WEA Trust Commercial |
$4,490.75
|
| Rate for Payer: WPS Commercial |
$6,047.82
|
|
|
zzCV Angiogram Renal Bilateral
|
Facility
|
OP
|
$8,165.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
630375
|
| Min. Negotiated Rate |
$3,150.53 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$7,348.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,021.90
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,307.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,082.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,919.20
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,327.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,150.53
|
| Rate for Payer: Cash Price |
$2,449.50
|
| Rate for Payer: Cash Price |
$2,449.50
|
| Rate for Payer: Cigna Commercial |
$7,511.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$7,266.85
|
| Rate for Payer: HFN Commercial |
$7,511.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,719.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,150.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,150.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,150.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,150.53
|
| Rate for Payer: Multiplan Commercial |
$6,532.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$7,511.80
|
| Rate for Payer: Quartz Beloit One Network |
$4,000.85
|
| Rate for Payer: Quartz Commercial |
$5,307.25
|
| Rate for Payer: Quartz Medicare Advantage |
$3,150.53
|
| Rate for Payer: The Alliance Commercial |
$12,602.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,150.53
|
| Rate for Payer: WEA Trust Commercial |
$4,490.75
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$6,047.82
|
|
|
zzCV Angiogram Renal Left
|
Facility
|
OP
|
$7,835.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
630377
|
| Min. Negotiated Rate |
$3,150.53 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$7,051.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,738.10
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,092.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,917.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,760.80
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,152.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,150.53
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cigna Commercial |
$7,208.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$6,973.15
|
| Rate for Payer: HFN Commercial |
$7,208.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,719.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,150.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,150.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,150.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,150.53
|
| Rate for Payer: Multiplan Commercial |
$6,268.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$7,208.20
|
| Rate for Payer: Quartz Beloit One Network |
$3,839.15
|
| Rate for Payer: Quartz Commercial |
$5,092.75
|
| Rate for Payer: Quartz Medicare Advantage |
$3,150.53
|
| Rate for Payer: The Alliance Commercial |
$12,602.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,150.53
|
| Rate for Payer: WEA Trust Commercial |
$4,309.25
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$5,803.38
|
|
|
zzCV Angiogram Renal Left
|
Facility
|
IP
|
$7,835.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
630377
|
| Min. Negotiated Rate |
$3,839.15 |
| Max. Negotiated Rate |
$7,208.20 |
| Rate for Payer: Aetna Commercial |
$7,051.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,738.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,152.55
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cigna Commercial |
$7,208.20
|
| Rate for Payer: Health EOS Commercial |
$6,973.15
|
| Rate for Payer: HFN Commercial |
$7,208.20
|
| Rate for Payer: Multiplan Commercial |
$6,268.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,701.00
|
| Rate for Payer: Preferred Network Access Commercial |
$7,208.20
|
| Rate for Payer: Quartz Beloit One Network |
$3,839.15
|
| Rate for Payer: Quartz Commercial |
$4,701.00
|
| Rate for Payer: WEA Trust Commercial |
$4,309.25
|
| Rate for Payer: WPS Commercial |
$5,803.38
|
|
|
zzCV Angiogram Renal Right
|
Facility
|
OP
|
$7,835.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
630379
|
| Min. Negotiated Rate |
$3,150.53 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$7,051.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,738.10
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,092.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,917.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,760.80
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,152.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,150.53
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cigna Commercial |
$7,208.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$6,973.15
|
| Rate for Payer: HFN Commercial |
$7,208.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,719.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,150.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,150.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,150.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,150.53
|
| Rate for Payer: Multiplan Commercial |
$6,268.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$7,208.20
|
| Rate for Payer: Quartz Beloit One Network |
$3,839.15
|
| Rate for Payer: Quartz Commercial |
$5,092.75
|
| Rate for Payer: Quartz Medicare Advantage |
$3,150.53
|
| Rate for Payer: The Alliance Commercial |
$12,602.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,150.53
|
| Rate for Payer: WEA Trust Commercial |
$4,309.25
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$5,803.38
|
|
|
zzCV Angiogram Renal Right
|
Facility
|
IP
|
$7,835.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
630379
|
| Min. Negotiated Rate |
$3,839.15 |
| Max. Negotiated Rate |
$7,208.20 |
| Rate for Payer: Aetna Commercial |
$7,051.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,738.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,152.55
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cigna Commercial |
$7,208.20
|
| Rate for Payer: Health EOS Commercial |
$6,973.15
|
| Rate for Payer: HFN Commercial |
$7,208.20
|
| Rate for Payer: Multiplan Commercial |
$6,268.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,701.00
|
| Rate for Payer: Preferred Network Access Commercial |
$7,208.20
|
| Rate for Payer: Quartz Beloit One Network |
$3,839.15
|
| Rate for Payer: Quartz Commercial |
$4,701.00
|
| Rate for Payer: WEA Trust Commercial |
$4,309.25
|
| Rate for Payer: WPS Commercial |
$5,803.38
|
|
|
zzCV Angiogram Vertebral
|
Facility
|
OP
|
$7,259.00
|
|
| Hospital Charge Code |
630383
|
| Min. Negotiated Rate |
$2,032.52 |
| Max. Negotiated Rate |
$29,036.00 |
| Rate for Payer: Aetna Commercial |
$6,533.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,242.74
|
| Rate for Payer: Aetna Managed Medicare |
$2,032.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,718.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,629.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,484.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,847.27
|
| Rate for Payer: Cash Price |
$2,177.70
|
| Rate for Payer: Cigna Commercial |
$6,678.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,062.14
|
| Rate for Payer: Health EOS Commercial |
$6,460.51
|
| Rate for Payer: HFN Commercial |
$6,678.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,444.25
|
| Rate for Payer: Multiplan Commercial |
$5,807.20
|
| Rate for Payer: NAPHCARE Commercial |
$4,355.40
|
| Rate for Payer: Preferred Network Access Commercial |
$6,678.28
|
| Rate for Payer: Quartz Beloit One Network |
$3,556.91
|
| Rate for Payer: Quartz Commercial |
$4,718.35
|
| Rate for Payer: Quartz Medicare Advantage |
$4,355.40
|
| Rate for Payer: The Alliance Commercial |
$29,036.00
|
| Rate for Payer: WEA Trust Commercial |
$3,992.45
|
| Rate for Payer: WPS Commercial |
$5,376.74
|
|
|
zzCV Angiogram Vertebral
|
Facility
|
IP
|
$7,259.00
|
|
| Hospital Charge Code |
630383
|
| Min. Negotiated Rate |
$3,556.91 |
| Max. Negotiated Rate |
$6,678.28 |
| Rate for Payer: Aetna Commercial |
$6,533.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,242.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,847.27
|
| Rate for Payer: Cash Price |
$2,177.70
|
| Rate for Payer: Cigna Commercial |
$6,678.28
|
| Rate for Payer: Health EOS Commercial |
$6,460.51
|
| Rate for Payer: HFN Commercial |
$6,678.28
|
| Rate for Payer: Multiplan Commercial |
$5,807.20
|
| Rate for Payer: NAPHCARE Commercial |
$4,355.40
|
| Rate for Payer: Preferred Network Access Commercial |
$6,678.28
|
| Rate for Payer: Quartz Beloit One Network |
$3,556.91
|
| Rate for Payer: Quartz Commercial |
$4,355.40
|
| Rate for Payer: WEA Trust Commercial |
$3,992.45
|
| Rate for Payer: WPS Commercial |
$5,376.74
|
|
|
zzCV Angio Through Existing Catheter
|
Facility
|
OP
|
$6,906.00
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
630283
|
| Min. Negotiated Rate |
$3,150.53 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$6,215.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,939.16
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,488.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,453.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,314.88
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,660.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,150.53
|
| Rate for Payer: Cash Price |
$2,071.80
|
| Rate for Payer: Cash Price |
$2,071.80
|
| Rate for Payer: Cigna Commercial |
$6,353.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,864.60
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$6,146.34
|
| Rate for Payer: HFN Commercial |
$6,353.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,719.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,150.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,150.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,150.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,150.53
|
| Rate for Payer: Multiplan Commercial |
$5,524.80
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$6,353.52
|
| Rate for Payer: Quartz Beloit One Network |
$3,383.94
|
| Rate for Payer: Quartz Commercial |
$4,488.90
|
| Rate for Payer: Quartz Medicare Advantage |
$3,150.53
|
| Rate for Payer: The Alliance Commercial |
$12,602.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,150.53
|
| Rate for Payer: WEA Trust Commercial |
$3,798.30
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$5,115.27
|
|
|
zzCV Angio Through Existing Catheter
|
Facility
|
IP
|
$6,906.00
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
630283
|
| Min. Negotiated Rate |
$3,383.94 |
| Max. Negotiated Rate |
$6,353.52 |
| Rate for Payer: Aetna Commercial |
$6,215.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,939.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,660.18
|
| Rate for Payer: Cash Price |
$2,071.80
|
| Rate for Payer: Cigna Commercial |
$6,353.52
|
| Rate for Payer: Health EOS Commercial |
$6,146.34
|
| Rate for Payer: HFN Commercial |
$6,353.52
|
| Rate for Payer: Multiplan Commercial |
$5,524.80
|
| Rate for Payer: NAPHCARE Commercial |
$4,143.60
|
| Rate for Payer: Preferred Network Access Commercial |
$6,353.52
|
| Rate for Payer: Quartz Beloit One Network |
$3,383.94
|
| Rate for Payer: Quartz Commercial |
$4,143.60
|
| Rate for Payer: WEA Trust Commercial |
$3,798.30
|
| Rate for Payer: WPS Commercial |
$5,115.27
|
|
|
zzCV Aortogram Abdominal + Iliofemoral
|
Facility
|
IP
|
$7,912.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
625620
|
| Min. Negotiated Rate |
$3,876.88 |
| Max. Negotiated Rate |
$7,279.04 |
| Rate for Payer: Aetna Commercial |
$7,120.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,804.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,193.36
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cigna Commercial |
$7,279.04
|
| Rate for Payer: Health EOS Commercial |
$7,041.68
|
| Rate for Payer: HFN Commercial |
$7,279.04
|
| Rate for Payer: Multiplan Commercial |
$6,329.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,747.20
|
| Rate for Payer: Preferred Network Access Commercial |
$7,279.04
|
| Rate for Payer: Quartz Beloit One Network |
$3,876.88
|
| Rate for Payer: Quartz Commercial |
$4,747.20
|
| Rate for Payer: WEA Trust Commercial |
$4,351.60
|
| Rate for Payer: WPS Commercial |
$5,860.42
|
|
|
zzCV Aortogram Abdominal + Iliofemoral
|
Facility
|
OP
|
$7,912.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
625620
|
| Min. Negotiated Rate |
$3,150.53 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$7,120.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,804.32
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,142.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,956.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,797.76
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,193.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,150.53
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cigna Commercial |
$7,279.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,427.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$7,041.68
|
| Rate for Payer: HFN Commercial |
$7,279.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,719.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,150.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,150.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,150.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,150.53
|
| Rate for Payer: Multiplan Commercial |
$6,329.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$7,279.04
|
| Rate for Payer: Quartz Beloit One Network |
$3,876.88
|
| Rate for Payer: Quartz Commercial |
$5,142.80
|
| Rate for Payer: Quartz Medicare Advantage |
$3,150.53
|
| Rate for Payer: The Alliance Commercial |
$12,602.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,150.53
|
| Rate for Payer: WEA Trust Commercial |
$4,351.60
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$5,860.42
|
|
|
zzCV Aortogram Abdominal w/ Serialography
|
Facility
|
IP
|
$5,654.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
625632
|
| Min. Negotiated Rate |
$2,770.46 |
| Max. Negotiated Rate |
$5,201.68 |
| Rate for Payer: Aetna Commercial |
$5,088.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,862.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,996.62
|
| Rate for Payer: Cash Price |
$1,696.20
|
| Rate for Payer: Cigna Commercial |
$5,201.68
|
| Rate for Payer: Health EOS Commercial |
$5,032.06
|
| Rate for Payer: HFN Commercial |
$5,201.68
|
| Rate for Payer: Multiplan Commercial |
$4,523.20
|
| Rate for Payer: NAPHCARE Commercial |
$3,392.40
|
| Rate for Payer: Preferred Network Access Commercial |
$5,201.68
|
| Rate for Payer: Quartz Beloit One Network |
$2,770.46
|
| Rate for Payer: Quartz Commercial |
$3,392.40
|
| Rate for Payer: WEA Trust Commercial |
$3,109.70
|
| Rate for Payer: WPS Commercial |
$4,187.92
|
|
|
zzCV Aortogram Abdominal w/ Serialography
|
Facility
|
OP
|
$5,654.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
625632
|
| Min. Negotiated Rate |
$2,713.92 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$5,088.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,862.44
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,675.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,827.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,713.92
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,996.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,150.53
|
| Rate for Payer: Cash Price |
$1,696.20
|
| Rate for Payer: Cash Price |
$1,696.20
|
| Rate for Payer: Cigna Commercial |
$5,201.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,163.98
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$5,032.06
|
| Rate for Payer: HFN Commercial |
$5,201.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,719.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,150.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,150.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,150.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,150.53
|
| Rate for Payer: Multiplan Commercial |
$4,523.20
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$5,201.68
|
| Rate for Payer: Quartz Beloit One Network |
$2,770.46
|
| Rate for Payer: Quartz Commercial |
$3,675.10
|
| Rate for Payer: Quartz Medicare Advantage |
$3,150.53
|
| Rate for Payer: The Alliance Commercial |
$12,602.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,150.53
|
| Rate for Payer: WEA Trust Commercial |
$3,109.70
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$4,187.92
|
|
|
zzCV Arch Aortography
|
Facility
|
IP
|
$8,700.00
|
|
| Hospital Charge Code |
1480848
|
| Min. Negotiated Rate |
$4,263.00 |
| Max. Negotiated Rate |
$8,004.00 |
| Rate for Payer: Aetna Commercial |
$7,830.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,482.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,611.00
|
| Rate for Payer: Cash Price |
$2,610.00
|
| Rate for Payer: Cigna Commercial |
$8,004.00
|
| Rate for Payer: Health EOS Commercial |
$7,743.00
|
| Rate for Payer: HFN Commercial |
$8,004.00
|
| Rate for Payer: Multiplan Commercial |
$6,960.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,220.00
|
| Rate for Payer: Preferred Network Access Commercial |
$8,004.00
|
| Rate for Payer: Quartz Beloit One Network |
$4,263.00
|
| Rate for Payer: Quartz Commercial |
$5,220.00
|
| Rate for Payer: WEA Trust Commercial |
$4,785.00
|
| Rate for Payer: WPS Commercial |
$6,444.09
|
|
|
zzCV Arch Aortography
|
Facility
|
OP
|
$8,700.00
|
|
| Hospital Charge Code |
1480848
|
| Min. Negotiated Rate |
$2,436.00 |
| Max. Negotiated Rate |
$34,800.00 |
| Rate for Payer: Aetna Commercial |
$7,830.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,482.00
|
| Rate for Payer: Aetna Managed Medicare |
$2,436.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,655.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,350.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,176.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,611.00
|
| Rate for Payer: Cash Price |
$2,610.00
|
| Rate for Payer: Cigna Commercial |
$8,004.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,868.52
|
| Rate for Payer: Health EOS Commercial |
$7,743.00
|
| Rate for Payer: HFN Commercial |
$8,004.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,525.00
|
| Rate for Payer: Multiplan Commercial |
$6,960.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,220.00
|
| Rate for Payer: Preferred Network Access Commercial |
$8,004.00
|
| Rate for Payer: Quartz Beloit One Network |
$4,263.00
|
| Rate for Payer: Quartz Commercial |
$5,655.00
|
| Rate for Payer: Quartz Medicare Advantage |
$5,220.00
|
| Rate for Payer: The Alliance Commercial |
$34,800.00
|
| Rate for Payer: WEA Trust Commercial |
$4,785.00
|
| Rate for Payer: WPS Commercial |
$6,444.09
|
|
|
zzCV Implant Loop Recorder
|
Facility
|
IP
|
$8,521.00
|
|
|
Service Code
|
CPT 33282
|
| Hospital Charge Code |
1478830
|
| Min. Negotiated Rate |
$4,175.29 |
| Max. Negotiated Rate |
$7,839.32 |
| Rate for Payer: Aetna Commercial |
$7,668.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,328.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,516.13
|
| Rate for Payer: Cash Price |
$2,556.30
|
| Rate for Payer: Cigna Commercial |
$7,839.32
|
| Rate for Payer: Health EOS Commercial |
$7,583.69
|
| Rate for Payer: HFN Commercial |
$7,839.32
|
| Rate for Payer: Multiplan Commercial |
$6,816.80
|
| Rate for Payer: NAPHCARE Commercial |
$5,112.60
|
| Rate for Payer: Preferred Network Access Commercial |
$7,839.32
|
| Rate for Payer: Quartz Beloit One Network |
$4,175.29
|
| Rate for Payer: Quartz Commercial |
$5,112.60
|
| Rate for Payer: WEA Trust Commercial |
$4,686.55
|
| Rate for Payer: WPS Commercial |
$6,311.50
|
|
|
zzCV Implant Loop Recorder
|
Facility
|
OP
|
$8,521.00
|
|
|
Service Code
|
CPT 33282
|
| Hospital Charge Code |
1478830
|
| Min. Negotiated Rate |
$2,385.88 |
| Max. Negotiated Rate |
$34,084.00 |
| Rate for Payer: Aetna Commercial |
$7,668.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,328.06
|
| Rate for Payer: Aetna Managed Medicare |
$2,385.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,538.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,260.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,090.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,516.13
|
| Rate for Payer: Cash Price |
$2,556.30
|
| Rate for Payer: Cash Price |
$2,556.30
|
| Rate for Payer: Cigna Commercial |
$7,839.32
|
| Rate for Payer: Health EOS Commercial |
$7,583.69
|
| Rate for Payer: HFN Commercial |
$7,839.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,390.75
|
| Rate for Payer: Multiplan Commercial |
$6,816.80
|
| Rate for Payer: NAPHCARE Commercial |
$5,112.60
|
| Rate for Payer: Preferred Network Access Commercial |
$7,839.32
|
| Rate for Payer: Quartz Beloit One Network |
$4,175.29
|
| Rate for Payer: Quartz Commercial |
$5,538.65
|
| Rate for Payer: Quartz Medicare Advantage |
$5,112.60
|
| Rate for Payer: The Alliance Commercial |
$34,084.00
|
| Rate for Payer: WEA Trust Commercial |
$4,686.55
|
| Rate for Payer: WPS Commercial |
$6,311.50
|
|
|
zzCV Insertion Venous Catheter w port
|
Facility
|
OP
|
$928.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
1480800
|
| Min. Negotiated Rate |
$445.44 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$835.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$798.08
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$603.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$464.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$445.44
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$491.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,150.53
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cigna Commercial |
$853.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,546.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$825.92
|
| Rate for Payer: HFN Commercial |
$853.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,719.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,150.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,150.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,150.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,150.53
|
| Rate for Payer: Multiplan Commercial |
$742.40
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$853.76
|
| Rate for Payer: Quartz Beloit One Network |
$454.72
|
| Rate for Payer: Quartz Commercial |
$603.20
|
| Rate for Payer: Quartz Medicare Advantage |
$3,150.53
|
| Rate for Payer: The Alliance Commercial |
$12,602.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,150.53
|
| Rate for Payer: WEA Trust Commercial |
$510.40
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$687.37
|
|
|
zzCV Insertion Venous Catheter w port
|
Facility
|
IP
|
$928.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
1480800
|
| Min. Negotiated Rate |
$454.72 |
| Max. Negotiated Rate |
$853.76 |
| Rate for Payer: Aetna Commercial |
$835.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$798.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$491.84
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cigna Commercial |
$853.76
|
| Rate for Payer: Health EOS Commercial |
$825.92
|
| Rate for Payer: HFN Commercial |
$853.76
|
| Rate for Payer: Multiplan Commercial |
$742.40
|
| Rate for Payer: NAPHCARE Commercial |
$556.80
|
| Rate for Payer: Preferred Network Access Commercial |
$853.76
|
| Rate for Payer: Quartz Beloit One Network |
$454.72
|
| Rate for Payer: Quartz Commercial |
$556.80
|
| Rate for Payer: WEA Trust Commercial |
$510.40
|
| Rate for Payer: WPS Commercial |
$687.37
|
|
|
zzCV Insert of IABP
|
Facility
|
OP
|
$9,597.00
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
1478832
|
| Min. Negotiated Rate |
$2,687.16 |
| Max. Negotiated Rate |
$38,388.00 |
| Rate for Payer: Aetna Commercial |
$8,637.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,253.42
|
| Rate for Payer: Aetna Managed Medicare |
$2,687.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,238.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,798.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,606.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,086.41
|
| Rate for Payer: Cash Price |
$2,879.10
|
| Rate for Payer: Cash Price |
$2,879.10
|
| Rate for Payer: Cigna Commercial |
$8,829.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Health EOS Commercial |
$8,541.33
|
| Rate for Payer: HFN Commercial |
$8,829.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,197.75
|
| Rate for Payer: Multiplan Commercial |
$7,677.60
|
| Rate for Payer: NAPHCARE Commercial |
$5,758.20
|
| Rate for Payer: Preferred Network Access Commercial |
$8,829.24
|
| Rate for Payer: Quartz Beloit One Network |
$4,702.53
|
| Rate for Payer: Quartz Commercial |
$6,238.05
|
| Rate for Payer: Quartz Medicare Advantage |
$5,758.20
|
| Rate for Payer: The Alliance Commercial |
$38,388.00
|
| Rate for Payer: WEA Trust Commercial |
$5,278.35
|
| Rate for Payer: WPS Commercial |
$7,108.50
|
|
|
zzCV Insert of IABP
|
Facility
|
IP
|
$9,597.00
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
1478832
|
| Min. Negotiated Rate |
$4,702.53 |
| Max. Negotiated Rate |
$8,829.24 |
| Rate for Payer: Aetna Commercial |
$8,637.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,253.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,086.41
|
| Rate for Payer: Cash Price |
$2,879.10
|
| Rate for Payer: Cigna Commercial |
$8,829.24
|
| Rate for Payer: Health EOS Commercial |
$8,541.33
|
| Rate for Payer: HFN Commercial |
$8,829.24
|
| Rate for Payer: Multiplan Commercial |
$7,677.60
|
| Rate for Payer: NAPHCARE Commercial |
$5,758.20
|
| Rate for Payer: Preferred Network Access Commercial |
$8,829.24
|
| Rate for Payer: Quartz Beloit One Network |
$4,702.53
|
| Rate for Payer: Quartz Commercial |
$5,758.20
|
| Rate for Payer: WEA Trust Commercial |
$5,278.35
|
| Rate for Payer: WPS Commercial |
$7,108.50
|
|
|
zzCV Insert Vena Cava Filter inc Filming
|
Facility
|
OP
|
$17,585.00
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
1480808
|
| Min. Negotiated Rate |
$5,431.64 |
| Max. Negotiated Rate |
$21,726.56 |
| Rate for Payer: Aetna Commercial |
$15,826.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$15,123.10
|
| Rate for Payer: Aetna Managed Medicare |
$5,431.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$11,430.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,792.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8,440.80
|
| Rate for Payer: Anthem Medicare Advantage |
$5,431.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,320.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,431.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,431.64
|
| Rate for Payer: Cash Price |
$5,275.50
|
| Rate for Payer: Cash Price |
$5,275.50
|
| Rate for Payer: Cigna Commercial |
$16,178.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,431.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,431.64
|
| Rate for Payer: Health EOS Commercial |
$15,650.65
|
| Rate for Payer: HFN Commercial |
$16,178.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,205.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,431.64
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,431.64
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,431.64
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,431.64
|
| Rate for Payer: Multiplan Commercial |
$14,068.00
|
| Rate for Payer: NAPHCARE Commercial |
$8,147.46
|
| Rate for Payer: Preferred Network Access Commercial |
$16,178.20
|
| Rate for Payer: Quartz Beloit One Network |
$8,616.65
|
| Rate for Payer: Quartz Commercial |
$11,430.25
|
| Rate for Payer: Quartz Medicare Advantage |
$5,431.64
|
| Rate for Payer: The Alliance Commercial |
$21,726.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,431.64
|
| Rate for Payer: WEA Trust Commercial |
$9,671.75
|
| Rate for Payer: Wellcare Medicare |
$5,431.64
|
| Rate for Payer: WPS Commercial |
$13,025.21
|
|
|
zzCV Insert Vena Cava Filter inc Filming
|
Facility
|
IP
|
$17,585.00
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
1480808
|
| Min. Negotiated Rate |
$8,616.65 |
| Max. Negotiated Rate |
$16,178.20 |
| Rate for Payer: Aetna Commercial |
$15,826.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$15,123.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,320.05
|
| Rate for Payer: Cash Price |
$5,275.50
|
| Rate for Payer: Cigna Commercial |
$16,178.20
|
| Rate for Payer: Health EOS Commercial |
$15,650.65
|
| Rate for Payer: HFN Commercial |
$16,178.20
|
| Rate for Payer: Multiplan Commercial |
$14,068.00
|
| Rate for Payer: NAPHCARE Commercial |
$10,551.00
|
| Rate for Payer: Preferred Network Access Commercial |
$16,178.20
|
| Rate for Payer: Quartz Beloit One Network |
$8,616.65
|
| Rate for Payer: Quartz Commercial |
$10,551.00
|
| Rate for Payer: WEA Trust Commercial |
$9,671.75
|
| Rate for Payer: WPS Commercial |
$13,025.21
|
|
