|
zzCV Removal Loop Recorder
|
Facility
|
OP
|
$2,771.00
|
|
|
Service Code
|
CPT 33284
|
| Hospital Charge Code |
1478831
|
| Min. Negotiated Rate |
$775.88 |
| Max. Negotiated Rate |
$11,084.00 |
| Rate for Payer: Aetna Commercial |
$2,493.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,383.06
|
| Rate for Payer: Aetna Managed Medicare |
$775.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,801.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,385.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,330.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,468.63
|
| Rate for Payer: Cash Price |
$831.30
|
| Rate for Payer: Cash Price |
$831.30
|
| Rate for Payer: Cigna Commercial |
$2,549.32
|
| Rate for Payer: Health EOS Commercial |
$2,466.19
|
| Rate for Payer: HFN Commercial |
$2,549.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,078.25
|
| Rate for Payer: Multiplan Commercial |
$2,216.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,662.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,549.32
|
| Rate for Payer: Quartz Beloit One Network |
$1,357.79
|
| Rate for Payer: Quartz Commercial |
$1,801.15
|
| Rate for Payer: Quartz Medicare Advantage |
$1,662.60
|
| Rate for Payer: The Alliance Commercial |
$11,084.00
|
| Rate for Payer: WEA Trust Commercial |
$1,524.05
|
| Rate for Payer: WPS Commercial |
$2,052.48
|
|
|
zzCV Removal Loop Recorder
|
Facility
|
IP
|
$2,771.00
|
|
|
Service Code
|
CPT 33284
|
| Hospital Charge Code |
1478831
|
| Min. Negotiated Rate |
$1,357.79 |
| Max. Negotiated Rate |
$2,549.32 |
| Rate for Payer: Aetna Commercial |
$2,493.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,383.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,468.63
|
| Rate for Payer: Cash Price |
$831.30
|
| Rate for Payer: Cigna Commercial |
$2,549.32
|
| Rate for Payer: Health EOS Commercial |
$2,466.19
|
| Rate for Payer: HFN Commercial |
$2,549.32
|
| Rate for Payer: Multiplan Commercial |
$2,216.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,662.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,549.32
|
| Rate for Payer: Quartz Beloit One Network |
$1,357.79
|
| Rate for Payer: Quartz Commercial |
$1,662.60
|
| Rate for Payer: WEA Trust Commercial |
$1,524.05
|
| Rate for Payer: WPS Commercial |
$2,052.48
|
|
|
zzCV Removal of IABP
|
Facility
|
OP
|
$837.00
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
1478833
|
| Min. Negotiated Rate |
$234.36 |
| Max. Negotiated Rate |
$11,874.87 |
| Rate for Payer: Aetna Commercial |
$753.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$719.82
|
| Rate for Payer: Aetna Managed Medicare |
$234.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$544.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$418.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$401.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$443.61
|
| Rate for Payer: Cash Price |
$251.10
|
| Rate for Payer: Cash Price |
$251.10
|
| Rate for Payer: Cigna Commercial |
$770.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Health EOS Commercial |
$744.93
|
| Rate for Payer: HFN Commercial |
$770.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$627.75
|
| Rate for Payer: Multiplan Commercial |
$669.60
|
| Rate for Payer: NAPHCARE Commercial |
$502.20
|
| Rate for Payer: Preferred Network Access Commercial |
$770.04
|
| Rate for Payer: Quartz Beloit One Network |
$410.13
|
| Rate for Payer: Quartz Commercial |
$544.05
|
| Rate for Payer: Quartz Medicare Advantage |
$502.20
|
| Rate for Payer: The Alliance Commercial |
$3,348.00
|
| Rate for Payer: WEA Trust Commercial |
$460.35
|
| Rate for Payer: WPS Commercial |
$619.97
|
|
|
zzCV Removal of IABP
|
Facility
|
IP
|
$837.00
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
1478833
|
| Min. Negotiated Rate |
$410.13 |
| Max. Negotiated Rate |
$770.04 |
| Rate for Payer: Aetna Commercial |
$753.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$719.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$443.61
|
| Rate for Payer: Cash Price |
$251.10
|
| Rate for Payer: Cigna Commercial |
$770.04
|
| Rate for Payer: Health EOS Commercial |
$744.93
|
| Rate for Payer: HFN Commercial |
$770.04
|
| Rate for Payer: Multiplan Commercial |
$669.60
|
| Rate for Payer: NAPHCARE Commercial |
$502.20
|
| Rate for Payer: Preferred Network Access Commercial |
$770.04
|
| Rate for Payer: Quartz Beloit One Network |
$410.13
|
| Rate for Payer: Quartz Commercial |
$502.20
|
| Rate for Payer: WEA Trust Commercial |
$460.35
|
| Rate for Payer: WPS Commercial |
$619.97
|
|
|
zzCV Renal Catheter Perc Placement Left
|
Facility
|
IP
|
$7,485.00
|
|
|
Service Code
|
CPT 74475
|
| Hospital Charge Code |
630567
|
| Min. Negotiated Rate |
$3,667.65 |
| Max. Negotiated Rate |
$6,886.20 |
| Rate for Payer: Aetna Commercial |
$6,736.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,437.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,967.05
|
| Rate for Payer: Cash Price |
$2,245.50
|
| Rate for Payer: Cigna Commercial |
$6,886.20
|
| Rate for Payer: Health EOS Commercial |
$6,661.65
|
| Rate for Payer: HFN Commercial |
$6,886.20
|
| Rate for Payer: Multiplan Commercial |
$5,988.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,491.00
|
| Rate for Payer: Preferred Network Access Commercial |
$6,886.20
|
| Rate for Payer: Quartz Beloit One Network |
$3,667.65
|
| Rate for Payer: Quartz Commercial |
$4,491.00
|
| Rate for Payer: WEA Trust Commercial |
$4,116.75
|
| Rate for Payer: WPS Commercial |
$5,544.14
|
|
|
zzCV Renal Catheter Perc Placement Left
|
Facility
|
OP
|
$7,485.00
|
|
|
Service Code
|
CPT 74475
|
| Hospital Charge Code |
630567
|
| Min. Negotiated Rate |
$2,095.80 |
| Max. Negotiated Rate |
$29,940.00 |
| Rate for Payer: Aetna Commercial |
$6,736.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,437.10
|
| Rate for Payer: Aetna Managed Medicare |
$2,095.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,865.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,742.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,592.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,967.05
|
| Rate for Payer: Cash Price |
$2,245.50
|
| Rate for Payer: Cigna Commercial |
$6,886.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,188.61
|
| Rate for Payer: Health EOS Commercial |
$6,661.65
|
| Rate for Payer: HFN Commercial |
$6,886.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,613.75
|
| Rate for Payer: Multiplan Commercial |
$5,988.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,491.00
|
| Rate for Payer: Preferred Network Access Commercial |
$6,886.20
|
| Rate for Payer: Quartz Beloit One Network |
$3,667.65
|
| Rate for Payer: Quartz Commercial |
$4,865.25
|
| Rate for Payer: Quartz Medicare Advantage |
$4,491.00
|
| Rate for Payer: The Alliance Commercial |
$29,940.00
|
| Rate for Payer: WEA Trust Commercial |
$4,116.75
|
| Rate for Payer: WPS Commercial |
$5,544.14
|
|
|
zzCV Renal Catheter Perc Placement Right
|
Facility
|
IP
|
$7,485.00
|
|
|
Service Code
|
CPT 74475
|
| Hospital Charge Code |
630571
|
| Min. Negotiated Rate |
$3,667.65 |
| Max. Negotiated Rate |
$6,886.20 |
| Rate for Payer: Aetna Commercial |
$6,736.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,437.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,967.05
|
| Rate for Payer: Cash Price |
$2,245.50
|
| Rate for Payer: Cigna Commercial |
$6,886.20
|
| Rate for Payer: Health EOS Commercial |
$6,661.65
|
| Rate for Payer: HFN Commercial |
$6,886.20
|
| Rate for Payer: Multiplan Commercial |
$5,988.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,491.00
|
| Rate for Payer: Preferred Network Access Commercial |
$6,886.20
|
| Rate for Payer: Quartz Beloit One Network |
$3,667.65
|
| Rate for Payer: Quartz Commercial |
$4,491.00
|
| Rate for Payer: WEA Trust Commercial |
$4,116.75
|
| Rate for Payer: WPS Commercial |
$5,544.14
|
|
|
zzCV Renal Catheter Perc Placement Right
|
Facility
|
OP
|
$7,485.00
|
|
|
Service Code
|
CPT 74475
|
| Hospital Charge Code |
630571
|
| Min. Negotiated Rate |
$2,095.80 |
| Max. Negotiated Rate |
$29,940.00 |
| Rate for Payer: Aetna Commercial |
$6,736.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,437.10
|
| Rate for Payer: Aetna Managed Medicare |
$2,095.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,865.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,742.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,592.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,967.05
|
| Rate for Payer: Cash Price |
$2,245.50
|
| Rate for Payer: Cigna Commercial |
$6,886.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,188.61
|
| Rate for Payer: Health EOS Commercial |
$6,661.65
|
| Rate for Payer: HFN Commercial |
$6,886.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,613.75
|
| Rate for Payer: Multiplan Commercial |
$5,988.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,491.00
|
| Rate for Payer: Preferred Network Access Commercial |
$6,886.20
|
| Rate for Payer: Quartz Beloit One Network |
$3,667.65
|
| Rate for Payer: Quartz Commercial |
$4,865.25
|
| Rate for Payer: Quartz Medicare Advantage |
$4,491.00
|
| Rate for Payer: The Alliance Commercial |
$29,940.00
|
| Rate for Payer: WEA Trust Commercial |
$4,116.75
|
| Rate for Payer: WPS Commercial |
$5,544.14
|
|
|
zzCV Reposition of Pace/ICD Lead
|
Facility
|
IP
|
$6,251.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
1478807
|
| Min. Negotiated Rate |
$3,062.99 |
| Max. Negotiated Rate |
$5,750.92 |
| Rate for Payer: Aetna Commercial |
$5,625.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,375.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,313.03
|
| Rate for Payer: Cash Price |
$1,875.30
|
| Rate for Payer: Cigna Commercial |
$5,750.92
|
| Rate for Payer: Health EOS Commercial |
$5,563.39
|
| Rate for Payer: HFN Commercial |
$5,750.92
|
| Rate for Payer: Multiplan Commercial |
$5,000.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,750.60
|
| Rate for Payer: Preferred Network Access Commercial |
$5,750.92
|
| Rate for Payer: Quartz Beloit One Network |
$3,062.99
|
| Rate for Payer: Quartz Commercial |
$3,750.60
|
| Rate for Payer: WEA Trust Commercial |
$3,438.05
|
| Rate for Payer: WPS Commercial |
$4,630.12
|
|
|
zzCV Reposition of Pace/ICD Lead
|
Facility
|
OP
|
$6,251.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
1478807
|
| Min. Negotiated Rate |
$3,000.48 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$5,625.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,375.86
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,063.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,125.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,000.48
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,313.03
|
| 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 |
$1,875.30
|
| Rate for Payer: Cash Price |
$1,875.30
|
| Rate for Payer: Cigna Commercial |
$5,750.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$5,563.39
|
| Rate for Payer: HFN Commercial |
$5,750.92
|
| 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 |
$5,000.80
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$5,750.92
|
| Rate for Payer: Quartz Beloit One Network |
$3,062.99
|
| Rate for Payer: Quartz Commercial |
$4,063.15
|
| 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 |
$3,438.05
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$4,630.12
|
|
|
zzCV Revision Pacemaker Pocket
|
Facility
|
IP
|
$5,959.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
1478812
|
| Min. Negotiated Rate |
$2,919.91 |
| Max. Negotiated Rate |
$5,482.28 |
| Rate for Payer: Aetna Commercial |
$5,363.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,124.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,158.27
|
| Rate for Payer: Cash Price |
$1,787.70
|
| Rate for Payer: Cigna Commercial |
$5,482.28
|
| Rate for Payer: Health EOS Commercial |
$5,303.51
|
| Rate for Payer: HFN Commercial |
$5,482.28
|
| Rate for Payer: Multiplan Commercial |
$4,767.20
|
| Rate for Payer: NAPHCARE Commercial |
$3,575.40
|
| Rate for Payer: Preferred Network Access Commercial |
$5,482.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,919.91
|
| Rate for Payer: Quartz Commercial |
$3,575.40
|
| Rate for Payer: WEA Trust Commercial |
$3,277.45
|
| Rate for Payer: WPS Commercial |
$4,413.83
|
|
|
zzCV Revision Pacemaker Pocket
|
Facility
|
OP
|
$5,959.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
1478812
|
| Min. Negotiated Rate |
$1,802.48 |
| Max. Negotiated Rate |
$7,209.92 |
| Rate for Payer: Aetna Commercial |
$5,363.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,124.74
|
| Rate for Payer: Aetna Managed Medicare |
$1,802.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,873.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,979.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,860.32
|
| Rate for Payer: Anthem Medicare Advantage |
$1,802.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,158.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,802.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,802.48
|
| Rate for Payer: Cash Price |
$1,787.70
|
| Rate for Payer: Cash Price |
$1,787.70
|
| Rate for Payer: Cigna Commercial |
$5,482.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,802.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,802.48
|
| Rate for Payer: Health EOS Commercial |
$5,303.51
|
| Rate for Payer: HFN Commercial |
$5,482.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,705.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,802.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,802.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,802.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,802.48
|
| Rate for Payer: Multiplan Commercial |
$4,767.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,703.72
|
| Rate for Payer: Preferred Network Access Commercial |
$5,482.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,919.91
|
| Rate for Payer: Quartz Commercial |
$3,873.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,802.48
|
| Rate for Payer: The Alliance Commercial |
$7,209.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,802.48
|
| Rate for Payer: WEA Trust Commercial |
$3,277.45
|
| Rate for Payer: Wellcare Medicare |
$1,802.48
|
| Rate for Payer: WPS Commercial |
$4,413.83
|
|
|
zzCV Temporary Pacemaker
|
Facility
|
OP
|
$4,446.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
1478802
|
| Min. Negotiated Rate |
$2,134.08 |
| Max. Negotiated Rate |
$33,588.76 |
| Rate for Payer: Aetna Commercial |
$4,001.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,823.56
|
| Rate for Payer: Aetna Managed Medicare |
$8,397.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,889.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,223.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,134.08
|
| Rate for Payer: Anthem Medicare Advantage |
$8,397.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,356.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,397.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,397.19
|
| Rate for Payer: Cash Price |
$1,333.80
|
| Rate for Payer: Cash Price |
$1,333.80
|
| Rate for Payer: Cigna Commercial |
$4,090.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,397.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,397.19
|
| Rate for Payer: Health EOS Commercial |
$3,956.94
|
| Rate for Payer: HFN Commercial |
$4,090.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31,237.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,397.19
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,397.19
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,397.19
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,397.19
|
| Rate for Payer: Multiplan Commercial |
$3,556.80
|
| Rate for Payer: NAPHCARE Commercial |
$12,595.78
|
| Rate for Payer: Preferred Network Access Commercial |
$4,090.32
|
| Rate for Payer: Quartz Beloit One Network |
$2,178.54
|
| Rate for Payer: Quartz Commercial |
$2,889.90
|
| Rate for Payer: Quartz Medicare Advantage |
$8,397.19
|
| Rate for Payer: The Alliance Commercial |
$33,588.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,397.19
|
| Rate for Payer: WEA Trust Commercial |
$2,445.30
|
| Rate for Payer: Wellcare Medicare |
$8,397.19
|
| Rate for Payer: WPS Commercial |
$3,293.15
|
|
|
zzCV Temporary Pacemaker
|
Facility
|
IP
|
$4,446.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
1478802
|
| Min. Negotiated Rate |
$2,178.54 |
| Max. Negotiated Rate |
$4,090.32 |
| Rate for Payer: Aetna Commercial |
$4,001.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,823.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,356.38
|
| Rate for Payer: Cash Price |
$1,333.80
|
| Rate for Payer: Cigna Commercial |
$4,090.32
|
| Rate for Payer: Health EOS Commercial |
$3,956.94
|
| Rate for Payer: HFN Commercial |
$4,090.32
|
| Rate for Payer: Multiplan Commercial |
$3,556.80
|
| Rate for Payer: NAPHCARE Commercial |
$2,667.60
|
| Rate for Payer: Preferred Network Access Commercial |
$4,090.32
|
| Rate for Payer: Quartz Beloit One Network |
$2,178.54
|
| Rate for Payer: Quartz Commercial |
$2,667.60
|
| Rate for Payer: WEA Trust Commercial |
$2,445.30
|
| Rate for Payer: WPS Commercial |
$3,293.15
|
|
|
zzCV Venogram Cava Inferior
|
Facility
|
IP
|
$7,465.00
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
629672
|
| Min. Negotiated Rate |
$3,657.85 |
| Max. Negotiated Rate |
$6,867.80 |
| Rate for Payer: Aetna Commercial |
$6,718.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,419.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,956.45
|
| Rate for Payer: Cash Price |
$2,239.50
|
| Rate for Payer: Cigna Commercial |
$6,867.80
|
| Rate for Payer: Health EOS Commercial |
$6,643.85
|
| Rate for Payer: HFN Commercial |
$6,867.80
|
| Rate for Payer: Multiplan Commercial |
$5,972.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,479.00
|
| Rate for Payer: Preferred Network Access Commercial |
$6,867.80
|
| Rate for Payer: Quartz Beloit One Network |
$3,657.85
|
| Rate for Payer: Quartz Commercial |
$4,479.00
|
| Rate for Payer: WEA Trust Commercial |
$4,105.75
|
| Rate for Payer: WPS Commercial |
$5,529.33
|
|
|
zzCV Venogram Cava Inferior
|
Facility
|
OP
|
$7,465.00
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
629672
|
| Min. Negotiated Rate |
$3,150.53 |
| Max. Negotiated Rate |
$12,602.12 |
| Rate for Payer: Aetna Commercial |
$6,718.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,419.90
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,852.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,732.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,583.20
|
| Rate for Payer: Anthem Medicare Advantage |
$3,150.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,956.45
|
| 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 |
$2,239.50
|
| Rate for Payer: Cash Price |
$2,239.50
|
| Rate for Payer: Cigna Commercial |
$6,867.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,150.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,177.41
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,150.53
|
| Rate for Payer: Health EOS Commercial |
$6,643.85
|
| Rate for Payer: HFN Commercial |
$6,867.80
|
| 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 |
$5,972.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,725.80
|
| Rate for Payer: Preferred Network Access Commercial |
$6,867.80
|
| Rate for Payer: Quartz Beloit One Network |
$3,657.85
|
| Rate for Payer: Quartz Commercial |
$4,852.25
|
| 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 |
$4,105.75
|
| Rate for Payer: Wellcare Medicare |
$3,150.53
|
| Rate for Payer: WPS Commercial |
$5,529.33
|
|
|
zzCV Venogram Cava Superior
|
Facility
|
OP
|
$6,544.00
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
629674
|
| Min. Negotiated Rate |
$1,582.97 |
| Max. Negotiated Rate |
$6,331.88 |
| Rate for Payer: Aetna Commercial |
$5,889.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,627.84
|
| Rate for Payer: Aetna Managed Medicare |
$1,582.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,253.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,272.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,141.12
|
| Rate for Payer: Anthem Medicare Advantage |
$1,582.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,468.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,582.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,582.97
|
| Rate for Payer: Cash Price |
$1,963.20
|
| Rate for Payer: Cash Price |
$1,963.20
|
| Rate for Payer: Cigna Commercial |
$6,020.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,582.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,662.02
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,582.97
|
| Rate for Payer: Health EOS Commercial |
$5,824.16
|
| Rate for Payer: HFN Commercial |
$6,020.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,888.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,582.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,582.97
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,582.97
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,582.97
|
| Rate for Payer: Multiplan Commercial |
$5,235.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,374.46
|
| Rate for Payer: Preferred Network Access Commercial |
$6,020.48
|
| Rate for Payer: Quartz Beloit One Network |
$3,206.56
|
| Rate for Payer: Quartz Commercial |
$4,253.60
|
| Rate for Payer: Quartz Medicare Advantage |
$1,582.97
|
| Rate for Payer: The Alliance Commercial |
$6,331.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,582.97
|
| Rate for Payer: WEA Trust Commercial |
$3,599.20
|
| Rate for Payer: Wellcare Medicare |
$1,582.97
|
| Rate for Payer: WPS Commercial |
$4,847.14
|
|
|
zzCV Venogram Cava Superior
|
Facility
|
IP
|
$6,544.00
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
629674
|
| Min. Negotiated Rate |
$3,206.56 |
| Max. Negotiated Rate |
$6,020.48 |
| Rate for Payer: Aetna Commercial |
$5,889.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,627.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,468.32
|
| Rate for Payer: Cash Price |
$1,963.20
|
| Rate for Payer: Cigna Commercial |
$6,020.48
|
| Rate for Payer: Health EOS Commercial |
$5,824.16
|
| Rate for Payer: HFN Commercial |
$6,020.48
|
| Rate for Payer: Multiplan Commercial |
$5,235.20
|
| Rate for Payer: NAPHCARE Commercial |
$3,926.40
|
| Rate for Payer: Preferred Network Access Commercial |
$6,020.48
|
| Rate for Payer: Quartz Beloit One Network |
$3,206.56
|
| Rate for Payer: Quartz Commercial |
$3,926.40
|
| Rate for Payer: WEA Trust Commercial |
$3,599.20
|
| Rate for Payer: WPS Commercial |
$4,847.14
|
|
|
zzEEG, AWAKE AND ASLEEP 9581926
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
CPT 95819 26
|
| Hospital Charge Code |
3015467
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$105.45 |
| Max. Negotiated Rate |
$380.95 |
| Rate for Payer: Aetna Commercial |
$380.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$344.86
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cigna Commercial |
$380.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$105.45
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$240.60
|
| Rate for Payer: Health EOS Commercial |
$364.91
|
| Rate for Payer: HFN Commercial |
$380.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$197.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$197.50
|
| Rate for Payer: Multiplan Commercial |
$320.80
|
| Rate for Payer: Preferred Network Access Commercial |
$380.95
|
| Rate for Payer: Quartz Beloit One Network |
$176.44
|
| Rate for Payer: Quartz Commercial |
$228.57
|
| Rate for Payer: The Alliance Commercial |
$200.50
|
| Rate for Payer: United Healthcare Medicaid |
$105.45
|
| Rate for Payer: WEA Trust Commercial |
$220.55
|
| Rate for Payer: WPS Commercial |
$297.02
|
|
|
zzEEG, OVER 1 HOUR 9581326
|
Professional
|
Both
|
$461.00
|
|
|
Service Code
|
CPT 95813 26
|
| Hospital Charge Code |
6121638
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$202.84 |
| Max. Negotiated Rate |
$437.95 |
| Rate for Payer: Aetna Commercial |
$437.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.46
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$437.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$225.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$276.60
|
| Rate for Payer: Health EOS Commercial |
$419.51
|
| Rate for Payer: HFN Commercial |
$437.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$298.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$298.04
|
| Rate for Payer: Multiplan Commercial |
$368.80
|
| Rate for Payer: Preferred Network Access Commercial |
$437.95
|
| Rate for Payer: Quartz Beloit One Network |
$202.84
|
| Rate for Payer: Quartz Commercial |
$262.77
|
| Rate for Payer: The Alliance Commercial |
$230.50
|
| Rate for Payer: United Healthcare Medicaid |
$225.11
|
| Rate for Payer: WEA Trust Commercial |
$253.55
|
| Rate for Payer: WPS Commercial |
$341.46
|
|
|
zzESOPHAGEAL ABLATION (HALO PROCEDURE)
|
Facility
|
IP
|
$2,515.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
2960020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,232.35 |
| Max. Negotiated Rate |
$2,313.80 |
| Rate for Payer: Aetna Commercial |
$2,263.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,162.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,332.95
|
| Rate for Payer: Cash Price |
$754.50
|
| Rate for Payer: Cigna Commercial |
$2,313.80
|
| Rate for Payer: Health EOS Commercial |
$2,238.35
|
| Rate for Payer: HFN Commercial |
$2,313.80
|
| Rate for Payer: Multiplan Commercial |
$2,012.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,509.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,313.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,232.35
|
| Rate for Payer: Quartz Commercial |
$1,509.00
|
| Rate for Payer: WEA Trust Commercial |
$1,383.25
|
| Rate for Payer: WPS Commercial |
$1,862.86
|
|
|
zzESOPHAGEAL ABLATION (HALO PROCEDURE)
|
Facility
|
OP
|
$2,515.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
2960020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.03 |
| Max. Negotiated Rate |
$3,613.44 |
| Rate for Payer: Aetna Commercial |
$2,263.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,162.90
|
| Rate for Payer: Aetna Managed Medicare |
$903.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,914.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,297.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,183.00
|
| Rate for Payer: Anthem Medicare Advantage |
$903.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,332.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$903.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$903.36
|
| Rate for Payer: Cash Price |
$754.50
|
| Rate for Payer: Cash Price |
$754.50
|
| Rate for Payer: Cash Price |
$754.50
|
| Rate for Payer: Cigna Commercial |
$2,313.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$903.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$636.03
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$903.36
|
| Rate for Payer: Health EOS Commercial |
$2,238.35
|
| Rate for Payer: HFN Commercial |
$2,313.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,360.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$903.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$903.36
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$903.36
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$903.36
|
| Rate for Payer: Multiplan Commercial |
$2,012.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,355.04
|
| Rate for Payer: Preferred Network Access Commercial |
$2,313.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,232.35
|
| Rate for Payer: Quartz Commercial |
$1,634.75
|
| Rate for Payer: Quartz Medicare Advantage |
$903.36
|
| Rate for Payer: The Alliance Commercial |
$3,613.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$903.36
|
| Rate for Payer: United Healthcare PPO |
$2,257.00
|
| Rate for Payer: WEA Trust Commercial |
$1,383.25
|
| Rate for Payer: Wellcare Medicare |
$903.36
|
| Rate for Payer: WPS Commercial |
$1,862.86
|
|
|
zzFlu A/B
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
979861
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$174.80 |
| Rate for Payer: The Alliance Commercial |
$92.00
|
| Rate for Payer: WEA Trust Commercial |
$101.20
|
| Rate for Payer: WPS Commercial |
$136.29
|
| Rate for Payer: Aetna Commercial |
$174.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$158.24
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cigna Commercial |
$174.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$92.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$110.40
|
| Rate for Payer: Health EOS Commercial |
$167.44
|
| Rate for Payer: HFN Commercial |
$174.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$58.42
|
| Rate for Payer: Multiplan Commercial |
$147.20
|
| Rate for Payer: Preferred Network Access Commercial |
$174.80
|
| Rate for Payer: Quartz Beloit One Network |
$80.96
|
| Rate for Payer: Quartz Commercial |
$104.88
|
|
|
zzFlu A/B
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
979861
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$90.16 |
| Max. Negotiated Rate |
$169.28 |
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$158.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$97.52
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cigna Commercial |
$169.28
|
| Rate for Payer: Health EOS Commercial |
$163.76
|
| Rate for Payer: HFN Commercial |
$169.28
|
| Rate for Payer: Multiplan Commercial |
$147.20
|
| Rate for Payer: NAPHCARE Commercial |
$110.40
|
| Rate for Payer: Preferred Network Access Commercial |
$169.28
|
| Rate for Payer: Quartz Beloit One Network |
$90.16
|
| Rate for Payer: Quartz Commercial |
$110.40
|
| Rate for Payer: WEA Trust Commercial |
$101.20
|
| Rate for Payer: WPS Commercial |
$136.29
|
|
|
zzFlu A/B
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
979861
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$169.28 |
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$158.24
|
| Rate for Payer: Aetna Managed Medicare |
$16.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$62.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.47
|
| Rate for Payer: Anthem Medicaid |
$16.86
|
| Rate for Payer: Anthem Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$97.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.55
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cigna Commercial |
$169.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$16.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$102.97
|
| Rate for Payer: Dean Health Medicaid |
$16.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.55
|
| Rate for Payer: Health EOS Commercial |
$163.76
|
| Rate for Payer: HFN Commercial |
$169.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.55
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.55
|
| Rate for Payer: Managed Health Services Medicaid |
$17.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$147.20
|
| Rate for Payer: NAPHCARE Commercial |
$24.82
|
| Rate for Payer: Preferred Network Access Commercial |
$169.28
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$16.86
|
| Rate for Payer: Quartz Beloit One Network |
$90.16
|
| Rate for Payer: Quartz Commercial |
$119.60
|
| Rate for Payer: Quartz Medicare Advantage |
$16.55
|
| Rate for Payer: The Alliance Commercial |
$66.20
|
| Rate for Payer: United Healthcare Medicaid |
$16.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.55
|
| Rate for Payer: United Healthcare PPO |
$138.00
|
| Rate for Payer: WEA Trust Commercial |
$101.20
|
| Rate for Payer: Wellcare Medicare |
$16.55
|
| Rate for Payer: WMAP Medicaid |
$16.86
|
| Rate for Payer: WPS Commercial |
$136.29
|
|
