|
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 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: 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 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 |
$12,967.60 |
| 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 |
$12,967.60
|
| 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: 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
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: 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 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 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: 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
|
|
|
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 |
$20,205.70 |
| 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 |
$12,148.04
|
| 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 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: 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 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 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: 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: 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: 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: 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
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: 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: 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: 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 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 |
$22,318.84 |
| 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 |
$22,318.84
|
| 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 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: 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 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 |
$22,318.84 |
| 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 |
$22,318.84
|
| 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 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: 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 Temporary Pacemaker
|
Facility
OP
|
$4,446.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
1478802
|
| Min. Negotiated Rate |
$2,134.08 |
| Max. Negotiated Rate |
$31,237.55 |
| 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 |
$22,318.84
|
| 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: 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
OP
|
$7,465.00
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
629672
|
| Min. Negotiated Rate |
$45.76 |
| Max. Negotiated Rate |
$11,719.97 |
| 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 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 |
$45.76
|
| 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 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: 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 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: 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
|
|
