|
XR Spine Thoracic 2 Views
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
CPT 72070 TC
|
| Hospital Charge Code |
1537361
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$92.27 |
| Max. Negotiated Rate |
$613.31 |
| Rate for Payer: Aetna Commercial |
$599.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$573.31
|
| Rate for Payer: Aetna Managed Medicare |
$186.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$423.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$339.05
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$322.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$353.32
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cigna Commercial |
$613.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$373.06
|
| Rate for Payer: Health EOS Commercial |
$593.31
|
| Rate for Payer: HFN Commercial |
$613.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$499.98
|
| Rate for Payer: Multiplan Commercial |
$533.31
|
| Rate for Payer: NAPHCARE Commercial |
$399.98
|
| Rate for Payer: Preferred Network Access Commercial |
$613.31
|
| Rate for Payer: Quartz Beloit One Network |
$326.65
|
| Rate for Payer: Quartz Commercial |
$433.32
|
| Rate for Payer: Quartz Medicare Advantage |
$399.98
|
| Rate for Payer: The Alliance Commercial |
$92.27
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$366.65
|
| Rate for Payer: WPS Commercial |
$493.76
|
|
|
XR Spine Thoracic 2 Views
|
Facility
|
IP
|
$593.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
630002
|
| Min. Negotiated Rate |
$302.19 |
| Max. Negotiated Rate |
$567.38 |
| Rate for Payer: Aetna Commercial |
$555.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$530.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$326.86
|
| Rate for Payer: Cash Price |
$177.90
|
| Rate for Payer: Cigna Commercial |
$567.38
|
| Rate for Payer: Health EOS Commercial |
$548.88
|
| Rate for Payer: HFN Commercial |
$567.38
|
| Rate for Payer: Multiplan Commercial |
$493.38
|
| Rate for Payer: Preferred Network Access Commercial |
$567.38
|
| Rate for Payer: Quartz Beloit One Network |
$302.19
|
| Rate for Payer: Quartz Commercial |
$370.03
|
| Rate for Payer: WEA Trust Commercial |
$339.20
|
| Rate for Payer: WPS Commercial |
$456.79
|
|
|
XR Spine Thoracic 2 Views
|
Facility
|
IP
|
$641.00
|
|
|
Service Code
|
CPT 72070 TC
|
| Hospital Charge Code |
5510673
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$326.65 |
| Max. Negotiated Rate |
$613.31 |
| Rate for Payer: Aetna Commercial |
$599.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$573.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$353.32
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cigna Commercial |
$613.31
|
| Rate for Payer: Health EOS Commercial |
$593.31
|
| Rate for Payer: HFN Commercial |
$613.31
|
| Rate for Payer: Multiplan Commercial |
$533.31
|
| Rate for Payer: Preferred Network Access Commercial |
$613.31
|
| Rate for Payer: Quartz Beloit One Network |
$326.65
|
| Rate for Payer: Quartz Commercial |
$399.98
|
| Rate for Payer: WEA Trust Commercial |
$366.65
|
| Rate for Payer: WPS Commercial |
$493.76
|
|
|
XR Spine Thoracic 2 Views
|
Professional
|
Both
|
$641.00
|
|
|
Service Code
|
CPT 72070 TC
|
| Hospital Charge Code |
5510673
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$23.07 |
| Max. Negotiated Rate |
$633.31 |
| Rate for Payer: Aetna Commercial |
$633.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$573.31
|
| Rate for Payer: Aetna Managed Medicare |
$23.07
|
| Rate for Payer: Anthem Medicare Advantage |
$23.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.07
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cigna Commercial |
$633.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$333.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.07
|
| Rate for Payer: Health EOS Commercial |
$606.64
|
| Rate for Payer: HFN Commercial |
$633.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$78.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$78.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.07
|
| Rate for Payer: Multiplan Commercial |
$533.31
|
| Rate for Payer: NAPHCARE Commercial |
$34.60
|
| Rate for Payer: Preferred Network Access Commercial |
$633.31
|
| Rate for Payer: Quartz Beloit One Network |
$293.32
|
| Rate for Payer: Quartz Commercial |
$379.98
|
| Rate for Payer: Quartz Medicare Advantage |
$23.07
|
| Rate for Payer: The Alliance Commercial |
$87.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.07
|
| Rate for Payer: WEA Trust Commercial |
$366.65
|
| Rate for Payer: WPS Commercial |
$115.34
|
|
|
XR Spine Thoracic 3 Views
|
Facility
|
OP
|
$737.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
629997
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$705.16 |
| Rate for Payer: Aetna Commercial |
$689.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$659.17
|
| Rate for Payer: Aetna Managed Medicare |
$110.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$498.21
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$383.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$367.91
|
| Rate for Payer: Anthem Medicare Advantage |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$406.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$110.02
|
| Rate for Payer: Cash Price |
$221.10
|
| Rate for Payer: Cash Price |
$221.10
|
| Rate for Payer: Cigna Commercial |
$705.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$110.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$428.93
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$110.02
|
| Rate for Payer: Health EOS Commercial |
$682.17
|
| Rate for Payer: HFN Commercial |
$705.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$409.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$110.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$110.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$110.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$110.02
|
| Rate for Payer: Multiplan Commercial |
$613.18
|
| Rate for Payer: NAPHCARE Commercial |
$165.03
|
| Rate for Payer: Preferred Network Access Commercial |
$705.16
|
| Rate for Payer: Quartz Beloit One Network |
$375.58
|
| Rate for Payer: Quartz Commercial |
$498.21
|
| Rate for Payer: Quartz Medicare Advantage |
$110.02
|
| Rate for Payer: The Alliance Commercial |
$440.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110.02
|
| Rate for Payer: WEA Trust Commercial |
$421.56
|
| Rate for Payer: Wellcare Medicare |
$110.02
|
| Rate for Payer: WPS Commercial |
$567.71
|
|
|
XR Spine Thoracic 3 Views
|
Facility
|
IP
|
$785.00
|
|
|
Service Code
|
CPT 72072 TC
|
| Hospital Charge Code |
1537363
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$400.04 |
| Max. Negotiated Rate |
$751.09 |
| Rate for Payer: Aetna Commercial |
$734.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$702.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$432.69
|
| Rate for Payer: Cash Price |
$235.50
|
| Rate for Payer: Cigna Commercial |
$751.09
|
| Rate for Payer: Health EOS Commercial |
$726.60
|
| Rate for Payer: HFN Commercial |
$751.09
|
| Rate for Payer: Multiplan Commercial |
$653.12
|
| Rate for Payer: Preferred Network Access Commercial |
$751.09
|
| Rate for Payer: Quartz Beloit One Network |
$400.04
|
| Rate for Payer: Quartz Commercial |
$489.84
|
| Rate for Payer: WEA Trust Commercial |
$449.02
|
| Rate for Payer: WPS Commercial |
$604.69
|
|
|
XR Spine Thoracic 3 Views
|
Facility
|
IP
|
$737.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
629997
|
| Min. Negotiated Rate |
$375.58 |
| Max. Negotiated Rate |
$705.16 |
| Rate for Payer: Aetna Commercial |
$689.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$659.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$406.23
|
| Rate for Payer: Cash Price |
$221.10
|
| Rate for Payer: Cigna Commercial |
$705.16
|
| Rate for Payer: Health EOS Commercial |
$682.17
|
| Rate for Payer: HFN Commercial |
$705.16
|
| Rate for Payer: Multiplan Commercial |
$613.18
|
| Rate for Payer: Preferred Network Access Commercial |
$705.16
|
| Rate for Payer: Quartz Beloit One Network |
$375.58
|
| Rate for Payer: Quartz Commercial |
$459.89
|
| Rate for Payer: WEA Trust Commercial |
$421.56
|
| Rate for Payer: WPS Commercial |
$567.71
|
|
|
XR Spine Thoracic 3 Views
|
Professional
|
Both
|
$785.00
|
|
|
Service Code
|
CPT 72072 TC
|
| Hospital Charge Code |
1537363
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$28.06 |
| Max. Negotiated Rate |
$775.58 |
| Rate for Payer: Aetna Commercial |
$775.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$702.10
|
| Rate for Payer: Aetna Managed Medicare |
$28.06
|
| Rate for Payer: Anthem Medicare Advantage |
$28.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$28.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$28.06
|
| Rate for Payer: Cash Price |
$235.50
|
| Rate for Payer: Cash Price |
$235.50
|
| Rate for Payer: Cash Price |
$235.50
|
| Rate for Payer: Cigna Commercial |
$775.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$408.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28.06
|
| Rate for Payer: Health EOS Commercial |
$742.92
|
| Rate for Payer: HFN Commercial |
$775.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$98.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$98.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$28.06
|
| Rate for Payer: Multiplan Commercial |
$653.12
|
| Rate for Payer: NAPHCARE Commercial |
$42.09
|
| Rate for Payer: Preferred Network Access Commercial |
$775.58
|
| Rate for Payer: Quartz Beloit One Network |
$359.22
|
| Rate for Payer: Quartz Commercial |
$465.35
|
| Rate for Payer: Quartz Medicare Advantage |
$28.06
|
| Rate for Payer: The Alliance Commercial |
$106.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28.06
|
| Rate for Payer: WEA Trust Commercial |
$449.02
|
| Rate for Payer: WPS Commercial |
$140.30
|
|
|
XR Spine Thoracic 3 Views
|
Facility
|
OP
|
$785.00
|
|
|
Service Code
|
CPT 72072 TC
|
| Hospital Charge Code |
1537363
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$112.24 |
| Max. Negotiated Rate |
$751.09 |
| Rate for Payer: Aetna Commercial |
$734.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$702.10
|
| Rate for Payer: Aetna Managed Medicare |
$228.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$423.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$339.05
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$322.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$432.69
|
| Rate for Payer: Cash Price |
$235.50
|
| Rate for Payer: Cash Price |
$235.50
|
| Rate for Payer: Cash Price |
$235.50
|
| Rate for Payer: Cigna Commercial |
$751.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$456.87
|
| Rate for Payer: Health EOS Commercial |
$726.60
|
| Rate for Payer: HFN Commercial |
$751.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$612.30
|
| Rate for Payer: Multiplan Commercial |
$653.12
|
| Rate for Payer: NAPHCARE Commercial |
$489.84
|
| Rate for Payer: Preferred Network Access Commercial |
$751.09
|
| Rate for Payer: Quartz Beloit One Network |
$400.04
|
| Rate for Payer: Quartz Commercial |
$530.66
|
| Rate for Payer: Quartz Medicare Advantage |
$489.84
|
| Rate for Payer: The Alliance Commercial |
$112.24
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$449.02
|
| Rate for Payer: WPS Commercial |
$604.69
|
|
|
XR Spine Thoracic 3 Views
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
629997
|
| Min. Negotiated Rate |
$38.47 |
| Max. Negotiated Rate |
$728.16 |
| Rate for Payer: Aetna Commercial |
$728.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$659.17
|
| Rate for Payer: Aetna Managed Medicare |
$38.47
|
| Rate for Payer: Anthem Medicare Advantage |
$38.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$38.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$38.47
|
| Rate for Payer: Cash Price |
$221.10
|
| Rate for Payer: Cash Price |
$221.10
|
| Rate for Payer: Cash Price |
$221.10
|
| Rate for Payer: Cigna Commercial |
$728.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$383.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$38.47
|
| Rate for Payer: Health EOS Commercial |
$697.50
|
| Rate for Payer: HFN Commercial |
$728.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$137.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$137.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$38.47
|
| Rate for Payer: Multiplan Commercial |
$613.18
|
| Rate for Payer: NAPHCARE Commercial |
$57.70
|
| Rate for Payer: Preferred Network Access Commercial |
$728.16
|
| Rate for Payer: Quartz Beloit One Network |
$337.25
|
| Rate for Payer: Quartz Commercial |
$436.89
|
| Rate for Payer: Quartz Medicare Advantage |
$38.47
|
| Rate for Payer: The Alliance Commercial |
$146.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$38.47
|
| Rate for Payer: WEA Trust Commercial |
$421.56
|
| Rate for Payer: WPS Commercial |
$192.35
|
|
|
XR Spine Thoracic Minimum 4 Views
|
Facility
|
IP
|
$759.00
|
|
|
Service Code
|
CPT 72074 TC
|
| Hospital Charge Code |
1537365
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$386.79 |
| Max. Negotiated Rate |
$726.21 |
| Rate for Payer: Aetna Commercial |
$710.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$678.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$418.36
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cigna Commercial |
$726.21
|
| Rate for Payer: Health EOS Commercial |
$702.53
|
| Rate for Payer: HFN Commercial |
$726.21
|
| Rate for Payer: Multiplan Commercial |
$631.49
|
| Rate for Payer: Preferred Network Access Commercial |
$726.21
|
| Rate for Payer: Quartz Beloit One Network |
$386.79
|
| Rate for Payer: Quartz Commercial |
$473.62
|
| Rate for Payer: WEA Trust Commercial |
$434.15
|
| Rate for Payer: WPS Commercial |
$584.66
|
|
|
XR Spine Thoracic Minimum 4 Views
|
Professional
|
Both
|
$759.00
|
|
|
Service Code
|
CPT 72074 TC
|
| Hospital Charge Code |
1537365
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.39 |
| Max. Negotiated Rate |
$749.89 |
| Rate for Payer: Aetna Commercial |
$749.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$678.85
|
| Rate for Payer: Aetna Managed Medicare |
$32.39
|
| Rate for Payer: Anthem Medicare Advantage |
$32.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$32.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$32.39
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cigna Commercial |
$749.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$394.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32.39
|
| Rate for Payer: Health EOS Commercial |
$718.32
|
| Rate for Payer: HFN Commercial |
$749.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$113.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$113.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$32.39
|
| Rate for Payer: Multiplan Commercial |
$631.49
|
| Rate for Payer: NAPHCARE Commercial |
$48.58
|
| Rate for Payer: Preferred Network Access Commercial |
$749.89
|
| Rate for Payer: Quartz Beloit One Network |
$347.32
|
| Rate for Payer: Quartz Commercial |
$449.94
|
| Rate for Payer: Quartz Medicare Advantage |
$32.39
|
| Rate for Payer: The Alliance Commercial |
$123.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32.39
|
| Rate for Payer: WEA Trust Commercial |
$434.15
|
| Rate for Payer: WPS Commercial |
$161.93
|
|
|
XR Spine Thoracic Minimum 4 Views
|
Facility
|
OP
|
$730.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
629994
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$698.46 |
| Rate for Payer: Aetna Commercial |
$683.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$652.91
|
| Rate for Payer: Aetna Managed Medicare |
$110.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$493.48
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$379.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$364.42
|
| Rate for Payer: Anthem Medicare Advantage |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$402.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$110.02
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$698.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$110.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$424.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$110.02
|
| Rate for Payer: Health EOS Commercial |
$675.69
|
| Rate for Payer: HFN Commercial |
$698.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$409.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$110.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$110.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$110.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$110.02
|
| Rate for Payer: Multiplan Commercial |
$607.36
|
| Rate for Payer: NAPHCARE Commercial |
$165.03
|
| Rate for Payer: Preferred Network Access Commercial |
$698.46
|
| Rate for Payer: Quartz Beloit One Network |
$372.01
|
| Rate for Payer: Quartz Commercial |
$493.48
|
| Rate for Payer: Quartz Medicare Advantage |
$110.02
|
| Rate for Payer: The Alliance Commercial |
$440.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110.02
|
| Rate for Payer: WEA Trust Commercial |
$417.56
|
| Rate for Payer: Wellcare Medicare |
$110.02
|
| Rate for Payer: WPS Commercial |
$562.32
|
|
|
XR Spine Thoracic Minimum 4 Views
|
Professional
|
Both
|
$730.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
629994
|
| Min. Negotiated Rate |
$43.83 |
| Max. Negotiated Rate |
$721.24 |
| Rate for Payer: Aetna Commercial |
$721.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$652.91
|
| Rate for Payer: Aetna Managed Medicare |
$43.83
|
| Rate for Payer: Anthem Medicare Advantage |
$43.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$43.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$43.83
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$721.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$379.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$43.83
|
| Rate for Payer: Health EOS Commercial |
$690.87
|
| Rate for Payer: HFN Commercial |
$721.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$157.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$157.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$43.83
|
| Rate for Payer: Multiplan Commercial |
$607.36
|
| Rate for Payer: NAPHCARE Commercial |
$65.74
|
| Rate for Payer: Preferred Network Access Commercial |
$721.24
|
| Rate for Payer: Quartz Beloit One Network |
$334.05
|
| Rate for Payer: Quartz Commercial |
$432.74
|
| Rate for Payer: Quartz Medicare Advantage |
$43.83
|
| Rate for Payer: The Alliance Commercial |
$166.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$43.83
|
| Rate for Payer: WEA Trust Commercial |
$417.56
|
| Rate for Payer: WPS Commercial |
$219.13
|
|
|
XR Spine Thoracic Minimum 4 Views
|
Facility
|
OP
|
$759.00
|
|
|
Service Code
|
CPT 72074 TC
|
| Hospital Charge Code |
1537365
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$129.54 |
| Max. Negotiated Rate |
$726.21 |
| Rate for Payer: Aetna Commercial |
$710.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$678.85
|
| Rate for Payer: Aetna Managed Medicare |
$221.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$423.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$339.05
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$322.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$418.36
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Cigna Commercial |
$726.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$441.74
|
| Rate for Payer: Health EOS Commercial |
$702.53
|
| Rate for Payer: HFN Commercial |
$726.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$592.02
|
| Rate for Payer: Multiplan Commercial |
$631.49
|
| Rate for Payer: NAPHCARE Commercial |
$473.62
|
| Rate for Payer: Preferred Network Access Commercial |
$726.21
|
| Rate for Payer: Quartz Beloit One Network |
$386.79
|
| Rate for Payer: Quartz Commercial |
$513.08
|
| Rate for Payer: Quartz Medicare Advantage |
$473.62
|
| Rate for Payer: The Alliance Commercial |
$129.54
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$434.15
|
| Rate for Payer: WPS Commercial |
$584.66
|
|
|
XR Spine Thoracic Minimum 4 Views
|
Facility
|
IP
|
$730.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
629994
|
| Min. Negotiated Rate |
$372.01 |
| Max. Negotiated Rate |
$698.46 |
| Rate for Payer: Aetna Commercial |
$683.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$652.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$402.38
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$698.46
|
| Rate for Payer: Health EOS Commercial |
$675.69
|
| Rate for Payer: HFN Commercial |
$698.46
|
| Rate for Payer: Multiplan Commercial |
$607.36
|
| Rate for Payer: Preferred Network Access Commercial |
$698.46
|
| Rate for Payer: Quartz Beloit One Network |
$372.01
|
| Rate for Payer: Quartz Commercial |
$455.52
|
| Rate for Payer: WEA Trust Commercial |
$417.56
|
| Rate for Payer: WPS Commercial |
$562.32
|
|
|
XR Spine Thoracolumbar 2 Views
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
CPT 72080 TC
|
| Hospital Charge Code |
1537367
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$24.73 |
| Max. Negotiated Rate |
$570.08 |
| Rate for Payer: Aetna Commercial |
$570.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$516.07
|
| Rate for Payer: Aetna Managed Medicare |
$24.73
|
| Rate for Payer: Anthem Medicare Advantage |
$24.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.73
|
| Rate for Payer: Cash Price |
$173.10
|
| Rate for Payer: Cash Price |
$173.10
|
| Rate for Payer: Cash Price |
$173.10
|
| Rate for Payer: Cigna Commercial |
$570.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$300.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24.73
|
| Rate for Payer: Health EOS Commercial |
$546.07
|
| Rate for Payer: HFN Commercial |
$570.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$84.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$84.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.73
|
| Rate for Payer: Multiplan Commercial |
$480.06
|
| Rate for Payer: NAPHCARE Commercial |
$37.10
|
| Rate for Payer: Preferred Network Access Commercial |
$570.08
|
| Rate for Payer: Quartz Beloit One Network |
$264.04
|
| Rate for Payer: Quartz Commercial |
$342.05
|
| Rate for Payer: Quartz Medicare Advantage |
$24.73
|
| Rate for Payer: The Alliance Commercial |
$93.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.73
|
| Rate for Payer: WEA Trust Commercial |
$330.04
|
| Rate for Payer: WPS Commercial |
$123.66
|
|
|
XR Spine Thoracolumbar 2 Views
|
Facility
|
OP
|
$577.00
|
|
|
Service Code
|
CPT 72080 TC
|
| Hospital Charge Code |
1537367
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$98.92 |
| Max. Negotiated Rate |
$552.07 |
| Rate for Payer: Aetna Commercial |
$540.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$516.07
|
| Rate for Payer: Aetna Managed Medicare |
$168.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$350.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$280.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$266.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$318.04
|
| Rate for Payer: Cash Price |
$173.10
|
| Rate for Payer: Cash Price |
$173.10
|
| Rate for Payer: Cash Price |
$173.10
|
| Rate for Payer: Cigna Commercial |
$552.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$335.81
|
| Rate for Payer: Health EOS Commercial |
$534.07
|
| Rate for Payer: HFN Commercial |
$552.07
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$450.06
|
| Rate for Payer: Multiplan Commercial |
$480.06
|
| Rate for Payer: NAPHCARE Commercial |
$360.05
|
| Rate for Payer: Preferred Network Access Commercial |
$552.07
|
| Rate for Payer: Quartz Beloit One Network |
$294.04
|
| Rate for Payer: Quartz Commercial |
$390.05
|
| Rate for Payer: Quartz Medicare Advantage |
$360.05
|
| Rate for Payer: The Alliance Commercial |
$98.92
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$330.04
|
| Rate for Payer: WPS Commercial |
$444.46
|
|
|
XR Spine Thoracolumbar 2 Views
|
Facility
|
IP
|
$535.00
|
|
|
Service Code
|
CPT 72080
|
| Hospital Charge Code |
629986
|
| Min. Negotiated Rate |
$272.64 |
| Max. Negotiated Rate |
$511.89 |
| Rate for Payer: Aetna Commercial |
$500.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$478.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$294.89
|
| Rate for Payer: Cash Price |
$160.50
|
| Rate for Payer: Cigna Commercial |
$511.89
|
| Rate for Payer: Health EOS Commercial |
$495.20
|
| Rate for Payer: HFN Commercial |
$511.89
|
| Rate for Payer: Multiplan Commercial |
$445.12
|
| Rate for Payer: Preferred Network Access Commercial |
$511.89
|
| Rate for Payer: Quartz Beloit One Network |
$272.64
|
| Rate for Payer: Quartz Commercial |
$333.84
|
| Rate for Payer: WEA Trust Commercial |
$306.02
|
| Rate for Payer: WPS Commercial |
$412.11
|
|
|
XR Spine Thoracolumbar 2 Views
|
Facility
|
IP
|
$577.00
|
|
|
Service Code
|
CPT 72080 TC
|
| Hospital Charge Code |
1537367
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$294.04 |
| Max. Negotiated Rate |
$552.07 |
| Rate for Payer: Aetna Commercial |
$540.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$516.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$318.04
|
| Rate for Payer: Cash Price |
$173.10
|
| Rate for Payer: Cigna Commercial |
$552.07
|
| Rate for Payer: Health EOS Commercial |
$534.07
|
| Rate for Payer: HFN Commercial |
$552.07
|
| Rate for Payer: Multiplan Commercial |
$480.06
|
| Rate for Payer: Preferred Network Access Commercial |
$552.07
|
| Rate for Payer: Quartz Beloit One Network |
$294.04
|
| Rate for Payer: Quartz Commercial |
$360.05
|
| Rate for Payer: WEA Trust Commercial |
$330.04
|
| Rate for Payer: WPS Commercial |
$444.46
|
|
|
XR Spine Thoracolumbar 2 Views
|
Facility
|
OP
|
$535.00
|
|
|
Service Code
|
CPT 72080
|
| Hospital Charge Code |
629986
|
| Min. Negotiated Rate |
$91.58 |
| Max. Negotiated Rate |
$511.89 |
| Rate for Payer: Aetna Commercial |
$500.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$478.50
|
| Rate for Payer: Aetna Managed Medicare |
$91.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$361.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$278.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$267.07
|
| Rate for Payer: Anthem Medicare Advantage |
$91.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$294.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$91.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$91.58
|
| Rate for Payer: Cash Price |
$160.50
|
| Rate for Payer: Cash Price |
$160.50
|
| Rate for Payer: Cigna Commercial |
$511.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$91.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$311.37
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$91.58
|
| Rate for Payer: Health EOS Commercial |
$495.20
|
| Rate for Payer: HFN Commercial |
$511.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$340.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$91.58
|
| Rate for Payer: Independent Care Health Plan Medicare |
$91.58
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$91.58
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$91.58
|
| Rate for Payer: Multiplan Commercial |
$445.12
|
| Rate for Payer: NAPHCARE Commercial |
$137.37
|
| Rate for Payer: Preferred Network Access Commercial |
$511.89
|
| Rate for Payer: Quartz Beloit One Network |
$272.64
|
| Rate for Payer: Quartz Commercial |
$361.66
|
| Rate for Payer: Quartz Medicare Advantage |
$91.58
|
| Rate for Payer: The Alliance Commercial |
$366.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.58
|
| Rate for Payer: WEA Trust Commercial |
$306.02
|
| Rate for Payer: Wellcare Medicare |
$91.58
|
| Rate for Payer: WPS Commercial |
$412.11
|
|
|
XR Spine Thoracolumbar 2 Views
|
Professional
|
Both
|
$535.00
|
|
|
Service Code
|
CPT 72080
|
| Hospital Charge Code |
629986
|
| Min. Negotiated Rate |
$34.78 |
| Max. Negotiated Rate |
$528.58 |
| Rate for Payer: Aetna Commercial |
$528.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$478.50
|
| Rate for Payer: Aetna Managed Medicare |
$34.78
|
| Rate for Payer: Anthem Medicare Advantage |
$34.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$34.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$34.78
|
| Rate for Payer: Cash Price |
$160.50
|
| Rate for Payer: Cash Price |
$160.50
|
| Rate for Payer: Cash Price |
$160.50
|
| Rate for Payer: Cigna Commercial |
$528.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$278.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$34.78
|
| Rate for Payer: Health EOS Commercial |
$506.32
|
| Rate for Payer: HFN Commercial |
$528.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$121.77
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$121.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$34.78
|
| Rate for Payer: Multiplan Commercial |
$445.12
|
| Rate for Payer: NAPHCARE Commercial |
$52.17
|
| Rate for Payer: Preferred Network Access Commercial |
$528.58
|
| Rate for Payer: Quartz Beloit One Network |
$244.82
|
| Rate for Payer: Quartz Commercial |
$317.15
|
| Rate for Payer: Quartz Medicare Advantage |
$34.78
|
| Rate for Payer: The Alliance Commercial |
$132.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34.78
|
| Rate for Payer: WEA Trust Commercial |
$306.02
|
| Rate for Payer: WPS Commercial |
$173.89
|
|
|
XR Sternoclavicular Joint(s)
|
Professional
|
Both
|
$555.00
|
|
|
Service Code
|
CPT 71130
|
| Hospital Charge Code |
629976
|
| Min. Negotiated Rate |
$41.12 |
| Max. Negotiated Rate |
$548.34 |
| Rate for Payer: Aetna Commercial |
$548.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$496.39
|
| Rate for Payer: Aetna Managed Medicare |
$41.12
|
| Rate for Payer: Anthem Medicare Advantage |
$41.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$41.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$41.12
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cigna Commercial |
$548.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$288.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$41.12
|
| Rate for Payer: Health EOS Commercial |
$525.25
|
| Rate for Payer: HFN Commercial |
$548.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$146.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$41.12
|
| Rate for Payer: Multiplan Commercial |
$461.76
|
| Rate for Payer: NAPHCARE Commercial |
$61.68
|
| Rate for Payer: Preferred Network Access Commercial |
$548.34
|
| Rate for Payer: Quartz Beloit One Network |
$253.97
|
| Rate for Payer: Quartz Commercial |
$329.00
|
| Rate for Payer: Quartz Medicare Advantage |
$41.12
|
| Rate for Payer: The Alliance Commercial |
$156.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41.12
|
| Rate for Payer: WEA Trust Commercial |
$317.46
|
| Rate for Payer: WPS Commercial |
$205.61
|
|
|
XR Sternoclavicular Joint(s)
|
Facility
|
OP
|
$555.00
|
|
|
Service Code
|
CPT 71130
|
| Hospital Charge Code |
629976
|
| Min. Negotiated Rate |
$91.58 |
| Max. Negotiated Rate |
$531.02 |
| Rate for Payer: Aetna Commercial |
$519.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$496.39
|
| Rate for Payer: Aetna Managed Medicare |
$91.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$375.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$288.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$277.06
|
| Rate for Payer: Anthem Medicare Advantage |
$91.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$305.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$91.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$91.58
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cigna Commercial |
$531.02
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$91.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$323.01
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$91.58
|
| Rate for Payer: Health EOS Commercial |
$513.71
|
| Rate for Payer: HFN Commercial |
$531.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$340.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$91.58
|
| Rate for Payer: Independent Care Health Plan Medicare |
$91.58
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$91.58
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$91.58
|
| Rate for Payer: Multiplan Commercial |
$461.76
|
| Rate for Payer: NAPHCARE Commercial |
$137.37
|
| Rate for Payer: Preferred Network Access Commercial |
$531.02
|
| Rate for Payer: Quartz Beloit One Network |
$282.83
|
| Rate for Payer: Quartz Commercial |
$375.18
|
| Rate for Payer: Quartz Medicare Advantage |
$91.58
|
| Rate for Payer: The Alliance Commercial |
$366.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.58
|
| Rate for Payer: WEA Trust Commercial |
$317.46
|
| Rate for Payer: Wellcare Medicare |
$91.58
|
| Rate for Payer: WPS Commercial |
$427.52
|
|
|
XR Sternoclavicular Joint(s)
|
Facility
|
IP
|
$555.00
|
|
|
Service Code
|
CPT 71130
|
| Hospital Charge Code |
629976
|
| Min. Negotiated Rate |
$282.83 |
| Max. Negotiated Rate |
$531.02 |
| Rate for Payer: Aetna Commercial |
$519.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$496.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$305.92
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cigna Commercial |
$531.02
|
| Rate for Payer: Health EOS Commercial |
$513.71
|
| Rate for Payer: HFN Commercial |
$531.02
|
| Rate for Payer: Multiplan Commercial |
$461.76
|
| Rate for Payer: Preferred Network Access Commercial |
$531.02
|
| Rate for Payer: Quartz Beloit One Network |
$282.83
|
| Rate for Payer: Quartz Commercial |
$346.32
|
| Rate for Payer: WEA Trust Commercial |
$317.46
|
| Rate for Payer: WPS Commercial |
$427.52
|
|
