|
zzCV Angiogram Carotid Cervical Left
|
Facility
|
IP
|
$4,786.00
|
|
| Hospital Charge Code |
629654
|
| Min. Negotiated Rate |
$2,438.95 |
| Max. Negotiated Rate |
$4,579.24 |
| Rate for Payer: Aetna Commercial |
$4,479.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,280.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,638.04
|
| Rate for Payer: Cash Price |
$1,435.80
|
| Rate for Payer: Cigna Commercial |
$4,579.24
|
| Rate for Payer: Health EOS Commercial |
$4,429.92
|
| Rate for Payer: HFN Commercial |
$4,579.24
|
| Rate for Payer: Multiplan Commercial |
$3,981.95
|
| Rate for Payer: Preferred Network Access Commercial |
$4,579.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,438.95
|
| Rate for Payer: Quartz Commercial |
$2,986.46
|
| Rate for Payer: WEA Trust Commercial |
$2,737.59
|
| Rate for Payer: WPS Commercial |
$3,686.66
|
|
|
zzCV Angiogram Carotid Cervical Right
|
Facility
|
OP
|
$4,786.00
|
|
| Hospital Charge Code |
629656
|
| Min. Negotiated Rate |
$1,393.68 |
| Max. Negotiated Rate |
$4,579.24 |
| Rate for Payer: Aetna Commercial |
$4,479.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,280.60
|
| Rate for Payer: Aetna Managed Medicare |
$1,393.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,235.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,488.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,389.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,638.04
|
| Rate for Payer: Cash Price |
$1,435.80
|
| Rate for Payer: Cigna Commercial |
$4,579.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,785.45
|
| Rate for Payer: Health EOS Commercial |
$4,429.92
|
| Rate for Payer: HFN Commercial |
$4,579.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,733.08
|
| Rate for Payer: Multiplan Commercial |
$3,981.95
|
| Rate for Payer: NAPHCARE Commercial |
$2,986.46
|
| Rate for Payer: Preferred Network Access Commercial |
$4,579.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,438.95
|
| Rate for Payer: Quartz Commercial |
$3,235.34
|
| Rate for Payer: Quartz Medicare Advantage |
$2,986.46
|
| Rate for Payer: The Alliance Commercial |
$2,488.72
|
| Rate for Payer: WEA Trust Commercial |
$2,737.59
|
| Rate for Payer: WPS Commercial |
$3,686.66
|
|
|
zzCV Angiogram Carotid Cervical Right
|
Facility
|
IP
|
$4,786.00
|
|
| Hospital Charge Code |
629656
|
| Min. Negotiated Rate |
$2,438.95 |
| Max. Negotiated Rate |
$4,579.24 |
| Rate for Payer: Aetna Commercial |
$4,479.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,280.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,638.04
|
| Rate for Payer: Cash Price |
$1,435.80
|
| Rate for Payer: Cigna Commercial |
$4,579.24
|
| Rate for Payer: Health EOS Commercial |
$4,429.92
|
| Rate for Payer: HFN Commercial |
$4,579.24
|
| Rate for Payer: Multiplan Commercial |
$3,981.95
|
| Rate for Payer: Preferred Network Access Commercial |
$4,579.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,438.95
|
| Rate for Payer: Quartz Commercial |
$2,986.46
|
| Rate for Payer: WEA Trust Commercial |
$2,737.59
|
| Rate for Payer: WPS Commercial |
$3,686.66
|
|
|
zzCV Angiogram Lower Extremity Bilateral
|
Facility
|
IP
|
$19,805.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
630319
|
| Min. Negotiated Rate |
$10,092.63 |
| Max. Negotiated Rate |
$18,949.42 |
| Rate for Payer: Aetna Commercial |
$18,537.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$17,713.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10,916.52
|
| Rate for Payer: Cash Price |
$5,941.50
|
| Rate for Payer: Cigna Commercial |
$18,949.42
|
| Rate for Payer: Health EOS Commercial |
$18,331.51
|
| Rate for Payer: HFN Commercial |
$18,949.42
|
| Rate for Payer: Multiplan Commercial |
$16,477.76
|
| Rate for Payer: Preferred Network Access Commercial |
$18,949.42
|
| Rate for Payer: Quartz Beloit One Network |
$10,092.63
|
| Rate for Payer: Quartz Commercial |
$12,358.32
|
| Rate for Payer: WEA Trust Commercial |
$11,328.46
|
| Rate for Payer: WPS Commercial |
$15,255.79
|
|
|
zzCV Angiogram Lower Extremity Bilateral
|
Facility
|
OP
|
$19,805.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
630319
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$18,949.42 |
| Rate for Payer: Aetna Commercial |
$18,537.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$17,713.59
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$13,388.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10,298.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9,886.66
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10,916.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$5,941.50
|
| Rate for Payer: Cash Price |
$5,941.50
|
| Rate for Payer: Cigna Commercial |
$18,949.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,526.51
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$18,331.51
|
| Rate for Payer: HFN Commercial |
$18,949.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$16,477.76
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$18,949.42
|
| Rate for Payer: Quartz Beloit One Network |
$10,092.63
|
| Rate for Payer: Quartz Commercial |
$13,388.18
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: WEA Trust Commercial |
$11,328.46
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$15,255.79
|
|
|
zzCV Angiogram LowerExtremity Left
|
Facility
|
IP
|
$9,904.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
630329
|
| Min. Negotiated Rate |
$5,047.08 |
| Max. Negotiated Rate |
$9,476.15 |
| Rate for Payer: Aetna Commercial |
$9,270.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,858.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,459.08
|
| Rate for Payer: Cash Price |
$2,971.20
|
| Rate for Payer: Cigna Commercial |
$9,476.15
|
| Rate for Payer: Health EOS Commercial |
$9,167.14
|
| Rate for Payer: HFN Commercial |
$9,476.15
|
| Rate for Payer: Multiplan Commercial |
$8,240.13
|
| Rate for Payer: Preferred Network Access Commercial |
$9,476.15
|
| Rate for Payer: Quartz Beloit One Network |
$5,047.08
|
| Rate for Payer: Quartz Commercial |
$6,180.10
|
| Rate for Payer: WEA Trust Commercial |
$5,665.09
|
| Rate for Payer: WPS Commercial |
$7,629.05
|
|
|
zzCV Angiogram LowerExtremity Left
|
Facility
|
OP
|
$9,904.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
630329
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$9,270.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,858.14
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,695.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,150.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,944.08
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,459.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$2,971.20
|
| Rate for Payer: Cash Price |
$2,971.20
|
| Rate for Payer: Cigna Commercial |
$9,476.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,764.13
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$9,167.14
|
| Rate for Payer: HFN Commercial |
$9,476.15
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$8,240.13
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$9,476.15
|
| Rate for Payer: Quartz Beloit One Network |
$5,047.08
|
| Rate for Payer: Quartz Commercial |
$6,695.10
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: WEA Trust Commercial |
$5,665.09
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$7,629.05
|
|
|
zzCV Angiogram Lower Extremity Right
|
Facility
|
IP
|
$9,904.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
630331
|
| Min. Negotiated Rate |
$5,047.08 |
| Max. Negotiated Rate |
$9,476.15 |
| Rate for Payer: Aetna Commercial |
$9,270.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,858.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,459.08
|
| Rate for Payer: Cash Price |
$2,971.20
|
| Rate for Payer: Cigna Commercial |
$9,476.15
|
| Rate for Payer: Health EOS Commercial |
$9,167.14
|
| Rate for Payer: HFN Commercial |
$9,476.15
|
| Rate for Payer: Multiplan Commercial |
$8,240.13
|
| Rate for Payer: Preferred Network Access Commercial |
$9,476.15
|
| Rate for Payer: Quartz Beloit One Network |
$5,047.08
|
| Rate for Payer: Quartz Commercial |
$6,180.10
|
| Rate for Payer: WEA Trust Commercial |
$5,665.09
|
| Rate for Payer: WPS Commercial |
$7,629.05
|
|
|
zzCV Angiogram Lower Extremity Right
|
Facility
|
OP
|
$9,904.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
630331
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$9,270.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,858.14
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,695.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,150.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,944.08
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,459.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$2,971.20
|
| Rate for Payer: Cash Price |
$2,971.20
|
| Rate for Payer: Cigna Commercial |
$9,476.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,764.13
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$9,167.14
|
| Rate for Payer: HFN Commercial |
$9,476.15
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$8,240.13
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$9,476.15
|
| Rate for Payer: Quartz Beloit One Network |
$5,047.08
|
| Rate for Payer: Quartz Commercial |
$6,695.10
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: WEA Trust Commercial |
$5,665.09
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$7,629.05
|
|
|
zzCV Angiogram Pelvis
|
Facility
|
IP
|
$7,023.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
630356
|
| Min. Negotiated Rate |
$3,578.92 |
| Max. Negotiated Rate |
$6,719.61 |
| Rate for Payer: Aetna Commercial |
$6,573.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,281.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,871.08
|
| Rate for Payer: Cash Price |
$2,106.90
|
| Rate for Payer: Cigna Commercial |
$6,719.61
|
| Rate for Payer: Health EOS Commercial |
$6,500.49
|
| Rate for Payer: HFN Commercial |
$6,719.61
|
| Rate for Payer: Multiplan Commercial |
$5,843.14
|
| Rate for Payer: Preferred Network Access Commercial |
$6,719.61
|
| Rate for Payer: Quartz Beloit One Network |
$3,578.92
|
| Rate for Payer: Quartz Commercial |
$4,382.35
|
| Rate for Payer: WEA Trust Commercial |
$4,017.16
|
| Rate for Payer: WPS Commercial |
$5,409.82
|
|
|
zzCV Angiogram Pelvis
|
Facility
|
OP
|
$7,023.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
630356
|
| Min. Negotiated Rate |
$3,505.88 |
| Max. Negotiated Rate |
$23,424.04 |
| Rate for Payer: Aetna Commercial |
$6,573.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,281.37
|
| Rate for Payer: Aetna Managed Medicare |
$5,856.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,747.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,651.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,505.88
|
| Rate for Payer: Anthem Medicare Advantage |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,871.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,856.01
|
| Rate for Payer: Cash Price |
$2,106.90
|
| Rate for Payer: Cash Price |
$2,106.90
|
| Rate for Payer: Cigna Commercial |
$6,719.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,856.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,087.39
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,856.01
|
| Rate for Payer: Health EOS Commercial |
$6,500.49
|
| Rate for Payer: HFN Commercial |
$6,719.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,784.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,856.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,856.01
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,856.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,856.01
|
| Rate for Payer: Multiplan Commercial |
$5,843.14
|
| Rate for Payer: NAPHCARE Commercial |
$8,784.02
|
| Rate for Payer: Preferred Network Access Commercial |
$6,719.61
|
| Rate for Payer: Quartz Beloit One Network |
$3,578.92
|
| Rate for Payer: Quartz Commercial |
$4,747.55
|
| Rate for Payer: Quartz Medicare Advantage |
$5,856.01
|
| Rate for Payer: The Alliance Commercial |
$23,424.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,856.01
|
| Rate for Payer: WEA Trust Commercial |
$4,017.16
|
| Rate for Payer: Wellcare Medicare |
$5,856.01
|
| Rate for Payer: WPS Commercial |
$5,409.82
|
|
|
zzCV Angiogram Renal Bilateral
|
Facility
|
IP
|
$8,165.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
630375
|
| Min. Negotiated Rate |
$4,160.88 |
| Max. Negotiated Rate |
$7,812.27 |
| Rate for Payer: Aetna Commercial |
$7,642.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,302.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,500.55
|
| Rate for Payer: Cash Price |
$2,449.50
|
| Rate for Payer: Cigna Commercial |
$7,812.27
|
| Rate for Payer: Health EOS Commercial |
$7,557.52
|
| Rate for Payer: HFN Commercial |
$7,812.27
|
| Rate for Payer: Multiplan Commercial |
$6,793.28
|
| Rate for Payer: Preferred Network Access Commercial |
$7,812.27
|
| Rate for Payer: Quartz Beloit One Network |
$4,160.88
|
| Rate for Payer: Quartz Commercial |
$5,094.96
|
| Rate for Payer: WEA Trust Commercial |
$4,670.38
|
| Rate for Payer: WPS Commercial |
$6,289.50
|
|
|
zzCV Angiogram Renal Bilateral
|
Facility
|
OP
|
$8,165.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
630375
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$7,642.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,302.78
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,519.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,245.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,075.97
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,500.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$2,449.50
|
| Rate for Payer: Cash Price |
$2,449.50
|
| Rate for Payer: Cigna Commercial |
$7,812.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,752.03
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$7,557.52
|
| Rate for Payer: HFN Commercial |
$7,812.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$6,793.28
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$7,812.27
|
| Rate for Payer: Quartz Beloit One Network |
$4,160.88
|
| Rate for Payer: Quartz Commercial |
$5,519.54
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: WEA Trust Commercial |
$4,670.38
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$6,289.50
|
|
|
zzCV Angiogram Renal Left
|
Facility
|
OP
|
$7,835.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
630377
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$7,333.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,007.62
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,296.46
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,074.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,911.23
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,318.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cigna Commercial |
$7,496.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,559.97
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$7,252.08
|
| Rate for Payer: HFN Commercial |
$7,496.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$6,518.72
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$7,496.53
|
| Rate for Payer: Quartz Beloit One Network |
$3,992.72
|
| Rate for Payer: Quartz Commercial |
$5,296.46
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: WEA Trust Commercial |
$4,481.62
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$6,035.30
|
|
|
zzCV Angiogram Renal Left
|
Facility
|
IP
|
$7,835.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
630377
|
| Min. Negotiated Rate |
$3,992.72 |
| Max. Negotiated Rate |
$7,496.53 |
| Rate for Payer: Aetna Commercial |
$7,333.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,007.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,318.65
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cigna Commercial |
$7,496.53
|
| Rate for Payer: Health EOS Commercial |
$7,252.08
|
| Rate for Payer: HFN Commercial |
$7,496.53
|
| Rate for Payer: Multiplan Commercial |
$6,518.72
|
| Rate for Payer: Preferred Network Access Commercial |
$7,496.53
|
| Rate for Payer: Quartz Beloit One Network |
$3,992.72
|
| Rate for Payer: Quartz Commercial |
$4,889.04
|
| Rate for Payer: WEA Trust Commercial |
$4,481.62
|
| Rate for Payer: WPS Commercial |
$6,035.30
|
|
|
zzCV Angiogram Renal Right
|
Facility
|
OP
|
$7,835.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
630379
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$7,333.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,007.62
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,296.46
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,074.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,911.23
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,318.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cigna Commercial |
$7,496.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,559.97
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$7,252.08
|
| Rate for Payer: HFN Commercial |
$7,496.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$6,518.72
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$7,496.53
|
| Rate for Payer: Quartz Beloit One Network |
$3,992.72
|
| Rate for Payer: Quartz Commercial |
$5,296.46
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: WEA Trust Commercial |
$4,481.62
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$6,035.30
|
|
|
zzCV Angiogram Renal Right
|
Facility
|
IP
|
$7,835.00
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
630379
|
| Min. Negotiated Rate |
$3,992.72 |
| Max. Negotiated Rate |
$7,496.53 |
| Rate for Payer: Aetna Commercial |
$7,333.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,007.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,318.65
|
| Rate for Payer: Cash Price |
$2,350.50
|
| Rate for Payer: Cigna Commercial |
$7,496.53
|
| Rate for Payer: Health EOS Commercial |
$7,252.08
|
| Rate for Payer: HFN Commercial |
$7,496.53
|
| Rate for Payer: Multiplan Commercial |
$6,518.72
|
| Rate for Payer: Preferred Network Access Commercial |
$7,496.53
|
| Rate for Payer: Quartz Beloit One Network |
$3,992.72
|
| Rate for Payer: Quartz Commercial |
$4,889.04
|
| Rate for Payer: WEA Trust Commercial |
$4,481.62
|
| Rate for Payer: WPS Commercial |
$6,035.30
|
|
|
zzCV Angiogram Vertebral
|
Facility
|
OP
|
$7,259.00
|
|
| Hospital Charge Code |
630383
|
| Min. Negotiated Rate |
$2,113.82 |
| Max. Negotiated Rate |
$6,945.41 |
| Rate for Payer: Aetna Commercial |
$6,794.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,492.45
|
| Rate for Payer: Aetna Managed Medicare |
$2,113.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,907.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,774.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,623.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,001.16
|
| Rate for Payer: Cash Price |
$2,177.70
|
| Rate for Payer: Cigna Commercial |
$6,945.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,224.74
|
| Rate for Payer: Health EOS Commercial |
$6,718.93
|
| Rate for Payer: HFN Commercial |
$6,945.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,662.02
|
| Rate for Payer: Multiplan Commercial |
$6,039.49
|
| Rate for Payer: NAPHCARE Commercial |
$4,529.62
|
| Rate for Payer: Preferred Network Access Commercial |
$6,945.41
|
| Rate for Payer: Quartz Beloit One Network |
$3,699.19
|
| Rate for Payer: Quartz Commercial |
$4,907.08
|
| Rate for Payer: Quartz Medicare Advantage |
$4,529.62
|
| Rate for Payer: The Alliance Commercial |
$3,774.68
|
| Rate for Payer: WEA Trust Commercial |
$4,152.15
|
| Rate for Payer: WPS Commercial |
$5,591.61
|
|
|
zzCV Angiogram Vertebral
|
Facility
|
IP
|
$7,259.00
|
|
| Hospital Charge Code |
630383
|
| Min. Negotiated Rate |
$3,699.19 |
| Max. Negotiated Rate |
$6,945.41 |
| Rate for Payer: Aetna Commercial |
$6,794.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,492.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,001.16
|
| Rate for Payer: Cash Price |
$2,177.70
|
| Rate for Payer: Cigna Commercial |
$6,945.41
|
| Rate for Payer: Health EOS Commercial |
$6,718.93
|
| Rate for Payer: HFN Commercial |
$6,945.41
|
| Rate for Payer: Multiplan Commercial |
$6,039.49
|
| Rate for Payer: Preferred Network Access Commercial |
$6,945.41
|
| Rate for Payer: Quartz Beloit One Network |
$3,699.19
|
| Rate for Payer: Quartz Commercial |
$4,529.62
|
| Rate for Payer: WEA Trust Commercial |
$4,152.15
|
| Rate for Payer: WPS Commercial |
$5,591.61
|
|
|
zzCV Angio Through Existing Catheter
|
Facility
|
IP
|
$6,906.00
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
630283
|
| Min. Negotiated Rate |
$3,519.30 |
| Max. Negotiated Rate |
$6,607.66 |
| Rate for Payer: Aetna Commercial |
$6,464.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,176.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,806.59
|
| Rate for Payer: Cash Price |
$2,071.80
|
| Rate for Payer: Cigna Commercial |
$6,607.66
|
| Rate for Payer: Health EOS Commercial |
$6,392.19
|
| Rate for Payer: HFN Commercial |
$6,607.66
|
| Rate for Payer: Multiplan Commercial |
$5,745.79
|
| Rate for Payer: Preferred Network Access Commercial |
$6,607.66
|
| Rate for Payer: Quartz Beloit One Network |
$3,519.30
|
| Rate for Payer: Quartz Commercial |
$4,309.34
|
| Rate for Payer: WEA Trust Commercial |
$3,950.23
|
| Rate for Payer: WPS Commercial |
$5,319.69
|
|
|
zzCV Angio Through Existing Catheter
|
Facility
|
OP
|
$6,906.00
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
630283
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$6,464.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,176.73
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,668.46
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,591.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,447.48
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,806.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$2,071.80
|
| Rate for Payer: Cash Price |
$2,071.80
|
| Rate for Payer: Cigna Commercial |
$6,607.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,019.29
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$6,392.19
|
| Rate for Payer: HFN Commercial |
$6,607.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$5,745.79
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$6,607.66
|
| Rate for Payer: Quartz Beloit One Network |
$3,519.30
|
| Rate for Payer: Quartz Commercial |
$4,668.46
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: WEA Trust Commercial |
$3,950.23
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$5,319.69
|
|
|
zzCV Aortogram Abdominal + Iliofemoral
|
Facility
|
IP
|
$7,912.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
625620
|
| Min. Negotiated Rate |
$4,031.96 |
| Max. Negotiated Rate |
$7,570.20 |
| Rate for Payer: Aetna Commercial |
$7,405.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,076.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,361.09
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cigna Commercial |
$7,570.20
|
| Rate for Payer: Health EOS Commercial |
$7,323.35
|
| Rate for Payer: HFN Commercial |
$7,570.20
|
| Rate for Payer: Multiplan Commercial |
$6,582.78
|
| Rate for Payer: Preferred Network Access Commercial |
$7,570.20
|
| Rate for Payer: Quartz Beloit One Network |
$4,031.96
|
| Rate for Payer: Quartz Commercial |
$4,937.09
|
| Rate for Payer: WEA Trust Commercial |
$4,525.66
|
| Rate for Payer: WPS Commercial |
$6,094.61
|
|
|
zzCV Aortogram Abdominal + Iliofemoral
|
Facility
|
OP
|
$7,912.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
625620
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$7,405.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,076.49
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,348.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,114.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,949.67
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,361.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cigna Commercial |
$7,570.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,604.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$7,323.35
|
| Rate for Payer: HFN Commercial |
$7,570.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$6,582.78
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$7,570.20
|
| Rate for Payer: Quartz Beloit One Network |
$4,031.96
|
| Rate for Payer: Quartz Commercial |
$5,348.51
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: WEA Trust Commercial |
$4,525.66
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$6,094.61
|
|
|
zzCV Aortogram Abdominal w/ Serialography
|
Facility
|
IP
|
$5,654.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
625632
|
| Min. Negotiated Rate |
$2,881.28 |
| Max. Negotiated Rate |
$5,409.75 |
| Rate for Payer: Aetna Commercial |
$5,292.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,056.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,116.48
|
| Rate for Payer: Cash Price |
$1,696.20
|
| Rate for Payer: Cigna Commercial |
$5,409.75
|
| Rate for Payer: Health EOS Commercial |
$5,233.34
|
| Rate for Payer: HFN Commercial |
$5,409.75
|
| Rate for Payer: Multiplan Commercial |
$4,704.13
|
| Rate for Payer: Preferred Network Access Commercial |
$5,409.75
|
| Rate for Payer: Quartz Beloit One Network |
$2,881.28
|
| Rate for Payer: Quartz Commercial |
$3,528.10
|
| Rate for Payer: WEA Trust Commercial |
$3,234.09
|
| Rate for Payer: WPS Commercial |
$4,355.28
|
|
|
zzCV Aortogram Abdominal w/ Serialography
|
Facility
|
OP
|
$5,654.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
625632
|
| Min. Negotiated Rate |
$2,822.48 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$5,292.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,056.94
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,822.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,940.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,822.48
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,116.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cash Price |
$1,696.20
|
| Rate for Payer: Cash Price |
$1,696.20
|
| Rate for Payer: Cigna Commercial |
$5,409.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,290.63
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$5,233.34
|
| Rate for Payer: HFN Commercial |
$5,409.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: Multiplan Commercial |
$4,704.13
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$5,409.75
|
| Rate for Payer: Quartz Beloit One Network |
$2,881.28
|
| Rate for Payer: Quartz Commercial |
$3,822.10
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: WEA Trust Commercial |
$3,234.09
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$4,355.28
|
|
