|
zzCV Arch Aortography
|
Facility
|
OP
|
$8,700.00
|
|
| Hospital Charge Code |
1480848
|
| Min. Negotiated Rate |
$2,533.44 |
| Max. Negotiated Rate |
$8,324.16 |
| Rate for Payer: Aetna Commercial |
$8,143.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,781.28
|
| Rate for Payer: Aetna Managed Medicare |
$2,533.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,881.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,524.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,343.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,795.44
|
| Rate for Payer: Cash Price |
$2,610.00
|
| Rate for Payer: Cigna Commercial |
$8,324.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,063.40
|
| Rate for Payer: Health EOS Commercial |
$8,052.72
|
| Rate for Payer: HFN Commercial |
$8,324.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,786.00
|
| Rate for Payer: Multiplan Commercial |
$7,238.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,428.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,324.16
|
| Rate for Payer: Quartz Beloit One Network |
$4,433.52
|
| Rate for Payer: Quartz Commercial |
$5,881.20
|
| Rate for Payer: Quartz Medicare Advantage |
$5,428.80
|
| Rate for Payer: The Alliance Commercial |
$4,524.00
|
| Rate for Payer: WEA Trust Commercial |
$4,976.40
|
| Rate for Payer: WPS Commercial |
$6,701.61
|
|
|
zzCV Arch Aortography
|
Facility
|
IP
|
$8,700.00
|
|
| Hospital Charge Code |
1480848
|
| Min. Negotiated Rate |
$4,433.52 |
| Max. Negotiated Rate |
$8,324.16 |
| Rate for Payer: HFN Commercial |
$8,324.16
|
| Rate for Payer: Aetna Commercial |
$8,143.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,781.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,795.44
|
| Rate for Payer: Cash Price |
$2,610.00
|
| Rate for Payer: Cigna Commercial |
$8,324.16
|
| Rate for Payer: Health EOS Commercial |
$8,052.72
|
| Rate for Payer: Multiplan Commercial |
$7,238.40
|
| Rate for Payer: Preferred Network Access Commercial |
$8,324.16
|
| Rate for Payer: Quartz Beloit One Network |
$4,433.52
|
| Rate for Payer: Quartz Commercial |
$5,428.80
|
| Rate for Payer: WEA Trust Commercial |
$4,976.40
|
| Rate for Payer: WPS Commercial |
$6,701.61
|
|
|
zzCV Implant Loop Recorder
|
Facility
|
OP
|
$8,521.00
|
|
|
Service Code
|
CPT 33282
|
| Hospital Charge Code |
1478830
|
| Min. Negotiated Rate |
$2,481.32 |
| Max. Negotiated Rate |
$8,152.89 |
| Rate for Payer: Aetna Commercial |
$7,975.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,621.18
|
| Rate for Payer: Aetna Managed Medicare |
$2,481.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,760.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,430.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,253.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,696.78
|
| Rate for Payer: Cash Price |
$2,556.30
|
| Rate for Payer: Cash Price |
$2,556.30
|
| Rate for Payer: Cigna Commercial |
$8,152.89
|
| Rate for Payer: Health EOS Commercial |
$7,887.04
|
| Rate for Payer: HFN Commercial |
$8,152.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,646.38
|
| Rate for Payer: Multiplan Commercial |
$7,089.47
|
| Rate for Payer: NAPHCARE Commercial |
$5,317.10
|
| Rate for Payer: Preferred Network Access Commercial |
$8,152.89
|
| Rate for Payer: Quartz Beloit One Network |
$4,342.30
|
| Rate for Payer: Quartz Commercial |
$5,760.20
|
| Rate for Payer: Quartz Medicare Advantage |
$5,317.10
|
| Rate for Payer: The Alliance Commercial |
$4,430.92
|
| Rate for Payer: WEA Trust Commercial |
$4,874.01
|
| Rate for Payer: WPS Commercial |
$6,563.73
|
|
|
zzCV Implant Loop Recorder
|
Facility
|
IP
|
$8,521.00
|
|
|
Service Code
|
CPT 33282
|
| Hospital Charge Code |
1478830
|
| Min. Negotiated Rate |
$4,342.30 |
| Max. Negotiated Rate |
$8,152.89 |
| Rate for Payer: Aetna Commercial |
$7,975.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,621.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,696.78
|
| Rate for Payer: Cash Price |
$2,556.30
|
| Rate for Payer: Cigna Commercial |
$8,152.89
|
| Rate for Payer: Health EOS Commercial |
$7,887.04
|
| Rate for Payer: HFN Commercial |
$8,152.89
|
| Rate for Payer: Multiplan Commercial |
$7,089.47
|
| Rate for Payer: Preferred Network Access Commercial |
$8,152.89
|
| Rate for Payer: Quartz Beloit One Network |
$4,342.30
|
| Rate for Payer: Quartz Commercial |
$5,317.10
|
| Rate for Payer: WEA Trust Commercial |
$4,874.01
|
| Rate for Payer: WPS Commercial |
$6,563.73
|
|
|
zzCV Insertion Venous Catheter w port
|
Facility
|
OP
|
$928.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
1480800
|
| Min. Negotiated Rate |
$463.26 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$868.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$830.00
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$627.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$482.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$463.26
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$511.51
|
| 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 |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cigna Commercial |
$887.91
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$540.10
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$858.96
|
| Rate for Payer: HFN Commercial |
$887.91
|
| 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 |
$772.10
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$887.91
|
| Rate for Payer: Quartz Beloit One Network |
$472.91
|
| Rate for Payer: Quartz Commercial |
$627.33
|
| 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 |
$530.82
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$714.84
|
|
|
zzCV Insertion Venous Catheter w port
|
Facility
|
IP
|
$928.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
1480800
|
| Min. Negotiated Rate |
$472.91 |
| Max. Negotiated Rate |
$887.91 |
| Rate for Payer: Aetna Commercial |
$868.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$830.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$511.51
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cigna Commercial |
$887.91
|
| Rate for Payer: Health EOS Commercial |
$858.96
|
| Rate for Payer: HFN Commercial |
$887.91
|
| Rate for Payer: Multiplan Commercial |
$772.10
|
| Rate for Payer: Preferred Network Access Commercial |
$887.91
|
| Rate for Payer: Quartz Beloit One Network |
$472.91
|
| Rate for Payer: Quartz Commercial |
$579.07
|
| Rate for Payer: WEA Trust Commercial |
$530.82
|
| Rate for Payer: WPS Commercial |
$714.84
|
|
|
zzCV Insert of IABP
|
Facility
|
IP
|
$9,597.00
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
1478832
|
| Min. Negotiated Rate |
$4,890.63 |
| Max. Negotiated Rate |
$9,182.41 |
| Rate for Payer: Aetna Commercial |
$8,982.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,583.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,289.87
|
| Rate for Payer: Cash Price |
$2,879.10
|
| Rate for Payer: Cigna Commercial |
$9,182.41
|
| Rate for Payer: Health EOS Commercial |
$8,882.98
|
| Rate for Payer: HFN Commercial |
$9,182.41
|
| Rate for Payer: Multiplan Commercial |
$7,984.70
|
| Rate for Payer: Preferred Network Access Commercial |
$9,182.41
|
| Rate for Payer: Quartz Beloit One Network |
$4,890.63
|
| Rate for Payer: Quartz Commercial |
$5,988.53
|
| Rate for Payer: WEA Trust Commercial |
$5,489.48
|
| Rate for Payer: WPS Commercial |
$7,392.57
|
|
|
zzCV Insert of IABP
|
Facility
|
OP
|
$9,597.00
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
1478832
|
| Min. Negotiated Rate |
$824.93 |
| Max. Negotiated Rate |
$9,182.41 |
| Rate for Payer: Aetna Commercial |
$8,982.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,583.56
|
| Rate for Payer: Aetna Managed Medicare |
$2,794.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,487.57
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,990.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,790.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,289.87
|
| Rate for Payer: Cash Price |
$2,879.10
|
| Rate for Payer: Cash Price |
$2,879.10
|
| Rate for Payer: Cigna Commercial |
$9,182.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,585.45
|
| Rate for Payer: Health EOS Commercial |
$8,882.98
|
| Rate for Payer: HFN Commercial |
$9,182.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,485.66
|
| Rate for Payer: Multiplan Commercial |
$7,984.70
|
| Rate for Payer: NAPHCARE Commercial |
$5,988.53
|
| Rate for Payer: Preferred Network Access Commercial |
$9,182.41
|
| Rate for Payer: Quartz Beloit One Network |
$4,890.63
|
| Rate for Payer: Quartz Commercial |
$6,487.57
|
| Rate for Payer: Quartz Medicare Advantage |
$5,988.53
|
| Rate for Payer: The Alliance Commercial |
$824.93
|
| Rate for Payer: WEA Trust Commercial |
$5,489.48
|
| Rate for Payer: WPS Commercial |
$7,392.57
|
|
|
zzCV Insert Vena Cava Filter inc Filming
|
Facility
|
OP
|
$17,585.00
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
1480808
|
| Min. Negotiated Rate |
$5,856.01 |
| Max. Negotiated Rate |
$23,424.04 |
| Rate for Payer: Aetna Commercial |
$16,459.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$15,728.02
|
| Rate for Payer: Aetna Managed Medicare |
$5,856.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$11,887.46
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9,144.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8,778.43
|
| Rate for Payer: Anthem Medicare Advantage |
$5,856.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,692.85
|
| 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 |
$5,275.50
|
| Rate for Payer: Cash Price |
$5,275.50
|
| Rate for Payer: Cigna Commercial |
$16,825.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,856.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10,234.47
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,856.01
|
| Rate for Payer: Health EOS Commercial |
$16,276.68
|
| Rate for Payer: HFN Commercial |
$16,825.33
|
| 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 |
$14,630.72
|
| Rate for Payer: NAPHCARE Commercial |
$8,784.02
|
| Rate for Payer: Preferred Network Access Commercial |
$16,825.33
|
| Rate for Payer: Quartz Beloit One Network |
$8,961.32
|
| Rate for Payer: Quartz Commercial |
$11,887.46
|
| 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 |
$10,058.62
|
| Rate for Payer: Wellcare Medicare |
$5,856.01
|
| Rate for Payer: WPS Commercial |
$13,545.73
|
|
|
zzCV Insert Vena Cava Filter inc Filming
|
Facility
|
IP
|
$17,585.00
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
1480808
|
| Min. Negotiated Rate |
$8,961.32 |
| Max. Negotiated Rate |
$16,825.33 |
| Rate for Payer: Aetna Commercial |
$16,459.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$15,728.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,692.85
|
| Rate for Payer: Cash Price |
$5,275.50
|
| Rate for Payer: Cigna Commercial |
$16,825.33
|
| Rate for Payer: Health EOS Commercial |
$16,276.68
|
| Rate for Payer: HFN Commercial |
$16,825.33
|
| Rate for Payer: Multiplan Commercial |
$14,630.72
|
| Rate for Payer: Preferred Network Access Commercial |
$16,825.33
|
| Rate for Payer: Quartz Beloit One Network |
$8,961.32
|
| Rate for Payer: Quartz Commercial |
$10,973.04
|
| Rate for Payer: WEA Trust Commercial |
$10,058.62
|
| Rate for Payer: WPS Commercial |
$13,545.73
|
|
|
zzCV Removal Loop Recorder
|
Facility
|
OP
|
$2,771.00
|
|
|
Service Code
|
CPT 33284
|
| Hospital Charge Code |
1478831
|
| Min. Negotiated Rate |
$806.92 |
| Max. Negotiated Rate |
$2,651.29 |
| Rate for Payer: Aetna Commercial |
$2,593.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,478.38
|
| Rate for Payer: Aetna Managed Medicare |
$806.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,873.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,440.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,383.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,527.38
|
| Rate for Payer: Cash Price |
$831.30
|
| Rate for Payer: Cash Price |
$831.30
|
| Rate for Payer: Cigna Commercial |
$2,651.29
|
| Rate for Payer: Health EOS Commercial |
$2,564.84
|
| Rate for Payer: HFN Commercial |
$2,651.29
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,161.38
|
| Rate for Payer: Multiplan Commercial |
$2,305.47
|
| Rate for Payer: NAPHCARE Commercial |
$1,729.10
|
| Rate for Payer: Preferred Network Access Commercial |
$2,651.29
|
| Rate for Payer: Quartz Beloit One Network |
$1,412.10
|
| Rate for Payer: Quartz Commercial |
$1,873.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,729.10
|
| Rate for Payer: The Alliance Commercial |
$1,440.92
|
| Rate for Payer: WEA Trust Commercial |
$1,585.01
|
| Rate for Payer: WPS Commercial |
$2,134.50
|
|
|
zzCV Removal Loop Recorder
|
Facility
|
IP
|
$2,771.00
|
|
|
Service Code
|
CPT 33284
|
| Hospital Charge Code |
1478831
|
| Min. Negotiated Rate |
$1,412.10 |
| Max. Negotiated Rate |
$2,651.29 |
| Rate for Payer: Aetna Commercial |
$2,593.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,478.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,527.38
|
| Rate for Payer: Cash Price |
$831.30
|
| Rate for Payer: Cigna Commercial |
$2,651.29
|
| Rate for Payer: Health EOS Commercial |
$2,564.84
|
| Rate for Payer: HFN Commercial |
$2,651.29
|
| Rate for Payer: Multiplan Commercial |
$2,305.47
|
| Rate for Payer: Preferred Network Access Commercial |
$2,651.29
|
| Rate for Payer: Quartz Beloit One Network |
$1,412.10
|
| Rate for Payer: Quartz Commercial |
$1,729.10
|
| Rate for Payer: WEA Trust Commercial |
$1,585.01
|
| Rate for Payer: WPS Commercial |
$2,134.50
|
|
|
zzCV Removal of IABP
|
Facility
|
OP
|
$837.00
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
1478833
|
| Min. Negotiated Rate |
$109.45 |
| Max. Negotiated Rate |
$800.84 |
| Rate for Payer: Aetna Commercial |
$783.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$748.61
|
| Rate for Payer: Aetna Managed Medicare |
$243.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$565.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$435.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$417.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$461.35
|
| Rate for Payer: Cash Price |
$251.10
|
| Rate for Payer: Cash Price |
$251.10
|
| Rate for Payer: Cigna Commercial |
$800.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$487.13
|
| Rate for Payer: Health EOS Commercial |
$774.73
|
| Rate for Payer: HFN Commercial |
$800.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$652.86
|
| Rate for Payer: Multiplan Commercial |
$696.38
|
| Rate for Payer: NAPHCARE Commercial |
$522.29
|
| Rate for Payer: Preferred Network Access Commercial |
$800.84
|
| Rate for Payer: Quartz Beloit One Network |
$426.54
|
| Rate for Payer: Quartz Commercial |
$565.81
|
| Rate for Payer: Quartz Medicare Advantage |
$522.29
|
| Rate for Payer: The Alliance Commercial |
$109.45
|
| Rate for Payer: WEA Trust Commercial |
$478.76
|
| Rate for Payer: WPS Commercial |
$644.74
|
|
|
zzCV Removal of IABP
|
Facility
|
IP
|
$837.00
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
1478833
|
| Min. Negotiated Rate |
$426.54 |
| Max. Negotiated Rate |
$800.84 |
| Rate for Payer: Aetna Commercial |
$783.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$748.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$461.35
|
| Rate for Payer: Cash Price |
$251.10
|
| Rate for Payer: Cigna Commercial |
$800.84
|
| Rate for Payer: Health EOS Commercial |
$774.73
|
| Rate for Payer: HFN Commercial |
$800.84
|
| Rate for Payer: Multiplan Commercial |
$696.38
|
| Rate for Payer: Preferred Network Access Commercial |
$800.84
|
| Rate for Payer: Quartz Beloit One Network |
$426.54
|
| Rate for Payer: Quartz Commercial |
$522.29
|
| Rate for Payer: WEA Trust Commercial |
$478.76
|
| Rate for Payer: WPS Commercial |
$644.74
|
|
|
zzCV Renal Catheter Perc Placement Left
|
Facility
|
IP
|
$7,485.00
|
|
|
Service Code
|
CPT 74475
|
| Hospital Charge Code |
630567
|
| Min. Negotiated Rate |
$3,814.36 |
| Max. Negotiated Rate |
$7,161.65 |
| Rate for Payer: Aetna Commercial |
$7,005.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,694.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,125.73
|
| Rate for Payer: Cash Price |
$2,245.50
|
| Rate for Payer: Cigna Commercial |
$7,161.65
|
| Rate for Payer: Health EOS Commercial |
$6,928.12
|
| Rate for Payer: HFN Commercial |
$7,161.65
|
| Rate for Payer: Multiplan Commercial |
$6,227.52
|
| Rate for Payer: Preferred Network Access Commercial |
$7,161.65
|
| Rate for Payer: Quartz Beloit One Network |
$3,814.36
|
| Rate for Payer: Quartz Commercial |
$4,670.64
|
| Rate for Payer: WEA Trust Commercial |
$4,281.42
|
| Rate for Payer: WPS Commercial |
$5,765.70
|
|
|
zzCV Renal Catheter Perc Placement Left
|
Facility
|
OP
|
$7,485.00
|
|
|
Service Code
|
CPT 74475
|
| Hospital Charge Code |
630567
|
| Min. Negotiated Rate |
$2,179.63 |
| Max. Negotiated Rate |
$7,161.65 |
| Rate for Payer: Aetna Commercial |
$7,005.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,694.58
|
| Rate for Payer: Aetna Managed Medicare |
$2,179.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,059.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,892.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,736.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,125.73
|
| Rate for Payer: Cash Price |
$2,245.50
|
| Rate for Payer: Cigna Commercial |
$7,161.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,356.27
|
| Rate for Payer: Health EOS Commercial |
$6,928.12
|
| Rate for Payer: HFN Commercial |
$7,161.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,838.30
|
| Rate for Payer: Multiplan Commercial |
$6,227.52
|
| Rate for Payer: NAPHCARE Commercial |
$4,670.64
|
| Rate for Payer: Preferred Network Access Commercial |
$7,161.65
|
| Rate for Payer: Quartz Beloit One Network |
$3,814.36
|
| Rate for Payer: Quartz Commercial |
$5,059.86
|
| Rate for Payer: Quartz Medicare Advantage |
$4,670.64
|
| Rate for Payer: The Alliance Commercial |
$3,892.20
|
| Rate for Payer: WEA Trust Commercial |
$4,281.42
|
| Rate for Payer: WPS Commercial |
$5,765.70
|
|
|
zzCV Renal Catheter Perc Placement Right
|
Facility
|
IP
|
$7,485.00
|
|
|
Service Code
|
CPT 74475
|
| Hospital Charge Code |
630571
|
| Min. Negotiated Rate |
$3,814.36 |
| Max. Negotiated Rate |
$7,161.65 |
| Rate for Payer: Aetna Commercial |
$7,005.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,694.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,125.73
|
| Rate for Payer: Cash Price |
$2,245.50
|
| Rate for Payer: Cigna Commercial |
$7,161.65
|
| Rate for Payer: Health EOS Commercial |
$6,928.12
|
| Rate for Payer: HFN Commercial |
$7,161.65
|
| Rate for Payer: Multiplan Commercial |
$6,227.52
|
| Rate for Payer: Preferred Network Access Commercial |
$7,161.65
|
| Rate for Payer: Quartz Beloit One Network |
$3,814.36
|
| Rate for Payer: Quartz Commercial |
$4,670.64
|
| Rate for Payer: WEA Trust Commercial |
$4,281.42
|
| Rate for Payer: WPS Commercial |
$5,765.70
|
|
|
zzCV Renal Catheter Perc Placement Right
|
Facility
|
OP
|
$7,485.00
|
|
|
Service Code
|
CPT 74475
|
| Hospital Charge Code |
630571
|
| Min. Negotiated Rate |
$2,179.63 |
| Max. Negotiated Rate |
$7,161.65 |
| Rate for Payer: Aetna Commercial |
$7,005.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,694.58
|
| Rate for Payer: Aetna Managed Medicare |
$2,179.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,059.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,892.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,736.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,125.73
|
| Rate for Payer: Cash Price |
$2,245.50
|
| Rate for Payer: Cigna Commercial |
$7,161.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,356.27
|
| Rate for Payer: Health EOS Commercial |
$6,928.12
|
| Rate for Payer: HFN Commercial |
$7,161.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,838.30
|
| Rate for Payer: Multiplan Commercial |
$6,227.52
|
| Rate for Payer: NAPHCARE Commercial |
$4,670.64
|
| Rate for Payer: Preferred Network Access Commercial |
$7,161.65
|
| Rate for Payer: Quartz Beloit One Network |
$3,814.36
|
| Rate for Payer: Quartz Commercial |
$5,059.86
|
| Rate for Payer: Quartz Medicare Advantage |
$4,670.64
|
| Rate for Payer: The Alliance Commercial |
$3,892.20
|
| Rate for Payer: WEA Trust Commercial |
$4,281.42
|
| Rate for Payer: WPS Commercial |
$5,765.70
|
|
|
zzCV Reposition of Pace/ICD Lead
|
Facility
|
IP
|
$6,251.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
1478807
|
| Min. Negotiated Rate |
$3,185.51 |
| Max. Negotiated Rate |
$5,980.96 |
| Rate for Payer: Aetna Commercial |
$5,850.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,590.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,445.55
|
| Rate for Payer: Cash Price |
$1,875.30
|
| Rate for Payer: Cigna Commercial |
$5,980.96
|
| Rate for Payer: Health EOS Commercial |
$5,785.93
|
| Rate for Payer: HFN Commercial |
$5,980.96
|
| Rate for Payer: Multiplan Commercial |
$5,200.83
|
| Rate for Payer: Preferred Network Access Commercial |
$5,980.96
|
| Rate for Payer: Quartz Beloit One Network |
$3,185.51
|
| Rate for Payer: Quartz Commercial |
$3,900.62
|
| Rate for Payer: WEA Trust Commercial |
$3,575.57
|
| Rate for Payer: WPS Commercial |
$4,815.15
|
|
|
zzCV Reposition of Pace/ICD Lead
|
Facility
|
OP
|
$6,251.00
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
1478807
|
| Min. Negotiated Rate |
$3,120.50 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$5,850.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,590.89
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,225.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,250.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,120.50
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,445.55
|
| 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 |
$1,875.30
|
| Rate for Payer: Cash Price |
$1,875.30
|
| Rate for Payer: Cigna Commercial |
$5,980.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,638.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$5,785.93
|
| Rate for Payer: HFN Commercial |
$5,980.96
|
| 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 |
$5,200.83
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$5,980.96
|
| Rate for Payer: Quartz Beloit One Network |
$3,185.51
|
| Rate for Payer: Quartz Commercial |
$4,225.68
|
| 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 |
$3,575.57
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$4,815.15
|
|
|
zzCV Revision Pacemaker Pocket
|
Facility
|
IP
|
$5,959.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
1478812
|
| Min. Negotiated Rate |
$3,036.71 |
| Max. Negotiated Rate |
$5,701.57 |
| Rate for Payer: Aetna Commercial |
$5,577.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,329.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,284.60
|
| Rate for Payer: Cash Price |
$1,787.70
|
| Rate for Payer: Cigna Commercial |
$5,701.57
|
| Rate for Payer: Health EOS Commercial |
$5,515.65
|
| Rate for Payer: HFN Commercial |
$5,701.57
|
| Rate for Payer: Multiplan Commercial |
$4,957.89
|
| Rate for Payer: Preferred Network Access Commercial |
$5,701.57
|
| Rate for Payer: Quartz Beloit One Network |
$3,036.71
|
| Rate for Payer: Quartz Commercial |
$3,718.42
|
| Rate for Payer: WEA Trust Commercial |
$3,408.55
|
| Rate for Payer: WPS Commercial |
$4,590.22
|
|
|
zzCV Revision Pacemaker Pocket
|
Facility
|
OP
|
$5,959.00
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
1478812
|
| Min. Negotiated Rate |
$2,171.37 |
| Max. Negotiated Rate |
$8,685.50 |
| Rate for Payer: Aetna Commercial |
$5,577.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,329.73
|
| Rate for Payer: Aetna Managed Medicare |
$2,171.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,028.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,098.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,974.73
|
| Rate for Payer: Anthem Medicare Advantage |
$2,171.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,284.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,171.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,171.37
|
| Rate for Payer: Cash Price |
$1,787.70
|
| Rate for Payer: Cash Price |
$1,787.70
|
| Rate for Payer: Cigna Commercial |
$5,701.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,171.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,468.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,171.37
|
| Rate for Payer: Health EOS Commercial |
$5,515.65
|
| Rate for Payer: HFN Commercial |
$5,701.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,077.51
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,171.37
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,171.37
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,171.37
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,171.37
|
| Rate for Payer: Multiplan Commercial |
$4,957.89
|
| Rate for Payer: NAPHCARE Commercial |
$3,257.06
|
| Rate for Payer: Preferred Network Access Commercial |
$5,701.57
|
| Rate for Payer: Quartz Beloit One Network |
$3,036.71
|
| Rate for Payer: Quartz Commercial |
$4,028.28
|
| Rate for Payer: Quartz Medicare Advantage |
$2,171.37
|
| Rate for Payer: The Alliance Commercial |
$8,685.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,171.37
|
| Rate for Payer: WEA Trust Commercial |
$3,408.55
|
| Rate for Payer: Wellcare Medicare |
$2,171.37
|
| Rate for Payer: WPS Commercial |
$4,590.22
|
|
|
zzCV Temporary Pacemaker
|
Facility
|
OP
|
$4,446.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
1478802
|
| Min. Negotiated Rate |
$2,219.44 |
| Max. Negotiated Rate |
$34,835.72 |
| Rate for Payer: Aetna Commercial |
$4,161.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,976.50
|
| Rate for Payer: Aetna Managed Medicare |
$8,708.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,005.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,311.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,219.44
|
| Rate for Payer: Anthem Medicare Advantage |
$8,708.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,450.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,708.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,708.93
|
| Rate for Payer: Cash Price |
$1,333.80
|
| Rate for Payer: Cash Price |
$1,333.80
|
| Rate for Payer: Cigna Commercial |
$4,253.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,708.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,587.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,708.93
|
| Rate for Payer: Health EOS Commercial |
$4,115.22
|
| Rate for Payer: HFN Commercial |
$4,253.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,397.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,708.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,708.93
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,708.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,708.93
|
| Rate for Payer: Multiplan Commercial |
$3,699.07
|
| Rate for Payer: NAPHCARE Commercial |
$13,063.39
|
| Rate for Payer: Preferred Network Access Commercial |
$4,253.93
|
| Rate for Payer: Quartz Beloit One Network |
$2,265.68
|
| Rate for Payer: Quartz Commercial |
$3,005.50
|
| Rate for Payer: Quartz Medicare Advantage |
$8,708.93
|
| Rate for Payer: The Alliance Commercial |
$34,835.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,708.93
|
| Rate for Payer: WEA Trust Commercial |
$2,543.11
|
| Rate for Payer: Wellcare Medicare |
$8,708.93
|
| Rate for Payer: WPS Commercial |
$3,424.75
|
|
|
zzCV Temporary Pacemaker
|
Facility
|
IP
|
$4,446.00
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
1478802
|
| Min. Negotiated Rate |
$2,265.68 |
| Max. Negotiated Rate |
$4,253.93 |
| Rate for Payer: Aetna Commercial |
$4,161.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,976.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,450.64
|
| Rate for Payer: Cash Price |
$1,333.80
|
| Rate for Payer: Cigna Commercial |
$4,253.93
|
| Rate for Payer: Health EOS Commercial |
$4,115.22
|
| Rate for Payer: HFN Commercial |
$4,253.93
|
| Rate for Payer: Multiplan Commercial |
$3,699.07
|
| Rate for Payer: Preferred Network Access Commercial |
$4,253.93
|
| Rate for Payer: Quartz Beloit One Network |
$2,265.68
|
| Rate for Payer: Quartz Commercial |
$2,774.30
|
| Rate for Payer: WEA Trust Commercial |
$2,543.11
|
| Rate for Payer: WPS Commercial |
$3,424.75
|
|
|
zzCV Venogram Cava Inferior
|
Facility
|
OP
|
$7,465.00
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
629672
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Commercial |
$6,987.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,676.70
|
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,046.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,881.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,726.53
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,114.71
|
| 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 |
$2,239.50
|
| Rate for Payer: Cash Price |
$2,239.50
|
| Rate for Payer: Cigna Commercial |
$7,142.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,344.63
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Health EOS Commercial |
$6,909.60
|
| Rate for Payer: HFN Commercial |
$7,142.51
|
| 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 |
$6,210.88
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Preferred Network Access Commercial |
$7,142.51
|
| Rate for Payer: Quartz Beloit One Network |
$3,804.16
|
| Rate for Payer: Quartz Commercial |
$5,046.34
|
| 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 |
$4,269.98
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
| Rate for Payer: WPS Commercial |
$5,750.29
|
|
