|
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 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 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 |
$4,386.95
|
| 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 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 |
$4,386.95
|
| 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 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
|
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
|
|
|
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 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: 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: HFN Commercial |
$8,324.16
|
| 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 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 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: Cash Price |
$2,556.30
|
| 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: 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 |
$6,807.99
|
| 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
|
OP
|
$9,597.00
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
1478832
|
| Min. Negotiated Rate |
$824.93 |
| Max. Negotiated Rate |
$12,349.86 |
| 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 |
$12,349.86
|
| 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 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 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 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 |
$12,349.86
|
| 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 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 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
|
|
