|
Biopsy of Tongue; Anterior Two-Thirds
|
Professional
|
$510.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
1190858
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.18 |
| Max. Negotiated Rate |
$484.50 |
| Rate for Payer: Aetna Commercial |
$484.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$438.60
|
| Rate for Payer: Aetna Managed Medicare |
$101.97
|
| Rate for Payer: Anthem Medicare Advantage |
$101.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$101.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$101.97
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cigna Commercial |
$484.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$255.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$101.97
|
| Rate for Payer: Health EOS Commercial |
$464.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$359.78
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$359.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$101.97
|
| Rate for Payer: Multiplan Commercial |
$408.00
|
| Rate for Payer: Preferred Network Access Commercial |
$484.50
|
| Rate for Payer: Quartz Beloit One Network |
$224.40
|
| Rate for Payer: Quartz Commercial |
$290.70
|
| Rate for Payer: Quartz Medicare Advantage |
$101.97
|
| Rate for Payer: The Alliance Commercial |
$433.37
|
| Rate for Payer: United Healthcare Medicaid |
$45.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$101.97
|
| Rate for Payer: WEA Trust Commercial |
$280.50
|
| Rate for Payer: WPS Commercial |
$458.86
|
|
|
BIOPSY OF TONGUE; ANTERIOR TWO-THIRDS
|
Facility
OP
|
$5,812.20
|
|
|
Service Code
|
CPT 41100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$543.83 |
| Max. Negotiated Rate |
$5,812.20 |
| Rate for Payer: Aetna Managed Medicare |
$543.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,914.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,297.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,183.00
|
| Rate for Payer: Anthem Medicare Advantage |
$543.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$543.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$543.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$543.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$543.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,023.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$543.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$543.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$543.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$543.83
|
| Rate for Payer: NAPHCARE Commercial |
$815.74
|
| Rate for Payer: Quartz Medicare Advantage |
$543.83
|
| Rate for Payer: The Alliance Commercial |
$5,812.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$543.83
|
| Rate for Payer: United Healthcare PPO |
$2,257.00
|
| Rate for Payer: Wellcare Medicare |
$543.83
|
|
|
BIOPSY OF URETHRA 53200
|
Professional
|
$753.00
|
|
|
Service Code
|
CPT 53200
|
| Hospital Charge Code |
3015009
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$120.52 |
| Max. Negotiated Rate |
$715.35 |
| Rate for Payer: Aetna Commercial |
$715.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$647.58
|
| Rate for Payer: Aetna Managed Medicare |
$131.30
|
| Rate for Payer: Anthem Medicare Advantage |
$131.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$131.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$131.30
|
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: Cigna Commercial |
$715.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$376.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$131.30
|
| Rate for Payer: Health EOS Commercial |
$685.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$471.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$471.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$131.30
|
| Rate for Payer: Multiplan Commercial |
$602.40
|
| Rate for Payer: Preferred Network Access Commercial |
$715.35
|
| Rate for Payer: Quartz Beloit One Network |
$331.32
|
| Rate for Payer: Quartz Commercial |
$429.21
|
| Rate for Payer: Quartz Medicare Advantage |
$131.30
|
| Rate for Payer: The Alliance Commercial |
$558.02
|
| Rate for Payer: United Healthcare Medicaid |
$120.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$131.30
|
| Rate for Payer: WEA Trust Commercial |
$414.15
|
| Rate for Payer: WPS Commercial |
$590.85
|
|
|
Biopsy Of Vagina
|
Professional
|
$404.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
1190837
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.18 |
| Max. Negotiated Rate |
$383.80 |
| Rate for Payer: Aetna Commercial |
$383.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$347.44
|
| Rate for Payer: Aetna Managed Medicare |
$60.39
|
| Rate for Payer: Anthem Medicare Advantage |
$60.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$60.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$60.39
|
| Rate for Payer: Cash Price |
$121.20
|
| Rate for Payer: Cash Price |
$121.20
|
| Rate for Payer: Cigna Commercial |
$383.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$202.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$60.39
|
| Rate for Payer: Health EOS Commercial |
$367.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$217.38
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$217.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$60.39
|
| Rate for Payer: Multiplan Commercial |
$323.20
|
| Rate for Payer: Preferred Network Access Commercial |
$383.80
|
| Rate for Payer: Quartz Beloit One Network |
$177.76
|
| Rate for Payer: Quartz Commercial |
$230.28
|
| Rate for Payer: Quartz Medicare Advantage |
$60.39
|
| Rate for Payer: The Alliance Commercial |
$256.66
|
| Rate for Payer: United Healthcare Medicaid |
$45.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$60.39
|
| Rate for Payer: WEA Trust Commercial |
$222.20
|
| Rate for Payer: WPS Commercial |
$271.76
|
|
|
BIOPSY OF VAGINA 57105
|
Professional
|
$606.00
|
|
|
Service Code
|
CPT 57105
|
| Hospital Charge Code |
3015069
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$114.93 |
| Max. Negotiated Rate |
$625.95 |
| Rate for Payer: Aetna Commercial |
$575.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$521.16
|
| Rate for Payer: Aetna Managed Medicare |
$139.10
|
| Rate for Payer: Anthem Medicare Advantage |
$139.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$139.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$139.10
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cigna Commercial |
$575.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$303.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$139.10
|
| Rate for Payer: Health EOS Commercial |
$551.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$480.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$480.22
|
| Rate for Payer: Independent Care Health Plan Medicare |
$139.10
|
| Rate for Payer: Multiplan Commercial |
$484.80
|
| Rate for Payer: Preferred Network Access Commercial |
$575.70
|
| Rate for Payer: Quartz Beloit One Network |
$266.64
|
| Rate for Payer: Quartz Commercial |
$345.42
|
| Rate for Payer: Quartz Medicare Advantage |
$139.10
|
| Rate for Payer: The Alliance Commercial |
$591.18
|
| Rate for Payer: United Healthcare Medicaid |
$114.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$139.10
|
| Rate for Payer: WEA Trust Commercial |
$333.30
|
| Rate for Payer: WPS Commercial |
$625.95
|
|
|
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION
|
Facility
OP
|
$7,358.52
|
|
|
Service Code
|
CPT 56605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$794.59 |
| Max. Negotiated Rate |
$7,358.52 |
| Rate for Payer: Aetna Managed Medicare |
$794.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,914.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,297.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,183.00
|
| Rate for Payer: Anthem Medicare Advantage |
$794.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$794.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$794.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$794.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$794.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,955.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$794.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$794.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$794.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$794.59
|
| Rate for Payer: NAPHCARE Commercial |
$1,191.88
|
| Rate for Payer: Quartz Medicare Advantage |
$794.59
|
| Rate for Payer: The Alliance Commercial |
$7,358.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$794.59
|
| Rate for Payer: United Healthcare PPO |
$2,257.00
|
| Rate for Payer: Wellcare Medicare |
$794.59
|
|
|
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); EACH SEPARATE ADDITIONAL LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
OP
|
$7,358.52
|
|
|
Service Code
|
CPT 56606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,218.22 |
| Max. Negotiated Rate |
$7,358.52 |
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: The Alliance Commercial |
$7,358.52
|
|
|
Biopsy Of Vulva/Perineum, 1 Lesion 56605
|
Professional
|
$612.00
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
1188884
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$54.97 |
| Max. Negotiated Rate |
$581.40 |
| Rate for Payer: Aetna Commercial |
$581.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$526.32
|
| Rate for Payer: Aetna Managed Medicare |
$54.97
|
| Rate for Payer: Anthem Medicare Advantage |
$54.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$54.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$54.97
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cigna Commercial |
$581.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$306.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$54.97
|
| Rate for Payer: Health EOS Commercial |
$556.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$197.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$197.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$54.97
|
| Rate for Payer: Multiplan Commercial |
$489.60
|
| Rate for Payer: Preferred Network Access Commercial |
$581.40
|
| Rate for Payer: Quartz Beloit One Network |
$269.28
|
| Rate for Payer: Quartz Commercial |
$348.84
|
| Rate for Payer: Quartz Medicare Advantage |
$54.97
|
| Rate for Payer: The Alliance Commercial |
$233.62
|
| Rate for Payer: United Healthcare Medicaid |
$73.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54.97
|
| Rate for Payer: WEA Trust Commercial |
$336.60
|
| Rate for Payer: WPS Commercial |
$247.36
|
|
|
Biopsy of Vulva/Perineum Each Add'l Lesion 56606
|
Professional
|
$169.00
|
|
|
Service Code
|
CPT 56606
|
| Hospital Charge Code |
1190844
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.11 |
| Max. Negotiated Rate |
$160.55 |
| Rate for Payer: Aetna Commercial |
$160.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$145.34
|
| Rate for Payer: Aetna Managed Medicare |
$27.11
|
| Rate for Payer: Anthem Medicare Advantage |
$27.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.11
|
| Rate for Payer: Cash Price |
$50.70
|
| Rate for Payer: Cash Price |
$50.70
|
| Rate for Payer: Cigna Commercial |
$160.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$84.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27.11
|
| Rate for Payer: Health EOS Commercial |
$153.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$96.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$96.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.11
|
| Rate for Payer: Multiplan Commercial |
$135.20
|
| Rate for Payer: Preferred Network Access Commercial |
$160.55
|
| Rate for Payer: Quartz Beloit One Network |
$74.36
|
| Rate for Payer: Quartz Commercial |
$96.33
|
| Rate for Payer: Quartz Medicare Advantage |
$27.11
|
| Rate for Payer: The Alliance Commercial |
$115.22
|
| Rate for Payer: United Healthcare Medicaid |
$36.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.11
|
| Rate for Payer: WEA Trust Commercial |
$92.95
|
| Rate for Payer: WPS Commercial |
$122.00
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP AXILLARY NODE(S)
|
Facility
OP
|
$14,015.29
|
|
|
Service Code
|
CPT 38525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,767.55 |
| Max. Negotiated Rate |
$14,015.29 |
| Rate for Payer: Aetna Managed Medicare |
$3,767.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,767.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,767.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,767.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,767.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,767.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,015.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,767.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,767.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,767.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,767.55
|
| Rate for Payer: NAPHCARE Commercial |
$5,651.32
|
| Rate for Payer: Quartz Medicare Advantage |
$3,767.55
|
| Rate for Payer: The Alliance Commercial |
$6,179.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,767.55
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,767.55
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP CERVICAL NODE(S)
|
Facility
OP
|
$21,990.36
|
|
|
Service Code
|
CPT 38510
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,767.55 |
| Max. Negotiated Rate |
$21,990.36 |
| Rate for Payer: Aetna Managed Medicare |
$3,767.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,767.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,767.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,767.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,767.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,767.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,015.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,767.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,767.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,767.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,767.55
|
| Rate for Payer: NAPHCARE Commercial |
$5,651.32
|
| Rate for Payer: Quartz Medicare Advantage |
$3,767.55
|
| Rate for Payer: The Alliance Commercial |
$21,990.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,767.55
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,767.55
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, INGUINOFEMORAL NODE(S)
|
Facility
OP
|
$208,264.68
|
|
|
Service Code
|
CPT 38531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,767.55 |
| Max. Negotiated Rate |
$208,264.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,767.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,767.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,767.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,767.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,767.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,767.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,015.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,767.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,767.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,767.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,767.55
|
| Rate for Payer: NAPHCARE Commercial |
$5,651.32
|
| Rate for Payer: Quartz Medicare Advantage |
$3,767.55
|
| Rate for Payer: The Alliance Commercial |
$208,264.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,767.55
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,767.55
|
|
|
Biopsy or Excision of Lymph Node(s); Open, Superficial
|
Professional
|
$1,137.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
1190864
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$136.08 |
| Max. Negotiated Rate |
$1,080.15 |
| Rate for Payer: Aetna Commercial |
$1,080.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$977.82
|
| Rate for Payer: Aetna Managed Medicare |
$233.52
|
| Rate for Payer: Anthem Medicare Advantage |
$233.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$233.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$233.52
|
| Rate for Payer: Cash Price |
$341.10
|
| Rate for Payer: Cash Price |
$341.10
|
| Rate for Payer: Cigna Commercial |
$1,080.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$568.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$233.52
|
| Rate for Payer: Health EOS Commercial |
$1,034.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$832.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$832.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$233.52
|
| Rate for Payer: Multiplan Commercial |
$909.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,080.15
|
| Rate for Payer: Quartz Beloit One Network |
$500.28
|
| Rate for Payer: Quartz Commercial |
$648.09
|
| Rate for Payer: Quartz Medicare Advantage |
$233.52
|
| Rate for Payer: The Alliance Commercial |
$992.46
|
| Rate for Payer: United Healthcare Medicaid |
$136.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$233.52
|
| Rate for Payer: WEA Trust Commercial |
$625.35
|
| Rate for Payer: WPS Commercial |
$1,050.84
|
|
|
Biopsy, Oropharynx
|
Professional
|
$435.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
1190854
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$60.63 |
| Max. Negotiated Rate |
$498.60 |
| Rate for Payer: Aetna Commercial |
$413.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$374.10
|
| Rate for Payer: Aetna Managed Medicare |
$110.80
|
| Rate for Payer: Anthem Medicare Advantage |
$110.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$110.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$110.80
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cigna Commercial |
$413.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$217.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$110.80
|
| Rate for Payer: Health EOS Commercial |
$395.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$380.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$380.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$110.80
|
| Rate for Payer: Multiplan Commercial |
$348.00
|
| Rate for Payer: Preferred Network Access Commercial |
$413.25
|
| Rate for Payer: Quartz Beloit One Network |
$191.40
|
| Rate for Payer: Quartz Commercial |
$247.95
|
| Rate for Payer: Quartz Medicare Advantage |
$110.80
|
| Rate for Payer: The Alliance Commercial |
$470.90
|
| Rate for Payer: United Healthcare Medicaid |
$60.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110.80
|
| Rate for Payer: WEA Trust Commercial |
$239.25
|
| Rate for Payer: WPS Commercial |
$498.60
|
|
|
Biopsy: Oropharynx
|
Professional
|
$435.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
1152811
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$60.63 |
| Max. Negotiated Rate |
$498.60 |
| Rate for Payer: Aetna Commercial |
$413.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$374.10
|
| Rate for Payer: Aetna Managed Medicare |
$110.80
|
| Rate for Payer: Anthem Medicare Advantage |
$110.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$110.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$110.80
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cigna Commercial |
$413.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$217.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$110.80
|
| Rate for Payer: Health EOS Commercial |
$395.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$380.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$380.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$110.80
|
| Rate for Payer: Multiplan Commercial |
$348.00
|
| Rate for Payer: Preferred Network Access Commercial |
$413.25
|
| Rate for Payer: Quartz Beloit One Network |
$191.40
|
| Rate for Payer: Quartz Commercial |
$247.95
|
| Rate for Payer: Quartz Medicare Advantage |
$110.80
|
| Rate for Payer: The Alliance Commercial |
$470.90
|
| Rate for Payer: United Healthcare Medicaid |
$60.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110.80
|
| Rate for Payer: WEA Trust Commercial |
$239.25
|
| Rate for Payer: WPS Commercial |
$498.60
|
|
|
BIOPSY, PANCREATIC
|
Facility
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959890
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$281.68 |
| Max. Negotiated Rate |
$4,024.00 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| Rate for Payer: Aetna Managed Medicare |
$281.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$653.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$503.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$482.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$562.96
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$754.50
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$653.90
|
| Rate for Payer: Quartz Medicare Advantage |
$603.60
|
| Rate for Payer: The Alliance Commercial |
$4,024.00
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
BIOPSY, PANCREATIC
|
Facility
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959890
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$492.94 |
| Max. Negotiated Rate |
$925.52 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$603.60
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
BIOPSY, PENIS/TESTICLE
|
Facility
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959896
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$492.94 |
| Max. Negotiated Rate |
$925.52 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$603.60
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
BIOPSY, PENIS/TESTICLE
|
Facility
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959896
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$281.68 |
| Max. Negotiated Rate |
$4,024.00 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| Rate for Payer: Aetna Managed Medicare |
$281.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$653.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$503.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$482.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$562.96
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$754.50
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$653.90
|
| Rate for Payer: Quartz Medicare Advantage |
$603.60
|
| Rate for Payer: The Alliance Commercial |
$4,024.00
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
BIOPSY, PLEURAL
|
Facility
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959892
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$281.68 |
| Max. Negotiated Rate |
$4,024.00 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| Rate for Payer: Aetna Managed Medicare |
$281.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$653.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$503.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$482.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$562.96
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$754.50
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$653.90
|
| Rate for Payer: Quartz Medicare Advantage |
$603.60
|
| Rate for Payer: The Alliance Commercial |
$4,024.00
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
BIOPSY, PLEURAL
|
Facility
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959892
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$492.94 |
| Max. Negotiated Rate |
$925.52 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$603.60
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
Biopsy, Prostate needle or punch 55700
|
Professional
|
$920.00
|
|
|
Service Code
|
CPT 55700
|
| Hospital Charge Code |
1188980
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$107.81 |
| Max. Negotiated Rate |
$874.00 |
| Rate for Payer: Aetna Commercial |
$874.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$791.20
|
| Rate for Payer: Aetna Managed Medicare |
$120.42
|
| Rate for Payer: Anthem Medicare Advantage |
$120.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$120.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$120.42
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cigna Commercial |
$874.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$460.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$120.42
|
| Rate for Payer: Health EOS Commercial |
$837.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$434.15
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$434.15
|
| Rate for Payer: Independent Care Health Plan Medicare |
$120.42
|
| Rate for Payer: Multiplan Commercial |
$736.00
|
| Rate for Payer: Preferred Network Access Commercial |
$874.00
|
| Rate for Payer: Quartz Beloit One Network |
$404.80
|
| Rate for Payer: Quartz Commercial |
$524.40
|
| Rate for Payer: Quartz Medicare Advantage |
$120.42
|
| Rate for Payer: The Alliance Commercial |
$511.78
|
| Rate for Payer: United Healthcare Medicaid |
$107.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$120.42
|
| Rate for Payer: WEA Trust Commercial |
$506.00
|
| Rate for Payer: WPS Commercial |
$541.89
|
|
|
BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH
|
Facility
OP
|
$51,915.80
|
|
|
Service Code
|
CPT 55700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,013.20 |
| Max. Negotiated Rate |
$51,915.80 |
| Rate for Payer: Aetna Managed Medicare |
$2,013.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$2,013.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,013.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,013.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,013.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,013.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,489.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,013.20
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,013.20
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,013.20
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,013.20
|
| Rate for Payer: NAPHCARE Commercial |
$3,019.80
|
| Rate for Payer: Quartz Medicare Advantage |
$2,013.20
|
| Rate for Payer: The Alliance Commercial |
$51,915.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,013.20
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$2,013.20
|
|
|
BIOPSY, PULMONARY
|
Facility
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959893
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$492.94 |
| Max. Negotiated Rate |
$925.52 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$603.60
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
BIOPSY, PULMONARY
|
Facility
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959893
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$281.68 |
| Max. Negotiated Rate |
$4,024.00 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| Rate for Payer: Aetna Managed Medicare |
$281.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$653.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$503.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$482.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$562.96
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$754.50
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$653.90
|
| Rate for Payer: Quartz Medicare Advantage |
$603.60
|
| Rate for Payer: The Alliance Commercial |
$4,024.00
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
