|
BIOPSY PUNCH DERMAL 4MM 33-34
|
Facility
IP
|
$64.00
|
|
| Hospital Charge Code |
2974548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.36 |
| Max. Negotiated Rate |
$58.88 |
| Rate for Payer: Aetna Commercial |
$57.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$33.92
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cigna Commercial |
$58.88
|
| Rate for Payer: Health EOS Commercial |
$56.96
|
| Rate for Payer: HFN Commercial |
$58.88
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: NAPHCARE Commercial |
$38.40
|
| Rate for Payer: Preferred Network Access Commercial |
$58.88
|
| Rate for Payer: Quartz Beloit One Network |
$31.36
|
| Rate for Payer: Quartz Commercial |
$38.40
|
| Rate for Payer: WEA Trust Commercial |
$35.20
|
| Rate for Payer: WPS Commercial |
$47.40
|
|
|
BIOPSY PUNCH DERMAL 4MM 33-34
|
Facility
OP
|
$64.00
|
|
| Hospital Charge Code |
2974548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.92 |
| Max. Negotiated Rate |
$256.00 |
| Rate for Payer: Aetna Commercial |
$57.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$55.04
|
| Rate for Payer: Aetna Managed Medicare |
$17.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$41.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$32.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$33.92
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cigna Commercial |
$58.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35.81
|
| Rate for Payer: Health EOS Commercial |
$56.96
|
| Rate for Payer: HFN Commercial |
$58.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.00
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: NAPHCARE Commercial |
$38.40
|
| Rate for Payer: Preferred Network Access Commercial |
$58.88
|
| Rate for Payer: Quartz Beloit One Network |
$31.36
|
| Rate for Payer: Quartz Commercial |
$41.60
|
| Rate for Payer: Quartz Medicare Advantage |
$38.40
|
| Rate for Payer: The Alliance Commercial |
$256.00
|
| Rate for Payer: WEA Trust Commercial |
$35.20
|
| Rate for Payer: WPS Commercial |
$47.40
|
|
|
BIOPSY/REMOVAL, LYMPH NODES 38510
|
Professional
|
$1,918.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
3014583
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$221.58 |
| Max. Negotiated Rate |
$1,822.10 |
| Rate for Payer: Aetna Commercial |
$1,822.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,649.48
|
| Rate for Payer: Aetna Managed Medicare |
$387.53
|
| Rate for Payer: Anthem Medicare Advantage |
$387.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$387.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$387.53
|
| Rate for Payer: Cash Price |
$575.40
|
| Rate for Payer: Cash Price |
$575.40
|
| Rate for Payer: Cigna Commercial |
$1,822.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$959.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$387.53
|
| Rate for Payer: Health EOS Commercial |
$1,745.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,372.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,372.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$387.53
|
| Rate for Payer: Multiplan Commercial |
$1,534.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,822.10
|
| Rate for Payer: Quartz Beloit One Network |
$843.92
|
| Rate for Payer: Quartz Commercial |
$1,093.26
|
| Rate for Payer: Quartz Medicare Advantage |
$387.53
|
| Rate for Payer: The Alliance Commercial |
$1,647.00
|
| Rate for Payer: United Healthcare Medicaid |
$221.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$387.53
|
| Rate for Payer: WEA Trust Commercial |
$1,054.90
|
| Rate for Payer: WPS Commercial |
$1,743.88
|
|
|
BIOPSY, RENAL
|
Facility
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959894
|
|
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, RENAL
|
Facility
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959894
|
|
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, SCALENE NODE
|
Facility
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959895
|
|
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, SCALENE NODE
|
Facility
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959895
|
|
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, SENTINAL LYMPH NODE
|
Facility
IP
|
$1,429.00
|
|
| Hospital Charge Code |
2960368
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$700.21 |
| Max. Negotiated Rate |
$1,314.68 |
| Rate for Payer: Aetna Commercial |
$1,286.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$757.37
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,314.68
|
| Rate for Payer: Health EOS Commercial |
$1,271.81
|
| Rate for Payer: HFN Commercial |
$1,314.68
|
| Rate for Payer: Multiplan Commercial |
$1,143.20
|
| Rate for Payer: NAPHCARE Commercial |
$857.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,314.68
|
| Rate for Payer: Quartz Beloit One Network |
$700.21
|
| Rate for Payer: Quartz Commercial |
$857.40
|
| Rate for Payer: WEA Trust Commercial |
$785.95
|
| Rate for Payer: WPS Commercial |
$1,058.46
|
|
|
BIOPSY, SENTINAL LYMPH NODE
|
Facility
OP
|
$1,429.00
|
|
| Hospital Charge Code |
2960368
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$400.12 |
| Max. Negotiated Rate |
$5,716.00 |
| Rate for Payer: Aetna Commercial |
$1,286.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.94
|
| Rate for Payer: Aetna Managed Medicare |
$400.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$928.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$714.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$685.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$757.37
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,314.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$799.67
|
| Rate for Payer: Health EOS Commercial |
$1,271.81
|
| Rate for Payer: HFN Commercial |
$1,314.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,071.75
|
| Rate for Payer: Multiplan Commercial |
$1,143.20
|
| Rate for Payer: NAPHCARE Commercial |
$857.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,314.68
|
| Rate for Payer: Quartz Beloit One Network |
$700.21
|
| Rate for Payer: Quartz Commercial |
$928.85
|
| Rate for Payer: Quartz Medicare Advantage |
$857.40
|
| Rate for Payer: The Alliance Commercial |
$5,716.00
|
| Rate for Payer: WEA Trust Commercial |
$785.95
|
| Rate for Payer: WPS Commercial |
$1,058.46
|
|
|
BIOPSY SHOULDER TISSUES 23065
|
Professional
|
$1,510.00
|
|
|
Service Code
|
CPT 23065
|
| Hospital Charge Code |
3013760
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.81 |
| Max. Negotiated Rate |
$1,434.50 |
| Rate for Payer: Aetna Commercial |
$1,434.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,298.60
|
| Rate for Payer: Aetna Managed Medicare |
$150.13
|
| Rate for Payer: Anthem Medicare Advantage |
$150.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$150.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$150.13
|
| Rate for Payer: Cash Price |
$453.00
|
| Rate for Payer: Cash Price |
$453.00
|
| Rate for Payer: Cigna Commercial |
$1,434.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$755.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$150.13
|
| Rate for Payer: Health EOS Commercial |
$1,374.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$542.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$542.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$150.13
|
| Rate for Payer: Multiplan Commercial |
$1,208.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,434.50
|
| Rate for Payer: Quartz Beloit One Network |
$664.40
|
| Rate for Payer: Quartz Commercial |
$860.70
|
| Rate for Payer: Quartz Medicare Advantage |
$150.13
|
| Rate for Payer: The Alliance Commercial |
$638.05
|
| Rate for Payer: United Healthcare Medicaid |
$49.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$150.13
|
| Rate for Payer: WEA Trust Commercial |
$830.50
|
| Rate for Payer: WPS Commercial |
$675.58
|
|
|
BIOPSY SHOULDER TISSUES 23066
|
Professional
|
$1,217.00
|
|
|
Service Code
|
CPT 23066
|
| Hospital Charge Code |
3013761
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$74.72 |
| Max. Negotiated Rate |
$1,548.72 |
| Rate for Payer: Aetna Commercial |
$1,156.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,046.62
|
| Rate for Payer: Aetna Managed Medicare |
$344.16
|
| Rate for Payer: Anthem Medicare Advantage |
$344.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$344.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$344.16
|
| Rate for Payer: Cash Price |
$365.10
|
| Rate for Payer: Cash Price |
$365.10
|
| Rate for Payer: Cigna Commercial |
$1,156.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$608.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$344.16
|
| Rate for Payer: Health EOS Commercial |
$1,107.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,217.71
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,217.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$344.16
|
| Rate for Payer: Multiplan Commercial |
$973.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,156.15
|
| Rate for Payer: Quartz Beloit One Network |
$535.48
|
| Rate for Payer: Quartz Commercial |
$693.69
|
| Rate for Payer: Quartz Medicare Advantage |
$344.16
|
| Rate for Payer: The Alliance Commercial |
$1,462.68
|
| Rate for Payer: United Healthcare Medicaid |
$74.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$344.16
|
| Rate for Payer: WEA Trust Commercial |
$669.35
|
| Rate for Payer: WPS Commercial |
$1,548.72
|
|
|
BIOPSY SOFT TISSUE OF BACK 21920
|
Professional
|
$509.00
|
|
|
Service Code
|
CPT 21920
|
| Hospital Charge Code |
3013745
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$72.65 |
| Max. Negotiated Rate |
$657.72 |
| Rate for Payer: Aetna Commercial |
$483.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$437.74
|
| Rate for Payer: Aetna Managed Medicare |
$146.16
|
| Rate for Payer: Anthem Medicare Advantage |
$146.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$146.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$146.16
|
| Rate for Payer: Cash Price |
$152.70
|
| Rate for Payer: Cash Price |
$152.70
|
| Rate for Payer: Cigna Commercial |
$483.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$254.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$146.16
|
| Rate for Payer: Health EOS Commercial |
$463.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$521.88
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$521.88
|
| Rate for Payer: Independent Care Health Plan Medicare |
$146.16
|
| Rate for Payer: Multiplan Commercial |
$407.20
|
| Rate for Payer: Preferred Network Access Commercial |
$483.55
|
| Rate for Payer: Quartz Beloit One Network |
$223.96
|
| Rate for Payer: Quartz Commercial |
$290.13
|
| Rate for Payer: Quartz Medicare Advantage |
$146.16
|
| Rate for Payer: The Alliance Commercial |
$621.18
|
| Rate for Payer: United Healthcare Medicaid |
$72.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$146.16
|
| Rate for Payer: WEA Trust Commercial |
$279.95
|
| Rate for Payer: WPS Commercial |
$657.72
|
|
|
BIOPSY, SOFT TISSUE OF BACK OR FLANK; DEEP
|
Facility
OP
|
$125,383.92
|
|
|
Service Code
|
CPT 21925
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,602.49 |
| Max. Negotiated Rate |
$125,383.92 |
| Rate for Payer: Aetna Managed Medicare |
$1,602.49
|
| 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 |
$1,602.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,602.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,602.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,602.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,602.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,961.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,602.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,602.49
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,602.49
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,602.49
|
| Rate for Payer: NAPHCARE Commercial |
$2,403.74
|
| Rate for Payer: Quartz Medicare Advantage |
$1,602.49
|
| Rate for Payer: The Alliance Commercial |
$125,383.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,602.49
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$1,602.49
|
|
|
BIOPSY, TEMPORAL ARTERY
|
Facility
IP
|
$1,129.00
|
|
| Hospital Charge Code |
2960403
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$553.21 |
| Max. Negotiated Rate |
$1,038.68 |
| Rate for Payer: Aetna Commercial |
$1,016.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$598.37
|
| Rate for Payer: Cash Price |
$338.70
|
| Rate for Payer: Cigna Commercial |
$1,038.68
|
| Rate for Payer: Health EOS Commercial |
$1,004.81
|
| Rate for Payer: HFN Commercial |
$1,038.68
|
| Rate for Payer: Multiplan Commercial |
$903.20
|
| Rate for Payer: NAPHCARE Commercial |
$677.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,038.68
|
| Rate for Payer: Quartz Beloit One Network |
$553.21
|
| Rate for Payer: Quartz Commercial |
$677.40
|
| Rate for Payer: WEA Trust Commercial |
$620.95
|
| Rate for Payer: WPS Commercial |
$836.25
|
|
|
BIOPSY, TEMPORAL ARTERY
|
Facility
OP
|
$1,129.00
|
|
| Hospital Charge Code |
2960403
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$316.12 |
| Max. Negotiated Rate |
$4,516.00 |
| Rate for Payer: Aetna Commercial |
$1,016.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$970.94
|
| Rate for Payer: Aetna Managed Medicare |
$316.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$733.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$564.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$541.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$598.37
|
| Rate for Payer: Cash Price |
$338.70
|
| Rate for Payer: Cigna Commercial |
$1,038.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$631.79
|
| Rate for Payer: Health EOS Commercial |
$1,004.81
|
| Rate for Payer: HFN Commercial |
$1,038.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$846.75
|
| Rate for Payer: Multiplan Commercial |
$903.20
|
| Rate for Payer: NAPHCARE Commercial |
$677.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,038.68
|
| Rate for Payer: Quartz Beloit One Network |
$553.21
|
| Rate for Payer: Quartz Commercial |
$733.85
|
| Rate for Payer: Quartz Medicare Advantage |
$677.40
|
| Rate for Payer: The Alliance Commercial |
$4,516.00
|
| Rate for Payer: WEA Trust Commercial |
$620.95
|
| Rate for Payer: WPS Commercial |
$836.25
|
|
|
BIOPSY, THIGH SOFT TISSUES 27323
|
Professional
|
$361.00
|
|
|
Service Code
|
CPT 27323
|
| Hospital Charge Code |
3014046
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$39.10 |
| Max. Negotiated Rate |
$743.90 |
| Rate for Payer: Aetna Commercial |
$342.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$310.46
|
| Rate for Payer: Aetna Managed Medicare |
$165.31
|
| Rate for Payer: Anthem Medicare Advantage |
$165.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$165.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$165.31
|
| Rate for Payer: Cash Price |
$108.30
|
| Rate for Payer: Cash Price |
$108.30
|
| Rate for Payer: Cigna Commercial |
$342.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$180.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$165.31
|
| Rate for Payer: Health EOS Commercial |
$328.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$583.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$583.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$165.31
|
| Rate for Payer: Multiplan Commercial |
$288.80
|
| Rate for Payer: Preferred Network Access Commercial |
$342.95
|
| Rate for Payer: Quartz Beloit One Network |
$158.84
|
| Rate for Payer: Quartz Commercial |
$205.77
|
| Rate for Payer: Quartz Medicare Advantage |
$165.31
|
| Rate for Payer: The Alliance Commercial |
$702.57
|
| Rate for Payer: United Healthcare Medicaid |
$39.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$165.31
|
| Rate for Payer: WEA Trust Commercial |
$198.55
|
| Rate for Payer: WPS Commercial |
$743.90
|
|
|
BIOPSY TONGUE POSTERIOR ONE-THIRD 41105
|
Professional
|
$1,146.00
|
|
|
Service Code
|
CPT 41105
|
| Hospital Charge Code |
5581933
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$1,088.70 |
| Rate for Payer: Aetna Commercial |
$1,088.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$985.56
|
| Rate for Payer: Aetna Managed Medicare |
$104.63
|
| Rate for Payer: Anthem Medicare Advantage |
$104.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$104.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$104.63
|
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Cigna Commercial |
$1,088.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$573.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$104.63
|
| Rate for Payer: Health EOS Commercial |
$1,042.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$369.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$369.41
|
| Rate for Payer: Independent Care Health Plan Medicare |
$104.63
|
| Rate for Payer: Multiplan Commercial |
$916.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,088.70
|
| Rate for Payer: Quartz Beloit One Network |
$504.24
|
| Rate for Payer: Quartz Commercial |
$653.22
|
| Rate for Payer: Quartz Medicare Advantage |
$104.63
|
| Rate for Payer: The Alliance Commercial |
$444.68
|
| Rate for Payer: United Healthcare Medicaid |
$75.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$104.63
|
| Rate for Payer: WEA Trust Commercial |
$630.30
|
| Rate for Payer: WPS Commercial |
$470.84
|
|
|
BIOPSY, TRANSANAL EXCISIONAL
|
Facility
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959897
|
|
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, TRANSANAL EXCISIONAL
|
Facility
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959897
|
|
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, URETHRA
|
Facility
OP
|
$1,455.00
|
|
| Hospital Charge Code |
2959898
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$407.40 |
| Max. Negotiated Rate |
$5,820.00 |
| Rate for Payer: Aetna Commercial |
$1,309.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,251.30
|
| Rate for Payer: Aetna Managed Medicare |
$407.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$945.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$727.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$698.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$771.15
|
| Rate for Payer: Cash Price |
$436.50
|
| Rate for Payer: Cigna Commercial |
$1,338.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$814.22
|
| Rate for Payer: Health EOS Commercial |
$1,294.95
|
| Rate for Payer: HFN Commercial |
$1,338.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,091.25
|
| Rate for Payer: Multiplan Commercial |
$1,164.00
|
| Rate for Payer: NAPHCARE Commercial |
$873.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,338.60
|
| Rate for Payer: Quartz Beloit One Network |
$712.95
|
| Rate for Payer: Quartz Commercial |
$945.75
|
| Rate for Payer: Quartz Medicare Advantage |
$873.00
|
| Rate for Payer: The Alliance Commercial |
$5,820.00
|
| Rate for Payer: WEA Trust Commercial |
$800.25
|
| Rate for Payer: WPS Commercial |
$1,077.72
|
|
|
BIOPSY, URETHRA
|
Facility
IP
|
$1,455.00
|
|
| Hospital Charge Code |
2959898
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$712.95 |
| Max. Negotiated Rate |
$1,338.60 |
| Rate for Payer: Aetna Commercial |
$1,309.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$771.15
|
| Rate for Payer: Cash Price |
$436.50
|
| Rate for Payer: Cigna Commercial |
$1,338.60
|
| Rate for Payer: Health EOS Commercial |
$1,294.95
|
| Rate for Payer: HFN Commercial |
$1,338.60
|
| Rate for Payer: Multiplan Commercial |
$1,164.00
|
| Rate for Payer: NAPHCARE Commercial |
$873.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,338.60
|
| Rate for Payer: Quartz Beloit One Network |
$712.95
|
| Rate for Payer: Quartz Commercial |
$873.00
|
| Rate for Payer: WEA Trust Commercial |
$800.25
|
| Rate for Payer: WPS Commercial |
$1,077.72
|
|
|
BIOPSY VALVE DISP W/IRRIGATION
|
Facility
IP
|
$144.00
|
|
| Hospital Charge Code |
2973332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.56 |
| Max. Negotiated Rate |
$132.48 |
| Rate for Payer: Aetna Commercial |
$129.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$76.32
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cigna Commercial |
$132.48
|
| Rate for Payer: Health EOS Commercial |
$128.16
|
| Rate for Payer: HFN Commercial |
$132.48
|
| Rate for Payer: Multiplan Commercial |
$115.20
|
| Rate for Payer: NAPHCARE Commercial |
$86.40
|
| Rate for Payer: Preferred Network Access Commercial |
$132.48
|
| Rate for Payer: Quartz Beloit One Network |
$70.56
|
| Rate for Payer: Quartz Commercial |
$86.40
|
| Rate for Payer: WEA Trust Commercial |
$79.20
|
| Rate for Payer: WPS Commercial |
$106.66
|
|
|
BIOPSY VALVE DISP W/IRRIGATION
|
Facility
OP
|
$144.00
|
|
| Hospital Charge Code |
2973332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.32 |
| Max. Negotiated Rate |
$576.00 |
| Rate for Payer: Aetna Commercial |
$129.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$123.84
|
| Rate for Payer: Aetna Managed Medicare |
$40.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$93.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$72.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$69.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$76.32
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cigna Commercial |
$132.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$80.58
|
| Rate for Payer: Health EOS Commercial |
$128.16
|
| Rate for Payer: HFN Commercial |
$132.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$108.00
|
| Rate for Payer: Multiplan Commercial |
$115.20
|
| Rate for Payer: NAPHCARE Commercial |
$86.40
|
| Rate for Payer: Preferred Network Access Commercial |
$132.48
|
| Rate for Payer: Quartz Beloit One Network |
$70.56
|
| Rate for Payer: Quartz Commercial |
$93.60
|
| Rate for Payer: Quartz Medicare Advantage |
$86.40
|
| Rate for Payer: The Alliance Commercial |
$576.00
|
| Rate for Payer: WEA Trust Commercial |
$79.20
|
| Rate for Payer: WPS Commercial |
$106.66
|
|
|
BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL - UNL PROC 2099920251
|
Professional
|
$3,383.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
6170069
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,488.52 |
| Max. Negotiated Rate |
$3,213.85 |
| Rate for Payer: Aetna Commercial |
$3,213.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,909.38
|
| Rate for Payer: Cash Price |
$1,014.90
|
| Rate for Payer: Cash Price |
$1,014.90
|
| Rate for Payer: Cigna Commercial |
$3,213.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,691.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,029.80
|
| Rate for Payer: Health EOS Commercial |
$3,078.53
|
| Rate for Payer: Multiplan Commercial |
$2,706.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,213.85
|
| Rate for Payer: Quartz Beloit One Network |
$1,488.52
|
| Rate for Payer: Quartz Commercial |
$1,928.31
|
| Rate for Payer: The Alliance Commercial |
$1,691.50
|
| Rate for Payer: WEA Trust Commercial |
$1,860.65
|
| Rate for Payer: WPS Commercial |
$2,505.79
|
|
|
Biopsy, Vestibule of Mouth
|
Professional
|
$328.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
1190861
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.18 |
| Max. Negotiated Rate |
$380.25 |
| Rate for Payer: Aetna Commercial |
$311.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$282.08
|
| Rate for Payer: Aetna Managed Medicare |
$84.50
|
| Rate for Payer: Anthem Medicare Advantage |
$84.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$84.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$84.50
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cigna Commercial |
$311.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$164.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$84.50
|
| Rate for Payer: Health EOS Commercial |
$298.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$291.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$291.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$84.50
|
| Rate for Payer: Multiplan Commercial |
$262.40
|
| Rate for Payer: Preferred Network Access Commercial |
$311.60
|
| Rate for Payer: Quartz Beloit One Network |
$144.32
|
| Rate for Payer: Quartz Commercial |
$186.96
|
| Rate for Payer: Quartz Medicare Advantage |
$84.50
|
| Rate for Payer: The Alliance Commercial |
$359.12
|
| Rate for Payer: United Healthcare Medicaid |
$45.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$84.50
|
| Rate for Payer: WEA Trust Commercial |
$180.40
|
| Rate for Payer: WPS Commercial |
$380.25
|
|
