|
Beta 2 Microglobulin
|
Facility
|
OP
|
$228.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
977878
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$218.15 |
| Rate for Payer: Aetna Commercial |
$213.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$203.92
|
| Rate for Payer: Aetna Managed Medicare |
$16.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$63.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29.45
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.93
|
| Rate for Payer: Anthem Medicare Advantage |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$125.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.83
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cigna Commercial |
$218.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$132.70
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.83
|
| Rate for Payer: Health EOS Commercial |
$211.04
|
| Rate for Payer: HFN Commercial |
$218.15
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$62.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.83
|
| Rate for Payer: Multiplan Commercial |
$189.70
|
| Rate for Payer: NAPHCARE Commercial |
$25.24
|
| Rate for Payer: Preferred Network Access Commercial |
$218.15
|
| Rate for Payer: Quartz Beloit One Network |
$116.19
|
| Rate for Payer: Quartz Commercial |
$154.13
|
| Rate for Payer: Quartz Medicare Advantage |
$16.83
|
| Rate for Payer: The Alliance Commercial |
$67.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.83
|
| Rate for Payer: United Healthcare PPO |
$177.84
|
| Rate for Payer: WEA Trust Commercial |
$130.42
|
| Rate for Payer: Wellcare Medicare |
$16.83
|
| Rate for Payer: WPS Commercial |
$175.63
|
|
|
Beta 2 Microglobulin
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
977878
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$225.26 |
| Rate for Payer: Aetna Commercial |
$225.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$203.92
|
| Rate for Payer: Aetna Managed Medicare |
$16.83
|
| Rate for Payer: Anthem Medicare Advantage |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.83
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cigna Commercial |
$225.26
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$118.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.83
|
| Rate for Payer: Health EOS Commercial |
$215.78
|
| Rate for Payer: HFN Commercial |
$225.26
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$59.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$59.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.83
|
| Rate for Payer: Multiplan Commercial |
$189.70
|
| Rate for Payer: NAPHCARE Commercial |
$25.24
|
| Rate for Payer: Preferred Network Access Commercial |
$225.26
|
| Rate for Payer: Quartz Beloit One Network |
$104.33
|
| Rate for Payer: Quartz Commercial |
$135.16
|
| Rate for Payer: Quartz Medicare Advantage |
$16.83
|
| Rate for Payer: The Alliance Commercial |
$66.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.83
|
| Rate for Payer: WEA Trust Commercial |
$130.42
|
| Rate for Payer: WPS Commercial |
$74.04
|
|
|
Beta 2 Microglobulin
|
Facility
|
IP
|
$228.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
977878
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$116.19 |
| Max. Negotiated Rate |
$218.15 |
| Rate for Payer: Aetna Commercial |
$213.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$203.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$125.67
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cigna Commercial |
$218.15
|
| Rate for Payer: Health EOS Commercial |
$211.04
|
| Rate for Payer: HFN Commercial |
$218.15
|
| Rate for Payer: Multiplan Commercial |
$189.70
|
| Rate for Payer: Preferred Network Access Commercial |
$218.15
|
| Rate for Payer: Quartz Beloit One Network |
$116.19
|
| Rate for Payer: Quartz Commercial |
$142.27
|
| Rate for Payer: WEA Trust Commercial |
$130.42
|
| Rate for Payer: WPS Commercial |
$175.63
|
|
|
Beta 2 Microglobulin Urine
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
977879
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$77.97 |
| Max. Negotiated Rate |
$146.39 |
| Rate for Payer: Aetna Commercial |
$143.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$136.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$84.33
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cigna Commercial |
$146.39
|
| Rate for Payer: Health EOS Commercial |
$141.62
|
| Rate for Payer: HFN Commercial |
$146.39
|
| Rate for Payer: Multiplan Commercial |
$127.30
|
| Rate for Payer: Preferred Network Access Commercial |
$146.39
|
| Rate for Payer: Quartz Beloit One Network |
$77.97
|
| Rate for Payer: Quartz Commercial |
$95.47
|
| Rate for Payer: WEA Trust Commercial |
$87.52
|
| Rate for Payer: WPS Commercial |
$117.86
|
|
|
Beta 2 Microglobulin Urine
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
977879
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$151.16 |
| Rate for Payer: Aetna Commercial |
$151.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$136.84
|
| Rate for Payer: Aetna Managed Medicare |
$16.83
|
| Rate for Payer: Anthem Medicare Advantage |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.83
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cigna Commercial |
$151.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$79.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.83
|
| Rate for Payer: Health EOS Commercial |
$144.80
|
| Rate for Payer: HFN Commercial |
$151.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$59.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$59.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.83
|
| Rate for Payer: Multiplan Commercial |
$127.30
|
| Rate for Payer: NAPHCARE Commercial |
$25.24
|
| Rate for Payer: Preferred Network Access Commercial |
$151.16
|
| Rate for Payer: Quartz Beloit One Network |
$70.01
|
| Rate for Payer: Quartz Commercial |
$90.70
|
| Rate for Payer: Quartz Medicare Advantage |
$16.83
|
| Rate for Payer: The Alliance Commercial |
$66.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.83
|
| Rate for Payer: WEA Trust Commercial |
$87.52
|
| Rate for Payer: WPS Commercial |
$74.04
|
|
|
Beta 2 Microglobulin Urine
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
977879
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$146.39 |
| Rate for Payer: Aetna Commercial |
$143.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$136.84
|
| Rate for Payer: Aetna Managed Medicare |
$16.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$63.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29.45
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.93
|
| Rate for Payer: Anthem Medicare Advantage |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$84.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.83
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cigna Commercial |
$146.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$89.05
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.83
|
| Rate for Payer: Health EOS Commercial |
$141.62
|
| Rate for Payer: HFN Commercial |
$146.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$62.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.83
|
| Rate for Payer: Multiplan Commercial |
$127.30
|
| Rate for Payer: NAPHCARE Commercial |
$25.24
|
| Rate for Payer: Preferred Network Access Commercial |
$146.39
|
| Rate for Payer: Quartz Beloit One Network |
$77.97
|
| Rate for Payer: Quartz Commercial |
$103.43
|
| Rate for Payer: Quartz Medicare Advantage |
$16.83
|
| Rate for Payer: The Alliance Commercial |
$67.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.83
|
| Rate for Payer: United Healthcare PPO |
$119.34
|
| Rate for Payer: WEA Trust Commercial |
$87.52
|
| Rate for Payer: Wellcare Medicare |
$16.83
|
| Rate for Payer: WPS Commercial |
$117.86
|
|
|
Beta-2 Transferrin
|
Facility
|
OP
|
$417.00
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
980036
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.52 |
| Max. Negotiated Rate |
$398.99 |
| Rate for Payer: Aetna Commercial |
$390.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$372.96
|
| Rate for Payer: Aetna Managed Medicare |
$30.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$114.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$53.42
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$50.67
|
| Rate for Payer: Anthem Medicare Advantage |
$30.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$229.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$30.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30.52
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cigna Commercial |
$398.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$30.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$242.69
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$30.52
|
| Rate for Payer: Health EOS Commercial |
$385.98
|
| Rate for Payer: HFN Commercial |
$398.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$113.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30.52
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$30.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$30.52
|
| Rate for Payer: Multiplan Commercial |
$346.94
|
| Rate for Payer: NAPHCARE Commercial |
$45.79
|
| Rate for Payer: Preferred Network Access Commercial |
$398.99
|
| Rate for Payer: Quartz Beloit One Network |
$212.50
|
| Rate for Payer: Quartz Commercial |
$281.89
|
| Rate for Payer: Quartz Medicare Advantage |
$30.52
|
| Rate for Payer: The Alliance Commercial |
$122.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30.52
|
| Rate for Payer: United Healthcare PPO |
$325.26
|
| Rate for Payer: WEA Trust Commercial |
$238.52
|
| Rate for Payer: Wellcare Medicare |
$30.52
|
| Rate for Payer: WPS Commercial |
$321.22
|
|
|
Beta-2 Transferrin
|
Facility
|
IP
|
$417.00
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
980036
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$212.50 |
| Max. Negotiated Rate |
$398.99 |
| Rate for Payer: Aetna Commercial |
$390.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$372.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$229.85
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cigna Commercial |
$398.99
|
| Rate for Payer: Health EOS Commercial |
$385.98
|
| Rate for Payer: HFN Commercial |
$398.99
|
| Rate for Payer: Multiplan Commercial |
$346.94
|
| Rate for Payer: Preferred Network Access Commercial |
$398.99
|
| Rate for Payer: Quartz Beloit One Network |
$212.50
|
| Rate for Payer: Quartz Commercial |
$260.21
|
| Rate for Payer: WEA Trust Commercial |
$238.52
|
| Rate for Payer: WPS Commercial |
$321.22
|
|
|
Beta-2 Transferrin
|
Professional
|
Both
|
$417.00
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
980036
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$412.00 |
| Rate for Payer: Aetna Commercial |
$412.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$372.96
|
| Rate for Payer: Aetna Managed Medicare |
$30.52
|
| Rate for Payer: Anthem Commercial |
$17.27
|
| Rate for Payer: Anthem Medicare Advantage |
$30.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$30.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30.52
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cigna Commercial |
$412.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$216.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30.52
|
| Rate for Payer: Health EOS Commercial |
$394.65
|
| Rate for Payer: HFN Commercial |
$412.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$107.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$107.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30.52
|
| Rate for Payer: Multiplan Commercial |
$346.94
|
| Rate for Payer: NAPHCARE Commercial |
$45.79
|
| Rate for Payer: Preferred Network Access Commercial |
$412.00
|
| Rate for Payer: Quartz Beloit One Network |
$190.82
|
| Rate for Payer: Quartz Commercial |
$247.20
|
| Rate for Payer: Quartz Medicare Advantage |
$30.52
|
| Rate for Payer: The Alliance Commercial |
$120.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30.52
|
| Rate for Payer: WEA Trust Commercial |
$238.52
|
| Rate for Payer: WPS Commercial |
$134.31
|
|
|
Beta-Amloid 42/40 Ratio, CSF
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
5613541
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$1,133.24 |
| Rate for Payer: Aetna Commercial |
$1,133.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,025.88
|
| Rate for Payer: Aetna Managed Medicare |
$25.05
|
| Rate for Payer: Anthem Medicare Advantage |
$25.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$25.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$25.05
|
| Rate for Payer: Cash Price |
$344.10
|
| Rate for Payer: Cash Price |
$344.10
|
| Rate for Payer: Cigna Commercial |
$1,133.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$596.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$25.05
|
| Rate for Payer: Health EOS Commercial |
$1,085.52
|
| Rate for Payer: HFN Commercial |
$1,133.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$88.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$88.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$25.05
|
| Rate for Payer: Multiplan Commercial |
$954.30
|
| Rate for Payer: NAPHCARE Commercial |
$37.58
|
| Rate for Payer: Preferred Network Access Commercial |
$1,133.24
|
| Rate for Payer: Quartz Beloit One Network |
$524.87
|
| Rate for Payer: Quartz Commercial |
$679.94
|
| Rate for Payer: Quartz Medicare Advantage |
$25.05
|
| Rate for Payer: The Alliance Commercial |
$98.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.05
|
| Rate for Payer: WEA Trust Commercial |
$656.08
|
| Rate for Payer: WPS Commercial |
$110.24
|
|
|
Beta-Amloid 42/40 Ratio, CSF
|
Facility
|
IP
|
$1,147.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
5613541
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$584.51 |
| Max. Negotiated Rate |
$1,097.45 |
| Rate for Payer: Aetna Commercial |
$1,073.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,025.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$632.23
|
| Rate for Payer: Cash Price |
$344.10
|
| Rate for Payer: Cigna Commercial |
$1,097.45
|
| Rate for Payer: Health EOS Commercial |
$1,061.66
|
| Rate for Payer: HFN Commercial |
$1,097.45
|
| Rate for Payer: Multiplan Commercial |
$954.30
|
| Rate for Payer: Preferred Network Access Commercial |
$1,097.45
|
| Rate for Payer: Quartz Beloit One Network |
$584.51
|
| Rate for Payer: Quartz Commercial |
$715.73
|
| Rate for Payer: WEA Trust Commercial |
$656.08
|
| Rate for Payer: WPS Commercial |
$883.53
|
|
|
Beta-Amloid 42/40 Ratio, CSF
|
Facility
|
OP
|
$1,147.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
5613541
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$1,097.45 |
| Rate for Payer: Aetna Commercial |
$1,073.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,025.88
|
| Rate for Payer: Aetna Managed Medicare |
$25.05
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$93.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41.59
|
| Rate for Payer: Anthem Medicare Advantage |
$25.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$632.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$25.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$25.05
|
| Rate for Payer: Cash Price |
$344.10
|
| Rate for Payer: Cash Price |
$344.10
|
| Rate for Payer: Cigna Commercial |
$1,097.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$25.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$667.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$25.05
|
| Rate for Payer: Health EOS Commercial |
$1,061.66
|
| Rate for Payer: HFN Commercial |
$1,097.45
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$93.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$25.05
|
| Rate for Payer: Independent Care Health Plan Medicare |
$25.05
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$25.05
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$25.05
|
| Rate for Payer: Multiplan Commercial |
$954.30
|
| Rate for Payer: NAPHCARE Commercial |
$37.58
|
| Rate for Payer: Preferred Network Access Commercial |
$1,097.45
|
| Rate for Payer: Quartz Beloit One Network |
$584.51
|
| Rate for Payer: Quartz Commercial |
$775.37
|
| Rate for Payer: Quartz Medicare Advantage |
$25.05
|
| Rate for Payer: The Alliance Commercial |
$100.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.05
|
| Rate for Payer: United Healthcare PPO |
$894.66
|
| Rate for Payer: WEA Trust Commercial |
$656.08
|
| Rate for Payer: Wellcare Medicare |
$25.05
|
| Rate for Payer: WPS Commercial |
$883.53
|
|
|
Beta-Globin Complete
|
Professional
|
Both
|
$1,344.00
|
|
|
Service Code
|
CPT 81364
|
| Hospital Charge Code |
4253861
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$337.56 |
| Max. Negotiated Rate |
$1,485.28 |
| Rate for Payer: Aetna Commercial |
$1,327.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,202.07
|
| Rate for Payer: Aetna Managed Medicare |
$337.56
|
| Rate for Payer: Anthem Medicare Advantage |
$337.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$337.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$337.56
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cigna Commercial |
$1,327.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$698.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$337.56
|
| Rate for Payer: Health EOS Commercial |
$1,271.96
|
| Rate for Payer: HFN Commercial |
$1,327.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,191.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,191.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$337.56
|
| Rate for Payer: Multiplan Commercial |
$1,118.21
|
| Rate for Payer: NAPHCARE Commercial |
$506.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,327.87
|
| Rate for Payer: Quartz Beloit One Network |
$615.01
|
| Rate for Payer: Quartz Commercial |
$796.72
|
| Rate for Payer: Quartz Medicare Advantage |
$337.56
|
| Rate for Payer: The Alliance Commercial |
$1,333.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$337.56
|
| Rate for Payer: WEA Trust Commercial |
$768.77
|
| Rate for Payer: WPS Commercial |
$1,485.28
|
|
|
Beta-Globin Complete
|
Facility
|
IP
|
$1,344.00
|
|
|
Service Code
|
CPT 81364
|
| Hospital Charge Code |
4253861
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$684.90 |
| Max. Negotiated Rate |
$1,285.94 |
| Rate for Payer: Aetna Commercial |
$1,257.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,202.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$740.81
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cigna Commercial |
$1,285.94
|
| Rate for Payer: Health EOS Commercial |
$1,244.01
|
| Rate for Payer: HFN Commercial |
$1,285.94
|
| Rate for Payer: Multiplan Commercial |
$1,118.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,285.94
|
| Rate for Payer: Quartz Beloit One Network |
$684.90
|
| Rate for Payer: Quartz Commercial |
$838.66
|
| Rate for Payer: WEA Trust Commercial |
$768.77
|
| Rate for Payer: WPS Commercial |
$1,035.28
|
|
|
Beta-Globin Complete
|
Facility
|
OP
|
$1,344.00
|
|
|
Service Code
|
CPT 81364
|
| Hospital Charge Code |
4253861
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$337.56 |
| Max. Negotiated Rate |
$1,350.25 |
| Rate for Payer: Aetna Commercial |
$1,257.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,202.07
|
| Rate for Payer: Aetna Managed Medicare |
$337.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,265.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$590.74
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$560.35
|
| Rate for Payer: Anthem Medicare Advantage |
$337.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$740.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$337.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$337.56
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cigna Commercial |
$1,285.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$337.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$782.21
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$337.56
|
| Rate for Payer: Health EOS Commercial |
$1,244.01
|
| Rate for Payer: HFN Commercial |
$1,285.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,255.74
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$337.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$337.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$337.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$337.56
|
| Rate for Payer: Multiplan Commercial |
$1,118.21
|
| Rate for Payer: NAPHCARE Commercial |
$506.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,285.94
|
| Rate for Payer: Quartz Beloit One Network |
$684.90
|
| Rate for Payer: Quartz Commercial |
$908.54
|
| Rate for Payer: Quartz Medicare Advantage |
$337.56
|
| Rate for Payer: The Alliance Commercial |
$1,350.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$337.56
|
| Rate for Payer: United Healthcare PPO |
$1,048.32
|
| Rate for Payer: WEA Trust Commercial |
$768.77
|
| Rate for Payer: Wellcare Medicare |
$337.56
|
| Rate for Payer: WPS Commercial |
$1,035.28
|
|
|
Beta Human Chorionic Gonadotropin Quantitative
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
633665
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$255.89 |
| Rate for Payer: Aetna Commercial |
$255.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$231.65
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$77.70
|
| Rate for Payer: Cash Price |
$77.70
|
| Rate for Payer: Cigna Commercial |
$255.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$134.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$245.12
|
| Rate for Payer: HFN Commercial |
$255.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$55.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$55.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$215.49
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$255.89
|
| Rate for Payer: Quartz Beloit One Network |
$118.52
|
| Rate for Payer: Quartz Commercial |
$153.54
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$61.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: WEA Trust Commercial |
$148.15
|
| Rate for Payer: WPS Commercial |
$68.87
|
|
|
Beta Human Chorionic Gonadotropin Quantitative
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
633665
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$247.81 |
| Rate for Payer: Aetna Commercial |
$242.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$231.65
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$58.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.98
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$142.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$77.70
|
| Rate for Payer: Cash Price |
$77.70
|
| Rate for Payer: Cigna Commercial |
$247.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$150.74
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$239.73
|
| Rate for Payer: HFN Commercial |
$247.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$215.49
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$247.81
|
| Rate for Payer: Quartz Beloit One Network |
$131.99
|
| Rate for Payer: Quartz Commercial |
$175.08
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$62.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: United Healthcare PPO |
$202.02
|
| Rate for Payer: WEA Trust Commercial |
$148.15
|
| Rate for Payer: Wellcare Medicare |
$15.65
|
| Rate for Payer: WPS Commercial |
$199.51
|
|
|
Beta Human Chorionic Gonadotropin Quantitative
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
633665
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$131.99 |
| Max. Negotiated Rate |
$247.81 |
| Rate for Payer: Aetna Commercial |
$242.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$231.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$142.76
|
| Rate for Payer: Cash Price |
$77.70
|
| Rate for Payer: Cigna Commercial |
$247.81
|
| Rate for Payer: Health EOS Commercial |
$239.73
|
| Rate for Payer: HFN Commercial |
$247.81
|
| Rate for Payer: Multiplan Commercial |
$215.49
|
| Rate for Payer: Preferred Network Access Commercial |
$247.81
|
| Rate for Payer: Quartz Beloit One Network |
$131.99
|
| Rate for Payer: Quartz Commercial |
$161.62
|
| Rate for Payer: WEA Trust Commercial |
$148.15
|
| Rate for Payer: WPS Commercial |
$199.51
|
|
|
Beta Human Chorionic Gonadotropin Tumor Marker
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
3473533
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$62.61 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$39.35
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$58.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$25.98
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$24.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cigna Commercial |
$42.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$25.61
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$40.73
|
| Rate for Payer: HFN Commercial |
$42.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$58.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$36.61
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$42.10
|
| Rate for Payer: Quartz Beloit One Network |
$22.42
|
| Rate for Payer: Quartz Commercial |
$29.74
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$62.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: United Healthcare PPO |
$34.32
|
| Rate for Payer: WEA Trust Commercial |
$25.17
|
| Rate for Payer: Wellcare Medicare |
$15.65
|
| Rate for Payer: WPS Commercial |
$33.89
|
|
|
Beta Human Chorionic Gonadotropin Tumor Marker
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
3473533
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.42 |
| Max. Negotiated Rate |
$42.10 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$39.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$24.25
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cigna Commercial |
$42.10
|
| Rate for Payer: Health EOS Commercial |
$40.73
|
| Rate for Payer: HFN Commercial |
$42.10
|
| Rate for Payer: Multiplan Commercial |
$36.61
|
| Rate for Payer: Preferred Network Access Commercial |
$42.10
|
| Rate for Payer: Quartz Beloit One Network |
$22.42
|
| Rate for Payer: Quartz Commercial |
$27.46
|
| Rate for Payer: WEA Trust Commercial |
$25.17
|
| Rate for Payer: WPS Commercial |
$33.89
|
|
|
Beta Human Chorionic Gonadotropin Tumor Marker
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
3473533
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$68.87 |
| Rate for Payer: Aetna Commercial |
$43.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$39.35
|
| Rate for Payer: Aetna Managed Medicare |
$15.65
|
| Rate for Payer: Anthem Medicare Advantage |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.65
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cigna Commercial |
$43.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$22.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.65
|
| Rate for Payer: Health EOS Commercial |
$41.64
|
| Rate for Payer: HFN Commercial |
$43.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$55.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$55.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$36.61
|
| Rate for Payer: NAPHCARE Commercial |
$23.48
|
| Rate for Payer: Preferred Network Access Commercial |
$43.47
|
| Rate for Payer: Quartz Beloit One Network |
$20.13
|
| Rate for Payer: Quartz Commercial |
$26.08
|
| Rate for Payer: Quartz Medicare Advantage |
$15.65
|
| Rate for Payer: The Alliance Commercial |
$61.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.65
|
| Rate for Payer: WEA Trust Commercial |
$25.17
|
| Rate for Payer: WPS Commercial |
$68.87
|
|
|
Beta Hydroxybutyrate
|
Facility
|
OP
|
$107.00
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
4676607
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$102.38 |
| Rate for Payer: Aetna Commercial |
$100.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$95.70
|
| Rate for Payer: Aetna Managed Medicare |
$8.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14.87
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14.10
|
| Rate for Payer: Anthem Medicare Advantage |
$8.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$58.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.50
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cigna Commercial |
$102.38
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$62.27
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8.50
|
| Rate for Payer: Health EOS Commercial |
$99.04
|
| Rate for Payer: HFN Commercial |
$102.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8.50
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8.50
|
| Rate for Payer: Multiplan Commercial |
$89.02
|
| Rate for Payer: NAPHCARE Commercial |
$12.75
|
| Rate for Payer: Preferred Network Access Commercial |
$102.38
|
| Rate for Payer: Quartz Beloit One Network |
$54.53
|
| Rate for Payer: Quartz Commercial |
$72.33
|
| Rate for Payer: Quartz Medicare Advantage |
$8.50
|
| Rate for Payer: The Alliance Commercial |
$33.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.50
|
| Rate for Payer: United Healthcare PPO |
$83.46
|
| Rate for Payer: WEA Trust Commercial |
$61.20
|
| Rate for Payer: Wellcare Medicare |
$8.50
|
| Rate for Payer: WPS Commercial |
$82.42
|
|
|
Beta Hydroxybutyrate
|
Facility
|
IP
|
$107.00
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
4676607
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$102.38 |
| Rate for Payer: Aetna Commercial |
$100.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$95.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$58.98
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cigna Commercial |
$102.38
|
| Rate for Payer: Health EOS Commercial |
$99.04
|
| Rate for Payer: HFN Commercial |
$102.38
|
| Rate for Payer: Multiplan Commercial |
$89.02
|
| Rate for Payer: Preferred Network Access Commercial |
$102.38
|
| Rate for Payer: Quartz Beloit One Network |
$54.53
|
| Rate for Payer: Quartz Commercial |
$66.77
|
| Rate for Payer: WEA Trust Commercial |
$61.20
|
| Rate for Payer: WPS Commercial |
$82.42
|
|
|
Beta Hydroxybutyrate
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
4676607
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$105.72 |
| Rate for Payer: Aetna Commercial |
$105.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$95.70
|
| Rate for Payer: Aetna Managed Medicare |
$8.50
|
| Rate for Payer: Anthem Medicare Advantage |
$8.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.50
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cigna Commercial |
$105.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$55.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.50
|
| Rate for Payer: Health EOS Commercial |
$101.26
|
| Rate for Payer: HFN Commercial |
$105.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.99
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$29.99
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.50
|
| Rate for Payer: Multiplan Commercial |
$89.02
|
| Rate for Payer: NAPHCARE Commercial |
$12.75
|
| Rate for Payer: Preferred Network Access Commercial |
$105.72
|
| Rate for Payer: Quartz Beloit One Network |
$48.96
|
| Rate for Payer: Quartz Commercial |
$63.43
|
| Rate for Payer: Quartz Medicare Advantage |
$8.50
|
| Rate for Payer: The Alliance Commercial |
$33.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.50
|
| Rate for Payer: WEA Trust Commercial |
$61.20
|
| Rate for Payer: WPS Commercial |
$37.39
|
|
|
Betamethasone acet&sod phosp 3Mg/3Mg J0702
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
HCPCS J0702
|
| Hospital Charge Code |
3376942
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.32 |
| Max. Negotiated Rate |
$30.62 |
| Rate for Payer: Aetna Commercial |
$29.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$28.62
|
| Rate for Payer: Aetna Managed Medicare |
$9.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$21.63
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$17.64
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cigna Commercial |
$30.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.47
|
| Rate for Payer: Health EOS Commercial |
$29.62
|
| Rate for Payer: HFN Commercial |
$30.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24.96
|
| Rate for Payer: Multiplan Commercial |
$26.62
|
| Rate for Payer: NAPHCARE Commercial |
$19.97
|
| Rate for Payer: Preferred Network Access Commercial |
$30.62
|
| Rate for Payer: Quartz Beloit One Network |
$16.31
|
| Rate for Payer: Quartz Commercial |
$21.63
|
| Rate for Payer: Quartz Medicare Advantage |
$19.97
|
| Rate for Payer: The Alliance Commercial |
$28.75
|
| Rate for Payer: WEA Trust Commercial |
$18.30
|
| Rate for Payer: WPS Commercial |
$17.90
|
|
