|
Biopsy of Vulva/Perineum Each Add'l Lesion 56606
|
Professional
|
Both
|
$169.00
|
|
|
Service Code
|
CPT 56606
|
| Hospital Charge Code |
1190844
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$36.12 |
| Max. Negotiated Rate |
$160.55 |
| Rate for Payer: Aetna Commercial |
$160.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$145.34
|
| 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 |
$36.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$101.40
|
| Rate for Payer: Health EOS Commercial |
$153.79
|
| Rate for Payer: HFN Commercial |
$160.55
|
| 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: 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: The Alliance Commercial |
$84.50
|
| Rate for Payer: United Healthcare Medicaid |
$36.12
|
| Rate for Payer: WEA Trust Commercial |
$92.95
|
| Rate for Payer: WPS Commercial |
$125.18
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP AXILLARY NODE(S)
|
Facility
|
OP
|
$15,070.20
|
|
|
Service Code
|
CPT 38525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,767.55 |
| Max. Negotiated Rate |
$15,070.20 |
| 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 |
$15,070.20
|
| 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
|
$15,070.20
|
|
|
Service Code
|
CPT 38510
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,767.55 |
| Max. Negotiated Rate |
$15,070.20 |
| 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 |
$15,070.20
|
| 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
|
$15,070.20
|
|
|
Service Code
|
CPT 38531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,767.55 |
| Max. Negotiated Rate |
$15,070.20 |
| 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 |
$15,070.20
|
| 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
|
Both
|
$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: 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 |
$136.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$682.20
|
| Rate for Payer: Health EOS Commercial |
$1,034.67
|
| Rate for Payer: HFN Commercial |
$1,080.15
|
| 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: 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: The Alliance Commercial |
$568.50
|
| Rate for Payer: United Healthcare Medicaid |
$136.08
|
| Rate for Payer: WEA Trust Commercial |
$625.35
|
| Rate for Payer: WPS Commercial |
$842.18
|
|
|
Biopsy, Oropharynx
|
Professional
|
Both
|
$435.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
1190854
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$60.63 |
| Max. Negotiated Rate |
$413.25 |
| Rate for Payer: Aetna Commercial |
$413.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$374.10
|
| 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 |
$60.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$261.00
|
| Rate for Payer: Health EOS Commercial |
$395.85
|
| Rate for Payer: HFN Commercial |
$413.25
|
| 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: 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: The Alliance Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicaid |
$60.63
|
| Rate for Payer: WEA Trust Commercial |
$239.25
|
| Rate for Payer: WPS Commercial |
$322.20
|
|
|
Biopsy: Oropharynx
|
Professional
|
Both
|
$435.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
1152811
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$60.63 |
| Max. Negotiated Rate |
$413.25 |
| Rate for Payer: Aetna Commercial |
$413.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$374.10
|
| 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 |
$60.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$261.00
|
| Rate for Payer: Health EOS Commercial |
$395.85
|
| Rate for Payer: HFN Commercial |
$413.25
|
| 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: 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: The Alliance Commercial |
$217.50
|
| Rate for Payer: United Healthcare Medicaid |
$60.63
|
| Rate for Payer: WEA Trust Commercial |
$239.25
|
| Rate for Payer: WPS Commercial |
$322.20
|
|
|
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: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| 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, 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, 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, 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: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| 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, 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: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| 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
|
Both
|
$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: 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 |
$107.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$552.00
|
| Rate for Payer: Health EOS Commercial |
$837.20
|
| Rate for Payer: HFN Commercial |
$874.00
|
| 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: 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: The Alliance Commercial |
$460.00
|
| Rate for Payer: United Healthcare Medicaid |
$107.81
|
| Rate for Payer: WEA Trust Commercial |
$506.00
|
| Rate for Payer: WPS Commercial |
$681.44
|
|
|
BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH
|
Facility
|
OP
|
$8,052.80
|
|
|
Service Code
|
CPT 55700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,013.20 |
| Max. Negotiated Rate |
$8,052.80 |
| 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 |
$8,052.80
|
| 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: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| 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
|
|
|
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 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: Aetna Gatekeeper/Not Gatekeeper |
$55.04
|
| 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/REMOVAL, LYMPH NODES 38510
|
Professional
|
Both
|
$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: 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 |
$221.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,150.80
|
| Rate for Payer: Health EOS Commercial |
$1,745.38
|
| Rate for Payer: HFN Commercial |
$1,822.10
|
| 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: 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: The Alliance Commercial |
$959.00
|
| Rate for Payer: United Healthcare Medicaid |
$221.58
|
| Rate for Payer: WEA Trust Commercial |
$1,054.90
|
| Rate for Payer: WPS Commercial |
$1,420.66
|
|
|
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: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| 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: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| 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: Aetna Gatekeeper/Not Gatekeeper |
$1,228.94
|
| 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
|
|
