|
BIOPSY, LYMPH NODE, OPEN
|
Facility
|
IP
|
$1,084.00
|
|
| Hospital Charge Code |
2959889
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$552.41 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$676.42
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
|
BIOPSY, MUSCLE
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959888
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$292.95 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Aetna Managed Medicare |
$292.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$680.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$523.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$502.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$585.49
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$784.68
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: NAPHCARE Commercial |
$627.74
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$680.06
|
| Rate for Payer: Quartz Medicare Advantage |
$627.74
|
| Rate for Payer: The Alliance Commercial |
$523.12
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
BIOPSY, MUSCLE
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959888
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.66 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$627.74
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
BIOPSY MUSCLE PERCUTANEOUS NEEDLE 20206
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
6181982
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.85 |
| Max. Negotiated Rate |
$682.71 |
| Rate for Payer: Aetna Commercial |
$682.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$618.03
|
| Rate for Payer: Aetna Managed Medicare |
$49.85
|
| Rate for Payer: Anthem Medicare Advantage |
$49.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$49.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$49.85
|
| Rate for Payer: Cash Price |
$207.30
|
| Rate for Payer: Cash Price |
$207.30
|
| Rate for Payer: Cash Price |
$207.30
|
| Rate for Payer: Cigna Commercial |
$682.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$136.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$49.85
|
| Rate for Payer: Health EOS Commercial |
$653.96
|
| Rate for Payer: HFN Commercial |
$682.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$200.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$200.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$49.85
|
| Rate for Payer: Multiplan Commercial |
$574.91
|
| Rate for Payer: NAPHCARE Commercial |
$74.77
|
| Rate for Payer: Preferred Network Access Commercial |
$682.71
|
| Rate for Payer: Quartz Beloit One Network |
$316.20
|
| Rate for Payer: Quartz Commercial |
$409.62
|
| Rate for Payer: Quartz Medicare Advantage |
$49.85
|
| Rate for Payer: The Alliance Commercial |
$211.85
|
| Rate for Payer: United Healthcare Medicaid |
$136.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$49.85
|
| Rate for Payer: WEA Trust Commercial |
$395.25
|
| Rate for Payer: WPS Commercial |
$224.31
|
|
|
BIOPSY OF ANORECTAL WALL, ANAL APPROACH (EG, CONGENITAL MEGACOLON)
|
Facility
|
OP
|
$11,684.32
|
|
|
Service Code
|
CPT 45100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,835.04 |
| Max. Negotiated Rate |
$11,684.32 |
| Rate for Payer: Aetna Managed Medicare |
$2,921.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$2,921.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,921.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,921.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,921.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,921.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,866.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,921.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,921.08
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,921.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,921.08
|
| Rate for Payer: NAPHCARE Commercial |
$4,381.62
|
| Rate for Payer: Quartz Medicare Advantage |
$2,921.08
|
| Rate for Payer: The Alliance Commercial |
$11,684.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,921.08
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$2,921.08
|
|
|
BIOPSY OF BREAST, OPEN 19101
|
Professional
|
Both
|
$1,670.00
|
|
|
Service Code
|
CPT 19101
|
| Hospital Charge Code |
3013676
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$1,649.96 |
| Rate for Payer: Aetna Commercial |
$1,649.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,493.65
|
| Rate for Payer: Aetna Managed Medicare |
$202.40
|
| Rate for Payer: Anthem Medicare Advantage |
$202.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$202.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$202.40
|
| Rate for Payer: Cash Price |
$501.00
|
| Rate for Payer: Cash Price |
$501.00
|
| Rate for Payer: Cash Price |
$501.00
|
| Rate for Payer: Cigna Commercial |
$1,649.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$279.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$202.40
|
| Rate for Payer: Health EOS Commercial |
$1,580.49
|
| Rate for Payer: HFN Commercial |
$1,649.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$759.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$759.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$1,389.44
|
| Rate for Payer: NAPHCARE Commercial |
$303.61
|
| Rate for Payer: Preferred Network Access Commercial |
$1,649.96
|
| Rate for Payer: Quartz Beloit One Network |
$764.19
|
| Rate for Payer: Quartz Commercial |
$989.98
|
| Rate for Payer: Quartz Medicare Advantage |
$202.40
|
| Rate for Payer: The Alliance Commercial |
$860.22
|
| Rate for Payer: United Healthcare Medicaid |
$279.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$202.40
|
| Rate for Payer: WEA Trust Commercial |
$955.24
|
| Rate for Payer: WPS Commercial |
$910.82
|
|
|
Biopsy Of Cervix, Single Or Multiple 57500
|
Professional
|
Both
|
$526.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
1188883
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$59.03 |
| Max. Negotiated Rate |
$519.69 |
| Rate for Payer: Aetna Commercial |
$519.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$470.45
|
| Rate for Payer: Aetna Managed Medicare |
$65.19
|
| Rate for Payer: Anthem Medicare Advantage |
$65.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$65.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$65.19
|
| Rate for Payer: Cash Price |
$157.80
|
| Rate for Payer: Cash Price |
$157.80
|
| Rate for Payer: Cash Price |
$157.80
|
| Rate for Payer: Cigna Commercial |
$519.69
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$59.03
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$65.19
|
| Rate for Payer: Health EOS Commercial |
$497.81
|
| Rate for Payer: HFN Commercial |
$519.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$257.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$257.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$65.19
|
| Rate for Payer: Multiplan Commercial |
$437.63
|
| Rate for Payer: NAPHCARE Commercial |
$97.78
|
| Rate for Payer: Preferred Network Access Commercial |
$519.69
|
| Rate for Payer: Quartz Beloit One Network |
$240.70
|
| Rate for Payer: Quartz Commercial |
$311.81
|
| Rate for Payer: Quartz Medicare Advantage |
$65.19
|
| Rate for Payer: The Alliance Commercial |
$277.05
|
| Rate for Payer: United Healthcare Medicaid |
$59.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$65.19
|
| Rate for Payer: WEA Trust Commercial |
$300.87
|
| Rate for Payer: WPS Commercial |
$293.34
|
|
|
BIOPSY OF CERVIX, SINGLE OR MULTIPLE, OR LOCAL EXCISION OF LESION, WITH OR WITHOUT FULGURATION (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$4,386.95
|
|
|
Service Code
|
CPT 57500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$969.30 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Managed Medicare |
$969.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,030.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,388.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,270.32
|
| Rate for Payer: Anthem Medicare Advantage |
$969.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$969.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$969.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$969.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$969.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,605.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$969.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$969.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$969.30
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$969.30
|
| Rate for Payer: NAPHCARE Commercial |
$1,453.95
|
| Rate for Payer: Quartz Medicare Advantage |
$969.30
|
| Rate for Payer: The Alliance Commercial |
$3,877.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$969.30
|
| Rate for Payer: United Healthcare PPO |
$2,347.28
|
| Rate for Payer: Wellcare Medicare |
$969.30
|
|
|
Biopsy of External Ear 69100
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
1190826
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$276.64 |
| Rate for Payer: Aetna Commercial |
$276.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$250.43
|
| Rate for Payer: Aetna Managed Medicare |
$36.85
|
| Rate for Payer: Anthem Medicare Advantage |
$36.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$36.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$36.85
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cigna Commercial |
$276.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$36.85
|
| Rate for Payer: Health EOS Commercial |
$264.99
|
| Rate for Payer: HFN Commercial |
$276.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$162.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$162.67
|
| Rate for Payer: Independent Care Health Plan Medicare |
$36.85
|
| Rate for Payer: Multiplan Commercial |
$232.96
|
| Rate for Payer: NAPHCARE Commercial |
$55.27
|
| Rate for Payer: Preferred Network Access Commercial |
$276.64
|
| Rate for Payer: Quartz Beloit One Network |
$128.13
|
| Rate for Payer: Quartz Commercial |
$165.98
|
| Rate for Payer: Quartz Medicare Advantage |
$36.85
|
| Rate for Payer: The Alliance Commercial |
$156.60
|
| Rate for Payer: United Healthcare Medicaid |
$46.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.85
|
| Rate for Payer: WEA Trust Commercial |
$160.16
|
| Rate for Payer: WPS Commercial |
$165.81
|
|
|
BIOPSY OF EXTERNAL EAR CANAL 69105
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
3015261
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.99 |
| Max. Negotiated Rate |
$320.11 |
| Rate for Payer: Aetna Commercial |
$320.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$289.79
|
| Rate for Payer: Aetna Managed Medicare |
$55.96
|
| Rate for Payer: Anthem Medicare Advantage |
$55.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$55.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$55.96
|
| Rate for Payer: Cash Price |
$97.20
|
| Rate for Payer: Cash Price |
$97.20
|
| Rate for Payer: Cash Price |
$97.20
|
| Rate for Payer: Cigna Commercial |
$320.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$55.96
|
| Rate for Payer: Health EOS Commercial |
$306.63
|
| Rate for Payer: HFN Commercial |
$320.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$215.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$215.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$55.96
|
| Rate for Payer: Multiplan Commercial |
$269.57
|
| Rate for Payer: NAPHCARE Commercial |
$83.94
|
| Rate for Payer: Preferred Network Access Commercial |
$320.11
|
| Rate for Payer: Quartz Beloit One Network |
$148.26
|
| Rate for Payer: Quartz Commercial |
$192.07
|
| Rate for Payer: Quartz Medicare Advantage |
$55.96
|
| Rate for Payer: The Alliance Commercial |
$237.84
|
| Rate for Payer: United Healthcare Medicaid |
$46.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$55.96
|
| Rate for Payer: WEA Trust Commercial |
$185.33
|
| Rate for Payer: WPS Commercial |
$251.83
|
|
|
Biopsy Of Eye Lid 67810
|
Professional
|
Both
|
$617.00
|
|
|
Service Code
|
CPT 67810
|
| Hospital Charge Code |
1190829
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$54.10 |
| Max. Negotiated Rate |
$609.60 |
| Rate for Payer: Aetna Commercial |
$609.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$551.84
|
| Rate for Payer: Aetna Managed Medicare |
$54.10
|
| Rate for Payer: Anthem Medicare Advantage |
$54.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$54.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$54.10
|
| Rate for Payer: Cash Price |
$185.10
|
| Rate for Payer: Cash Price |
$185.10
|
| Rate for Payer: Cash Price |
$185.10
|
| Rate for Payer: Cigna Commercial |
$609.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$74.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$54.10
|
| Rate for Payer: Health EOS Commercial |
$583.93
|
| Rate for Payer: HFN Commercial |
$609.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$239.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$239.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$54.10
|
| Rate for Payer: Multiplan Commercial |
$513.34
|
| Rate for Payer: NAPHCARE Commercial |
$81.15
|
| Rate for Payer: Preferred Network Access Commercial |
$609.60
|
| Rate for Payer: Quartz Beloit One Network |
$282.34
|
| Rate for Payer: Quartz Commercial |
$365.76
|
| Rate for Payer: Quartz Medicare Advantage |
$54.10
|
| Rate for Payer: The Alliance Commercial |
$229.93
|
| Rate for Payer: United Healthcare Medicaid |
$74.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54.10
|
| Rate for Payer: WEA Trust Commercial |
$352.92
|
| Rate for Payer: WPS Commercial |
$243.45
|
|
|
BIOPSY OF FLOOR OF MOUTH 41108
|
Professional
|
Both
|
$386.00
|
|
|
Service Code
|
CPT 41108
|
| Hospital Charge Code |
3014612
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.34 |
| Max. Negotiated Rate |
$381.37 |
| Rate for Payer: Aetna Commercial |
$381.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$345.24
|
| Rate for Payer: Aetna Managed Medicare |
$82.04
|
| Rate for Payer: Anthem Medicare Advantage |
$82.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$82.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$82.04
|
| Rate for Payer: Cash Price |
$115.80
|
| Rate for Payer: Cash Price |
$115.80
|
| Rate for Payer: Cash Price |
$115.80
|
| Rate for Payer: Cigna Commercial |
$381.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$78.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$82.04
|
| Rate for Payer: Health EOS Commercial |
$365.31
|
| Rate for Payer: HFN Commercial |
$381.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$316.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$316.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$82.04
|
| Rate for Payer: Multiplan Commercial |
$321.15
|
| Rate for Payer: NAPHCARE Commercial |
$123.05
|
| Rate for Payer: Preferred Network Access Commercial |
$381.37
|
| Rate for Payer: Quartz Beloit One Network |
$176.63
|
| Rate for Payer: Quartz Commercial |
$228.82
|
| Rate for Payer: Quartz Medicare Advantage |
$82.04
|
| Rate for Payer: The Alliance Commercial |
$348.65
|
| Rate for Payer: United Healthcare Medicaid |
$78.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$82.04
|
| Rate for Payer: WEA Trust Commercial |
$220.79
|
| Rate for Payer: WPS Commercial |
$369.16
|
|
|
BIOPSY OF FOOT JOINT LINING 28052
|
Professional
|
Both
|
$1,696.00
|
|
|
Service Code
|
CPT 28052
|
| Hospital Charge Code |
3014188
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$239.47 |
| Max. Negotiated Rate |
$1,675.65 |
| Rate for Payer: Aetna Commercial |
$1,675.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,516.90
|
| Rate for Payer: Aetna Managed Medicare |
$239.47
|
| Rate for Payer: Anthem Medicare Advantage |
$239.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$239.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$239.47
|
| Rate for Payer: Cash Price |
$508.80
|
| Rate for Payer: Cash Price |
$508.80
|
| Rate for Payer: Cash Price |
$508.80
|
| Rate for Payer: Cigna Commercial |
$1,675.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$282.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$239.47
|
| Rate for Payer: Health EOS Commercial |
$1,605.09
|
| Rate for Payer: HFN Commercial |
$1,675.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$992.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$992.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$239.47
|
| Rate for Payer: Multiplan Commercial |
$1,411.07
|
| Rate for Payer: NAPHCARE Commercial |
$359.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,675.65
|
| Rate for Payer: Quartz Beloit One Network |
$776.09
|
| Rate for Payer: Quartz Commercial |
$1,005.39
|
| Rate for Payer: Quartz Medicare Advantage |
$239.47
|
| Rate for Payer: The Alliance Commercial |
$1,017.75
|
| Rate for Payer: United Healthcare Medicaid |
$282.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$239.47
|
| Rate for Payer: WEA Trust Commercial |
$970.11
|
| Rate for Payer: WPS Commercial |
$1,077.62
|
|
|
Biopsy of Lip 40490
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
CPT 40490
|
| Hospital Charge Code |
1190863
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.99 |
| Max. Negotiated Rate |
$351.73 |
| Rate for Payer: Aetna Commercial |
$351.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$318.41
|
| Rate for Payer: Aetna Managed Medicare |
$54.93
|
| Rate for Payer: Anthem Medicare Advantage |
$54.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$54.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$54.93
|
| Rate for Payer: Cash Price |
$106.80
|
| Rate for Payer: Cash Price |
$106.80
|
| Rate for Payer: Cash Price |
$106.80
|
| Rate for Payer: Cigna Commercial |
$351.73
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$54.93
|
| Rate for Payer: Health EOS Commercial |
$336.92
|
| Rate for Payer: HFN Commercial |
$351.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$243.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$243.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$54.93
|
| Rate for Payer: Multiplan Commercial |
$296.19
|
| Rate for Payer: NAPHCARE Commercial |
$82.40
|
| Rate for Payer: Preferred Network Access Commercial |
$351.73
|
| Rate for Payer: Quartz Beloit One Network |
$162.91
|
| Rate for Payer: Quartz Commercial |
$211.04
|
| Rate for Payer: Quartz Medicare Advantage |
$54.93
|
| Rate for Payer: The Alliance Commercial |
$233.46
|
| Rate for Payer: United Healthcare Medicaid |
$46.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54.93
|
| Rate for Payer: WEA Trust Commercial |
$203.63
|
| Rate for Payer: WPS Commercial |
$247.20
|
|
|
BIOPSY OF LIVER, NEEDLE; PERCUTANEOUS
|
Facility
|
OP
|
$6,952.48
|
|
|
Service Code
|
CPT 47000
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,738.12 |
| Max. Negotiated Rate |
$6,952.48 |
| Rate for Payer: Aetna Managed Medicare |
$1,738.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,738.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,738.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,738.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,465.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,738.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,738.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,738.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,738.12
|
| Rate for Payer: NAPHCARE Commercial |
$2,607.18
|
| Rate for Payer: Quartz Medicare Advantage |
$1,738.12
|
| Rate for Payer: The Alliance Commercial |
$6,952.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,738.12
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,738.12
|
|
|
Biopsy of Nail unit 11755
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
CPT 11755
|
| Hospital Charge Code |
3013572
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$53.54 |
| Max. Negotiated Rate |
$314.18 |
| Rate for Payer: Aetna Commercial |
$314.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$284.42
|
| Rate for Payer: Aetna Managed Medicare |
$53.54
|
| Rate for Payer: Anthem Medicare Advantage |
$53.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$53.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$53.54
|
| Rate for Payer: Cash Price |
$95.40
|
| Rate for Payer: Cash Price |
$95.40
|
| Rate for Payer: Cash Price |
$95.40
|
| Rate for Payer: Cigna Commercial |
$314.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$102.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$53.54
|
| Rate for Payer: Health EOS Commercial |
$300.96
|
| Rate for Payer: HFN Commercial |
$314.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$215.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$215.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$53.54
|
| Rate for Payer: Multiplan Commercial |
$264.58
|
| Rate for Payer: NAPHCARE Commercial |
$80.31
|
| Rate for Payer: Preferred Network Access Commercial |
$314.18
|
| Rate for Payer: Quartz Beloit One Network |
$145.52
|
| Rate for Payer: Quartz Commercial |
$188.51
|
| Rate for Payer: Quartz Medicare Advantage |
$53.54
|
| Rate for Payer: The Alliance Commercial |
$227.54
|
| Rate for Payer: United Healthcare Medicaid |
$102.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.54
|
| Rate for Payer: WEA Trust Commercial |
$181.90
|
| Rate for Payer: WPS Commercial |
$240.93
|
|
|
BIOPSY OF NECK/CHEST 21550
|
Professional
|
Both
|
$588.00
|
|
|
Service Code
|
CPT 21550
|
| Hospital Charge Code |
3013736
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.80 |
| Max. Negotiated Rate |
$626.98 |
| Rate for Payer: Aetna Commercial |
$580.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Aetna Managed Medicare |
$139.33
|
| Rate for Payer: Anthem Medicare Advantage |
$139.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$139.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$139.33
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$580.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$51.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$139.33
|
| Rate for Payer: Health EOS Commercial |
$556.48
|
| Rate for Payer: HFN Commercial |
$580.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$542.38
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$542.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$139.33
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: NAPHCARE Commercial |
$208.99
|
| Rate for Payer: Preferred Network Access Commercial |
$580.94
|
| Rate for Payer: Quartz Beloit One Network |
$269.07
|
| Rate for Payer: Quartz Commercial |
$348.57
|
| Rate for Payer: Quartz Medicare Advantage |
$139.33
|
| Rate for Payer: The Alliance Commercial |
$592.15
|
| Rate for Payer: United Healthcare Medicaid |
$51.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$139.33
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$626.98
|
|
|
Biopsy Of Penis 54100
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
1190846
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.99 |
| Max. Negotiated Rate |
$583.91 |
| Rate for Payer: Aetna Commercial |
$583.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$528.59
|
| Rate for Payer: Aetna Managed Medicare |
$101.68
|
| Rate for Payer: Anthem Medicare Advantage |
$101.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$101.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$101.68
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Cigna Commercial |
$583.91
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$101.68
|
| Rate for Payer: Health EOS Commercial |
$559.32
|
| Rate for Payer: HFN Commercial |
$583.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$423.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$423.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$101.68
|
| Rate for Payer: Multiplan Commercial |
$491.71
|
| Rate for Payer: NAPHCARE Commercial |
$152.52
|
| Rate for Payer: Preferred Network Access Commercial |
$583.91
|
| Rate for Payer: Quartz Beloit One Network |
$270.44
|
| Rate for Payer: Quartz Commercial |
$350.34
|
| Rate for Payer: Quartz Medicare Advantage |
$101.68
|
| Rate for Payer: The Alliance Commercial |
$432.14
|
| Rate for Payer: United Healthcare Medicaid |
$46.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$101.68
|
| Rate for Payer: WEA Trust Commercial |
$338.05
|
| Rate for Payer: WPS Commercial |
$457.56
|
|
|
BIOPSY OF PENIS; (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$6,952.48
|
|
|
Service Code
|
CPT 54100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,738.12 |
| Max. Negotiated Rate |
$6,952.48 |
| Rate for Payer: Aetna Managed Medicare |
$1,738.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,738.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,738.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,738.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,465.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,738.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,738.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,738.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,738.12
|
| Rate for Payer: NAPHCARE Commercial |
$2,607.18
|
| Rate for Payer: Quartz Medicare Advantage |
$1,738.12
|
| Rate for Payer: The Alliance Commercial |
$6,952.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,738.12
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,738.12
|
|
|
BIOPSY OF SALIVARY GLAND 42405
|
Professional
|
Both
|
$836.00
|
|
|
Service Code
|
CPT 42405
|
| Hospital Charge Code |
3014631
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.34 |
| Max. Negotiated Rate |
$880.64 |
| Rate for Payer: Aetna Commercial |
$825.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$747.72
|
| Rate for Payer: Aetna Managed Medicare |
$195.70
|
| Rate for Payer: Anthem Medicare Advantage |
$195.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$195.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$195.70
|
| Rate for Payer: Cash Price |
$250.80
|
| Rate for Payer: Cash Price |
$250.80
|
| Rate for Payer: Cash Price |
$250.80
|
| Rate for Payer: Cigna Commercial |
$825.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$78.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$195.70
|
| Rate for Payer: Health EOS Commercial |
$791.19
|
| Rate for Payer: HFN Commercial |
$825.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$782.78
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$782.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$195.70
|
| Rate for Payer: Multiplan Commercial |
$695.55
|
| Rate for Payer: NAPHCARE Commercial |
$293.55
|
| Rate for Payer: Preferred Network Access Commercial |
$825.97
|
| Rate for Payer: Quartz Beloit One Network |
$382.55
|
| Rate for Payer: Quartz Commercial |
$495.58
|
| Rate for Payer: Quartz Medicare Advantage |
$195.70
|
| Rate for Payer: The Alliance Commercial |
$831.71
|
| Rate for Payer: United Healthcare Medicaid |
$78.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$195.70
|
| Rate for Payer: WEA Trust Commercial |
$478.19
|
| Rate for Payer: WPS Commercial |
$880.64
|
|
|
BIOPSY OF SOFT TISSUES 27040
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
CPT 27040
|
| Hospital Charge Code |
3014007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$40.66 |
| Max. Negotiated Rate |
$912.91 |
| Rate for Payer: Aetna Commercial |
$912.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$826.43
|
| Rate for Payer: Aetna Managed Medicare |
$176.48
|
| Rate for Payer: Anthem Medicare Advantage |
$176.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$176.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$176.48
|
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Cigna Commercial |
$912.91
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$40.66
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$176.48
|
| Rate for Payer: Health EOS Commercial |
$874.47
|
| Rate for Payer: HFN Commercial |
$912.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$690.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$690.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$176.48
|
| Rate for Payer: Multiplan Commercial |
$768.77
|
| Rate for Payer: NAPHCARE Commercial |
$264.72
|
| Rate for Payer: Preferred Network Access Commercial |
$912.91
|
| Rate for Payer: Quartz Beloit One Network |
$422.82
|
| Rate for Payer: Quartz Commercial |
$547.75
|
| Rate for Payer: Quartz Medicare Advantage |
$176.48
|
| Rate for Payer: The Alliance Commercial |
$750.03
|
| Rate for Payer: United Healthcare Medicaid |
$40.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$176.48
|
| Rate for Payer: WEA Trust Commercial |
$528.53
|
| Rate for Payer: WPS Commercial |
$794.15
|
|
|
BIOPSY OF THYROID 60100
|
Professional
|
Both
|
$893.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
3015174
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$63.61 |
| Max. Negotiated Rate |
$882.28 |
| Rate for Payer: Aetna Commercial |
$882.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$798.70
|
| Rate for Payer: Aetna Managed Medicare |
$63.61
|
| Rate for Payer: Anthem Medicare Advantage |
$63.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$63.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$63.61
|
| Rate for Payer: Cash Price |
$267.90
|
| Rate for Payer: Cash Price |
$267.90
|
| Rate for Payer: Cash Price |
$267.90
|
| Rate for Payer: Cigna Commercial |
$882.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$90.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$63.61
|
| Rate for Payer: Health EOS Commercial |
$845.14
|
| Rate for Payer: HFN Commercial |
$882.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$270.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$270.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$63.61
|
| Rate for Payer: Multiplan Commercial |
$742.98
|
| Rate for Payer: NAPHCARE Commercial |
$95.41
|
| Rate for Payer: Preferred Network Access Commercial |
$882.28
|
| Rate for Payer: Quartz Beloit One Network |
$408.64
|
| Rate for Payer: Quartz Commercial |
$529.37
|
| Rate for Payer: Quartz Medicare Advantage |
$63.61
|
| Rate for Payer: The Alliance Commercial |
$270.33
|
| Rate for Payer: United Healthcare Medicaid |
$90.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$63.61
|
| Rate for Payer: WEA Trust Commercial |
$510.80
|
| Rate for Payer: WPS Commercial |
$286.23
|
|
|
BIOPSY OF TOE JOINT LINING 28054
|
Professional
|
Both
|
$1,671.00
|
|
|
Service Code
|
CPT 28054
|
| Hospital Charge Code |
3014189
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$220.16 |
| Max. Negotiated Rate |
$1,650.95 |
| Rate for Payer: Aetna Commercial |
$1,650.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,494.54
|
| Rate for Payer: Aetna Managed Medicare |
$220.16
|
| Rate for Payer: Anthem Medicare Advantage |
$220.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$220.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$220.16
|
| Rate for Payer: Cash Price |
$501.30
|
| Rate for Payer: Cash Price |
$501.30
|
| Rate for Payer: Cash Price |
$501.30
|
| Rate for Payer: Cigna Commercial |
$1,650.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$235.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$220.16
|
| Rate for Payer: Health EOS Commercial |
$1,581.43
|
| Rate for Payer: HFN Commercial |
$1,650.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$824.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$824.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$220.16
|
| Rate for Payer: Multiplan Commercial |
$1,390.27
|
| Rate for Payer: NAPHCARE Commercial |
$330.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,650.95
|
| Rate for Payer: Quartz Beloit One Network |
$764.65
|
| Rate for Payer: Quartz Commercial |
$990.57
|
| Rate for Payer: Quartz Medicare Advantage |
$220.16
|
| Rate for Payer: The Alliance Commercial |
$935.67
|
| Rate for Payer: United Healthcare Medicaid |
$235.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$220.16
|
| Rate for Payer: WEA Trust Commercial |
$955.81
|
| Rate for Payer: WPS Commercial |
$990.71
|
|
|
Biopsy of Tongue; Anterior Two-Thirds
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
1190858
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.99 |
| Max. Negotiated Rate |
$503.88 |
| Rate for Payer: Aetna Commercial |
$503.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$456.14
|
| Rate for Payer: Aetna Managed Medicare |
$94.90
|
| Rate for Payer: Anthem Medicare Advantage |
$94.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$94.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$94.90
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cigna Commercial |
$503.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$94.90
|
| Rate for Payer: Health EOS Commercial |
$482.66
|
| Rate for Payer: HFN Commercial |
$503.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$374.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$374.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$94.90
|
| Rate for Payer: Multiplan Commercial |
$424.32
|
| Rate for Payer: NAPHCARE Commercial |
$142.35
|
| Rate for Payer: Preferred Network Access Commercial |
$503.88
|
| Rate for Payer: Quartz Beloit One Network |
$233.38
|
| Rate for Payer: Quartz Commercial |
$302.33
|
| Rate for Payer: Quartz Medicare Advantage |
$94.90
|
| Rate for Payer: The Alliance Commercial |
$403.32
|
| Rate for Payer: United Healthcare Medicaid |
$46.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$94.90
|
| Rate for Payer: WEA Trust Commercial |
$291.72
|
| Rate for Payer: WPS Commercial |
$427.05
|
|
|
BIOPSY OF TONGUE; ANTERIOR TWO-THIRDS
|
Facility
|
OP
|
$4,386.95
|
|
|
Service Code
|
CPT 41100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$567.58 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Managed Medicare |
$567.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,030.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,388.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,270.32
|
| Rate for Payer: Anthem Medicare Advantage |
$567.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$567.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$567.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$567.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$567.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,111.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$567.58
|
| Rate for Payer: Independent Care Health Plan Medicare |
$567.58
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$567.58
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$567.58
|
| Rate for Payer: NAPHCARE Commercial |
$851.37
|
| Rate for Payer: Quartz Medicare Advantage |
$567.58
|
| Rate for Payer: The Alliance Commercial |
$2,270.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$567.58
|
| Rate for Payer: United Healthcare PPO |
$2,347.28
|
| Rate for Payer: Wellcare Medicare |
$567.58
|
|
