|
BIOPSY OF URETHRA 53200
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
CPT 53200
|
| Hospital Charge Code |
3015009
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$122.56 |
| Max. Negotiated Rate |
$743.96 |
| Rate for Payer: Aetna Commercial |
$743.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$673.48
|
| Rate for Payer: Aetna Managed Medicare |
$122.56
|
| Rate for Payer: Anthem Medicare Advantage |
$122.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$122.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$122.56
|
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: Cash Price |
$225.90
|
| Rate for Payer: Cigna Commercial |
$743.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$125.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$122.56
|
| Rate for Payer: Health EOS Commercial |
$712.64
|
| Rate for Payer: HFN Commercial |
$743.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$489.92
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$489.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$122.56
|
| Rate for Payer: Multiplan Commercial |
$626.50
|
| Rate for Payer: NAPHCARE Commercial |
$183.85
|
| Rate for Payer: Preferred Network Access Commercial |
$743.96
|
| Rate for Payer: Quartz Beloit One Network |
$344.57
|
| Rate for Payer: Quartz Commercial |
$446.38
|
| Rate for Payer: Quartz Medicare Advantage |
$122.56
|
| Rate for Payer: The Alliance Commercial |
$520.90
|
| Rate for Payer: United Healthcare Medicaid |
$125.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.56
|
| Rate for Payer: WEA Trust Commercial |
$430.72
|
| Rate for Payer: WPS Commercial |
$551.54
|
|
|
Biopsy Of Vagina
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
1190837
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.99 |
| Max. Negotiated Rate |
$399.15 |
| Rate for Payer: Aetna Commercial |
$399.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$361.34
|
| Rate for Payer: Aetna Managed Medicare |
$54.97
|
| Rate for Payer: Anthem Medicare Advantage |
$54.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$54.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$54.97
|
| Rate for Payer: Cash Price |
$121.20
|
| Rate for Payer: Cash Price |
$121.20
|
| Rate for Payer: Cash Price |
$121.20
|
| Rate for Payer: Cigna Commercial |
$399.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$54.97
|
| Rate for Payer: Health EOS Commercial |
$382.35
|
| Rate for Payer: HFN Commercial |
$399.15
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$226.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$226.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$54.97
|
| Rate for Payer: Multiplan Commercial |
$336.13
|
| Rate for Payer: NAPHCARE Commercial |
$82.46
|
| Rate for Payer: Preferred Network Access Commercial |
$399.15
|
| Rate for Payer: Quartz Beloit One Network |
$184.87
|
| Rate for Payer: Quartz Commercial |
$239.49
|
| Rate for Payer: Quartz Medicare Advantage |
$54.97
|
| Rate for Payer: The Alliance Commercial |
$233.64
|
| Rate for Payer: United Healthcare Medicaid |
$46.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54.97
|
| Rate for Payer: WEA Trust Commercial |
$231.09
|
| Rate for Payer: WPS Commercial |
$247.38
|
|
|
BIOPSY OF VAGINA 57105
|
Professional
|
Both
|
$606.00
|
|
|
Service Code
|
CPT 57105
|
| Hospital Charge Code |
3015069
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$119.53 |
| Max. Negotiated Rate |
$598.73 |
| Rate for Payer: Aetna Commercial |
$598.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$542.01
|
| Rate for Payer: Aetna Managed Medicare |
$130.14
|
| Rate for Payer: Anthem Medicare Advantage |
$130.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$130.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$130.14
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cigna Commercial |
$598.73
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$119.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$130.14
|
| Rate for Payer: Health EOS Commercial |
$573.52
|
| Rate for Payer: HFN Commercial |
$598.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$499.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$499.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$130.14
|
| Rate for Payer: Multiplan Commercial |
$504.19
|
| Rate for Payer: NAPHCARE Commercial |
$195.20
|
| Rate for Payer: Preferred Network Access Commercial |
$598.73
|
| Rate for Payer: Quartz Beloit One Network |
$277.31
|
| Rate for Payer: Quartz Commercial |
$359.24
|
| Rate for Payer: Quartz Medicare Advantage |
$130.14
|
| Rate for Payer: The Alliance Commercial |
$553.07
|
| Rate for Payer: United Healthcare Medicaid |
$119.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$130.14
|
| Rate for Payer: WEA Trust Commercial |
$346.63
|
| Rate for Payer: WPS Commercial |
$585.61
|
|
|
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION
|
Facility
|
OP
|
$4,386.95
|
|
|
Service Code
|
CPT 56605
|
|
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 VULVA OR PERINEUM (SEPARATE PROCEDURE); EACH SEPARATE ADDITIONAL LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$4,386.95
|
|
|
Service Code
|
CPT 56606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$96.18 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: The Alliance Commercial |
$96.18
|
|
|
Biopsy Of Vulva/Perineum, 1 Lesion 56605
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
1188884
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.85 |
| Max. Negotiated Rate |
$604.66 |
| Rate for Payer: Aetna Commercial |
$604.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$547.37
|
| Rate for Payer: Aetna Managed Medicare |
$48.85
|
| Rate for Payer: Anthem Medicare Advantage |
$48.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$48.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$48.85
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cigna Commercial |
$604.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$76.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.85
|
| Rate for Payer: Health EOS Commercial |
$579.20
|
| Rate for Payer: HFN Commercial |
$604.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$204.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$204.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$48.85
|
| Rate for Payer: Multiplan Commercial |
$509.18
|
| Rate for Payer: NAPHCARE Commercial |
$73.27
|
| Rate for Payer: Preferred Network Access Commercial |
$604.66
|
| Rate for Payer: Quartz Beloit One Network |
$280.05
|
| Rate for Payer: Quartz Commercial |
$362.79
|
| Rate for Payer: Quartz Medicare Advantage |
$48.85
|
| Rate for Payer: The Alliance Commercial |
$207.61
|
| Rate for Payer: United Healthcare Medicaid |
$76.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48.85
|
| Rate for Payer: WEA Trust Commercial |
$350.06
|
| Rate for Payer: WPS Commercial |
$219.82
|
|
|
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 |
$24.04 |
| Max. Negotiated Rate |
$166.97 |
| Rate for Payer: Aetna Commercial |
$166.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$151.15
|
| Rate for Payer: Aetna Managed Medicare |
$24.04
|
| Rate for Payer: Anthem Medicare Advantage |
$24.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.04
|
| Rate for Payer: Cash Price |
$50.70
|
| Rate for Payer: Cash Price |
$50.70
|
| Rate for Payer: Cash Price |
$50.70
|
| Rate for Payer: Cigna Commercial |
$166.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$37.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24.04
|
| Rate for Payer: Health EOS Commercial |
$159.94
|
| Rate for Payer: HFN Commercial |
$166.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$100.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$100.41
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.04
|
| Rate for Payer: Multiplan Commercial |
$140.61
|
| Rate for Payer: NAPHCARE Commercial |
$36.07
|
| Rate for Payer: Preferred Network Access Commercial |
$166.97
|
| Rate for Payer: Quartz Beloit One Network |
$77.33
|
| Rate for Payer: Quartz Commercial |
$100.18
|
| Rate for Payer: Quartz Medicare Advantage |
$24.04
|
| Rate for Payer: The Alliance Commercial |
$102.19
|
| Rate for Payer: United Healthcare Medicaid |
$37.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.04
|
| Rate for Payer: WEA Trust Commercial |
$96.67
|
| Rate for Payer: WPS Commercial |
$108.20
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP AXILLARY NODE(S)
|
Facility
|
OP
|
$16,482.25
|
|
|
Service Code
|
CPT 38525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,120.56 |
| Max. Negotiated Rate |
$16,482.25 |
| Rate for Payer: Aetna Managed Medicare |
$4,120.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$4,120.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4,120.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4,120.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4,120.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4,120.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15,328.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4,120.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4,120.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4,120.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4,120.56
|
| Rate for Payer: NAPHCARE Commercial |
$6,180.84
|
| Rate for Payer: Quartz Medicare Advantage |
$4,120.56
|
| Rate for Payer: The Alliance Commercial |
$16,482.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,120.56
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$4,120.56
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP CERVICAL NODE(S)
|
Facility
|
OP
|
$16,482.25
|
|
|
Service Code
|
CPT 38510
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,120.56 |
| Max. Negotiated Rate |
$16,482.25 |
| Rate for Payer: Aetna Managed Medicare |
$4,120.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$4,120.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4,120.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4,120.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4,120.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4,120.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15,328.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4,120.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4,120.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4,120.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4,120.56
|
| Rate for Payer: NAPHCARE Commercial |
$6,180.84
|
| Rate for Payer: Quartz Medicare Advantage |
$4,120.56
|
| Rate for Payer: The Alliance Commercial |
$16,482.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,120.56
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$4,120.56
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, INGUINOFEMORAL NODE(S)
|
Facility
|
OP
|
$16,482.25
|
|
|
Service Code
|
CPT 38531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,120.56 |
| Max. Negotiated Rate |
$16,482.25 |
| Rate for Payer: Aetna Managed Medicare |
$4,120.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$4,120.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4,120.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4,120.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4,120.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4,120.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15,328.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4,120.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4,120.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4,120.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4,120.56
|
| Rate for Payer: NAPHCARE Commercial |
$6,180.84
|
| Rate for Payer: Quartz Medicare Advantage |
$4,120.56
|
| Rate for Payer: The Alliance Commercial |
$16,482.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,120.56
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$4,120.56
|
|
|
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 |
$141.52 |
| Max. Negotiated Rate |
$1,123.36 |
| Rate for Payer: Aetna Commercial |
$1,123.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,016.93
|
| Rate for Payer: Aetna Managed Medicare |
$229.67
|
| Rate for Payer: Anthem Medicare Advantage |
$229.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$229.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$229.67
|
| Rate for Payer: Cash Price |
$341.10
|
| Rate for Payer: Cash Price |
$341.10
|
| Rate for Payer: Cash Price |
$341.10
|
| Rate for Payer: Cigna Commercial |
$1,123.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$141.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$229.67
|
| Rate for Payer: Health EOS Commercial |
$1,076.06
|
| Rate for Payer: HFN Commercial |
$1,123.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$865.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$865.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$229.67
|
| Rate for Payer: Multiplan Commercial |
$945.98
|
| Rate for Payer: NAPHCARE Commercial |
$344.51
|
| Rate for Payer: Preferred Network Access Commercial |
$1,123.36
|
| Rate for Payer: Quartz Beloit One Network |
$520.29
|
| Rate for Payer: Quartz Commercial |
$674.01
|
| Rate for Payer: Quartz Medicare Advantage |
$229.67
|
| Rate for Payer: The Alliance Commercial |
$976.11
|
| Rate for Payer: United Healthcare Medicaid |
$141.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$229.67
|
| Rate for Payer: WEA Trust Commercial |
$650.36
|
| Rate for Payer: WPS Commercial |
$1,033.53
|
|
|
Biopsy, Oropharynx
|
Professional
|
Both
|
$435.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
1190854
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$63.06 |
| Max. Negotiated Rate |
$464.07 |
| Rate for Payer: Aetna Commercial |
$429.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$389.06
|
| Rate for Payer: Aetna Managed Medicare |
$103.13
|
| Rate for Payer: Anthem Medicare Advantage |
$103.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$103.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$103.13
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cigna Commercial |
$429.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$63.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$103.13
|
| Rate for Payer: Health EOS Commercial |
$411.68
|
| Rate for Payer: HFN Commercial |
$429.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$395.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$395.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$103.13
|
| Rate for Payer: Multiplan Commercial |
$361.92
|
| Rate for Payer: NAPHCARE Commercial |
$154.69
|
| Rate for Payer: Preferred Network Access Commercial |
$429.78
|
| Rate for Payer: Quartz Beloit One Network |
$199.06
|
| Rate for Payer: Quartz Commercial |
$257.87
|
| Rate for Payer: Quartz Medicare Advantage |
$103.13
|
| Rate for Payer: The Alliance Commercial |
$438.29
|
| Rate for Payer: United Healthcare Medicaid |
$63.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.13
|
| Rate for Payer: WEA Trust Commercial |
$248.82
|
| Rate for Payer: WPS Commercial |
$464.07
|
|
|
Biopsy: Oropharynx
|
Professional
|
Both
|
$435.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
1152811
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$63.06 |
| Max. Negotiated Rate |
$464.07 |
| Rate for Payer: Aetna Commercial |
$429.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$389.06
|
| Rate for Payer: Aetna Managed Medicare |
$103.13
|
| Rate for Payer: Anthem Medicare Advantage |
$103.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$103.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$103.13
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cigna Commercial |
$429.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$63.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$103.13
|
| Rate for Payer: Health EOS Commercial |
$411.68
|
| Rate for Payer: HFN Commercial |
$429.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$395.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$395.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$103.13
|
| Rate for Payer: Multiplan Commercial |
$361.92
|
| Rate for Payer: NAPHCARE Commercial |
$154.69
|
| Rate for Payer: Preferred Network Access Commercial |
$429.78
|
| Rate for Payer: Quartz Beloit One Network |
$199.06
|
| Rate for Payer: Quartz Commercial |
$257.87
|
| Rate for Payer: Quartz Medicare Advantage |
$103.13
|
| Rate for Payer: The Alliance Commercial |
$438.29
|
| Rate for Payer: United Healthcare Medicaid |
$63.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.13
|
| Rate for Payer: WEA Trust Commercial |
$248.82
|
| Rate for Payer: WPS Commercial |
$464.07
|
|
|
BIOPSY, PANCREATIC
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959890
|
|
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, PANCREATIC
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959890
|
|
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, PENIS/TESTICLE
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959896
|
|
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, PENIS/TESTICLE
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959896
|
|
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, PLEURAL
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959892
|
|
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, PLEURAL
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959892
|
|
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, Prostate needle or punch 55700
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
CPT 55700
|
| Hospital Charge Code |
1188980
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$420.99 |
| Max. Negotiated Rate |
$908.96 |
| Rate for Payer: Aetna Commercial |
$908.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$822.85
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cigna Commercial |
$908.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$478.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$574.08
|
| Rate for Payer: Health EOS Commercial |
$870.69
|
| Rate for Payer: HFN Commercial |
$908.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$451.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$451.52
|
| Rate for Payer: Multiplan Commercial |
$765.44
|
| Rate for Payer: Preferred Network Access Commercial |
$908.96
|
| Rate for Payer: Quartz Beloit One Network |
$420.99
|
| Rate for Payer: Quartz Commercial |
$545.38
|
| Rate for Payer: The Alliance Commercial |
$478.40
|
| Rate for Payer: WEA Trust Commercial |
$526.24
|
| Rate for Payer: WPS Commercial |
$708.68
|
|
|
BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH
|
Facility
|
OP
|
$4,947.89
|
|
|
Service Code
|
CPT 55700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,835.04 |
| Max. Negotiated Rate |
$4,947.89 |
| 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: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
|
|
BIOPSY, PULMONARY
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959893
|
|
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, PULMONARY
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959893
|
|
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 PUNCH DERMAL 4MM 33-34
|
Facility
|
IP
|
$64.00
|
|
| Hospital Charge Code |
2974548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.61 |
| Max. Negotiated Rate |
$61.24 |
| Rate for Payer: Aetna Commercial |
$59.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$57.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$35.28
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cigna Commercial |
$61.24
|
| Rate for Payer: Health EOS Commercial |
$59.24
|
| Rate for Payer: HFN Commercial |
$61.24
|
| Rate for Payer: Multiplan Commercial |
$53.25
|
| Rate for Payer: Preferred Network Access Commercial |
$61.24
|
| Rate for Payer: Quartz Beloit One Network |
$32.61
|
| Rate for Payer: Quartz Commercial |
$39.94
|
| Rate for Payer: WEA Trust Commercial |
$36.61
|
| Rate for Payer: WPS Commercial |
$49.30
|
|
|
BIOPSY PUNCH DERMAL 4MM 33-34
|
Facility
|
OP
|
$64.00
|
|
| Hospital Charge Code |
2974548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.64 |
| Max. Negotiated Rate |
$61.24 |
| Rate for Payer: Aetna Commercial |
$59.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$57.24
|
| Rate for Payer: Aetna Managed Medicare |
$18.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$43.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$33.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$31.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$35.28
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cigna Commercial |
$61.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$37.25
|
| Rate for Payer: Health EOS Commercial |
$59.24
|
| Rate for Payer: HFN Commercial |
$61.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$49.92
|
| Rate for Payer: Multiplan Commercial |
$53.25
|
| Rate for Payer: NAPHCARE Commercial |
$39.94
|
| Rate for Payer: Preferred Network Access Commercial |
$61.24
|
| Rate for Payer: Quartz Beloit One Network |
$32.61
|
| Rate for Payer: Quartz Commercial |
$43.26
|
| Rate for Payer: Quartz Medicare Advantage |
$39.94
|
| Rate for Payer: The Alliance Commercial |
$33.28
|
| Rate for Payer: WEA Trust Commercial |
$36.61
|
| Rate for Payer: WPS Commercial |
$49.30
|
|
