|
BLOCK SPHENOPALATINE GANGLION
|
Facility
|
IP
|
$1,218.00
|
|
| Hospital Charge Code |
5262687
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$620.69 |
| Max. Negotiated Rate |
$1,165.38 |
| Rate for Payer: Aetna Commercial |
$1,140.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,089.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$671.36
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cigna Commercial |
$1,165.38
|
| Rate for Payer: Health EOS Commercial |
$1,127.38
|
| Rate for Payer: HFN Commercial |
$1,165.38
|
| Rate for Payer: Multiplan Commercial |
$1,013.38
|
| Rate for Payer: Preferred Network Access Commercial |
$1,165.38
|
| Rate for Payer: Quartz Beloit One Network |
$620.69
|
| Rate for Payer: Quartz Commercial |
$760.03
|
| Rate for Payer: WEA Trust Commercial |
$696.70
|
| Rate for Payer: WPS Commercial |
$938.23
|
|
|
BLOCK, STELLATE GANGLION
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
CPT 64510
|
| Hospital Charge Code |
2960388
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$465.26 |
| Max. Negotiated Rate |
$873.56 |
| Rate for Payer: Aetna Commercial |
$854.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$816.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$503.25
|
| Rate for Payer: Cash Price |
$273.90
|
| Rate for Payer: Cigna Commercial |
$873.56
|
| Rate for Payer: Health EOS Commercial |
$845.07
|
| Rate for Payer: HFN Commercial |
$873.56
|
| Rate for Payer: Multiplan Commercial |
$759.62
|
| Rate for Payer: Preferred Network Access Commercial |
$873.56
|
| Rate for Payer: Quartz Beloit One Network |
$465.26
|
| Rate for Payer: Quartz Commercial |
$569.71
|
| Rate for Payer: WEA Trust Commercial |
$522.24
|
| Rate for Payer: WPS Commercial |
$703.28
|
|
|
BLOCK, STELLATE GANGLION
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
CPT 64510
|
| Hospital Charge Code |
2960388
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$465.26 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$854.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$816.59
|
| Rate for Payer: Aetna Managed Medicare |
$930.81
|
| 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 |
$930.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$503.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$930.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$930.81
|
| Rate for Payer: Cash Price |
$273.90
|
| Rate for Payer: Cash Price |
$273.90
|
| Rate for Payer: Cash Price |
$273.90
|
| Rate for Payer: Cigna Commercial |
$873.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$930.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$930.81
|
| Rate for Payer: Health EOS Commercial |
$845.07
|
| Rate for Payer: HFN Commercial |
$873.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,462.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$930.81
|
| Rate for Payer: Independent Care Health Plan Medicare |
$930.81
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$930.81
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$930.81
|
| Rate for Payer: Multiplan Commercial |
$759.62
|
| Rate for Payer: NAPHCARE Commercial |
$1,396.22
|
| Rate for Payer: Preferred Network Access Commercial |
$873.56
|
| Rate for Payer: Quartz Beloit One Network |
$465.26
|
| Rate for Payer: Quartz Commercial |
$617.19
|
| Rate for Payer: Quartz Medicare Advantage |
$930.81
|
| Rate for Payer: The Alliance Commercial |
$3,723.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$930.81
|
| Rate for Payer: United Healthcare PPO |
$2,347.28
|
| Rate for Payer: WEA Trust Commercial |
$522.24
|
| Rate for Payer: Wellcare Medicare |
$930.81
|
| Rate for Payer: WPS Commercial |
$703.28
|
|
|
BLOCK SZ 7 TIB AUGMENT LCCK 5988-07-26
|
Facility
|
IP
|
$8,160.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
2969413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,158.34 |
| Max. Negotiated Rate |
$7,807.49 |
| Rate for Payer: Aetna Commercial |
$7,637.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,298.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,497.79
|
| Rate for Payer: Cash Price |
$2,448.00
|
| Rate for Payer: Cigna Commercial |
$7,807.49
|
| Rate for Payer: Health EOS Commercial |
$7,552.90
|
| Rate for Payer: HFN Commercial |
$7,807.49
|
| Rate for Payer: Multiplan Commercial |
$6,789.12
|
| Rate for Payer: Preferred Network Access Commercial |
$7,807.49
|
| Rate for Payer: Quartz Beloit One Network |
$4,158.34
|
| Rate for Payer: Quartz Commercial |
$5,091.84
|
| Rate for Payer: WEA Trust Commercial |
$4,667.52
|
| Rate for Payer: WPS Commercial |
$6,285.65
|
|
|
BLOCK SZ 7 TIB AUGMENT LCCK 5988-07-26
|
Facility
|
OP
|
$8,160.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
2969413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,376.19 |
| Max. Negotiated Rate |
$7,807.49 |
| Rate for Payer: Aetna Commercial |
$7,637.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,298.30
|
| Rate for Payer: Aetna Managed Medicare |
$2,376.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,516.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,243.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,073.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,497.79
|
| Rate for Payer: Cash Price |
$2,448.00
|
| Rate for Payer: Cigna Commercial |
$7,807.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,749.12
|
| Rate for Payer: Health EOS Commercial |
$7,552.90
|
| Rate for Payer: HFN Commercial |
$7,807.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,364.80
|
| Rate for Payer: Multiplan Commercial |
$6,789.12
|
| Rate for Payer: NAPHCARE Commercial |
$5,091.84
|
| Rate for Payer: Preferred Network Access Commercial |
$7,807.49
|
| Rate for Payer: Quartz Beloit One Network |
$4,158.34
|
| Rate for Payer: Quartz Commercial |
$5,516.16
|
| Rate for Payer: Quartz Medicare Advantage |
$5,091.84
|
| Rate for Payer: The Alliance Commercial |
$4,243.20
|
| Rate for Payer: WEA Trust Commercial |
$4,667.52
|
| Rate for Payer: WPS Commercial |
$6,285.65
|
|
|
BLOCK WITH GENERAL ANES - SET-UP CHARGE
|
Facility
|
OP
|
$1,668.00
|
|
| Hospital Charge Code |
4519582
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$485.72 |
| Max. Negotiated Rate |
$1,595.94 |
| Rate for Payer: Aetna Commercial |
$1,561.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,491.86
|
| Rate for Payer: Aetna Managed Medicare |
$485.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,127.57
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$867.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$832.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$919.40
|
| Rate for Payer: Cash Price |
$500.40
|
| Rate for Payer: Cigna Commercial |
$1,595.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$970.78
|
| Rate for Payer: Health EOS Commercial |
$1,543.90
|
| Rate for Payer: HFN Commercial |
$1,595.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,301.04
|
| Rate for Payer: Multiplan Commercial |
$1,387.78
|
| Rate for Payer: NAPHCARE Commercial |
$1,040.83
|
| Rate for Payer: Preferred Network Access Commercial |
$1,595.94
|
| Rate for Payer: Quartz Beloit One Network |
$850.01
|
| Rate for Payer: Quartz Commercial |
$1,127.57
|
| Rate for Payer: Quartz Medicare Advantage |
$1,040.83
|
| Rate for Payer: The Alliance Commercial |
$867.36
|
| Rate for Payer: WEA Trust Commercial |
$954.10
|
| Rate for Payer: WPS Commercial |
$1,284.86
|
|
|
BLOCK WITH GENERAL ANES - SET-UP CHARGE
|
Facility
|
IP
|
$1,668.00
|
|
| Hospital Charge Code |
4519582
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$850.01 |
| Max. Negotiated Rate |
$1,595.94 |
| Rate for Payer: Aetna Commercial |
$1,561.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,491.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$919.40
|
| Rate for Payer: Cash Price |
$500.40
|
| Rate for Payer: Cigna Commercial |
$1,595.94
|
| Rate for Payer: Health EOS Commercial |
$1,543.90
|
| Rate for Payer: HFN Commercial |
$1,595.94
|
| Rate for Payer: Multiplan Commercial |
$1,387.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,595.94
|
| Rate for Payer: Quartz Beloit One Network |
$850.01
|
| Rate for Payer: Quartz Commercial |
$1,040.83
|
| Rate for Payer: WEA Trust Commercial |
$954.10
|
| Rate for Payer: WPS Commercial |
$1,284.86
|
|
|
BLOCK WITH MAC ANES - SET-UP CHARGE
|
Facility
|
OP
|
$1,303.00
|
|
| Hospital Charge Code |
4519581
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$379.43 |
| Max. Negotiated Rate |
$1,246.71 |
| Rate for Payer: Aetna Commercial |
$1,219.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,165.40
|
| Rate for Payer: Aetna Managed Medicare |
$379.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$880.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$677.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$650.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$718.21
|
| Rate for Payer: Cash Price |
$390.90
|
| Rate for Payer: Cigna Commercial |
$1,246.71
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$758.35
|
| Rate for Payer: Health EOS Commercial |
$1,206.06
|
| Rate for Payer: HFN Commercial |
$1,246.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,016.34
|
| Rate for Payer: Multiplan Commercial |
$1,084.10
|
| Rate for Payer: NAPHCARE Commercial |
$813.07
|
| Rate for Payer: Preferred Network Access Commercial |
$1,246.71
|
| Rate for Payer: Quartz Beloit One Network |
$664.01
|
| Rate for Payer: Quartz Commercial |
$880.83
|
| Rate for Payer: Quartz Medicare Advantage |
$813.07
|
| Rate for Payer: The Alliance Commercial |
$677.56
|
| Rate for Payer: WEA Trust Commercial |
$745.32
|
| Rate for Payer: WPS Commercial |
$1,003.70
|
|
|
BLOCK WITH MAC ANES - SET-UP CHARGE
|
Facility
|
IP
|
$1,303.00
|
|
| Hospital Charge Code |
4519581
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$664.01 |
| Max. Negotiated Rate |
$1,246.71 |
| Rate for Payer: Aetna Commercial |
$1,219.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,165.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$718.21
|
| Rate for Payer: Cash Price |
$390.90
|
| Rate for Payer: Cigna Commercial |
$1,246.71
|
| Rate for Payer: Health EOS Commercial |
$1,206.06
|
| Rate for Payer: HFN Commercial |
$1,246.71
|
| Rate for Payer: Multiplan Commercial |
$1,084.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,246.71
|
| Rate for Payer: Quartz Beloit One Network |
$664.01
|
| Rate for Payer: Quartz Commercial |
$813.07
|
| Rate for Payer: WEA Trust Commercial |
$745.32
|
| Rate for Payer: WPS Commercial |
$1,003.70
|
|
|
Blood Culture
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
633882
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$288.95 |
| Rate for Payer: Aetna Commercial |
$282.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$270.11
|
| Rate for Payer: Aetna Managed Medicare |
$10.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$40.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18.78
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17.82
|
| Rate for Payer: Anthem Medicare Advantage |
$10.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$166.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.73
|
| Rate for Payer: Cash Price |
$90.60
|
| Rate for Payer: Cash Price |
$90.60
|
| Rate for Payer: Cigna Commercial |
$288.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$175.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10.73
|
| Rate for Payer: Health EOS Commercial |
$279.53
|
| Rate for Payer: HFN Commercial |
$288.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$39.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.73
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10.73
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$251.26
|
| Rate for Payer: NAPHCARE Commercial |
$16.10
|
| Rate for Payer: Preferred Network Access Commercial |
$288.95
|
| Rate for Payer: Quartz Beloit One Network |
$153.90
|
| Rate for Payer: Quartz Commercial |
$204.15
|
| Rate for Payer: Quartz Medicare Advantage |
$10.73
|
| Rate for Payer: The Alliance Commercial |
$42.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.73
|
| Rate for Payer: United Healthcare PPO |
$235.56
|
| Rate for Payer: WEA Trust Commercial |
$172.74
|
| Rate for Payer: Wellcare Medicare |
$10.73
|
| Rate for Payer: WPS Commercial |
$232.63
|
|
|
Blood Culture
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
633882
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$298.38 |
| Rate for Payer: Aetna Commercial |
$298.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$270.11
|
| Rate for Payer: Aetna Managed Medicare |
$10.73
|
| Rate for Payer: Anthem Medicare Advantage |
$10.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.73
|
| Rate for Payer: Cash Price |
$90.60
|
| Rate for Payer: Cash Price |
$90.60
|
| Rate for Payer: Cigna Commercial |
$298.38
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$157.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10.73
|
| Rate for Payer: Health EOS Commercial |
$285.81
|
| Rate for Payer: HFN Commercial |
$298.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$37.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$251.26
|
| Rate for Payer: NAPHCARE Commercial |
$16.10
|
| Rate for Payer: Preferred Network Access Commercial |
$298.38
|
| Rate for Payer: Quartz Beloit One Network |
$138.20
|
| Rate for Payer: Quartz Commercial |
$179.03
|
| Rate for Payer: Quartz Medicare Advantage |
$10.73
|
| Rate for Payer: The Alliance Commercial |
$42.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.73
|
| Rate for Payer: WEA Trust Commercial |
$172.74
|
| Rate for Payer: WPS Commercial |
$47.22
|
|
|
Blood Culture
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
633882
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$153.90 |
| Max. Negotiated Rate |
$288.95 |
| Rate for Payer: Aetna Commercial |
$282.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$270.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$166.46
|
| Rate for Payer: Cash Price |
$90.60
|
| Rate for Payer: Cigna Commercial |
$288.95
|
| Rate for Payer: Health EOS Commercial |
$279.53
|
| Rate for Payer: HFN Commercial |
$288.95
|
| Rate for Payer: Multiplan Commercial |
$251.26
|
| Rate for Payer: Preferred Network Access Commercial |
$288.95
|
| Rate for Payer: Quartz Beloit One Network |
$153.90
|
| Rate for Payer: Quartz Commercial |
$188.45
|
| Rate for Payer: WEA Trust Commercial |
$172.74
|
| Rate for Payer: WPS Commercial |
$232.63
|
|
|
Blood Gas Arterial
|
Facility
|
OP
|
$538.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
633675
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.92 |
| Max. Negotiated Rate |
$514.76 |
| Rate for Payer: Aetna Commercial |
$503.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Aetna Managed Medicare |
$81.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$307.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$143.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$135.99
|
| Rate for Payer: Anthem Medicare Advantage |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$296.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$81.92
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$514.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$81.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$313.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$81.92
|
| Rate for Payer: Health EOS Commercial |
$497.97
|
| Rate for Payer: HFN Commercial |
$514.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$304.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$81.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$81.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$81.92
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$81.92
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: NAPHCARE Commercial |
$122.88
|
| Rate for Payer: Preferred Network Access Commercial |
$514.76
|
| Rate for Payer: Quartz Beloit One Network |
$274.16
|
| Rate for Payer: Quartz Commercial |
$363.69
|
| Rate for Payer: Quartz Medicare Advantage |
$81.92
|
| Rate for Payer: The Alliance Commercial |
$327.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.92
|
| Rate for Payer: United Healthcare PPO |
$419.64
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: Wellcare Medicare |
$81.92
|
| Rate for Payer: WPS Commercial |
$414.42
|
|
|
Blood Gas Arterial
|
Facility
|
IP
|
$538.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
633675
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$274.16 |
| Max. Negotiated Rate |
$514.76 |
| Rate for Payer: Aetna Commercial |
$503.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$296.55
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$514.76
|
| Rate for Payer: Health EOS Commercial |
$497.97
|
| Rate for Payer: HFN Commercial |
$514.76
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: Preferred Network Access Commercial |
$514.76
|
| Rate for Payer: Quartz Beloit One Network |
$274.16
|
| Rate for Payer: Quartz Commercial |
$335.71
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: WPS Commercial |
$414.42
|
|
|
Blood Gas Arterial
|
Professional
|
Both
|
$538.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
633675
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.92 |
| Max. Negotiated Rate |
$531.54 |
| Rate for Payer: Aetna Commercial |
$531.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Aetna Managed Medicare |
$81.92
|
| Rate for Payer: Anthem Medicare Advantage |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$81.92
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$531.54
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$279.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$81.92
|
| Rate for Payer: Health EOS Commercial |
$509.16
|
| Rate for Payer: HFN Commercial |
$531.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$289.18
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$289.18
|
| Rate for Payer: Independent Care Health Plan Medicare |
$81.92
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: NAPHCARE Commercial |
$122.88
|
| Rate for Payer: Preferred Network Access Commercial |
$531.54
|
| Rate for Payer: Quartz Beloit One Network |
$246.19
|
| Rate for Payer: Quartz Commercial |
$318.93
|
| Rate for Payer: Quartz Medicare Advantage |
$81.92
|
| Rate for Payer: The Alliance Commercial |
$323.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.92
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: WPS Commercial |
$360.45
|
|
|
Blood Gas Capillary
|
Facility
|
OP
|
$538.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
633676
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.92 |
| Max. Negotiated Rate |
$514.76 |
| Rate for Payer: Aetna Commercial |
$503.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Aetna Managed Medicare |
$81.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$307.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$143.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$135.99
|
| Rate for Payer: Anthem Medicare Advantage |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$296.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$81.92
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$514.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$81.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$313.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$81.92
|
| Rate for Payer: Health EOS Commercial |
$497.97
|
| Rate for Payer: HFN Commercial |
$514.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$304.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$81.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$81.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$81.92
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$81.92
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: NAPHCARE Commercial |
$122.88
|
| Rate for Payer: Preferred Network Access Commercial |
$514.76
|
| Rate for Payer: Quartz Beloit One Network |
$274.16
|
| Rate for Payer: Quartz Commercial |
$363.69
|
| Rate for Payer: Quartz Medicare Advantage |
$81.92
|
| Rate for Payer: The Alliance Commercial |
$327.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.92
|
| Rate for Payer: United Healthcare PPO |
$419.64
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: Wellcare Medicare |
$81.92
|
| Rate for Payer: WPS Commercial |
$414.42
|
|
|
Blood Gas Capillary
|
Facility
|
IP
|
$538.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
633676
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$274.16 |
| Max. Negotiated Rate |
$514.76 |
| Rate for Payer: Aetna Commercial |
$503.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$296.55
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$514.76
|
| Rate for Payer: Health EOS Commercial |
$497.97
|
| Rate for Payer: HFN Commercial |
$514.76
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: Preferred Network Access Commercial |
$514.76
|
| Rate for Payer: Quartz Beloit One Network |
$274.16
|
| Rate for Payer: Quartz Commercial |
$335.71
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: WPS Commercial |
$414.42
|
|
|
Blood Gas Capillary
|
Professional
|
Both
|
$538.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
633676
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.92 |
| Max. Negotiated Rate |
$531.54 |
| Rate for Payer: Aetna Commercial |
$531.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Aetna Managed Medicare |
$81.92
|
| Rate for Payer: Anthem Medicare Advantage |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$81.92
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$531.54
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$279.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$81.92
|
| Rate for Payer: Health EOS Commercial |
$509.16
|
| Rate for Payer: HFN Commercial |
$531.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$289.18
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$289.18
|
| Rate for Payer: Independent Care Health Plan Medicare |
$81.92
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: NAPHCARE Commercial |
$122.88
|
| Rate for Payer: Preferred Network Access Commercial |
$531.54
|
| Rate for Payer: Quartz Beloit One Network |
$246.19
|
| Rate for Payer: Quartz Commercial |
$318.93
|
| Rate for Payer: Quartz Medicare Advantage |
$81.92
|
| Rate for Payer: The Alliance Commercial |
$323.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.92
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: WPS Commercial |
$360.45
|
|
|
Blood Gas Venous
|
Facility
|
OP
|
$538.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
633677
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.92 |
| Max. Negotiated Rate |
$514.76 |
| Rate for Payer: Aetna Commercial |
$503.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Aetna Managed Medicare |
$81.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$307.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$143.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$135.99
|
| Rate for Payer: Anthem Medicare Advantage |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$296.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$81.92
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$514.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$81.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$313.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$81.92
|
| Rate for Payer: Health EOS Commercial |
$497.97
|
| Rate for Payer: HFN Commercial |
$514.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$304.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$81.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$81.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$81.92
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$81.92
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: NAPHCARE Commercial |
$122.88
|
| Rate for Payer: Preferred Network Access Commercial |
$514.76
|
| Rate for Payer: Quartz Beloit One Network |
$274.16
|
| Rate for Payer: Quartz Commercial |
$363.69
|
| Rate for Payer: Quartz Medicare Advantage |
$81.92
|
| Rate for Payer: The Alliance Commercial |
$327.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.92
|
| Rate for Payer: United Healthcare PPO |
$419.64
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: Wellcare Medicare |
$81.92
|
| Rate for Payer: WPS Commercial |
$414.42
|
|
|
Blood Gas Venous
|
Facility
|
IP
|
$538.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
633677
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$274.16 |
| Max. Negotiated Rate |
$514.76 |
| Rate for Payer: Aetna Commercial |
$503.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$296.55
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$514.76
|
| Rate for Payer: Health EOS Commercial |
$497.97
|
| Rate for Payer: HFN Commercial |
$514.76
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: Preferred Network Access Commercial |
$514.76
|
| Rate for Payer: Quartz Beloit One Network |
$274.16
|
| Rate for Payer: Quartz Commercial |
$335.71
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: WPS Commercial |
$414.42
|
|
|
Blood Gas Venous
|
Professional
|
Both
|
$538.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
633677
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.92 |
| Max. Negotiated Rate |
$531.54 |
| Rate for Payer: Aetna Commercial |
$531.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Aetna Managed Medicare |
$81.92
|
| Rate for Payer: Anthem Medicare Advantage |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$81.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$81.92
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$531.54
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$279.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$81.92
|
| Rate for Payer: Health EOS Commercial |
$509.16
|
| Rate for Payer: HFN Commercial |
$531.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$289.18
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$289.18
|
| Rate for Payer: Independent Care Health Plan Medicare |
$81.92
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: NAPHCARE Commercial |
$122.88
|
| Rate for Payer: Preferred Network Access Commercial |
$531.54
|
| Rate for Payer: Quartz Beloit One Network |
$246.19
|
| Rate for Payer: Quartz Commercial |
$318.93
|
| Rate for Payer: Quartz Medicare Advantage |
$81.92
|
| Rate for Payer: The Alliance Commercial |
$323.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$81.92
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: WPS Commercial |
$360.45
|
|
|
Blood Glucose, Capillary
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
CPT 82948
|
| Hospital Charge Code |
681592
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$73.67 |
| Rate for Payer: Aetna Commercial |
$72.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$68.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$42.44
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Cigna Commercial |
$73.67
|
| Rate for Payer: Health EOS Commercial |
$71.27
|
| Rate for Payer: HFN Commercial |
$73.67
|
| Rate for Payer: Multiplan Commercial |
$64.06
|
| Rate for Payer: Preferred Network Access Commercial |
$73.67
|
| Rate for Payer: Quartz Beloit One Network |
$39.24
|
| Rate for Payer: Quartz Commercial |
$48.05
|
| Rate for Payer: WEA Trust Commercial |
$44.04
|
| Rate for Payer: WPS Commercial |
$59.31
|
|
|
Blood Glucose, Capillary
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
CPT 82948
|
| Hospital Charge Code |
681592
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$73.67 |
| Rate for Payer: Aetna Commercial |
$72.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$68.87
|
| Rate for Payer: Aetna Managed Medicare |
$5.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.17
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.70
|
| Rate for Payer: Anthem Medicare Advantage |
$5.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$42.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.24
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Cigna Commercial |
$73.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$44.81
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.24
|
| Rate for Payer: Health EOS Commercial |
$71.27
|
| Rate for Payer: HFN Commercial |
$73.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.24
|
| Rate for Payer: Multiplan Commercial |
$64.06
|
| Rate for Payer: NAPHCARE Commercial |
$7.86
|
| Rate for Payer: Preferred Network Access Commercial |
$73.67
|
| Rate for Payer: Quartz Beloit One Network |
$39.24
|
| Rate for Payer: Quartz Commercial |
$52.05
|
| Rate for Payer: Quartz Medicare Advantage |
$5.24
|
| Rate for Payer: The Alliance Commercial |
$20.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.24
|
| Rate for Payer: United Healthcare PPO |
$60.06
|
| Rate for Payer: WEA Trust Commercial |
$44.04
|
| Rate for Payer: Wellcare Medicare |
$5.24
|
| Rate for Payer: WPS Commercial |
$59.31
|
|
|
Blood, occult, pt provided with 3 take home cards POC 82272
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT 82272
|
| Hospital Charge Code |
1190881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$46.88 |
| Rate for Payer: Aetna Commercial |
$45.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Aetna Managed Medicare |
$4.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$16.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.70
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7.30
|
| Rate for Payer: Anthem Medicare Advantage |
$4.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.40
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$46.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28.52
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.40
|
| Rate for Payer: Health EOS Commercial |
$45.35
|
| Rate for Payer: HFN Commercial |
$46.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$16.37
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.40
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.40
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.40
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: NAPHCARE Commercial |
$6.60
|
| Rate for Payer: Preferred Network Access Commercial |
$46.88
|
| Rate for Payer: Quartz Beloit One Network |
$24.97
|
| Rate for Payer: Quartz Commercial |
$33.12
|
| Rate for Payer: Quartz Medicare Advantage |
$4.40
|
| Rate for Payer: The Alliance Commercial |
$17.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.40
|
| Rate for Payer: United Healthcare PPO |
$38.22
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: Wellcare Medicare |
$4.40
|
| Rate for Payer: WPS Commercial |
$37.74
|
|
|
Blood, occult, pt provided with 3 take home cards POC 82272
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
CPT 82272
|
| Hospital Charge Code |
1190881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$48.41 |
| Rate for Payer: Aetna Commercial |
$48.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Aetna Managed Medicare |
$4.40
|
| Rate for Payer: Anthem Medicare Advantage |
$4.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.40
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$48.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.40
|
| Rate for Payer: Health EOS Commercial |
$46.37
|
| Rate for Payer: HFN Commercial |
$48.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.40
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: NAPHCARE Commercial |
$6.60
|
| Rate for Payer: Preferred Network Access Commercial |
$48.41
|
| Rate for Payer: Quartz Beloit One Network |
$22.42
|
| Rate for Payer: Quartz Commercial |
$29.05
|
| Rate for Payer: Quartz Medicare Advantage |
$4.40
|
| Rate for Payer: The Alliance Commercial |
$17.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.40
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$19.36
|
|
