|
Blood Type ABO/Rh Typing
|
Facility
|
IP
|
$108.00
|
|
|
Service Code
|
CPT 86900
|
| Hospital Charge Code |
634326
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.04 |
| Max. Negotiated Rate |
$103.33 |
| Rate for Payer: Aetna Commercial |
$101.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$96.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$59.53
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$103.33
|
| Rate for Payer: Health EOS Commercial |
$99.96
|
| Rate for Payer: HFN Commercial |
$103.33
|
| Rate for Payer: Multiplan Commercial |
$89.86
|
| Rate for Payer: Preferred Network Access Commercial |
$103.33
|
| Rate for Payer: Quartz Beloit One Network |
$55.04
|
| Rate for Payer: Quartz Commercial |
$67.39
|
| Rate for Payer: WEA Trust Commercial |
$61.78
|
| Rate for Payer: WPS Commercial |
$83.19
|
|
|
Blood Type ABO/Rh Typing
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
CPT 86900
|
| Hospital Charge Code |
634326
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.11 |
| Max. Negotiated Rate |
$106.70 |
| Rate for Payer: Aetna Commercial |
$106.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$96.60
|
| Rate for Payer: Aetna Managed Medicare |
$3.11
|
| Rate for Payer: Anthem Medicare Advantage |
$3.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.11
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$106.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$56.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3.11
|
| Rate for Payer: Health EOS Commercial |
$102.21
|
| Rate for Payer: HFN Commercial |
$106.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.11
|
| Rate for Payer: Multiplan Commercial |
$89.86
|
| Rate for Payer: NAPHCARE Commercial |
$4.66
|
| Rate for Payer: Preferred Network Access Commercial |
$106.70
|
| Rate for Payer: Quartz Beloit One Network |
$49.42
|
| Rate for Payer: Quartz Commercial |
$64.02
|
| Rate for Payer: Quartz Medicare Advantage |
$3.11
|
| Rate for Payer: The Alliance Commercial |
$12.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.11
|
| Rate for Payer: WEA Trust Commercial |
$61.78
|
| Rate for Payer: WPS Commercial |
$13.68
|
|
|
Blood Urea Nitrogen
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
633605
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.73 |
| Max. Negotiated Rate |
$72.72 |
| Rate for Payer: Aetna Commercial |
$71.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$41.89
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cigna Commercial |
$72.72
|
| Rate for Payer: Health EOS Commercial |
$70.35
|
| Rate for Payer: HFN Commercial |
$72.72
|
| Rate for Payer: Multiplan Commercial |
$63.23
|
| Rate for Payer: Preferred Network Access Commercial |
$72.72
|
| Rate for Payer: Quartz Beloit One Network |
$38.73
|
| Rate for Payer: Quartz Commercial |
$47.42
|
| Rate for Payer: WEA Trust Commercial |
$43.47
|
| Rate for Payer: WPS Commercial |
$58.54
|
|
|
Blood Urea Nitrogen
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
633605
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.11 |
| Max. Negotiated Rate |
$75.09 |
| Rate for Payer: Aetna Commercial |
$75.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.97
|
| Rate for Payer: Aetna Managed Medicare |
$4.11
|
| Rate for Payer: Anthem Medicare Advantage |
$4.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.11
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cigna Commercial |
$75.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$39.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.11
|
| Rate for Payer: Health EOS Commercial |
$71.93
|
| Rate for Payer: HFN Commercial |
$75.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.11
|
| Rate for Payer: Multiplan Commercial |
$63.23
|
| Rate for Payer: NAPHCARE Commercial |
$6.16
|
| Rate for Payer: Preferred Network Access Commercial |
$75.09
|
| Rate for Payer: Quartz Beloit One Network |
$34.78
|
| Rate for Payer: Quartz Commercial |
$45.05
|
| Rate for Payer: Quartz Medicare Advantage |
$4.11
|
| Rate for Payer: The Alliance Commercial |
$16.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.11
|
| Rate for Payer: WEA Trust Commercial |
$43.47
|
| Rate for Payer: WPS Commercial |
$18.08
|
|
|
Blood Urea Nitrogen
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
633605
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.11 |
| Max. Negotiated Rate |
$72.72 |
| Rate for Payer: Aetna Commercial |
$71.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.97
|
| Rate for Payer: Aetna Managed Medicare |
$4.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.19
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.82
|
| Rate for Payer: Anthem Medicare Advantage |
$4.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$41.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.11
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cigna Commercial |
$72.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$44.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.11
|
| Rate for Payer: Health EOS Commercial |
$70.35
|
| Rate for Payer: HFN Commercial |
$72.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.11
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.11
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.11
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.11
|
| Rate for Payer: Multiplan Commercial |
$63.23
|
| Rate for Payer: NAPHCARE Commercial |
$6.16
|
| Rate for Payer: Preferred Network Access Commercial |
$72.72
|
| Rate for Payer: Quartz Beloit One Network |
$38.73
|
| Rate for Payer: Quartz Commercial |
$51.38
|
| Rate for Payer: Quartz Medicare Advantage |
$4.11
|
| Rate for Payer: The Alliance Commercial |
$16.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.11
|
| Rate for Payer: United Healthcare PPO |
$59.28
|
| Rate for Payer: WEA Trust Commercial |
$43.47
|
| Rate for Payer: Wellcare Medicare |
$4.11
|
| Rate for Payer: WPS Commercial |
$58.54
|
|
|
Blood volume removed from patient
|
Facility
|
IP
|
$233.00
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
4125565
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$118.74 |
| Max. Negotiated Rate |
$222.93 |
| Rate for Payer: Aetna Commercial |
$218.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$208.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$128.43
|
| Rate for Payer: Cash Price |
$69.90
|
| Rate for Payer: Cigna Commercial |
$222.93
|
| Rate for Payer: Health EOS Commercial |
$215.66
|
| Rate for Payer: HFN Commercial |
$222.93
|
| Rate for Payer: Multiplan Commercial |
$193.86
|
| Rate for Payer: Preferred Network Access Commercial |
$222.93
|
| Rate for Payer: Quartz Beloit One Network |
$118.74
|
| Rate for Payer: Quartz Commercial |
$145.39
|
| Rate for Payer: WEA Trust Commercial |
$133.28
|
| Rate for Payer: WPS Commercial |
$179.48
|
|
|
Blood volume removed from patient
|
Facility
|
OP
|
$233.00
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
4125565
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$116.31 |
| Max. Negotiated Rate |
$560.06 |
| Rate for Payer: Aetna Commercial |
$218.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$208.40
|
| Rate for Payer: Aetna Managed Medicare |
$140.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$157.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$121.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$116.31
|
| Rate for Payer: Anthem Medicare Advantage |
$140.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$128.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$140.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$140.02
|
| Rate for Payer: Cash Price |
$69.90
|
| Rate for Payer: Cash Price |
$69.90
|
| Rate for Payer: Cigna Commercial |
$222.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$140.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$135.61
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$140.02
|
| Rate for Payer: Health EOS Commercial |
$215.66
|
| Rate for Payer: HFN Commercial |
$222.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$520.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$140.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$140.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$140.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$140.02
|
| Rate for Payer: Multiplan Commercial |
$193.86
|
| Rate for Payer: NAPHCARE Commercial |
$210.02
|
| Rate for Payer: Preferred Network Access Commercial |
$222.93
|
| Rate for Payer: Quartz Beloit One Network |
$118.74
|
| Rate for Payer: Quartz Commercial |
$157.51
|
| Rate for Payer: Quartz Medicare Advantage |
$140.02
|
| Rate for Payer: The Alliance Commercial |
$560.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$140.02
|
| Rate for Payer: United Healthcare PPO |
$181.74
|
| Rate for Payer: WEA Trust Commercial |
$133.28
|
| Rate for Payer: Wellcare Medicare |
$140.02
|
| Rate for Payer: WPS Commercial |
$179.48
|
|
|
Blood Volume Removed from Patient
|
Facility
|
OP
|
$275.00
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
4582615
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$137.28 |
| Max. Negotiated Rate |
$560.06 |
| Rate for Payer: Aetna Commercial |
$257.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$245.96
|
| Rate for Payer: Aetna Managed Medicare |
$140.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$185.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$143.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$137.28
|
| Rate for Payer: Anthem Medicare Advantage |
$140.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$151.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$140.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$140.02
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cigna Commercial |
$263.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$140.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$160.05
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$140.02
|
| Rate for Payer: Health EOS Commercial |
$254.54
|
| Rate for Payer: HFN Commercial |
$263.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$520.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$140.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$140.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$140.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$140.02
|
| Rate for Payer: Multiplan Commercial |
$228.80
|
| Rate for Payer: NAPHCARE Commercial |
$210.02
|
| Rate for Payer: Preferred Network Access Commercial |
$263.12
|
| Rate for Payer: Quartz Beloit One Network |
$140.14
|
| Rate for Payer: Quartz Commercial |
$185.90
|
| Rate for Payer: Quartz Medicare Advantage |
$140.02
|
| Rate for Payer: The Alliance Commercial |
$560.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$140.02
|
| Rate for Payer: United Healthcare PPO |
$214.50
|
| Rate for Payer: WEA Trust Commercial |
$157.30
|
| Rate for Payer: Wellcare Medicare |
$140.02
|
| Rate for Payer: WPS Commercial |
$211.83
|
|
|
Blood Volume Removed from Patient
|
Facility
|
IP
|
$275.00
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
4582615
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$140.14 |
| Max. Negotiated Rate |
$263.12 |
| Rate for Payer: Aetna Commercial |
$257.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$245.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$151.58
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cigna Commercial |
$263.12
|
| Rate for Payer: Health EOS Commercial |
$254.54
|
| Rate for Payer: HFN Commercial |
$263.12
|
| Rate for Payer: Multiplan Commercial |
$228.80
|
| Rate for Payer: Preferred Network Access Commercial |
$263.12
|
| Rate for Payer: Quartz Beloit One Network |
$140.14
|
| Rate for Payer: Quartz Commercial |
$171.60
|
| Rate for Payer: WEA Trust Commercial |
$157.30
|
| Rate for Payer: WPS Commercial |
$211.83
|
|
|
BLUEBAG BODYFIX 14 REC 700X1825MM/ 50L P10104-823
|
Facility
|
IP
|
$4,672.00
|
|
| Hospital Charge Code |
5248762
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,380.85 |
| Max. Negotiated Rate |
$4,470.17 |
| Rate for Payer: Aetna Commercial |
$4,372.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,178.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,575.21
|
| Rate for Payer: Cash Price |
$1,401.60
|
| Rate for Payer: Cigna Commercial |
$4,470.17
|
| Rate for Payer: Health EOS Commercial |
$4,324.40
|
| Rate for Payer: HFN Commercial |
$4,470.17
|
| Rate for Payer: Multiplan Commercial |
$3,887.10
|
| Rate for Payer: Preferred Network Access Commercial |
$4,470.17
|
| Rate for Payer: Quartz Beloit One Network |
$2,380.85
|
| Rate for Payer: Quartz Commercial |
$2,915.33
|
| Rate for Payer: WEA Trust Commercial |
$2,672.38
|
| Rate for Payer: WPS Commercial |
$3,598.84
|
|
|
BLUEBAG BODYFIX 14 REC 700X1825MM/ 50L P10104-823
|
Facility
|
OP
|
$4,672.00
|
|
| Hospital Charge Code |
5248762
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,360.49 |
| Max. Negotiated Rate |
$4,470.17 |
| Rate for Payer: Aetna Commercial |
$4,372.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,178.64
|
| Rate for Payer: Aetna Managed Medicare |
$1,360.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,158.27
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,429.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,332.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,575.21
|
| Rate for Payer: Cash Price |
$1,401.60
|
| Rate for Payer: Cigna Commercial |
$4,470.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,719.10
|
| Rate for Payer: Health EOS Commercial |
$4,324.40
|
| Rate for Payer: HFN Commercial |
$4,470.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,644.16
|
| Rate for Payer: Multiplan Commercial |
$3,887.10
|
| Rate for Payer: NAPHCARE Commercial |
$2,915.33
|
| Rate for Payer: Preferred Network Access Commercial |
$4,470.17
|
| Rate for Payer: Quartz Beloit One Network |
$2,380.85
|
| Rate for Payer: Quartz Commercial |
$3,158.27
|
| Rate for Payer: Quartz Medicare Advantage |
$2,915.33
|
| Rate for Payer: The Alliance Commercial |
$2,429.44
|
| Rate for Payer: WEA Trust Commercial |
$2,672.38
|
| Rate for Payer: WPS Commercial |
$3,598.84
|
|
|
Blue (prong O.D.: 3.5mm) - RAM Cannula
|
Facility
|
IP
|
$223.00
|
|
| Hospital Charge Code |
5983676
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$113.64 |
| Max. Negotiated Rate |
$213.37 |
| Rate for Payer: Aetna Commercial |
$208.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$199.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$122.92
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$213.37
|
| Rate for Payer: Health EOS Commercial |
$206.41
|
| Rate for Payer: HFN Commercial |
$213.37
|
| Rate for Payer: Multiplan Commercial |
$185.54
|
| Rate for Payer: Preferred Network Access Commercial |
$213.37
|
| Rate for Payer: Quartz Beloit One Network |
$113.64
|
| Rate for Payer: Quartz Commercial |
$139.15
|
| Rate for Payer: WEA Trust Commercial |
$127.56
|
| Rate for Payer: WPS Commercial |
$171.78
|
|
|
Blue (prong O.D.: 3.5mm) - RAM Cannula
|
Facility
|
OP
|
$223.00
|
|
| Hospital Charge Code |
5983676
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$64.94 |
| Max. Negotiated Rate |
$213.37 |
| Rate for Payer: Aetna Commercial |
$208.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$199.45
|
| Rate for Payer: Aetna Managed Medicare |
$64.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$150.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$115.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$111.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$122.92
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$213.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$129.79
|
| Rate for Payer: Health EOS Commercial |
$206.41
|
| Rate for Payer: HFN Commercial |
$213.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$173.94
|
| Rate for Payer: Multiplan Commercial |
$185.54
|
| Rate for Payer: NAPHCARE Commercial |
$139.15
|
| Rate for Payer: Preferred Network Access Commercial |
$213.37
|
| Rate for Payer: Quartz Beloit One Network |
$113.64
|
| Rate for Payer: Quartz Commercial |
$150.75
|
| Rate for Payer: Quartz Medicare Advantage |
$139.15
|
| Rate for Payer: The Alliance Commercial |
$115.96
|
| Rate for Payer: WEA Trust Commercial |
$127.56
|
| Rate for Payer: WPS Commercial |
$171.78
|
|
|
BLUNT PIN 5MM X 150MM 5020-7-150
|
Facility
|
OP
|
$1,285.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5685711
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$374.19 |
| Max. Negotiated Rate |
$1,229.49 |
| Rate for Payer: Aetna Commercial |
$1,202.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,149.30
|
| Rate for Payer: Aetna Managed Medicare |
$374.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$868.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$668.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$641.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$708.29
|
| Rate for Payer: Cash Price |
$385.50
|
| Rate for Payer: Cigna Commercial |
$1,229.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$747.87
|
| Rate for Payer: Health EOS Commercial |
$1,189.40
|
| Rate for Payer: HFN Commercial |
$1,229.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,002.30
|
| Rate for Payer: Multiplan Commercial |
$1,069.12
|
| Rate for Payer: NAPHCARE Commercial |
$801.84
|
| Rate for Payer: Preferred Network Access Commercial |
$1,229.49
|
| Rate for Payer: Quartz Beloit One Network |
$654.84
|
| Rate for Payer: Quartz Commercial |
$868.66
|
| Rate for Payer: Quartz Medicare Advantage |
$801.84
|
| Rate for Payer: The Alliance Commercial |
$668.20
|
| Rate for Payer: WEA Trust Commercial |
$735.02
|
| Rate for Payer: WPS Commercial |
$989.84
|
|
|
BLUNT PIN 5MM X 150MM 5020-7-150
|
Facility
|
IP
|
$1,285.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5685711
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$654.84 |
| Max. Negotiated Rate |
$1,229.49 |
| Rate for Payer: Aetna Commercial |
$1,202.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,149.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$708.29
|
| Rate for Payer: Cash Price |
$385.50
|
| Rate for Payer: Cigna Commercial |
$1,229.49
|
| Rate for Payer: Health EOS Commercial |
$1,189.40
|
| Rate for Payer: HFN Commercial |
$1,229.49
|
| Rate for Payer: Multiplan Commercial |
$1,069.12
|
| Rate for Payer: Preferred Network Access Commercial |
$1,229.49
|
| Rate for Payer: Quartz Beloit One Network |
$654.84
|
| Rate for Payer: Quartz Commercial |
$801.84
|
| Rate for Payer: WEA Trust Commercial |
$735.02
|
| Rate for Payer: WPS Commercial |
$989.84
|
|
|
BO AG ID Patient
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
975765
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$1,385.59 |
| Rate for Payer: Aetna Commercial |
$201.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$192.30
|
| Rate for Payer: Aetna Managed Medicare |
$3.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,385.59
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$646.61
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$613.36
|
| Rate for Payer: Anthem Medicare Advantage |
$3.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$118.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.98
|
| Rate for Payer: Cash Price |
$64.50
|
| Rate for Payer: Cash Price |
$64.50
|
| Rate for Payer: Cigna Commercial |
$205.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$125.13
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.98
|
| Rate for Payer: Health EOS Commercial |
$199.00
|
| Rate for Payer: HFN Commercial |
$205.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.98
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.98
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.98
|
| Rate for Payer: Multiplan Commercial |
$178.88
|
| Rate for Payer: NAPHCARE Commercial |
$5.97
|
| Rate for Payer: Preferred Network Access Commercial |
$205.71
|
| Rate for Payer: Quartz Beloit One Network |
$109.56
|
| Rate for Payer: Quartz Commercial |
$145.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3.98
|
| Rate for Payer: The Alliance Commercial |
$15.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.98
|
| Rate for Payer: United Healthcare PPO |
$167.70
|
| Rate for Payer: WEA Trust Commercial |
$122.98
|
| Rate for Payer: Wellcare Medicare |
$3.98
|
| Rate for Payer: WPS Commercial |
$165.61
|
|
|
BO AG ID Patient
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
975765
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$109.56 |
| Max. Negotiated Rate |
$205.71 |
| Rate for Payer: Aetna Commercial |
$201.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$192.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$118.51
|
| Rate for Payer: Cash Price |
$64.50
|
| Rate for Payer: Cigna Commercial |
$205.71
|
| Rate for Payer: Health EOS Commercial |
$199.00
|
| Rate for Payer: HFN Commercial |
$205.71
|
| Rate for Payer: Multiplan Commercial |
$178.88
|
| Rate for Payer: Preferred Network Access Commercial |
$205.71
|
| Rate for Payer: Quartz Beloit One Network |
$109.56
|
| Rate for Payer: Quartz Commercial |
$134.16
|
| Rate for Payer: WEA Trust Commercial |
$122.98
|
| Rate for Payer: WPS Commercial |
$165.61
|
|
|
BO AG ID Unit
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
975766
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.54 |
| Max. Negotiated Rate |
$153.09 |
| Rate for Payer: Aetna Commercial |
$149.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$143.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$88.19
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cigna Commercial |
$153.09
|
| Rate for Payer: Health EOS Commercial |
$148.10
|
| Rate for Payer: HFN Commercial |
$153.09
|
| Rate for Payer: Multiplan Commercial |
$133.12
|
| Rate for Payer: Preferred Network Access Commercial |
$153.09
|
| Rate for Payer: Quartz Beloit One Network |
$81.54
|
| Rate for Payer: Quartz Commercial |
$99.84
|
| Rate for Payer: WEA Trust Commercial |
$91.52
|
| Rate for Payer: WPS Commercial |
$123.25
|
|
|
BO AG ID Unit
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
975766
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$1,385.59 |
| Rate for Payer: Aetna Commercial |
$149.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$143.10
|
| Rate for Payer: Aetna Managed Medicare |
$6.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,385.59
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$646.61
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$613.36
|
| Rate for Payer: Anthem Medicare Advantage |
$6.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$88.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.60
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cigna Commercial |
$153.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$93.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.60
|
| Rate for Payer: Health EOS Commercial |
$148.10
|
| Rate for Payer: HFN Commercial |
$153.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.60
|
| Rate for Payer: Multiplan Commercial |
$133.12
|
| Rate for Payer: NAPHCARE Commercial |
$9.91
|
| Rate for Payer: Preferred Network Access Commercial |
$153.09
|
| Rate for Payer: Quartz Beloit One Network |
$81.54
|
| Rate for Payer: Quartz Commercial |
$108.16
|
| Rate for Payer: Quartz Medicare Advantage |
$6.60
|
| Rate for Payer: The Alliance Commercial |
$26.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.60
|
| Rate for Payer: United Healthcare PPO |
$124.80
|
| Rate for Payer: WEA Trust Commercial |
$91.52
|
| Rate for Payer: Wellcare Medicare |
$6.60
|
| Rate for Payer: WPS Commercial |
$123.25
|
|
|
BO Antibody Adsorption
|
Facility
|
IP
|
$645.00
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
975763
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$328.69 |
| Max. Negotiated Rate |
$617.14 |
| Rate for Payer: Aetna Commercial |
$603.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$576.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$355.52
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cigna Commercial |
$617.14
|
| Rate for Payer: Health EOS Commercial |
$597.01
|
| Rate for Payer: HFN Commercial |
$617.14
|
| Rate for Payer: Multiplan Commercial |
$536.64
|
| Rate for Payer: Preferred Network Access Commercial |
$617.14
|
| Rate for Payer: Quartz Beloit One Network |
$328.69
|
| Rate for Payer: Quartz Commercial |
$402.48
|
| Rate for Payer: WEA Trust Commercial |
$368.94
|
| Rate for Payer: WPS Commercial |
$496.84
|
|
|
BO Antibody Adsorption
|
Facility
|
OP
|
$645.00
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
975763
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$62.09 |
| Max. Negotiated Rate |
$617.14 |
| Rate for Payer: Aetna Commercial |
$603.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$576.89
|
| Rate for Payer: Aetna Managed Medicare |
$62.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$235.79
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$110.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$104.38
|
| Rate for Payer: Anthem Medicare Advantage |
$62.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$355.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$62.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$62.09
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cigna Commercial |
$617.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$62.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$375.39
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$62.09
|
| Rate for Payer: Health EOS Commercial |
$597.01
|
| Rate for Payer: HFN Commercial |
$617.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$230.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$62.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$62.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$62.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$62.09
|
| Rate for Payer: Multiplan Commercial |
$536.64
|
| Rate for Payer: NAPHCARE Commercial |
$93.13
|
| Rate for Payer: Preferred Network Access Commercial |
$617.14
|
| Rate for Payer: Quartz Beloit One Network |
$328.69
|
| Rate for Payer: Quartz Commercial |
$436.02
|
| Rate for Payer: Quartz Medicare Advantage |
$62.09
|
| Rate for Payer: The Alliance Commercial |
$248.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$62.09
|
| Rate for Payer: United Healthcare PPO |
$503.10
|
| Rate for Payer: WEA Trust Commercial |
$368.94
|
| Rate for Payer: Wellcare Medicare |
$62.09
|
| Rate for Payer: WPS Commercial |
$496.84
|
|
|
BO Antibody ID
|
Facility
|
IP
|
$286.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
975764
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$273.64 |
| Rate for Payer: Aetna Commercial |
$267.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$255.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$157.64
|
| Rate for Payer: Cash Price |
$85.80
|
| Rate for Payer: Cigna Commercial |
$273.64
|
| Rate for Payer: Health EOS Commercial |
$264.72
|
| Rate for Payer: HFN Commercial |
$273.64
|
| Rate for Payer: Multiplan Commercial |
$237.95
|
| Rate for Payer: Preferred Network Access Commercial |
$273.64
|
| Rate for Payer: Quartz Beloit One Network |
$145.75
|
| Rate for Payer: Quartz Commercial |
$178.46
|
| Rate for Payer: WEA Trust Commercial |
$163.59
|
| Rate for Payer: WPS Commercial |
$220.31
|
|
|
BO Antibody ID
|
Facility
|
OP
|
$286.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
975764
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$1,508.92 |
| Rate for Payer: Aetna Commercial |
$267.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$255.80
|
| Rate for Payer: Aetna Managed Medicare |
$377.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,385.59
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$646.61
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$613.36
|
| Rate for Payer: Anthem Medicare Advantage |
$377.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$157.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$377.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$377.23
|
| Rate for Payer: Cash Price |
$85.80
|
| Rate for Payer: Cash Price |
$85.80
|
| Rate for Payer: Cigna Commercial |
$273.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$377.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$166.45
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$377.23
|
| Rate for Payer: Health EOS Commercial |
$264.72
|
| Rate for Payer: HFN Commercial |
$273.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,403.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$377.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$377.23
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$377.23
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$377.23
|
| Rate for Payer: Multiplan Commercial |
$237.95
|
| Rate for Payer: NAPHCARE Commercial |
$565.84
|
| Rate for Payer: Preferred Network Access Commercial |
$273.64
|
| Rate for Payer: Quartz Beloit One Network |
$145.75
|
| Rate for Payer: Quartz Commercial |
$193.34
|
| Rate for Payer: Quartz Medicare Advantage |
$377.23
|
| Rate for Payer: The Alliance Commercial |
$1,508.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$377.23
|
| Rate for Payer: United Healthcare PPO |
$223.08
|
| Rate for Payer: WEA Trust Commercial |
$163.59
|
| Rate for Payer: Wellcare Medicare |
$377.23
|
| Rate for Payer: WPS Commercial |
$220.31
|
|
|
BO Antibody Screen
|
Facility
|
IP
|
$191.00
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
975767
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$97.33 |
| Max. Negotiated Rate |
$182.75 |
| Rate for Payer: Aetna Commercial |
$178.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$170.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$105.28
|
| Rate for Payer: Cash Price |
$57.30
|
| Rate for Payer: Cigna Commercial |
$182.75
|
| Rate for Payer: Health EOS Commercial |
$176.79
|
| Rate for Payer: HFN Commercial |
$182.75
|
| Rate for Payer: Multiplan Commercial |
$158.91
|
| Rate for Payer: Preferred Network Access Commercial |
$182.75
|
| Rate for Payer: Quartz Beloit One Network |
$97.33
|
| Rate for Payer: Quartz Commercial |
$119.18
|
| Rate for Payer: WEA Trust Commercial |
$109.25
|
| Rate for Payer: WPS Commercial |
$147.13
|
|
|
BO Antibody Screen
|
Facility
|
OP
|
$191.00
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
975767
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.16 |
| Max. Negotiated Rate |
$208.88 |
| Rate for Payer: Aetna Commercial |
$178.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$170.83
|
| Rate for Payer: Aetna Managed Medicare |
$10.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$208.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$97.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$92.47
|
| Rate for Payer: Anthem Medicare Advantage |
$10.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$105.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.16
|
| Rate for Payer: Cash Price |
$57.30
|
| Rate for Payer: Cash Price |
$57.30
|
| Rate for Payer: Cigna Commercial |
$182.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$111.16
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10.16
|
| Rate for Payer: Health EOS Commercial |
$176.79
|
| Rate for Payer: HFN Commercial |
$182.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.16
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10.16
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10.16
|
| Rate for Payer: Multiplan Commercial |
$158.91
|
| Rate for Payer: NAPHCARE Commercial |
$15.24
|
| Rate for Payer: Preferred Network Access Commercial |
$182.75
|
| Rate for Payer: Quartz Beloit One Network |
$97.33
|
| Rate for Payer: Quartz Commercial |
$129.12
|
| Rate for Payer: Quartz Medicare Advantage |
$10.16
|
| Rate for Payer: The Alliance Commercial |
$40.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.16
|
| Rate for Payer: United Healthcare PPO |
$148.98
|
| Rate for Payer: WEA Trust Commercial |
$109.25
|
| Rate for Payer: Wellcare Medicare |
$10.16
|
| Rate for Payer: WPS Commercial |
$147.13
|
|
