|
Calcium
|
Facility
IP
|
$128.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
2942966
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$62.72 |
| Max. Negotiated Rate |
$117.76 |
| Rate for Payer: Aetna Commercial |
$115.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$67.84
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cigna Commercial |
$117.76
|
| Rate for Payer: Health EOS Commercial |
$113.92
|
| Rate for Payer: HFN Commercial |
$117.76
|
| Rate for Payer: Multiplan Commercial |
$102.40
|
| Rate for Payer: NAPHCARE Commercial |
$76.80
|
| Rate for Payer: Preferred Network Access Commercial |
$117.76
|
| Rate for Payer: Quartz Beloit One Network |
$62.72
|
| Rate for Payer: Quartz Commercial |
$76.80
|
| Rate for Payer: WEA Trust Commercial |
$70.40
|
| Rate for Payer: WPS Commercial |
$94.81
|
|
|
.Calcium, 24-hour Urine w/creatinine
|
Professional
|
$22.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
4506619
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$20.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.92
|
| Rate for Payer: Aetna Managed Medicare |
$6.03
|
| Rate for Payer: Anthem Medicare Advantage |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.03
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$20.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.03
|
| Rate for Payer: Health EOS Commercial |
$20.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.03
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: Preferred Network Access Commercial |
$20.90
|
| Rate for Payer: Quartz Beloit One Network |
$9.68
|
| Rate for Payer: Quartz Commercial |
$12.54
|
| Rate for Payer: Quartz Medicare Advantage |
$6.03
|
| Rate for Payer: The Alliance Commercial |
$23.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: WEA Trust Commercial |
$12.10
|
| Rate for Payer: WPS Commercial |
$26.53
|
|
|
.Calcium, 24-hour Urine w/creatinine
|
Facility
IP
|
$22.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
4506619
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.78 |
| Max. Negotiated Rate |
$20.24 |
| Rate for Payer: Aetna Commercial |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.66
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$20.24
|
| Rate for Payer: Health EOS Commercial |
$19.58
|
| Rate for Payer: HFN Commercial |
$20.24
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: NAPHCARE Commercial |
$13.20
|
| Rate for Payer: Preferred Network Access Commercial |
$20.24
|
| Rate for Payer: Quartz Beloit One Network |
$10.78
|
| Rate for Payer: Quartz Commercial |
$13.20
|
| Rate for Payer: WEA Trust Commercial |
$12.10
|
| Rate for Payer: WPS Commercial |
$16.30
|
|
|
.Calcium, 24-hour Urine w/creatinine
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
4506619
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$88.00 |
| Rate for Payer: Aetna Commercial |
$19.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.92
|
| Rate for Payer: Aetna Managed Medicare |
$6.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.55
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.01
|
| Rate for Payer: Anthem Medicaid |
$6.23
|
| Rate for Payer: Anthem Medicare Advantage |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.03
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$20.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6.23
|
| Rate for Payer: Dean Health Medicaid |
$6.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.03
|
| Rate for Payer: Health EOS Commercial |
$19.58
|
| Rate for Payer: HFN Commercial |
$20.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.03
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.03
|
| Rate for Payer: Managed Health Services Medicaid |
$6.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.03
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.03
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: NAPHCARE Commercial |
$9.04
|
| Rate for Payer: Preferred Network Access Commercial |
$20.24
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6.23
|
| Rate for Payer: Quartz Beloit One Network |
$10.78
|
| Rate for Payer: Quartz Commercial |
$14.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6.03
|
| Rate for Payer: The Alliance Commercial |
$88.00
|
| Rate for Payer: United Healthcare Medicaid |
$6.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: United Healthcare PPO |
$16.50
|
| Rate for Payer: WEA Trust Commercial |
$12.10
|
| Rate for Payer: Wellcare Medicare |
$6.03
|
| Rate for Payer: WMAP Medicaid |
$6.23
|
| Rate for Payer: WPS Commercial |
$16.30
|
|
|
Calcium Gluconate 10 ml Charge
|
Facility
OP
|
$83.00
|
|
|
Service Code
|
HCPCS J0610
|
| Hospital Charge Code |
2958898
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.24 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.38
|
| Rate for Payer: Aetna Managed Medicare |
$23.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$39.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.99
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$76.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$46.45
|
| Rate for Payer: Health EOS Commercial |
$73.87
|
| Rate for Payer: HFN Commercial |
$76.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$62.25
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: NAPHCARE Commercial |
$49.80
|
| Rate for Payer: Preferred Network Access Commercial |
$76.36
|
| Rate for Payer: Quartz Beloit One Network |
$40.67
|
| Rate for Payer: Quartz Commercial |
$53.95
|
| Rate for Payer: Quartz Medicare Advantage |
$49.80
|
| Rate for Payer: The Alliance Commercial |
$332.00
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Calcium Gluconate 10 ml Charge
|
Professional
|
$83.00
|
|
|
Service Code
|
HCPCS J0610
|
| Hospital Charge Code |
2958898
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$78.85 |
| Rate for Payer: Aetna Commercial |
$78.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.38
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$78.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$49.80
|
| Rate for Payer: Health EOS Commercial |
$75.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.30
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: Preferred Network Access Commercial |
$78.85
|
| Rate for Payer: Quartz Beloit One Network |
$36.52
|
| Rate for Payer: Quartz Commercial |
$47.31
|
| Rate for Payer: The Alliance Commercial |
$41.50
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Calcium Gluconate 10 ml Charge
|
Facility
IP
|
$83.00
|
|
|
Service Code
|
HCPCS J0610
|
| Hospital Charge Code |
2958898
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.67 |
| Max. Negotiated Rate |
$76.36 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.99
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$76.36
|
| Rate for Payer: Health EOS Commercial |
$73.87
|
| Rate for Payer: HFN Commercial |
$76.36
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: NAPHCARE Commercial |
$49.80
|
| Rate for Payer: Preferred Network Access Commercial |
$76.36
|
| Rate for Payer: Quartz Beloit One Network |
$40.67
|
| Rate for Payer: Quartz Commercial |
$49.80
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Calcium gluconate inj 10 ml charge J0610
|
Facility
IP
|
$83.00
|
|
|
Service Code
|
HCPCS J0610
|
| Hospital Charge Code |
3451631
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.67 |
| Max. Negotiated Rate |
$76.36 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.99
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$76.36
|
| Rate for Payer: Health EOS Commercial |
$73.87
|
| Rate for Payer: HFN Commercial |
$76.36
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: NAPHCARE Commercial |
$49.80
|
| Rate for Payer: Preferred Network Access Commercial |
$76.36
|
| Rate for Payer: Quartz Beloit One Network |
$40.67
|
| Rate for Payer: Quartz Commercial |
$49.80
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Calcium gluconate inj 10 ml charge J0610
|
Facility
OP
|
$83.00
|
|
|
Service Code
|
HCPCS J0610
|
| Hospital Charge Code |
3451631
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.24 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.38
|
| Rate for Payer: Aetna Managed Medicare |
$23.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$39.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$43.99
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$76.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$46.45
|
| Rate for Payer: Health EOS Commercial |
$73.87
|
| Rate for Payer: HFN Commercial |
$76.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$62.25
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: NAPHCARE Commercial |
$49.80
|
| Rate for Payer: Preferred Network Access Commercial |
$76.36
|
| Rate for Payer: Quartz Beloit One Network |
$40.67
|
| Rate for Payer: Quartz Commercial |
$53.95
|
| Rate for Payer: Quartz Medicare Advantage |
$49.80
|
| Rate for Payer: The Alliance Commercial |
$332.00
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Calcium gluconate inj 10 ml charge J0610
|
Professional
|
$83.00
|
|
|
Service Code
|
HCPCS J0610
|
| Hospital Charge Code |
3451631
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$78.85 |
| Rate for Payer: Aetna Commercial |
$78.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$71.38
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$78.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$49.80
|
| Rate for Payer: Health EOS Commercial |
$75.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.30
|
| Rate for Payer: Multiplan Commercial |
$66.40
|
| Rate for Payer: Preferred Network Access Commercial |
$78.85
|
| Rate for Payer: Quartz Beloit One Network |
$36.52
|
| Rate for Payer: Quartz Commercial |
$47.31
|
| Rate for Payer: The Alliance Commercial |
$41.50
|
| Rate for Payer: WEA Trust Commercial |
$45.65
|
| Rate for Payer: WPS Commercial |
$61.48
|
|
|
Calcium, Ionized to Quest
|
Professional
|
$272.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
3091491
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.68 |
| Max. Negotiated Rate |
$258.40 |
| Rate for Payer: Aetna Commercial |
$258.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$233.92
|
| Rate for Payer: Aetna Managed Medicare |
$13.68
|
| Rate for Payer: Anthem Medicare Advantage |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.68
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cigna Commercial |
$258.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$136.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.68
|
| Rate for Payer: Health EOS Commercial |
$247.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$48.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.68
|
| Rate for Payer: Multiplan Commercial |
$217.60
|
| Rate for Payer: Preferred Network Access Commercial |
$258.40
|
| Rate for Payer: Quartz Beloit One Network |
$119.68
|
| Rate for Payer: Quartz Commercial |
$155.04
|
| Rate for Payer: Quartz Medicare Advantage |
$13.68
|
| Rate for Payer: The Alliance Commercial |
$54.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.68
|
| Rate for Payer: WEA Trust Commercial |
$149.60
|
| Rate for Payer: WPS Commercial |
$60.19
|
|
|
Calcium, Ionized to Quest
|
Facility
IP
|
$272.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
3091491
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$133.28 |
| Max. Negotiated Rate |
$250.24 |
| Rate for Payer: Aetna Commercial |
$244.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$144.16
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cigna Commercial |
$250.24
|
| Rate for Payer: Health EOS Commercial |
$242.08
|
| Rate for Payer: HFN Commercial |
$250.24
|
| Rate for Payer: Multiplan Commercial |
$217.60
|
| Rate for Payer: NAPHCARE Commercial |
$163.20
|
| Rate for Payer: Preferred Network Access Commercial |
$250.24
|
| Rate for Payer: Quartz Beloit One Network |
$133.28
|
| Rate for Payer: Quartz Commercial |
$163.20
|
| Rate for Payer: WEA Trust Commercial |
$149.60
|
| Rate for Payer: WPS Commercial |
$201.47
|
|
|
Calcium, Ionized to Quest
|
Facility
OP
|
$272.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
3091491
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.68 |
| Max. Negotiated Rate |
$1,088.00 |
| Rate for Payer: Aetna Commercial |
$244.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$233.92
|
| Rate for Payer: Aetna Managed Medicare |
$13.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$51.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$23.94
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22.71
|
| Rate for Payer: Anthem Medicaid |
$14.14
|
| Rate for Payer: Anthem Medicare Advantage |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$144.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.68
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cigna Commercial |
$250.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14.14
|
| Rate for Payer: Dean Health Medicaid |
$14.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.68
|
| Rate for Payer: Health EOS Commercial |
$242.08
|
| Rate for Payer: HFN Commercial |
$250.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.68
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.68
|
| Rate for Payer: Managed Health Services Medicaid |
$14.71
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.68
|
| Rate for Payer: Multiplan Commercial |
$217.60
|
| Rate for Payer: NAPHCARE Commercial |
$20.52
|
| Rate for Payer: Preferred Network Access Commercial |
$250.24
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14.14
|
| Rate for Payer: Quartz Beloit One Network |
$133.28
|
| Rate for Payer: Quartz Commercial |
$176.80
|
| Rate for Payer: Quartz Medicare Advantage |
$13.68
|
| Rate for Payer: The Alliance Commercial |
$1,088.00
|
| Rate for Payer: United Healthcare Medicaid |
$14.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.68
|
| Rate for Payer: United Healthcare PPO |
$204.00
|
| Rate for Payer: WEA Trust Commercial |
$149.60
|
| Rate for Payer: Wellcare Medicare |
$13.68
|
| Rate for Payer: WMAP Medicaid |
$14.14
|
| Rate for Payer: WPS Commercial |
$201.47
|
|
|
Calcium Level 24 Hour Urine
|
Facility
IP
|
$105.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633687
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$51.45 |
| Max. Negotiated Rate |
$96.60 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$55.65
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$96.60
|
| Rate for Payer: Health EOS Commercial |
$93.45
|
| Rate for Payer: HFN Commercial |
$96.60
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: NAPHCARE Commercial |
$63.00
|
| Rate for Payer: Preferred Network Access Commercial |
$96.60
|
| Rate for Payer: Quartz Beloit One Network |
$51.45
|
| Rate for Payer: Quartz Commercial |
$63.00
|
| Rate for Payer: WEA Trust Commercial |
$57.75
|
| Rate for Payer: WPS Commercial |
$77.77
|
|
|
Calcium Level 24 Hour Urine
|
Professional
|
$105.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633687
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$99.75 |
| Rate for Payer: Aetna Commercial |
$99.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$90.30
|
| Rate for Payer: Aetna Managed Medicare |
$6.03
|
| Rate for Payer: Anthem Medicare Advantage |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.03
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$99.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$52.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.03
|
| Rate for Payer: Health EOS Commercial |
$95.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.03
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Preferred Network Access Commercial |
$99.75
|
| Rate for Payer: Quartz Beloit One Network |
$46.20
|
| Rate for Payer: Quartz Commercial |
$59.85
|
| Rate for Payer: Quartz Medicare Advantage |
$6.03
|
| Rate for Payer: The Alliance Commercial |
$23.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: WEA Trust Commercial |
$57.75
|
| Rate for Payer: WPS Commercial |
$26.53
|
|
|
Calcium Level 24 Hour Urine
|
Facility
OP
|
$105.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633687
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$90.30
|
| Rate for Payer: Aetna Managed Medicare |
$6.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.55
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.01
|
| Rate for Payer: Anthem Medicaid |
$6.23
|
| Rate for Payer: Anthem Medicare Advantage |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$55.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.03
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$96.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6.23
|
| Rate for Payer: Dean Health Medicaid |
$6.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.03
|
| Rate for Payer: Health EOS Commercial |
$93.45
|
| Rate for Payer: HFN Commercial |
$96.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.03
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.03
|
| Rate for Payer: Managed Health Services Medicaid |
$6.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.03
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.03
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: NAPHCARE Commercial |
$9.04
|
| Rate for Payer: Preferred Network Access Commercial |
$96.60
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6.23
|
| Rate for Payer: Quartz Beloit One Network |
$51.45
|
| Rate for Payer: Quartz Commercial |
$68.25
|
| Rate for Payer: Quartz Medicare Advantage |
$6.03
|
| Rate for Payer: The Alliance Commercial |
$420.00
|
| Rate for Payer: United Healthcare Medicaid |
$6.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: United Healthcare PPO |
$78.75
|
| Rate for Payer: WEA Trust Commercial |
$57.75
|
| Rate for Payer: Wellcare Medicare |
$6.03
|
| Rate for Payer: WMAP Medicaid |
$6.23
|
| Rate for Payer: WPS Commercial |
$77.77
|
|
|
Calcium Level Ionized
|
Professional
|
$233.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
633689
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.68 |
| Max. Negotiated Rate |
$221.35 |
| Rate for Payer: Aetna Commercial |
$221.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$200.38
|
| Rate for Payer: Aetna Managed Medicare |
$13.68
|
| Rate for Payer: Anthem Medicare Advantage |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.68
|
| Rate for Payer: Cash Price |
$69.90
|
| Rate for Payer: Cash Price |
$69.90
|
| Rate for Payer: Cigna Commercial |
$221.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$116.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.68
|
| Rate for Payer: Health EOS Commercial |
$212.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$48.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.68
|
| Rate for Payer: Multiplan Commercial |
$186.40
|
| Rate for Payer: Preferred Network Access Commercial |
$221.35
|
| Rate for Payer: Quartz Beloit One Network |
$102.52
|
| Rate for Payer: Quartz Commercial |
$132.81
|
| Rate for Payer: Quartz Medicare Advantage |
$13.68
|
| Rate for Payer: The Alliance Commercial |
$54.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.68
|
| Rate for Payer: WEA Trust Commercial |
$128.15
|
| Rate for Payer: WPS Commercial |
$60.19
|
|
|
Calcium Level Ionized
|
Facility
IP
|
$233.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
633689
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$114.17 |
| Max. Negotiated Rate |
$214.36 |
| Rate for Payer: Aetna Commercial |
$209.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$123.49
|
| Rate for Payer: Cash Price |
$69.90
|
| Rate for Payer: Cigna Commercial |
$214.36
|
| Rate for Payer: Health EOS Commercial |
$207.37
|
| Rate for Payer: HFN Commercial |
$214.36
|
| Rate for Payer: Multiplan Commercial |
$186.40
|
| Rate for Payer: NAPHCARE Commercial |
$139.80
|
| Rate for Payer: Preferred Network Access Commercial |
$214.36
|
| Rate for Payer: Quartz Beloit One Network |
$114.17
|
| Rate for Payer: Quartz Commercial |
$139.80
|
| Rate for Payer: WEA Trust Commercial |
$128.15
|
| Rate for Payer: WPS Commercial |
$172.58
|
|
|
Calcium Level Ionized
|
Facility
OP
|
$233.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
633689
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.68 |
| Max. Negotiated Rate |
$932.00 |
| Rate for Payer: Aetna Commercial |
$209.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$200.38
|
| Rate for Payer: Aetna Managed Medicare |
$13.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$51.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$23.94
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22.71
|
| Rate for Payer: Anthem Medicaid |
$14.14
|
| Rate for Payer: Anthem Medicare Advantage |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$123.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.68
|
| Rate for Payer: Cash Price |
$69.90
|
| Rate for Payer: Cash Price |
$69.90
|
| Rate for Payer: Cigna Commercial |
$214.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14.14
|
| Rate for Payer: Dean Health Medicaid |
$14.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.68
|
| Rate for Payer: Health EOS Commercial |
$207.37
|
| Rate for Payer: HFN Commercial |
$214.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.68
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$14.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.68
|
| Rate for Payer: Managed Health Services Medicaid |
$14.71
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.68
|
| Rate for Payer: Multiplan Commercial |
$186.40
|
| Rate for Payer: NAPHCARE Commercial |
$20.52
|
| Rate for Payer: Preferred Network Access Commercial |
$214.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14.14
|
| Rate for Payer: Quartz Beloit One Network |
$114.17
|
| Rate for Payer: Quartz Commercial |
$151.45
|
| Rate for Payer: Quartz Medicare Advantage |
$13.68
|
| Rate for Payer: The Alliance Commercial |
$932.00
|
| Rate for Payer: United Healthcare Medicaid |
$14.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.68
|
| Rate for Payer: United Healthcare PPO |
$174.75
|
| Rate for Payer: WEA Trust Commercial |
$128.15
|
| Rate for Payer: Wellcare Medicare |
$13.68
|
| Rate for Payer: WMAP Medicaid |
$14.14
|
| Rate for Payer: WPS Commercial |
$172.58
|
|
|
Calcium Level Total
|
Facility
IP
|
$86.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
633690
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.14 |
| Max. Negotiated Rate |
$79.12 |
| Rate for Payer: Aetna Commercial |
$77.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.58
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$79.12
|
| Rate for Payer: Health EOS Commercial |
$76.54
|
| Rate for Payer: HFN Commercial |
$79.12
|
| Rate for Payer: Multiplan Commercial |
$68.80
|
| Rate for Payer: NAPHCARE Commercial |
$51.60
|
| Rate for Payer: Preferred Network Access Commercial |
$79.12
|
| Rate for Payer: Quartz Beloit One Network |
$42.14
|
| Rate for Payer: Quartz Commercial |
$51.60
|
| Rate for Payer: WEA Trust Commercial |
$47.30
|
| Rate for Payer: WPS Commercial |
$63.70
|
|
|
Calcium Level Total
|
Professional
|
$86.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
633690
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$81.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$73.96
|
| Rate for Payer: Aetna Managed Medicare |
$5.16
|
| Rate for Payer: Anthem Medicare Advantage |
$5.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.16
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$81.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.16
|
| Rate for Payer: Health EOS Commercial |
$78.26
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.21
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.21
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.16
|
| Rate for Payer: Multiplan Commercial |
$68.80
|
| Rate for Payer: Preferred Network Access Commercial |
$81.70
|
| Rate for Payer: Quartz Beloit One Network |
$37.84
|
| Rate for Payer: Quartz Commercial |
$49.02
|
| Rate for Payer: Quartz Medicare Advantage |
$5.16
|
| Rate for Payer: The Alliance Commercial |
$20.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.16
|
| Rate for Payer: WEA Trust Commercial |
$47.30
|
| Rate for Payer: WPS Commercial |
$22.70
|
|
|
Calcium Level Total
|
Facility
OP
|
$86.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
633690
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$344.00 |
| Rate for Payer: Aetna Commercial |
$77.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$73.96
|
| Rate for Payer: Aetna Managed Medicare |
$5.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.03
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.57
|
| Rate for Payer: Anthem Medicaid |
$5.33
|
| Rate for Payer: Anthem Medicare Advantage |
$5.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.16
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$79.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.33
|
| Rate for Payer: Dean Health Medicaid |
$5.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.16
|
| Rate for Payer: Health EOS Commercial |
$76.54
|
| Rate for Payer: HFN Commercial |
$79.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.16
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.16
|
| Rate for Payer: Managed Health Services Medicaid |
$5.54
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.16
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.16
|
| Rate for Payer: Multiplan Commercial |
$68.80
|
| Rate for Payer: NAPHCARE Commercial |
$7.74
|
| Rate for Payer: Preferred Network Access Commercial |
$79.12
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.33
|
| Rate for Payer: Quartz Beloit One Network |
$42.14
|
| Rate for Payer: Quartz Commercial |
$55.90
|
| Rate for Payer: Quartz Medicare Advantage |
$5.16
|
| Rate for Payer: The Alliance Commercial |
$344.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.16
|
| Rate for Payer: United Healthcare PPO |
$64.50
|
| Rate for Payer: WEA Trust Commercial |
$47.30
|
| Rate for Payer: Wellcare Medicare |
$5.16
|
| Rate for Payer: WMAP Medicaid |
$5.33
|
| Rate for Payer: WPS Commercial |
$63.70
|
|
|
Calcium Level Urine
|
Facility
OP
|
$89.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633691
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$356.00 |
| Rate for Payer: Aetna Commercial |
$80.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.54
|
| Rate for Payer: Aetna Managed Medicare |
$6.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.55
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.01
|
| Rate for Payer: Anthem Medicaid |
$6.23
|
| Rate for Payer: Anthem Medicare Advantage |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$47.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.03
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$81.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6.23
|
| Rate for Payer: Dean Health Medicaid |
$6.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.03
|
| Rate for Payer: Health EOS Commercial |
$79.21
|
| Rate for Payer: HFN Commercial |
$81.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.03
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.03
|
| Rate for Payer: Managed Health Services Medicaid |
$6.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.03
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.03
|
| Rate for Payer: Multiplan Commercial |
$71.20
|
| Rate for Payer: NAPHCARE Commercial |
$9.04
|
| Rate for Payer: Preferred Network Access Commercial |
$81.88
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6.23
|
| Rate for Payer: Quartz Beloit One Network |
$43.61
|
| Rate for Payer: Quartz Commercial |
$57.85
|
| Rate for Payer: Quartz Medicare Advantage |
$6.03
|
| Rate for Payer: The Alliance Commercial |
$356.00
|
| Rate for Payer: United Healthcare Medicaid |
$6.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: United Healthcare PPO |
$66.75
|
| Rate for Payer: WEA Trust Commercial |
$48.95
|
| Rate for Payer: Wellcare Medicare |
$6.03
|
| Rate for Payer: WMAP Medicaid |
$6.23
|
| Rate for Payer: WPS Commercial |
$65.92
|
|
|
Calcium Level Urine
|
Facility
IP
|
$89.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633691
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.61 |
| Max. Negotiated Rate |
$81.88 |
| Rate for Payer: Aetna Commercial |
$80.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$47.17
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$81.88
|
| Rate for Payer: Health EOS Commercial |
$79.21
|
| Rate for Payer: HFN Commercial |
$81.88
|
| Rate for Payer: Multiplan Commercial |
$71.20
|
| Rate for Payer: NAPHCARE Commercial |
$53.40
|
| Rate for Payer: Preferred Network Access Commercial |
$81.88
|
| Rate for Payer: Quartz Beloit One Network |
$43.61
|
| Rate for Payer: Quartz Commercial |
$53.40
|
| Rate for Payer: WEA Trust Commercial |
$48.95
|
| Rate for Payer: WPS Commercial |
$65.92
|
|
|
Calcium Level Urine
|
Professional
|
$89.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633691
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$84.55 |
| Rate for Payer: Aetna Commercial |
$84.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.54
|
| Rate for Payer: Aetna Managed Medicare |
$6.03
|
| Rate for Payer: Anthem Medicare Advantage |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.03
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$84.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$44.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.03
|
| Rate for Payer: Health EOS Commercial |
$80.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.03
|
| Rate for Payer: Multiplan Commercial |
$71.20
|
| Rate for Payer: Preferred Network Access Commercial |
$84.55
|
| Rate for Payer: Quartz Beloit One Network |
$39.16
|
| Rate for Payer: Quartz Commercial |
$50.73
|
| Rate for Payer: Quartz Medicare Advantage |
$6.03
|
| Rate for Payer: The Alliance Commercial |
$23.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: WEA Trust Commercial |
$48.95
|
| Rate for Payer: WPS Commercial |
$26.53
|
|
