|
CAD for Screening Mammography
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
1158804
|
| Min. Negotiated Rate |
$23.88 |
| Max. Negotiated Rate |
$78.46 |
| Rate for Payer: Aetna Commercial |
$76.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$73.34
|
| Rate for Payer: Aetna Managed Medicare |
$23.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$55.43
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$42.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$40.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.20
|
| Rate for Payer: Cash Price |
$24.60
|
| Rate for Payer: Cigna Commercial |
$78.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$47.72
|
| Rate for Payer: Health EOS Commercial |
$75.90
|
| Rate for Payer: HFN Commercial |
$78.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.96
|
| Rate for Payer: Multiplan Commercial |
$68.22
|
| Rate for Payer: NAPHCARE Commercial |
$51.17
|
| Rate for Payer: Preferred Network Access Commercial |
$78.46
|
| Rate for Payer: Quartz Beloit One Network |
$41.79
|
| Rate for Payer: Quartz Commercial |
$55.43
|
| Rate for Payer: Quartz Medicare Advantage |
$51.17
|
| Rate for Payer: The Alliance Commercial |
$42.64
|
| Rate for Payer: WEA Trust Commercial |
$46.90
|
| Rate for Payer: WPS Commercial |
$63.16
|
|
|
CAD for Screening Mammography
|
Professional
|
Both
|
$82.00
|
|
| Hospital Charge Code |
1158804
|
| Min. Negotiated Rate |
$37.52 |
| Max. Negotiated Rate |
$81.02 |
| Rate for Payer: Aetna Commercial |
$81.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$73.34
|
| Rate for Payer: Cash Price |
$24.60
|
| Rate for Payer: Cigna Commercial |
$81.02
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$42.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$51.17
|
| Rate for Payer: Health EOS Commercial |
$77.60
|
| Rate for Payer: HFN Commercial |
$81.02
|
| Rate for Payer: Multiplan Commercial |
$68.22
|
| Rate for Payer: Preferred Network Access Commercial |
$81.02
|
| Rate for Payer: Quartz Beloit One Network |
$37.52
|
| Rate for Payer: Quartz Commercial |
$48.61
|
| Rate for Payer: The Alliance Commercial |
$42.64
|
| Rate for Payer: WEA Trust Commercial |
$46.90
|
| Rate for Payer: WPS Commercial |
$63.16
|
|
|
Cadmium Level
|
Facility
|
IP
|
$583.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
977891
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$297.10 |
| Max. Negotiated Rate |
$557.81 |
| Rate for Payer: Aetna Commercial |
$545.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$521.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$321.35
|
| Rate for Payer: Cash Price |
$174.90
|
| Rate for Payer: Cigna Commercial |
$557.81
|
| Rate for Payer: Health EOS Commercial |
$539.62
|
| Rate for Payer: HFN Commercial |
$557.81
|
| Rate for Payer: Multiplan Commercial |
$485.06
|
| Rate for Payer: Preferred Network Access Commercial |
$557.81
|
| Rate for Payer: Quartz Beloit One Network |
$297.10
|
| Rate for Payer: Quartz Commercial |
$363.79
|
| Rate for Payer: WEA Trust Commercial |
$333.48
|
| Rate for Payer: WPS Commercial |
$449.08
|
|
|
Cadmium Level
|
Facility
|
OP
|
$583.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
977891
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.59 |
| Max. Negotiated Rate |
$557.81 |
| Rate for Payer: Aetna Commercial |
$545.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$521.44
|
| Rate for Payer: Aetna Managed Medicare |
$24.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$92.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.02
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$40.81
|
| Rate for Payer: Anthem Medicare Advantage |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$321.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.59
|
| Rate for Payer: Cash Price |
$174.90
|
| Rate for Payer: Cash Price |
$174.90
|
| Rate for Payer: Cigna Commercial |
$557.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$24.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$339.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$24.59
|
| Rate for Payer: Health EOS Commercial |
$539.62
|
| Rate for Payer: HFN Commercial |
$557.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$91.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$24.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$24.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$24.59
|
| Rate for Payer: Multiplan Commercial |
$485.06
|
| Rate for Payer: NAPHCARE Commercial |
$36.88
|
| Rate for Payer: Preferred Network Access Commercial |
$557.81
|
| Rate for Payer: Quartz Beloit One Network |
$297.10
|
| Rate for Payer: Quartz Commercial |
$394.11
|
| Rate for Payer: Quartz Medicare Advantage |
$24.59
|
| Rate for Payer: The Alliance Commercial |
$98.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.59
|
| Rate for Payer: United Healthcare PPO |
$454.74
|
| Rate for Payer: WEA Trust Commercial |
$333.48
|
| Rate for Payer: Wellcare Medicare |
$24.59
|
| Rate for Payer: WPS Commercial |
$449.08
|
|
|
Cadmium Level
|
Professional
|
Both
|
$583.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
977891
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.59 |
| Max. Negotiated Rate |
$576.00 |
| Rate for Payer: Aetna Commercial |
$576.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$521.44
|
| Rate for Payer: Aetna Managed Medicare |
$24.59
|
| Rate for Payer: Anthem Medicare Advantage |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.59
|
| Rate for Payer: Cash Price |
$174.90
|
| Rate for Payer: Cash Price |
$174.90
|
| Rate for Payer: Cigna Commercial |
$576.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$303.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24.59
|
| Rate for Payer: Health EOS Commercial |
$551.75
|
| Rate for Payer: HFN Commercial |
$576.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$86.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$86.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.59
|
| Rate for Payer: Multiplan Commercial |
$485.06
|
| Rate for Payer: NAPHCARE Commercial |
$36.88
|
| Rate for Payer: Preferred Network Access Commercial |
$576.00
|
| Rate for Payer: Quartz Beloit One Network |
$266.78
|
| Rate for Payer: Quartz Commercial |
$345.60
|
| Rate for Payer: Quartz Medicare Advantage |
$24.59
|
| Rate for Payer: The Alliance Commercial |
$97.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.59
|
| Rate for Payer: WEA Trust Commercial |
$333.48
|
| Rate for Payer: WPS Commercial |
$108.18
|
|
|
Cadmium, Occupational Exposure, Random, Urine
|
Facility
|
OP
|
$89.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
6173611
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.59 |
| Max. Negotiated Rate |
$98.34 |
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Aetna Managed Medicare |
$24.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$92.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.02
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$40.81
|
| Rate for Payer: Anthem Medicare Advantage |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$49.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.59
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$85.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$24.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$51.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$24.59
|
| Rate for Payer: Health EOS Commercial |
$82.38
|
| Rate for Payer: HFN Commercial |
$85.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$91.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$24.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$24.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$24.59
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: NAPHCARE Commercial |
$36.88
|
| Rate for Payer: Preferred Network Access Commercial |
$85.16
|
| Rate for Payer: Quartz Beloit One Network |
$45.35
|
| Rate for Payer: Quartz Commercial |
$60.16
|
| Rate for Payer: Quartz Medicare Advantage |
$24.59
|
| Rate for Payer: The Alliance Commercial |
$98.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.59
|
| Rate for Payer: United Healthcare PPO |
$69.42
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: Wellcare Medicare |
$24.59
|
| Rate for Payer: WPS Commercial |
$68.56
|
|
|
Cadmium, Occupational Exposure, Random, Urine
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
6173611
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.59 |
| Max. Negotiated Rate |
$108.18 |
| Rate for Payer: Aetna Commercial |
$87.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Aetna Managed Medicare |
$24.59
|
| Rate for Payer: Anthem Medicare Advantage |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.59
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$87.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24.59
|
| Rate for Payer: Health EOS Commercial |
$84.23
|
| Rate for Payer: HFN Commercial |
$87.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$86.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$86.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.59
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: NAPHCARE Commercial |
$36.88
|
| Rate for Payer: Preferred Network Access Commercial |
$87.93
|
| Rate for Payer: Quartz Beloit One Network |
$40.73
|
| Rate for Payer: Quartz Commercial |
$52.76
|
| Rate for Payer: Quartz Medicare Advantage |
$24.59
|
| Rate for Payer: The Alliance Commercial |
$97.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.59
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: WPS Commercial |
$108.18
|
|
|
Cadmium, Occupational Exposure, Random, Urine
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
6173611
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$49.06
|
| Rate for Payer: Cash Price |
$26.70
|
| Rate for Payer: Cigna Commercial |
$85.16
|
| Rate for Payer: Health EOS Commercial |
$82.38
|
| Rate for Payer: HFN Commercial |
$85.16
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: Preferred Network Access Commercial |
$85.16
|
| Rate for Payer: Quartz Beloit One Network |
$45.35
|
| Rate for Payer: Quartz Commercial |
$55.54
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: WPS Commercial |
$68.56
|
|
|
Caffeine Level
|
Facility
|
IP
|
$238.00
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
977893
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$121.28 |
| Max. Negotiated Rate |
$227.72 |
| Rate for Payer: Aetna Commercial |
$222.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$212.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$131.19
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cigna Commercial |
$227.72
|
| Rate for Payer: Health EOS Commercial |
$220.29
|
| Rate for Payer: HFN Commercial |
$227.72
|
| Rate for Payer: Multiplan Commercial |
$198.02
|
| Rate for Payer: Preferred Network Access Commercial |
$227.72
|
| Rate for Payer: Quartz Beloit One Network |
$121.28
|
| Rate for Payer: Quartz Commercial |
$148.51
|
| Rate for Payer: WEA Trust Commercial |
$136.14
|
| Rate for Payer: WPS Commercial |
$183.33
|
|
|
Caffeine Level
|
Facility
|
OP
|
$238.00
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
977893
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$227.72 |
| Rate for Payer: Aetna Commercial |
$222.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$212.87
|
| Rate for Payer: Aetna Managed Medicare |
$40.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$150.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$70.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$66.59
|
| Rate for Payer: Anthem Medicare Advantage |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$131.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$40.11
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cigna Commercial |
$227.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$40.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$138.52
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$40.11
|
| Rate for Payer: Health EOS Commercial |
$220.29
|
| Rate for Payer: HFN Commercial |
$227.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$149.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$40.11
|
| Rate for Payer: Independent Care Health Plan Medicare |
$40.11
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$40.11
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$40.11
|
| Rate for Payer: Multiplan Commercial |
$198.02
|
| Rate for Payer: NAPHCARE Commercial |
$60.17
|
| Rate for Payer: Preferred Network Access Commercial |
$227.72
|
| Rate for Payer: Quartz Beloit One Network |
$121.28
|
| Rate for Payer: Quartz Commercial |
$160.89
|
| Rate for Payer: Quartz Medicare Advantage |
$40.11
|
| Rate for Payer: The Alliance Commercial |
$160.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.11
|
| Rate for Payer: United Healthcare PPO |
$185.64
|
| Rate for Payer: WEA Trust Commercial |
$136.14
|
| Rate for Payer: Wellcare Medicare |
$40.11
|
| Rate for Payer: WPS Commercial |
$183.33
|
|
|
Caffeine Level
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
977893
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$235.14 |
| Rate for Payer: Aetna Commercial |
$235.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$212.87
|
| Rate for Payer: Aetna Managed Medicare |
$40.11
|
| Rate for Payer: Anthem Medicare Advantage |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$40.11
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cigna Commercial |
$235.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$123.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40.11
|
| Rate for Payer: Health EOS Commercial |
$225.24
|
| Rate for Payer: HFN Commercial |
$235.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$141.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$141.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$40.11
|
| Rate for Payer: Multiplan Commercial |
$198.02
|
| Rate for Payer: NAPHCARE Commercial |
$60.17
|
| Rate for Payer: Preferred Network Access Commercial |
$235.14
|
| Rate for Payer: Quartz Beloit One Network |
$108.91
|
| Rate for Payer: Quartz Commercial |
$141.09
|
| Rate for Payer: Quartz Medicare Advantage |
$40.11
|
| Rate for Payer: The Alliance Commercial |
$158.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.11
|
| Rate for Payer: WEA Trust Commercial |
$136.14
|
| Rate for Payer: WPS Commercial |
$176.50
|
|
|
Caffeine, Urine
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
3313617
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.55 |
| Max. Negotiated Rate |
$104.29 |
| Rate for Payer: Aetna Commercial |
$102.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$97.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.08
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cigna Commercial |
$104.29
|
| Rate for Payer: Health EOS Commercial |
$100.89
|
| Rate for Payer: HFN Commercial |
$104.29
|
| Rate for Payer: Multiplan Commercial |
$90.69
|
| Rate for Payer: Preferred Network Access Commercial |
$104.29
|
| Rate for Payer: Quartz Beloit One Network |
$55.55
|
| Rate for Payer: Quartz Commercial |
$68.02
|
| Rate for Payer: WEA Trust Commercial |
$62.35
|
| Rate for Payer: WPS Commercial |
$83.96
|
|
|
Caffeine, Urine
|
Professional
|
Both
|
$109.00
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
3313617
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$176.50 |
| Rate for Payer: Aetna Commercial |
$107.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$97.49
|
| Rate for Payer: Aetna Managed Medicare |
$40.11
|
| Rate for Payer: Anthem Medicare Advantage |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$40.11
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cigna Commercial |
$107.69
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$56.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40.11
|
| Rate for Payer: Health EOS Commercial |
$103.16
|
| Rate for Payer: HFN Commercial |
$107.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$141.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$141.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$40.11
|
| Rate for Payer: Multiplan Commercial |
$90.69
|
| Rate for Payer: NAPHCARE Commercial |
$60.17
|
| Rate for Payer: Preferred Network Access Commercial |
$107.69
|
| Rate for Payer: Quartz Beloit One Network |
$49.88
|
| Rate for Payer: Quartz Commercial |
$64.62
|
| Rate for Payer: Quartz Medicare Advantage |
$40.11
|
| Rate for Payer: The Alliance Commercial |
$158.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.11
|
| Rate for Payer: WEA Trust Commercial |
$62.35
|
| Rate for Payer: WPS Commercial |
$176.50
|
|
|
Caffeine, Urine
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
3313617
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$160.45 |
| Rate for Payer: Aetna Commercial |
$102.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$97.49
|
| Rate for Payer: Aetna Managed Medicare |
$40.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$150.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$70.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$66.59
|
| Rate for Payer: Anthem Medicare Advantage |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$40.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$40.11
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cigna Commercial |
$104.29
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$40.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$63.44
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$40.11
|
| Rate for Payer: Health EOS Commercial |
$100.89
|
| Rate for Payer: HFN Commercial |
$104.29
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$149.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$40.11
|
| Rate for Payer: Independent Care Health Plan Medicare |
$40.11
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$40.11
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$40.11
|
| Rate for Payer: Multiplan Commercial |
$90.69
|
| Rate for Payer: NAPHCARE Commercial |
$60.17
|
| Rate for Payer: Preferred Network Access Commercial |
$104.29
|
| Rate for Payer: Quartz Beloit One Network |
$55.55
|
| Rate for Payer: Quartz Commercial |
$73.68
|
| Rate for Payer: Quartz Medicare Advantage |
$40.11
|
| Rate for Payer: The Alliance Commercial |
$160.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.11
|
| Rate for Payer: United Healthcare PPO |
$85.02
|
| Rate for Payer: WEA Trust Commercial |
$62.35
|
| Rate for Payer: Wellcare Medicare |
$40.11
|
| Rate for Payer: WPS Commercial |
$83.96
|
|
|
Calcitonin Level
|
Facility
|
OP
|
$368.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
633686
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$352.10 |
| Rate for Payer: Aetna Commercial |
$344.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$329.14
|
| Rate for Payer: Aetna Managed Medicare |
$27.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$104.48
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$48.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$46.25
|
| Rate for Payer: Anthem Medicare Advantage |
$27.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$202.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.86
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cigna Commercial |
$352.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$27.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$214.18
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$27.86
|
| Rate for Payer: Health EOS Commercial |
$340.62
|
| Rate for Payer: HFN Commercial |
$352.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$103.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$27.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$27.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$27.86
|
| Rate for Payer: Multiplan Commercial |
$306.18
|
| Rate for Payer: NAPHCARE Commercial |
$41.79
|
| Rate for Payer: Preferred Network Access Commercial |
$352.10
|
| Rate for Payer: Quartz Beloit One Network |
$187.53
|
| Rate for Payer: Quartz Commercial |
$248.77
|
| Rate for Payer: Quartz Medicare Advantage |
$27.86
|
| Rate for Payer: The Alliance Commercial |
$111.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.86
|
| Rate for Payer: United Healthcare PPO |
$287.04
|
| Rate for Payer: WEA Trust Commercial |
$210.50
|
| Rate for Payer: Wellcare Medicare |
$27.86
|
| Rate for Payer: WPS Commercial |
$283.47
|
|
|
Calcitonin Level
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
633686
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$363.58 |
| Rate for Payer: Aetna Commercial |
$363.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$329.14
|
| Rate for Payer: Aetna Managed Medicare |
$27.86
|
| Rate for Payer: Anthem Medicare Advantage |
$27.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$27.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$27.86
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cigna Commercial |
$363.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$191.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27.86
|
| Rate for Payer: Health EOS Commercial |
$348.28
|
| Rate for Payer: HFN Commercial |
$363.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$98.35
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$98.35
|
| Rate for Payer: Independent Care Health Plan Medicare |
$27.86
|
| Rate for Payer: Multiplan Commercial |
$306.18
|
| Rate for Payer: NAPHCARE Commercial |
$41.79
|
| Rate for Payer: Preferred Network Access Commercial |
$363.58
|
| Rate for Payer: Quartz Beloit One Network |
$168.40
|
| Rate for Payer: Quartz Commercial |
$218.15
|
| Rate for Payer: Quartz Medicare Advantage |
$27.86
|
| Rate for Payer: The Alliance Commercial |
$110.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.86
|
| Rate for Payer: WEA Trust Commercial |
$210.50
|
| Rate for Payer: WPS Commercial |
$122.59
|
|
|
Calcitonin Level
|
Facility
|
IP
|
$368.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
633686
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$187.53 |
| Max. Negotiated Rate |
$352.10 |
| Rate for Payer: Aetna Commercial |
$344.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$329.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$202.84
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cigna Commercial |
$352.10
|
| Rate for Payer: Health EOS Commercial |
$340.62
|
| Rate for Payer: HFN Commercial |
$352.10
|
| Rate for Payer: Multiplan Commercial |
$306.18
|
| Rate for Payer: Preferred Network Access Commercial |
$352.10
|
| Rate for Payer: Quartz Beloit One Network |
$187.53
|
| Rate for Payer: Quartz Commercial |
$229.63
|
| Rate for Payer: WEA Trust Commercial |
$210.50
|
| Rate for Payer: WPS Commercial |
$283.47
|
|
|
Calcitriol 1,25 Dihyroxy Level
|
Facility
|
IP
|
$606.00
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
978114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$308.82 |
| Max. Negotiated Rate |
$579.82 |
| Rate for Payer: Aetna Commercial |
$567.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$542.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$334.03
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cigna Commercial |
$579.82
|
| Rate for Payer: Health EOS Commercial |
$560.91
|
| Rate for Payer: HFN Commercial |
$579.82
|
| Rate for Payer: Multiplan Commercial |
$504.19
|
| Rate for Payer: Preferred Network Access Commercial |
$579.82
|
| Rate for Payer: Quartz Beloit One Network |
$308.82
|
| Rate for Payer: Quartz Commercial |
$378.14
|
| Rate for Payer: WEA Trust Commercial |
$346.63
|
| Rate for Payer: WPS Commercial |
$466.80
|
|
|
Calcitriol 1,25 Dihyroxy Level
|
Professional
|
Both
|
$606.00
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
978114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.04 |
| Max. Negotiated Rate |
$598.73 |
| Rate for Payer: Aetna Commercial |
$598.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$542.01
|
| Rate for Payer: Aetna Managed Medicare |
$40.04
|
| Rate for Payer: Anthem Medicare Advantage |
$40.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$40.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$40.04
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cigna Commercial |
$598.73
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$315.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40.04
|
| Rate for Payer: Health EOS Commercial |
$573.52
|
| Rate for Payer: HFN Commercial |
$598.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$141.35
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$141.35
|
| Rate for Payer: Independent Care Health Plan Medicare |
$40.04
|
| Rate for Payer: Multiplan Commercial |
$504.19
|
| Rate for Payer: NAPHCARE Commercial |
$60.06
|
| Rate for Payer: Preferred Network Access Commercial |
$598.73
|
| Rate for Payer: Quartz Beloit One Network |
$277.31
|
| Rate for Payer: Quartz Commercial |
$359.24
|
| Rate for Payer: Quartz Medicare Advantage |
$40.04
|
| Rate for Payer: The Alliance Commercial |
$158.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.04
|
| Rate for Payer: WEA Trust Commercial |
$346.63
|
| Rate for Payer: WPS Commercial |
$176.18
|
|
|
Calcitriol 1,25 Dihyroxy Level
|
Facility
|
OP
|
$606.00
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
978114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.04 |
| Max. Negotiated Rate |
$579.82 |
| Rate for Payer: Aetna Commercial |
$567.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$542.01
|
| Rate for Payer: Aetna Managed Medicare |
$40.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$150.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$70.07
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$66.47
|
| Rate for Payer: Anthem Medicare Advantage |
$40.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$334.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$40.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$40.04
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cigna Commercial |
$579.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$40.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$352.69
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$40.04
|
| Rate for Payer: Health EOS Commercial |
$560.91
|
| Rate for Payer: HFN Commercial |
$579.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$148.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$40.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$40.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$40.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$40.04
|
| Rate for Payer: Multiplan Commercial |
$504.19
|
| Rate for Payer: NAPHCARE Commercial |
$60.06
|
| Rate for Payer: Preferred Network Access Commercial |
$579.82
|
| Rate for Payer: Quartz Beloit One Network |
$308.82
|
| Rate for Payer: Quartz Commercial |
$409.66
|
| Rate for Payer: Quartz Medicare Advantage |
$40.04
|
| Rate for Payer: The Alliance Commercial |
$160.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.04
|
| Rate for Payer: United Healthcare PPO |
$472.68
|
| Rate for Payer: WEA Trust Commercial |
$346.63
|
| Rate for Payer: Wellcare Medicare |
$40.04
|
| Rate for Payer: WPS Commercial |
$466.80
|
|
|
Calcitriol Medication 0.25mcg
|
Facility
|
IP
|
$12.00
|
|
| Hospital Charge Code |
3005564
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.12 |
| Max. Negotiated Rate |
$11.48 |
| Rate for Payer: Aetna Commercial |
$11.23
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6.61
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cigna Commercial |
$11.48
|
| Rate for Payer: Health EOS Commercial |
$11.11
|
| Rate for Payer: HFN Commercial |
$11.48
|
| Rate for Payer: Multiplan Commercial |
$9.98
|
| Rate for Payer: Preferred Network Access Commercial |
$11.48
|
| Rate for Payer: Quartz Beloit One Network |
$6.12
|
| Rate for Payer: Quartz Commercial |
$7.49
|
| Rate for Payer: WEA Trust Commercial |
$6.86
|
| Rate for Payer: WPS Commercial |
$9.24
|
|
|
Calcitriol Medication 0.25mcg
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
3005564
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$11.48 |
| Rate for Payer: Aetna Commercial |
$11.23
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10.73
|
| Rate for Payer: Aetna Managed Medicare |
$3.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$8.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6.61
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cigna Commercial |
$11.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.98
|
| Rate for Payer: Health EOS Commercial |
$11.11
|
| Rate for Payer: HFN Commercial |
$11.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$9.36
|
| Rate for Payer: Multiplan Commercial |
$9.98
|
| Rate for Payer: NAPHCARE Commercial |
$7.49
|
| Rate for Payer: Preferred Network Access Commercial |
$11.48
|
| Rate for Payer: Quartz Beloit One Network |
$6.12
|
| Rate for Payer: Quartz Commercial |
$8.11
|
| Rate for Payer: Quartz Medicare Advantage |
$7.49
|
| Rate for Payer: The Alliance Commercial |
$6.24
|
| Rate for Payer: WEA Trust Commercial |
$6.86
|
| Rate for Payer: WPS Commercial |
$9.24
|
|
|
Calcitriol Medication 0.5 mcg
|
Facility
|
OP
|
$11.00
|
|
| Hospital Charge Code |
3005563
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$10.52 |
| Rate for Payer: Aetna Commercial |
$10.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9.84
|
| Rate for Payer: Aetna Managed Medicare |
$3.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6.06
|
| Rate for Payer: Cash Price |
$3.30
|
| Rate for Payer: Cigna Commercial |
$10.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.40
|
| Rate for Payer: Health EOS Commercial |
$10.18
|
| Rate for Payer: HFN Commercial |
$10.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8.58
|
| Rate for Payer: Multiplan Commercial |
$9.15
|
| Rate for Payer: NAPHCARE Commercial |
$6.86
|
| Rate for Payer: Preferred Network Access Commercial |
$10.52
|
| Rate for Payer: Quartz Beloit One Network |
$5.61
|
| Rate for Payer: Quartz Commercial |
$7.44
|
| Rate for Payer: Quartz Medicare Advantage |
$6.86
|
| Rate for Payer: The Alliance Commercial |
$5.72
|
| Rate for Payer: WEA Trust Commercial |
$6.29
|
| Rate for Payer: WPS Commercial |
$8.47
|
|
|
Calcitriol Medication 0.5 mcg
|
Facility
|
IP
|
$11.00
|
|
| Hospital Charge Code |
3005563
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$10.52 |
| Rate for Payer: Aetna Commercial |
$10.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6.06
|
| Rate for Payer: Cash Price |
$3.30
|
| Rate for Payer: Cigna Commercial |
$10.52
|
| Rate for Payer: Health EOS Commercial |
$10.18
|
| Rate for Payer: HFN Commercial |
$10.52
|
| Rate for Payer: Multiplan Commercial |
$9.15
|
| Rate for Payer: Preferred Network Access Commercial |
$10.52
|
| Rate for Payer: Quartz Beloit One Network |
$5.61
|
| Rate for Payer: Quartz Commercial |
$6.86
|
| Rate for Payer: WEA Trust Commercial |
$6.29
|
| Rate for Payer: WPS Commercial |
$8.47
|
|
|
Calcium
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
2942966
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$122.47 |
| Rate for Payer: Aetna Commercial |
$119.81
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$114.48
|
| Rate for Payer: Aetna Managed Medicare |
$5.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.12
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.91
|
| Rate for Payer: Anthem Medicare Advantage |
$5.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$70.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.37
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cigna Commercial |
$122.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$74.50
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.37
|
| Rate for Payer: Health EOS Commercial |
$118.48
|
| Rate for Payer: HFN Commercial |
$122.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.37
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.37
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.37
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.37
|
| Rate for Payer: Multiplan Commercial |
$106.50
|
| Rate for Payer: NAPHCARE Commercial |
$8.05
|
| Rate for Payer: Preferred Network Access Commercial |
$122.47
|
| Rate for Payer: Quartz Beloit One Network |
$65.23
|
| Rate for Payer: Quartz Commercial |
$86.53
|
| Rate for Payer: Quartz Medicare Advantage |
$5.37
|
| Rate for Payer: The Alliance Commercial |
$21.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.37
|
| Rate for Payer: United Healthcare PPO |
$99.84
|
| Rate for Payer: WEA Trust Commercial |
$73.22
|
| Rate for Payer: Wellcare Medicare |
$5.37
|
| Rate for Payer: WPS Commercial |
$98.60
|
|
