|
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
|
|
|
Calcium
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
2942966
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$126.46 |
| Rate for Payer: Aetna Commercial |
$126.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$114.48
|
| Rate for Payer: Aetna Managed Medicare |
$5.37
|
| Rate for Payer: Anthem Medicare Advantage |
$5.37
|
| 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 |
$126.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$66.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.37
|
| Rate for Payer: Health EOS Commercial |
$121.14
|
| Rate for Payer: HFN Commercial |
$126.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.37
|
| Rate for Payer: Multiplan Commercial |
$106.50
|
| Rate for Payer: NAPHCARE Commercial |
$8.05
|
| Rate for Payer: Preferred Network Access Commercial |
$126.46
|
| Rate for Payer: Quartz Beloit One Network |
$58.57
|
| Rate for Payer: Quartz Commercial |
$75.88
|
| Rate for Payer: Quartz Medicare Advantage |
$5.37
|
| Rate for Payer: The Alliance Commercial |
$21.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.37
|
| Rate for Payer: WEA Trust Commercial |
$73.22
|
| Rate for Payer: WPS Commercial |
$23.61
|
|
|
.Calcium, 24-hour Urine w/creatinine
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
4506619
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$27.59 |
| Rate for Payer: Aetna Commercial |
$21.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$19.68
|
| Rate for Payer: Aetna Managed Medicare |
$6.27
|
| Rate for Payer: Anthem Medicare Advantage |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.27
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$21.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.27
|
| Rate for Payer: Health EOS Commercial |
$20.82
|
| Rate for Payer: HFN Commercial |
$21.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.27
|
| Rate for Payer: Multiplan Commercial |
$18.30
|
| Rate for Payer: NAPHCARE Commercial |
$9.41
|
| Rate for Payer: Preferred Network Access Commercial |
$21.74
|
| Rate for Payer: Quartz Beloit One Network |
$10.07
|
| Rate for Payer: Quartz Commercial |
$13.04
|
| Rate for Payer: Quartz Medicare Advantage |
$6.27
|
| Rate for Payer: The Alliance Commercial |
$24.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.27
|
| Rate for Payer: WEA Trust Commercial |
$12.58
|
| Rate for Payer: WPS Commercial |
$27.59
|
|
|
.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 |
$6.27 |
| Max. Negotiated Rate |
$25.08 |
| Rate for Payer: Aetna Commercial |
$20.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$19.68
|
| Rate for Payer: Aetna Managed Medicare |
$6.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.97
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.41
|
| Rate for Payer: Anthem Medicare Advantage |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$12.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.27
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$21.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.27
|
| Rate for Payer: Health EOS Commercial |
$20.36
|
| Rate for Payer: HFN Commercial |
$21.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.27
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.27
|
| Rate for Payer: Multiplan Commercial |
$18.30
|
| Rate for Payer: NAPHCARE Commercial |
$9.41
|
| Rate for Payer: Preferred Network Access Commercial |
$21.05
|
| Rate for Payer: Quartz Beloit One Network |
$11.21
|
| Rate for Payer: Quartz Commercial |
$14.87
|
| Rate for Payer: Quartz Medicare Advantage |
$6.27
|
| Rate for Payer: The Alliance Commercial |
$25.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.27
|
| Rate for Payer: United Healthcare PPO |
$17.16
|
| Rate for Payer: WEA Trust Commercial |
$12.58
|
| Rate for Payer: Wellcare Medicare |
$6.27
|
| Rate for Payer: WPS Commercial |
$16.95
|
|
|
.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 |
$11.21 |
| Max. Negotiated Rate |
$21.05 |
| Rate for Payer: Aetna Commercial |
$20.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$19.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$12.13
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$21.05
|
| Rate for Payer: Health EOS Commercial |
$20.36
|
| Rate for Payer: HFN Commercial |
$21.05
|
| Rate for Payer: Multiplan Commercial |
$18.30
|
| Rate for Payer: Preferred Network Access Commercial |
$21.05
|
| Rate for Payer: Quartz Beloit One Network |
$11.21
|
| Rate for Payer: Quartz Commercial |
$13.73
|
| Rate for Payer: WEA Trust Commercial |
$12.58
|
| Rate for Payer: WPS Commercial |
$16.95
|
|
|
Calcium Gluconate 10 ml Charge
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS J0610
|
| Hospital Charge Code |
2958898
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$82.00 |
| Rate for Payer: Aetna Commercial |
$82.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$82.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$51.79
|
| Rate for Payer: Health EOS Commercial |
$78.55
|
| Rate for Payer: HFN Commercial |
$82.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5.51
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.51
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: Preferred Network Access Commercial |
$82.00
|
| Rate for Payer: Quartz Beloit One Network |
$37.98
|
| Rate for Payer: Quartz Commercial |
$49.20
|
| Rate for Payer: The Alliance Commercial |
$43.16
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Calcium Gluconate 10 ml Charge
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
HCPCS J0610
|
| Hospital Charge Code |
2958898
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.17 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$24.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.31
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64.74
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$51.79
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$56.11
|
| Rate for Payer: Quartz Medicare Advantage |
$51.79
|
| Rate for Payer: The Alliance Commercial |
$43.16
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Calcium Gluconate 10 ml Charge
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
HCPCS J0610
|
| Hospital Charge Code |
2958898
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$51.79
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Calcium gluconate inj 10 ml charge J0610
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS J0610
|
| Hospital Charge Code |
3451631
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$82.00 |
| Rate for Payer: Aetna Commercial |
$82.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$82.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$51.79
|
| Rate for Payer: Health EOS Commercial |
$78.55
|
| Rate for Payer: HFN Commercial |
$82.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5.51
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.51
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: Preferred Network Access Commercial |
$82.00
|
| Rate for Payer: Quartz Beloit One Network |
$37.98
|
| Rate for Payer: Quartz Commercial |
$49.20
|
| Rate for Payer: The Alliance Commercial |
$43.16
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
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 |
$24.17 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$24.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.31
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64.74
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$51.79
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$56.11
|
| Rate for Payer: Quartz Medicare Advantage |
$51.79
|
| Rate for Payer: The Alliance Commercial |
$43.16
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
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 |
$42.30 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$51.79
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Calcium, Ionized to Quest
|
Facility
|
IP
|
$272.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
3091491
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$138.61 |
| Max. Negotiated Rate |
$260.25 |
| Rate for Payer: Aetna Commercial |
$254.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$243.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$149.93
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cigna Commercial |
$260.25
|
| Rate for Payer: Health EOS Commercial |
$251.76
|
| Rate for Payer: HFN Commercial |
$260.25
|
| Rate for Payer: Multiplan Commercial |
$226.30
|
| Rate for Payer: Preferred Network Access Commercial |
$260.25
|
| Rate for Payer: Quartz Beloit One Network |
$138.61
|
| Rate for Payer: Quartz Commercial |
$169.73
|
| Rate for Payer: WEA Trust Commercial |
$155.58
|
| Rate for Payer: WPS Commercial |
$209.52
|
|
|
Calcium, Ionized to Quest
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
3091491
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.23 |
| Max. Negotiated Rate |
$268.74 |
| Rate for Payer: Aetna Commercial |
$268.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$243.28
|
| Rate for Payer: Aetna Managed Medicare |
$14.23
|
| Rate for Payer: Anthem Medicare Advantage |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.23
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cigna Commercial |
$268.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$141.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.23
|
| Rate for Payer: Health EOS Commercial |
$257.42
|
| Rate for Payer: HFN Commercial |
$268.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$50.22
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.23
|
| Rate for Payer: Multiplan Commercial |
$226.30
|
| Rate for Payer: NAPHCARE Commercial |
$21.34
|
| Rate for Payer: Preferred Network Access Commercial |
$268.74
|
| Rate for Payer: Quartz Beloit One Network |
$124.47
|
| Rate for Payer: Quartz Commercial |
$161.24
|
| Rate for Payer: Quartz Medicare Advantage |
$14.23
|
| Rate for Payer: The Alliance Commercial |
$56.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.23
|
| Rate for Payer: WEA Trust Commercial |
$155.58
|
| Rate for Payer: WPS Commercial |
$62.60
|
|
|
Calcium, Ionized to Quest
|
Facility
|
OP
|
$272.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
3091491
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.23 |
| Max. Negotiated Rate |
$260.25 |
| Rate for Payer: Aetna Commercial |
$254.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$243.28
|
| Rate for Payer: Aetna Managed Medicare |
$14.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.90
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.62
|
| Rate for Payer: Anthem Medicare Advantage |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$149.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.23
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cigna Commercial |
$260.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$158.30
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.23
|
| Rate for Payer: Health EOS Commercial |
$251.76
|
| Rate for Payer: HFN Commercial |
$260.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$52.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.23
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.23
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.23
|
| Rate for Payer: Multiplan Commercial |
$226.30
|
| Rate for Payer: NAPHCARE Commercial |
$21.34
|
| Rate for Payer: Preferred Network Access Commercial |
$260.25
|
| Rate for Payer: Quartz Beloit One Network |
$138.61
|
| Rate for Payer: Quartz Commercial |
$183.87
|
| Rate for Payer: Quartz Medicare Advantage |
$14.23
|
| Rate for Payer: The Alliance Commercial |
$56.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.23
|
| Rate for Payer: United Healthcare PPO |
$212.16
|
| Rate for Payer: WEA Trust Commercial |
$155.58
|
| Rate for Payer: Wellcare Medicare |
$14.23
|
| Rate for Payer: WPS Commercial |
$209.52
|
|
|
Calcium Level 24 Hour Urine
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633687
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.51 |
| Max. Negotiated Rate |
$100.46 |
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.88
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$100.46
|
| Rate for Payer: Health EOS Commercial |
$97.19
|
| Rate for Payer: HFN Commercial |
$100.46
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: Preferred Network Access Commercial |
$100.46
|
| Rate for Payer: Quartz Beloit One Network |
$53.51
|
| Rate for Payer: Quartz Commercial |
$65.52
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: WPS Commercial |
$80.88
|
|
|
Calcium Level 24 Hour Urine
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633687
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$100.46 |
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Aetna Managed Medicare |
$6.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.97
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.41
|
| Rate for Payer: Anthem Medicare Advantage |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.27
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$100.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$61.11
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.27
|
| Rate for Payer: Health EOS Commercial |
$97.19
|
| Rate for Payer: HFN Commercial |
$100.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.27
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.27
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: NAPHCARE Commercial |
$9.41
|
| Rate for Payer: Preferred Network Access Commercial |
$100.46
|
| Rate for Payer: Quartz Beloit One Network |
$53.51
|
| Rate for Payer: Quartz Commercial |
$70.98
|
| Rate for Payer: Quartz Medicare Advantage |
$6.27
|
| Rate for Payer: The Alliance Commercial |
$25.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.27
|
| Rate for Payer: United Healthcare PPO |
$81.90
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: Wellcare Medicare |
$6.27
|
| Rate for Payer: WPS Commercial |
$80.88
|
|
|
Calcium Level 24 Hour Urine
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633687
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$103.74 |
| Rate for Payer: Aetna Commercial |
$103.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Aetna Managed Medicare |
$6.27
|
| Rate for Payer: Anthem Medicare Advantage |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.27
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$103.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$54.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.27
|
| Rate for Payer: Health EOS Commercial |
$99.37
|
| Rate for Payer: HFN Commercial |
$103.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.27
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: NAPHCARE Commercial |
$9.41
|
| Rate for Payer: Preferred Network Access Commercial |
$103.74
|
| Rate for Payer: Quartz Beloit One Network |
$48.05
|
| Rate for Payer: Quartz Commercial |
$62.24
|
| Rate for Payer: Quartz Medicare Advantage |
$6.27
|
| Rate for Payer: The Alliance Commercial |
$24.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.27
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: WPS Commercial |
$27.59
|
|
|
Calcium Level Ionized
|
Professional
|
Both
|
$233.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
633689
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.23 |
| Max. Negotiated Rate |
$230.20 |
| Rate for Payer: Aetna Commercial |
$230.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$208.40
|
| Rate for Payer: Aetna Managed Medicare |
$14.23
|
| Rate for Payer: Anthem Medicare Advantage |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.23
|
| Rate for Payer: Cash Price |
$69.90
|
| Rate for Payer: Cash Price |
$69.90
|
| Rate for Payer: Cigna Commercial |
$230.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$121.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.23
|
| Rate for Payer: Health EOS Commercial |
$220.51
|
| Rate for Payer: HFN Commercial |
$230.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$50.22
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.23
|
| Rate for Payer: Multiplan Commercial |
$193.86
|
| Rate for Payer: NAPHCARE Commercial |
$21.34
|
| Rate for Payer: Preferred Network Access Commercial |
$230.20
|
| Rate for Payer: Quartz Beloit One Network |
$106.62
|
| Rate for Payer: Quartz Commercial |
$138.12
|
| Rate for Payer: Quartz Medicare Advantage |
$14.23
|
| Rate for Payer: The Alliance Commercial |
$56.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.23
|
| Rate for Payer: WEA Trust Commercial |
$133.28
|
| Rate for Payer: WPS Commercial |
$62.60
|
|
|
Calcium Level Ionized
|
Facility
|
IP
|
$233.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
633689
|
|
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
|
|
|
Calcium Level Ionized
|
Facility
|
OP
|
$233.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
633689
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.23 |
| Max. Negotiated Rate |
$222.93 |
| Rate for Payer: Aetna Commercial |
$218.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$208.40
|
| Rate for Payer: Aetna Managed Medicare |
$14.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.90
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.62
|
| Rate for Payer: Anthem Medicare Advantage |
$14.23
|
| 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 |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.23
|
| 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 |
$14.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$135.61
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.23
|
| Rate for Payer: Health EOS Commercial |
$215.66
|
| Rate for Payer: HFN Commercial |
$222.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$52.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.23
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.23
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.23
|
| Rate for Payer: Multiplan Commercial |
$193.86
|
| Rate for Payer: NAPHCARE Commercial |
$21.34
|
| 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 |
$14.23
|
| Rate for Payer: The Alliance Commercial |
$56.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.23
|
| Rate for Payer: United Healthcare PPO |
$181.74
|
| Rate for Payer: WEA Trust Commercial |
$133.28
|
| Rate for Payer: Wellcare Medicare |
$14.23
|
| Rate for Payer: WPS Commercial |
$179.48
|
|
|
Calcium Level Total
|
Facility
|
IP
|
$86.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
633690
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.83 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Aetna Commercial |
$80.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$47.40
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$82.28
|
| Rate for Payer: Health EOS Commercial |
$79.60
|
| Rate for Payer: HFN Commercial |
$82.28
|
| Rate for Payer: Multiplan Commercial |
$71.55
|
| Rate for Payer: Preferred Network Access Commercial |
$82.28
|
| Rate for Payer: Quartz Beloit One Network |
$43.83
|
| Rate for Payer: Quartz Commercial |
$53.66
|
| Rate for Payer: WEA Trust Commercial |
$49.19
|
| Rate for Payer: WPS Commercial |
$66.25
|
|
|
Calcium Level Total
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
633690
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$84.97 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.92
|
| Rate for Payer: Aetna Managed Medicare |
$5.37
|
| Rate for Payer: Anthem Medicare Advantage |
$5.37
|
| 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 |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$84.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$44.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.37
|
| Rate for Payer: Health EOS Commercial |
$81.39
|
| Rate for Payer: HFN Commercial |
$84.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.37
|
| Rate for Payer: Multiplan Commercial |
$71.55
|
| Rate for Payer: NAPHCARE Commercial |
$8.05
|
| Rate for Payer: Preferred Network Access Commercial |
$84.97
|
| Rate for Payer: Quartz Beloit One Network |
$39.35
|
| Rate for Payer: Quartz Commercial |
$50.98
|
| Rate for Payer: Quartz Medicare Advantage |
$5.37
|
| Rate for Payer: The Alliance Commercial |
$21.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.37
|
| Rate for Payer: WEA Trust Commercial |
$49.19
|
| Rate for Payer: WPS Commercial |
$23.61
|
|
|
Calcium Level Total
|
Facility
|
OP
|
$86.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
633690
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Aetna Commercial |
$80.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.92
|
| 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 |
$47.40
|
| 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 |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$82.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$50.05
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.37
|
| Rate for Payer: Health EOS Commercial |
$79.60
|
| Rate for Payer: HFN Commercial |
$82.28
|
| 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 |
$71.55
|
| Rate for Payer: NAPHCARE Commercial |
$8.05
|
| Rate for Payer: Preferred Network Access Commercial |
$82.28
|
| Rate for Payer: Quartz Beloit One Network |
$43.83
|
| Rate for Payer: Quartz Commercial |
$58.14
|
| 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 |
$67.08
|
| Rate for Payer: WEA Trust Commercial |
$49.19
|
| Rate for Payer: Wellcare Medicare |
$5.37
|
| Rate for Payer: WPS Commercial |
$66.25
|
|
|
Calcium Level Urine
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633691
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$87.93 |
| Rate for Payer: Aetna Commercial |
$87.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$79.60
|
| Rate for Payer: Aetna Managed Medicare |
$6.27
|
| Rate for Payer: Anthem Medicare Advantage |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.27
|
| 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 |
$6.27
|
| Rate for Payer: Health EOS Commercial |
$84.23
|
| Rate for Payer: HFN Commercial |
$87.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.27
|
| Rate for Payer: Multiplan Commercial |
$74.05
|
| Rate for Payer: NAPHCARE Commercial |
$9.41
|
| 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 |
$6.27
|
| Rate for Payer: The Alliance Commercial |
$24.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.27
|
| Rate for Payer: WEA Trust Commercial |
$50.91
|
| Rate for Payer: WPS Commercial |
$27.59
|
|
|
Calcium Level Urine
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
633691
|
|
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
|
|
