|
Carnitine Free and Total
|
Professional
|
Both
|
$425.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
977895
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$419.90 |
| Rate for Payer: Aetna Commercial |
$419.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$380.12
|
| Rate for Payer: Aetna Managed Medicare |
$17.54
|
| Rate for Payer: Anthem Medicare Advantage |
$17.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.54
|
| Rate for Payer: Cash Price |
$127.50
|
| Rate for Payer: Cash Price |
$127.50
|
| Rate for Payer: Cigna Commercial |
$419.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$221.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.54
|
| Rate for Payer: Health EOS Commercial |
$402.22
|
| Rate for Payer: HFN Commercial |
$419.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$61.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.54
|
| Rate for Payer: Multiplan Commercial |
$353.60
|
| Rate for Payer: NAPHCARE Commercial |
$26.32
|
| Rate for Payer: Preferred Network Access Commercial |
$419.90
|
| Rate for Payer: Quartz Beloit One Network |
$194.48
|
| Rate for Payer: Quartz Commercial |
$251.94
|
| Rate for Payer: Quartz Medicare Advantage |
$17.54
|
| Rate for Payer: The Alliance Commercial |
$69.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.54
|
| Rate for Payer: WEA Trust Commercial |
$243.10
|
| Rate for Payer: WPS Commercial |
$77.20
|
|
|
Carnitine, Urine
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
5280663
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$247.67 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Aetna Commercial |
$454.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$434.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$267.88
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cigna Commercial |
$465.00
|
| Rate for Payer: Health EOS Commercial |
$449.84
|
| Rate for Payer: HFN Commercial |
$465.00
|
| Rate for Payer: Multiplan Commercial |
$404.35
|
| Rate for Payer: Preferred Network Access Commercial |
$465.00
|
| Rate for Payer: Quartz Beloit One Network |
$247.67
|
| Rate for Payer: Quartz Commercial |
$303.26
|
| Rate for Payer: WEA Trust Commercial |
$277.99
|
| Rate for Payer: WPS Commercial |
$374.37
|
|
|
Carnitine, Urine
|
Professional
|
Both
|
$486.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
5280663
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$480.17 |
| Rate for Payer: Aetna Commercial |
$480.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$434.68
|
| Rate for Payer: Aetna Managed Medicare |
$17.54
|
| Rate for Payer: Anthem Medicare Advantage |
$17.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.54
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cigna Commercial |
$480.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$252.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.54
|
| Rate for Payer: Health EOS Commercial |
$459.95
|
| Rate for Payer: HFN Commercial |
$480.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$61.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.54
|
| Rate for Payer: Multiplan Commercial |
$404.35
|
| Rate for Payer: NAPHCARE Commercial |
$26.32
|
| Rate for Payer: Preferred Network Access Commercial |
$480.17
|
| Rate for Payer: Quartz Beloit One Network |
$222.39
|
| Rate for Payer: Quartz Commercial |
$288.10
|
| Rate for Payer: Quartz Medicare Advantage |
$17.54
|
| Rate for Payer: The Alliance Commercial |
$69.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.54
|
| Rate for Payer: WEA Trust Commercial |
$277.99
|
| Rate for Payer: WPS Commercial |
$77.20
|
|
|
Carnitine, Urine
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
5280663
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Aetna Commercial |
$454.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$434.68
|
| Rate for Payer: Aetna Managed Medicare |
$17.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$65.79
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.70
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.12
|
| Rate for Payer: Anthem Medicare Advantage |
$17.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$267.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.54
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cigna Commercial |
$465.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$282.85
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.54
|
| Rate for Payer: Health EOS Commercial |
$449.84
|
| Rate for Payer: HFN Commercial |
$465.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.27
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.54
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.54
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.54
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.54
|
| Rate for Payer: Multiplan Commercial |
$404.35
|
| Rate for Payer: NAPHCARE Commercial |
$26.32
|
| Rate for Payer: Preferred Network Access Commercial |
$465.00
|
| Rate for Payer: Quartz Beloit One Network |
$247.67
|
| Rate for Payer: Quartz Commercial |
$328.54
|
| Rate for Payer: Quartz Medicare Advantage |
$17.54
|
| Rate for Payer: The Alliance Commercial |
$70.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.54
|
| Rate for Payer: United Healthcare PPO |
$379.08
|
| Rate for Payer: WEA Trust Commercial |
$277.99
|
| Rate for Payer: Wellcare Medicare |
$17.54
|
| Rate for Payer: WPS Commercial |
$374.37
|
|
|
Carotene Level
|
Facility
|
OP
|
$502.00
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
977896
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$480.31 |
| Rate for Payer: Aetna Commercial |
$469.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$448.99
|
| Rate for Payer: Aetna Managed Medicare |
$9.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$35.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16.78
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15.92
|
| Rate for Payer: Anthem Medicare Advantage |
$9.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$276.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.59
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Cigna Commercial |
$480.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$292.16
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9.59
|
| Rate for Payer: Health EOS Commercial |
$464.65
|
| Rate for Payer: HFN Commercial |
$480.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9.59
|
| Rate for Payer: Multiplan Commercial |
$417.66
|
| Rate for Payer: NAPHCARE Commercial |
$14.38
|
| Rate for Payer: Preferred Network Access Commercial |
$480.31
|
| Rate for Payer: Quartz Beloit One Network |
$255.82
|
| Rate for Payer: Quartz Commercial |
$339.35
|
| Rate for Payer: Quartz Medicare Advantage |
$9.59
|
| Rate for Payer: The Alliance Commercial |
$38.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.59
|
| Rate for Payer: United Healthcare PPO |
$391.56
|
| Rate for Payer: WEA Trust Commercial |
$287.14
|
| Rate for Payer: Wellcare Medicare |
$9.59
|
| Rate for Payer: WPS Commercial |
$386.69
|
|
|
Carotene Level
|
Facility
|
IP
|
$502.00
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
977896
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$255.82 |
| Max. Negotiated Rate |
$480.31 |
| Rate for Payer: Aetna Commercial |
$469.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$448.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$276.70
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Cigna Commercial |
$480.31
|
| Rate for Payer: Health EOS Commercial |
$464.65
|
| Rate for Payer: HFN Commercial |
$480.31
|
| Rate for Payer: Multiplan Commercial |
$417.66
|
| Rate for Payer: Preferred Network Access Commercial |
$480.31
|
| Rate for Payer: Quartz Beloit One Network |
$255.82
|
| Rate for Payer: Quartz Commercial |
$313.25
|
| Rate for Payer: WEA Trust Commercial |
$287.14
|
| Rate for Payer: WPS Commercial |
$386.69
|
|
|
Carotene Level
|
Professional
|
Both
|
$502.00
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
977896
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$495.98 |
| Rate for Payer: Aetna Commercial |
$495.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$448.99
|
| Rate for Payer: Aetna Managed Medicare |
$9.59
|
| Rate for Payer: Anthem Medicare Advantage |
$9.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.59
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Cigna Commercial |
$495.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$261.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.59
|
| Rate for Payer: Health EOS Commercial |
$475.09
|
| Rate for Payer: HFN Commercial |
$495.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$33.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$33.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.59
|
| Rate for Payer: Multiplan Commercial |
$417.66
|
| Rate for Payer: NAPHCARE Commercial |
$14.38
|
| Rate for Payer: Preferred Network Access Commercial |
$495.98
|
| Rate for Payer: Quartz Beloit One Network |
$229.72
|
| Rate for Payer: Quartz Commercial |
$297.59
|
| Rate for Payer: Quartz Medicare Advantage |
$9.59
|
| Rate for Payer: The Alliance Commercial |
$37.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.59
|
| Rate for Payer: WEA Trust Commercial |
$287.14
|
| Rate for Payer: WPS Commercial |
$42.19
|
|
|
CAROTID ARTERY STENT PROCEDURES WITH CC
|
Facility
|
IP
|
$63,913.20
|
|
|
Service Code
|
MSDRG 035
|
| Min. Negotiated Rate |
$18,813.71 |
| Max. Negotiated Rate |
$63,913.20 |
| Rate for Payer: Aetna Managed Medicare |
$18,813.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$52,158.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$39,979.30
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$37,982.94
|
| Rate for Payer: Anthem Medicare Advantage |
$18,813.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,813.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,813.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,813.71
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$42,164.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,813.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46,633.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,813.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,813.71
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,813.71
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,813.71
|
| Rate for Payer: NAPHCARE Commercial |
$28,220.57
|
| Rate for Payer: Quartz Medicare Advantage |
$18,813.71
|
| Rate for Payer: The Alliance Commercial |
$63,913.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,813.71
|
| Rate for Payer: United Healthcare PPO |
$36,305.06
|
| Rate for Payer: Wellcare Medicare |
$18,813.71
|
|
|
CAROTID ARTERY STENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$108,204.72
|
|
|
Service Code
|
MSDRG 034
|
| Min. Negotiated Rate |
$30,149.36 |
| Max. Negotiated Rate |
$108,204.72 |
| Rate for Payer: Aetna Managed Medicare |
$30,149.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$84,455.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$64,734.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$61,502.02
|
| Rate for Payer: Anthem Medicare Advantage |
$30,149.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$30,149.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30,149.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$30,149.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$68,272.88
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$30,149.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$79,120.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30,149.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30,149.36
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$30,149.36
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$30,149.36
|
| Rate for Payer: NAPHCARE Commercial |
$45,224.04
|
| Rate for Payer: Quartz Medicare Advantage |
$30,149.36
|
| Rate for Payer: The Alliance Commercial |
$108,204.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,149.36
|
| Rate for Payer: United Healthcare PPO |
$61,596.24
|
| Rate for Payer: Wellcare Medicare |
$30,149.36
|
|
|
CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$50,328.72
|
|
|
Service Code
|
MSDRG 036
|
| Min. Negotiated Rate |
$15,385.13 |
| Max. Negotiated Rate |
$50,328.72 |
| Rate for Payer: Aetna Managed Medicare |
$15,385.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$42,390.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$32,491.85
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30,869.38
|
| Rate for Payer: Anthem Medicare Advantage |
$15,385.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15,385.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15,385.13
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15,385.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$34,267.84
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15,385.13
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$36,670.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15,385.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15,385.13
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15,385.13
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15,385.13
|
| Rate for Payer: NAPHCARE Commercial |
$23,077.69
|
| Rate for Payer: Quartz Medicare Advantage |
$15,385.13
|
| Rate for Payer: The Alliance Commercial |
$50,328.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,385.13
|
| Rate for Payer: United Healthcare PPO |
$28,548.29
|
| Rate for Payer: Wellcare Medicare |
$15,385.13
|
|
|
Carotid Bilateral 93880
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
5272960
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$172.73 |
| Max. Negotiated Rate |
$748.92 |
| Rate for Payer: Aetna Commercial |
$540.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$489.24
|
| Rate for Payer: Aetna Managed Medicare |
$187.23
|
| Rate for Payer: Anthem Medicare Advantage |
$187.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$187.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$187.23
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cigna Commercial |
$540.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$172.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$187.23
|
| Rate for Payer: Health EOS Commercial |
$517.68
|
| Rate for Payer: HFN Commercial |
$540.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$705.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$705.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$187.23
|
| Rate for Payer: Multiplan Commercial |
$455.10
|
| Rate for Payer: NAPHCARE Commercial |
$280.85
|
| Rate for Payer: Preferred Network Access Commercial |
$540.44
|
| Rate for Payer: Quartz Beloit One Network |
$250.31
|
| Rate for Payer: Quartz Commercial |
$324.26
|
| Rate for Payer: Quartz Medicare Advantage |
$187.23
|
| Rate for Payer: The Alliance Commercial |
$468.08
|
| Rate for Payer: United Healthcare Medicaid |
$172.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$187.23
|
| Rate for Payer: WEA Trust Commercial |
$312.88
|
| Rate for Payer: WPS Commercial |
$748.92
|
|
|
CAROTID BILATERAL 9388026
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
CPT 93880 26
|
| Hospital Charge Code |
3015428
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$30.72 |
| Max. Negotiated Rate |
$540.44 |
| Rate for Payer: Aetna Commercial |
$540.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$489.24
|
| Rate for Payer: Aetna Managed Medicare |
$36.83
|
| Rate for Payer: Anthem Medicare Advantage |
$36.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$36.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$36.83
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cigna Commercial |
$540.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$30.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$36.83
|
| Rate for Payer: Health EOS Commercial |
$517.68
|
| Rate for Payer: HFN Commercial |
$540.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$136.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$136.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$36.83
|
| Rate for Payer: Multiplan Commercial |
$455.10
|
| Rate for Payer: NAPHCARE Commercial |
$55.24
|
| Rate for Payer: Preferred Network Access Commercial |
$540.44
|
| Rate for Payer: Quartz Beloit One Network |
$250.31
|
| Rate for Payer: Quartz Commercial |
$324.26
|
| Rate for Payer: Quartz Medicare Advantage |
$36.83
|
| Rate for Payer: The Alliance Commercial |
$92.07
|
| Rate for Payer: United Healthcare Medicaid |
$30.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.83
|
| Rate for Payer: WEA Trust Commercial |
$312.88
|
| Rate for Payer: WPS Commercial |
$147.31
|
|
|
CAROTID ENDARTERECTOMY/ARTERY REPAIR
|
Facility
|
IP
|
$16,743.00
|
|
| Hospital Charge Code |
2959907
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,532.23 |
| Max. Negotiated Rate |
$16,019.70 |
| Rate for Payer: Aetna Commercial |
$15,671.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$14,974.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,228.74
|
| Rate for Payer: Cash Price |
$5,022.90
|
| Rate for Payer: Cigna Commercial |
$16,019.70
|
| Rate for Payer: Health EOS Commercial |
$15,497.32
|
| Rate for Payer: HFN Commercial |
$16,019.70
|
| Rate for Payer: Multiplan Commercial |
$13,930.18
|
| Rate for Payer: Preferred Network Access Commercial |
$16,019.70
|
| Rate for Payer: Quartz Beloit One Network |
$8,532.23
|
| Rate for Payer: Quartz Commercial |
$10,447.63
|
| Rate for Payer: WEA Trust Commercial |
$9,577.00
|
| Rate for Payer: WPS Commercial |
$12,897.13
|
|
|
CAROTID ENDARTERECTOMY/ARTERY REPAIR
|
Facility
|
OP
|
$16,743.00
|
|
| Hospital Charge Code |
2959907
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,875.56 |
| Max. Negotiated Rate |
$16,019.70 |
| Rate for Payer: Aetna Commercial |
$15,671.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$14,974.94
|
| Rate for Payer: Aetna Managed Medicare |
$4,875.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$11,318.27
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,706.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8,358.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,228.74
|
| Rate for Payer: Cash Price |
$5,022.90
|
| Rate for Payer: Cigna Commercial |
$16,019.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,744.43
|
| Rate for Payer: Health EOS Commercial |
$15,497.32
|
| Rate for Payer: HFN Commercial |
$16,019.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13,059.54
|
| Rate for Payer: Multiplan Commercial |
$13,930.18
|
| Rate for Payer: NAPHCARE Commercial |
$10,447.63
|
| Rate for Payer: Preferred Network Access Commercial |
$16,019.70
|
| Rate for Payer: Quartz Beloit One Network |
$8,532.23
|
| Rate for Payer: Quartz Commercial |
$11,318.27
|
| Rate for Payer: Quartz Medicare Advantage |
$10,447.63
|
| Rate for Payer: The Alliance Commercial |
$8,706.36
|
| Rate for Payer: WEA Trust Commercial |
$9,577.00
|
| Rate for Payer: WPS Commercial |
$12,897.13
|
|
|
Carotid Stent Intrathoracic Com/Innominate
|
Facility
|
OP
|
$1,918.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
4458575
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$558.52 |
| Max. Negotiated Rate |
$12,349.86 |
| Rate for Payer: Aetna Commercial |
$1,795.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,715.46
|
| Rate for Payer: Aetna Managed Medicare |
$558.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,057.20
|
| Rate for Payer: Cash Price |
$575.40
|
| Rate for Payer: Cash Price |
$575.40
|
| Rate for Payer: Cash Price |
$575.40
|
| Rate for Payer: Cigna Commercial |
$1,835.14
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Health EOS Commercial |
$1,775.30
|
| Rate for Payer: HFN Commercial |
$1,835.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,496.04
|
| Rate for Payer: Multiplan Commercial |
$1,595.78
|
| Rate for Payer: NAPHCARE Commercial |
$1,196.83
|
| Rate for Payer: Preferred Network Access Commercial |
$1,835.14
|
| Rate for Payer: Quartz Beloit One Network |
$977.41
|
| Rate for Payer: Quartz Commercial |
$1,296.57
|
| Rate for Payer: Quartz Medicare Advantage |
$1,196.83
|
| Rate for Payer: The Alliance Commercial |
$2,717.02
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$1,097.10
|
| Rate for Payer: WPS Commercial |
$1,477.44
|
|
|
Carotid Stent Intrathoracic Com/Innominate
|
Facility
|
IP
|
$1,918.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
4458575
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$977.41 |
| Max. Negotiated Rate |
$1,835.14 |
| Rate for Payer: Aetna Commercial |
$1,795.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,715.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,057.20
|
| Rate for Payer: Cash Price |
$575.40
|
| Rate for Payer: Cigna Commercial |
$1,835.14
|
| Rate for Payer: Health EOS Commercial |
$1,775.30
|
| Rate for Payer: HFN Commercial |
$1,835.14
|
| Rate for Payer: Multiplan Commercial |
$1,595.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,835.14
|
| Rate for Payer: Quartz Beloit One Network |
$977.41
|
| Rate for Payer: Quartz Commercial |
$1,196.83
|
| Rate for Payer: WEA Trust Commercial |
$1,097.10
|
| Rate for Payer: WPS Commercial |
$1,477.44
|
|
|
Carotid Stent W/Dist Embol Protection
|
Facility
|
IP
|
$15,006.00
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
3932028
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,647.06 |
| Max. Negotiated Rate |
$14,357.74 |
| Rate for Payer: Aetna Commercial |
$14,045.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$13,421.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$8,271.31
|
| Rate for Payer: Cash Price |
$4,501.80
|
| Rate for Payer: Cigna Commercial |
$14,357.74
|
| Rate for Payer: Health EOS Commercial |
$13,889.55
|
| Rate for Payer: HFN Commercial |
$14,357.74
|
| Rate for Payer: Multiplan Commercial |
$12,484.99
|
| Rate for Payer: Preferred Network Access Commercial |
$14,357.74
|
| Rate for Payer: Quartz Beloit One Network |
$7,647.06
|
| Rate for Payer: Quartz Commercial |
$9,363.74
|
| Rate for Payer: WEA Trust Commercial |
$8,583.43
|
| Rate for Payer: WPS Commercial |
$11,559.12
|
|
|
Carotid Stent W/Dist Embol Protection
|
Facility
|
OP
|
$15,006.00
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
3932028
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,228.53 |
| Max. Negotiated Rate |
$14,357.74 |
| Rate for Payer: Aetna Commercial |
$14,045.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$13,421.37
|
| Rate for Payer: Aetna Managed Medicare |
$4,369.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$8,271.31
|
| Rate for Payer: Cash Price |
$4,501.80
|
| Rate for Payer: Cash Price |
$4,501.80
|
| Rate for Payer: Cash Price |
$4,501.80
|
| Rate for Payer: Cigna Commercial |
$14,357.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Health EOS Commercial |
$13,889.55
|
| Rate for Payer: HFN Commercial |
$14,357.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,704.68
|
| Rate for Payer: Multiplan Commercial |
$12,484.99
|
| Rate for Payer: NAPHCARE Commercial |
$9,363.74
|
| Rate for Payer: Preferred Network Access Commercial |
$14,357.74
|
| Rate for Payer: Quartz Beloit One Network |
$7,647.06
|
| Rate for Payer: Quartz Commercial |
$10,144.06
|
| Rate for Payer: Quartz Medicare Advantage |
$9,363.74
|
| Rate for Payer: The Alliance Commercial |
$3,228.53
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$8,583.43
|
| Rate for Payer: WPS Commercial |
$11,559.12
|
|
|
Carotid Stent W/O Dist Embol Protect
|
Facility
|
IP
|
$15,006.00
|
|
|
Service Code
|
CPT 37216
|
| Hospital Charge Code |
3932033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,647.06 |
| Max. Negotiated Rate |
$14,357.74 |
| Rate for Payer: Aetna Commercial |
$14,045.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$13,421.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$8,271.31
|
| Rate for Payer: Cash Price |
$4,501.80
|
| Rate for Payer: Cigna Commercial |
$14,357.74
|
| Rate for Payer: Health EOS Commercial |
$13,889.55
|
| Rate for Payer: HFN Commercial |
$14,357.74
|
| Rate for Payer: Multiplan Commercial |
$12,484.99
|
| Rate for Payer: Preferred Network Access Commercial |
$14,357.74
|
| Rate for Payer: Quartz Beloit One Network |
$7,647.06
|
| Rate for Payer: Quartz Commercial |
$9,363.74
|
| Rate for Payer: WEA Trust Commercial |
$8,583.43
|
| Rate for Payer: WPS Commercial |
$11,559.12
|
|
|
Carotid Stent W/O Dist Embol Protect
|
Facility
|
OP
|
$15,006.00
|
|
|
Service Code
|
CPT 37216
|
| Hospital Charge Code |
3932033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,369.75 |
| Max. Negotiated Rate |
$18,182.32 |
| Rate for Payer: Aetna Commercial |
$14,045.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$13,421.37
|
| Rate for Payer: Aetna Managed Medicare |
$4,369.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,182.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,724.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,889.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$8,271.31
|
| Rate for Payer: Cash Price |
$4,501.80
|
| Rate for Payer: Cash Price |
$4,501.80
|
| Rate for Payer: Cash Price |
$4,501.80
|
| Rate for Payer: Cigna Commercial |
$14,357.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Health EOS Commercial |
$13,889.55
|
| Rate for Payer: HFN Commercial |
$14,357.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,704.68
|
| Rate for Payer: Multiplan Commercial |
$12,484.99
|
| Rate for Payer: NAPHCARE Commercial |
$9,363.74
|
| Rate for Payer: Preferred Network Access Commercial |
$14,357.74
|
| Rate for Payer: Quartz Beloit One Network |
$7,647.06
|
| Rate for Payer: Quartz Commercial |
$10,144.06
|
| Rate for Payer: Quartz Medicare Advantage |
$9,363.74
|
| Rate for Payer: The Alliance Commercial |
$7,803.12
|
| Rate for Payer: United Healthcare PPO |
$8,790.08
|
| Rate for Payer: WEA Trust Commercial |
$8,583.43
|
| Rate for Payer: WPS Commercial |
$11,559.12
|
|
|
Carotid Unilateral 93882
|
Professional
|
Both
|
$384.00
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
5272962
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$122.37 |
| Max. Negotiated Rate |
$489.47 |
| Rate for Payer: Aetna Commercial |
$379.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$343.45
|
| Rate for Payer: Aetna Managed Medicare |
$122.37
|
| Rate for Payer: Anthem Medicare Advantage |
$122.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$122.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$122.37
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$379.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$134.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$122.37
|
| Rate for Payer: Health EOS Commercial |
$363.42
|
| Rate for Payer: HFN Commercial |
$379.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$456.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$456.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$122.37
|
| Rate for Payer: Multiplan Commercial |
$319.49
|
| Rate for Payer: NAPHCARE Commercial |
$183.55
|
| Rate for Payer: Preferred Network Access Commercial |
$379.39
|
| Rate for Payer: Quartz Beloit One Network |
$175.72
|
| Rate for Payer: Quartz Commercial |
$227.64
|
| Rate for Payer: Quartz Medicare Advantage |
$122.37
|
| Rate for Payer: The Alliance Commercial |
$305.92
|
| Rate for Payer: United Healthcare Medicaid |
$134.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: WEA Trust Commercial |
$219.65
|
| Rate for Payer: WPS Commercial |
$489.47
|
|
|
CAROTID UNILATERAL 9388226
|
Professional
|
Both
|
$384.00
|
|
|
Service Code
|
CPT 93882 26
|
| Hospital Charge Code |
3015429
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.48 |
| Max. Negotiated Rate |
$379.39 |
| Rate for Payer: Aetna Commercial |
$379.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$343.45
|
| Rate for Payer: Aetna Managed Medicare |
$22.65
|
| Rate for Payer: Anthem Medicare Advantage |
$22.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$22.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$22.65
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$379.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$22.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$22.65
|
| Rate for Payer: Health EOS Commercial |
$363.42
|
| Rate for Payer: HFN Commercial |
$379.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$84.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$84.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$22.65
|
| Rate for Payer: Multiplan Commercial |
$319.49
|
| Rate for Payer: NAPHCARE Commercial |
$33.98
|
| Rate for Payer: Preferred Network Access Commercial |
$379.39
|
| Rate for Payer: Quartz Beloit One Network |
$175.72
|
| Rate for Payer: Quartz Commercial |
$227.64
|
| Rate for Payer: Quartz Medicare Advantage |
$22.65
|
| Rate for Payer: The Alliance Commercial |
$56.63
|
| Rate for Payer: United Healthcare Medicaid |
$22.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22.65
|
| Rate for Payer: WEA Trust Commercial |
$219.65
|
| Rate for Payer: WPS Commercial |
$90.60
|
|
|
CARPAL TUNNEL RELEASE
|
Facility
|
IP
|
$1,337.00
|
|
| Hospital Charge Code |
2959908
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$681.34 |
| Max. Negotiated Rate |
$1,279.24 |
| Rate for Payer: Aetna Commercial |
$1,251.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,195.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$736.95
|
| Rate for Payer: Cash Price |
$401.10
|
| Rate for Payer: Cigna Commercial |
$1,279.24
|
| Rate for Payer: Health EOS Commercial |
$1,237.53
|
| Rate for Payer: HFN Commercial |
$1,279.24
|
| Rate for Payer: Multiplan Commercial |
$1,112.38
|
| Rate for Payer: Preferred Network Access Commercial |
$1,279.24
|
| Rate for Payer: Quartz Beloit One Network |
$681.34
|
| Rate for Payer: Quartz Commercial |
$834.29
|
| Rate for Payer: WEA Trust Commercial |
$764.76
|
| Rate for Payer: WPS Commercial |
$1,029.89
|
|
|
CARPAL TUNNEL RELEASE
|
Facility
|
OP
|
$1,337.00
|
|
| Hospital Charge Code |
2959908
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$389.33 |
| Max. Negotiated Rate |
$1,279.24 |
| Rate for Payer: Aetna Commercial |
$1,251.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,195.81
|
| Rate for Payer: Aetna Managed Medicare |
$389.33
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$903.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$695.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$667.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$736.95
|
| Rate for Payer: Cash Price |
$401.10
|
| Rate for Payer: Cigna Commercial |
$1,279.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$778.13
|
| Rate for Payer: Health EOS Commercial |
$1,237.53
|
| Rate for Payer: HFN Commercial |
$1,279.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,042.86
|
| Rate for Payer: Multiplan Commercial |
$1,112.38
|
| Rate for Payer: NAPHCARE Commercial |
$834.29
|
| Rate for Payer: Preferred Network Access Commercial |
$1,279.24
|
| Rate for Payer: Quartz Beloit One Network |
$681.34
|
| Rate for Payer: Quartz Commercial |
$903.81
|
| Rate for Payer: Quartz Medicare Advantage |
$834.29
|
| Rate for Payer: The Alliance Commercial |
$695.24
|
| Rate for Payer: WEA Trust Commercial |
$764.76
|
| Rate for Payer: WPS Commercial |
$1,029.89
|
|
|
CARPAL TUNNEL RELEASE, ENDOSCOPIC
|
Facility
|
IP
|
$6,866.00
|
|
| Hospital Charge Code |
2960008
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,498.91 |
| Max. Negotiated Rate |
$6,569.39 |
| Rate for Payer: Aetna Commercial |
$6,426.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,140.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,784.54
|
| Rate for Payer: Cash Price |
$2,059.80
|
| Rate for Payer: Cigna Commercial |
$6,569.39
|
| Rate for Payer: Health EOS Commercial |
$6,355.17
|
| Rate for Payer: HFN Commercial |
$6,569.39
|
| Rate for Payer: Multiplan Commercial |
$5,712.51
|
| Rate for Payer: Preferred Network Access Commercial |
$6,569.39
|
| Rate for Payer: Quartz Beloit One Network |
$3,498.91
|
| Rate for Payer: Quartz Commercial |
$4,284.38
|
| Rate for Payer: WEA Trust Commercial |
$3,927.35
|
| Rate for Payer: WPS Commercial |
$5,288.88
|
|
