|
CARDIOMYOPATHY
|
Facility
|
IP
|
$5,085.62
|
|
|
Service Code
|
APR-DRG 2051
|
| Min. Negotiated Rate |
$4,517.36 |
| Max. Negotiated Rate |
$5,085.62 |
| Rate for Payer: Anthem Medicaid |
$4,869.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$4,869.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,869.76
|
| Rate for Payer: Dean Health Medicaid |
$4,869.76
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4,517.36
|
| Rate for Payer: Managed Health Services Medicaid |
$5,085.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,869.76
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4,869.76
|
| Rate for Payer: United Healthcare Medicaid |
$4,869.76
|
|
|
CARDIOMYOPATHY
|
Facility
|
IP
|
$18,676.50
|
|
|
Service Code
|
APR-DRG 2054
|
| Min. Negotiated Rate |
$16,589.63 |
| Max. Negotiated Rate |
$18,676.50 |
| Rate for Payer: Anthem Medicaid |
$17,883.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$17,883.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17,883.78
|
| Rate for Payer: Dean Health Medicaid |
$17,883.78
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,589.63
|
| Rate for Payer: Managed Health Services Medicaid |
$18,676.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$17,883.78
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17,883.78
|
| Rate for Payer: United Healthcare Medicaid |
$17,883.78
|
|
|
CARDIOMYOPATHY DIAGNOSES
|
Facility
|
OP
|
$26.77
|
|
|
Service Code
|
EAPG 00607
|
| Min. Negotiated Rate |
$25.74 |
| Max. Negotiated Rate |
$26.77 |
| Rate for Payer: Anthem Medicaid |
$25.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$25.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.74
|
| Rate for Payer: Dean Health Medicaid |
$25.74
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$25.74
|
| Rate for Payer: Managed Health Services Medicaid |
$26.77
|
| Rate for Payer: Molina Healthcare Medicaid |
$25.74
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$25.74
|
| Rate for Payer: United Healthcare Medicaid |
$25.74
|
|
|
CARDIOVASCULAR STRESS TEST 93015
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
CPT 93015
|
| Hospital Charge Code |
3015355
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$73.37 |
| Max. Negotiated Rate |
$476.22 |
| Rate for Payer: Aetna Commercial |
$476.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$431.10
|
| Rate for Payer: Aetna Managed Medicare |
$73.37
|
| Rate for Payer: Anthem Medicare Advantage |
$73.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$73.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$73.37
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cigna Commercial |
$476.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$95.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$73.37
|
| Rate for Payer: Health EOS Commercial |
$456.16
|
| Rate for Payer: HFN Commercial |
$476.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$250.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$250.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$73.37
|
| Rate for Payer: Multiplan Commercial |
$401.02
|
| Rate for Payer: NAPHCARE Commercial |
$110.06
|
| Rate for Payer: Preferred Network Access Commercial |
$476.22
|
| Rate for Payer: Quartz Beloit One Network |
$220.56
|
| Rate for Payer: Quartz Commercial |
$285.73
|
| Rate for Payer: Quartz Medicare Advantage |
$73.37
|
| Rate for Payer: The Alliance Commercial |
$278.81
|
| Rate for Payer: United Healthcare Medicaid |
$95.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$73.37
|
| Rate for Payer: WEA Trust Commercial |
$275.70
|
| Rate for Payer: WPS Commercial |
$293.49
|
|
|
Cardioversion
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
3114196
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$600.31 |
| Max. Negotiated Rate |
$1,127.11 |
| Rate for Payer: Aetna Commercial |
$1,102.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,053.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$649.31
|
| Rate for Payer: Cash Price |
$353.40
|
| Rate for Payer: Cigna Commercial |
$1,127.11
|
| Rate for Payer: Health EOS Commercial |
$1,090.36
|
| Rate for Payer: HFN Commercial |
$1,127.11
|
| Rate for Payer: Multiplan Commercial |
$980.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,127.11
|
| Rate for Payer: Quartz Beloit One Network |
$600.31
|
| Rate for Payer: Quartz Commercial |
$735.07
|
| Rate for Payer: WEA Trust Commercial |
$673.82
|
| Rate for Payer: WPS Commercial |
$907.41
|
|
|
Cardioversion
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
3114196
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$588.06 |
| Max. Negotiated Rate |
$2,782.29 |
| Rate for Payer: Aetna Commercial |
$1,102.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,053.60
|
| Rate for Payer: Aetna Managed Medicare |
$695.57
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$796.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$612.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$588.06
|
| Rate for Payer: Anthem Medicare Advantage |
$695.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$649.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$695.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$695.57
|
| Rate for Payer: Cash Price |
$353.40
|
| Rate for Payer: Cash Price |
$353.40
|
| Rate for Payer: Cigna Commercial |
$1,127.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$695.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$685.60
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$695.57
|
| Rate for Payer: Health EOS Commercial |
$1,090.36
|
| Rate for Payer: HFN Commercial |
$1,127.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,587.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$695.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$695.57
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$695.57
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$695.57
|
| Rate for Payer: Multiplan Commercial |
$980.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,043.36
|
| Rate for Payer: Preferred Network Access Commercial |
$1,127.11
|
| Rate for Payer: Quartz Beloit One Network |
$600.31
|
| Rate for Payer: Quartz Commercial |
$796.33
|
| Rate for Payer: Quartz Medicare Advantage |
$695.57
|
| Rate for Payer: The Alliance Commercial |
$2,782.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$695.57
|
| Rate for Payer: WEA Trust Commercial |
$673.82
|
| Rate for Payer: Wellcare Medicare |
$695.57
|
| Rate for Payer: WPS Commercial |
$907.41
|
|
|
CARDIOVERSION
|
Facility
|
OP
|
$140.04
|
|
|
Service Code
|
EAPG 00093
|
| Min. Negotiated Rate |
$134.65 |
| Max. Negotiated Rate |
$140.04 |
| Rate for Payer: Anthem Medicaid |
$134.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$134.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$134.65
|
| Rate for Payer: Dean Health Medicaid |
$134.65
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$134.65
|
| Rate for Payer: Managed Health Services Medicaid |
$140.04
|
| Rate for Payer: Molina Healthcare Medicaid |
$134.65
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$134.65
|
| Rate for Payer: United Healthcare Medicaid |
$134.65
|
|
|
Cardioversion Electric,EXT 92960
|
Professional
|
Both
|
$607.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
3227480
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$93.96 |
| Max. Negotiated Rate |
$599.72 |
| Rate for Payer: Aetna Commercial |
$599.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$542.90
|
| Rate for Payer: Aetna Managed Medicare |
$93.96
|
| Rate for Payer: Anthem Medicare Advantage |
$93.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$93.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$93.96
|
| Rate for Payer: Cash Price |
$182.10
|
| Rate for Payer: Cash Price |
$182.10
|
| Rate for Payer: Cash Price |
$182.10
|
| Rate for Payer: Cigna Commercial |
$599.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$249.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$93.96
|
| Rate for Payer: Health EOS Commercial |
$574.46
|
| Rate for Payer: HFN Commercial |
$599.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$383.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$383.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$93.96
|
| Rate for Payer: Multiplan Commercial |
$505.02
|
| Rate for Payer: NAPHCARE Commercial |
$140.95
|
| Rate for Payer: Preferred Network Access Commercial |
$599.72
|
| Rate for Payer: Quartz Beloit One Network |
$277.76
|
| Rate for Payer: Quartz Commercial |
$359.83
|
| Rate for Payer: Quartz Medicare Advantage |
$93.96
|
| Rate for Payer: The Alliance Commercial |
$357.06
|
| Rate for Payer: United Healthcare Medicaid |
$249.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$93.96
|
| Rate for Payer: WEA Trust Commercial |
$347.20
|
| Rate for Payer: WPS Commercial |
$375.86
|
|
|
Cardioversion Electric,EXT 9296026
|
Professional
|
Both
|
$607.00
|
|
|
Service Code
|
CPT 92960 26
|
| Hospital Charge Code |
4634616
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$249.56 |
| Max. Negotiated Rate |
$599.72 |
| Rate for Payer: Aetna Commercial |
$599.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$542.90
|
| Rate for Payer: Cash Price |
$182.10
|
| Rate for Payer: Cash Price |
$182.10
|
| Rate for Payer: Cash Price |
$182.10
|
| Rate for Payer: Cigna Commercial |
$599.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$249.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$378.77
|
| Rate for Payer: Health EOS Commercial |
$574.46
|
| Rate for Payer: HFN Commercial |
$599.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$383.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$383.75
|
| Rate for Payer: Multiplan Commercial |
$505.02
|
| Rate for Payer: Preferred Network Access Commercial |
$599.72
|
| Rate for Payer: Quartz Beloit One Network |
$277.76
|
| Rate for Payer: Quartz Commercial |
$359.83
|
| Rate for Payer: The Alliance Commercial |
$315.64
|
| Rate for Payer: United Healthcare Medicaid |
$249.56
|
| Rate for Payer: WEA Trust Commercial |
$347.20
|
| Rate for Payer: WPS Commercial |
$467.57
|
|
|
Cardioversion Performed By
|
Facility
|
IP
|
$6,028.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
2844880
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,071.87 |
| Max. Negotiated Rate |
$5,767.59 |
| Rate for Payer: Aetna Commercial |
$5,642.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,391.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,322.63
|
| Rate for Payer: Cash Price |
$1,808.40
|
| Rate for Payer: Cigna Commercial |
$5,767.59
|
| Rate for Payer: Health EOS Commercial |
$5,579.52
|
| Rate for Payer: HFN Commercial |
$5,767.59
|
| Rate for Payer: Multiplan Commercial |
$5,015.30
|
| Rate for Payer: Preferred Network Access Commercial |
$5,767.59
|
| Rate for Payer: Quartz Beloit One Network |
$3,071.87
|
| Rate for Payer: Quartz Commercial |
$3,761.47
|
| Rate for Payer: WEA Trust Commercial |
$3,448.02
|
| Rate for Payer: WPS Commercial |
$4,643.37
|
|
|
Cardioversion Performed By
|
Facility
|
OP
|
$6,028.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
2844880
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.04 |
| Max. Negotiated Rate |
$5,767.59 |
| Rate for Payer: Aetna Commercial |
$5,642.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,391.44
|
| Rate for Payer: Aetna Managed Medicare |
$695.57
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,074.93
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,134.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,009.18
|
| Rate for Payer: Anthem Medicare Advantage |
$695.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,322.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$695.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$695.57
|
| Rate for Payer: Cash Price |
$1,808.40
|
| Rate for Payer: Cash Price |
$1,808.40
|
| Rate for Payer: Cash Price |
$1,808.40
|
| Rate for Payer: Cigna Commercial |
$5,767.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$695.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,508.30
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$695.57
|
| Rate for Payer: Health EOS Commercial |
$5,579.52
|
| Rate for Payer: HFN Commercial |
$5,767.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,587.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$695.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$695.57
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$695.57
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$695.57
|
| Rate for Payer: Multiplan Commercial |
$5,015.30
|
| Rate for Payer: NAPHCARE Commercial |
$1,043.36
|
| Rate for Payer: Preferred Network Access Commercial |
$5,767.59
|
| Rate for Payer: Quartz Beloit One Network |
$3,071.87
|
| Rate for Payer: Quartz Commercial |
$4,074.93
|
| Rate for Payer: Quartz Medicare Advantage |
$695.57
|
| Rate for Payer: The Alliance Commercial |
$2,782.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$695.57
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$3,448.02
|
| Rate for Payer: Wellcare Medicare |
$695.57
|
| Rate for Payer: WPS Commercial |
$4,643.37
|
|
|
CARE OF MISCARRIAGE 59820
|
Professional
|
Both
|
$1,461.00
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
3015170
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$323.11 |
| Max. Negotiated Rate |
$1,453.98 |
| Rate for Payer: Aetna Commercial |
$1,443.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,306.72
|
| Rate for Payer: Aetna Managed Medicare |
$323.11
|
| Rate for Payer: Anthem Medicare Advantage |
$323.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$323.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$323.11
|
| Rate for Payer: Cash Price |
$438.30
|
| Rate for Payer: Cash Price |
$438.30
|
| Rate for Payer: Cash Price |
$438.30
|
| Rate for Payer: Cigna Commercial |
$1,443.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$338.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$323.11
|
| Rate for Payer: Health EOS Commercial |
$1,382.69
|
| Rate for Payer: HFN Commercial |
$1,443.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,281.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,281.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$323.11
|
| Rate for Payer: Multiplan Commercial |
$1,215.55
|
| Rate for Payer: NAPHCARE Commercial |
$484.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,443.47
|
| Rate for Payer: Quartz Beloit One Network |
$668.55
|
| Rate for Payer: Quartz Commercial |
$866.08
|
| Rate for Payer: Quartz Medicare Advantage |
$323.11
|
| Rate for Payer: The Alliance Commercial |
$1,373.21
|
| Rate for Payer: United Healthcare Medicaid |
$338.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$323.11
|
| Rate for Payer: WEA Trust Commercial |
$835.69
|
| Rate for Payer: WPS Commercial |
$1,453.98
|
|
|
Carnitine Free and Total
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
977895
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$216.58 |
| Max. Negotiated Rate |
$406.64 |
| Rate for Payer: Aetna Commercial |
$397.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$380.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$234.26
|
| Rate for Payer: Cash Price |
$127.50
|
| Rate for Payer: Cigna Commercial |
$406.64
|
| Rate for Payer: Health EOS Commercial |
$393.38
|
| Rate for Payer: HFN Commercial |
$406.64
|
| Rate for Payer: Multiplan Commercial |
$353.60
|
| Rate for Payer: Preferred Network Access Commercial |
$406.64
|
| Rate for Payer: Quartz Beloit One Network |
$216.58
|
| Rate for Payer: Quartz Commercial |
$265.20
|
| Rate for Payer: WEA Trust Commercial |
$243.10
|
| Rate for Payer: WPS Commercial |
$327.38
|
|
|
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 Free and Total
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
977895
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$406.64 |
| Rate for Payer: Aetna Commercial |
$397.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$380.12
|
| 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 |
$234.26
|
| 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 |
$406.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$247.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.54
|
| Rate for Payer: Health EOS Commercial |
$393.38
|
| Rate for Payer: HFN Commercial |
$406.64
|
| 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 |
$353.60
|
| Rate for Payer: NAPHCARE Commercial |
$26.32
|
| Rate for Payer: Preferred Network Access Commercial |
$406.64
|
| Rate for Payer: Quartz Beloit One Network |
$216.58
|
| Rate for Payer: Quartz Commercial |
$287.30
|
| 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 |
$331.50
|
| Rate for Payer: WEA Trust Commercial |
$243.10
|
| Rate for Payer: Wellcare Medicare |
$17.54
|
| Rate for Payer: WPS Commercial |
$327.38
|
|
|
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
|
|
|
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
|
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
|
|
|
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
|
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
|
|
|
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
|
|
|
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
|
|
