|
Chlamydophila pneumoniae Antibodies
|
Facility
OP
|
$16.00
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
5569258
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$64.00 |
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$13.76
|
| Rate for Payer: Aetna Managed Medicare |
$11.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$44.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19.62
|
| Rate for Payer: Anthem Medicaid |
$8.17
|
| Rate for Payer: Anthem Medicare Advantage |
$11.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$8.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.82
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna Commercial |
$14.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11.82
|
| Rate for Payer: Health EOS Commercial |
$14.24
|
| Rate for Payer: HFN Commercial |
$14.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$43.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11.82
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.82
|
| Rate for Payer: Managed Health Services Medicaid |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11.82
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: NAPHCARE Commercial |
$17.73
|
| Rate for Payer: Preferred Network Access Commercial |
$14.72
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.17
|
| Rate for Payer: Quartz Beloit One Network |
$7.84
|
| Rate for Payer: Quartz Commercial |
$10.40
|
| Rate for Payer: Quartz Medicare Advantage |
$11.82
|
| Rate for Payer: The Alliance Commercial |
$64.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.82
|
| Rate for Payer: United Healthcare PPO |
$12.00
|
| Rate for Payer: WEA Trust Commercial |
$8.80
|
| Rate for Payer: Wellcare Medicare |
$11.82
|
| Rate for Payer: WMAP Medicaid |
$8.17
|
| Rate for Payer: WPS Commercial |
$11.85
|
|
|
Chlamydophila pneumoniae Antibodies
|
Facility
IP
|
$16.00
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
5569258
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$14.72 |
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$8.48
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna Commercial |
$14.72
|
| Rate for Payer: Health EOS Commercial |
$14.24
|
| Rate for Payer: HFN Commercial |
$14.72
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: NAPHCARE Commercial |
$9.60
|
| Rate for Payer: Preferred Network Access Commercial |
$14.72
|
| Rate for Payer: Quartz Beloit One Network |
$7.84
|
| Rate for Payer: Quartz Commercial |
$9.60
|
| Rate for Payer: WEA Trust Commercial |
$8.80
|
| Rate for Payer: WPS Commercial |
$11.85
|
|
|
Chlamydophila pneumoniae IgA
|
Facility
OP
|
$16.00
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
5569281
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$64.00 |
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$13.76
|
| Rate for Payer: Aetna Managed Medicare |
$11.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$44.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19.62
|
| Rate for Payer: Anthem Medicaid |
$8.17
|
| Rate for Payer: Anthem Medicare Advantage |
$11.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$8.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.82
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna Commercial |
$14.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11.82
|
| Rate for Payer: Health EOS Commercial |
$14.24
|
| Rate for Payer: HFN Commercial |
$14.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$43.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11.82
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.82
|
| Rate for Payer: Managed Health Services Medicaid |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11.82
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: NAPHCARE Commercial |
$17.73
|
| Rate for Payer: Preferred Network Access Commercial |
$14.72
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.17
|
| Rate for Payer: Quartz Beloit One Network |
$7.84
|
| Rate for Payer: Quartz Commercial |
$10.40
|
| Rate for Payer: Quartz Medicare Advantage |
$11.82
|
| Rate for Payer: The Alliance Commercial |
$64.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.82
|
| Rate for Payer: United Healthcare PPO |
$12.00
|
| Rate for Payer: WEA Trust Commercial |
$8.80
|
| Rate for Payer: Wellcare Medicare |
$11.82
|
| Rate for Payer: WMAP Medicaid |
$8.17
|
| Rate for Payer: WPS Commercial |
$11.85
|
|
|
Chlamydophila pneumoniae IgA
|
Professional
|
$16.00
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
5569281
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.04 |
| Max. Negotiated Rate |
$52.01 |
| Rate for Payer: Aetna Commercial |
$15.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$13.76
|
| Rate for Payer: Aetna Managed Medicare |
$11.82
|
| Rate for Payer: Anthem Medicare Advantage |
$11.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.82
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna Commercial |
$15.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11.82
|
| Rate for Payer: Health EOS Commercial |
$14.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$41.72
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$41.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.82
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Preferred Network Access Commercial |
$15.20
|
| Rate for Payer: Quartz Beloit One Network |
$7.04
|
| Rate for Payer: Quartz Commercial |
$9.12
|
| Rate for Payer: Quartz Medicare Advantage |
$11.82
|
| Rate for Payer: The Alliance Commercial |
$46.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.82
|
| Rate for Payer: WEA Trust Commercial |
$8.80
|
| Rate for Payer: WPS Commercial |
$52.01
|
|
|
Chlamydophila pneumoniae IgA
|
Facility
IP
|
$16.00
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
5569281
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$14.72 |
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$8.48
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna Commercial |
$14.72
|
| Rate for Payer: Health EOS Commercial |
$14.24
|
| Rate for Payer: HFN Commercial |
$14.72
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: NAPHCARE Commercial |
$9.60
|
| Rate for Payer: Preferred Network Access Commercial |
$14.72
|
| Rate for Payer: Quartz Beloit One Network |
$7.84
|
| Rate for Payer: Quartz Commercial |
$9.60
|
| Rate for Payer: WEA Trust Commercial |
$8.80
|
| Rate for Payer: WPS Commercial |
$11.85
|
|
|
Chlamydophila pneumoniae IgM
|
Professional
|
$16.00
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
5569282
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.04 |
| Max. Negotiated Rate |
$55.79 |
| Rate for Payer: Aetna Commercial |
$15.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$13.76
|
| Rate for Payer: Aetna Managed Medicare |
$12.68
|
| Rate for Payer: Anthem Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.68
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna Commercial |
$15.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.68
|
| Rate for Payer: Health EOS Commercial |
$14.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$44.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.68
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Preferred Network Access Commercial |
$15.20
|
| Rate for Payer: Quartz Beloit One Network |
$7.04
|
| Rate for Payer: Quartz Commercial |
$9.12
|
| Rate for Payer: Quartz Medicare Advantage |
$12.68
|
| Rate for Payer: The Alliance Commercial |
$50.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.68
|
| Rate for Payer: WEA Trust Commercial |
$8.80
|
| Rate for Payer: WPS Commercial |
$55.79
|
|
|
Chlamydophila pneumoniae IgM
|
Facility
OP
|
$16.00
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
5569282
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$64.00 |
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$13.76
|
| Rate for Payer: Aetna Managed Medicare |
$12.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$47.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22.19
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21.05
|
| Rate for Payer: Anthem Medicaid |
$8.17
|
| Rate for Payer: Anthem Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$8.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.68
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna Commercial |
$14.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.68
|
| Rate for Payer: Health EOS Commercial |
$14.24
|
| Rate for Payer: HFN Commercial |
$14.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$47.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.68
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.68
|
| Rate for Payer: Managed Health Services Medicaid |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.68
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: NAPHCARE Commercial |
$19.02
|
| Rate for Payer: Preferred Network Access Commercial |
$14.72
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.17
|
| Rate for Payer: Quartz Beloit One Network |
$7.84
|
| Rate for Payer: Quartz Commercial |
$10.40
|
| Rate for Payer: Quartz Medicare Advantage |
$12.68
|
| Rate for Payer: The Alliance Commercial |
$64.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.68
|
| Rate for Payer: United Healthcare PPO |
$12.00
|
| Rate for Payer: WEA Trust Commercial |
$8.80
|
| Rate for Payer: Wellcare Medicare |
$12.68
|
| Rate for Payer: WMAP Medicaid |
$8.17
|
| Rate for Payer: WPS Commercial |
$11.85
|
|
|
Chlamydophila pneumoniae IgM
|
Facility
IP
|
$16.00
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
5569282
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$14.72 |
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$8.48
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna Commercial |
$14.72
|
| Rate for Payer: Health EOS Commercial |
$14.24
|
| Rate for Payer: HFN Commercial |
$14.72
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: NAPHCARE Commercial |
$9.60
|
| Rate for Payer: Preferred Network Access Commercial |
$14.72
|
| Rate for Payer: Quartz Beloit One Network |
$7.84
|
| Rate for Payer: Quartz Commercial |
$9.60
|
| Rate for Payer: WEA Trust Commercial |
$8.80
|
| Rate for Payer: WPS Commercial |
$11.85
|
|
|
Chloride Level
|
Facility
IP
|
$70.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
633621
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.30 |
| Max. Negotiated Rate |
$64.40 |
| Rate for Payer: Aetna Commercial |
$63.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$37.10
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$64.40
|
| Rate for Payer: Health EOS Commercial |
$62.30
|
| Rate for Payer: HFN Commercial |
$64.40
|
| Rate for Payer: Multiplan Commercial |
$56.00
|
| Rate for Payer: NAPHCARE Commercial |
$42.00
|
| Rate for Payer: Preferred Network Access Commercial |
$64.40
|
| Rate for Payer: Quartz Beloit One Network |
$34.30
|
| Rate for Payer: Quartz Commercial |
$42.00
|
| Rate for Payer: WEA Trust Commercial |
$38.50
|
| Rate for Payer: WPS Commercial |
$51.85
|
|
|
Chloride Level
|
Facility
OP
|
$70.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
633621
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: Aetna Commercial |
$63.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$60.20
|
| Rate for Payer: Aetna Managed Medicare |
$4.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.05
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7.64
|
| Rate for Payer: Anthem Medicaid |
$4.75
|
| Rate for Payer: Anthem Medicare Advantage |
$4.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$37.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.60
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$64.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.75
|
| Rate for Payer: Dean Health Medicaid |
$4.75
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.60
|
| Rate for Payer: Health EOS Commercial |
$62.30
|
| Rate for Payer: HFN Commercial |
$64.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.60
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.60
|
| Rate for Payer: Managed Health Services Medicaid |
$4.94
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$56.00
|
| Rate for Payer: NAPHCARE Commercial |
$6.90
|
| Rate for Payer: Preferred Network Access Commercial |
$64.40
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.75
|
| Rate for Payer: Quartz Beloit One Network |
$34.30
|
| Rate for Payer: Quartz Commercial |
$45.50
|
| Rate for Payer: Quartz Medicare Advantage |
$4.60
|
| Rate for Payer: The Alliance Commercial |
$280.00
|
| Rate for Payer: United Healthcare Medicaid |
$4.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.60
|
| Rate for Payer: United Healthcare PPO |
$52.50
|
| Rate for Payer: WEA Trust Commercial |
$38.50
|
| Rate for Payer: Wellcare Medicare |
$4.60
|
| Rate for Payer: WMAP Medicaid |
$4.75
|
| Rate for Payer: WPS Commercial |
$51.85
|
|
|
Chloride Level
|
Professional
|
$70.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
633621
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$66.50 |
| Rate for Payer: Aetna Commercial |
$66.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$60.20
|
| Rate for Payer: Aetna Managed Medicare |
$4.60
|
| Rate for Payer: Anthem Medicare Advantage |
$4.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.60
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$66.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$35.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.60
|
| Rate for Payer: Health EOS Commercial |
$63.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$16.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$56.00
|
| Rate for Payer: Preferred Network Access Commercial |
$66.50
|
| Rate for Payer: Quartz Beloit One Network |
$30.80
|
| Rate for Payer: Quartz Commercial |
$39.90
|
| Rate for Payer: Quartz Medicare Advantage |
$4.60
|
| Rate for Payer: The Alliance Commercial |
$18.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.60
|
| Rate for Payer: WEA Trust Commercial |
$38.50
|
| Rate for Payer: WPS Commercial |
$20.24
|
|
|
Chloride Random Urine
|
Facility
OP
|
$38.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
3304824
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$152.00 |
| Rate for Payer: Aetna Commercial |
$34.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$32.68
|
| Rate for Payer: Aetna Managed Medicare |
$5.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$21.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.06
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.54
|
| Rate for Payer: Anthem Medicaid |
$5.94
|
| Rate for Payer: Anthem Medicare Advantage |
$5.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$20.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.75
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cigna Commercial |
$34.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.94
|
| Rate for Payer: Dean Health Medicaid |
$5.94
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.75
|
| Rate for Payer: Health EOS Commercial |
$33.82
|
| Rate for Payer: HFN Commercial |
$34.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.75
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.75
|
| Rate for Payer: Managed Health Services Medicaid |
$6.18
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.75
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.75
|
| Rate for Payer: Multiplan Commercial |
$30.40
|
| Rate for Payer: NAPHCARE Commercial |
$8.62
|
| Rate for Payer: Preferred Network Access Commercial |
$34.96
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.94
|
| Rate for Payer: Quartz Beloit One Network |
$18.62
|
| Rate for Payer: Quartz Commercial |
$24.70
|
| Rate for Payer: Quartz Medicare Advantage |
$5.75
|
| Rate for Payer: The Alliance Commercial |
$152.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.75
|
| Rate for Payer: United Healthcare PPO |
$28.50
|
| Rate for Payer: WEA Trust Commercial |
$20.90
|
| Rate for Payer: Wellcare Medicare |
$5.75
|
| Rate for Payer: WMAP Medicaid |
$5.94
|
| Rate for Payer: WPS Commercial |
$28.15
|
|
|
Chloride Random Urine
|
Professional
|
$38.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
3304824
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$36.10 |
| Rate for Payer: Aetna Commercial |
$36.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$32.68
|
| Rate for Payer: Aetna Managed Medicare |
$5.75
|
| Rate for Payer: Anthem Medicare Advantage |
$5.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.75
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cigna Commercial |
$36.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.75
|
| Rate for Payer: Health EOS Commercial |
$34.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.75
|
| Rate for Payer: Multiplan Commercial |
$30.40
|
| Rate for Payer: Preferred Network Access Commercial |
$36.10
|
| Rate for Payer: Quartz Beloit One Network |
$16.72
|
| Rate for Payer: Quartz Commercial |
$21.66
|
| Rate for Payer: Quartz Medicare Advantage |
$5.75
|
| Rate for Payer: The Alliance Commercial |
$22.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.75
|
| Rate for Payer: WEA Trust Commercial |
$20.90
|
| Rate for Payer: WPS Commercial |
$25.30
|
|
|
Chloride Random Urine
|
Facility
IP
|
$38.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
3304824
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.62 |
| Max. Negotiated Rate |
$34.96 |
| Rate for Payer: Aetna Commercial |
$34.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$20.14
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cigna Commercial |
$34.96
|
| Rate for Payer: Health EOS Commercial |
$33.82
|
| Rate for Payer: HFN Commercial |
$34.96
|
| Rate for Payer: Multiplan Commercial |
$30.40
|
| Rate for Payer: NAPHCARE Commercial |
$22.80
|
| Rate for Payer: Preferred Network Access Commercial |
$34.96
|
| Rate for Payer: Quartz Beloit One Network |
$18.62
|
| Rate for Payer: Quartz Commercial |
$22.80
|
| Rate for Payer: WEA Trust Commercial |
$20.90
|
| Rate for Payer: WPS Commercial |
$28.15
|
|
|
Chloride Stool
|
Facility
IP
|
$145.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
2942897
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$71.05 |
| Max. Negotiated Rate |
$133.40 |
| Rate for Payer: Aetna Commercial |
$130.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$76.85
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cigna Commercial |
$133.40
|
| Rate for Payer: Health EOS Commercial |
$129.05
|
| Rate for Payer: HFN Commercial |
$133.40
|
| Rate for Payer: Multiplan Commercial |
$116.00
|
| Rate for Payer: NAPHCARE Commercial |
$87.00
|
| Rate for Payer: Preferred Network Access Commercial |
$133.40
|
| Rate for Payer: Quartz Beloit One Network |
$71.05
|
| Rate for Payer: Quartz Commercial |
$87.00
|
| Rate for Payer: WEA Trust Commercial |
$79.75
|
| Rate for Payer: WPS Commercial |
$107.40
|
|
|
Chloride Stool
|
Facility
OP
|
$145.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
2942897
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$580.00 |
| Rate for Payer: Aetna Commercial |
$130.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$124.70
|
| Rate for Payer: Aetna Managed Medicare |
$5.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.75
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.30
|
| Rate for Payer: Anthem Medicaid |
$5.17
|
| Rate for Payer: Anthem Medicare Advantage |
$5.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$76.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.00
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cigna Commercial |
$133.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.17
|
| Rate for Payer: Dean Health Medicaid |
$5.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.00
|
| Rate for Payer: Health EOS Commercial |
$129.05
|
| Rate for Payer: HFN Commercial |
$133.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.00
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.00
|
| Rate for Payer: Managed Health Services Medicaid |
$5.38
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.00
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$116.00
|
| Rate for Payer: NAPHCARE Commercial |
$7.50
|
| Rate for Payer: Preferred Network Access Commercial |
$133.40
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.17
|
| Rate for Payer: Quartz Beloit One Network |
$71.05
|
| Rate for Payer: Quartz Commercial |
$94.25
|
| Rate for Payer: Quartz Medicare Advantage |
$5.00
|
| Rate for Payer: The Alliance Commercial |
$580.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.00
|
| Rate for Payer: United Healthcare PPO |
$108.75
|
| Rate for Payer: WEA Trust Commercial |
$79.75
|
| Rate for Payer: Wellcare Medicare |
$5.00
|
| Rate for Payer: WMAP Medicaid |
$5.17
|
| Rate for Payer: WPS Commercial |
$107.40
|
|
|
Chloride Stool
|
Professional
|
$145.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
2942897
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$137.75 |
| Rate for Payer: Aetna Commercial |
$137.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$124.70
|
| Rate for Payer: Aetna Managed Medicare |
$5.00
|
| Rate for Payer: Anthem Medicare Advantage |
$5.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.00
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cigna Commercial |
$137.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$72.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.00
|
| Rate for Payer: Health EOS Commercial |
$131.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$116.00
|
| Rate for Payer: Preferred Network Access Commercial |
$137.75
|
| Rate for Payer: Quartz Beloit One Network |
$63.80
|
| Rate for Payer: Quartz Commercial |
$82.65
|
| Rate for Payer: Quartz Medicare Advantage |
$5.00
|
| Rate for Payer: The Alliance Commercial |
$19.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.00
|
| Rate for Payer: WEA Trust Commercial |
$79.75
|
| Rate for Payer: WPS Commercial |
$22.00
|
|
|
Chloride, Stool
|
Facility
IP
|
$40.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
4732606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$36.80 |
| Rate for Payer: Aetna Commercial |
$36.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$21.20
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$36.80
|
| Rate for Payer: Health EOS Commercial |
$35.60
|
| Rate for Payer: HFN Commercial |
$36.80
|
| Rate for Payer: Multiplan Commercial |
$32.00
|
| Rate for Payer: NAPHCARE Commercial |
$24.00
|
| Rate for Payer: Preferred Network Access Commercial |
$36.80
|
| Rate for Payer: Quartz Beloit One Network |
$19.60
|
| Rate for Payer: Quartz Commercial |
$24.00
|
| Rate for Payer: WEA Trust Commercial |
$22.00
|
| Rate for Payer: WPS Commercial |
$29.63
|
|
|
Chloride, Stool
|
Facility
OP
|
$40.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
4732606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Aetna Commercial |
$36.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$34.40
|
| Rate for Payer: Aetna Managed Medicare |
$5.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.75
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.30
|
| Rate for Payer: Anthem Medicaid |
$5.17
|
| Rate for Payer: Anthem Medicare Advantage |
$5.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$21.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$36.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.17
|
| Rate for Payer: Dean Health Medicaid |
$5.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.00
|
| Rate for Payer: Health EOS Commercial |
$35.60
|
| Rate for Payer: HFN Commercial |
$36.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.00
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.00
|
| Rate for Payer: Managed Health Services Medicaid |
$5.38
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.00
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$32.00
|
| Rate for Payer: NAPHCARE Commercial |
$7.50
|
| Rate for Payer: Preferred Network Access Commercial |
$36.80
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.17
|
| Rate for Payer: Quartz Beloit One Network |
$19.60
|
| Rate for Payer: Quartz Commercial |
$26.00
|
| Rate for Payer: Quartz Medicare Advantage |
$5.00
|
| Rate for Payer: The Alliance Commercial |
$160.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.00
|
| Rate for Payer: United Healthcare PPO |
$30.00
|
| Rate for Payer: WEA Trust Commercial |
$22.00
|
| Rate for Payer: Wellcare Medicare |
$5.00
|
| Rate for Payer: WMAP Medicaid |
$5.17
|
| Rate for Payer: WPS Commercial |
$29.63
|
|
|
Chloride, Stool
|
Professional
|
$40.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
4732606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$38.00 |
| Rate for Payer: Aetna Commercial |
$38.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$34.40
|
| Rate for Payer: Aetna Managed Medicare |
$5.00
|
| Rate for Payer: Anthem Medicare Advantage |
$5.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$38.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$20.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.00
|
| Rate for Payer: Health EOS Commercial |
$36.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$32.00
|
| Rate for Payer: Preferred Network Access Commercial |
$38.00
|
| Rate for Payer: Quartz Beloit One Network |
$17.60
|
| Rate for Payer: Quartz Commercial |
$22.80
|
| Rate for Payer: Quartz Medicare Advantage |
$5.00
|
| Rate for Payer: The Alliance Commercial |
$19.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.00
|
| Rate for Payer: WEA Trust Commercial |
$22.00
|
| Rate for Payer: WPS Commercial |
$22.00
|
|
|
Chloride, Urine
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
5474689
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$25.80
|
| Rate for Payer: Aetna Managed Medicare |
$5.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14.40
|
| Rate for Payer: Anthem Medicaid |
$5.94
|
| Rate for Payer: Anthem Medicare Advantage |
$5.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$15.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.75
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$27.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.94
|
| Rate for Payer: Dean Health Medicaid |
$5.94
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.75
|
| Rate for Payer: Health EOS Commercial |
$26.70
|
| Rate for Payer: HFN Commercial |
$27.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.75
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.75
|
| Rate for Payer: Managed Health Services Medicaid |
$6.18
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.75
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.75
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: NAPHCARE Commercial |
$8.62
|
| Rate for Payer: Preferred Network Access Commercial |
$27.60
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.94
|
| Rate for Payer: Quartz Beloit One Network |
$14.70
|
| Rate for Payer: Quartz Commercial |
$19.50
|
| Rate for Payer: Quartz Medicare Advantage |
$5.75
|
| Rate for Payer: The Alliance Commercial |
$120.00
|
| Rate for Payer: United Healthcare Medicaid |
$5.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.75
|
| Rate for Payer: WEA Trust Commercial |
$16.50
|
| Rate for Payer: Wellcare Medicare |
$5.75
|
| Rate for Payer: WMAP Medicaid |
$5.94
|
| Rate for Payer: WPS Commercial |
$22.22
|
|
|
Chloride, Urine
|
Professional
|
$30.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
5474689
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Aetna Commercial |
$28.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$25.80
|
| Rate for Payer: Aetna Managed Medicare |
$5.75
|
| Rate for Payer: Anthem Medicare Advantage |
$5.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.75
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$28.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$15.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.75
|
| Rate for Payer: Health EOS Commercial |
$27.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.75
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: Preferred Network Access Commercial |
$28.50
|
| Rate for Payer: Quartz Beloit One Network |
$13.20
|
| Rate for Payer: Quartz Commercial |
$17.10
|
| Rate for Payer: Quartz Medicare Advantage |
$5.75
|
| Rate for Payer: The Alliance Commercial |
$22.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.75
|
| Rate for Payer: WEA Trust Commercial |
$16.50
|
| Rate for Payer: WPS Commercial |
$25.30
|
|
|
Chloride, Urine
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
5474689
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$27.60 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$15.90
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$27.60
|
| Rate for Payer: Health EOS Commercial |
$26.70
|
| Rate for Payer: HFN Commercial |
$27.60
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: NAPHCARE Commercial |
$18.00
|
| Rate for Payer: Preferred Network Access Commercial |
$27.60
|
| Rate for Payer: Quartz Beloit One Network |
$14.70
|
| Rate for Payer: Quartz Commercial |
$18.00
|
| Rate for Payer: WEA Trust Commercial |
$16.50
|
| Rate for Payer: WPS Commercial |
$22.22
|
|
|
Cholangiography &/Pancreatography IntraOp RS&I 7430026
|
Professional
|
$229.00
|
|
|
Service Code
|
CPT 74300 26
|
| Hospital Charge Code |
5284615
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.58 |
| Max. Negotiated Rate |
$217.55 |
| Rate for Payer: Aetna Commercial |
$217.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$196.94
|
| Rate for Payer: Aetna Managed Medicare |
$12.58
|
| Rate for Payer: Anthem Medicare Advantage |
$12.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.58
|
| Rate for Payer: Cash Price |
$68.70
|
| Rate for Payer: Cash Price |
$68.70
|
| Rate for Payer: Cigna Commercial |
$217.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$114.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.58
|
| Rate for Payer: Health EOS Commercial |
$208.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$47.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$47.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.58
|
| Rate for Payer: Multiplan Commercial |
$183.20
|
| Rate for Payer: Preferred Network Access Commercial |
$217.55
|
| Rate for Payer: Quartz Beloit One Network |
$100.76
|
| Rate for Payer: Quartz Commercial |
$130.53
|
| Rate for Payer: Quartz Medicare Advantage |
$12.58
|
| Rate for Payer: The Alliance Commercial |
$47.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.58
|
| Rate for Payer: WEA Trust Commercial |
$125.95
|
| Rate for Payer: WPS Commercial |
$62.90
|
|
|
CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC
|
Facility
IP
|
$52,849.00
|
|
|
Service Code
|
MS-DRG 415
|
| Min. Negotiated Rate |
$19,010.41 |
| Max. Negotiated Rate |
$52,849.00 |
| Rate for Payer: Aetna Managed Medicare |
$19,010.41
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$41,540.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31,840.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30,250.44
|
| Rate for Payer: Anthem Medicare Advantage |
$19,010.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19,010.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19,010.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$19,010.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$33,580.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$19,010.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$38,528.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19,010.41
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19,010.41
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$19,010.41
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$19,010.41
|
| Rate for Payer: NAPHCARE Commercial |
$28,515.62
|
| Rate for Payer: Quartz Medicare Advantage |
$19,010.41
|
| Rate for Payer: The Alliance Commercial |
$52,849.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,010.41
|
| Rate for Payer: United Healthcare PPO |
$29,994.62
|
| Rate for Payer: Wellcare Medicare |
$19,010.41
|
|
