|
Chromatin (Nucleosomal) Antibody
|
Facility
IP
|
$114.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
3403546
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.86 |
| Max. Negotiated Rate |
$104.88 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$68.40
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$68.40
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Chromatin (Nucleosomal) Antibody
|
Facility
OP
|
$114.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
3403546
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$456.00 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.76
|
| Rate for Payer: Anthem Medicaid |
$18.53
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18.53
|
| Rate for Payer: Dean Health Medicaid |
$18.53
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Managed Health Services Medicaid |
$19.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$26.90
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$18.53
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$74.10
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$456.00
|
| Rate for Payer: United Healthcare Medicaid |
$18.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Healthcare PPO |
$85.50
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: Wellcare Medicare |
$17.93
|
| Rate for Payer: WMAP Medicaid |
$18.53
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Chromatin (Nucleosomal) Antibody
|
Facility
OP
|
$81.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
4606710
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$324.00 |
| Rate for Payer: Aetna Commercial |
$72.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$69.66
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.76
|
| Rate for Payer: Anthem Medicaid |
$18.53
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$42.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna Commercial |
$74.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18.53
|
| Rate for Payer: Dean Health Medicaid |
$18.53
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$72.09
|
| Rate for Payer: HFN Commercial |
$74.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Managed Health Services Medicaid |
$19.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$64.80
|
| Rate for Payer: NAPHCARE Commercial |
$26.90
|
| Rate for Payer: Preferred Network Access Commercial |
$74.52
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$18.53
|
| Rate for Payer: Quartz Beloit One Network |
$39.69
|
| Rate for Payer: Quartz Commercial |
$52.65
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$324.00
|
| Rate for Payer: United Healthcare Medicaid |
$18.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Healthcare PPO |
$60.75
|
| Rate for Payer: WEA Trust Commercial |
$44.55
|
| Rate for Payer: Wellcare Medicare |
$17.93
|
| Rate for Payer: WMAP Medicaid |
$18.53
|
| Rate for Payer: WPS Commercial |
$60.00
|
|
|
Chromatin (Nucleosomal) Antibody
|
Professional
|
$81.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
4606710
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$78.89 |
| Rate for Payer: Aetna Commercial |
$76.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$69.66
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna Commercial |
$76.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$40.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$73.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$64.80
|
| Rate for Payer: Preferred Network Access Commercial |
$76.95
|
| Rate for Payer: Quartz Beloit One Network |
$35.64
|
| Rate for Payer: Quartz Commercial |
$46.17
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$70.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: WEA Trust Commercial |
$44.55
|
| Rate for Payer: WPS Commercial |
$78.89
|
|
|
Chromatin (Nucleosomal) Antibody
|
Facility
IP
|
$81.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
4606710
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.69 |
| Max. Negotiated Rate |
$74.52 |
| Rate for Payer: Aetna Commercial |
$72.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$42.93
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna Commercial |
$74.52
|
| Rate for Payer: Health EOS Commercial |
$72.09
|
| Rate for Payer: HFN Commercial |
$74.52
|
| Rate for Payer: Multiplan Commercial |
$64.80
|
| Rate for Payer: NAPHCARE Commercial |
$48.60
|
| Rate for Payer: Preferred Network Access Commercial |
$74.52
|
| Rate for Payer: Quartz Beloit One Network |
$39.69
|
| Rate for Payer: Quartz Commercial |
$48.60
|
| Rate for Payer: WEA Trust Commercial |
$44.55
|
| Rate for Payer: WPS Commercial |
$60.00
|
|
|
Chromatin (Nucleosomal) Antibody
|
Professional
|
$114.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
3403546
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$108.30 |
| Rate for Payer: Aetna Commercial |
$108.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$108.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$57.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$103.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: Preferred Network Access Commercial |
$108.30
|
| Rate for Payer: Quartz Beloit One Network |
$50.16
|
| Rate for Payer: Quartz Commercial |
$64.98
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$70.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$78.89
|
|
|
Chromatin to TheraTest
|
Facility
OP
|
$61.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2792802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$244.00 |
| Rate for Payer: Aetna Commercial |
$54.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$52.46
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.76
|
| Rate for Payer: Anthem Medicaid |
$18.53
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$32.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cigna Commercial |
$56.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18.53
|
| Rate for Payer: Dean Health Medicaid |
$18.53
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$54.29
|
| Rate for Payer: HFN Commercial |
$56.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Managed Health Services Medicaid |
$19.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$48.80
|
| Rate for Payer: NAPHCARE Commercial |
$26.90
|
| Rate for Payer: Preferred Network Access Commercial |
$56.12
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$18.53
|
| Rate for Payer: Quartz Beloit One Network |
$29.89
|
| Rate for Payer: Quartz Commercial |
$39.65
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$244.00
|
| Rate for Payer: United Healthcare Medicaid |
$18.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Healthcare PPO |
$45.75
|
| Rate for Payer: WEA Trust Commercial |
$33.55
|
| Rate for Payer: Wellcare Medicare |
$17.93
|
| Rate for Payer: WMAP Medicaid |
$18.53
|
| Rate for Payer: WPS Commercial |
$45.18
|
|
|
Chromatin to TheraTest
|
Facility
IP
|
$61.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2792802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.89 |
| Max. Negotiated Rate |
$56.12 |
| Rate for Payer: Aetna Commercial |
$54.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$32.33
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cigna Commercial |
$56.12
|
| Rate for Payer: Health EOS Commercial |
$54.29
|
| Rate for Payer: HFN Commercial |
$56.12
|
| Rate for Payer: Multiplan Commercial |
$48.80
|
| Rate for Payer: NAPHCARE Commercial |
$36.60
|
| Rate for Payer: Preferred Network Access Commercial |
$56.12
|
| Rate for Payer: Quartz Beloit One Network |
$29.89
|
| Rate for Payer: Quartz Commercial |
$36.60
|
| Rate for Payer: WEA Trust Commercial |
$33.55
|
| Rate for Payer: WPS Commercial |
$45.18
|
|
|
Chromatin to TheraTest
|
Professional
|
$61.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2792802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$78.89 |
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$52.46
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cigna Commercial |
$57.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$30.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$55.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$48.80
|
| Rate for Payer: Preferred Network Access Commercial |
$57.95
|
| Rate for Payer: Quartz Beloit One Network |
$26.84
|
| Rate for Payer: Quartz Commercial |
$34.77
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$70.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: WEA Trust Commercial |
$33.55
|
| Rate for Payer: WPS Commercial |
$78.89
|
|
|
Chromium Level, Plasma
|
Professional
|
$331.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
3959975
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.28 |
| Max. Negotiated Rate |
$314.45 |
| Rate for Payer: Aetna Commercial |
$314.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$284.66
|
| Rate for Payer: Aetna Managed Medicare |
$20.28
|
| Rate for Payer: Anthem Medicare Advantage |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.28
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cigna Commercial |
$314.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$165.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20.28
|
| Rate for Payer: Health EOS Commercial |
$301.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$71.59
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$71.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.28
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: Preferred Network Access Commercial |
$314.45
|
| Rate for Payer: Quartz Beloit One Network |
$145.64
|
| Rate for Payer: Quartz Commercial |
$188.67
|
| Rate for Payer: Quartz Medicare Advantage |
$20.28
|
| Rate for Payer: The Alliance Commercial |
$80.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.28
|
| Rate for Payer: WEA Trust Commercial |
$182.05
|
| Rate for Payer: WPS Commercial |
$89.23
|
|
|
Chromium Level, Plasma
|
Facility
OP
|
$331.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
3959975
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.23 |
| Max. Negotiated Rate |
$1,324.00 |
| Rate for Payer: Aetna Commercial |
$297.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$284.66
|
| Rate for Payer: Aetna Managed Medicare |
$20.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$76.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$35.49
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33.66
|
| Rate for Payer: Anthem Medicaid |
$10.23
|
| Rate for Payer: Anthem Medicare Advantage |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$175.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.28
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cigna Commercial |
$304.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10.23
|
| Rate for Payer: Dean Health Medicaid |
$10.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20.28
|
| Rate for Payer: Health EOS Commercial |
$294.59
|
| Rate for Payer: HFN Commercial |
$304.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$75.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.28
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.28
|
| Rate for Payer: Managed Health Services Medicaid |
$10.64
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20.28
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: NAPHCARE Commercial |
$30.42
|
| Rate for Payer: Preferred Network Access Commercial |
$304.52
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10.23
|
| Rate for Payer: Quartz Beloit One Network |
$162.19
|
| Rate for Payer: Quartz Commercial |
$215.15
|
| Rate for Payer: Quartz Medicare Advantage |
$20.28
|
| Rate for Payer: The Alliance Commercial |
$1,324.00
|
| Rate for Payer: United Healthcare Medicaid |
$10.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.28
|
| Rate for Payer: United Healthcare PPO |
$248.25
|
| Rate for Payer: WEA Trust Commercial |
$182.05
|
| Rate for Payer: Wellcare Medicare |
$20.28
|
| Rate for Payer: WMAP Medicaid |
$10.23
|
| Rate for Payer: WPS Commercial |
$245.17
|
|
|
Chromium Level, Plasma
|
Facility
IP
|
$331.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
3959975
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$162.19 |
| Max. Negotiated Rate |
$304.52 |
| Rate for Payer: Aetna Commercial |
$297.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$175.43
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cigna Commercial |
$304.52
|
| Rate for Payer: Health EOS Commercial |
$294.59
|
| Rate for Payer: HFN Commercial |
$304.52
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: NAPHCARE Commercial |
$198.60
|
| Rate for Payer: Preferred Network Access Commercial |
$304.52
|
| Rate for Payer: Quartz Beloit One Network |
$162.19
|
| Rate for Payer: Quartz Commercial |
$198.60
|
| Rate for Payer: WEA Trust Commercial |
$182.05
|
| Rate for Payer: WPS Commercial |
$245.17
|
|
|
Chromium Level, Serum
|
Facility
OP
|
$223.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
977900
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.23 |
| Max. Negotiated Rate |
$892.00 |
| Rate for Payer: Aetna Commercial |
$200.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$191.78
|
| Rate for Payer: Aetna Managed Medicare |
$20.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$76.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$35.49
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$33.66
|
| Rate for Payer: Anthem Medicaid |
$10.23
|
| Rate for Payer: Anthem Medicare Advantage |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$118.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.28
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$205.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10.23
|
| Rate for Payer: Dean Health Medicaid |
$10.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20.28
|
| Rate for Payer: Health EOS Commercial |
$198.47
|
| Rate for Payer: HFN Commercial |
$205.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$75.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.28
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.28
|
| Rate for Payer: Managed Health Services Medicaid |
$10.64
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20.28
|
| Rate for Payer: Multiplan Commercial |
$178.40
|
| Rate for Payer: NAPHCARE Commercial |
$30.42
|
| Rate for Payer: Preferred Network Access Commercial |
$205.16
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$10.23
|
| Rate for Payer: Quartz Beloit One Network |
$109.27
|
| Rate for Payer: Quartz Commercial |
$144.95
|
| Rate for Payer: Quartz Medicare Advantage |
$20.28
|
| Rate for Payer: The Alliance Commercial |
$892.00
|
| Rate for Payer: United Healthcare Medicaid |
$10.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.28
|
| Rate for Payer: United Healthcare PPO |
$167.25
|
| Rate for Payer: WEA Trust Commercial |
$122.65
|
| Rate for Payer: Wellcare Medicare |
$20.28
|
| Rate for Payer: WMAP Medicaid |
$10.23
|
| Rate for Payer: WPS Commercial |
$165.18
|
|
|
Chromium Level, Serum
|
Facility
IP
|
$223.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
977900
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$205.16 |
| Rate for Payer: Aetna Commercial |
$200.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$118.19
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$205.16
|
| Rate for Payer: Health EOS Commercial |
$198.47
|
| Rate for Payer: HFN Commercial |
$205.16
|
| Rate for Payer: Multiplan Commercial |
$178.40
|
| Rate for Payer: NAPHCARE Commercial |
$133.80
|
| Rate for Payer: Preferred Network Access Commercial |
$205.16
|
| Rate for Payer: Quartz Beloit One Network |
$109.27
|
| Rate for Payer: Quartz Commercial |
$133.80
|
| Rate for Payer: WEA Trust Commercial |
$122.65
|
| Rate for Payer: WPS Commercial |
$165.18
|
|
|
Chromium Level, Serum
|
Professional
|
$223.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
977900
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.28 |
| Max. Negotiated Rate |
$211.85 |
| Rate for Payer: Aetna Commercial |
$211.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$191.78
|
| Rate for Payer: Aetna Managed Medicare |
$20.28
|
| Rate for Payer: Anthem Medicare Advantage |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.28
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$211.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$111.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20.28
|
| Rate for Payer: Health EOS Commercial |
$202.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$71.59
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$71.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.28
|
| Rate for Payer: Multiplan Commercial |
$178.40
|
| Rate for Payer: Preferred Network Access Commercial |
$211.85
|
| Rate for Payer: Quartz Beloit One Network |
$98.12
|
| Rate for Payer: Quartz Commercial |
$127.11
|
| Rate for Payer: Quartz Medicare Advantage |
$20.28
|
| Rate for Payer: The Alliance Commercial |
$80.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.28
|
| Rate for Payer: WEA Trust Commercial |
$122.65
|
| Rate for Payer: WPS Commercial |
$89.23
|
|
|
Chromogranin A
|
Professional
|
$350.00
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
977901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.81 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$332.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$301.00
|
| Rate for Payer: Aetna Managed Medicare |
$20.81
|
| Rate for Payer: Anthem Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.81
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$175.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$20.81
|
| Rate for Payer: Health EOS Commercial |
$318.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$73.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$73.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.81
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Preferred Network Access Commercial |
$332.50
|
| Rate for Payer: Quartz Beloit One Network |
$154.00
|
| Rate for Payer: Quartz Commercial |
$199.50
|
| Rate for Payer: Quartz Medicare Advantage |
$20.81
|
| Rate for Payer: The Alliance Commercial |
$82.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.81
|
| Rate for Payer: WEA Trust Commercial |
$192.50
|
| Rate for Payer: WPS Commercial |
$91.56
|
|
|
Chromogranin A
|
Facility
OP
|
$350.00
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
977901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.81 |
| Max. Negotiated Rate |
$1,400.00 |
| Rate for Payer: Aetna Commercial |
$315.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$301.00
|
| Rate for Payer: Aetna Managed Medicare |
$20.81
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$78.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$36.42
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$34.54
|
| Rate for Payer: Anthem Medicaid |
$21.50
|
| Rate for Payer: Anthem Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$185.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20.81
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$322.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21.50
|
| Rate for Payer: Dean Health Medicaid |
$21.50
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20.81
|
| Rate for Payer: Health EOS Commercial |
$311.50
|
| Rate for Payer: HFN Commercial |
$322.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$77.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20.81
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$21.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20.81
|
| Rate for Payer: Managed Health Services Medicaid |
$22.36
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20.81
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20.81
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: NAPHCARE Commercial |
$31.22
|
| Rate for Payer: Preferred Network Access Commercial |
$322.00
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$21.50
|
| Rate for Payer: Quartz Beloit One Network |
$171.50
|
| Rate for Payer: Quartz Commercial |
$227.50
|
| Rate for Payer: Quartz Medicare Advantage |
$20.81
|
| Rate for Payer: The Alliance Commercial |
$1,400.00
|
| Rate for Payer: United Healthcare Medicaid |
$21.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20.81
|
| Rate for Payer: United Healthcare PPO |
$262.50
|
| Rate for Payer: WEA Trust Commercial |
$192.50
|
| Rate for Payer: Wellcare Medicare |
$20.81
|
| Rate for Payer: WMAP Medicaid |
$21.50
|
| Rate for Payer: WPS Commercial |
$259.24
|
|
|
Chromogranin A
|
Facility
IP
|
$350.00
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
977901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$171.50 |
| Max. Negotiated Rate |
$322.00 |
| Rate for Payer: Aetna Commercial |
$315.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$185.50
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$322.00
|
| Rate for Payer: Health EOS Commercial |
$311.50
|
| Rate for Payer: HFN Commercial |
$322.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: NAPHCARE Commercial |
$210.00
|
| Rate for Payer: Preferred Network Access Commercial |
$322.00
|
| Rate for Payer: Quartz Beloit One Network |
$171.50
|
| Rate for Payer: Quartz Commercial |
$210.00
|
| Rate for Payer: WEA Trust Commercial |
$192.50
|
| Rate for Payer: WPS Commercial |
$259.24
|
|
|
Chromosomal Microarray, Postnatal
|
Facility
IP
|
$3,915.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
4568651
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1,918.35 |
| Max. Negotiated Rate |
$3,601.80 |
| Rate for Payer: Aetna Commercial |
$3,523.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,074.95
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Cigna Commercial |
$3,601.80
|
| Rate for Payer: Health EOS Commercial |
$3,484.35
|
| Rate for Payer: HFN Commercial |
$3,601.80
|
| Rate for Payer: Multiplan Commercial |
$3,132.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,349.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,601.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,918.35
|
| Rate for Payer: Quartz Commercial |
$2,349.00
|
| Rate for Payer: WEA Trust Commercial |
$2,153.25
|
| Rate for Payer: WPS Commercial |
$2,899.84
|
|
|
Chromosomal Microarray, Postnatal
|
Facility
OP
|
$3,915.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
4568651
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$608.00 |
| Max. Negotiated Rate |
$15,660.00 |
| Rate for Payer: Aetna Commercial |
$3,523.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,366.90
|
| Rate for Payer: Aetna Managed Medicare |
$1,160.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,350.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,030.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,925.60
|
| Rate for Payer: Anthem Medicaid |
$608.00
|
| Rate for Payer: Anthem Medicare Advantage |
$1,160.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,074.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,160.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,160.00
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Cigna Commercial |
$3,601.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,160.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$608.00
|
| Rate for Payer: Dean Health Medicaid |
$608.00
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,160.00
|
| Rate for Payer: Health EOS Commercial |
$3,484.35
|
| Rate for Payer: HFN Commercial |
$3,601.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,315.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,160.00
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$608.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,160.00
|
| Rate for Payer: Managed Health Services Medicaid |
$632.32
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,160.00
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,160.00
|
| Rate for Payer: Multiplan Commercial |
$3,132.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,740.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,601.80
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$608.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,918.35
|
| Rate for Payer: Quartz Commercial |
$2,544.75
|
| Rate for Payer: Quartz Medicare Advantage |
$1,160.00
|
| Rate for Payer: The Alliance Commercial |
$15,660.00
|
| Rate for Payer: United Healthcare Medicaid |
$608.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,160.00
|
| Rate for Payer: United Healthcare PPO |
$2,936.25
|
| Rate for Payer: WEA Trust Commercial |
$2,153.25
|
| Rate for Payer: Wellcare Medicare |
$1,160.00
|
| Rate for Payer: WMAP Medicaid |
$608.00
|
| Rate for Payer: WPS Commercial |
$2,899.84
|
|
|
Chromosomal Microarray, Postnatal
|
Professional
|
$3,915.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
4568651
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1,160.00 |
| Max. Negotiated Rate |
$5,104.00 |
| Rate for Payer: Aetna Commercial |
$3,719.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,366.90
|
| Rate for Payer: Aetna Managed Medicare |
$1,160.00
|
| Rate for Payer: Anthem Medicare Advantage |
$1,160.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,160.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,160.00
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Cigna Commercial |
$3,719.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,957.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,160.00
|
| Rate for Payer: Health EOS Commercial |
$3,562.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,094.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4,094.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,160.00
|
| Rate for Payer: Multiplan Commercial |
$3,132.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,719.25
|
| Rate for Payer: Quartz Beloit One Network |
$1,722.60
|
| Rate for Payer: Quartz Commercial |
$2,231.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,160.00
|
| Rate for Payer: The Alliance Commercial |
$4,582.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,160.00
|
| Rate for Payer: WEA Trust Commercial |
$2,153.25
|
| Rate for Payer: WPS Commercial |
$5,104.00
|
|
|
Chromosome Analysis
|
Facility
IP
|
$781.00
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
2792803
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$382.69 |
| Max. Negotiated Rate |
$718.52 |
| Rate for Payer: Aetna Commercial |
$702.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$413.93
|
| Rate for Payer: Cash Price |
$234.30
|
| Rate for Payer: Cigna Commercial |
$718.52
|
| Rate for Payer: Health EOS Commercial |
$695.09
|
| Rate for Payer: HFN Commercial |
$718.52
|
| Rate for Payer: Multiplan Commercial |
$624.80
|
| Rate for Payer: NAPHCARE Commercial |
$468.60
|
| Rate for Payer: Preferred Network Access Commercial |
$718.52
|
| Rate for Payer: Quartz Beloit One Network |
$382.69
|
| Rate for Payer: Quartz Commercial |
$468.60
|
| Rate for Payer: WEA Trust Commercial |
$429.55
|
| Rate for Payer: WPS Commercial |
$578.49
|
|
|
Chromosome Analysis
|
Facility
OP
|
$781.00
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
2792803
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.56 |
| Max. Negotiated Rate |
$718.52 |
| Rate for Payer: Aetna Commercial |
$702.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$671.66
|
| Rate for Payer: Aetna Managed Medicare |
$53.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$200.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$93.73
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$88.91
|
| Rate for Payer: Anthem Medicare Advantage |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$413.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$53.56
|
| Rate for Payer: Cash Price |
$234.30
|
| Rate for Payer: Cash Price |
$234.30
|
| Rate for Payer: Cigna Commercial |
$718.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$53.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$53.56
|
| Rate for Payer: Health EOS Commercial |
$695.09
|
| Rate for Payer: HFN Commercial |
$718.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$199.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$53.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$53.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$53.56
|
| Rate for Payer: Multiplan Commercial |
$624.80
|
| Rate for Payer: NAPHCARE Commercial |
$80.34
|
| Rate for Payer: Preferred Network Access Commercial |
$718.52
|
| Rate for Payer: Quartz Beloit One Network |
$382.69
|
| Rate for Payer: Quartz Commercial |
$507.65
|
| Rate for Payer: Quartz Medicare Advantage |
$53.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.56
|
| Rate for Payer: United Healthcare PPO |
$585.75
|
| Rate for Payer: WEA Trust Commercial |
$429.55
|
| Rate for Payer: Wellcare Medicare |
$53.56
|
| Rate for Payer: WPS Commercial |
$578.49
|
|
|
Chromosome Analysis
|
Professional
|
$781.00
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
2792803
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.30 |
| Max. Negotiated Rate |
$741.95 |
| Rate for Payer: Aetna Commercial |
$741.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$671.66
|
| Rate for Payer: Aetna Managed Medicare |
$154.11
|
| Rate for Payer: Anthem Commercial |
$33.30
|
| Rate for Payer: Anthem Medicare Advantage |
$154.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$154.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$154.11
|
| Rate for Payer: Cash Price |
$234.30
|
| Rate for Payer: Cash Price |
$234.30
|
| Rate for Payer: Cigna Commercial |
$741.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$390.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$154.11
|
| Rate for Payer: Health EOS Commercial |
$710.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$469.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$469.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$154.11
|
| Rate for Payer: Multiplan Commercial |
$624.80
|
| Rate for Payer: Preferred Network Access Commercial |
$741.95
|
| Rate for Payer: Quartz Beloit One Network |
$343.64
|
| Rate for Payer: Quartz Commercial |
$445.17
|
| Rate for Payer: Quartz Medicare Advantage |
$154.11
|
| Rate for Payer: The Alliance Commercial |
$608.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$154.11
|
| Rate for Payer: WEA Trust Commercial |
$429.55
|
| Rate for Payer: WPS Commercial |
$678.08
|
|
|
Chromosome Analysis, 20-25 Cells
|
Facility
IP
|
$190.00
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
3313615
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$93.10 |
| Max. Negotiated Rate |
$174.80 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$100.70
|
| Rate for Payer: Cash Price |
$57.00
|
| Rate for Payer: Cigna Commercial |
$174.80
|
| Rate for Payer: Health EOS Commercial |
$169.10
|
| Rate for Payer: HFN Commercial |
$174.80
|
| Rate for Payer: Multiplan Commercial |
$152.00
|
| Rate for Payer: NAPHCARE Commercial |
$114.00
|
| Rate for Payer: Preferred Network Access Commercial |
$174.80
|
| Rate for Payer: Quartz Beloit One Network |
$93.10
|
| Rate for Payer: Quartz Commercial |
$114.00
|
| Rate for Payer: WEA Trust Commercial |
$104.50
|
| Rate for Payer: WPS Commercial |
$140.73
|
|
