|
CLAMP UMBILICAL CORD
|
Facility
OP
|
$48.00
|
|
| Hospital Charge Code |
2963464
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.44 |
| Max. Negotiated Rate |
$192.00 |
| Rate for Payer: Aetna Commercial |
$43.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$41.28
|
| Rate for Payer: Aetna Managed Medicare |
$13.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$25.44
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$44.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$26.86
|
| Rate for Payer: Health EOS Commercial |
$42.72
|
| Rate for Payer: HFN Commercial |
$44.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$38.40
|
| Rate for Payer: NAPHCARE Commercial |
$28.80
|
| Rate for Payer: Preferred Network Access Commercial |
$44.16
|
| Rate for Payer: Quartz Beloit One Network |
$23.52
|
| Rate for Payer: Quartz Commercial |
$31.20
|
| Rate for Payer: Quartz Medicare Advantage |
$28.80
|
| Rate for Payer: The Alliance Commercial |
$192.00
|
| Rate for Payer: WEA Trust Commercial |
$26.40
|
| Rate for Payer: WPS Commercial |
$35.55
|
|
|
CLAMP UNIVERSAL 393.75
|
Facility
OP
|
$4,859.00
|
|
| Hospital Charge Code |
5811629
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,360.52 |
| Max. Negotiated Rate |
$19,436.00 |
| Rate for Payer: Aetna Commercial |
$4,373.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,178.74
|
| Rate for Payer: Aetna Managed Medicare |
$1,360.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,158.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,429.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,332.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,575.27
|
| Rate for Payer: Cash Price |
$1,457.70
|
| Rate for Payer: Cigna Commercial |
$4,470.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,719.10
|
| Rate for Payer: Health EOS Commercial |
$4,324.51
|
| Rate for Payer: HFN Commercial |
$4,470.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,644.25
|
| Rate for Payer: Multiplan Commercial |
$3,887.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,915.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,470.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,380.91
|
| Rate for Payer: Quartz Commercial |
$3,158.35
|
| Rate for Payer: Quartz Medicare Advantage |
$2,915.40
|
| Rate for Payer: The Alliance Commercial |
$19,436.00
|
| Rate for Payer: WEA Trust Commercial |
$2,672.45
|
| Rate for Payer: WPS Commercial |
$3,599.06
|
|
|
CLAMP UNIVERSAL 393.75
|
Facility
IP
|
$4,859.00
|
|
| Hospital Charge Code |
5811629
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,380.91 |
| Max. Negotiated Rate |
$4,470.28 |
| Rate for Payer: Aetna Commercial |
$4,373.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,575.27
|
| Rate for Payer: Cash Price |
$1,457.70
|
| Rate for Payer: Cigna Commercial |
$4,470.28
|
| Rate for Payer: Health EOS Commercial |
$4,324.51
|
| Rate for Payer: HFN Commercial |
$4,470.28
|
| Rate for Payer: Multiplan Commercial |
$3,887.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,915.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,470.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,380.91
|
| Rate for Payer: Quartz Commercial |
$2,915.40
|
| Rate for Payer: WEA Trust Commercial |
$2,672.45
|
| Rate for Payer: WPS Commercial |
$3,599.06
|
|
|
Clapping
|
Facility
OP
|
$139.00
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
2989716
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$66.72 |
| Max. Negotiated Rate |
$469.69 |
| Rate for Payer: Aetna Commercial |
$125.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$119.54
|
| Rate for Payer: Aetna Managed Medicare |
$126.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$90.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$69.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$66.72
|
| Rate for Payer: Anthem Medicare Advantage |
$126.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$73.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$126.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$126.26
|
| Rate for Payer: Cash Price |
$41.70
|
| Rate for Payer: Cash Price |
$41.70
|
| Rate for Payer: Cigna Commercial |
$127.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$126.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$77.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$126.26
|
| Rate for Payer: Health EOS Commercial |
$123.71
|
| Rate for Payer: HFN Commercial |
$127.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$469.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$126.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$126.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$126.26
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$126.26
|
| Rate for Payer: Multiplan Commercial |
$111.20
|
| Rate for Payer: NAPHCARE Commercial |
$189.39
|
| Rate for Payer: Preferred Network Access Commercial |
$127.88
|
| Rate for Payer: Quartz Beloit One Network |
$68.11
|
| Rate for Payer: Quartz Commercial |
$90.35
|
| Rate for Payer: Quartz Medicare Advantage |
$126.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.26
|
| Rate for Payer: United Healthcare PPO |
$104.25
|
| Rate for Payer: WEA Trust Commercial |
$76.45
|
| Rate for Payer: Wellcare Medicare |
$126.26
|
| Rate for Payer: WPS Commercial |
$102.96
|
|
|
Clapping
|
Facility
IP
|
$139.00
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
2989716
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$68.11 |
| Max. Negotiated Rate |
$127.88 |
| Rate for Payer: Aetna Commercial |
$125.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$73.67
|
| Rate for Payer: Cash Price |
$41.70
|
| Rate for Payer: Cigna Commercial |
$127.88
|
| Rate for Payer: Health EOS Commercial |
$123.71
|
| Rate for Payer: HFN Commercial |
$127.88
|
| Rate for Payer: Multiplan Commercial |
$111.20
|
| Rate for Payer: NAPHCARE Commercial |
$83.40
|
| Rate for Payer: Preferred Network Access Commercial |
$127.88
|
| Rate for Payer: Quartz Beloit One Network |
$68.11
|
| Rate for Payer: Quartz Commercial |
$83.40
|
| Rate for Payer: WEA Trust Commercial |
$76.45
|
| Rate for Payer: WPS Commercial |
$102.96
|
|
|
Clarient, FISH Manual
|
Facility
OP
|
$557.00
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
5194629
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$168.82 |
| Max. Negotiated Rate |
$633.08 |
| Rate for Payer: Aetna Commercial |
$501.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$479.02
|
| Rate for Payer: Aetna Managed Medicare |
$168.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$633.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$295.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$280.24
|
| Rate for Payer: Anthem Medicare Advantage |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$295.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$168.82
|
| Rate for Payer: Cash Price |
$167.10
|
| Rate for Payer: Cash Price |
$167.10
|
| Rate for Payer: Cigna Commercial |
$512.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$168.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$168.82
|
| Rate for Payer: Health EOS Commercial |
$495.73
|
| Rate for Payer: HFN Commercial |
$512.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$168.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$168.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$168.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$168.82
|
| Rate for Payer: Multiplan Commercial |
$445.60
|
| Rate for Payer: NAPHCARE Commercial |
$253.23
|
| Rate for Payer: Preferred Network Access Commercial |
$512.44
|
| Rate for Payer: Quartz Beloit One Network |
$272.93
|
| Rate for Payer: Quartz Commercial |
$362.05
|
| Rate for Payer: Quartz Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare PPO |
$417.75
|
| Rate for Payer: WEA Trust Commercial |
$306.35
|
| Rate for Payer: Wellcare Medicare |
$168.82
|
| Rate for Payer: WPS Commercial |
$412.57
|
|
|
Clarient, FISH Manual
|
Facility
IP
|
$557.00
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
5194629
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$272.93 |
| Max. Negotiated Rate |
$512.44 |
| Rate for Payer: Aetna Commercial |
$501.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$295.21
|
| Rate for Payer: Cash Price |
$167.10
|
| Rate for Payer: Cigna Commercial |
$512.44
|
| Rate for Payer: Health EOS Commercial |
$495.73
|
| Rate for Payer: HFN Commercial |
$512.44
|
| Rate for Payer: Multiplan Commercial |
$445.60
|
| Rate for Payer: NAPHCARE Commercial |
$334.20
|
| Rate for Payer: Preferred Network Access Commercial |
$512.44
|
| Rate for Payer: Quartz Beloit One Network |
$272.93
|
| Rate for Payer: Quartz Commercial |
$334.20
|
| Rate for Payer: WEA Trust Commercial |
$306.35
|
| Rate for Payer: WPS Commercial |
$412.57
|
|
|
Clarient, IC Chem
|
Facility
IP
|
$107.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
4590607
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.43 |
| Max. Negotiated Rate |
$98.44 |
| Rate for Payer: Aetna Commercial |
$96.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.71
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cigna Commercial |
$98.44
|
| Rate for Payer: Health EOS Commercial |
$95.23
|
| Rate for Payer: HFN Commercial |
$98.44
|
| Rate for Payer: Multiplan Commercial |
$85.60
|
| Rate for Payer: NAPHCARE Commercial |
$64.20
|
| Rate for Payer: Preferred Network Access Commercial |
$98.44
|
| Rate for Payer: Quartz Beloit One Network |
$52.43
|
| Rate for Payer: Quartz Commercial |
$64.20
|
| Rate for Payer: WEA Trust Commercial |
$58.85
|
| Rate for Payer: WPS Commercial |
$79.25
|
|
|
Clarient, IC Chem
|
Facility
OP
|
$107.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
4590607
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.43 |
| Max. Negotiated Rate |
$633.08 |
| Rate for Payer: Aetna Commercial |
$96.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.02
|
| Rate for Payer: Aetna Managed Medicare |
$168.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$633.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$295.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$280.24
|
| Rate for Payer: Anthem Medicare Advantage |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$168.82
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cigna Commercial |
$98.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$168.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$168.82
|
| Rate for Payer: Health EOS Commercial |
$95.23
|
| Rate for Payer: HFN Commercial |
$98.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$168.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$168.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$168.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$168.82
|
| Rate for Payer: Multiplan Commercial |
$85.60
|
| Rate for Payer: NAPHCARE Commercial |
$253.23
|
| Rate for Payer: Preferred Network Access Commercial |
$98.44
|
| Rate for Payer: Quartz Beloit One Network |
$52.43
|
| Rate for Payer: Quartz Commercial |
$69.55
|
| Rate for Payer: Quartz Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare PPO |
$80.25
|
| Rate for Payer: WEA Trust Commercial |
$58.85
|
| Rate for Payer: Wellcare Medicare |
$168.82
|
| Rate for Payer: WPS Commercial |
$79.25
|
|
|
Clarient, IH
|
Facility
OP
|
$244.00
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
5098653
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$68.32 |
| Max. Negotiated Rate |
$224.48 |
| Rate for Payer: Aetna Commercial |
$219.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$209.84
|
| Rate for Payer: Aetna Managed Medicare |
$68.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$158.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$122.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$117.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$129.32
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$224.48
|
| Rate for Payer: Health EOS Commercial |
$217.16
|
| Rate for Payer: HFN Commercial |
$224.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$183.00
|
| Rate for Payer: Multiplan Commercial |
$195.20
|
| Rate for Payer: NAPHCARE Commercial |
$146.40
|
| Rate for Payer: Preferred Network Access Commercial |
$224.48
|
| Rate for Payer: Quartz Beloit One Network |
$119.56
|
| Rate for Payer: Quartz Commercial |
$158.60
|
| Rate for Payer: Quartz Medicare Advantage |
$146.40
|
| Rate for Payer: United Healthcare PPO |
$183.00
|
| Rate for Payer: WEA Trust Commercial |
$134.20
|
| Rate for Payer: WPS Commercial |
$180.73
|
|
|
Clarient, IH
|
Facility
IP
|
$244.00
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
5098653
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$119.56 |
| Max. Negotiated Rate |
$224.48 |
| Rate for Payer: Aetna Commercial |
$219.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$129.32
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$224.48
|
| Rate for Payer: Health EOS Commercial |
$217.16
|
| Rate for Payer: HFN Commercial |
$224.48
|
| Rate for Payer: Multiplan Commercial |
$195.20
|
| Rate for Payer: NAPHCARE Commercial |
$146.40
|
| Rate for Payer: Preferred Network Access Commercial |
$224.48
|
| Rate for Payer: Quartz Beloit One Network |
$119.56
|
| Rate for Payer: Quartz Commercial |
$146.40
|
| Rate for Payer: WEA Trust Commercial |
$134.20
|
| Rate for Payer: WPS Commercial |
$180.73
|
|
|
Clarient, IH 1st Stain
|
Facility
OP
|
$244.00
|
|
|
Service Code
|
CPT 88365
|
| Hospital Charge Code |
5098654
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$119.56 |
| Max. Negotiated Rate |
$633.08 |
| Rate for Payer: Aetna Commercial |
$219.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$209.84
|
| Rate for Payer: Aetna Managed Medicare |
$168.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$633.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$295.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$280.24
|
| Rate for Payer: Anthem Medicare Advantage |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$129.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$168.82
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$224.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$168.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$168.82
|
| Rate for Payer: Health EOS Commercial |
$217.16
|
| Rate for Payer: HFN Commercial |
$224.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$168.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$168.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$168.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$168.82
|
| Rate for Payer: Multiplan Commercial |
$195.20
|
| Rate for Payer: NAPHCARE Commercial |
$253.23
|
| Rate for Payer: Preferred Network Access Commercial |
$224.48
|
| Rate for Payer: Quartz Beloit One Network |
$119.56
|
| Rate for Payer: Quartz Commercial |
$158.60
|
| Rate for Payer: Quartz Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare PPO |
$183.00
|
| Rate for Payer: WEA Trust Commercial |
$134.20
|
| Rate for Payer: Wellcare Medicare |
$168.82
|
| Rate for Payer: WPS Commercial |
$180.73
|
|
|
Clarient, IH 1st Stain
|
Facility
IP
|
$244.00
|
|
|
Service Code
|
CPT 88365
|
| Hospital Charge Code |
5098654
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$119.56 |
| Max. Negotiated Rate |
$224.48 |
| Rate for Payer: Aetna Commercial |
$219.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$129.32
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$224.48
|
| Rate for Payer: Health EOS Commercial |
$217.16
|
| Rate for Payer: HFN Commercial |
$224.48
|
| Rate for Payer: Multiplan Commercial |
$195.20
|
| Rate for Payer: NAPHCARE Commercial |
$146.40
|
| Rate for Payer: Preferred Network Access Commercial |
$224.48
|
| Rate for Payer: Quartz Beloit One Network |
$119.56
|
| Rate for Payer: Quartz Commercial |
$146.40
|
| Rate for Payer: WEA Trust Commercial |
$134.20
|
| Rate for Payer: WPS Commercial |
$180.73
|
|
|
Clarient, IH Ab
|
Facility
OP
|
$107.00
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
4590606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.96 |
| Max. Negotiated Rate |
$98.44 |
| Rate for Payer: Aetna Commercial |
$96.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.02
|
| Rate for Payer: Aetna Managed Medicare |
$29.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$69.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$53.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$51.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.71
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cigna Commercial |
$98.44
|
| Rate for Payer: Health EOS Commercial |
$95.23
|
| Rate for Payer: HFN Commercial |
$98.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$80.25
|
| Rate for Payer: Multiplan Commercial |
$85.60
|
| Rate for Payer: NAPHCARE Commercial |
$64.20
|
| Rate for Payer: Preferred Network Access Commercial |
$98.44
|
| Rate for Payer: Quartz Beloit One Network |
$52.43
|
| Rate for Payer: Quartz Commercial |
$69.55
|
| Rate for Payer: Quartz Medicare Advantage |
$64.20
|
| Rate for Payer: United Healthcare PPO |
$80.25
|
| Rate for Payer: WEA Trust Commercial |
$58.85
|
| Rate for Payer: WPS Commercial |
$79.25
|
|
|
Clarient, IH Ab
|
Facility
IP
|
$107.00
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
4590606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.43 |
| Max. Negotiated Rate |
$98.44 |
| Rate for Payer: Aetna Commercial |
$96.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.71
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Cigna Commercial |
$98.44
|
| Rate for Payer: Health EOS Commercial |
$95.23
|
| Rate for Payer: HFN Commercial |
$98.44
|
| Rate for Payer: Multiplan Commercial |
$85.60
|
| Rate for Payer: NAPHCARE Commercial |
$64.20
|
| Rate for Payer: Preferred Network Access Commercial |
$98.44
|
| Rate for Payer: Quartz Beloit One Network |
$52.43
|
| Rate for Payer: Quartz Commercial |
$64.20
|
| Rate for Payer: WEA Trust Commercial |
$58.85
|
| Rate for Payer: WPS Commercial |
$79.25
|
|
|
Clarient, IHC Quant
|
Facility
IP
|
$132.00
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
5194630
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$64.68 |
| Max. Negotiated Rate |
$121.44 |
| Rate for Payer: Aetna Commercial |
$118.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$69.96
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna Commercial |
$121.44
|
| Rate for Payer: Health EOS Commercial |
$117.48
|
| Rate for Payer: HFN Commercial |
$121.44
|
| Rate for Payer: Multiplan Commercial |
$105.60
|
| Rate for Payer: NAPHCARE Commercial |
$79.20
|
| Rate for Payer: Preferred Network Access Commercial |
$121.44
|
| Rate for Payer: Quartz Beloit One Network |
$64.68
|
| Rate for Payer: Quartz Commercial |
$79.20
|
| Rate for Payer: WEA Trust Commercial |
$72.60
|
| Rate for Payer: WPS Commercial |
$97.77
|
|
|
Clarient, IHC Quant
|
Facility
OP
|
$132.00
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
5194630
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$64.68 |
| Max. Negotiated Rate |
$633.08 |
| Rate for Payer: Aetna Commercial |
$118.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$113.52
|
| Rate for Payer: Aetna Managed Medicare |
$168.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$633.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$295.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$280.24
|
| Rate for Payer: Anthem Medicare Advantage |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$69.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$168.82
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna Commercial |
$121.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$168.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$168.82
|
| Rate for Payer: Health EOS Commercial |
$117.48
|
| Rate for Payer: HFN Commercial |
$121.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$168.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$168.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$168.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$168.82
|
| Rate for Payer: Multiplan Commercial |
$105.60
|
| Rate for Payer: NAPHCARE Commercial |
$253.23
|
| Rate for Payer: Preferred Network Access Commercial |
$121.44
|
| Rate for Payer: Quartz Beloit One Network |
$64.68
|
| Rate for Payer: Quartz Commercial |
$85.80
|
| Rate for Payer: Quartz Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare PPO |
$99.00
|
| Rate for Payer: WEA Trust Commercial |
$72.60
|
| Rate for Payer: Wellcare Medicare |
$168.82
|
| Rate for Payer: WPS Commercial |
$97.77
|
|
|
Clarient, IHS Ab Slide
|
Facility
OP
|
$320.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
4856608
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$156.80 |
| Max. Negotiated Rate |
$1,332.30 |
| Rate for Payer: Aetna Commercial |
$288.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$275.20
|
| Rate for Payer: Aetna Managed Medicare |
$355.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,332.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$621.74
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$589.76
|
| Rate for Payer: Anthem Medicare Advantage |
$355.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$169.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$355.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$355.28
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$294.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$355.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$355.28
|
| Rate for Payer: Health EOS Commercial |
$284.80
|
| Rate for Payer: HFN Commercial |
$294.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,321.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$355.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$355.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$355.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$355.28
|
| Rate for Payer: Multiplan Commercial |
$256.00
|
| Rate for Payer: NAPHCARE Commercial |
$532.92
|
| Rate for Payer: Preferred Network Access Commercial |
$294.40
|
| Rate for Payer: Quartz Beloit One Network |
$156.80
|
| Rate for Payer: Quartz Commercial |
$208.00
|
| Rate for Payer: Quartz Medicare Advantage |
$355.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$355.28
|
| Rate for Payer: United Healthcare PPO |
$240.00
|
| Rate for Payer: WEA Trust Commercial |
$176.00
|
| Rate for Payer: Wellcare Medicare |
$355.28
|
| Rate for Payer: WPS Commercial |
$237.02
|
|
|
Clarient, IHS Ab Slide
|
Facility
IP
|
$320.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
4856608
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$156.80 |
| Max. Negotiated Rate |
$294.40 |
| Rate for Payer: Aetna Commercial |
$288.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$169.60
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$294.40
|
| Rate for Payer: Health EOS Commercial |
$284.80
|
| Rate for Payer: HFN Commercial |
$294.40
|
| Rate for Payer: Multiplan Commercial |
$256.00
|
| Rate for Payer: NAPHCARE Commercial |
$192.00
|
| Rate for Payer: Preferred Network Access Commercial |
$294.40
|
| Rate for Payer: Quartz Beloit One Network |
$156.80
|
| Rate for Payer: Quartz Commercial |
$192.00
|
| Rate for Payer: WEA Trust Commercial |
$176.00
|
| Rate for Payer: WPS Commercial |
$237.02
|
|
|
Clarient, ImmHisto Ab
|
Facility
OP
|
$266.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
4590608
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$130.34 |
| Max. Negotiated Rate |
$1,332.30 |
| Rate for Payer: Aetna Commercial |
$239.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$228.76
|
| Rate for Payer: Aetna Managed Medicare |
$355.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,332.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$621.74
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$589.76
|
| Rate for Payer: Anthem Medicare Advantage |
$355.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$140.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$355.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$355.28
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cigna Commercial |
$244.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$355.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$355.28
|
| Rate for Payer: Health EOS Commercial |
$236.74
|
| Rate for Payer: HFN Commercial |
$244.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,321.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$355.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$355.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$355.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$355.28
|
| Rate for Payer: Multiplan Commercial |
$212.80
|
| Rate for Payer: NAPHCARE Commercial |
$532.92
|
| Rate for Payer: Preferred Network Access Commercial |
$244.72
|
| Rate for Payer: Quartz Beloit One Network |
$130.34
|
| Rate for Payer: Quartz Commercial |
$172.90
|
| Rate for Payer: Quartz Medicare Advantage |
$355.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$355.28
|
| Rate for Payer: United Healthcare PPO |
$199.50
|
| Rate for Payer: WEA Trust Commercial |
$146.30
|
| Rate for Payer: Wellcare Medicare |
$355.28
|
| Rate for Payer: WPS Commercial |
$197.03
|
|
|
Clarient, ImmHisto Ab
|
Facility
IP
|
$266.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
4590608
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$130.34 |
| Max. Negotiated Rate |
$244.72 |
| Rate for Payer: Aetna Commercial |
$239.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$140.98
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cigna Commercial |
$244.72
|
| Rate for Payer: Health EOS Commercial |
$236.74
|
| Rate for Payer: HFN Commercial |
$244.72
|
| Rate for Payer: Multiplan Commercial |
$212.80
|
| Rate for Payer: NAPHCARE Commercial |
$159.60
|
| Rate for Payer: Preferred Network Access Commercial |
$244.72
|
| Rate for Payer: Quartz Beloit One Network |
$130.34
|
| Rate for Payer: Quartz Commercial |
$159.60
|
| Rate for Payer: WEA Trust Commercial |
$146.30
|
| Rate for Payer: WPS Commercial |
$197.03
|
|
|
Clarient, M/PH Alys
|
Facility
OP
|
$602.00
|
|
|
Service Code
|
CPT 88374
|
| Hospital Charge Code |
4590609
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$168.82 |
| Max. Negotiated Rate |
$633.08 |
| Rate for Payer: Aetna Commercial |
$541.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$517.72
|
| Rate for Payer: Aetna Managed Medicare |
$168.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$633.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$295.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$280.24
|
| Rate for Payer: Anthem Medicare Advantage |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$168.82
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cigna Commercial |
$553.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$168.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$168.82
|
| Rate for Payer: Health EOS Commercial |
$535.78
|
| Rate for Payer: HFN Commercial |
$553.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$168.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$168.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$168.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$168.82
|
| Rate for Payer: Multiplan Commercial |
$481.60
|
| Rate for Payer: NAPHCARE Commercial |
$253.23
|
| Rate for Payer: Preferred Network Access Commercial |
$553.84
|
| Rate for Payer: Quartz Beloit One Network |
$294.98
|
| Rate for Payer: Quartz Commercial |
$391.30
|
| Rate for Payer: Quartz Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare PPO |
$451.50
|
| Rate for Payer: WEA Trust Commercial |
$331.10
|
| Rate for Payer: Wellcare Medicare |
$168.82
|
| Rate for Payer: WPS Commercial |
$445.90
|
|
|
Clarient, M/PH Alys
|
Facility
IP
|
$602.00
|
|
|
Service Code
|
CPT 88374
|
| Hospital Charge Code |
4590609
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$294.98 |
| Max. Negotiated Rate |
$553.84 |
| Rate for Payer: Aetna Commercial |
$541.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.06
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cigna Commercial |
$553.84
|
| Rate for Payer: Health EOS Commercial |
$535.78
|
| Rate for Payer: HFN Commercial |
$553.84
|
| Rate for Payer: Multiplan Commercial |
$481.60
|
| Rate for Payer: NAPHCARE Commercial |
$361.20
|
| Rate for Payer: Preferred Network Access Commercial |
$553.84
|
| Rate for Payer: Quartz Beloit One Network |
$294.98
|
| Rate for Payer: Quartz Commercial |
$361.20
|
| Rate for Payer: WEA Trust Commercial |
$331.10
|
| Rate for Payer: WPS Commercial |
$445.90
|
|
|
Clarient, M/Phmtrc Alys
|
Facility
OP
|
$725.00
|
|
|
Service Code
|
CPT 88374
|
| Hospital Charge Code |
4856606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$168.82 |
| Max. Negotiated Rate |
$667.00 |
| Rate for Payer: Aetna Commercial |
$652.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$623.50
|
| Rate for Payer: Aetna Managed Medicare |
$168.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$633.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$295.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$280.24
|
| Rate for Payer: Anthem Medicare Advantage |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$384.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$168.82
|
| Rate for Payer: Cash Price |
$217.50
|
| Rate for Payer: Cash Price |
$217.50
|
| Rate for Payer: Cigna Commercial |
$667.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$168.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$168.82
|
| Rate for Payer: Health EOS Commercial |
$645.25
|
| Rate for Payer: HFN Commercial |
$667.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$168.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$168.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$168.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$168.82
|
| Rate for Payer: Multiplan Commercial |
$580.00
|
| Rate for Payer: NAPHCARE Commercial |
$253.23
|
| Rate for Payer: Preferred Network Access Commercial |
$667.00
|
| Rate for Payer: Quartz Beloit One Network |
$355.25
|
| Rate for Payer: Quartz Commercial |
$471.25
|
| Rate for Payer: Quartz Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare PPO |
$543.75
|
| Rate for Payer: WEA Trust Commercial |
$398.75
|
| Rate for Payer: Wellcare Medicare |
$168.82
|
| Rate for Payer: WPS Commercial |
$537.01
|
|
|
Clarient, M/Phmtrc Alys
|
Facility
IP
|
$725.00
|
|
|
Service Code
|
CPT 88374
|
| Hospital Charge Code |
4856606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$355.25 |
| Max. Negotiated Rate |
$667.00 |
| Rate for Payer: Aetna Commercial |
$652.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$384.25
|
| Rate for Payer: Cash Price |
$217.50
|
| Rate for Payer: Cigna Commercial |
$667.00
|
| Rate for Payer: Health EOS Commercial |
$645.25
|
| Rate for Payer: HFN Commercial |
$667.00
|
| Rate for Payer: Multiplan Commercial |
$580.00
|
| Rate for Payer: NAPHCARE Commercial |
$435.00
|
| Rate for Payer: Preferred Network Access Commercial |
$667.00
|
| Rate for Payer: Quartz Beloit One Network |
$355.25
|
| Rate for Payer: Quartz Commercial |
$435.00
|
| Rate for Payer: WEA Trust Commercial |
$398.75
|
| Rate for Payer: WPS Commercial |
$537.01
|
|
