|
CCC Pulmonary Capillary Wedge Pressure Monitoring - CCC Monitoring Charges
|
Facility
|
IP
|
$354.00
|
|
| Hospital Charge Code |
3715550
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$180.40 |
| Max. Negotiated Rate |
$338.71 |
| Rate for Payer: Aetna Commercial |
$331.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$316.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$195.12
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna Commercial |
$338.71
|
| Rate for Payer: Health EOS Commercial |
$327.66
|
| Rate for Payer: HFN Commercial |
$338.71
|
| Rate for Payer: Multiplan Commercial |
$294.53
|
| Rate for Payer: Preferred Network Access Commercial |
$338.71
|
| Rate for Payer: Quartz Beloit One Network |
$180.40
|
| Rate for Payer: Quartz Commercial |
$220.90
|
| Rate for Payer: WEA Trust Commercial |
$202.49
|
| Rate for Payer: WPS Commercial |
$272.69
|
|
|
CCC Pulmonary Capillary Wedge Pressure Monitoring - CCC Monitoring Charges
|
Facility
|
OP
|
$354.00
|
|
| Hospital Charge Code |
3715550
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$103.08 |
| Max. Negotiated Rate |
$338.71 |
| Rate for Payer: Aetna Commercial |
$331.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$316.62
|
| Rate for Payer: Aetna Managed Medicare |
$103.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$239.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$184.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$176.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$195.12
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna Commercial |
$338.71
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$206.03
|
| Rate for Payer: Health EOS Commercial |
$327.66
|
| Rate for Payer: HFN Commercial |
$338.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$276.12
|
| Rate for Payer: Multiplan Commercial |
$294.53
|
| Rate for Payer: NAPHCARE Commercial |
$220.90
|
| Rate for Payer: Preferred Network Access Commercial |
$338.71
|
| Rate for Payer: Quartz Beloit One Network |
$180.40
|
| Rate for Payer: Quartz Commercial |
$239.30
|
| Rate for Payer: Quartz Medicare Advantage |
$220.90
|
| Rate for Payer: The Alliance Commercial |
$184.08
|
| Rate for Payer: WEA Trust Commercial |
$202.49
|
| Rate for Payer: WPS Commercial |
$272.69
|
|
|
CCPD Completed Training Day
|
Facility
|
IP
|
$1,904.00
|
|
|
Service Code
|
CPT 90989
|
| Hospital Charge Code |
3215531
|
|
Hospital Revenue Code
|
850
|
| Min. Negotiated Rate |
$970.28 |
| Max. Negotiated Rate |
$1,821.75 |
| Rate for Payer: Aetna Commercial |
$1,782.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,702.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,049.48
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cigna Commercial |
$1,821.75
|
| Rate for Payer: Health EOS Commercial |
$1,762.34
|
| Rate for Payer: HFN Commercial |
$1,821.75
|
| Rate for Payer: Multiplan Commercial |
$1,584.13
|
| Rate for Payer: Preferred Network Access Commercial |
$1,821.75
|
| Rate for Payer: Quartz Beloit One Network |
$970.28
|
| Rate for Payer: Quartz Commercial |
$1,188.10
|
| Rate for Payer: WEA Trust Commercial |
$1,089.09
|
| Rate for Payer: WPS Commercial |
$1,466.65
|
|
|
CCPD Completed Training Day
|
Facility
|
OP
|
$1,904.00
|
|
|
Service Code
|
CPT 90989
|
| Hospital Charge Code |
3215531
|
|
Hospital Revenue Code
|
850
|
| Min. Negotiated Rate |
$554.44 |
| Max. Negotiated Rate |
$1,821.75 |
| Rate for Payer: Health EOS Commercial |
$1,762.34
|
| Rate for Payer: Aetna Commercial |
$1,782.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,702.94
|
| Rate for Payer: Aetna Managed Medicare |
$554.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,287.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$990.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$950.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,049.48
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cigna Commercial |
$1,821.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,108.13
|
| Rate for Payer: HFN Commercial |
$1,821.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,485.12
|
| Rate for Payer: Multiplan Commercial |
$1,584.13
|
| Rate for Payer: NAPHCARE Commercial |
$1,188.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,821.75
|
| Rate for Payer: Quartz Beloit One Network |
$970.28
|
| Rate for Payer: Quartz Commercial |
$1,287.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,188.10
|
| Rate for Payer: The Alliance Commercial |
$990.08
|
| Rate for Payer: United Healthcare PPO |
$1,485.12
|
| Rate for Payer: WEA Trust Commercial |
$1,089.09
|
| Rate for Payer: WPS Commercial |
$1,466.65
|
|
|
CCPD Inpatient
|
Facility
|
OP
|
$1,455.00
|
|
| Hospital Charge Code |
3603560
|
|
Hospital Revenue Code
|
804
|
| Min. Negotiated Rate |
$423.70 |
| Max. Negotiated Rate |
$1,392.14 |
| Rate for Payer: Aetna Commercial |
$1,361.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,301.35
|
| Rate for Payer: Aetna Managed Medicare |
$423.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$983.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$756.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$726.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$802.00
|
| Rate for Payer: Cash Price |
$436.50
|
| Rate for Payer: Cigna Commercial |
$1,392.14
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$846.81
|
| Rate for Payer: Health EOS Commercial |
$1,346.75
|
| Rate for Payer: HFN Commercial |
$1,392.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,134.90
|
| Rate for Payer: Multiplan Commercial |
$1,210.56
|
| Rate for Payer: NAPHCARE Commercial |
$907.92
|
| Rate for Payer: Preferred Network Access Commercial |
$1,392.14
|
| Rate for Payer: Quartz Beloit One Network |
$741.47
|
| Rate for Payer: Quartz Commercial |
$983.58
|
| Rate for Payer: Quartz Medicare Advantage |
$907.92
|
| Rate for Payer: The Alliance Commercial |
$756.60
|
| Rate for Payer: WEA Trust Commercial |
$832.26
|
| Rate for Payer: WPS Commercial |
$1,120.79
|
|
|
CCPD Inpatient
|
Facility
|
IP
|
$1,455.00
|
|
| Hospital Charge Code |
3603560
|
|
Hospital Revenue Code
|
804
|
| Min. Negotiated Rate |
$741.47 |
| Max. Negotiated Rate |
$1,392.14 |
| Rate for Payer: Aetna Commercial |
$1,361.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,301.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$802.00
|
| Rate for Payer: Cash Price |
$436.50
|
| Rate for Payer: Cigna Commercial |
$1,392.14
|
| Rate for Payer: Health EOS Commercial |
$1,346.75
|
| Rate for Payer: HFN Commercial |
$1,392.14
|
| Rate for Payer: Multiplan Commercial |
$1,210.56
|
| Rate for Payer: Preferred Network Access Commercial |
$1,392.14
|
| Rate for Payer: Quartz Beloit One Network |
$741.47
|
| Rate for Payer: Quartz Commercial |
$907.92
|
| Rate for Payer: WEA Trust Commercial |
$832.26
|
| Rate for Payer: WPS Commercial |
$1,120.79
|
|
|
CCPD Method I
|
Facility
|
OP
|
$849.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
3005581
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$432.65 |
| Max. Negotiated Rate |
$1,756.48 |
| Rate for Payer: Aetna Commercial |
$794.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$759.35
|
| Rate for Payer: Aetna Managed Medicare |
$439.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$726.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$596.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$566.80
|
| Rate for Payer: Anthem Medicare Advantage |
$439.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$467.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$439.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$439.12
|
| Rate for Payer: Cash Price |
$254.70
|
| Rate for Payer: Cash Price |
$254.70
|
| Rate for Payer: Cash Price |
$254.70
|
| Rate for Payer: Cigna Commercial |
$812.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$439.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$494.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$439.12
|
| Rate for Payer: Health EOS Commercial |
$785.83
|
| Rate for Payer: HFN Commercial |
$812.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,633.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$439.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$439.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$439.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$439.12
|
| Rate for Payer: Multiplan Commercial |
$706.37
|
| Rate for Payer: NAPHCARE Commercial |
$658.68
|
| Rate for Payer: Preferred Network Access Commercial |
$812.32
|
| Rate for Payer: Quartz Beloit One Network |
$432.65
|
| Rate for Payer: Quartz Commercial |
$573.92
|
| Rate for Payer: Quartz Medicare Advantage |
$439.12
|
| Rate for Payer: The Alliance Commercial |
$1,756.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$439.12
|
| Rate for Payer: United Healthcare PPO |
$662.22
|
| Rate for Payer: WEA Trust Commercial |
$485.63
|
| Rate for Payer: Wellcare Medicare |
$439.12
|
| Rate for Payer: WPS Commercial |
$653.98
|
|
|
CCPD Method I
|
Facility
|
IP
|
$849.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
3005581
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$432.65 |
| Max. Negotiated Rate |
$812.32 |
| Rate for Payer: Aetna Commercial |
$794.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$759.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$467.97
|
| Rate for Payer: Cash Price |
$254.70
|
| Rate for Payer: Cigna Commercial |
$812.32
|
| Rate for Payer: Health EOS Commercial |
$785.83
|
| Rate for Payer: HFN Commercial |
$812.32
|
| Rate for Payer: Multiplan Commercial |
$706.37
|
| Rate for Payer: Preferred Network Access Commercial |
$812.32
|
| Rate for Payer: Quartz Beloit One Network |
$432.65
|
| Rate for Payer: Quartz Commercial |
$529.78
|
| Rate for Payer: WEA Trust Commercial |
$485.63
|
| Rate for Payer: WPS Commercial |
$653.98
|
|
|
CCPD Support Method 2
|
Facility
|
OP
|
$5,029.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
3603559
|
|
Hospital Revenue Code
|
855
|
| Min. Negotiated Rate |
$439.12 |
| Max. Negotiated Rate |
$4,811.75 |
| Rate for Payer: Aetna Commercial |
$4,707.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,497.94
|
| Rate for Payer: Aetna Managed Medicare |
$439.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,399.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,615.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,510.48
|
| Rate for Payer: Anthem Medicare Advantage |
$439.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,771.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$439.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$439.12
|
| Rate for Payer: Cash Price |
$1,508.70
|
| Rate for Payer: Cash Price |
$1,508.70
|
| Rate for Payer: Cigna Commercial |
$4,811.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$439.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,926.88
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$439.12
|
| Rate for Payer: Health EOS Commercial |
$4,654.84
|
| Rate for Payer: HFN Commercial |
$4,811.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,633.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$439.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$439.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$439.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$439.12
|
| Rate for Payer: Multiplan Commercial |
$4,184.13
|
| Rate for Payer: NAPHCARE Commercial |
$658.68
|
| Rate for Payer: Preferred Network Access Commercial |
$4,811.75
|
| Rate for Payer: Quartz Beloit One Network |
$2,562.78
|
| Rate for Payer: Quartz Commercial |
$3,399.60
|
| Rate for Payer: Quartz Medicare Advantage |
$439.12
|
| Rate for Payer: The Alliance Commercial |
$1,756.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$439.12
|
| Rate for Payer: United Healthcare PPO |
$3,922.62
|
| Rate for Payer: WEA Trust Commercial |
$2,876.59
|
| Rate for Payer: Wellcare Medicare |
$439.12
|
| Rate for Payer: WPS Commercial |
$3,873.84
|
|
|
CCPD Support Method 2
|
Facility
|
IP
|
$5,029.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
3603559
|
|
Hospital Revenue Code
|
855
|
| Min. Negotiated Rate |
$2,562.78 |
| Max. Negotiated Rate |
$4,811.75 |
| Rate for Payer: Aetna Commercial |
$4,707.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,497.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,771.98
|
| Rate for Payer: Cash Price |
$1,508.70
|
| Rate for Payer: Cigna Commercial |
$4,811.75
|
| Rate for Payer: Health EOS Commercial |
$4,654.84
|
| Rate for Payer: HFN Commercial |
$4,811.75
|
| Rate for Payer: Multiplan Commercial |
$4,184.13
|
| Rate for Payer: Preferred Network Access Commercial |
$4,811.75
|
| Rate for Payer: Quartz Beloit One Network |
$2,562.78
|
| Rate for Payer: Quartz Commercial |
$3,138.10
|
| Rate for Payer: WEA Trust Commercial |
$2,876.59
|
| Rate for Payer: WPS Commercial |
$3,873.84
|
|
|
CCPD Training per Day
|
Facility
|
IP
|
$1,904.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
3005583
|
|
Hospital Revenue Code
|
850
|
| Min. Negotiated Rate |
$970.28 |
| Max. Negotiated Rate |
$1,821.75 |
| Rate for Payer: HFN Commercial |
$1,821.75
|
| Rate for Payer: Aetna Commercial |
$1,782.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,702.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,049.48
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cigna Commercial |
$1,821.75
|
| Rate for Payer: Health EOS Commercial |
$1,762.34
|
| Rate for Payer: Multiplan Commercial |
$1,584.13
|
| Rate for Payer: Preferred Network Access Commercial |
$1,821.75
|
| Rate for Payer: Quartz Beloit One Network |
$970.28
|
| Rate for Payer: Quartz Commercial |
$1,188.10
|
| Rate for Payer: WEA Trust Commercial |
$1,089.09
|
| Rate for Payer: WPS Commercial |
$1,466.65
|
|
|
CCPD Training per Day
|
Facility
|
OP
|
$1,904.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
3005583
|
|
Hospital Revenue Code
|
850
|
| Min. Negotiated Rate |
$554.44 |
| Max. Negotiated Rate |
$1,821.75 |
| Rate for Payer: Aetna Commercial |
$1,782.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,702.94
|
| Rate for Payer: Aetna Managed Medicare |
$554.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,287.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$990.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$950.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,049.48
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cigna Commercial |
$1,821.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,108.13
|
| Rate for Payer: Health EOS Commercial |
$1,762.34
|
| Rate for Payer: HFN Commercial |
$1,821.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,485.12
|
| Rate for Payer: Multiplan Commercial |
$1,584.13
|
| Rate for Payer: NAPHCARE Commercial |
$1,188.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,821.75
|
| Rate for Payer: Quartz Beloit One Network |
$970.28
|
| Rate for Payer: Quartz Commercial |
$1,287.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,188.10
|
| Rate for Payer: The Alliance Commercial |
$990.08
|
| Rate for Payer: United Healthcare PPO |
$1,485.12
|
| Rate for Payer: WEA Trust Commercial |
$1,089.09
|
| Rate for Payer: WPS Commercial |
$1,466.65
|
|
|
CD19, CD20 to Mayo
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
4620679
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$573.04 |
| Rate for Payer: Aetna Commercial |
$573.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$518.75
|
| Rate for Payer: Aetna Managed Medicare |
$39.24
|
| Rate for Payer: Anthem Medicare Advantage |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.24
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Cigna Commercial |
$573.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$301.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$39.24
|
| Rate for Payer: Health EOS Commercial |
$548.91
|
| Rate for Payer: HFN Commercial |
$573.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$138.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$138.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$482.56
|
| Rate for Payer: NAPHCARE Commercial |
$58.86
|
| Rate for Payer: Preferred Network Access Commercial |
$573.04
|
| Rate for Payer: Quartz Beloit One Network |
$265.41
|
| Rate for Payer: Quartz Commercial |
$343.82
|
| Rate for Payer: Quartz Medicare Advantage |
$39.24
|
| Rate for Payer: The Alliance Commercial |
$154.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.24
|
| Rate for Payer: WEA Trust Commercial |
$331.76
|
| Rate for Payer: WPS Commercial |
$172.65
|
|
|
CD19, CD20 to Mayo
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
4620679
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$554.94 |
| Rate for Payer: Aetna Commercial |
$542.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$518.75
|
| Rate for Payer: Aetna Managed Medicare |
$39.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$147.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$68.67
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$65.14
|
| Rate for Payer: Anthem Medicare Advantage |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.24
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Cigna Commercial |
$554.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$337.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.24
|
| Rate for Payer: Health EOS Commercial |
$536.85
|
| Rate for Payer: HFN Commercial |
$554.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$145.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$482.56
|
| Rate for Payer: NAPHCARE Commercial |
$58.86
|
| Rate for Payer: Preferred Network Access Commercial |
$554.94
|
| Rate for Payer: Quartz Beloit One Network |
$295.57
|
| Rate for Payer: Quartz Commercial |
$392.08
|
| Rate for Payer: Quartz Medicare Advantage |
$39.24
|
| Rate for Payer: The Alliance Commercial |
$156.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.24
|
| Rate for Payer: United Healthcare PPO |
$452.40
|
| Rate for Payer: WEA Trust Commercial |
$331.76
|
| Rate for Payer: Wellcare Medicare |
$39.24
|
| Rate for Payer: WPS Commercial |
$446.77
|
|
|
CD19, CD20 to Mayo
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
4620679
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$295.57 |
| Max. Negotiated Rate |
$554.94 |
| Rate for Payer: Aetna Commercial |
$542.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$518.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.70
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Cigna Commercial |
$554.94
|
| Rate for Payer: Health EOS Commercial |
$536.85
|
| Rate for Payer: HFN Commercial |
$554.94
|
| Rate for Payer: Multiplan Commercial |
$482.56
|
| Rate for Payer: Preferred Network Access Commercial |
$554.94
|
| Rate for Payer: Quartz Beloit One Network |
$295.57
|
| Rate for Payer: Quartz Commercial |
$361.92
|
| Rate for Payer: WEA Trust Commercial |
$331.76
|
| Rate for Payer: WPS Commercial |
$446.77
|
|
|
CD4/CD8 Ratio
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
4746614
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$49.43 |
| Max. Negotiated Rate |
$92.81 |
| Rate for Payer: Aetna Commercial |
$90.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$53.47
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$92.81
|
| Rate for Payer: Health EOS Commercial |
$89.78
|
| Rate for Payer: HFN Commercial |
$92.81
|
| Rate for Payer: Multiplan Commercial |
$80.70
|
| Rate for Payer: Preferred Network Access Commercial |
$92.81
|
| Rate for Payer: Quartz Beloit One Network |
$49.43
|
| Rate for Payer: Quartz Commercial |
$60.53
|
| Rate for Payer: WEA Trust Commercial |
$55.48
|
| Rate for Payer: WPS Commercial |
$74.72
|
|
|
CD4/CD8 Ratio
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
4746614
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.39 |
| Max. Negotiated Rate |
$214.98 |
| Rate for Payer: Aetna Commercial |
$95.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.76
|
| Rate for Payer: Aetna Managed Medicare |
$48.86
|
| Rate for Payer: Anthem Medicare Advantage |
$48.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$48.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$48.86
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$95.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$50.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.86
|
| Rate for Payer: Health EOS Commercial |
$91.80
|
| Rate for Payer: HFN Commercial |
$95.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$172.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$172.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$48.86
|
| Rate for Payer: Multiplan Commercial |
$80.70
|
| Rate for Payer: NAPHCARE Commercial |
$73.29
|
| Rate for Payer: Preferred Network Access Commercial |
$95.84
|
| Rate for Payer: Quartz Beloit One Network |
$44.39
|
| Rate for Payer: Quartz Commercial |
$57.50
|
| Rate for Payer: Quartz Medicare Advantage |
$48.86
|
| Rate for Payer: The Alliance Commercial |
$192.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48.86
|
| Rate for Payer: WEA Trust Commercial |
$55.48
|
| Rate for Payer: WPS Commercial |
$214.98
|
|
|
CD4/CD8 Ratio
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
4746614
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.86 |
| Max. Negotiated Rate |
$195.44 |
| Rate for Payer: Aetna Commercial |
$90.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.76
|
| Rate for Payer: Aetna Managed Medicare |
$48.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$183.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$85.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$81.11
|
| Rate for Payer: Anthem Medicare Advantage |
$48.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$53.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$48.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$48.86
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$92.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$48.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$56.45
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$48.86
|
| Rate for Payer: Health EOS Commercial |
$89.78
|
| Rate for Payer: HFN Commercial |
$92.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$181.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$48.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$48.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$48.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$48.86
|
| Rate for Payer: Multiplan Commercial |
$80.70
|
| Rate for Payer: NAPHCARE Commercial |
$73.29
|
| Rate for Payer: Preferred Network Access Commercial |
$92.81
|
| Rate for Payer: Quartz Beloit One Network |
$49.43
|
| Rate for Payer: Quartz Commercial |
$65.57
|
| Rate for Payer: Quartz Medicare Advantage |
$48.86
|
| Rate for Payer: The Alliance Commercial |
$195.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48.86
|
| Rate for Payer: United Healthcare PPO |
$75.66
|
| Rate for Payer: WEA Trust Commercial |
$55.48
|
| Rate for Payer: Wellcare Medicare |
$48.86
|
| Rate for Payer: WPS Commercial |
$74.72
|
|
|
CD57, CD3, CD8 Flow Cytometry
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
3451558
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$93.77 |
| Rate for Payer: Aetna Commercial |
$91.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$87.65
|
| Rate for Payer: Aetna Managed Medicare |
$28.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$66.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$50.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$48.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$54.02
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cigna Commercial |
$93.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$57.04
|
| Rate for Payer: Health EOS Commercial |
$90.71
|
| Rate for Payer: HFN Commercial |
$93.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$76.44
|
| Rate for Payer: Multiplan Commercial |
$81.54
|
| Rate for Payer: NAPHCARE Commercial |
$61.15
|
| Rate for Payer: Preferred Network Access Commercial |
$93.77
|
| Rate for Payer: Quartz Beloit One Network |
$49.94
|
| Rate for Payer: Quartz Commercial |
$66.25
|
| Rate for Payer: Quartz Medicare Advantage |
$61.15
|
| Rate for Payer: The Alliance Commercial |
$91.85
|
| Rate for Payer: United Healthcare PPO |
$76.44
|
| Rate for Payer: WEA Trust Commercial |
$56.06
|
| Rate for Payer: WPS Commercial |
$75.49
|
|
|
CD57, CD3, CD8 Flow Cytometry
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
3451558
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$49.94 |
| Max. Negotiated Rate |
$93.77 |
| Rate for Payer: Aetna Commercial |
$91.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$87.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$54.02
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cigna Commercial |
$93.77
|
| Rate for Payer: Health EOS Commercial |
$90.71
|
| Rate for Payer: HFN Commercial |
$93.77
|
| Rate for Payer: Multiplan Commercial |
$81.54
|
| Rate for Payer: Preferred Network Access Commercial |
$93.77
|
| Rate for Payer: Quartz Beloit One Network |
$49.94
|
| Rate for Payer: Quartz Commercial |
$61.15
|
| Rate for Payer: WEA Trust Commercial |
$56.06
|
| Rate for Payer: WPS Commercial |
$75.49
|
|
|
CD57, CD3, CD8 Flow Cytometry
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
3451558
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.96 |
| Max. Negotiated Rate |
$101.04 |
| Rate for Payer: Aetna Commercial |
$96.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$87.65
|
| Rate for Payer: Aetna Managed Medicare |
$22.96
|
| Rate for Payer: Anthem Medicare Advantage |
$22.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$22.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$22.96
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cigna Commercial |
$96.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$50.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$22.96
|
| Rate for Payer: Health EOS Commercial |
$92.75
|
| Rate for Payer: HFN Commercial |
$96.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$79.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$79.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$22.96
|
| Rate for Payer: Multiplan Commercial |
$81.54
|
| Rate for Payer: NAPHCARE Commercial |
$34.44
|
| Rate for Payer: Preferred Network Access Commercial |
$96.82
|
| Rate for Payer: Quartz Beloit One Network |
$44.84
|
| Rate for Payer: Quartz Commercial |
$58.09
|
| Rate for Payer: Quartz Medicare Advantage |
$22.96
|
| Rate for Payer: The Alliance Commercial |
$90.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22.96
|
| Rate for Payer: WEA Trust Commercial |
$56.06
|
| Rate for Payer: WPS Commercial |
$101.04
|
|
|
C diff 027-NAP1-BI
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
4125436
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.76 |
| Max. Negotiated Rate |
$160.74 |
| Rate for Payer: Aetna Commercial |
$157.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$150.26
|
| Rate for Payer: Aetna Managed Medicare |
$38.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$145.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$67.83
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$64.34
|
| Rate for Payer: Anthem Medicare Advantage |
$38.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$92.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$38.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$38.76
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna Commercial |
$160.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$38.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$97.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$38.76
|
| Rate for Payer: Health EOS Commercial |
$155.50
|
| Rate for Payer: HFN Commercial |
$160.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$144.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$38.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$38.76
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$38.76
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$38.76
|
| Rate for Payer: Multiplan Commercial |
$139.78
|
| Rate for Payer: NAPHCARE Commercial |
$58.14
|
| Rate for Payer: Preferred Network Access Commercial |
$160.74
|
| Rate for Payer: Quartz Beloit One Network |
$85.61
|
| Rate for Payer: Quartz Commercial |
$113.57
|
| Rate for Payer: Quartz Medicare Advantage |
$38.76
|
| Rate for Payer: The Alliance Commercial |
$155.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$38.76
|
| Rate for Payer: United Healthcare PPO |
$131.04
|
| Rate for Payer: WEA Trust Commercial |
$96.10
|
| Rate for Payer: Wellcare Medicare |
$38.76
|
| Rate for Payer: WPS Commercial |
$129.41
|
|
|
C diff 027-NAP1-BI
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
4125436
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$85.61 |
| Max. Negotiated Rate |
$160.74 |
| Rate for Payer: Aetna Commercial |
$157.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$150.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$92.60
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna Commercial |
$160.74
|
| Rate for Payer: Health EOS Commercial |
$155.50
|
| Rate for Payer: HFN Commercial |
$160.74
|
| Rate for Payer: Multiplan Commercial |
$139.78
|
| Rate for Payer: Preferred Network Access Commercial |
$160.74
|
| Rate for Payer: Quartz Beloit One Network |
$85.61
|
| Rate for Payer: Quartz Commercial |
$104.83
|
| Rate for Payer: WEA Trust Commercial |
$96.10
|
| Rate for Payer: WPS Commercial |
$129.41
|
|
|
C diff 027-NAP1-BI
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
4125436
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.76 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Multiplan Commercial |
$139.78
|
| Rate for Payer: NAPHCARE Commercial |
$58.14
|
| Rate for Payer: Aetna Commercial |
$165.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$150.26
|
| Rate for Payer: Aetna Managed Medicare |
$38.76
|
| Rate for Payer: Anthem Medicare Advantage |
$38.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$38.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$38.76
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna Commercial |
$165.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$87.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$38.76
|
| Rate for Payer: Health EOS Commercial |
$159.00
|
| Rate for Payer: HFN Commercial |
$165.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$136.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$136.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$38.76
|
| Rate for Payer: Preferred Network Access Commercial |
$165.98
|
| Rate for Payer: Quartz Beloit One Network |
$76.88
|
| Rate for Payer: Quartz Commercial |
$99.59
|
| Rate for Payer: Quartz Medicare Advantage |
$38.76
|
| Rate for Payer: The Alliance Commercial |
$153.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$38.76
|
| Rate for Payer: WEA Trust Commercial |
$96.10
|
| Rate for Payer: WPS Commercial |
$170.55
|
|
|
C diff B
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
2790811
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.46 |
| Max. Negotiated Rate |
$636.27 |
| Rate for Payer: Aetna Commercial |
$622.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$594.78
|
| Rate for Payer: Aetna Managed Medicare |
$12.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$46.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20.68
|
| Rate for Payer: Anthem Medicare Advantage |
$12.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$366.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.46
|
| Rate for Payer: Cash Price |
$199.50
|
| Rate for Payer: Cash Price |
$199.50
|
| Rate for Payer: Cigna Commercial |
$636.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$387.03
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.46
|
| Rate for Payer: Health EOS Commercial |
$615.52
|
| Rate for Payer: HFN Commercial |
$636.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.35
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.46
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$553.28
|
| Rate for Payer: NAPHCARE Commercial |
$18.69
|
| Rate for Payer: Preferred Network Access Commercial |
$636.27
|
| Rate for Payer: Quartz Beloit One Network |
$338.88
|
| Rate for Payer: Quartz Commercial |
$449.54
|
| Rate for Payer: Quartz Medicare Advantage |
$12.46
|
| Rate for Payer: The Alliance Commercial |
$49.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.46
|
| Rate for Payer: United Healthcare PPO |
$518.70
|
| Rate for Payer: WEA Trust Commercial |
$380.38
|
| Rate for Payer: Wellcare Medicare |
$12.46
|
| Rate for Payer: WPS Commercial |
$512.25
|
|
