|
CEFUROXIME 1.5GM (MED)
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
5415713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.12 |
| Max. Negotiated Rate |
$95.68 |
| Rate for Payer: Aetna Commercial |
$93.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$89.44
|
| Rate for Payer: Aetna Managed Medicare |
$29.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$52.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$49.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$55.12
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cigna Commercial |
$95.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$58.20
|
| Rate for Payer: Health EOS Commercial |
$92.56
|
| Rate for Payer: HFN Commercial |
$95.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$83.20
|
| Rate for Payer: NAPHCARE Commercial |
$62.40
|
| Rate for Payer: Preferred Network Access Commercial |
$95.68
|
| Rate for Payer: Quartz Beloit One Network |
$50.96
|
| Rate for Payer: Quartz Commercial |
$67.60
|
| Rate for Payer: Quartz Medicare Advantage |
$62.40
|
| Rate for Payer: The Alliance Commercial |
$52.00
|
| Rate for Payer: WEA Trust Commercial |
$57.20
|
| Rate for Payer: WPS Commercial |
$77.03
|
|
|
CEFUROXIME 1.5GM (MED)
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
5415713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$50.96 |
| Max. Negotiated Rate |
$95.68 |
| Rate for Payer: Aetna Commercial |
$93.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$89.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$55.12
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cigna Commercial |
$95.68
|
| Rate for Payer: Health EOS Commercial |
$92.56
|
| Rate for Payer: HFN Commercial |
$95.68
|
| Rate for Payer: Multiplan Commercial |
$83.20
|
| Rate for Payer: Preferred Network Access Commercial |
$95.68
|
| Rate for Payer: Quartz Beloit One Network |
$50.96
|
| Rate for Payer: Quartz Commercial |
$62.40
|
| Rate for Payer: WEA Trust Commercial |
$57.20
|
| Rate for Payer: WPS Commercial |
$77.03
|
|
|
Celestone 3 mg Charge
|
Facility
|
IP
|
$38.00
|
|
|
Service Code
|
HCPCS J0702
|
| Hospital Charge Code |
2958882
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.36 |
| Max. Negotiated Rate |
$36.36 |
| Rate for Payer: Aetna Commercial |
$35.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$33.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$20.95
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cigna Commercial |
$36.36
|
| Rate for Payer: Health EOS Commercial |
$35.17
|
| Rate for Payer: HFN Commercial |
$36.36
|
| Rate for Payer: Multiplan Commercial |
$31.62
|
| Rate for Payer: Preferred Network Access Commercial |
$36.36
|
| Rate for Payer: Quartz Beloit One Network |
$19.36
|
| Rate for Payer: Quartz Commercial |
$23.71
|
| Rate for Payer: WEA Trust Commercial |
$21.74
|
| Rate for Payer: WPS Commercial |
$29.27
|
|
|
Celestone 3 mg Charge
|
Facility
|
OP
|
$38.00
|
|
|
Service Code
|
HCPCS J0702
|
| Hospital Charge Code |
2958882
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$36.36 |
| Rate for Payer: Aetna Commercial |
$35.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$33.99
|
| Rate for Payer: Aetna Managed Medicare |
$11.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$25.69
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$20.95
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cigna Commercial |
$36.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.47
|
| Rate for Payer: Health EOS Commercial |
$35.17
|
| Rate for Payer: HFN Commercial |
$36.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.64
|
| Rate for Payer: Multiplan Commercial |
$31.62
|
| Rate for Payer: NAPHCARE Commercial |
$23.71
|
| Rate for Payer: Preferred Network Access Commercial |
$36.36
|
| Rate for Payer: Quartz Beloit One Network |
$19.36
|
| Rate for Payer: Quartz Commercial |
$25.69
|
| Rate for Payer: Quartz Medicare Advantage |
$23.71
|
| Rate for Payer: The Alliance Commercial |
$29.66
|
| Rate for Payer: WEA Trust Commercial |
$21.74
|
| Rate for Payer: WPS Commercial |
$17.90
|
|
|
Celestone 3 mg Charge
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS J0702
|
| Hospital Charge Code |
2958882
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$37.54 |
| Rate for Payer: Aetna Commercial |
$37.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$33.99
|
| Rate for Payer: Aetna Managed Medicare |
$7.42
|
| Rate for Payer: Anthem Medicare Advantage |
$7.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.42
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cigna Commercial |
$37.54
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7.16
|
| Rate for Payer: Health EOS Commercial |
$35.96
|
| Rate for Payer: HFN Commercial |
$37.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$9.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9.25
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.42
|
| Rate for Payer: Multiplan Commercial |
$31.62
|
| Rate for Payer: NAPHCARE Commercial |
$11.12
|
| Rate for Payer: Preferred Network Access Commercial |
$37.54
|
| Rate for Payer: Quartz Beloit One Network |
$17.39
|
| Rate for Payer: Quartz Commercial |
$22.53
|
| Rate for Payer: Quartz Medicare Advantage |
$7.42
|
| Rate for Payer: The Alliance Commercial |
$20.39
|
| Rate for Payer: United Healthcare Medicaid |
$7.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.42
|
| Rate for Payer: WEA Trust Commercial |
$21.74
|
| Rate for Payer: WPS Commercial |
$17.90
|
|
|
Celiac Disease, HLA Typing
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
5438800
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$51.98 |
| Max. Negotiated Rate |
$514.51 |
| Rate for Payer: Aetna Commercial |
$95.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.23
|
| Rate for Payer: Aetna Managed Medicare |
$128.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$482.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$225.10
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$213.52
|
| Rate for Payer: Anthem Medicare Advantage |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$128.63
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$97.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$128.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$59.36
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$128.63
|
| Rate for Payer: Health EOS Commercial |
$94.41
|
| Rate for Payer: HFN Commercial |
$97.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$478.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$128.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$128.63
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$128.63
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$128.63
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: NAPHCARE Commercial |
$192.94
|
| Rate for Payer: Preferred Network Access Commercial |
$97.59
|
| Rate for Payer: Quartz Beloit One Network |
$51.98
|
| Rate for Payer: Quartz Commercial |
$68.95
|
| Rate for Payer: Quartz Medicare Advantage |
$128.63
|
| Rate for Payer: The Alliance Commercial |
$514.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$128.63
|
| Rate for Payer: United Healthcare PPO |
$79.56
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: Wellcare Medicare |
$128.63
|
| Rate for Payer: WPS Commercial |
$78.57
|
|
|
Celiac Disease, HLA Typing
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
5438800
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$51.98 |
| Max. Negotiated Rate |
$97.59 |
| Rate for Payer: Aetna Commercial |
$95.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.22
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$97.59
|
| Rate for Payer: Health EOS Commercial |
$94.41
|
| Rate for Payer: HFN Commercial |
$97.59
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: Preferred Network Access Commercial |
$97.59
|
| Rate for Payer: Quartz Beloit One Network |
$51.98
|
| Rate for Payer: Quartz Commercial |
$63.65
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: WPS Commercial |
$78.57
|
|
|
Celiac Disease, HLA Typing
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
5438800
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.68 |
| Max. Negotiated Rate |
$565.96 |
| Rate for Payer: Aetna Commercial |
$100.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$91.23
|
| Rate for Payer: Aetna Managed Medicare |
$128.63
|
| Rate for Payer: Anthem Medicare Advantage |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$128.63
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$100.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$53.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$128.63
|
| Rate for Payer: Health EOS Commercial |
$96.53
|
| Rate for Payer: HFN Commercial |
$100.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$454.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$454.05
|
| Rate for Payer: Independent Care Health Plan Medicare |
$128.63
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: NAPHCARE Commercial |
$192.94
|
| Rate for Payer: Preferred Network Access Commercial |
$100.78
|
| Rate for Payer: Quartz Beloit One Network |
$46.68
|
| Rate for Payer: Quartz Commercial |
$60.47
|
| Rate for Payer: Quartz Medicare Advantage |
$128.63
|
| Rate for Payer: The Alliance Commercial |
$508.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$128.63
|
| Rate for Payer: WEA Trust Commercial |
$58.34
|
| Rate for Payer: WPS Commercial |
$565.96
|
|
|
Celiac Disease Panel
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
1038848
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$167.96 |
| Rate for Payer: Aetna Commercial |
$167.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$152.05
|
| Rate for Payer: Aetna Managed Medicare |
$11.99
|
| Rate for Payer: Anthem Medicare Advantage |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.99
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$167.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$88.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11.99
|
| Rate for Payer: Health EOS Commercial |
$160.89
|
| Rate for Payer: HFN Commercial |
$167.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$42.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.99
|
| Rate for Payer: Multiplan Commercial |
$141.44
|
| Rate for Payer: NAPHCARE Commercial |
$17.99
|
| Rate for Payer: Preferred Network Access Commercial |
$167.96
|
| Rate for Payer: Quartz Beloit One Network |
$77.79
|
| Rate for Payer: Quartz Commercial |
$100.78
|
| Rate for Payer: Quartz Medicare Advantage |
$11.99
|
| Rate for Payer: The Alliance Commercial |
$47.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.99
|
| Rate for Payer: WEA Trust Commercial |
$97.24
|
| Rate for Payer: WPS Commercial |
$52.76
|
|
|
Celiac Disease Panel
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
1038848
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$162.66 |
| Rate for Payer: Dean Health DHI/DHP/ASO |
$98.94
|
| Rate for Payer: Aetna Commercial |
$159.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$152.05
|
| Rate for Payer: Aetna Managed Medicare |
$11.99
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$44.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20.98
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19.91
|
| Rate for Payer: Anthem Medicare Advantage |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$93.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.99
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$162.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11.99
|
| Rate for Payer: Health EOS Commercial |
$157.35
|
| Rate for Payer: HFN Commercial |
$162.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11.99
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.99
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11.99
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11.99
|
| Rate for Payer: Multiplan Commercial |
$141.44
|
| Rate for Payer: NAPHCARE Commercial |
$17.99
|
| Rate for Payer: Preferred Network Access Commercial |
$162.66
|
| Rate for Payer: Quartz Beloit One Network |
$86.63
|
| Rate for Payer: Quartz Commercial |
$114.92
|
| Rate for Payer: Quartz Medicare Advantage |
$11.99
|
| Rate for Payer: The Alliance Commercial |
$47.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.99
|
| Rate for Payer: United Healthcare PPO |
$132.60
|
| Rate for Payer: WEA Trust Commercial |
$97.24
|
| Rate for Payer: Wellcare Medicare |
$11.99
|
| Rate for Payer: WPS Commercial |
$130.95
|
|
|
Celiac Disease Panel
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
1038848
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$86.63 |
| Max. Negotiated Rate |
$162.66 |
| Rate for Payer: Aetna Commercial |
$159.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$152.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$93.70
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$162.66
|
| Rate for Payer: Health EOS Commercial |
$157.35
|
| Rate for Payer: HFN Commercial |
$162.66
|
| Rate for Payer: Multiplan Commercial |
$141.44
|
| Rate for Payer: Preferred Network Access Commercial |
$162.66
|
| Rate for Payer: Quartz Beloit One Network |
$86.63
|
| Rate for Payer: Quartz Commercial |
$106.08
|
| Rate for Payer: WEA Trust Commercial |
$97.24
|
| Rate for Payer: WPS Commercial |
$130.95
|
|
|
Celiac Disease Panel, <5 yrs old
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
4586620
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$53.58 |
| Rate for Payer: Aetna Commercial |
$52.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Aetna Managed Medicare |
$11.99
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$44.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20.98
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19.91
|
| Rate for Payer: Anthem Medicare Advantage |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$30.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.99
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$53.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11.99
|
| Rate for Payer: Health EOS Commercial |
$51.83
|
| Rate for Payer: HFN Commercial |
$53.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11.99
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.99
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11.99
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11.99
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: NAPHCARE Commercial |
$17.99
|
| Rate for Payer: Preferred Network Access Commercial |
$53.58
|
| Rate for Payer: Quartz Beloit One Network |
$28.54
|
| Rate for Payer: Quartz Commercial |
$37.86
|
| Rate for Payer: Quartz Medicare Advantage |
$11.99
|
| Rate for Payer: The Alliance Commercial |
$47.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.99
|
| Rate for Payer: United Healthcare PPO |
$43.68
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: Wellcare Medicare |
$11.99
|
| Rate for Payer: WPS Commercial |
$43.14
|
|
|
Celiac Disease Panel, <5 yrs old
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
4586620
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$55.33 |
| Rate for Payer: Aetna Commercial |
$55.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Aetna Managed Medicare |
$11.99
|
| Rate for Payer: Anthem Medicare Advantage |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.99
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$55.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$29.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11.99
|
| Rate for Payer: Health EOS Commercial |
$53.00
|
| Rate for Payer: HFN Commercial |
$55.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$42.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.99
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: NAPHCARE Commercial |
$17.99
|
| Rate for Payer: Preferred Network Access Commercial |
$55.33
|
| Rate for Payer: Quartz Beloit One Network |
$25.63
|
| Rate for Payer: Quartz Commercial |
$33.20
|
| Rate for Payer: Quartz Medicare Advantage |
$11.99
|
| Rate for Payer: The Alliance Commercial |
$47.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.99
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: WPS Commercial |
$52.76
|
|
|
Celiac Disease Panel, <5 yrs old
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
4586620
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$53.58 |
| Rate for Payer: Aetna Commercial |
$52.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$30.87
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$53.58
|
| Rate for Payer: Health EOS Commercial |
$51.83
|
| Rate for Payer: HFN Commercial |
$53.58
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: Preferred Network Access Commercial |
$53.58
|
| Rate for Payer: Quartz Beloit One Network |
$28.54
|
| Rate for Payer: Quartz Commercial |
$34.94
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: WPS Commercial |
$43.14
|
|
|
Celiac Disease Panel, Infant
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
5582863
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$51.79
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Celiac Disease Panel, Infant
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
5582863
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$82.00 |
| Rate for Payer: Aetna Commercial |
$82.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$11.99
|
| Rate for Payer: Anthem Medicare Advantage |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.99
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$82.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11.99
|
| Rate for Payer: Health EOS Commercial |
$78.55
|
| Rate for Payer: HFN Commercial |
$82.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$42.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.99
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$17.99
|
| Rate for Payer: Preferred Network Access Commercial |
$82.00
|
| Rate for Payer: Quartz Beloit One Network |
$37.98
|
| Rate for Payer: Quartz Commercial |
$49.20
|
| Rate for Payer: Quartz Medicare Advantage |
$11.99
|
| Rate for Payer: The Alliance Commercial |
$47.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.99
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: WPS Commercial |
$52.76
|
|
|
Celiac Disease Panel, Infant
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
5582863
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$79.41 |
| Rate for Payer: Aetna Commercial |
$77.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.24
|
| Rate for Payer: Aetna Managed Medicare |
$11.99
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$44.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20.98
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19.91
|
| Rate for Payer: Anthem Medicare Advantage |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.99
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cash Price |
$24.90
|
| Rate for Payer: Cigna Commercial |
$79.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11.99
|
| Rate for Payer: Health EOS Commercial |
$76.82
|
| Rate for Payer: HFN Commercial |
$79.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11.99
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.99
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11.99
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11.99
|
| Rate for Payer: Multiplan Commercial |
$69.06
|
| Rate for Payer: NAPHCARE Commercial |
$17.99
|
| Rate for Payer: Preferred Network Access Commercial |
$79.41
|
| Rate for Payer: Quartz Beloit One Network |
$42.30
|
| Rate for Payer: Quartz Commercial |
$56.11
|
| Rate for Payer: Quartz Medicare Advantage |
$11.99
|
| Rate for Payer: The Alliance Commercial |
$47.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.99
|
| Rate for Payer: United Healthcare PPO |
$64.74
|
| Rate for Payer: WEA Trust Commercial |
$47.48
|
| Rate for Payer: Wellcare Medicare |
$11.99
|
| Rate for Payer: WPS Commercial |
$63.93
|
|
|
Celiac Genetics to Prometheus
|
Facility
|
IP
|
$702.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
3279496
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$357.74 |
| Max. Negotiated Rate |
$671.67 |
| Rate for Payer: Aetna Commercial |
$657.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.94
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cigna Commercial |
$671.67
|
| Rate for Payer: Health EOS Commercial |
$649.77
|
| Rate for Payer: HFN Commercial |
$671.67
|
| Rate for Payer: Multiplan Commercial |
$584.06
|
| Rate for Payer: Preferred Network Access Commercial |
$671.67
|
| Rate for Payer: Quartz Beloit One Network |
$357.74
|
| Rate for Payer: Quartz Commercial |
$438.05
|
| Rate for Payer: WEA Trust Commercial |
$401.54
|
| Rate for Payer: WPS Commercial |
$540.75
|
|
|
Celiac Genetics to Prometheus
|
Facility
|
OP
|
$702.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
3279496
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$128.63 |
| Max. Negotiated Rate |
$671.67 |
| Rate for Payer: Aetna Commercial |
$657.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.87
|
| Rate for Payer: Aetna Managed Medicare |
$128.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$482.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$225.10
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$213.52
|
| Rate for Payer: Anthem Medicare Advantage |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$128.63
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cigna Commercial |
$671.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$128.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$408.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$128.63
|
| Rate for Payer: Health EOS Commercial |
$649.77
|
| Rate for Payer: HFN Commercial |
$671.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$478.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$128.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$128.63
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$128.63
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$128.63
|
| Rate for Payer: Multiplan Commercial |
$584.06
|
| Rate for Payer: NAPHCARE Commercial |
$192.94
|
| Rate for Payer: Preferred Network Access Commercial |
$671.67
|
| Rate for Payer: Quartz Beloit One Network |
$357.74
|
| Rate for Payer: Quartz Commercial |
$474.55
|
| Rate for Payer: Quartz Medicare Advantage |
$128.63
|
| Rate for Payer: The Alliance Commercial |
$514.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$128.63
|
| Rate for Payer: United Healthcare PPO |
$547.56
|
| Rate for Payer: WEA Trust Commercial |
$401.54
|
| Rate for Payer: Wellcare Medicare |
$128.63
|
| Rate for Payer: WPS Commercial |
$540.75
|
|
|
Celiac Genetics to Prometheus
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
3279496
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$128.63 |
| Max. Negotiated Rate |
$693.58 |
| Rate for Payer: Aetna Commercial |
$693.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.87
|
| Rate for Payer: Aetna Managed Medicare |
$128.63
|
| Rate for Payer: Anthem Medicare Advantage |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$128.63
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cigna Commercial |
$693.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$365.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$128.63
|
| Rate for Payer: Health EOS Commercial |
$664.37
|
| Rate for Payer: HFN Commercial |
$693.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$454.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$454.05
|
| Rate for Payer: Independent Care Health Plan Medicare |
$128.63
|
| Rate for Payer: Multiplan Commercial |
$584.06
|
| Rate for Payer: NAPHCARE Commercial |
$192.94
|
| Rate for Payer: Preferred Network Access Commercial |
$693.58
|
| Rate for Payer: Quartz Beloit One Network |
$321.24
|
| Rate for Payer: Quartz Commercial |
$416.15
|
| Rate for Payer: Quartz Medicare Advantage |
$128.63
|
| Rate for Payer: The Alliance Commercial |
$508.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$128.63
|
| Rate for Payer: WEA Trust Commercial |
$401.54
|
| Rate for Payer: WPS Commercial |
$565.96
|
|
|
Celiac Plus to Prometheus
|
Professional
|
Both
|
$540.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
3279495
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$128.63 |
| Max. Negotiated Rate |
$565.96 |
| Rate for Payer: Quartz Commercial |
$320.11
|
| Rate for Payer: Aetna Commercial |
$533.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$482.98
|
| Rate for Payer: Aetna Managed Medicare |
$128.63
|
| Rate for Payer: Anthem Medicare Advantage |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$128.63
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$533.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$280.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$128.63
|
| Rate for Payer: Health EOS Commercial |
$511.06
|
| Rate for Payer: HFN Commercial |
$533.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$454.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$454.05
|
| Rate for Payer: Independent Care Health Plan Medicare |
$128.63
|
| Rate for Payer: Multiplan Commercial |
$449.28
|
| Rate for Payer: NAPHCARE Commercial |
$192.94
|
| Rate for Payer: Preferred Network Access Commercial |
$533.52
|
| Rate for Payer: Quartz Beloit One Network |
$247.10
|
| Rate for Payer: Quartz Medicare Advantage |
$128.63
|
| Rate for Payer: The Alliance Commercial |
$508.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$128.63
|
| Rate for Payer: WEA Trust Commercial |
$308.88
|
| Rate for Payer: WPS Commercial |
$565.96
|
|
|
Celiac Plus to Prometheus
|
Facility
|
IP
|
$540.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
3279495
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$275.18 |
| Max. Negotiated Rate |
$516.67 |
| Rate for Payer: Aetna Commercial |
$505.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$482.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$297.65
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$516.67
|
| Rate for Payer: Health EOS Commercial |
$499.82
|
| Rate for Payer: HFN Commercial |
$516.67
|
| Rate for Payer: Multiplan Commercial |
$449.28
|
| Rate for Payer: Preferred Network Access Commercial |
$516.67
|
| Rate for Payer: Quartz Beloit One Network |
$275.18
|
| Rate for Payer: Quartz Commercial |
$336.96
|
| Rate for Payer: WEA Trust Commercial |
$308.88
|
| Rate for Payer: WPS Commercial |
$415.96
|
|
|
Celiac Plus to Prometheus
|
Facility
|
OP
|
$540.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
3279495
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$128.63 |
| Max. Negotiated Rate |
$516.67 |
| Rate for Payer: Aetna Commercial |
$505.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$482.98
|
| Rate for Payer: Aetna Managed Medicare |
$128.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$482.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$225.10
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$213.52
|
| Rate for Payer: Anthem Medicare Advantage |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$297.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$128.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$128.63
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$516.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$128.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$314.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$128.63
|
| Rate for Payer: Health EOS Commercial |
$499.82
|
| Rate for Payer: HFN Commercial |
$516.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$478.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$128.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$128.63
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$128.63
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$128.63
|
| Rate for Payer: Multiplan Commercial |
$449.28
|
| Rate for Payer: NAPHCARE Commercial |
$192.94
|
| Rate for Payer: Preferred Network Access Commercial |
$516.67
|
| Rate for Payer: Quartz Beloit One Network |
$275.18
|
| Rate for Payer: Quartz Commercial |
$365.04
|
| Rate for Payer: Quartz Medicare Advantage |
$128.63
|
| Rate for Payer: The Alliance Commercial |
$514.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$128.63
|
| Rate for Payer: United Healthcare PPO |
$421.20
|
| Rate for Payer: WEA Trust Commercial |
$308.88
|
| Rate for Payer: Wellcare Medicare |
$128.63
|
| Rate for Payer: WPS Commercial |
$415.96
|
|
|
Celiac Serology EMA
|
Facility
|
IP
|
$427.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
3331526
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$217.60 |
| Max. Negotiated Rate |
$408.55 |
| Rate for Payer: Aetna Commercial |
$399.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$381.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$235.36
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cigna Commercial |
$408.55
|
| Rate for Payer: Health EOS Commercial |
$395.23
|
| Rate for Payer: HFN Commercial |
$408.55
|
| Rate for Payer: Multiplan Commercial |
$355.26
|
| Rate for Payer: Preferred Network Access Commercial |
$408.55
|
| Rate for Payer: Quartz Beloit One Network |
$217.60
|
| Rate for Payer: Quartz Commercial |
$266.45
|
| Rate for Payer: WEA Trust Commercial |
$244.24
|
| Rate for Payer: WPS Commercial |
$328.92
|
|
|
Celiac Serology EMA
|
Professional
|
Both
|
$427.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
3331526
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.77 |
| Max. Negotiated Rate |
$601.97 |
| Rate for Payer: Aetna Commercial |
$421.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$381.91
|
| Rate for Payer: Aetna Managed Medicare |
$136.81
|
| Rate for Payer: Anthem Commercial |
$34.77
|
| Rate for Payer: Anthem Medicare Advantage |
$136.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$136.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$136.81
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cigna Commercial |
$421.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$222.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$136.81
|
| Rate for Payer: Health EOS Commercial |
$404.11
|
| Rate for Payer: HFN Commercial |
$421.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$508.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$508.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$136.81
|
| Rate for Payer: Multiplan Commercial |
$355.26
|
| Rate for Payer: NAPHCARE Commercial |
$205.22
|
| Rate for Payer: Preferred Network Access Commercial |
$421.88
|
| Rate for Payer: Quartz Beloit One Network |
$195.40
|
| Rate for Payer: Quartz Commercial |
$253.13
|
| Rate for Payer: Quartz Medicare Advantage |
$136.81
|
| Rate for Payer: The Alliance Commercial |
$540.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$136.81
|
| Rate for Payer: WEA Trust Commercial |
$244.24
|
| Rate for Payer: WPS Commercial |
$601.97
|
|
