|
CLUB FOOT DEFORMITY REPAIR
|
Facility
OP
|
$4,560.00
|
|
| Hospital Charge Code |
2959935
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,276.80 |
| Max. Negotiated Rate |
$18,240.00 |
| Rate for Payer: Aetna Commercial |
$4,104.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,921.60
|
| Rate for Payer: Aetna Managed Medicare |
$1,276.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,964.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,280.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,188.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,416.80
|
| Rate for Payer: Cash Price |
$1,368.00
|
| Rate for Payer: Cigna Commercial |
$4,195.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,551.78
|
| Rate for Payer: Health EOS Commercial |
$4,058.40
|
| Rate for Payer: HFN Commercial |
$4,195.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,420.00
|
| Rate for Payer: Multiplan Commercial |
$3,648.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,736.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,195.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,234.40
|
| Rate for Payer: Quartz Commercial |
$2,964.00
|
| Rate for Payer: Quartz Medicare Advantage |
$2,736.00
|
| Rate for Payer: The Alliance Commercial |
$18,240.00
|
| Rate for Payer: WEA Trust Commercial |
$2,508.00
|
| Rate for Payer: WPS Commercial |
$3,377.59
|
|
|
CLUB FOOT DEFORMITY REPAIR
|
Facility
IP
|
$4,560.00
|
|
| Hospital Charge Code |
2959935
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,234.40 |
| Max. Negotiated Rate |
$4,195.20 |
| Rate for Payer: Aetna Commercial |
$4,104.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,416.80
|
| Rate for Payer: Cash Price |
$1,368.00
|
| Rate for Payer: Cigna Commercial |
$4,195.20
|
| Rate for Payer: Health EOS Commercial |
$4,058.40
|
| Rate for Payer: HFN Commercial |
$4,195.20
|
| Rate for Payer: Multiplan Commercial |
$3,648.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,736.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,195.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,234.40
|
| Rate for Payer: Quartz Commercial |
$2,736.00
|
| Rate for Payer: WEA Trust Commercial |
$2,508.00
|
| Rate for Payer: WPS Commercial |
$3,377.59
|
|
|
Cmptr ophth dx img ant segmt 92132
|
Professional
|
$98.00
|
|
|
Service Code
|
CPT 92132
|
| Hospital Charge Code |
3015326
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$26.08 |
| Max. Negotiated Rate |
$121.36 |
| Rate for Payer: Aetna Commercial |
$93.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$84.28
|
| Rate for Payer: Aetna Managed Medicare |
$30.34
|
| Rate for Payer: Anthem Medicare Advantage |
$30.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$30.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30.34
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cigna Commercial |
$93.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$49.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30.34
|
| Rate for Payer: Health EOS Commercial |
$89.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$107.31
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$107.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30.34
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Preferred Network Access Commercial |
$93.10
|
| Rate for Payer: Quartz Beloit One Network |
$43.12
|
| Rate for Payer: Quartz Commercial |
$55.86
|
| Rate for Payer: Quartz Medicare Advantage |
$30.34
|
| Rate for Payer: The Alliance Commercial |
$75.85
|
| Rate for Payer: United Healthcare Medicaid |
$26.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30.34
|
| Rate for Payer: WEA Trust Commercial |
$53.90
|
| Rate for Payer: WPS Commercial |
$121.36
|
|
|
Cmptr ophth dx img ant segmt 9213226
|
Professional
|
$98.00
|
|
|
Service Code
|
CPT 92132 26
|
| Hospital Charge Code |
3015327
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$93.10 |
| Rate for Payer: Aetna Commercial |
$93.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$84.28
|
| Rate for Payer: Aetna Managed Medicare |
$15.75
|
| Rate for Payer: Anthem Medicare Advantage |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.75
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cigna Commercial |
$93.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$49.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.75
|
| Rate for Payer: Health EOS Commercial |
$89.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$55.88
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$55.88
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.75
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Preferred Network Access Commercial |
$93.10
|
| Rate for Payer: Quartz Beloit One Network |
$43.12
|
| Rate for Payer: Quartz Commercial |
$55.86
|
| Rate for Payer: Quartz Medicare Advantage |
$15.75
|
| Rate for Payer: The Alliance Commercial |
$39.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.75
|
| Rate for Payer: WEA Trust Commercial |
$53.90
|
| Rate for Payer: WPS Commercial |
$63.00
|
|
|
CMS SCORING ASSISTANT
|
Facility
IP
|
$6,397.00
|
|
| Hospital Charge Code |
2973707
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3,134.53 |
| Max. Negotiated Rate |
$5,885.24 |
| Rate for Payer: Aetna Commercial |
$5,757.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,390.41
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cigna Commercial |
$5,885.24
|
| Rate for Payer: Health EOS Commercial |
$5,693.33
|
| Rate for Payer: HFN Commercial |
$5,885.24
|
| Rate for Payer: Multiplan Commercial |
$5,117.60
|
| Rate for Payer: NAPHCARE Commercial |
$3,838.20
|
| Rate for Payer: Preferred Network Access Commercial |
$5,885.24
|
| Rate for Payer: Quartz Beloit One Network |
$3,134.53
|
| Rate for Payer: Quartz Commercial |
$3,838.20
|
| Rate for Payer: WEA Trust Commercial |
$3,518.35
|
| Rate for Payer: WPS Commercial |
$4,738.26
|
|
|
CMS SCORING ASSISTANT
|
Facility
OP
|
$6,397.00
|
|
| Hospital Charge Code |
2973707
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1,791.16 |
| Max. Negotiated Rate |
$25,588.00 |
| Rate for Payer: Aetna Commercial |
$5,757.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,501.42
|
| Rate for Payer: Aetna Managed Medicare |
$1,791.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,158.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,198.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,070.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,390.41
|
| Rate for Payer: Cash Price |
$1,919.10
|
| Rate for Payer: Cigna Commercial |
$5,885.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,579.76
|
| Rate for Payer: Health EOS Commercial |
$5,693.33
|
| Rate for Payer: HFN Commercial |
$5,885.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,797.75
|
| Rate for Payer: Multiplan Commercial |
$5,117.60
|
| Rate for Payer: NAPHCARE Commercial |
$3,838.20
|
| Rate for Payer: Preferred Network Access Commercial |
$5,885.24
|
| Rate for Payer: Quartz Beloit One Network |
$3,134.53
|
| Rate for Payer: Quartz Commercial |
$4,158.05
|
| Rate for Payer: Quartz Medicare Advantage |
$3,838.20
|
| Rate for Payer: The Alliance Commercial |
$25,588.00
|
| Rate for Payer: WEA Trust Commercial |
$3,518.35
|
| Rate for Payer: WPS Commercial |
$4,738.26
|
|
|
CMV Ab IgM, CSF
|
Facility
IP
|
$69.00
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
4597184
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$63.48 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$36.57
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$63.48
|
| Rate for Payer: Health EOS Commercial |
$61.41
|
| Rate for Payer: HFN Commercial |
$63.48
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: NAPHCARE Commercial |
$41.40
|
| Rate for Payer: Preferred Network Access Commercial |
$63.48
|
| Rate for Payer: Quartz Beloit One Network |
$33.81
|
| Rate for Payer: Quartz Commercial |
$41.40
|
| Rate for Payer: WEA Trust Commercial |
$37.95
|
| Rate for Payer: WPS Commercial |
$51.11
|
|
|
CMV Ab IgM, CSF
|
Professional
|
$69.00
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
4597184
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.85 |
| Max. Negotiated Rate |
$74.14 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.34
|
| Rate for Payer: Aetna Managed Medicare |
$16.85
|
| Rate for Payer: Anthem Medicare Advantage |
$16.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.85
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$65.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$34.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.85
|
| Rate for Payer: Health EOS Commercial |
$62.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$59.48
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$59.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.85
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: Preferred Network Access Commercial |
$65.55
|
| Rate for Payer: Quartz Beloit One Network |
$30.36
|
| Rate for Payer: Quartz Commercial |
$39.33
|
| Rate for Payer: Quartz Medicare Advantage |
$16.85
|
| Rate for Payer: The Alliance Commercial |
$66.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.85
|
| Rate for Payer: WEA Trust Commercial |
$37.95
|
| Rate for Payer: WPS Commercial |
$74.14
|
|
|
CMV Ab IgM, CSF
|
Facility
OP
|
$69.00
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
4597184
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$276.00 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.34
|
| Rate for Payer: Aetna Managed Medicare |
$16.85
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$63.19
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29.49
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.97
|
| Rate for Payer: Anthem Medicaid |
$8.17
|
| Rate for Payer: Anthem Medicare Advantage |
$16.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$36.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.85
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$63.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.85
|
| Rate for Payer: Health EOS Commercial |
$61.41
|
| Rate for Payer: HFN Commercial |
$63.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$62.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.85
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.85
|
| Rate for Payer: Managed Health Services Medicaid |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.85
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.85
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: NAPHCARE Commercial |
$25.28
|
| Rate for Payer: Preferred Network Access Commercial |
$63.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.17
|
| Rate for Payer: Quartz Beloit One Network |
$33.81
|
| Rate for Payer: Quartz Commercial |
$44.85
|
| Rate for Payer: Quartz Medicare Advantage |
$16.85
|
| Rate for Payer: The Alliance Commercial |
$276.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.85
|
| Rate for Payer: United Healthcare PPO |
$51.75
|
| Rate for Payer: WEA Trust Commercial |
$37.95
|
| Rate for Payer: Wellcare Medicare |
$16.85
|
| Rate for Payer: WMAP Medicaid |
$8.17
|
| Rate for Payer: WPS Commercial |
$51.11
|
|
|
CMV Antibody IgM
|
Professional
|
$102.00
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
2943018
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.85 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$87.72
|
| Rate for Payer: Aetna Managed Medicare |
$16.85
|
| Rate for Payer: Anthem Medicare Advantage |
$16.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.85
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$96.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$51.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.85
|
| Rate for Payer: Health EOS Commercial |
$92.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$59.48
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$59.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.85
|
| Rate for Payer: Multiplan Commercial |
$81.60
|
| Rate for Payer: Preferred Network Access Commercial |
$96.90
|
| Rate for Payer: Quartz Beloit One Network |
$44.88
|
| Rate for Payer: Quartz Commercial |
$58.14
|
| Rate for Payer: Quartz Medicare Advantage |
$16.85
|
| Rate for Payer: The Alliance Commercial |
$66.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.85
|
| Rate for Payer: WEA Trust Commercial |
$56.10
|
| Rate for Payer: WPS Commercial |
$74.14
|
|
|
CMV Antibody IgM
|
Facility
OP
|
$102.00
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
2943018
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$87.72
|
| Rate for Payer: Aetna Managed Medicare |
$16.85
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$63.19
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29.49
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.97
|
| Rate for Payer: Anthem Medicaid |
$8.17
|
| Rate for Payer: Anthem Medicare Advantage |
$16.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$54.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.85
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$93.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.85
|
| Rate for Payer: Health EOS Commercial |
$90.78
|
| Rate for Payer: HFN Commercial |
$93.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$62.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.85
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.85
|
| Rate for Payer: Managed Health Services Medicaid |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.85
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.85
|
| Rate for Payer: Multiplan Commercial |
$81.60
|
| Rate for Payer: NAPHCARE Commercial |
$25.28
|
| Rate for Payer: Preferred Network Access Commercial |
$93.84
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.17
|
| Rate for Payer: Quartz Beloit One Network |
$49.98
|
| Rate for Payer: Quartz Commercial |
$66.30
|
| Rate for Payer: Quartz Medicare Advantage |
$16.85
|
| Rate for Payer: The Alliance Commercial |
$408.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.85
|
| Rate for Payer: United Healthcare PPO |
$76.50
|
| Rate for Payer: WEA Trust Commercial |
$56.10
|
| Rate for Payer: Wellcare Medicare |
$16.85
|
| Rate for Payer: WMAP Medicaid |
$8.17
|
| Rate for Payer: WPS Commercial |
$75.55
|
|
|
CMV Antibody IgM
|
Facility
IP
|
$102.00
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
2943018
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$93.84 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$54.06
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna Commercial |
$93.84
|
| Rate for Payer: Health EOS Commercial |
$90.78
|
| Rate for Payer: HFN Commercial |
$93.84
|
| Rate for Payer: Multiplan Commercial |
$81.60
|
| Rate for Payer: NAPHCARE Commercial |
$61.20
|
| Rate for Payer: Preferred Network Access Commercial |
$93.84
|
| Rate for Payer: Quartz Beloit One Network |
$49.98
|
| Rate for Payer: Quartz Commercial |
$61.20
|
| Rate for Payer: WEA Trust Commercial |
$56.10
|
| Rate for Payer: WPS Commercial |
$75.55
|
|
|
CMV Genotype
|
Facility
IP
|
$704.00
|
|
|
Service Code
|
CPT 87910
|
| Hospital Charge Code |
4732608
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$344.96 |
| Max. Negotiated Rate |
$647.68 |
| Rate for Payer: Aetna Commercial |
$633.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$373.12
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cigna Commercial |
$647.68
|
| Rate for Payer: Health EOS Commercial |
$626.56
|
| Rate for Payer: HFN Commercial |
$647.68
|
| Rate for Payer: Multiplan Commercial |
$563.20
|
| Rate for Payer: NAPHCARE Commercial |
$422.40
|
| Rate for Payer: Preferred Network Access Commercial |
$647.68
|
| Rate for Payer: Quartz Beloit One Network |
$344.96
|
| Rate for Payer: Quartz Commercial |
$422.40
|
| Rate for Payer: WEA Trust Commercial |
$387.20
|
| Rate for Payer: WPS Commercial |
$521.45
|
|
|
CMV Genotype
|
Facility
OP
|
$704.00
|
|
|
Service Code
|
CPT 87910
|
| Hospital Charge Code |
4732608
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$257.45 |
| Max. Negotiated Rate |
$2,816.00 |
| Rate for Payer: Aetna Commercial |
$633.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$605.44
|
| Rate for Payer: Aetna Managed Medicare |
$257.45
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$965.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$450.54
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$427.37
|
| Rate for Payer: Anthem Medicaid |
$266.02
|
| Rate for Payer: Anthem Medicare Advantage |
$257.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$373.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$257.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$257.45
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cigna Commercial |
$647.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$257.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$266.02
|
| Rate for Payer: Dean Health Medicaid |
$266.02
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$257.45
|
| Rate for Payer: Health EOS Commercial |
$626.56
|
| Rate for Payer: HFN Commercial |
$647.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$957.71
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$257.45
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$266.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$257.45
|
| Rate for Payer: Managed Health Services Medicaid |
$276.66
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$257.45
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$257.45
|
| Rate for Payer: Multiplan Commercial |
$563.20
|
| Rate for Payer: NAPHCARE Commercial |
$386.18
|
| Rate for Payer: Preferred Network Access Commercial |
$647.68
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$266.02
|
| Rate for Payer: Quartz Beloit One Network |
$344.96
|
| Rate for Payer: Quartz Commercial |
$457.60
|
| Rate for Payer: Quartz Medicare Advantage |
$257.45
|
| Rate for Payer: The Alliance Commercial |
$2,816.00
|
| Rate for Payer: United Healthcare Medicaid |
$266.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$257.45
|
| Rate for Payer: United Healthcare PPO |
$528.00
|
| Rate for Payer: WEA Trust Commercial |
$387.20
|
| Rate for Payer: Wellcare Medicare |
$257.45
|
| Rate for Payer: WMAP Medicaid |
$266.02
|
| Rate for Payer: WPS Commercial |
$521.45
|
|
|
CMV Genotype
|
Professional
|
$704.00
|
|
|
Service Code
|
CPT 87910
|
| Hospital Charge Code |
4732608
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$257.45 |
| Max. Negotiated Rate |
$1,132.78 |
| Rate for Payer: Dean Health DHI/DHP/ASO |
$257.45
|
| Rate for Payer: Aetna Commercial |
$668.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$605.44
|
| Rate for Payer: Aetna Managed Medicare |
$257.45
|
| Rate for Payer: Anthem Medicare Advantage |
$257.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$257.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$257.45
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cigna Commercial |
$668.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$352.00
|
| Rate for Payer: Health EOS Commercial |
$640.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$908.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$908.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$257.45
|
| Rate for Payer: Multiplan Commercial |
$563.20
|
| Rate for Payer: Preferred Network Access Commercial |
$668.80
|
| Rate for Payer: Quartz Beloit One Network |
$309.76
|
| Rate for Payer: Quartz Commercial |
$401.28
|
| Rate for Payer: Quartz Medicare Advantage |
$257.45
|
| Rate for Payer: The Alliance Commercial |
$1,016.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$257.45
|
| Rate for Payer: WEA Trust Commercial |
$387.20
|
| Rate for Payer: WPS Commercial |
$1,132.78
|
|
|
CNSLT BEFORE SCREEN COLONOSCOPY S0285
|
Professional
|
$51.00
|
|
|
Service Code
|
HCPCS S0285
|
| Hospital Charge Code |
6180167
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$48.45 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.86
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cigna Commercial |
$48.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30.60
|
| Rate for Payer: Health EOS Commercial |
$46.41
|
| Rate for Payer: Multiplan Commercial |
$40.80
|
| Rate for Payer: Preferred Network Access Commercial |
$48.45
|
| Rate for Payer: Quartz Beloit One Network |
$22.44
|
| Rate for Payer: Quartz Commercial |
$29.07
|
| Rate for Payer: The Alliance Commercial |
$25.50
|
| Rate for Payer: WEA Trust Commercial |
$28.05
|
| Rate for Payer: WPS Commercial |
$37.78
|
|
|
COAGULATION DISORDERS
|
Facility
IP
|
$41,795.00
|
|
|
Service Code
|
MS-DRG 813
|
| Min. Negotiated Rate |
$15,034.00 |
| Max. Negotiated Rate |
$41,795.00 |
| Rate for Payer: Aetna Managed Medicare |
$15,034.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$32,728.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25,086.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23,833.68
|
| Rate for Payer: Anthem Medicare Advantage |
$15,034.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15,034.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15,034.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$15,034.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$26,457.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$15,034.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30,420.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15,034.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15,034.00
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$15,034.00
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$15,034.00
|
| Rate for Payer: NAPHCARE Commercial |
$22,551.00
|
| Rate for Payer: Quartz Medicare Advantage |
$15,034.00
|
| Rate for Payer: The Alliance Commercial |
$41,795.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,034.00
|
| Rate for Payer: United Healthcare PPO |
$23,682.36
|
| Rate for Payer: Wellcare Medicare |
$15,034.00
|
|
|
Cobalt Level
|
Professional
|
$297.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
1038893
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.96 |
| Max. Negotiated Rate |
$282.15 |
| Rate for Payer: Aetna Commercial |
$282.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$255.42
|
| Rate for Payer: Aetna Managed Medicare |
$21.96
|
| Rate for Payer: Anthem Medicare Advantage |
$21.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.96
|
| Rate for Payer: Cash Price |
$89.10
|
| Rate for Payer: Cash Price |
$89.10
|
| Rate for Payer: Cigna Commercial |
$282.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$148.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21.96
|
| Rate for Payer: Health EOS Commercial |
$270.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$77.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$77.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.96
|
| Rate for Payer: Multiplan Commercial |
$237.60
|
| Rate for Payer: Preferred Network Access Commercial |
$282.15
|
| Rate for Payer: Quartz Beloit One Network |
$130.68
|
| Rate for Payer: Quartz Commercial |
$169.29
|
| Rate for Payer: Quartz Medicare Advantage |
$21.96
|
| Rate for Payer: The Alliance Commercial |
$86.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.96
|
| Rate for Payer: WEA Trust Commercial |
$163.35
|
| Rate for Payer: WPS Commercial |
$96.62
|
|
|
Cobalt Level
|
Facility
OP
|
$297.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
1038893
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.96 |
| Max. Negotiated Rate |
$1,188.00 |
| Rate for Payer: Aetna Commercial |
$267.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$255.42
|
| Rate for Payer: Aetna Managed Medicare |
$21.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$82.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$38.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$36.45
|
| Rate for Payer: Anthem Medicaid |
$22.69
|
| Rate for Payer: Anthem Medicare Advantage |
$21.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$157.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.96
|
| Rate for Payer: Cash Price |
$89.10
|
| Rate for Payer: Cash Price |
$89.10
|
| Rate for Payer: Cigna Commercial |
$273.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$21.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$22.69
|
| Rate for Payer: Dean Health Medicaid |
$22.69
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$21.96
|
| Rate for Payer: Health EOS Commercial |
$264.33
|
| Rate for Payer: HFN Commercial |
$273.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$81.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.96
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$22.69
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.96
|
| Rate for Payer: Managed Health Services Medicaid |
$23.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$21.96
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$21.96
|
| Rate for Payer: Multiplan Commercial |
$237.60
|
| Rate for Payer: NAPHCARE Commercial |
$32.94
|
| Rate for Payer: Preferred Network Access Commercial |
$273.24
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$22.69
|
| Rate for Payer: Quartz Beloit One Network |
$145.53
|
| Rate for Payer: Quartz Commercial |
$193.05
|
| Rate for Payer: Quartz Medicare Advantage |
$21.96
|
| Rate for Payer: The Alliance Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare Medicaid |
$22.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.96
|
| Rate for Payer: United Healthcare PPO |
$222.75
|
| Rate for Payer: WEA Trust Commercial |
$163.35
|
| Rate for Payer: Wellcare Medicare |
$21.96
|
| Rate for Payer: WMAP Medicaid |
$22.69
|
| Rate for Payer: WPS Commercial |
$219.99
|
|
|
Cobalt Level
|
Facility
IP
|
$297.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
1038893
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$145.53 |
| Max. Negotiated Rate |
$273.24 |
| Rate for Payer: Aetna Commercial |
$267.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$157.41
|
| Rate for Payer: Cash Price |
$89.10
|
| Rate for Payer: Cigna Commercial |
$273.24
|
| Rate for Payer: Health EOS Commercial |
$264.33
|
| Rate for Payer: HFN Commercial |
$273.24
|
| Rate for Payer: Multiplan Commercial |
$237.60
|
| Rate for Payer: NAPHCARE Commercial |
$178.20
|
| Rate for Payer: Preferred Network Access Commercial |
$273.24
|
| Rate for Payer: Quartz Beloit One Network |
$145.53
|
| Rate for Payer: Quartz Commercial |
$178.20
|
| Rate for Payer: WEA Trust Commercial |
$163.35
|
| Rate for Payer: WPS Commercial |
$219.99
|
|
|
Coban
|
Facility
OP
|
$3.00
|
|
| Hospital Charge Code |
3153477
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Aetna Commercial |
$2.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2.58
|
| Rate for Payer: Aetna Managed Medicare |
$0.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1.59
|
| Rate for Payer: Cash Price |
$0.90
|
| Rate for Payer: Cigna Commercial |
$2.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1.68
|
| Rate for Payer: Health EOS Commercial |
$2.67
|
| Rate for Payer: HFN Commercial |
$2.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2.25
|
| Rate for Payer: Multiplan Commercial |
$2.40
|
| Rate for Payer: NAPHCARE Commercial |
$1.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2.76
|
| Rate for Payer: Quartz Beloit One Network |
$1.47
|
| Rate for Payer: Quartz Commercial |
$1.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1.80
|
| Rate for Payer: The Alliance Commercial |
$12.00
|
| Rate for Payer: WEA Trust Commercial |
$1.65
|
| Rate for Payer: WPS Commercial |
$2.22
|
|
|
Coban
|
Facility
IP
|
$3.00
|
|
| Hospital Charge Code |
3153477
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.47 |
| Max. Negotiated Rate |
$2.76 |
| Rate for Payer: Aetna Commercial |
$2.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1.59
|
| Rate for Payer: Cash Price |
$0.90
|
| Rate for Payer: Cigna Commercial |
$2.76
|
| Rate for Payer: Health EOS Commercial |
$2.67
|
| Rate for Payer: HFN Commercial |
$2.76
|
| Rate for Payer: Multiplan Commercial |
$2.40
|
| Rate for Payer: NAPHCARE Commercial |
$1.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2.76
|
| Rate for Payer: Quartz Beloit One Network |
$1.47
|
| Rate for Payer: Quartz Commercial |
$1.80
|
| Rate for Payer: WEA Trust Commercial |
$1.65
|
| Rate for Payer: WPS Commercial |
$2.22
|
|
|
COBRA ADHERE XL
|
Facility
IP
|
$33,832.00
|
|
| Hospital Charge Code |
2965109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16,577.68 |
| Max. Negotiated Rate |
$31,125.44 |
| Rate for Payer: Aetna Commercial |
$30,448.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$17,930.96
|
| Rate for Payer: Cash Price |
$10,149.60
|
| Rate for Payer: Cigna Commercial |
$31,125.44
|
| Rate for Payer: Health EOS Commercial |
$30,110.48
|
| Rate for Payer: HFN Commercial |
$31,125.44
|
| Rate for Payer: Multiplan Commercial |
$27,065.60
|
| Rate for Payer: NAPHCARE Commercial |
$20,299.20
|
| Rate for Payer: Preferred Network Access Commercial |
$31,125.44
|
| Rate for Payer: Quartz Beloit One Network |
$16,577.68
|
| Rate for Payer: Quartz Commercial |
$20,299.20
|
| Rate for Payer: WEA Trust Commercial |
$18,607.60
|
| Rate for Payer: WPS Commercial |
$25,059.36
|
|
|
COBRA ADHERE XL
|
Facility
OP
|
$33,832.00
|
|
| Hospital Charge Code |
2965109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9,472.96 |
| Max. Negotiated Rate |
$135,328.00 |
| Rate for Payer: Aetna Commercial |
$30,448.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$29,095.52
|
| Rate for Payer: Aetna Managed Medicare |
$9,472.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$21,990.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,916.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16,239.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$17,930.96
|
| Rate for Payer: Cash Price |
$10,149.60
|
| Rate for Payer: Cigna Commercial |
$31,125.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18,932.39
|
| Rate for Payer: Health EOS Commercial |
$30,110.48
|
| Rate for Payer: HFN Commercial |
$31,125.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25,374.00
|
| Rate for Payer: Multiplan Commercial |
$27,065.60
|
| Rate for Payer: NAPHCARE Commercial |
$20,299.20
|
| Rate for Payer: Preferred Network Access Commercial |
$31,125.44
|
| Rate for Payer: Quartz Beloit One Network |
$16,577.68
|
| Rate for Payer: Quartz Commercial |
$21,990.80
|
| Rate for Payer: Quartz Medicare Advantage |
$20,299.20
|
| Rate for Payer: The Alliance Commercial |
$135,328.00
|
| Rate for Payer: WEA Trust Commercial |
$18,607.60
|
| Rate for Payer: WPS Commercial |
$25,059.36
|
|
|
COBRA BIPOLAR INSERT
|
Facility
OP
|
$14,644.00
|
|
| Hospital Charge Code |
2965110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,100.32 |
| Max. Negotiated Rate |
$58,576.00 |
| Rate for Payer: Aetna Commercial |
$13,179.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$12,593.84
|
| Rate for Payer: Aetna Managed Medicare |
$4,100.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,518.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7,322.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,029.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,761.32
|
| Rate for Payer: Cash Price |
$4,393.20
|
| Rate for Payer: Cigna Commercial |
$13,472.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,194.78
|
| Rate for Payer: Health EOS Commercial |
$13,033.16
|
| Rate for Payer: HFN Commercial |
$13,472.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,983.00
|
| Rate for Payer: Multiplan Commercial |
$11,715.20
|
| Rate for Payer: NAPHCARE Commercial |
$8,786.40
|
| Rate for Payer: Preferred Network Access Commercial |
$13,472.48
|
| Rate for Payer: Quartz Beloit One Network |
$7,175.56
|
| Rate for Payer: Quartz Commercial |
$9,518.60
|
| Rate for Payer: Quartz Medicare Advantage |
$8,786.40
|
| Rate for Payer: The Alliance Commercial |
$58,576.00
|
| Rate for Payer: WEA Trust Commercial |
$8,054.20
|
| Rate for Payer: WPS Commercial |
$10,846.81
|
|
