|
CHOLEDOCHOSCOPY
|
Facility
|
OP
|
$6,713.00
|
|
| Hospital Charge Code |
2959928
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,954.83 |
| Max. Negotiated Rate |
$6,423.00 |
| Rate for Payer: Aetna Commercial |
$6,283.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,004.11
|
| Rate for Payer: Aetna Managed Medicare |
$1,954.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,537.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,490.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,351.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,700.21
|
| Rate for Payer: Cash Price |
$2,013.90
|
| Rate for Payer: Cigna Commercial |
$6,423.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,906.97
|
| Rate for Payer: Health EOS Commercial |
$6,213.55
|
| Rate for Payer: HFN Commercial |
$6,423.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,236.14
|
| Rate for Payer: Multiplan Commercial |
$5,585.22
|
| Rate for Payer: NAPHCARE Commercial |
$4,188.91
|
| Rate for Payer: Preferred Network Access Commercial |
$6,423.00
|
| Rate for Payer: Quartz Beloit One Network |
$3,420.94
|
| Rate for Payer: Quartz Commercial |
$4,537.99
|
| Rate for Payer: Quartz Medicare Advantage |
$4,188.91
|
| Rate for Payer: The Alliance Commercial |
$3,490.76
|
| Rate for Payer: WEA Trust Commercial |
$3,839.84
|
| Rate for Payer: WPS Commercial |
$5,171.02
|
|
|
CHOLESTECH MULTI-ANALYTE CNTRL
|
Facility
|
OP
|
$1,395.00
|
|
| Hospital Charge Code |
2969875
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$406.22 |
| Max. Negotiated Rate |
$1,334.74 |
| Rate for Payer: Aetna Commercial |
$1,305.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,247.69
|
| Rate for Payer: Aetna Managed Medicare |
$406.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$943.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$725.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$696.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$768.92
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Cigna Commercial |
$1,334.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$811.89
|
| Rate for Payer: Health EOS Commercial |
$1,291.21
|
| Rate for Payer: HFN Commercial |
$1,334.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,088.10
|
| Rate for Payer: Multiplan Commercial |
$1,160.64
|
| Rate for Payer: NAPHCARE Commercial |
$870.48
|
| Rate for Payer: Preferred Network Access Commercial |
$1,334.74
|
| Rate for Payer: Quartz Beloit One Network |
$710.89
|
| Rate for Payer: Quartz Commercial |
$943.02
|
| Rate for Payer: Quartz Medicare Advantage |
$870.48
|
| Rate for Payer: The Alliance Commercial |
$725.40
|
| Rate for Payer: WEA Trust Commercial |
$797.94
|
| Rate for Payer: WPS Commercial |
$1,074.57
|
|
|
CHOLESTECH MULTI-ANALYTE CNTRL
|
Facility
|
IP
|
$1,395.00
|
|
| Hospital Charge Code |
2969875
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$710.89 |
| Max. Negotiated Rate |
$1,334.74 |
| Rate for Payer: Aetna Commercial |
$1,305.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,247.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$768.92
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Cigna Commercial |
$1,334.74
|
| Rate for Payer: Health EOS Commercial |
$1,291.21
|
| Rate for Payer: HFN Commercial |
$1,334.74
|
| Rate for Payer: Multiplan Commercial |
$1,160.64
|
| Rate for Payer: Preferred Network Access Commercial |
$1,334.74
|
| Rate for Payer: Quartz Beloit One Network |
$710.89
|
| Rate for Payer: Quartz Commercial |
$870.48
|
| Rate for Payer: WEA Trust Commercial |
$797.94
|
| Rate for Payer: WPS Commercial |
$1,074.57
|
|
|
CHOLESTEROL AND GLUCOSE TOTAL
|
Facility
|
IP
|
$121.00
|
|
| Hospital Charge Code |
2971691
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$61.66 |
| Max. Negotiated Rate |
$115.77 |
| Rate for Payer: Aetna Commercial |
$113.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$108.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.70
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna Commercial |
$115.77
|
| Rate for Payer: Health EOS Commercial |
$112.00
|
| Rate for Payer: HFN Commercial |
$115.77
|
| Rate for Payer: Multiplan Commercial |
$100.67
|
| Rate for Payer: Preferred Network Access Commercial |
$115.77
|
| Rate for Payer: Quartz Beloit One Network |
$61.66
|
| Rate for Payer: Quartz Commercial |
$75.50
|
| Rate for Payer: WEA Trust Commercial |
$69.21
|
| Rate for Payer: WPS Commercial |
$93.21
|
|
|
CHOLESTEROL AND GLUCOSE TOTAL
|
Facility
|
OP
|
$121.00
|
|
| Hospital Charge Code |
2971691
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$35.24 |
| Max. Negotiated Rate |
$115.77 |
| Rate for Payer: Aetna Commercial |
$113.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$108.22
|
| Rate for Payer: Aetna Managed Medicare |
$35.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$81.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$62.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$60.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.70
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna Commercial |
$115.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$70.42
|
| Rate for Payer: Health EOS Commercial |
$112.00
|
| Rate for Payer: HFN Commercial |
$115.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$94.38
|
| Rate for Payer: Multiplan Commercial |
$100.67
|
| Rate for Payer: NAPHCARE Commercial |
$75.50
|
| Rate for Payer: Preferred Network Access Commercial |
$115.77
|
| Rate for Payer: Quartz Beloit One Network |
$61.66
|
| Rate for Payer: Quartz Commercial |
$81.80
|
| Rate for Payer: Quartz Medicare Advantage |
$75.50
|
| Rate for Payer: The Alliance Commercial |
$62.92
|
| Rate for Payer: WEA Trust Commercial |
$69.21
|
| Rate for Payer: WPS Commercial |
$93.21
|
|
|
Cholesterol High Density Lipid
|
Facility
|
IP
|
$129.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
633703
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.74 |
| Max. Negotiated Rate |
$123.43 |
| Rate for Payer: Aetna Commercial |
$120.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$115.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$71.10
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cigna Commercial |
$123.43
|
| Rate for Payer: Health EOS Commercial |
$119.40
|
| Rate for Payer: HFN Commercial |
$123.43
|
| Rate for Payer: Multiplan Commercial |
$107.33
|
| Rate for Payer: Preferred Network Access Commercial |
$123.43
|
| Rate for Payer: Quartz Beloit One Network |
$65.74
|
| Rate for Payer: Quartz Commercial |
$80.50
|
| Rate for Payer: WEA Trust Commercial |
$73.79
|
| Rate for Payer: WPS Commercial |
$99.37
|
|
|
Cholesterol High Density Lipid
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
633703
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$127.45 |
| Rate for Payer: Aetna Commercial |
$127.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$115.38
|
| Rate for Payer: Aetna Managed Medicare |
$8.52
|
| Rate for Payer: Anthem Medicare Advantage |
$8.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.52
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cigna Commercial |
$127.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$67.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.52
|
| Rate for Payer: Health EOS Commercial |
$122.09
|
| Rate for Payer: HFN Commercial |
$127.45
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.52
|
| Rate for Payer: Multiplan Commercial |
$107.33
|
| Rate for Payer: NAPHCARE Commercial |
$12.78
|
| Rate for Payer: Preferred Network Access Commercial |
$127.45
|
| Rate for Payer: Quartz Beloit One Network |
$59.03
|
| Rate for Payer: Quartz Commercial |
$76.47
|
| Rate for Payer: Quartz Medicare Advantage |
$8.52
|
| Rate for Payer: The Alliance Commercial |
$33.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.52
|
| Rate for Payer: WEA Trust Commercial |
$73.79
|
| Rate for Payer: WPS Commercial |
$37.48
|
|
|
Cholesterol High Density Lipid
|
Facility
|
OP
|
$129.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
633703
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$123.43 |
| Rate for Payer: Aetna Commercial |
$120.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$115.38
|
| Rate for Payer: Aetna Managed Medicare |
$8.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14.91
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14.14
|
| Rate for Payer: Anthem Medicare Advantage |
$8.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$71.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.52
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cigna Commercial |
$123.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$75.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8.52
|
| Rate for Payer: Health EOS Commercial |
$119.40
|
| Rate for Payer: HFN Commercial |
$123.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.52
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8.52
|
| Rate for Payer: Multiplan Commercial |
$107.33
|
| Rate for Payer: NAPHCARE Commercial |
$12.78
|
| Rate for Payer: Preferred Network Access Commercial |
$123.43
|
| Rate for Payer: Quartz Beloit One Network |
$65.74
|
| Rate for Payer: Quartz Commercial |
$87.20
|
| Rate for Payer: Quartz Medicare Advantage |
$8.52
|
| Rate for Payer: The Alliance Commercial |
$34.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.52
|
| Rate for Payer: United Healthcare PPO |
$100.62
|
| Rate for Payer: WEA Trust Commercial |
$73.79
|
| Rate for Payer: Wellcare Medicare |
$8.52
|
| Rate for Payer: WPS Commercial |
$99.37
|
|
|
Cholesterol, Pleural Fluid
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
4163505
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$37.07 |
| Rate for Payer: Aetna Commercial |
$29.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$26.83
|
| Rate for Payer: Aetna Managed Medicare |
$8.42
|
| Rate for Payer: Anthem Medicare Advantage |
$8.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.42
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$29.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$15.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.42
|
| Rate for Payer: Health EOS Commercial |
$28.39
|
| Rate for Payer: HFN Commercial |
$29.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$29.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.42
|
| Rate for Payer: Multiplan Commercial |
$24.96
|
| Rate for Payer: NAPHCARE Commercial |
$12.64
|
| Rate for Payer: Preferred Network Access Commercial |
$29.64
|
| Rate for Payer: Quartz Beloit One Network |
$13.73
|
| Rate for Payer: Quartz Commercial |
$17.78
|
| Rate for Payer: Quartz Medicare Advantage |
$8.42
|
| Rate for Payer: The Alliance Commercial |
$33.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.42
|
| Rate for Payer: WEA Trust Commercial |
$17.16
|
| Rate for Payer: WPS Commercial |
$37.07
|
|
|
Cholesterol, Pleural Fluid
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
4163505
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$28.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$26.83
|
| Rate for Payer: Aetna Managed Medicare |
$8.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31.59
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14.74
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$13.98
|
| Rate for Payer: Anthem Medicare Advantage |
$8.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$16.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.42
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$28.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.46
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8.42
|
| Rate for Payer: Health EOS Commercial |
$27.77
|
| Rate for Payer: HFN Commercial |
$28.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8.42
|
| Rate for Payer: Multiplan Commercial |
$24.96
|
| Rate for Payer: NAPHCARE Commercial |
$12.64
|
| Rate for Payer: Preferred Network Access Commercial |
$28.70
|
| Rate for Payer: Quartz Beloit One Network |
$15.29
|
| Rate for Payer: Quartz Commercial |
$20.28
|
| Rate for Payer: Quartz Medicare Advantage |
$8.42
|
| Rate for Payer: The Alliance Commercial |
$33.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.42
|
| Rate for Payer: United Healthcare PPO |
$23.40
|
| Rate for Payer: WEA Trust Commercial |
$17.16
|
| Rate for Payer: Wellcare Medicare |
$8.42
|
| Rate for Payer: WPS Commercial |
$23.11
|
|
|
Cholesterol, Pleural Fluid
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
4163505
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.29 |
| Max. Negotiated Rate |
$28.70 |
| Rate for Payer: Aetna Commercial |
$28.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$26.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$16.54
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$28.70
|
| Rate for Payer: Health EOS Commercial |
$27.77
|
| Rate for Payer: HFN Commercial |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$24.96
|
| Rate for Payer: Preferred Network Access Commercial |
$28.70
|
| Rate for Payer: Quartz Beloit One Network |
$15.29
|
| Rate for Payer: Quartz Commercial |
$18.72
|
| Rate for Payer: WEA Trust Commercial |
$17.16
|
| Rate for Payer: WPS Commercial |
$23.11
|
|
|
Cholesterol Total
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
633705
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.73 |
| Max. Negotiated Rate |
$72.72 |
| Rate for Payer: Aetna Commercial |
$71.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$41.89
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cigna Commercial |
$72.72
|
| Rate for Payer: Health EOS Commercial |
$70.35
|
| Rate for Payer: HFN Commercial |
$72.72
|
| Rate for Payer: Multiplan Commercial |
$63.23
|
| Rate for Payer: Preferred Network Access Commercial |
$72.72
|
| Rate for Payer: Quartz Beloit One Network |
$38.73
|
| Rate for Payer: Quartz Commercial |
$47.42
|
| Rate for Payer: WEA Trust Commercial |
$43.47
|
| Rate for Payer: WPS Commercial |
$58.54
|
|
|
Cholesterol Total
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
633705
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$72.72 |
| Rate for Payer: Aetna Commercial |
$71.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.97
|
| Rate for Payer: Aetna Managed Medicare |
$4.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$16.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7.51
|
| Rate for Payer: Anthem Medicare Advantage |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$41.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.52
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cigna Commercial |
$72.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$44.23
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.52
|
| Rate for Payer: Health EOS Commercial |
$70.35
|
| Rate for Payer: HFN Commercial |
$72.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$16.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.52
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.52
|
| Rate for Payer: Multiplan Commercial |
$63.23
|
| Rate for Payer: NAPHCARE Commercial |
$6.79
|
| Rate for Payer: Preferred Network Access Commercial |
$72.72
|
| Rate for Payer: Quartz Beloit One Network |
$38.73
|
| Rate for Payer: Quartz Commercial |
$51.38
|
| Rate for Payer: Quartz Medicare Advantage |
$4.52
|
| Rate for Payer: The Alliance Commercial |
$18.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.52
|
| Rate for Payer: United Healthcare PPO |
$59.28
|
| Rate for Payer: WEA Trust Commercial |
$43.47
|
| Rate for Payer: Wellcare Medicare |
$4.52
|
| Rate for Payer: WPS Commercial |
$58.54
|
|
|
Cholesterol Total
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
633705
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$75.09 |
| Rate for Payer: Aetna Commercial |
$75.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.97
|
| Rate for Payer: Aetna Managed Medicare |
$4.52
|
| Rate for Payer: Anthem Medicare Advantage |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.52
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cigna Commercial |
$75.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$39.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.52
|
| Rate for Payer: Health EOS Commercial |
$71.93
|
| Rate for Payer: HFN Commercial |
$75.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$15.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.52
|
| Rate for Payer: Multiplan Commercial |
$63.23
|
| Rate for Payer: NAPHCARE Commercial |
$6.79
|
| Rate for Payer: Preferred Network Access Commercial |
$75.09
|
| Rate for Payer: Quartz Beloit One Network |
$34.78
|
| Rate for Payer: Quartz Commercial |
$45.05
|
| Rate for Payer: Quartz Medicare Advantage |
$4.52
|
| Rate for Payer: The Alliance Commercial |
$17.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.52
|
| Rate for Payer: WEA Trust Commercial |
$43.47
|
| Rate for Payer: WPS Commercial |
$19.91
|
|
|
CHOLINESTERASE INHIBITOR CHALLENGE TEST 95857
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
CPT 95857
|
| Hospital Charge Code |
3015469
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$301.34 |
| Rate for Payer: Aetna Commercial |
$301.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$272.79
|
| Rate for Payer: Aetna Managed Medicare |
$23.48
|
| Rate for Payer: Anthem Medicare Advantage |
$23.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.48
|
| Rate for Payer: Cash Price |
$91.50
|
| Rate for Payer: Cash Price |
$91.50
|
| Rate for Payer: Cash Price |
$91.50
|
| Rate for Payer: Cigna Commercial |
$301.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$39.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.48
|
| Rate for Payer: Health EOS Commercial |
$288.65
|
| Rate for Payer: HFN Commercial |
$301.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$197.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$197.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.48
|
| Rate for Payer: Multiplan Commercial |
$253.76
|
| Rate for Payer: NAPHCARE Commercial |
$35.22
|
| Rate for Payer: Preferred Network Access Commercial |
$301.34
|
| Rate for Payer: Quartz Beloit One Network |
$139.57
|
| Rate for Payer: Quartz Commercial |
$180.80
|
| Rate for Payer: Quartz Medicare Advantage |
$23.48
|
| Rate for Payer: The Alliance Commercial |
$58.71
|
| Rate for Payer: United Healthcare Medicaid |
$39.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.48
|
| Rate for Payer: WEA Trust Commercial |
$174.46
|
| Rate for Payer: WPS Commercial |
$93.93
|
|
|
CHONDROCYTES MACI AUTOLOGOUS CULTURED 81073
|
Facility
|
IP
|
$54,750.00
|
|
|
Service Code
|
HCPCS J7330
|
| Hospital Charge Code |
5307123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27,900.60 |
| Max. Negotiated Rate |
$52,384.80 |
| Rate for Payer: Aetna Commercial |
$51,246.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$48,968.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$30,178.20
|
| Rate for Payer: Cash Price |
$16,425.00
|
| Rate for Payer: Cigna Commercial |
$52,384.80
|
| Rate for Payer: Health EOS Commercial |
$50,676.60
|
| Rate for Payer: HFN Commercial |
$52,384.80
|
| Rate for Payer: Multiplan Commercial |
$45,552.00
|
| Rate for Payer: Preferred Network Access Commercial |
$52,384.80
|
| Rate for Payer: Quartz Beloit One Network |
$27,900.60
|
| Rate for Payer: Quartz Commercial |
$34,164.00
|
| Rate for Payer: WEA Trust Commercial |
$31,317.00
|
| Rate for Payer: WPS Commercial |
$42,173.93
|
|
|
CHONDROCYTES MACI AUTOLOGOUS CULTURED 81073
|
Facility
|
OP
|
$54,750.00
|
|
|
Service Code
|
HCPCS J7330
|
| Hospital Charge Code |
5307123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15,943.20 |
| Max. Negotiated Rate |
$52,384.80 |
| Rate for Payer: Aetna Commercial |
$51,246.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$48,968.40
|
| Rate for Payer: Aetna Managed Medicare |
$15,943.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$37,011.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28,470.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27,331.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$30,178.20
|
| Rate for Payer: Cash Price |
$16,425.00
|
| Rate for Payer: Cigna Commercial |
$52,384.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31,864.50
|
| Rate for Payer: Health EOS Commercial |
$50,676.60
|
| Rate for Payer: HFN Commercial |
$52,384.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42,705.00
|
| Rate for Payer: Multiplan Commercial |
$45,552.00
|
| Rate for Payer: NAPHCARE Commercial |
$34,164.00
|
| Rate for Payer: Preferred Network Access Commercial |
$52,384.80
|
| Rate for Payer: Quartz Beloit One Network |
$27,900.60
|
| Rate for Payer: Quartz Commercial |
$37,011.00
|
| Rate for Payer: Quartz Medicare Advantage |
$34,164.00
|
| Rate for Payer: The Alliance Commercial |
$28,470.00
|
| Rate for Payer: WEA Trust Commercial |
$31,317.00
|
| Rate for Payer: WPS Commercial |
$42,173.93
|
|
|
Chromatin (Nucleosomal) Antibody
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
4606710
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$41.28 |
| Max. Negotiated Rate |
$77.50 |
| Rate for Payer: Aetna Commercial |
$75.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$72.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$44.65
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna Commercial |
$77.50
|
| Rate for Payer: Health EOS Commercial |
$74.97
|
| Rate for Payer: HFN Commercial |
$77.50
|
| Rate for Payer: Multiplan Commercial |
$67.39
|
| Rate for Payer: Preferred Network Access Commercial |
$77.50
|
| Rate for Payer: Quartz Beloit One Network |
$41.28
|
| Rate for Payer: Quartz Commercial |
$50.54
|
| Rate for Payer: WEA Trust Commercial |
$46.33
|
| Rate for Payer: WPS Commercial |
$62.39
|
|
|
Chromatin (Nucleosomal) Antibody
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
4606710
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$77.50 |
| Rate for Payer: Aetna Commercial |
$75.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$72.45
|
| Rate for Payer: Aetna Managed Medicare |
$18.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$69.93
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$32.63
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30.95
|
| Rate for Payer: Anthem Medicare Advantage |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$44.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.65
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna Commercial |
$77.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$47.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18.65
|
| Rate for Payer: Health EOS Commercial |
$74.97
|
| Rate for Payer: HFN Commercial |
$77.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$69.37
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$67.39
|
| Rate for Payer: NAPHCARE Commercial |
$27.97
|
| Rate for Payer: Preferred Network Access Commercial |
$77.50
|
| Rate for Payer: Quartz Beloit One Network |
$41.28
|
| Rate for Payer: Quartz Commercial |
$54.76
|
| Rate for Payer: Quartz Medicare Advantage |
$18.65
|
| Rate for Payer: The Alliance Commercial |
$74.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.65
|
| Rate for Payer: United Healthcare PPO |
$63.18
|
| Rate for Payer: WEA Trust Commercial |
$46.33
|
| Rate for Payer: Wellcare Medicare |
$18.65
|
| Rate for Payer: WPS Commercial |
$62.39
|
|
|
Chromatin (Nucleosomal) Antibody
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
4606710
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$82.05 |
| Rate for Payer: Aetna Commercial |
$80.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$72.45
|
| Rate for Payer: Aetna Managed Medicare |
$18.65
|
| Rate for Payer: Anthem Medicare Advantage |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.65
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna Commercial |
$80.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$42.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18.65
|
| Rate for Payer: Health EOS Commercial |
$76.66
|
| Rate for Payer: HFN Commercial |
$80.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$65.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$67.39
|
| Rate for Payer: NAPHCARE Commercial |
$27.97
|
| Rate for Payer: Preferred Network Access Commercial |
$80.03
|
| Rate for Payer: Quartz Beloit One Network |
$37.07
|
| Rate for Payer: Quartz Commercial |
$48.02
|
| Rate for Payer: Quartz Medicare Advantage |
$18.65
|
| Rate for Payer: The Alliance Commercial |
$73.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.65
|
| Rate for Payer: WEA Trust Commercial |
$46.33
|
| Rate for Payer: WPS Commercial |
$82.05
|
|
|
Chromatin (Nucleosomal) Antibody
|
Facility
|
IP
|
$114.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
3403546
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.09 |
| Max. Negotiated Rate |
$109.08 |
| Rate for Payer: Aetna Commercial |
$106.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$62.84
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$109.08
|
| Rate for Payer: Health EOS Commercial |
$105.52
|
| Rate for Payer: HFN Commercial |
$109.08
|
| Rate for Payer: Multiplan Commercial |
$94.85
|
| Rate for Payer: Preferred Network Access Commercial |
$109.08
|
| Rate for Payer: Quartz Beloit One Network |
$58.09
|
| Rate for Payer: Quartz Commercial |
$71.14
|
| Rate for Payer: WEA Trust Commercial |
$65.21
|
| Rate for Payer: WPS Commercial |
$87.81
|
|
|
Chromatin (Nucleosomal) Antibody
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
3403546
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$112.63 |
| Rate for Payer: Aetna Commercial |
$112.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.96
|
| Rate for Payer: Aetna Managed Medicare |
$18.65
|
| Rate for Payer: Anthem Medicare Advantage |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.65
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$112.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$59.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18.65
|
| Rate for Payer: Health EOS Commercial |
$107.89
|
| Rate for Payer: HFN Commercial |
$112.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$65.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$94.85
|
| Rate for Payer: NAPHCARE Commercial |
$27.97
|
| Rate for Payer: Preferred Network Access Commercial |
$112.63
|
| Rate for Payer: Quartz Beloit One Network |
$52.17
|
| Rate for Payer: Quartz Commercial |
$67.58
|
| Rate for Payer: Quartz Medicare Advantage |
$18.65
|
| Rate for Payer: The Alliance Commercial |
$73.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.65
|
| Rate for Payer: WEA Trust Commercial |
$65.21
|
| Rate for Payer: WPS Commercial |
$82.05
|
|
|
Chromatin (Nucleosomal) Antibody
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
3403546
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$109.08 |
| Rate for Payer: Aetna Commercial |
$106.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.96
|
| Rate for Payer: Aetna Managed Medicare |
$18.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$69.93
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$32.63
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30.95
|
| Rate for Payer: Anthem Medicare Advantage |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$62.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.65
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$109.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$66.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18.65
|
| Rate for Payer: Health EOS Commercial |
$105.52
|
| Rate for Payer: HFN Commercial |
$109.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$69.37
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$94.85
|
| Rate for Payer: NAPHCARE Commercial |
$27.97
|
| Rate for Payer: Preferred Network Access Commercial |
$109.08
|
| Rate for Payer: Quartz Beloit One Network |
$58.09
|
| Rate for Payer: Quartz Commercial |
$77.06
|
| Rate for Payer: Quartz Medicare Advantage |
$18.65
|
| Rate for Payer: The Alliance Commercial |
$74.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.65
|
| Rate for Payer: United Healthcare PPO |
$88.92
|
| Rate for Payer: WEA Trust Commercial |
$65.21
|
| Rate for Payer: Wellcare Medicare |
$18.65
|
| Rate for Payer: WPS Commercial |
$87.81
|
|
|
Chromatin to TheraTest
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2792802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.09 |
| Max. Negotiated Rate |
$58.36 |
| Rate for Payer: Aetna Commercial |
$57.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$54.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$33.62
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cigna Commercial |
$58.36
|
| Rate for Payer: Health EOS Commercial |
$56.46
|
| Rate for Payer: HFN Commercial |
$58.36
|
| Rate for Payer: Multiplan Commercial |
$50.75
|
| Rate for Payer: Preferred Network Access Commercial |
$58.36
|
| Rate for Payer: Quartz Beloit One Network |
$31.09
|
| Rate for Payer: Quartz Commercial |
$38.06
|
| Rate for Payer: WEA Trust Commercial |
$34.89
|
| Rate for Payer: WPS Commercial |
$46.99
|
|
|
Chromatin to TheraTest
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2792802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$82.05 |
| Rate for Payer: Aetna Commercial |
$60.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$54.56
|
| Rate for Payer: Aetna Managed Medicare |
$18.65
|
| Rate for Payer: Anthem Medicare Advantage |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.65
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cigna Commercial |
$60.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$31.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18.65
|
| Rate for Payer: Health EOS Commercial |
$57.73
|
| Rate for Payer: HFN Commercial |
$60.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$65.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$50.75
|
| Rate for Payer: NAPHCARE Commercial |
$27.97
|
| Rate for Payer: Preferred Network Access Commercial |
$60.27
|
| Rate for Payer: Quartz Beloit One Network |
$27.91
|
| Rate for Payer: Quartz Commercial |
$36.16
|
| Rate for Payer: Quartz Medicare Advantage |
$18.65
|
| Rate for Payer: The Alliance Commercial |
$73.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.65
|
| Rate for Payer: WEA Trust Commercial |
$34.89
|
| Rate for Payer: WPS Commercial |
$82.05
|
|
