|
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 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
|
|
|
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
|
|
|
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
|
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
|
|
|
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
|
|
|
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 (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
|
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
|
$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
|
$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 to TheraTest
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2792802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$74.59 |
| Rate for Payer: Aetna Commercial |
$57.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$54.56
|
| 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 |
$33.62
|
| 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 |
$58.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35.50
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18.65
|
| Rate for Payer: Health EOS Commercial |
$56.46
|
| Rate for Payer: HFN Commercial |
$58.36
|
| 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 |
$50.75
|
| Rate for Payer: NAPHCARE Commercial |
$27.97
|
| Rate for Payer: Preferred Network Access Commercial |
$58.36
|
| Rate for Payer: Quartz Beloit One Network |
$31.09
|
| Rate for Payer: Quartz Commercial |
$41.24
|
| 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 |
$47.58
|
| Rate for Payer: WEA Trust Commercial |
$34.89
|
| Rate for Payer: Wellcare Medicare |
$18.65
|
| 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
|
|
|
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
|
|
|
Chromium Level, Plasma
|
Facility
|
IP
|
$331.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
3959975
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$168.68 |
| Max. Negotiated Rate |
$316.70 |
| Rate for Payer: Aetna Commercial |
$309.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$296.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$182.45
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cigna Commercial |
$316.70
|
| Rate for Payer: Health EOS Commercial |
$306.37
|
| Rate for Payer: HFN Commercial |
$316.70
|
| Rate for Payer: Multiplan Commercial |
$275.39
|
| Rate for Payer: Preferred Network Access Commercial |
$316.70
|
| Rate for Payer: Quartz Beloit One Network |
$168.68
|
| Rate for Payer: Quartz Commercial |
$206.54
|
| Rate for Payer: WEA Trust Commercial |
$189.33
|
| Rate for Payer: WPS Commercial |
$254.97
|
|
|
Chromium Level, Plasma
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
3959975
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$316.70 |
| Rate for Payer: Aetna Commercial |
$309.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$296.05
|
| Rate for Payer: Aetna Managed Medicare |
$21.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$79.09
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$36.91
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$35.01
|
| Rate for Payer: Anthem Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$182.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.09
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cigna Commercial |
$316.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$21.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$192.64
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$21.09
|
| Rate for Payer: Health EOS Commercial |
$306.37
|
| Rate for Payer: HFN Commercial |
$316.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$78.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$21.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$21.09
|
| Rate for Payer: Multiplan Commercial |
$275.39
|
| Rate for Payer: NAPHCARE Commercial |
$31.64
|
| Rate for Payer: Preferred Network Access Commercial |
$316.70
|
| Rate for Payer: Quartz Beloit One Network |
$168.68
|
| Rate for Payer: Quartz Commercial |
$223.76
|
| Rate for Payer: Quartz Medicare Advantage |
$21.09
|
| Rate for Payer: The Alliance Commercial |
$84.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.09
|
| Rate for Payer: United Healthcare PPO |
$258.18
|
| Rate for Payer: WEA Trust Commercial |
$189.33
|
| Rate for Payer: Wellcare Medicare |
$21.09
|
| Rate for Payer: WPS Commercial |
$254.97
|
|
|
Chromium Level, Plasma
|
Professional
|
Both
|
$331.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
3959975
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$327.03 |
| Rate for Payer: Aetna Commercial |
$327.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$296.05
|
| Rate for Payer: Aetna Managed Medicare |
$21.09
|
| Rate for Payer: Anthem Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.09
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cigna Commercial |
$327.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$172.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21.09
|
| Rate for Payer: Health EOS Commercial |
$313.26
|
| Rate for Payer: HFN Commercial |
$327.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$74.45
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$74.45
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.09
|
| Rate for Payer: Multiplan Commercial |
$275.39
|
| Rate for Payer: NAPHCARE Commercial |
$31.64
|
| Rate for Payer: Preferred Network Access Commercial |
$327.03
|
| Rate for Payer: Quartz Beloit One Network |
$151.47
|
| Rate for Payer: Quartz Commercial |
$196.22
|
| Rate for Payer: Quartz Medicare Advantage |
$21.09
|
| Rate for Payer: The Alliance Commercial |
$83.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.09
|
| Rate for Payer: WEA Trust Commercial |
$189.33
|
| Rate for Payer: WPS Commercial |
$92.80
|
|
|
Chromium Level, Serum
|
Professional
|
Both
|
$223.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
977900
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$199.45
|
| Rate for Payer: Aetna Managed Medicare |
$21.09
|
| Rate for Payer: Anthem Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.09
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$220.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$115.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21.09
|
| Rate for Payer: Health EOS Commercial |
$211.05
|
| Rate for Payer: HFN Commercial |
$220.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$74.45
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$74.45
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.09
|
| Rate for Payer: Multiplan Commercial |
$185.54
|
| Rate for Payer: NAPHCARE Commercial |
$31.64
|
| Rate for Payer: Preferred Network Access Commercial |
$220.32
|
| Rate for Payer: Quartz Beloit One Network |
$102.04
|
| Rate for Payer: Quartz Commercial |
$132.19
|
| Rate for Payer: Quartz Medicare Advantage |
$21.09
|
| Rate for Payer: The Alliance Commercial |
$83.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.09
|
| Rate for Payer: WEA Trust Commercial |
$127.56
|
| Rate for Payer: WPS Commercial |
$92.80
|
|
|
Chromium Level, Serum
|
Facility
|
IP
|
$223.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
977900
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$113.64 |
| Max. Negotiated Rate |
$213.37 |
| Rate for Payer: Aetna Commercial |
$208.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$199.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$122.92
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$213.37
|
| Rate for Payer: Health EOS Commercial |
$206.41
|
| Rate for Payer: HFN Commercial |
$213.37
|
| Rate for Payer: Multiplan Commercial |
$185.54
|
| Rate for Payer: Preferred Network Access Commercial |
$213.37
|
| Rate for Payer: Quartz Beloit One Network |
$113.64
|
| Rate for Payer: Quartz Commercial |
$139.15
|
| Rate for Payer: WEA Trust Commercial |
$127.56
|
| Rate for Payer: WPS Commercial |
$171.78
|
|
|
Chromium Level, Serum
|
Facility
|
OP
|
$223.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
977900
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$213.37 |
| Rate for Payer: Aetna Commercial |
$208.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$199.45
|
| Rate for Payer: Aetna Managed Medicare |
$21.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$79.09
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$36.91
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$35.01
|
| Rate for Payer: Anthem Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$122.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.09
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cash Price |
$66.90
|
| Rate for Payer: Cigna Commercial |
$213.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$21.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$129.79
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$21.09
|
| Rate for Payer: Health EOS Commercial |
$206.41
|
| Rate for Payer: HFN Commercial |
$213.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$78.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$21.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$21.09
|
| Rate for Payer: Multiplan Commercial |
$185.54
|
| Rate for Payer: NAPHCARE Commercial |
$31.64
|
| Rate for Payer: Preferred Network Access Commercial |
$213.37
|
| Rate for Payer: Quartz Beloit One Network |
$113.64
|
| Rate for Payer: Quartz Commercial |
$150.75
|
| Rate for Payer: Quartz Medicare Advantage |
$21.09
|
| Rate for Payer: The Alliance Commercial |
$84.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.09
|
| Rate for Payer: United Healthcare PPO |
$173.94
|
| Rate for Payer: WEA Trust Commercial |
$127.56
|
| Rate for Payer: Wellcare Medicare |
$21.09
|
| Rate for Payer: WPS Commercial |
$171.78
|
|
|
Chromogranin A
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
977901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$345.80 |
| Rate for Payer: Aetna Commercial |
$345.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$313.04
|
| Rate for Payer: Aetna Managed Medicare |
$21.64
|
| Rate for Payer: Anthem Medicare Advantage |
$21.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.64
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$345.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$182.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21.64
|
| Rate for Payer: Health EOS Commercial |
$331.24
|
| Rate for Payer: HFN Commercial |
$345.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$76.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$76.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.64
|
| Rate for Payer: Multiplan Commercial |
$291.20
|
| Rate for Payer: NAPHCARE Commercial |
$32.46
|
| Rate for Payer: Preferred Network Access Commercial |
$345.80
|
| Rate for Payer: Quartz Beloit One Network |
$160.16
|
| Rate for Payer: Quartz Commercial |
$207.48
|
| Rate for Payer: Quartz Medicare Advantage |
$21.64
|
| Rate for Payer: The Alliance Commercial |
$85.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.64
|
| Rate for Payer: WEA Trust Commercial |
$200.20
|
| Rate for Payer: WPS Commercial |
$95.23
|
|
|
Chromogranin A
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
977901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$178.36 |
| Max. Negotiated Rate |
$334.88 |
| Rate for Payer: Aetna Commercial |
$327.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$313.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$192.92
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$334.88
|
| Rate for Payer: Health EOS Commercial |
$323.96
|
| Rate for Payer: HFN Commercial |
$334.88
|
| Rate for Payer: Multiplan Commercial |
$291.20
|
| Rate for Payer: Preferred Network Access Commercial |
$334.88
|
| Rate for Payer: Quartz Beloit One Network |
$178.36
|
| Rate for Payer: Quartz Commercial |
$218.40
|
| Rate for Payer: WEA Trust Commercial |
$200.20
|
| Rate for Payer: WPS Commercial |
$269.61
|
|
|
Chromogranin A
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
977901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$334.88 |
| Rate for Payer: Aetna Commercial |
$327.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$313.04
|
| Rate for Payer: Aetna Managed Medicare |
$21.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$81.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$37.87
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$35.93
|
| Rate for Payer: Anthem Medicare Advantage |
$21.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$192.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.64
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$334.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$21.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$203.70
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$21.64
|
| Rate for Payer: Health EOS Commercial |
$323.96
|
| Rate for Payer: HFN Commercial |
$334.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$80.51
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.64
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.64
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$21.64
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$21.64
|
| Rate for Payer: Multiplan Commercial |
$291.20
|
| Rate for Payer: NAPHCARE Commercial |
$32.46
|
| Rate for Payer: Preferred Network Access Commercial |
$334.88
|
| Rate for Payer: Quartz Beloit One Network |
$178.36
|
| Rate for Payer: Quartz Commercial |
$236.60
|
| Rate for Payer: Quartz Medicare Advantage |
$21.64
|
| Rate for Payer: The Alliance Commercial |
$86.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.64
|
| Rate for Payer: United Healthcare PPO |
$273.00
|
| Rate for Payer: WEA Trust Commercial |
$200.20
|
| Rate for Payer: Wellcare Medicare |
$21.64
|
| Rate for Payer: WPS Commercial |
$269.61
|
|
