|
COLON DECOMPRESSION
|
Facility
|
IP
|
$2,026.00
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
2960551
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$992.74 |
| Max. Negotiated Rate |
$1,863.92 |
| Rate for Payer: Aetna Commercial |
$1,823.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,742.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,073.78
|
| Rate for Payer: Cash Price |
$607.80
|
| Rate for Payer: Cigna Commercial |
$1,863.92
|
| Rate for Payer: Health EOS Commercial |
$1,803.14
|
| Rate for Payer: HFN Commercial |
$1,863.92
|
| Rate for Payer: Multiplan Commercial |
$1,620.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,215.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,863.92
|
| Rate for Payer: Quartz Beloit One Network |
$992.74
|
| Rate for Payer: Quartz Commercial |
$1,215.60
|
| Rate for Payer: WEA Trust Commercial |
$1,114.30
|
| Rate for Payer: WPS Commercial |
$1,500.66
|
|
|
COLON DECOMPRESSION SET 14 FR G22181
|
Facility
|
OP
|
$2,191.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
2972898
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$613.48 |
| Max. Negotiated Rate |
$8,764.00 |
| Rate for Payer: Aetna Commercial |
$1,971.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,884.26
|
| Rate for Payer: Aetna Managed Medicare |
$613.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,424.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,095.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,051.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,161.23
|
| Rate for Payer: Cash Price |
$657.30
|
| Rate for Payer: Cigna Commercial |
$2,015.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,226.08
|
| Rate for Payer: Health EOS Commercial |
$1,949.99
|
| Rate for Payer: HFN Commercial |
$2,015.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,643.25
|
| Rate for Payer: Multiplan Commercial |
$1,752.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,314.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,015.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,073.59
|
| Rate for Payer: Quartz Commercial |
$1,424.15
|
| Rate for Payer: Quartz Medicare Advantage |
$1,314.60
|
| Rate for Payer: The Alliance Commercial |
$8,764.00
|
| Rate for Payer: WEA Trust Commercial |
$1,205.05
|
| Rate for Payer: WPS Commercial |
$1,622.87
|
|
|
COLON DECOMPRESSION SET 14 FR G22181
|
Facility
|
IP
|
$2,191.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
2972898
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,073.59 |
| Max. Negotiated Rate |
$2,015.72 |
| Rate for Payer: Aetna Commercial |
$1,971.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,884.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,161.23
|
| Rate for Payer: Cash Price |
$657.30
|
| Rate for Payer: Cigna Commercial |
$2,015.72
|
| Rate for Payer: Health EOS Commercial |
$1,949.99
|
| Rate for Payer: HFN Commercial |
$2,015.72
|
| Rate for Payer: Multiplan Commercial |
$1,752.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,314.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,015.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,073.59
|
| Rate for Payer: Quartz Commercial |
$1,314.60
|
| Rate for Payer: WEA Trust Commercial |
$1,205.05
|
| Rate for Payer: WPS Commercial |
$1,622.87
|
|
|
COLONOSCOPY
|
Facility
|
IP
|
$1,084.00
|
|
| Hospital Charge Code |
2959939
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$531.16 |
| Max. Negotiated Rate |
$997.28 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$932.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$574.52
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$997.28
|
| Rate for Payer: Health EOS Commercial |
$964.76
|
| Rate for Payer: HFN Commercial |
$997.28
|
| Rate for Payer: Multiplan Commercial |
$867.20
|
| Rate for Payer: NAPHCARE Commercial |
$650.40
|
| Rate for Payer: Preferred Network Access Commercial |
$997.28
|
| Rate for Payer: Quartz Beloit One Network |
$531.16
|
| Rate for Payer: Quartz Commercial |
$650.40
|
| Rate for Payer: WEA Trust Commercial |
$596.20
|
| Rate for Payer: WPS Commercial |
$802.92
|
|
|
COLONOSCOPY
|
Facility
|
OP
|
$1,084.00
|
|
| Hospital Charge Code |
2959939
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$303.52 |
| Max. Negotiated Rate |
$4,336.00 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$932.24
|
| Rate for Payer: Aetna Managed Medicare |
$303.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$704.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$542.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$520.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$574.52
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$997.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$606.61
|
| Rate for Payer: Health EOS Commercial |
$964.76
|
| Rate for Payer: HFN Commercial |
$997.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$813.00
|
| Rate for Payer: Multiplan Commercial |
$867.20
|
| Rate for Payer: NAPHCARE Commercial |
$650.40
|
| Rate for Payer: Preferred Network Access Commercial |
$997.28
|
| Rate for Payer: Quartz Beloit One Network |
$531.16
|
| Rate for Payer: Quartz Commercial |
$704.60
|
| Rate for Payer: Quartz Medicare Advantage |
$650.40
|
| Rate for Payer: The Alliance Commercial |
$4,336.00
|
| Rate for Payer: WEA Trust Commercial |
$596.20
|
| Rate for Payer: WPS Commercial |
$802.92
|
|
|
COLONOSCOPY AND BIOPSY 45380
|
Professional
|
Both
|
$2,432.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
3014807
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$414.07 |
| Max. Negotiated Rate |
$2,310.40 |
| Rate for Payer: Aetna Commercial |
$2,310.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,091.52
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cigna Commercial |
$2,310.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$414.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,459.20
|
| Rate for Payer: Health EOS Commercial |
$2,213.12
|
| Rate for Payer: HFN Commercial |
$2,310.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$670.77
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$670.77
|
| Rate for Payer: Multiplan Commercial |
$1,945.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,310.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,070.08
|
| Rate for Payer: Quartz Commercial |
$1,386.24
|
| Rate for Payer: The Alliance Commercial |
$1,216.00
|
| Rate for Payer: United Healthcare Medicaid |
$414.07
|
| Rate for Payer: WEA Trust Commercial |
$1,337.60
|
| Rate for Payer: WPS Commercial |
$1,801.38
|
|
|
COLONOSCOPY/CONTROL BLEEDING 45382
|
Professional
|
Both
|
$2,594.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
3014809
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$628.04 |
| Max. Negotiated Rate |
$2,464.30 |
| Rate for Payer: Aetna Commercial |
$2,464.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,230.84
|
| Rate for Payer: Cash Price |
$778.20
|
| Rate for Payer: Cash Price |
$778.20
|
| Rate for Payer: Cigna Commercial |
$2,464.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$628.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,556.40
|
| Rate for Payer: Health EOS Commercial |
$2,360.54
|
| Rate for Payer: HFN Commercial |
$2,464.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$866.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$866.40
|
| Rate for Payer: Multiplan Commercial |
$2,075.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,464.30
|
| Rate for Payer: Quartz Beloit One Network |
$1,141.36
|
| Rate for Payer: Quartz Commercial |
$1,478.58
|
| Rate for Payer: The Alliance Commercial |
$1,297.00
|
| Rate for Payer: United Healthcare Medicaid |
$628.04
|
| Rate for Payer: WEA Trust Commercial |
$1,426.70
|
| Rate for Payer: WPS Commercial |
$1,921.38
|
|
|
COLONOSCOPY DILATE STRICTURE 45386
|
Professional
|
Both
|
$2,800.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
3014812
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$562.74 |
| Max. Negotiated Rate |
$2,660.00 |
| Rate for Payer: Aetna Commercial |
$2,660.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,408.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cigna Commercial |
$2,660.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$562.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,680.00
|
| Rate for Payer: Health EOS Commercial |
$2,548.00
|
| Rate for Payer: HFN Commercial |
$2,660.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$705.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$705.86
|
| Rate for Payer: Multiplan Commercial |
$2,240.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,660.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,232.00
|
| Rate for Payer: Quartz Commercial |
$1,596.00
|
| Rate for Payer: The Alliance Commercial |
$1,400.00
|
| Rate for Payer: United Healthcare Medicaid |
$562.74
|
| Rate for Payer: WEA Trust Commercial |
$1,540.00
|
| Rate for Payer: WPS Commercial |
$2,073.96
|
|
|
COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$4,757.59
|
|
|
Service Code
|
CPT 45378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$903.36 |
| Max. Negotiated Rate |
$4,757.59 |
| Rate for Payer: Aetna Managed Medicare |
$903.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,914.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,297.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,183.00
|
| Rate for Payer: Anthem Medicare Advantage |
$903.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$903.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$903.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$903.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$903.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,360.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$903.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$903.36
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$903.36
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$903.36
|
| Rate for Payer: NAPHCARE Commercial |
$1,355.04
|
| Rate for Payer: Quartz Medicare Advantage |
$903.36
|
| Rate for Payer: The Alliance Commercial |
$3,613.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$903.36
|
| Rate for Payer: United Healthcare PPO |
$2,257.00
|
| Rate for Payer: Wellcare Medicare |
$903.36
|
|
|
COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$4,757.59
|
|
|
Service Code
|
CPT 45380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,166.39 |
| Max. Negotiated Rate |
$4,757.59 |
| Rate for Payer: Aetna Managed Medicare |
$1,166.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,166.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,166.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,166.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,338.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,166.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,166.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,166.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,166.39
|
| Rate for Payer: NAPHCARE Commercial |
$1,749.58
|
| Rate for Payer: Quartz Medicare Advantage |
$1,166.39
|
| Rate for Payer: The Alliance Commercial |
$4,665.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,166.39
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$1,166.39
|
|
|
COLONOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING, ANY METHOD
|
Facility
|
OP
|
$4,757.59
|
|
|
Service Code
|
CPT 45382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,166.39 |
| Max. Negotiated Rate |
$4,757.59 |
| Rate for Payer: Aetna Managed Medicare |
$1,166.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,166.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,166.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,166.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,338.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,166.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,166.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,166.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,166.39
|
| Rate for Payer: NAPHCARE Commercial |
$1,749.58
|
| Rate for Payer: Quartz Medicare Advantage |
$1,166.39
|
| Rate for Payer: The Alliance Commercial |
$4,665.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,166.39
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$1,166.39
|
|
|
Colonoscopy Flexible with Decompression 45393
|
Professional
|
Both
|
$2,107.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
5430710
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$260.21 |
| Max. Negotiated Rate |
$2,001.65 |
| Rate for Payer: Aetna Commercial |
$2,001.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,812.02
|
| Rate for Payer: Cash Price |
$632.10
|
| Rate for Payer: Cash Price |
$632.10
|
| Rate for Payer: Cigna Commercial |
$2,001.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$260.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,264.20
|
| Rate for Payer: Health EOS Commercial |
$1,917.37
|
| Rate for Payer: HFN Commercial |
$2,001.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$841.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$841.62
|
| Rate for Payer: Multiplan Commercial |
$1,685.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,001.65
|
| Rate for Payer: Quartz Beloit One Network |
$927.08
|
| Rate for Payer: Quartz Commercial |
$1,200.99
|
| Rate for Payer: The Alliance Commercial |
$1,053.50
|
| Rate for Payer: United Healthcare Medicaid |
$260.21
|
| Rate for Payer: WEA Trust Commercial |
$1,158.85
|
| Rate for Payer: WPS Commercial |
$1,560.65
|
|
|
COLONOSCOPY, FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE
|
Facility
|
OP
|
$4,757.59
|
|
|
Service Code
|
CPT 45381
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,166.39 |
| Max. Negotiated Rate |
$4,757.59 |
| Rate for Payer: Aetna Managed Medicare |
$1,166.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,166.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,166.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,166.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,338.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,166.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,166.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,166.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,166.39
|
| Rate for Payer: NAPHCARE Commercial |
$1,749.58
|
| Rate for Payer: Quartz Medicare Advantage |
$1,166.39
|
| Rate for Payer: The Alliance Commercial |
$4,665.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,166.39
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$1,166.39
|
|
|
COLONOSCOPY, FLEXIBLE; WITH ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$11,100.96
|
|
|
Service Code
|
CPT 45390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,726.00 |
| Max. Negotiated Rate |
$11,100.96 |
| Rate for Payer: Aetna Managed Medicare |
$2,775.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$2,775.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,775.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,775.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,775.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,775.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,323.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,775.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,775.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,775.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,775.24
|
| Rate for Payer: NAPHCARE Commercial |
$4,162.86
|
| Rate for Payer: Quartz Medicare Advantage |
$2,775.24
|
| Rate for Payer: The Alliance Commercial |
$11,100.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,775.24
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$2,775.24
|
|
|
COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
OP
|
$4,757.59
|
|
|
Service Code
|
CPT 45384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,166.39 |
| Max. Negotiated Rate |
$4,757.59 |
| Rate for Payer: Aetna Managed Medicare |
$1,166.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,166.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,166.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,166.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,338.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,166.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,166.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,166.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,166.39
|
| Rate for Payer: NAPHCARE Commercial |
$1,749.58
|
| Rate for Payer: Quartz Medicare Advantage |
$1,166.39
|
| Rate for Payer: The Alliance Commercial |
$4,665.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,166.39
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$1,166.39
|
|
|
COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$4,757.59
|
|
|
Service Code
|
CPT 45385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,166.39 |
| Max. Negotiated Rate |
$4,757.59 |
| Rate for Payer: Aetna Managed Medicare |
$1,166.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,166.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,166.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,166.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,338.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,166.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,166.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,166.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,166.39
|
| Rate for Payer: NAPHCARE Commercial |
$1,749.58
|
| Rate for Payer: Quartz Medicare Advantage |
$1,166.39
|
| Rate for Payer: The Alliance Commercial |
$4,665.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,166.39
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$1,166.39
|
|
|
COLONOSCOPY NP
|
Facility
|
OP
|
$5,241.00
|
|
| Hospital Charge Code |
5388776
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,467.48 |
| Max. Negotiated Rate |
$20,964.00 |
| Rate for Payer: Aetna Commercial |
$4,716.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,507.26
|
| Rate for Payer: Aetna Managed Medicare |
$1,467.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,406.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,620.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,515.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,777.73
|
| Rate for Payer: Cash Price |
$1,572.30
|
| Rate for Payer: Cigna Commercial |
$4,821.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,932.86
|
| Rate for Payer: Health EOS Commercial |
$4,664.49
|
| Rate for Payer: HFN Commercial |
$4,821.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,930.75
|
| Rate for Payer: Multiplan Commercial |
$4,192.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,144.60
|
| Rate for Payer: Preferred Network Access Commercial |
$4,821.72
|
| Rate for Payer: Quartz Beloit One Network |
$2,568.09
|
| Rate for Payer: Quartz Commercial |
$3,406.65
|
| Rate for Payer: Quartz Medicare Advantage |
$3,144.60
|
| Rate for Payer: The Alliance Commercial |
$20,964.00
|
| Rate for Payer: WEA Trust Commercial |
$2,882.55
|
| Rate for Payer: WPS Commercial |
$3,882.01
|
|
|
COLONOSCOPY NP
|
Facility
|
IP
|
$5,241.00
|
|
| Hospital Charge Code |
5388776
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,568.09 |
| Max. Negotiated Rate |
$4,821.72 |
| Rate for Payer: Aetna Commercial |
$4,716.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,507.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,777.73
|
| Rate for Payer: Cash Price |
$1,572.30
|
| Rate for Payer: Cigna Commercial |
$4,821.72
|
| Rate for Payer: Health EOS Commercial |
$4,664.49
|
| Rate for Payer: HFN Commercial |
$4,821.72
|
| Rate for Payer: Multiplan Commercial |
$4,192.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,144.60
|
| Rate for Payer: Preferred Network Access Commercial |
$4,821.72
|
| Rate for Payer: Quartz Beloit One Network |
$2,568.09
|
| Rate for Payer: Quartz Commercial |
$3,144.60
|
| Rate for Payer: WEA Trust Commercial |
$2,882.55
|
| Rate for Payer: WPS Commercial |
$3,882.01
|
|
|
COLONOSCOPY, SUBMUCOUS INJ 45381
|
Professional
|
Both
|
$2,216.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
3014808
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$379.37 |
| Max. Negotiated Rate |
$2,105.20 |
| Rate for Payer: Aetna Commercial |
$2,105.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,905.76
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cigna Commercial |
$2,105.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$379.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,329.60
|
| Rate for Payer: Health EOS Commercial |
$2,016.56
|
| Rate for Payer: HFN Commercial |
$2,105.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$670.77
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$670.77
|
| Rate for Payer: Multiplan Commercial |
$1,772.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,105.20
|
| Rate for Payer: Quartz Beloit One Network |
$975.04
|
| Rate for Payer: Quartz Commercial |
$1,263.12
|
| Rate for Payer: The Alliance Commercial |
$1,108.00
|
| Rate for Payer: United Healthcare Medicaid |
$379.37
|
| Rate for Payer: WEA Trust Commercial |
$1,218.80
|
| Rate for Payer: WPS Commercial |
$1,641.39
|
|
|
COLONOSCOPY THROUGH STOMA WITH ABLATION OF TUMOR, POLYP OR LESION
|
Facility
|
OP
|
$4,892.00
|
|
|
Service Code
|
CPT 44401
|
| Hospital Charge Code |
4494710
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,166.39 |
| Max. Negotiated Rate |
$4,665.56 |
| Rate for Payer: Aetna Commercial |
$4,402.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,207.12
|
| Rate for Payer: Aetna Managed Medicare |
$1,166.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,592.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,166.39
|
| Rate for Payer: Cash Price |
$1,467.60
|
| Rate for Payer: Cash Price |
$1,467.60
|
| Rate for Payer: Cash Price |
$1,467.60
|
| Rate for Payer: Cigna Commercial |
$4,500.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,166.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,166.39
|
| Rate for Payer: Health EOS Commercial |
$4,353.88
|
| Rate for Payer: HFN Commercial |
$4,500.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,338.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,166.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,166.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,166.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,166.39
|
| Rate for Payer: Multiplan Commercial |
$3,913.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,749.58
|
| Rate for Payer: Preferred Network Access Commercial |
$4,500.64
|
| Rate for Payer: Quartz Beloit One Network |
$2,397.08
|
| Rate for Payer: Quartz Commercial |
$3,179.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,166.39
|
| Rate for Payer: The Alliance Commercial |
$4,665.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,166.39
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: WEA Trust Commercial |
$2,690.60
|
| Rate for Payer: Wellcare Medicare |
$1,166.39
|
| Rate for Payer: WPS Commercial |
$3,623.50
|
|
|
COLONOSCOPY THROUGH STOMA WITH ABLATION OF TUMOR, POLYP OR LESION
|
Facility
|
IP
|
$4,892.00
|
|
|
Service Code
|
CPT 44401
|
| Hospital Charge Code |
4494710
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,397.08 |
| Max. Negotiated Rate |
$4,500.64 |
| Rate for Payer: Aetna Commercial |
$4,402.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,207.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,592.76
|
| Rate for Payer: Cash Price |
$1,467.60
|
| Rate for Payer: Cigna Commercial |
$4,500.64
|
| Rate for Payer: Health EOS Commercial |
$4,353.88
|
| Rate for Payer: HFN Commercial |
$4,500.64
|
| Rate for Payer: Multiplan Commercial |
$3,913.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,935.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,500.64
|
| Rate for Payer: Quartz Beloit One Network |
$2,397.08
|
| Rate for Payer: Quartz Commercial |
$2,935.20
|
| Rate for Payer: WEA Trust Commercial |
$2,690.60
|
| Rate for Payer: WPS Commercial |
$3,623.50
|
|
|
COLONOSCOPY THROUGH STOMA WITH BALLOON DILATION
|
Facility
|
OP
|
$5,173.00
|
|
|
Service Code
|
CPT 44405
|
| Hospital Charge Code |
4494712
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,166.39 |
| Max. Negotiated Rate |
$4,759.16 |
| Rate for Payer: Aetna Commercial |
$4,655.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,448.78
|
| Rate for Payer: Aetna Managed Medicare |
$1,166.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,741.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,166.39
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cigna Commercial |
$4,759.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,166.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,166.39
|
| Rate for Payer: Health EOS Commercial |
$4,603.97
|
| Rate for Payer: HFN Commercial |
$4,759.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,338.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,166.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,166.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,166.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,166.39
|
| Rate for Payer: Multiplan Commercial |
$4,138.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,749.58
|
| Rate for Payer: Preferred Network Access Commercial |
$4,759.16
|
| Rate for Payer: Quartz Beloit One Network |
$2,534.77
|
| Rate for Payer: Quartz Commercial |
$3,362.45
|
| Rate for Payer: Quartz Medicare Advantage |
$1,166.39
|
| Rate for Payer: The Alliance Commercial |
$4,665.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,166.39
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: WEA Trust Commercial |
$2,845.15
|
| Rate for Payer: Wellcare Medicare |
$1,166.39
|
| Rate for Payer: WPS Commercial |
$3,831.64
|
|
|
COLONOSCOPY THROUGH STOMA WITH BALLOON DILATION
|
Facility
|
IP
|
$5,173.00
|
|
|
Service Code
|
CPT 44405
|
| Hospital Charge Code |
4494712
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,534.77 |
| Max. Negotiated Rate |
$4,759.16 |
| Rate for Payer: Aetna Commercial |
$4,655.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,448.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,741.69
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cigna Commercial |
$4,759.16
|
| Rate for Payer: Health EOS Commercial |
$4,603.97
|
| Rate for Payer: HFN Commercial |
$4,759.16
|
| Rate for Payer: Multiplan Commercial |
$4,138.40
|
| Rate for Payer: NAPHCARE Commercial |
$3,103.80
|
| Rate for Payer: Preferred Network Access Commercial |
$4,759.16
|
| Rate for Payer: Quartz Beloit One Network |
$2,534.77
|
| Rate for Payer: Quartz Commercial |
$3,103.80
|
| Rate for Payer: WEA Trust Commercial |
$2,845.15
|
| Rate for Payer: WPS Commercial |
$3,831.64
|
|
|
COLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$4,665.56
|
|
|
Service Code
|
CPT 44389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,166.39 |
| Max. Negotiated Rate |
$4,665.56 |
| Rate for Payer: Aetna Managed Medicare |
$1,166.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,166.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,166.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,166.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,338.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,166.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,166.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,166.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,166.39
|
| Rate for Payer: NAPHCARE Commercial |
$1,749.58
|
| Rate for Payer: Quartz Medicare Advantage |
$1,166.39
|
| Rate for Payer: The Alliance Commercial |
$4,665.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,166.39
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$1,166.39
|
|
|
COLONOSCOPY THROUGH STOMA WITH DECOMPRESSON
|
Facility
|
OP
|
$1,948.00
|
|
|
Service Code
|
CPT 44408
|
| Hospital Charge Code |
4494713
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$903.36 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$1,753.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,675.28
|
| Rate for Payer: Aetna Managed Medicare |
$903.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,914.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,297.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,183.00
|
| Rate for Payer: Anthem Medicare Advantage |
$903.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,032.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$903.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$903.36
|
| Rate for Payer: Cash Price |
$584.40
|
| Rate for Payer: Cash Price |
$584.40
|
| Rate for Payer: Cash Price |
$584.40
|
| Rate for Payer: Cigna Commercial |
$1,792.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$903.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$903.36
|
| Rate for Payer: Health EOS Commercial |
$1,733.72
|
| Rate for Payer: HFN Commercial |
$1,792.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,360.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$903.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$903.36
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$903.36
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$903.36
|
| Rate for Payer: Multiplan Commercial |
$1,558.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,355.04
|
| Rate for Payer: Preferred Network Access Commercial |
$1,792.16
|
| Rate for Payer: Quartz Beloit One Network |
$954.52
|
| Rate for Payer: Quartz Commercial |
$1,266.20
|
| Rate for Payer: Quartz Medicare Advantage |
$903.36
|
| Rate for Payer: The Alliance Commercial |
$3,613.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$903.36
|
| Rate for Payer: United Healthcare PPO |
$2,257.00
|
| Rate for Payer: WEA Trust Commercial |
$1,071.40
|
| Rate for Payer: Wellcare Medicare |
$903.36
|
| Rate for Payer: WPS Commercial |
$1,442.88
|
|
