|
CONTROL PUMP WITH IZ AMS 800 72404127
|
Facility
OP
|
$34,254.00
|
|
|
Service Code
|
HCPCS C1815
|
| Hospital Charge Code |
5385020
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,591.12 |
| Max. Negotiated Rate |
$31,513.68 |
| Rate for Payer: Aetna Commercial |
$30,828.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$29,458.44
|
| Rate for Payer: Aetna Managed Medicare |
$9,591.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$22,265.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17,127.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16,441.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$18,154.62
|
| Rate for Payer: Cash Price |
$10,276.20
|
| Rate for Payer: Cigna Commercial |
$31,513.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19,168.54
|
| Rate for Payer: Health EOS Commercial |
$30,486.06
|
| Rate for Payer: HFN Commercial |
$31,513.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25,690.50
|
| Rate for Payer: Multiplan Commercial |
$27,403.20
|
| Rate for Payer: NAPHCARE Commercial |
$20,552.40
|
| Rate for Payer: Preferred Network Access Commercial |
$31,513.68
|
| Rate for Payer: Quartz Beloit One Network |
$16,784.46
|
| Rate for Payer: Quartz Commercial |
$22,265.10
|
| Rate for Payer: Quartz Medicare Advantage |
$20,552.40
|
| Rate for Payer: WEA Trust Commercial |
$18,839.70
|
| Rate for Payer: WPS Commercial |
$25,371.94
|
|
|
Copper Level
|
Facility
OP
|
$208.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
977909
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.41 |
| Max. Negotiated Rate |
$832.00 |
| Rate for Payer: Aetna Commercial |
$187.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$178.88
|
| Rate for Payer: Aetna Managed Medicare |
$12.41
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$46.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20.60
|
| Rate for Payer: Anthem Medicaid |
$12.82
|
| Rate for Payer: Anthem Medicare Advantage |
$12.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$110.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.41
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cigna Commercial |
$191.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12.82
|
| Rate for Payer: Dean Health Medicaid |
$12.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.41
|
| Rate for Payer: Health EOS Commercial |
$185.12
|
| Rate for Payer: HFN Commercial |
$191.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.41
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$12.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.41
|
| Rate for Payer: Managed Health Services Medicaid |
$13.33
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.41
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.41
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: NAPHCARE Commercial |
$18.62
|
| Rate for Payer: Preferred Network Access Commercial |
$191.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12.82
|
| Rate for Payer: Quartz Beloit One Network |
$101.92
|
| Rate for Payer: Quartz Commercial |
$135.20
|
| Rate for Payer: Quartz Medicare Advantage |
$12.41
|
| Rate for Payer: The Alliance Commercial |
$832.00
|
| Rate for Payer: United Healthcare Medicaid |
$12.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.41
|
| Rate for Payer: United Healthcare PPO |
$156.00
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: Wellcare Medicare |
$12.41
|
| Rate for Payer: WMAP Medicaid |
$12.82
|
| Rate for Payer: WPS Commercial |
$154.07
|
|
|
Copper Level
|
Facility
IP
|
$208.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
977909
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$101.92 |
| Max. Negotiated Rate |
$191.36 |
| Rate for Payer: Aetna Commercial |
$187.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$110.24
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cigna Commercial |
$191.36
|
| Rate for Payer: Health EOS Commercial |
$185.12
|
| Rate for Payer: HFN Commercial |
$191.36
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: NAPHCARE Commercial |
$124.80
|
| Rate for Payer: Preferred Network Access Commercial |
$191.36
|
| Rate for Payer: Quartz Beloit One Network |
$101.92
|
| Rate for Payer: Quartz Commercial |
$124.80
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: WPS Commercial |
$154.07
|
|
|
Copper Level
|
Professional
|
$208.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
977909
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.41 |
| Max. Negotiated Rate |
$197.60 |
| Rate for Payer: Aetna Commercial |
$197.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$178.88
|
| Rate for Payer: Aetna Managed Medicare |
$12.41
|
| Rate for Payer: Anthem Medicare Advantage |
$12.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.41
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cigna Commercial |
$197.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$104.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.41
|
| Rate for Payer: Health EOS Commercial |
$189.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$43.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$43.81
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.41
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: Preferred Network Access Commercial |
$197.60
|
| Rate for Payer: Quartz Beloit One Network |
$91.52
|
| Rate for Payer: Quartz Commercial |
$118.56
|
| Rate for Payer: Quartz Medicare Advantage |
$12.41
|
| Rate for Payer: The Alliance Commercial |
$49.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.41
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: WPS Commercial |
$54.60
|
|
|
Copper Level 24 Hour Urine
|
Professional
|
$208.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
980587
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.41 |
| Max. Negotiated Rate |
$197.60 |
| Rate for Payer: Aetna Commercial |
$197.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$178.88
|
| Rate for Payer: Aetna Managed Medicare |
$12.41
|
| Rate for Payer: Anthem Medicare Advantage |
$12.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.41
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cigna Commercial |
$197.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$104.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.41
|
| Rate for Payer: Health EOS Commercial |
$189.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$43.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$43.81
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.41
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: Preferred Network Access Commercial |
$197.60
|
| Rate for Payer: Quartz Beloit One Network |
$91.52
|
| Rate for Payer: Quartz Commercial |
$118.56
|
| Rate for Payer: Quartz Medicare Advantage |
$12.41
|
| Rate for Payer: The Alliance Commercial |
$49.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.41
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: WPS Commercial |
$54.60
|
|
|
Copper Level 24 Hour Urine
|
Facility
IP
|
$208.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
980587
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$101.92 |
| Max. Negotiated Rate |
$191.36 |
| Rate for Payer: Aetna Commercial |
$187.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$110.24
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cigna Commercial |
$191.36
|
| Rate for Payer: Health EOS Commercial |
$185.12
|
| Rate for Payer: HFN Commercial |
$191.36
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: NAPHCARE Commercial |
$124.80
|
| Rate for Payer: Preferred Network Access Commercial |
$191.36
|
| Rate for Payer: Quartz Beloit One Network |
$101.92
|
| Rate for Payer: Quartz Commercial |
$124.80
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: WPS Commercial |
$154.07
|
|
|
Copper Level 24 Hour Urine
|
Facility
OP
|
$208.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
980587
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.41 |
| Max. Negotiated Rate |
$832.00 |
| Rate for Payer: Aetna Commercial |
$187.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$178.88
|
| Rate for Payer: Aetna Managed Medicare |
$12.41
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$46.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20.60
|
| Rate for Payer: Anthem Medicaid |
$12.82
|
| Rate for Payer: Anthem Medicare Advantage |
$12.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$110.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.41
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cigna Commercial |
$191.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12.82
|
| Rate for Payer: Dean Health Medicaid |
$12.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.41
|
| Rate for Payer: Health EOS Commercial |
$185.12
|
| Rate for Payer: HFN Commercial |
$191.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.41
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$12.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.41
|
| Rate for Payer: Managed Health Services Medicaid |
$13.33
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.41
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.41
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: NAPHCARE Commercial |
$18.62
|
| Rate for Payer: Preferred Network Access Commercial |
$191.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12.82
|
| Rate for Payer: Quartz Beloit One Network |
$101.92
|
| Rate for Payer: Quartz Commercial |
$135.20
|
| Rate for Payer: Quartz Medicare Advantage |
$12.41
|
| Rate for Payer: The Alliance Commercial |
$832.00
|
| Rate for Payer: United Healthcare Medicaid |
$12.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.41
|
| Rate for Payer: United Healthcare PPO |
$156.00
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: Wellcare Medicare |
$12.41
|
| Rate for Payer: WMAP Medicaid |
$12.82
|
| Rate for Payer: WPS Commercial |
$154.07
|
|
|
CORACOACROMIAL LIGAMENT RELEASE, WITH OR WITHOUT ACROMIOPLASTY
|
Facility
OP
|
$66,121.56
|
|
|
Service Code
|
CPT 23415
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,071.12 |
| Max. Negotiated Rate |
$66,121.56 |
| Rate for Payer: Aetna Managed Medicare |
$7,071.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,071.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,071.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,339.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,071.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,304.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,071.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,071.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,071.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,071.12
|
| Rate for Payer: NAPHCARE Commercial |
$10,606.68
|
| Rate for Payer: Quartz Medicare Advantage |
$7,071.12
|
| Rate for Payer: The Alliance Commercial |
$66,121.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,071.12
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$7,071.12
|
|
|
Cor Athrectomy W/PTCA
|
Facility
OP
|
$4,681.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
4125713
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,293.69 |
| Max. Negotiated Rate |
$40,449.87 |
| Rate for Payer: Aetna Commercial |
$4,212.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,025.66
|
| Rate for Payer: Aetna Managed Medicare |
$10,873.62
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,311.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,676.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,643.00
|
| Rate for Payer: Anthem Medicare Advantage |
$10,873.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,480.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,873.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,873.62
|
| Rate for Payer: Cash Price |
$1,404.30
|
| Rate for Payer: Cash Price |
$1,404.30
|
| Rate for Payer: Cash Price |
$1,404.30
|
| Rate for Payer: Cigna Commercial |
$4,306.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,873.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,873.62
|
| Rate for Payer: Health EOS Commercial |
$4,166.09
|
| Rate for Payer: HFN Commercial |
$4,306.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$40,449.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,873.62
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,873.62
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,873.62
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,873.62
|
| Rate for Payer: Multiplan Commercial |
$3,744.80
|
| Rate for Payer: NAPHCARE Commercial |
$16,310.43
|
| Rate for Payer: Preferred Network Access Commercial |
$4,306.52
|
| Rate for Payer: Quartz Beloit One Network |
$2,293.69
|
| Rate for Payer: Quartz Commercial |
$3,042.65
|
| Rate for Payer: Quartz Medicare Advantage |
$10,873.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,873.62
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: WEA Trust Commercial |
$2,574.55
|
| Rate for Payer: Wellcare Medicare |
$10,873.62
|
| Rate for Payer: WPS Commercial |
$3,467.22
|
|
|
Cor Athrectomy W/PTCA
|
Facility
IP
|
$4,681.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
4125713
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,293.69 |
| Max. Negotiated Rate |
$4,306.52 |
| Rate for Payer: Aetna Commercial |
$4,212.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,480.93
|
| Rate for Payer: Cash Price |
$1,404.30
|
| Rate for Payer: Cigna Commercial |
$4,306.52
|
| Rate for Payer: Health EOS Commercial |
$4,166.09
|
| Rate for Payer: HFN Commercial |
$4,306.52
|
| Rate for Payer: Multiplan Commercial |
$3,744.80
|
| Rate for Payer: NAPHCARE Commercial |
$2,808.60
|
| Rate for Payer: Preferred Network Access Commercial |
$4,306.52
|
| Rate for Payer: Quartz Beloit One Network |
$2,293.69
|
| Rate for Payer: Quartz Commercial |
$2,808.60
|
| Rate for Payer: WEA Trust Commercial |
$2,574.55
|
| Rate for Payer: WPS Commercial |
$3,467.22
|
|
|
Cor Athrectomy W/PTCA Ea Add Branch +
|
Facility
IP
|
$1,233.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
4125714
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$604.17 |
| Max. Negotiated Rate |
$1,134.36 |
| Rate for Payer: Aetna Commercial |
$1,109.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$653.49
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cigna Commercial |
$1,134.36
|
| Rate for Payer: Health EOS Commercial |
$1,097.37
|
| Rate for Payer: HFN Commercial |
$1,134.36
|
| Rate for Payer: Multiplan Commercial |
$986.40
|
| Rate for Payer: NAPHCARE Commercial |
$739.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,134.36
|
| Rate for Payer: Quartz Beloit One Network |
$604.17
|
| Rate for Payer: Quartz Commercial |
$739.80
|
| Rate for Payer: WEA Trust Commercial |
$678.15
|
| Rate for Payer: WPS Commercial |
$913.28
|
|
|
Cor Athrectomy W/PTCA Ea Add Branch +
|
Facility
OP
|
$1,233.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
4125714
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$345.24 |
| Max. Negotiated Rate |
$23,311.00 |
| Rate for Payer: Aetna Commercial |
$1,109.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,060.38
|
| Rate for Payer: Aetna Managed Medicare |
$345.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,311.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,676.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,643.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$653.49
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cigna Commercial |
$1,134.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Health EOS Commercial |
$1,097.37
|
| Rate for Payer: HFN Commercial |
$1,134.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$924.75
|
| Rate for Payer: Multiplan Commercial |
$986.40
|
| Rate for Payer: NAPHCARE Commercial |
$739.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,134.36
|
| Rate for Payer: Quartz Beloit One Network |
$604.17
|
| Rate for Payer: Quartz Commercial |
$801.45
|
| Rate for Payer: Quartz Medicare Advantage |
$739.80
|
| Rate for Payer: WEA Trust Commercial |
$678.15
|
| Rate for Payer: WPS Commercial |
$913.28
|
|
|
Cor Athrec W/Stent & PTCA
|
Facility
IP
|
$31,599.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
4125715
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$15,483.51 |
| Max. Negotiated Rate |
$29,071.08 |
| Rate for Payer: Aetna Commercial |
$28,439.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$16,747.47
|
| Rate for Payer: Cash Price |
$9,479.70
|
| Rate for Payer: Cigna Commercial |
$29,071.08
|
| Rate for Payer: Health EOS Commercial |
$28,123.11
|
| Rate for Payer: HFN Commercial |
$29,071.08
|
| Rate for Payer: Multiplan Commercial |
$25,279.20
|
| Rate for Payer: NAPHCARE Commercial |
$18,959.40
|
| Rate for Payer: Preferred Network Access Commercial |
$29,071.08
|
| Rate for Payer: Quartz Beloit One Network |
$15,483.51
|
| Rate for Payer: Quartz Commercial |
$18,959.40
|
| Rate for Payer: WEA Trust Commercial |
$17,379.45
|
| Rate for Payer: WPS Commercial |
$23,405.38
|
|
|
Cor Athrec W/Stent & PTCA
|
Facility
OP
|
$31,599.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
4125715
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,078.00 |
| Max. Negotiated Rate |
$64,474.41 |
| Rate for Payer: Aetna Commercial |
$28,439.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$27,175.14
|
| Rate for Payer: Aetna Managed Medicare |
$17,331.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,311.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,676.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,643.00
|
| Rate for Payer: Anthem Medicare Advantage |
$17,331.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$16,747.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17,331.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17,331.83
|
| Rate for Payer: Cash Price |
$9,479.70
|
| Rate for Payer: Cash Price |
$9,479.70
|
| Rate for Payer: Cash Price |
$9,479.70
|
| Rate for Payer: Cigna Commercial |
$29,071.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17,331.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17,331.83
|
| Rate for Payer: Health EOS Commercial |
$28,123.11
|
| Rate for Payer: HFN Commercial |
$29,071.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64,474.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17,331.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17,331.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17,331.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17,331.83
|
| Rate for Payer: Multiplan Commercial |
$25,279.20
|
| Rate for Payer: NAPHCARE Commercial |
$25,997.74
|
| Rate for Payer: Preferred Network Access Commercial |
$29,071.08
|
| Rate for Payer: Quartz Beloit One Network |
$15,483.51
|
| Rate for Payer: Quartz Commercial |
$20,539.35
|
| Rate for Payer: Quartz Medicare Advantage |
$17,331.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,331.83
|
| Rate for Payer: United Healthcare PPO |
$11,078.00
|
| Rate for Payer: WEA Trust Commercial |
$17,379.45
|
| Rate for Payer: Wellcare Medicare |
$17,331.83
|
| Rate for Payer: WPS Commercial |
$23,405.38
|
|
|
Cor Athrec W/Stent & PTCA add Branch +
|
Facility
OP
|
$3,112.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
4125716
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$871.36 |
| Max. Negotiated Rate |
$23,311.00 |
| Rate for Payer: Aetna Commercial |
$2,800.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,676.32
|
| Rate for Payer: Aetna Managed Medicare |
$871.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,311.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,676.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,643.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,649.36
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cigna Commercial |
$2,863.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Health EOS Commercial |
$2,769.68
|
| Rate for Payer: HFN Commercial |
$2,863.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,334.00
|
| Rate for Payer: Multiplan Commercial |
$2,489.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,867.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,863.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,524.88
|
| Rate for Payer: Quartz Commercial |
$2,022.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,867.20
|
| Rate for Payer: WEA Trust Commercial |
$1,711.60
|
| Rate for Payer: WPS Commercial |
$2,305.06
|
|
|
Cor Athrec W/Stent & PTCA add Branch +
|
Facility
IP
|
$3,112.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
4125716
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,524.88 |
| Max. Negotiated Rate |
$2,863.04 |
| Rate for Payer: Aetna Commercial |
$2,800.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,649.36
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cigna Commercial |
$2,863.04
|
| Rate for Payer: Health EOS Commercial |
$2,769.68
|
| Rate for Payer: HFN Commercial |
$2,863.04
|
| Rate for Payer: Multiplan Commercial |
$2,489.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,867.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,863.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,524.88
|
| Rate for Payer: Quartz Commercial |
$1,867.20
|
| Rate for Payer: WEA Trust Commercial |
$1,711.60
|
| Rate for Payer: WPS Commercial |
$2,305.06
|
|
|
Cor BPG Any PTCA/Stent/Athrec Add Branch +
|
Facility
OP
|
$1,481.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
3052467
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$414.68 |
| Max. Negotiated Rate |
$23,311.00 |
| Rate for Payer: Aetna Commercial |
$1,332.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,273.66
|
| Rate for Payer: Aetna Managed Medicare |
$414.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,311.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,676.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,643.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$784.93
|
| Rate for Payer: Cash Price |
$444.30
|
| Rate for Payer: Cash Price |
$444.30
|
| Rate for Payer: Cash Price |
$444.30
|
| Rate for Payer: Cigna Commercial |
$1,362.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Health EOS Commercial |
$1,318.09
|
| Rate for Payer: HFN Commercial |
$1,362.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,110.75
|
| Rate for Payer: Multiplan Commercial |
$1,184.80
|
| Rate for Payer: NAPHCARE Commercial |
$888.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,362.52
|
| Rate for Payer: Quartz Beloit One Network |
$725.69
|
| Rate for Payer: Quartz Commercial |
$962.65
|
| Rate for Payer: Quartz Medicare Advantage |
$888.60
|
| Rate for Payer: WEA Trust Commercial |
$814.55
|
| Rate for Payer: WPS Commercial |
$1,096.98
|
|
|
Cor BPG Any PTCA/Stent/Athrec Add Branch +
|
Facility
IP
|
$1,481.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
3052467
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$725.69 |
| Max. Negotiated Rate |
$1,362.52 |
| Rate for Payer: Aetna Commercial |
$1,332.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$784.93
|
| Rate for Payer: Cash Price |
$444.30
|
| Rate for Payer: Cigna Commercial |
$1,362.52
|
| Rate for Payer: Health EOS Commercial |
$1,318.09
|
| Rate for Payer: HFN Commercial |
$1,362.52
|
| Rate for Payer: Multiplan Commercial |
$1,184.80
|
| Rate for Payer: NAPHCARE Commercial |
$888.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,362.52
|
| Rate for Payer: Quartz Beloit One Network |
$725.69
|
| Rate for Payer: Quartz Commercial |
$888.60
|
| Rate for Payer: WEA Trust Commercial |
$814.55
|
| Rate for Payer: WPS Commercial |
$1,096.98
|
|
|
COR CTO STENT/ATHREC/PTCA
|
Facility
OP
|
$26,746.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
3052521
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$10,873.62 |
| Max. Negotiated Rate |
$40,449.87 |
| Rate for Payer: Aetna Commercial |
$24,071.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$23,001.56
|
| Rate for Payer: Aetna Managed Medicare |
$10,873.62
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,311.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,676.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,643.00
|
| Rate for Payer: Anthem Medicare Advantage |
$10,873.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14,175.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,873.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,873.62
|
| Rate for Payer: Cash Price |
$8,023.80
|
| Rate for Payer: Cash Price |
$8,023.80
|
| Rate for Payer: Cash Price |
$8,023.80
|
| Rate for Payer: Cigna Commercial |
$24,606.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,873.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,873.62
|
| Rate for Payer: Health EOS Commercial |
$23,803.94
|
| Rate for Payer: HFN Commercial |
$24,606.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$40,449.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,873.62
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,873.62
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,873.62
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,873.62
|
| Rate for Payer: Multiplan Commercial |
$21,396.80
|
| Rate for Payer: NAPHCARE Commercial |
$16,310.43
|
| Rate for Payer: Preferred Network Access Commercial |
$24,606.32
|
| Rate for Payer: Quartz Beloit One Network |
$13,105.54
|
| Rate for Payer: Quartz Commercial |
$17,384.90
|
| Rate for Payer: Quartz Medicare Advantage |
$10,873.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,873.62
|
| Rate for Payer: United Healthcare PPO |
$20,059.50
|
| Rate for Payer: WEA Trust Commercial |
$14,710.30
|
| Rate for Payer: Wellcare Medicare |
$10,873.62
|
| Rate for Payer: WPS Commercial |
$19,810.76
|
|
|
COR CTO STENT/ATHREC/PTCA
|
Facility
IP
|
$26,746.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
3052521
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$13,105.54 |
| Max. Negotiated Rate |
$24,606.32 |
| Rate for Payer: Aetna Commercial |
$24,071.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14,175.38
|
| Rate for Payer: Cash Price |
$8,023.80
|
| Rate for Payer: Cigna Commercial |
$24,606.32
|
| Rate for Payer: Health EOS Commercial |
$23,803.94
|
| Rate for Payer: HFN Commercial |
$24,606.32
|
| Rate for Payer: Multiplan Commercial |
$21,396.80
|
| Rate for Payer: NAPHCARE Commercial |
$16,047.60
|
| Rate for Payer: Preferred Network Access Commercial |
$24,606.32
|
| Rate for Payer: Quartz Beloit One Network |
$13,105.54
|
| Rate for Payer: Quartz Commercial |
$16,047.60
|
| Rate for Payer: WEA Trust Commercial |
$14,710.30
|
| Rate for Payer: WPS Commercial |
$19,810.76
|
|
|
Cor CTO Stent/Athrec/PTCA Brch/BPG +
|
Facility
IP
|
$812.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
3052522
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$397.88 |
| Max. Negotiated Rate |
$747.04 |
| Rate for Payer: Aetna Commercial |
$730.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$430.36
|
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cigna Commercial |
$747.04
|
| Rate for Payer: Health EOS Commercial |
$722.68
|
| Rate for Payer: HFN Commercial |
$747.04
|
| Rate for Payer: Multiplan Commercial |
$649.60
|
| Rate for Payer: NAPHCARE Commercial |
$487.20
|
| Rate for Payer: Preferred Network Access Commercial |
$747.04
|
| Rate for Payer: Quartz Beloit One Network |
$397.88
|
| Rate for Payer: Quartz Commercial |
$487.20
|
| Rate for Payer: WEA Trust Commercial |
$446.60
|
| Rate for Payer: WPS Commercial |
$601.45
|
|
|
Cor CTO Stent/Athrec/PTCA Brch/BPG +
|
Facility
OP
|
$812.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
3052522
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$227.36 |
| Max. Negotiated Rate |
$23,311.00 |
| Rate for Payer: Aetna Commercial |
$730.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$698.32
|
| Rate for Payer: Aetna Managed Medicare |
$227.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,311.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,676.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,643.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$430.36
|
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cigna Commercial |
$747.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Health EOS Commercial |
$722.68
|
| Rate for Payer: HFN Commercial |
$747.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$609.00
|
| Rate for Payer: Multiplan Commercial |
$649.60
|
| Rate for Payer: NAPHCARE Commercial |
$487.20
|
| Rate for Payer: Preferred Network Access Commercial |
$747.04
|
| Rate for Payer: Quartz Beloit One Network |
$397.88
|
| Rate for Payer: Quartz Commercial |
$527.80
|
| Rate for Payer: Quartz Medicare Advantage |
$487.20
|
| Rate for Payer: United Healthcare PPO |
$609.00
|
| Rate for Payer: WEA Trust Commercial |
$446.60
|
| Rate for Payer: WPS Commercial |
$601.45
|
|
|
CORD FOOTSWITCH BIPOLAR CORD E0509/E0512
|
Facility
OP
|
$125.00
|
|
| Hospital Charge Code |
2963077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$500.00 |
| Rate for Payer: Aetna Commercial |
$112.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$107.50
|
| Rate for Payer: Aetna Managed Medicare |
$35.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$81.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$62.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$60.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.25
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$69.95
|
| Rate for Payer: Health EOS Commercial |
$111.25
|
| Rate for Payer: HFN Commercial |
$115.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$93.75
|
| Rate for Payer: Multiplan Commercial |
$100.00
|
| Rate for Payer: NAPHCARE Commercial |
$75.00
|
| Rate for Payer: Preferred Network Access Commercial |
$115.00
|
| Rate for Payer: Quartz Beloit One Network |
$61.25
|
| Rate for Payer: Quartz Commercial |
$81.25
|
| Rate for Payer: Quartz Medicare Advantage |
$75.00
|
| Rate for Payer: The Alliance Commercial |
$500.00
|
| Rate for Payer: WEA Trust Commercial |
$68.75
|
| Rate for Payer: WPS Commercial |
$92.59
|
|
|
CORD FOOTSWITCH BIPOLAR CORD E0509/E0512
|
Facility
IP
|
$125.00
|
|
| Hospital Charge Code |
2963077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.25 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$112.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.25
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: Health EOS Commercial |
$111.25
|
| Rate for Payer: HFN Commercial |
$115.00
|
| Rate for Payer: Multiplan Commercial |
$100.00
|
| Rate for Payer: NAPHCARE Commercial |
$75.00
|
| Rate for Payer: Preferred Network Access Commercial |
$115.00
|
| Rate for Payer: Quartz Beloit One Network |
$61.25
|
| Rate for Payer: Quartz Commercial |
$75.00
|
| Rate for Payer: WEA Trust Commercial |
$68.75
|
| Rate for Payer: WPS Commercial |
$92.59
|
|
|
Core BPG Any PTCA/Stent/Athrec
|
Facility
OP
|
$27,942.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
3052466
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,596.00 |
| Max. Negotiated Rate |
$40,449.87 |
| Rate for Payer: Aetna Commercial |
$25,147.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$24,030.12
|
| Rate for Payer: Aetna Managed Medicare |
$10,873.62
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,311.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,676.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,643.00
|
| Rate for Payer: Anthem Medicare Advantage |
$10,873.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14,809.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,873.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,873.62
|
| Rate for Payer: Cash Price |
$8,382.60
|
| Rate for Payer: Cash Price |
$8,382.60
|
| Rate for Payer: Cash Price |
$8,382.60
|
| Rate for Payer: Cigna Commercial |
$25,706.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,873.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,873.62
|
| Rate for Payer: Health EOS Commercial |
$24,868.38
|
| Rate for Payer: HFN Commercial |
$25,706.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$40,449.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,873.62
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,873.62
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,873.62
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,873.62
|
| Rate for Payer: Multiplan Commercial |
$22,353.60
|
| Rate for Payer: NAPHCARE Commercial |
$16,310.43
|
| Rate for Payer: Preferred Network Access Commercial |
$25,706.64
|
| Rate for Payer: Quartz Beloit One Network |
$13,691.58
|
| Rate for Payer: Quartz Commercial |
$18,162.30
|
| Rate for Payer: Quartz Medicare Advantage |
$10,873.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,873.62
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: WEA Trust Commercial |
$15,368.10
|
| Rate for Payer: Wellcare Medicare |
$10,873.62
|
| Rate for Payer: WPS Commercial |
$20,696.64
|
|
