|
C-Reactive Protein
|
Professional
|
$137.00
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
633716
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$130.15 |
| Rate for Payer: Aetna Commercial |
$130.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$117.82
|
| Rate for Payer: Aetna Managed Medicare |
$5.18
|
| Rate for Payer: Anthem Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.18
|
| Rate for Payer: Cash Price |
$41.10
|
| Rate for Payer: Cash Price |
$41.10
|
| Rate for Payer: Cigna Commercial |
$130.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$68.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.18
|
| Rate for Payer: Health EOS Commercial |
$124.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.18
|
| Rate for Payer: Multiplan Commercial |
$109.60
|
| Rate for Payer: Preferred Network Access Commercial |
$130.15
|
| Rate for Payer: Quartz Beloit One Network |
$60.28
|
| Rate for Payer: Quartz Commercial |
$78.09
|
| Rate for Payer: Quartz Medicare Advantage |
$5.18
|
| Rate for Payer: The Alliance Commercial |
$20.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: WEA Trust Commercial |
$75.35
|
| Rate for Payer: WPS Commercial |
$22.79
|
|
|
C-Reactive Protein High Sensitivity
|
Professional
|
$208.00
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
977885
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.95 |
| 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 |
$12.95
|
| Rate for Payer: Anthem Medicare Advantage |
$12.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.95
|
| 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 |
$12.95
|
| Rate for Payer: Health EOS Commercial |
$189.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$45.71
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$45.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.95
|
| 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 |
$12.95
|
| Rate for Payer: The Alliance Commercial |
$51.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.95
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: WPS Commercial |
$56.98
|
|
|
C-Reactive Protein High Sensitivity
|
Facility
OP
|
$208.00
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
977885
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.95 |
| 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 |
$12.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$48.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22.66
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21.50
|
| Rate for Payer: Anthem Medicaid |
$13.38
|
| Rate for Payer: Anthem Medicare Advantage |
$12.95
|
| 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 |
$12.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.95
|
| 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 |
$12.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13.38
|
| Rate for Payer: Dean Health Medicaid |
$13.38
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.95
|
| Rate for Payer: Health EOS Commercial |
$185.12
|
| Rate for Payer: HFN Commercial |
$191.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.95
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$13.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.95
|
| Rate for Payer: Managed Health Services Medicaid |
$13.92
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.95
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: NAPHCARE Commercial |
$19.42
|
| Rate for Payer: Preferred Network Access Commercial |
$191.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$13.38
|
| Rate for Payer: Quartz Beloit One Network |
$101.92
|
| Rate for Payer: Quartz Commercial |
$135.20
|
| Rate for Payer: Quartz Medicare Advantage |
$12.95
|
| Rate for Payer: The Alliance Commercial |
$832.00
|
| Rate for Payer: United Healthcare Medicaid |
$13.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.95
|
| Rate for Payer: United Healthcare PPO |
$156.00
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: Wellcare Medicare |
$12.95
|
| Rate for Payer: WMAP Medicaid |
$13.38
|
| Rate for Payer: WPS Commercial |
$154.07
|
|
|
C-Reactive Protein High Sensitivity
|
Facility
IP
|
$208.00
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
977885
|
|
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
|
|
|
C-REAMER 9MM 8772A
|
Facility
IP
|
$1,575.00
|
|
| Hospital Charge Code |
2964907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$771.75 |
| Max. Negotiated Rate |
$1,449.00 |
| Rate for Payer: Aetna Commercial |
$1,417.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$834.75
|
| Rate for Payer: Cash Price |
$472.50
|
| Rate for Payer: Cigna Commercial |
$1,449.00
|
| Rate for Payer: Health EOS Commercial |
$1,401.75
|
| Rate for Payer: HFN Commercial |
$1,449.00
|
| Rate for Payer: Multiplan Commercial |
$1,260.00
|
| Rate for Payer: NAPHCARE Commercial |
$945.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,449.00
|
| Rate for Payer: Quartz Beloit One Network |
$771.75
|
| Rate for Payer: Quartz Commercial |
$945.00
|
| Rate for Payer: WEA Trust Commercial |
$866.25
|
| Rate for Payer: WPS Commercial |
$1,166.60
|
|
|
C-REAMER 9MM 8772A
|
Facility
OP
|
$1,575.00
|
|
| Hospital Charge Code |
2964907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$441.00 |
| Max. Negotiated Rate |
$6,300.00 |
| Rate for Payer: Aetna Commercial |
$1,417.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,354.50
|
| Rate for Payer: Aetna Managed Medicare |
$441.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,023.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$787.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$756.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$834.75
|
| Rate for Payer: Cash Price |
$472.50
|
| Rate for Payer: Cigna Commercial |
$1,449.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$881.37
|
| Rate for Payer: Health EOS Commercial |
$1,401.75
|
| Rate for Payer: HFN Commercial |
$1,449.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,181.25
|
| Rate for Payer: Multiplan Commercial |
$1,260.00
|
| Rate for Payer: NAPHCARE Commercial |
$945.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,449.00
|
| Rate for Payer: Quartz Beloit One Network |
$771.75
|
| Rate for Payer: Quartz Commercial |
$1,023.75
|
| Rate for Payer: Quartz Medicare Advantage |
$945.00
|
| Rate for Payer: The Alliance Commercial |
$6,300.00
|
| Rate for Payer: WEA Trust Commercial |
$866.25
|
| Rate for Payer: WPS Commercial |
$1,166.60
|
|
|
CREAM FREE UP MASSAGE 8OZ #8319
|
Facility
IP
|
$232.00
|
|
| Hospital Charge Code |
2974048
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$113.68 |
| Max. Negotiated Rate |
$213.44 |
| Rate for Payer: Aetna Commercial |
$208.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$122.96
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cigna Commercial |
$213.44
|
| Rate for Payer: Health EOS Commercial |
$206.48
|
| Rate for Payer: HFN Commercial |
$213.44
|
| Rate for Payer: Multiplan Commercial |
$185.60
|
| Rate for Payer: NAPHCARE Commercial |
$139.20
|
| Rate for Payer: Preferred Network Access Commercial |
$213.44
|
| Rate for Payer: Quartz Beloit One Network |
$113.68
|
| Rate for Payer: Quartz Commercial |
$139.20
|
| Rate for Payer: WEA Trust Commercial |
$127.60
|
| Rate for Payer: WPS Commercial |
$171.84
|
|
|
CREAM FREE UP MASSAGE 8OZ #8319
|
Facility
OP
|
$232.00
|
|
| Hospital Charge Code |
2974048
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$64.96 |
| Max. Negotiated Rate |
$928.00 |
| Rate for Payer: Aetna Commercial |
$208.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$199.52
|
| Rate for Payer: Aetna Managed Medicare |
$64.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$150.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$116.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$111.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$122.96
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cigna Commercial |
$213.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$129.83
|
| Rate for Payer: Health EOS Commercial |
$206.48
|
| Rate for Payer: HFN Commercial |
$213.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$174.00
|
| Rate for Payer: Multiplan Commercial |
$185.60
|
| Rate for Payer: NAPHCARE Commercial |
$139.20
|
| Rate for Payer: Preferred Network Access Commercial |
$213.44
|
| Rate for Payer: Quartz Beloit One Network |
$113.68
|
| Rate for Payer: Quartz Commercial |
$150.80
|
| Rate for Payer: Quartz Medicare Advantage |
$139.20
|
| Rate for Payer: The Alliance Commercial |
$928.00
|
| Rate for Payer: WEA Trust Commercial |
$127.60
|
| Rate for Payer: WPS Commercial |
$171.84
|
|
|
CREAM MASSAGE BIOTONE 1 GAL #5583-82
|
Facility
IP
|
$1,192.00
|
|
| Hospital Charge Code |
2969735
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$584.08 |
| Max. Negotiated Rate |
$1,096.64 |
| Rate for Payer: Aetna Commercial |
$1,072.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$631.76
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cigna Commercial |
$1,096.64
|
| Rate for Payer: Health EOS Commercial |
$1,060.88
|
| Rate for Payer: HFN Commercial |
$1,096.64
|
| Rate for Payer: Multiplan Commercial |
$953.60
|
| Rate for Payer: NAPHCARE Commercial |
$715.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,096.64
|
| Rate for Payer: Quartz Beloit One Network |
$584.08
|
| Rate for Payer: Quartz Commercial |
$715.20
|
| Rate for Payer: WEA Trust Commercial |
$655.60
|
| Rate for Payer: WPS Commercial |
$882.91
|
|
|
CREAM MASSAGE BIOTONE 1 GAL #5583-82
|
Facility
OP
|
$1,192.00
|
|
| Hospital Charge Code |
2969735
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$333.76 |
| Max. Negotiated Rate |
$4,768.00 |
| Rate for Payer: Aetna Commercial |
$1,072.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,025.12
|
| Rate for Payer: Aetna Managed Medicare |
$333.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$774.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$596.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$572.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$631.76
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cigna Commercial |
$1,096.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$667.04
|
| Rate for Payer: Health EOS Commercial |
$1,060.88
|
| Rate for Payer: HFN Commercial |
$1,096.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$894.00
|
| Rate for Payer: Multiplan Commercial |
$953.60
|
| Rate for Payer: NAPHCARE Commercial |
$715.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,096.64
|
| Rate for Payer: Quartz Beloit One Network |
$584.08
|
| Rate for Payer: Quartz Commercial |
$774.80
|
| Rate for Payer: Quartz Medicare Advantage |
$715.20
|
| Rate for Payer: The Alliance Commercial |
$4,768.00
|
| Rate for Payer: WEA Trust Commercial |
$655.60
|
| Rate for Payer: WPS Commercial |
$882.91
|
|
|
CREAM SENSICARE SKIN 4 OZ **SUB FOR 2100314**
|
Facility
OP
|
$144.00
|
|
| Hospital Charge Code |
2963316
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$40.32 |
| Max. Negotiated Rate |
$576.00 |
| Rate for Payer: Aetna Commercial |
$129.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$123.84
|
| Rate for Payer: Aetna Managed Medicare |
$40.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$93.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$72.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$69.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$76.32
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cigna Commercial |
$132.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$80.58
|
| Rate for Payer: Health EOS Commercial |
$128.16
|
| Rate for Payer: HFN Commercial |
$132.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$108.00
|
| Rate for Payer: Multiplan Commercial |
$115.20
|
| Rate for Payer: NAPHCARE Commercial |
$86.40
|
| Rate for Payer: Preferred Network Access Commercial |
$132.48
|
| Rate for Payer: Quartz Beloit One Network |
$70.56
|
| Rate for Payer: Quartz Commercial |
$93.60
|
| Rate for Payer: Quartz Medicare Advantage |
$86.40
|
| Rate for Payer: The Alliance Commercial |
$576.00
|
| Rate for Payer: WEA Trust Commercial |
$79.20
|
| Rate for Payer: WPS Commercial |
$106.66
|
|
|
CREAM SENSICARE SKIN 4 OZ **SUB FOR 2100314**
|
Facility
IP
|
$144.00
|
|
| Hospital Charge Code |
2963316
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$70.56 |
| Max. Negotiated Rate |
$132.48 |
| Rate for Payer: Aetna Commercial |
$129.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$76.32
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cigna Commercial |
$132.48
|
| Rate for Payer: Health EOS Commercial |
$128.16
|
| Rate for Payer: HFN Commercial |
$132.48
|
| Rate for Payer: Multiplan Commercial |
$115.20
|
| Rate for Payer: NAPHCARE Commercial |
$86.40
|
| Rate for Payer: Preferred Network Access Commercial |
$132.48
|
| Rate for Payer: Quartz Beloit One Network |
$70.56
|
| Rate for Payer: Quartz Commercial |
$86.40
|
| Rate for Payer: WEA Trust Commercial |
$79.20
|
| Rate for Payer: WPS Commercial |
$106.66
|
|
|
CREAM SHAVING 1.5oz
|
Facility
OP
|
$87.00
|
|
| Hospital Charge Code |
2963222
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$24.36 |
| Max. Negotiated Rate |
$348.00 |
| Rate for Payer: Aetna Commercial |
$78.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.82
|
| Rate for Payer: Aetna Managed Medicare |
$24.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.11
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna Commercial |
$80.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.69
|
| Rate for Payer: Health EOS Commercial |
$77.43
|
| Rate for Payer: HFN Commercial |
$80.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.25
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: NAPHCARE Commercial |
$52.20
|
| Rate for Payer: Preferred Network Access Commercial |
$80.04
|
| Rate for Payer: Quartz Beloit One Network |
$42.63
|
| Rate for Payer: Quartz Commercial |
$56.55
|
| Rate for Payer: Quartz Medicare Advantage |
$52.20
|
| Rate for Payer: The Alliance Commercial |
$348.00
|
| Rate for Payer: WEA Trust Commercial |
$47.85
|
| Rate for Payer: WPS Commercial |
$64.44
|
|
|
CREAM SHAVING 1.5oz
|
Facility
IP
|
$87.00
|
|
| Hospital Charge Code |
2963222
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$42.63 |
| Max. Negotiated Rate |
$80.04 |
| Rate for Payer: Aetna Commercial |
$78.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.11
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna Commercial |
$80.04
|
| Rate for Payer: Health EOS Commercial |
$77.43
|
| Rate for Payer: HFN Commercial |
$80.04
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: NAPHCARE Commercial |
$52.20
|
| Rate for Payer: Preferred Network Access Commercial |
$80.04
|
| Rate for Payer: Quartz Beloit One Network |
$42.63
|
| Rate for Payer: Quartz Commercial |
$52.20
|
| Rate for Payer: WEA Trust Commercial |
$47.85
|
| Rate for Payer: WPS Commercial |
$64.44
|
|
|
Create Eardrum Opening 6943350
|
Professional
|
$1,619.00
|
|
|
Service Code
|
CPT 69433 50
|
| Hospital Charge Code |
3975035
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$165.08 |
| Max. Negotiated Rate |
$1,538.05 |
| Rate for Payer: Aetna Commercial |
$1,538.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,392.34
|
| Rate for Payer: Cash Price |
$485.70
|
| Rate for Payer: Cash Price |
$485.70
|
| Rate for Payer: Cigna Commercial |
$1,538.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$809.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$971.40
|
| Rate for Payer: Health EOS Commercial |
$1,473.29
|
| Rate for Payer: Multiplan Commercial |
$1,295.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,538.05
|
| Rate for Payer: Quartz Beloit One Network |
$712.36
|
| Rate for Payer: Quartz Commercial |
$922.83
|
| Rate for Payer: The Alliance Commercial |
$809.50
|
| Rate for Payer: United Healthcare Medicaid |
$165.08
|
| Rate for Payer: WEA Trust Commercial |
$890.45
|
| Rate for Payer: WPS Commercial |
$1,199.19
|
|
|
Creatine Kinase
|
Professional
|
$114.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633712
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$108.30 |
| Rate for Payer: Aetna Commercial |
$108.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Aetna Managed Medicare |
$6.51
|
| Rate for Payer: Anthem Medicare Advantage |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.51
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$108.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$57.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.51
|
| Rate for Payer: Health EOS Commercial |
$103.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.51
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: Preferred Network Access Commercial |
$108.30
|
| Rate for Payer: Quartz Beloit One Network |
$50.16
|
| Rate for Payer: Quartz Commercial |
$64.98
|
| Rate for Payer: Quartz Medicare Advantage |
$6.51
|
| Rate for Payer: The Alliance Commercial |
$25.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.51
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$28.64
|
|
|
Creatine Kinase
|
Facility
OP
|
$114.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633712
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$456.00 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Aetna Managed Medicare |
$6.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.81
|
| Rate for Payer: Anthem Medicaid |
$6.73
|
| Rate for Payer: Anthem Medicare Advantage |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.51
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6.73
|
| Rate for Payer: Dean Health Medicaid |
$6.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.51
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.51
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.51
|
| Rate for Payer: Managed Health Services Medicaid |
$7.00
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.51
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.51
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$9.76
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6.73
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$74.10
|
| Rate for Payer: Quartz Medicare Advantage |
$6.51
|
| Rate for Payer: The Alliance Commercial |
$456.00
|
| Rate for Payer: United Healthcare Medicaid |
$6.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.51
|
| Rate for Payer: United Healthcare PPO |
$85.50
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: Wellcare Medicare |
$6.51
|
| Rate for Payer: WMAP Medicaid |
$6.73
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Creatine Kinase
|
Facility
IP
|
$114.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633712
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.86 |
| Max. Negotiated Rate |
$104.88 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$68.40
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$68.40
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Creatine Kinase Interpretation
|
Professional
|
$204.00
|
|
|
Service Code
|
CPT 82552
|
| Hospital Charge Code |
2942881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$193.80 |
| Rate for Payer: Aetna Commercial |
$193.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$175.44
|
| Rate for Payer: Aetna Managed Medicare |
$13.39
|
| Rate for Payer: Anthem Medicare Advantage |
$13.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.39
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$193.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$102.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.39
|
| Rate for Payer: Health EOS Commercial |
$185.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$47.27
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$47.27
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.39
|
| Rate for Payer: Multiplan Commercial |
$163.20
|
| Rate for Payer: Preferred Network Access Commercial |
$193.80
|
| Rate for Payer: Quartz Beloit One Network |
$89.76
|
| Rate for Payer: Quartz Commercial |
$116.28
|
| Rate for Payer: Quartz Medicare Advantage |
$13.39
|
| Rate for Payer: The Alliance Commercial |
$52.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.39
|
| Rate for Payer: WEA Trust Commercial |
$112.20
|
| Rate for Payer: WPS Commercial |
$58.92
|
|
|
Creatine Kinase Interpretation
|
Facility
OP
|
$204.00
|
|
|
Service Code
|
CPT 82552
|
| Hospital Charge Code |
2942881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna Commercial |
$183.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$175.44
|
| Rate for Payer: Aetna Managed Medicare |
$13.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$50.21
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$23.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22.23
|
| Rate for Payer: Anthem Medicaid |
$13.84
|
| Rate for Payer: Anthem Medicare Advantage |
$13.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$108.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.39
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$187.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13.84
|
| Rate for Payer: Dean Health Medicaid |
$13.84
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.39
|
| Rate for Payer: Health EOS Commercial |
$181.56
|
| Rate for Payer: HFN Commercial |
$187.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$49.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.39
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$13.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.39
|
| Rate for Payer: Managed Health Services Medicaid |
$14.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.39
|
| Rate for Payer: Multiplan Commercial |
$163.20
|
| Rate for Payer: NAPHCARE Commercial |
$20.08
|
| Rate for Payer: Preferred Network Access Commercial |
$187.68
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$13.84
|
| Rate for Payer: Quartz Beloit One Network |
$99.96
|
| Rate for Payer: Quartz Commercial |
$132.60
|
| Rate for Payer: Quartz Medicare Advantage |
$13.39
|
| Rate for Payer: The Alliance Commercial |
$816.00
|
| Rate for Payer: United Healthcare Medicaid |
$13.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.39
|
| Rate for Payer: United Healthcare PPO |
$153.00
|
| Rate for Payer: WEA Trust Commercial |
$112.20
|
| Rate for Payer: Wellcare Medicare |
$13.39
|
| Rate for Payer: WMAP Medicaid |
$13.84
|
| Rate for Payer: WPS Commercial |
$151.10
|
|
|
Creatine Kinase Interpretation
|
Facility
IP
|
$204.00
|
|
|
Service Code
|
CPT 82552
|
| Hospital Charge Code |
2942881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$99.96 |
| Max. Negotiated Rate |
$187.68 |
| Rate for Payer: Aetna Commercial |
$183.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$108.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$187.68
|
| Rate for Payer: Health EOS Commercial |
$181.56
|
| Rate for Payer: HFN Commercial |
$187.68
|
| Rate for Payer: Multiplan Commercial |
$163.20
|
| Rate for Payer: NAPHCARE Commercial |
$122.40
|
| Rate for Payer: Preferred Network Access Commercial |
$187.68
|
| Rate for Payer: Quartz Beloit One Network |
$99.96
|
| Rate for Payer: Quartz Commercial |
$122.40
|
| Rate for Payer: WEA Trust Commercial |
$112.20
|
| Rate for Payer: WPS Commercial |
$151.10
|
|
|
Creatine Kinase Isoenzymes
|
Facility
OP
|
$200.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633714
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$172.00
|
| Rate for Payer: Aetna Managed Medicare |
$6.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.81
|
| Rate for Payer: Anthem Medicaid |
$6.73
|
| Rate for Payer: Anthem Medicare Advantage |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$106.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.51
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$184.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6.73
|
| Rate for Payer: Dean Health Medicaid |
$6.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.51
|
| Rate for Payer: Health EOS Commercial |
$178.00
|
| Rate for Payer: HFN Commercial |
$184.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.51
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.51
|
| Rate for Payer: Managed Health Services Medicaid |
$7.00
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.51
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.51
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: NAPHCARE Commercial |
$9.76
|
| Rate for Payer: Preferred Network Access Commercial |
$184.00
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6.73
|
| Rate for Payer: Quartz Beloit One Network |
$98.00
|
| Rate for Payer: Quartz Commercial |
$130.00
|
| Rate for Payer: Quartz Medicare Advantage |
$6.51
|
| Rate for Payer: The Alliance Commercial |
$800.00
|
| Rate for Payer: United Healthcare Medicaid |
$6.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.51
|
| Rate for Payer: United Healthcare PPO |
$150.00
|
| Rate for Payer: WEA Trust Commercial |
$110.00
|
| Rate for Payer: Wellcare Medicare |
$6.51
|
| Rate for Payer: WMAP Medicaid |
$6.73
|
| Rate for Payer: WPS Commercial |
$148.14
|
|
|
Creatine Kinase Isoenzymes
|
Professional
|
$200.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633714
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$190.00 |
| Rate for Payer: Aetna Commercial |
$190.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$172.00
|
| Rate for Payer: Aetna Managed Medicare |
$6.51
|
| Rate for Payer: Anthem Medicare Advantage |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.51
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$190.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$100.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.51
|
| Rate for Payer: Health EOS Commercial |
$182.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.51
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: Preferred Network Access Commercial |
$190.00
|
| Rate for Payer: Quartz Beloit One Network |
$88.00
|
| Rate for Payer: Quartz Commercial |
$114.00
|
| Rate for Payer: Quartz Medicare Advantage |
$6.51
|
| Rate for Payer: The Alliance Commercial |
$25.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.51
|
| Rate for Payer: WEA Trust Commercial |
$110.00
|
| Rate for Payer: WPS Commercial |
$28.64
|
|
|
Creatine Kinase Isoenzymes
|
Facility
IP
|
$200.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633714
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$98.00 |
| Max. Negotiated Rate |
$184.00 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$106.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$184.00
|
| Rate for Payer: Health EOS Commercial |
$178.00
|
| Rate for Payer: HFN Commercial |
$184.00
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: NAPHCARE Commercial |
$120.00
|
| Rate for Payer: Preferred Network Access Commercial |
$184.00
|
| Rate for Payer: Quartz Beloit One Network |
$98.00
|
| Rate for Payer: Quartz Commercial |
$120.00
|
| Rate for Payer: WEA Trust Commercial |
$110.00
|
| Rate for Payer: WPS Commercial |
$148.14
|
|
|
Creatine Kinase only, No Reflex
|
Facility
IP
|
$114.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
979893
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.86 |
| Max. Negotiated Rate |
$104.88 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$68.40
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$68.40
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
