|
COLONOSCOPY, FLEXIBLE; WITH ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$11,684.32
|
|
|
Service Code
|
CPT 45390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,835.04 |
| Max. Negotiated Rate |
$11,684.32 |
| Rate for Payer: Aetna Managed Medicare |
$2,921.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$2,921.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,921.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,921.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,921.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,921.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,866.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,921.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,921.08
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,921.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,921.08
|
| Rate for Payer: NAPHCARE Commercial |
$4,381.62
|
| Rate for Payer: Quartz Medicare Advantage |
$2,921.08
|
| Rate for Payer: The Alliance Commercial |
$11,684.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,921.08
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$2,921.08
|
|
|
COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
OP
|
$5,037.34
|
|
|
Service Code
|
CPT 45384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,259.34 |
| Max. Negotiated Rate |
$5,037.34 |
| Rate for Payer: Aetna Managed Medicare |
$1,259.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,259.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,259.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,259.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,684.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,259.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,259.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,259.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,259.34
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,259.34
|
| Rate for Payer: The Alliance Commercial |
$5,037.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,259.34
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,259.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$5,037.34
|
|
|
Service Code
|
CPT 45385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,259.34 |
| Max. Negotiated Rate |
$5,037.34 |
| Rate for Payer: Aetna Managed Medicare |
$1,259.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,259.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,259.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,259.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,684.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,259.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,259.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,259.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,259.34
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,259.34
|
| Rate for Payer: The Alliance Commercial |
$5,037.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,259.34
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,259.34
|
|
|
COLONOSCOPY NP
|
Facility
|
OP
|
$5,241.00
|
|
| Hospital Charge Code |
5388776
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,526.18 |
| Max. Negotiated Rate |
$5,014.59 |
| Rate for Payer: Aetna Commercial |
$4,905.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,687.55
|
| Rate for Payer: Aetna Managed Medicare |
$1,526.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,542.92
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,725.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,616.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,888.84
|
| Rate for Payer: Cash Price |
$1,572.30
|
| Rate for Payer: Cigna Commercial |
$5,014.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,050.26
|
| Rate for Payer: Health EOS Commercial |
$4,851.07
|
| Rate for Payer: HFN Commercial |
$5,014.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,087.98
|
| Rate for Payer: Multiplan Commercial |
$4,360.51
|
| Rate for Payer: NAPHCARE Commercial |
$3,270.38
|
| Rate for Payer: Preferred Network Access Commercial |
$5,014.59
|
| Rate for Payer: Quartz Beloit One Network |
$2,670.81
|
| Rate for Payer: Quartz Commercial |
$3,542.92
|
| Rate for Payer: Quartz Medicare Advantage |
$3,270.38
|
| Rate for Payer: The Alliance Commercial |
$2,725.32
|
| Rate for Payer: WEA Trust Commercial |
$2,997.85
|
| Rate for Payer: WPS Commercial |
$4,037.14
|
|
|
COLONOSCOPY NP
|
Facility
|
IP
|
$5,241.00
|
|
| Hospital Charge Code |
5388776
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,670.81 |
| Max. Negotiated Rate |
$5,014.59 |
| Rate for Payer: Aetna Commercial |
$4,905.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,687.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,888.84
|
| Rate for Payer: Cash Price |
$1,572.30
|
| Rate for Payer: Cigna Commercial |
$5,014.59
|
| Rate for Payer: Health EOS Commercial |
$4,851.07
|
| Rate for Payer: HFN Commercial |
$5,014.59
|
| Rate for Payer: Multiplan Commercial |
$4,360.51
|
| Rate for Payer: Preferred Network Access Commercial |
$5,014.59
|
| Rate for Payer: Quartz Beloit One Network |
$2,670.81
|
| Rate for Payer: Quartz Commercial |
$3,270.38
|
| Rate for Payer: WEA Trust Commercial |
$2,997.85
|
| Rate for Payer: WPS Commercial |
$4,037.14
|
|
|
COLONOSCOPY, SUBMUCOUS INJ 45381
|
Professional
|
Both
|
$2,216.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
3014808
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$172.62 |
| Max. Negotiated Rate |
$2,189.41 |
| Rate for Payer: Aetna Commercial |
$2,189.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,981.99
|
| Rate for Payer: Aetna Managed Medicare |
$172.62
|
| Rate for Payer: Anthem Medicare Advantage |
$172.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$172.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$172.62
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cigna Commercial |
$2,189.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$394.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$172.62
|
| Rate for Payer: Health EOS Commercial |
$2,097.22
|
| Rate for Payer: HFN Commercial |
$2,189.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$697.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$697.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$172.62
|
| Rate for Payer: Multiplan Commercial |
$1,843.71
|
| Rate for Payer: NAPHCARE Commercial |
$258.93
|
| Rate for Payer: Preferred Network Access Commercial |
$2,189.41
|
| Rate for Payer: Quartz Beloit One Network |
$1,014.04
|
| Rate for Payer: Quartz Commercial |
$1,313.64
|
| Rate for Payer: Quartz Medicare Advantage |
$172.62
|
| Rate for Payer: The Alliance Commercial |
$733.63
|
| Rate for Payer: United Healthcare Medicaid |
$394.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$172.62
|
| Rate for Payer: WEA Trust Commercial |
$1,267.55
|
| Rate for Payer: WPS Commercial |
$776.79
|
|
|
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 |
$2,492.96 |
| Max. Negotiated Rate |
$4,680.67 |
| Rate for Payer: Aetna Commercial |
$4,578.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,375.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,696.47
|
| Rate for Payer: Cash Price |
$1,467.60
|
| Rate for Payer: Cigna Commercial |
$4,680.67
|
| Rate for Payer: Health EOS Commercial |
$4,528.04
|
| Rate for Payer: HFN Commercial |
$4,680.67
|
| Rate for Payer: Multiplan Commercial |
$4,070.14
|
| Rate for Payer: Preferred Network Access Commercial |
$4,680.67
|
| Rate for Payer: Quartz Beloit One Network |
$2,492.96
|
| Rate for Payer: Quartz Commercial |
$3,052.61
|
| Rate for Payer: WEA Trust Commercial |
$2,798.22
|
| Rate for Payer: WPS Commercial |
$3,768.31
|
|
|
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 |
$1,259.34 |
| Max. Negotiated Rate |
$5,037.34 |
| Rate for Payer: Aetna Commercial |
$4,578.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,375.40
|
| Rate for Payer: Aetna Managed Medicare |
$1,259.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,696.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,259.34
|
| 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 |
$4,680.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,259.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,259.34
|
| Rate for Payer: Health EOS Commercial |
$4,528.04
|
| Rate for Payer: HFN Commercial |
$4,680.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,684.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,259.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,259.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,259.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,259.34
|
| Rate for Payer: Multiplan Commercial |
$4,070.14
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,680.67
|
| Rate for Payer: Quartz Beloit One Network |
$2,492.96
|
| Rate for Payer: Quartz Commercial |
$3,306.99
|
| Rate for Payer: Quartz Medicare Advantage |
$1,259.34
|
| Rate for Payer: The Alliance Commercial |
$5,037.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,259.34
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: WEA Trust Commercial |
$2,798.22
|
| Rate for Payer: Wellcare Medicare |
$1,259.34
|
| Rate for Payer: WPS Commercial |
$3,768.31
|
|
|
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 |
$1,259.34 |
| Max. Negotiated Rate |
$5,037.34 |
| Rate for Payer: Aetna Commercial |
$4,841.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,626.73
|
| Rate for Payer: Aetna Managed Medicare |
$1,259.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,851.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,259.34
|
| 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 |
$4,949.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,259.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,259.34
|
| Rate for Payer: Health EOS Commercial |
$4,788.13
|
| Rate for Payer: HFN Commercial |
$4,949.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,684.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,259.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,259.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,259.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,259.34
|
| Rate for Payer: Multiplan Commercial |
$4,303.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,949.53
|
| Rate for Payer: Quartz Beloit One Network |
$2,636.16
|
| Rate for Payer: Quartz Commercial |
$3,496.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,259.34
|
| Rate for Payer: The Alliance Commercial |
$5,037.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,259.34
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: WEA Trust Commercial |
$2,958.96
|
| Rate for Payer: Wellcare Medicare |
$1,259.34
|
| Rate for Payer: WPS Commercial |
$3,984.76
|
|
|
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 |
$2,636.16 |
| Max. Negotiated Rate |
$4,949.53 |
| Rate for Payer: Aetna Commercial |
$4,841.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,626.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,851.36
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cigna Commercial |
$4,949.53
|
| Rate for Payer: Health EOS Commercial |
$4,788.13
|
| Rate for Payer: HFN Commercial |
$4,949.53
|
| Rate for Payer: Multiplan Commercial |
$4,303.94
|
| Rate for Payer: Preferred Network Access Commercial |
$4,949.53
|
| Rate for Payer: Quartz Beloit One Network |
$2,636.16
|
| Rate for Payer: Quartz Commercial |
$3,227.95
|
| Rate for Payer: WEA Trust Commercial |
$2,958.96
|
| Rate for Payer: WPS Commercial |
$3,984.76
|
|
|
COLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$5,037.34
|
|
|
Service Code
|
CPT 44389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,259.34 |
| Max. Negotiated Rate |
$5,037.34 |
| Rate for Payer: Aetna Managed Medicare |
$1,259.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,259.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,259.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,259.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,684.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,259.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,259.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,259.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,259.34
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,259.34
|
| Rate for Payer: The Alliance Commercial |
$5,037.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,259.34
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,259.34
|
|
|
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 |
$978.68 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$1,823.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,742.29
|
| Rate for Payer: Aetna Managed Medicare |
$978.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,030.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,388.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,270.32
|
| Rate for Payer: Anthem Medicare Advantage |
$978.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,073.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$978.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$978.68
|
| 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 |
$1,863.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$978.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$978.68
|
| Rate for Payer: Health EOS Commercial |
$1,803.07
|
| Rate for Payer: HFN Commercial |
$1,863.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,640.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$978.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$978.68
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$978.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$978.68
|
| Rate for Payer: Multiplan Commercial |
$1,620.74
|
| Rate for Payer: NAPHCARE Commercial |
$1,468.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,863.85
|
| Rate for Payer: Quartz Beloit One Network |
$992.70
|
| Rate for Payer: Quartz Commercial |
$1,316.85
|
| Rate for Payer: Quartz Medicare Advantage |
$978.68
|
| Rate for Payer: The Alliance Commercial |
$3,914.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$978.68
|
| Rate for Payer: United Healthcare PPO |
$2,347.28
|
| Rate for Payer: WEA Trust Commercial |
$1,114.26
|
| Rate for Payer: Wellcare Medicare |
$978.68
|
| Rate for Payer: WPS Commercial |
$1,500.54
|
|
|
COLONOSCOPY THROUGH STOMA WITH DECOMPRESSON
|
Facility
|
IP
|
$1,948.00
|
|
|
Service Code
|
CPT 44408
|
| Hospital Charge Code |
4494713
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$992.70 |
| Max. Negotiated Rate |
$1,863.85 |
| Rate for Payer: Aetna Commercial |
$1,823.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,742.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,073.74
|
| Rate for Payer: Cash Price |
$584.40
|
| Rate for Payer: Cigna Commercial |
$1,863.85
|
| Rate for Payer: Health EOS Commercial |
$1,803.07
|
| Rate for Payer: HFN Commercial |
$1,863.85
|
| Rate for Payer: Multiplan Commercial |
$1,620.74
|
| Rate for Payer: Preferred Network Access Commercial |
$1,863.85
|
| Rate for Payer: Quartz Beloit One Network |
$992.70
|
| Rate for Payer: Quartz Commercial |
$1,215.55
|
| Rate for Payer: WEA Trust Commercial |
$1,114.26
|
| Rate for Payer: WPS Commercial |
$1,500.54
|
|
|
COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$5,037.34
|
|
|
Service Code
|
CPT 44394
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,259.34 |
| Max. Negotiated Rate |
$5,037.34 |
| Rate for Payer: Aetna Managed Medicare |
$1,259.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,259.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,259.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,259.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,684.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,259.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,259.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,259.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,259.34
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,259.34
|
| Rate for Payer: The Alliance Commercial |
$5,037.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,259.34
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,259.34
|
|
|
COLONOSCOPY THROUGH STOMA WITH STENT PLACEMENT
|
Facility
|
IP
|
$4,569.00
|
|
|
Service Code
|
CPT 44402
|
| Hospital Charge Code |
4494711
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,328.36 |
| Max. Negotiated Rate |
$4,371.62 |
| Rate for Payer: Aetna Commercial |
$4,276.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,086.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,518.43
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cigna Commercial |
$4,371.62
|
| Rate for Payer: Health EOS Commercial |
$4,229.07
|
| Rate for Payer: HFN Commercial |
$4,371.62
|
| Rate for Payer: Multiplan Commercial |
$3,801.41
|
| Rate for Payer: Preferred Network Access Commercial |
$4,371.62
|
| Rate for Payer: Quartz Beloit One Network |
$2,328.36
|
| Rate for Payer: Quartz Commercial |
$2,851.06
|
| Rate for Payer: WEA Trust Commercial |
$2,613.47
|
| Rate for Payer: WPS Commercial |
$3,519.50
|
|
|
COLONOSCOPY THROUGH STOMA WITH STENT PLACEMENT
|
Facility
|
OP
|
$4,569.00
|
|
|
Service Code
|
CPT 44402
|
| Hospital Charge Code |
4494711
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,328.36 |
| Max. Negotiated Rate |
$25,555.80 |
| Rate for Payer: Aetna Commercial |
$4,276.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,086.51
|
| Rate for Payer: Aetna Managed Medicare |
$6,388.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$12,727.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11,350.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10,781.68
|
| Rate for Payer: Anthem Medicare Advantage |
$6,388.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,518.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,388.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,388.95
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cigna Commercial |
$4,371.62
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,388.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,388.95
|
| Rate for Payer: Health EOS Commercial |
$4,229.07
|
| Rate for Payer: HFN Commercial |
$4,371.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23,766.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,388.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,388.95
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,388.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,388.95
|
| Rate for Payer: Multiplan Commercial |
$3,801.41
|
| Rate for Payer: NAPHCARE Commercial |
$9,583.42
|
| Rate for Payer: Preferred Network Access Commercial |
$4,371.62
|
| Rate for Payer: Quartz Beloit One Network |
$2,328.36
|
| Rate for Payer: Quartz Commercial |
$3,088.64
|
| Rate for Payer: Quartz Medicare Advantage |
$6,388.95
|
| Rate for Payer: The Alliance Commercial |
$25,555.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,388.95
|
| Rate for Payer: United Healthcare PPO |
$4,409.60
|
| Rate for Payer: WEA Trust Commercial |
$2,613.47
|
| Rate for Payer: Wellcare Medicare |
$6,388.95
|
| Rate for Payer: WPS Commercial |
$3,519.50
|
|
|
Colonoscopy thru stoma with submuc inj 44404
|
Facility
|
OP
|
$1,659.00
|
|
|
Service Code
|
CPT 44404
|
| Hospital Charge Code |
5544706
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$828.17 |
| Max. Negotiated Rate |
$5,037.34 |
| Rate for Payer: Aetna Commercial |
$1,552.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,483.81
|
| Rate for Payer: Aetna Managed Medicare |
$1,259.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,121.48
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$862.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$828.17
|
| Rate for Payer: Anthem Medicare Advantage |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$914.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,259.34
|
| Rate for Payer: Cash Price |
$497.70
|
| Rate for Payer: Cash Price |
$497.70
|
| Rate for Payer: Cigna Commercial |
$1,587.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,259.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,259.34
|
| Rate for Payer: Health EOS Commercial |
$1,535.57
|
| Rate for Payer: HFN Commercial |
$1,587.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,684.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,259.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,259.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,259.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,259.34
|
| Rate for Payer: Multiplan Commercial |
$1,380.29
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,587.33
|
| Rate for Payer: Quartz Beloit One Network |
$845.43
|
| Rate for Payer: Quartz Commercial |
$1,121.48
|
| Rate for Payer: Quartz Medicare Advantage |
$1,259.34
|
| Rate for Payer: The Alliance Commercial |
$5,037.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,259.34
|
| Rate for Payer: WEA Trust Commercial |
$948.95
|
| Rate for Payer: Wellcare Medicare |
$1,259.34
|
| Rate for Payer: WPS Commercial |
$1,277.93
|
|
|
Colonoscopy thru stoma with submuc inj 44404
|
Facility
|
IP
|
$1,659.00
|
|
|
Service Code
|
CPT 44404
|
| Hospital Charge Code |
5544706
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$845.43 |
| Max. Negotiated Rate |
$1,587.33 |
| Rate for Payer: Aetna Commercial |
$1,552.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,483.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$914.44
|
| Rate for Payer: Cash Price |
$497.70
|
| Rate for Payer: Cigna Commercial |
$1,587.33
|
| Rate for Payer: Health EOS Commercial |
$1,535.57
|
| Rate for Payer: HFN Commercial |
$1,587.33
|
| Rate for Payer: Multiplan Commercial |
$1,380.29
|
| Rate for Payer: Preferred Network Access Commercial |
$1,587.33
|
| Rate for Payer: Quartz Beloit One Network |
$845.43
|
| Rate for Payer: Quartz Commercial |
$1,035.22
|
| Rate for Payer: WEA Trust Commercial |
$948.95
|
| Rate for Payer: WPS Commercial |
$1,277.93
|
|
|
COLONOSCOPY WITH ABLATION OF TUMOR, POLYP OR LESION
|
Facility
|
OP
|
$4,892.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
4494705
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,259.34 |
| Max. Negotiated Rate |
$5,037.34 |
| Rate for Payer: Aetna Commercial |
$4,578.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,375.40
|
| Rate for Payer: Aetna Managed Medicare |
$1,259.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,696.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,259.34
|
| 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 |
$4,680.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,259.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,259.34
|
| Rate for Payer: Health EOS Commercial |
$4,528.04
|
| Rate for Payer: HFN Commercial |
$4,680.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,684.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,259.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,259.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,259.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,259.34
|
| Rate for Payer: Multiplan Commercial |
$4,070.14
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,680.67
|
| Rate for Payer: Quartz Beloit One Network |
$2,492.96
|
| Rate for Payer: Quartz Commercial |
$3,306.99
|
| Rate for Payer: Quartz Medicare Advantage |
$1,259.34
|
| Rate for Payer: The Alliance Commercial |
$5,037.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,259.34
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: WEA Trust Commercial |
$2,798.22
|
| Rate for Payer: Wellcare Medicare |
$1,259.34
|
| Rate for Payer: WPS Commercial |
$3,768.31
|
|
|
COLONOSCOPY WITH ABLATION OF TUMOR, POLYP OR LESION
|
Facility
|
IP
|
$4,892.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
4494705
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,492.96 |
| Max. Negotiated Rate |
$4,680.67 |
| Rate for Payer: Aetna Commercial |
$4,578.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,375.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,696.47
|
| Rate for Payer: Cash Price |
$1,467.60
|
| Rate for Payer: Cigna Commercial |
$4,680.67
|
| Rate for Payer: Health EOS Commercial |
$4,528.04
|
| Rate for Payer: HFN Commercial |
$4,680.67
|
| Rate for Payer: Multiplan Commercial |
$4,070.14
|
| Rate for Payer: Preferred Network Access Commercial |
$4,680.67
|
| Rate for Payer: Quartz Beloit One Network |
$2,492.96
|
| Rate for Payer: Quartz Commercial |
$3,052.61
|
| Rate for Payer: WEA Trust Commercial |
$2,798.22
|
| Rate for Payer: WPS Commercial |
$3,768.31
|
|
|
COLONOSCOPY WITH BANDING
|
Facility
|
IP
|
$6,092.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
4494704
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$3,104.48 |
| Max. Negotiated Rate |
$5,828.83 |
| Rate for Payer: Aetna Commercial |
$5,702.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,448.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,357.91
|
| Rate for Payer: Cash Price |
$1,827.60
|
| Rate for Payer: Cigna Commercial |
$5,828.83
|
| Rate for Payer: Health EOS Commercial |
$5,638.76
|
| Rate for Payer: HFN Commercial |
$5,828.83
|
| Rate for Payer: Multiplan Commercial |
$5,068.54
|
| Rate for Payer: Preferred Network Access Commercial |
$5,828.83
|
| Rate for Payer: Quartz Beloit One Network |
$3,104.48
|
| Rate for Payer: Quartz Commercial |
$3,801.41
|
| Rate for Payer: WEA Trust Commercial |
$3,484.62
|
| Rate for Payer: WPS Commercial |
$4,692.67
|
|
|
COLONOSCOPY WITH BANDING
|
Facility
|
OP
|
$6,092.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
4494704
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,259.34 |
| Max. Negotiated Rate |
$5,828.83 |
| Rate for Payer: Aetna Commercial |
$5,702.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,448.68
|
| Rate for Payer: Aetna Managed Medicare |
$1,259.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,357.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,259.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,259.34
|
| Rate for Payer: Cash Price |
$1,827.60
|
| Rate for Payer: Cash Price |
$1,827.60
|
| Rate for Payer: Cash Price |
$1,827.60
|
| Rate for Payer: Cigna Commercial |
$5,828.83
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,259.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,259.34
|
| Rate for Payer: Health EOS Commercial |
$5,638.76
|
| Rate for Payer: HFN Commercial |
$5,828.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,684.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,259.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,259.34
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,259.34
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,259.34
|
| Rate for Payer: Multiplan Commercial |
$5,068.54
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,828.83
|
| Rate for Payer: Quartz Beloit One Network |
$3,104.48
|
| Rate for Payer: Quartz Commercial |
$4,118.19
|
| Rate for Payer: Quartz Medicare Advantage |
$1,259.34
|
| Rate for Payer: The Alliance Commercial |
$5,037.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,259.34
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: WEA Trust Commercial |
$3,484.62
|
| Rate for Payer: Wellcare Medicare |
$1,259.34
|
| Rate for Payer: WPS Commercial |
$4,692.67
|
|
|
COLONOSCOPY WITH BIOPSY
|
Facility
|
OP
|
$6,866.00
|
|
| Hospital Charge Code |
2960553
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,999.38 |
| Max. Negotiated Rate |
$6,569.39 |
| Rate for Payer: Aetna Commercial |
$6,426.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,140.95
|
| Rate for Payer: Aetna Managed Medicare |
$1,999.38
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,641.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,570.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,427.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,784.54
|
| Rate for Payer: Cash Price |
$2,059.80
|
| Rate for Payer: Cigna Commercial |
$6,569.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,996.01
|
| Rate for Payer: Health EOS Commercial |
$6,355.17
|
| Rate for Payer: HFN Commercial |
$6,569.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,355.48
|
| Rate for Payer: Multiplan Commercial |
$5,712.51
|
| Rate for Payer: NAPHCARE Commercial |
$4,284.38
|
| Rate for Payer: Preferred Network Access Commercial |
$6,569.39
|
| Rate for Payer: Quartz Beloit One Network |
$3,498.91
|
| Rate for Payer: Quartz Commercial |
$4,641.42
|
| Rate for Payer: Quartz Medicare Advantage |
$4,284.38
|
| Rate for Payer: The Alliance Commercial |
$3,570.32
|
| Rate for Payer: WEA Trust Commercial |
$3,927.35
|
| Rate for Payer: WPS Commercial |
$5,288.88
|
|
|
COLONOSCOPY WITH BIOPSY
|
Facility
|
IP
|
$6,866.00
|
|
| Hospital Charge Code |
2960553
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$3,498.91 |
| Max. Negotiated Rate |
$6,569.39 |
| Rate for Payer: Aetna Commercial |
$6,426.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,140.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,784.54
|
| Rate for Payer: Cash Price |
$2,059.80
|
| Rate for Payer: Cigna Commercial |
$6,569.39
|
| Rate for Payer: Health EOS Commercial |
$6,355.17
|
| Rate for Payer: HFN Commercial |
$6,569.39
|
| Rate for Payer: Multiplan Commercial |
$5,712.51
|
| Rate for Payer: Preferred Network Access Commercial |
$6,569.39
|
| Rate for Payer: Quartz Beloit One Network |
$3,498.91
|
| Rate for Payer: Quartz Commercial |
$4,284.38
|
| Rate for Payer: WEA Trust Commercial |
$3,927.35
|
| Rate for Payer: WPS Commercial |
$5,288.88
|
|
|
COLONOSCOPY WITH DECOMPRESSION
|
Facility
|
IP
|
$1,948.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
4494706
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$992.70 |
| Max. Negotiated Rate |
$1,863.85 |
| Rate for Payer: Aetna Commercial |
$1,823.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,742.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,073.74
|
| Rate for Payer: Cash Price |
$584.40
|
| Rate for Payer: Cigna Commercial |
$1,863.85
|
| Rate for Payer: Health EOS Commercial |
$1,803.07
|
| Rate for Payer: HFN Commercial |
$1,863.85
|
| Rate for Payer: Multiplan Commercial |
$1,620.74
|
| Rate for Payer: Preferred Network Access Commercial |
$1,863.85
|
| Rate for Payer: Quartz Beloit One Network |
$992.70
|
| Rate for Payer: Quartz Commercial |
$1,215.55
|
| Rate for Payer: WEA Trust Commercial |
$1,114.26
|
| Rate for Payer: WPS Commercial |
$1,500.54
|
|
