|
Commercial cleansing solution - Incision, Wound Cleansing:
|
Facility
|
OP
|
$10.00
|
|
| Hospital Charge Code |
2999832
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$9.57 |
| Rate for Payer: Aetna Commercial |
$9.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8.94
|
| Rate for Payer: Aetna Managed Medicare |
$2.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5.51
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$9.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.82
|
| Rate for Payer: Health EOS Commercial |
$9.26
|
| Rate for Payer: HFN Commercial |
$9.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7.80
|
| Rate for Payer: Multiplan Commercial |
$8.32
|
| Rate for Payer: NAPHCARE Commercial |
$6.24
|
| Rate for Payer: Preferred Network Access Commercial |
$9.57
|
| Rate for Payer: Quartz Beloit One Network |
$5.10
|
| Rate for Payer: Quartz Commercial |
$6.76
|
| Rate for Payer: Quartz Medicare Advantage |
$6.24
|
| Rate for Payer: The Alliance Commercial |
$5.20
|
| Rate for Payer: WEA Trust Commercial |
$5.72
|
| Rate for Payer: WPS Commercial |
$7.70
|
|
|
Commercial Insurance/Self Pay 90471
|
Facility
|
IP
|
$12.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
5470726
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$6.12 |
| Max. Negotiated Rate |
$11.48 |
| Rate for Payer: Aetna Commercial |
$11.23
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6.61
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cigna Commercial |
$11.48
|
| Rate for Payer: Health EOS Commercial |
$11.11
|
| Rate for Payer: HFN Commercial |
$11.48
|
| Rate for Payer: Multiplan Commercial |
$9.98
|
| Rate for Payer: Preferred Network Access Commercial |
$11.48
|
| Rate for Payer: Quartz Beloit One Network |
$6.12
|
| Rate for Payer: Quartz Commercial |
$7.49
|
| Rate for Payer: WEA Trust Commercial |
$6.86
|
| Rate for Payer: WPS Commercial |
$9.24
|
|
|
Commercial Insurance/Self Pay 90471
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
5470726
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$5.49 |
| Max. Negotiated Rate |
$87.94 |
| Rate for Payer: Aetna Commercial |
$11.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10.73
|
| Rate for Payer: Aetna Managed Medicare |
$21.99
|
| Rate for Payer: Anthem Medicare Advantage |
$21.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.99
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cigna Commercial |
$11.86
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$15.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21.99
|
| Rate for Payer: Health EOS Commercial |
$11.36
|
| Rate for Payer: HFN Commercial |
$11.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$24.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.99
|
| Rate for Payer: Multiplan Commercial |
$9.98
|
| Rate for Payer: NAPHCARE Commercial |
$32.98
|
| Rate for Payer: Preferred Network Access Commercial |
$11.86
|
| Rate for Payer: Quartz Beloit One Network |
$5.49
|
| Rate for Payer: Quartz Commercial |
$7.11
|
| Rate for Payer: Quartz Medicare Advantage |
$21.99
|
| Rate for Payer: The Alliance Commercial |
$54.96
|
| Rate for Payer: United Healthcare Medicaid |
$15.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.99
|
| Rate for Payer: WEA Trust Commercial |
$6.86
|
| Rate for Payer: WPS Commercial |
$87.94
|
|
|
Commercial Insurance/Self Pay 90471
|
Facility
|
OP
|
$12.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
5470726
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$303.10 |
| Rate for Payer: Aetna Commercial |
$11.23
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10.73
|
| Rate for Payer: Aetna Managed Medicare |
$75.77
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$8.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5.99
|
| Rate for Payer: Anthem Medicare Advantage |
$75.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$75.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$75.77
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cigna Commercial |
$11.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$75.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.98
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$75.77
|
| Rate for Payer: Health EOS Commercial |
$11.11
|
| Rate for Payer: HFN Commercial |
$11.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$281.88
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$75.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$75.77
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$75.77
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$75.77
|
| Rate for Payer: Multiplan Commercial |
$9.98
|
| Rate for Payer: NAPHCARE Commercial |
$113.66
|
| Rate for Payer: Preferred Network Access Commercial |
$11.48
|
| Rate for Payer: Quartz Beloit One Network |
$6.12
|
| Rate for Payer: Quartz Commercial |
$8.11
|
| Rate for Payer: Quartz Medicare Advantage |
$75.77
|
| Rate for Payer: The Alliance Commercial |
$303.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$75.77
|
| Rate for Payer: United Healthcare PPO |
$9.36
|
| Rate for Payer: WEA Trust Commercial |
$6.86
|
| Rate for Payer: Wellcare Medicare |
$75.77
|
| Rate for Payer: WPS Commercial |
$9.24
|
|
|
Compatible - Crossmatch AHG Interpretation
|
Facility
|
IP
|
$237.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
2952714
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$120.78 |
| Max. Negotiated Rate |
$226.76 |
| Rate for Payer: Aetna Commercial |
$221.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$211.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$130.63
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cigna Commercial |
$226.76
|
| Rate for Payer: Health EOS Commercial |
$219.37
|
| Rate for Payer: HFN Commercial |
$226.76
|
| Rate for Payer: Multiplan Commercial |
$197.18
|
| Rate for Payer: Preferred Network Access Commercial |
$226.76
|
| Rate for Payer: Quartz Beloit One Network |
$120.78
|
| Rate for Payer: Quartz Commercial |
$147.89
|
| Rate for Payer: WEA Trust Commercial |
$135.56
|
| Rate for Payer: WPS Commercial |
$182.56
|
|
|
Compatible - Crossmatch AHG Interpretation
|
Facility
|
OP
|
$237.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
2952714
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$120.78 |
| Max. Negotiated Rate |
$717.18 |
| Rate for Payer: Aetna Commercial |
$221.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$211.97
|
| Rate for Payer: Aetna Managed Medicare |
$179.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$658.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$307.25
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$291.45
|
| Rate for Payer: Anthem Medicare Advantage |
$179.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$130.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$179.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$179.30
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cigna Commercial |
$226.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$179.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$137.93
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$179.30
|
| Rate for Payer: Health EOS Commercial |
$219.37
|
| Rate for Payer: HFN Commercial |
$226.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$666.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$179.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$179.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$179.30
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$179.30
|
| Rate for Payer: Multiplan Commercial |
$197.18
|
| Rate for Payer: NAPHCARE Commercial |
$268.94
|
| Rate for Payer: Preferred Network Access Commercial |
$226.76
|
| Rate for Payer: Quartz Beloit One Network |
$120.78
|
| Rate for Payer: Quartz Commercial |
$160.21
|
| Rate for Payer: Quartz Medicare Advantage |
$179.30
|
| Rate for Payer: The Alliance Commercial |
$717.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$179.30
|
| Rate for Payer: United Healthcare PPO |
$184.86
|
| Rate for Payer: WEA Trust Commercial |
$135.56
|
| Rate for Payer: Wellcare Medicare |
$179.30
|
| Rate for Payer: WPS Commercial |
$182.56
|
|
|
Compatible - Crossmatch Immediate Spin Interpretation
|
Facility
|
IP
|
$118.00
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
2952720
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.13 |
| Max. Negotiated Rate |
$112.90 |
| Rate for Payer: Aetna Commercial |
$110.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$105.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$65.04
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$112.90
|
| Rate for Payer: Health EOS Commercial |
$109.22
|
| Rate for Payer: HFN Commercial |
$112.90
|
| Rate for Payer: Multiplan Commercial |
$98.18
|
| Rate for Payer: Preferred Network Access Commercial |
$112.90
|
| Rate for Payer: Quartz Beloit One Network |
$60.13
|
| Rate for Payer: Quartz Commercial |
$73.63
|
| Rate for Payer: WEA Trust Commercial |
$67.50
|
| Rate for Payer: WPS Commercial |
$90.90
|
|
|
Compatible - Crossmatch Immediate Spin Interpretation
|
Facility
|
OP
|
$118.00
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
2952720
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.13 |
| Max. Negotiated Rate |
$717.18 |
| Rate for Payer: Aetna Commercial |
$110.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$105.54
|
| Rate for Payer: Aetna Managed Medicare |
$179.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$658.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$307.25
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$291.45
|
| Rate for Payer: Anthem Medicare Advantage |
$179.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$65.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$179.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$179.30
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$112.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$179.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$68.68
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$179.30
|
| Rate for Payer: Health EOS Commercial |
$109.22
|
| Rate for Payer: HFN Commercial |
$112.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$666.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$179.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$179.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$179.30
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$179.30
|
| Rate for Payer: Multiplan Commercial |
$98.18
|
| Rate for Payer: NAPHCARE Commercial |
$268.94
|
| Rate for Payer: Preferred Network Access Commercial |
$112.90
|
| Rate for Payer: Quartz Beloit One Network |
$60.13
|
| Rate for Payer: Quartz Commercial |
$79.77
|
| Rate for Payer: Quartz Medicare Advantage |
$179.30
|
| Rate for Payer: The Alliance Commercial |
$717.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$179.30
|
| Rate for Payer: United Healthcare PPO |
$92.04
|
| Rate for Payer: WEA Trust Commercial |
$67.50
|
| Rate for Payer: Wellcare Medicare |
$179.30
|
| Rate for Payer: WPS Commercial |
$90.90
|
|
|
Complement C1q
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
3256215
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.48 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Aetna Commercial |
$78.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Aetna Managed Medicare |
$12.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$46.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20.72
|
| Rate for Payer: Anthem Medicare Advantage |
$12.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.48
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$80.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.48
|
| Rate for Payer: Health EOS Commercial |
$77.75
|
| Rate for Payer: HFN Commercial |
$80.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.48
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: NAPHCARE Commercial |
$18.72
|
| Rate for Payer: Preferred Network Access Commercial |
$80.37
|
| Rate for Payer: Quartz Beloit One Network |
$42.81
|
| Rate for Payer: Quartz Commercial |
$56.78
|
| Rate for Payer: Quartz Medicare Advantage |
$12.48
|
| Rate for Payer: The Alliance Commercial |
$49.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.48
|
| Rate for Payer: United Healthcare PPO |
$65.52
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: Wellcare Medicare |
$12.48
|
| Rate for Payer: WPS Commercial |
$64.71
|
|
|
Complement C1q
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
3256215
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.81 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Aetna Commercial |
$78.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.30
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$80.37
|
| Rate for Payer: Health EOS Commercial |
$77.75
|
| Rate for Payer: HFN Commercial |
$80.37
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: Preferred Network Access Commercial |
$80.37
|
| Rate for Payer: Quartz Beloit One Network |
$42.81
|
| Rate for Payer: Quartz Commercial |
$52.42
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: WPS Commercial |
$64.71
|
|
|
Complement C1q
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
3256215
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.48 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Aetna Commercial |
$82.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$75.13
|
| Rate for Payer: Aetna Managed Medicare |
$12.48
|
| Rate for Payer: Anthem Medicare Advantage |
$12.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.48
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$82.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.48
|
| Rate for Payer: Health EOS Commercial |
$79.50
|
| Rate for Payer: HFN Commercial |
$82.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$44.05
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.48
|
| Rate for Payer: Multiplan Commercial |
$69.89
|
| Rate for Payer: NAPHCARE Commercial |
$18.72
|
| Rate for Payer: Preferred Network Access Commercial |
$82.99
|
| Rate for Payer: Quartz Beloit One Network |
$38.44
|
| Rate for Payer: Quartz Commercial |
$49.80
|
| Rate for Payer: Quartz Medicare Advantage |
$12.48
|
| Rate for Payer: The Alliance Commercial |
$49.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.48
|
| Rate for Payer: WEA Trust Commercial |
$48.05
|
| Rate for Payer: WPS Commercial |
$54.91
|
|
|
Complement Total
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
CPT 86162
|
| Hospital Charge Code |
977908
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$128.42 |
| Max. Negotiated Rate |
$241.11 |
| Rate for Payer: Aetna Commercial |
$235.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$225.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$138.90
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna Commercial |
$241.11
|
| Rate for Payer: Health EOS Commercial |
$233.25
|
| Rate for Payer: HFN Commercial |
$241.11
|
| Rate for Payer: Multiplan Commercial |
$209.66
|
| Rate for Payer: Preferred Network Access Commercial |
$241.11
|
| Rate for Payer: Quartz Beloit One Network |
$128.42
|
| Rate for Payer: Quartz Commercial |
$157.25
|
| Rate for Payer: WEA Trust Commercial |
$144.14
|
| Rate for Payer: WPS Commercial |
$194.12
|
|
|
Complement Total
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
CPT 86162
|
| Hospital Charge Code |
977908
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.13 |
| Max. Negotiated Rate |
$241.11 |
| Rate for Payer: Aetna Commercial |
$235.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$225.39
|
| Rate for Payer: Aetna Managed Medicare |
$21.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$79.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$36.98
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$35.08
|
| Rate for Payer: Anthem Medicare Advantage |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$138.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.13
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna Commercial |
$241.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$21.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$146.66
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$21.13
|
| Rate for Payer: Health EOS Commercial |
$233.25
|
| Rate for Payer: HFN Commercial |
$241.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$78.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$21.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.13
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$21.13
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$21.13
|
| Rate for Payer: Multiplan Commercial |
$209.66
|
| Rate for Payer: NAPHCARE Commercial |
$31.70
|
| Rate for Payer: Preferred Network Access Commercial |
$241.11
|
| Rate for Payer: Quartz Beloit One Network |
$128.42
|
| Rate for Payer: Quartz Commercial |
$170.35
|
| Rate for Payer: Quartz Medicare Advantage |
$21.13
|
| Rate for Payer: The Alliance Commercial |
$84.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.13
|
| Rate for Payer: United Healthcare PPO |
$196.56
|
| Rate for Payer: WEA Trust Commercial |
$144.14
|
| Rate for Payer: Wellcare Medicare |
$21.13
|
| Rate for Payer: WPS Commercial |
$194.12
|
|
|
Complement Total
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
CPT 86162
|
| Hospital Charge Code |
977908
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.13 |
| Max. Negotiated Rate |
$248.98 |
| Rate for Payer: Aetna Commercial |
$248.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$225.39
|
| Rate for Payer: Aetna Managed Medicare |
$21.13
|
| Rate for Payer: Anthem Medicare Advantage |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$21.13
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna Commercial |
$248.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$131.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21.13
|
| Rate for Payer: Health EOS Commercial |
$238.49
|
| Rate for Payer: HFN Commercial |
$248.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$74.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$74.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$21.13
|
| Rate for Payer: Multiplan Commercial |
$209.66
|
| Rate for Payer: NAPHCARE Commercial |
$31.70
|
| Rate for Payer: Preferred Network Access Commercial |
$248.98
|
| Rate for Payer: Quartz Beloit One Network |
$115.32
|
| Rate for Payer: Quartz Commercial |
$149.39
|
| Rate for Payer: Quartz Medicare Advantage |
$21.13
|
| Rate for Payer: The Alliance Commercial |
$83.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.13
|
| Rate for Payer: WEA Trust Commercial |
$144.14
|
| Rate for Payer: WPS Commercial |
$92.98
|
|
|
Complete-PFT - Pulmonary Function Test Charge
|
Facility
|
OP
|
$1,746.00
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
3006998
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$392.70 |
| Max. Negotiated Rate |
$1,670.57 |
| Rate for Payer: Aetna Commercial |
$1,634.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,561.62
|
| Rate for Payer: Aetna Managed Medicare |
$392.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,180.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$907.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$871.60
|
| Rate for Payer: Anthem Medicare Advantage |
$392.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$962.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$392.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$392.70
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cigna Commercial |
$1,670.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$392.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,016.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$392.70
|
| Rate for Payer: Health EOS Commercial |
$1,616.10
|
| Rate for Payer: HFN Commercial |
$1,670.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,460.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$392.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$392.70
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$392.70
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$392.70
|
| Rate for Payer: Multiplan Commercial |
$1,452.67
|
| Rate for Payer: NAPHCARE Commercial |
$589.06
|
| Rate for Payer: Preferred Network Access Commercial |
$1,670.57
|
| Rate for Payer: Quartz Beloit One Network |
$889.76
|
| Rate for Payer: Quartz Commercial |
$1,180.30
|
| Rate for Payer: Quartz Medicare Advantage |
$392.70
|
| Rate for Payer: The Alliance Commercial |
$1,570.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$392.70
|
| Rate for Payer: United Healthcare PPO |
$1,361.88
|
| Rate for Payer: WEA Trust Commercial |
$998.71
|
| Rate for Payer: Wellcare Medicare |
$392.70
|
| Rate for Payer: WPS Commercial |
$1,344.94
|
|
|
Complete-PFT - Pulmonary Function Test Charge
|
Facility
|
IP
|
$1,746.00
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
3006998
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$889.76 |
| Max. Negotiated Rate |
$1,670.57 |
| Rate for Payer: Aetna Commercial |
$1,634.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,561.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$962.40
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cigna Commercial |
$1,670.57
|
| Rate for Payer: Health EOS Commercial |
$1,616.10
|
| Rate for Payer: HFN Commercial |
$1,670.57
|
| Rate for Payer: Multiplan Commercial |
$1,452.67
|
| Rate for Payer: Preferred Network Access Commercial |
$1,670.57
|
| Rate for Payer: Quartz Beloit One Network |
$889.76
|
| Rate for Payer: Quartz Commercial |
$1,089.50
|
| Rate for Payer: WEA Trust Commercial |
$998.71
|
| Rate for Payer: WPS Commercial |
$1,344.94
|
|
|
COMPLEX AORTIC ARCH PROCEDURES
|
Facility
|
IP
|
$246,967.16
|
|
|
Service Code
|
MSDRG 209
|
| Min. Negotiated Rate |
$87,188.38 |
| Max. Negotiated Rate |
$246,967.16 |
| Rate for Payer: Aetna Managed Medicare |
$87,188.38
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$246,967.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$189,298.33
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$179,845.77
|
| Rate for Payer: Anthem Medicare Advantage |
$87,188.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$87,188.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$87,188.38
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$87,188.38
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$199,645.30
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$87,188.38
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$87,188.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$87,188.38
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$87,188.38
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$87,188.38
|
| Rate for Payer: NAPHCARE Commercial |
$130,782.57
|
| Rate for Payer: Quartz Medicare Advantage |
$87,188.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$87,188.38
|
| Rate for Payer: Wellcare Medicare |
$87,188.38
|
|
|
COMPLEX BLOOD COLLECTION SERVICES
|
Facility
|
OP
|
$22.28
|
|
|
Service Code
|
EAPG 00494
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$22.28 |
| Rate for Payer: Anthem Medicaid |
$21.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$21.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21.42
|
| Rate for Payer: Dean Health Medicaid |
$21.42
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$21.42
|
| Rate for Payer: Managed Health Services Medicaid |
$22.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$21.42
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$21.42
|
| Rate for Payer: United Healthcare Medicaid |
$21.42
|
|
|
COMPLEX DRAINAGE, WOUND 10180
|
Professional
|
Both
|
$810.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
3013509
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$113.31 |
| Max. Negotiated Rate |
$800.28 |
| Rate for Payer: Aetna Commercial |
$800.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$724.46
|
| Rate for Payer: Aetna Managed Medicare |
$167.02
|
| Rate for Payer: Anthem Medicare Advantage |
$167.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$167.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$167.02
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cigna Commercial |
$800.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$113.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$167.02
|
| Rate for Payer: Health EOS Commercial |
$766.58
|
| Rate for Payer: HFN Commercial |
$800.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$607.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$607.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$167.02
|
| Rate for Payer: Multiplan Commercial |
$673.92
|
| Rate for Payer: NAPHCARE Commercial |
$250.54
|
| Rate for Payer: Preferred Network Access Commercial |
$800.28
|
| Rate for Payer: Quartz Beloit One Network |
$370.66
|
| Rate for Payer: Quartz Commercial |
$480.17
|
| Rate for Payer: Quartz Medicare Advantage |
$167.02
|
| Rate for Payer: The Alliance Commercial |
$709.85
|
| Rate for Payer: United Healthcare Medicaid |
$113.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$167.02
|
| Rate for Payer: WEA Trust Commercial |
$463.32
|
| Rate for Payer: WPS Commercial |
$751.61
|
|
|
Complex Dressing - Incision, Wound Dressing:
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
3003559
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.09 |
| Max. Negotiated Rate |
$164.57 |
| Rate for Payer: Aetna Commercial |
$160.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$153.84
|
| Rate for Payer: Aetna Managed Medicare |
$50.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$116.27
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$89.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$85.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$94.81
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cigna Commercial |
$164.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$100.10
|
| Rate for Payer: Health EOS Commercial |
$159.20
|
| Rate for Payer: HFN Commercial |
$164.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$134.16
|
| Rate for Payer: Multiplan Commercial |
$143.10
|
| Rate for Payer: NAPHCARE Commercial |
$107.33
|
| Rate for Payer: Preferred Network Access Commercial |
$164.57
|
| Rate for Payer: Quartz Beloit One Network |
$87.65
|
| Rate for Payer: Quartz Commercial |
$116.27
|
| Rate for Payer: Quartz Medicare Advantage |
$107.33
|
| Rate for Payer: The Alliance Commercial |
$122.47
|
| Rate for Payer: WEA Trust Commercial |
$98.38
|
| Rate for Payer: WPS Commercial |
$132.49
|
|
|
Complex Dressing - Incision, Wound Dressing:
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
3003559
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$87.65 |
| Max. Negotiated Rate |
$164.57 |
| Rate for Payer: Aetna Commercial |
$160.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$153.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$94.81
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cigna Commercial |
$164.57
|
| Rate for Payer: Health EOS Commercial |
$159.20
|
| Rate for Payer: HFN Commercial |
$164.57
|
| Rate for Payer: Multiplan Commercial |
$143.10
|
| Rate for Payer: Preferred Network Access Commercial |
$164.57
|
| Rate for Payer: Quartz Beloit One Network |
$87.65
|
| Rate for Payer: Quartz Commercial |
$107.33
|
| Rate for Payer: WEA Trust Commercial |
$98.38
|
| Rate for Payer: WPS Commercial |
$132.49
|
|
|
COMPLEX KIDNEY AND URINARY TRACT INFECTIONS
|
Facility
|
OP
|
$104.82
|
|
|
Service Code
|
EAPG 00723
|
| Min. Negotiated Rate |
$100.79 |
| Max. Negotiated Rate |
$104.82 |
| Rate for Payer: Anthem Medicaid |
$100.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$100.79
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$100.79
|
| Rate for Payer: Dean Health Medicaid |
$100.79
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$100.79
|
| Rate for Payer: Managed Health Services Medicaid |
$104.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$100.79
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$100.79
|
| Rate for Payer: United Healthcare Medicaid |
$100.79
|
|
|
Complex Uroflometry 51741
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
CPT 51741
|
| Hospital Charge Code |
1188974
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$520.68 |
| Rate for Payer: Aetna Commercial |
$520.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$471.35
|
| Rate for Payer: Aetna Managed Medicare |
$14.88
|
| Rate for Payer: Anthem Medicare Advantage |
$14.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.88
|
| Rate for Payer: Cash Price |
$158.10
|
| Rate for Payer: Cash Price |
$158.10
|
| Rate for Payer: Cash Price |
$158.10
|
| Rate for Payer: Cigna Commercial |
$520.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$77.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.88
|
| Rate for Payer: Health EOS Commercial |
$498.75
|
| Rate for Payer: HFN Commercial |
$520.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$48.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.88
|
| Rate for Payer: Multiplan Commercial |
$438.46
|
| Rate for Payer: NAPHCARE Commercial |
$22.32
|
| Rate for Payer: Preferred Network Access Commercial |
$520.68
|
| Rate for Payer: Quartz Beloit One Network |
$241.16
|
| Rate for Payer: Quartz Commercial |
$312.41
|
| Rate for Payer: Quartz Medicare Advantage |
$14.88
|
| Rate for Payer: The Alliance Commercial |
$63.25
|
| Rate for Payer: United Healthcare Medicaid |
$77.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.88
|
| Rate for Payer: WEA Trust Commercial |
$301.44
|
| Rate for Payer: WPS Commercial |
$66.97
|
|
|
COMPLEX WOUND REPAIR AND TREATMENT
|
Facility
|
OP
|
$993.21
|
|
|
Service Code
|
EAPG 00018
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$993.21 |
| Rate for Payer: Anthem Medicaid |
$955.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$955.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$955.00
|
| Rate for Payer: Dean Health Medicaid |
$955.00
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$955.00
|
| Rate for Payer: Managed Health Services Medicaid |
$993.21
|
| Rate for Payer: Molina Healthcare Medicaid |
$955.00
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$955.00
|
| Rate for Payer: United Healthcare Medicaid |
$955.00
|
|
|
COMPLICATED PEPTIC ULCER WITH CC
|
Facility
|
IP
|
$30,000.88
|
|
|
Service Code
|
MSDRG 381
|
| Min. Negotiated Rate |
$8,804.44 |
| Max. Negotiated Rate |
$30,000.88 |
| Rate for Payer: Aetna Managed Medicare |
$8,804.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$23,641.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,120.71
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,215.86
|
| Rate for Payer: Anthem Medicare Advantage |
$8,804.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,804.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,804.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,804.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19,111.18
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,804.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,760.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,804.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,804.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,804.44
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,804.44
|
| Rate for Payer: NAPHCARE Commercial |
$13,206.66
|
| Rate for Payer: Quartz Medicare Advantage |
$8,804.44
|
| Rate for Payer: The Alliance Commercial |
$30,000.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,804.44
|
| Rate for Payer: United Healthcare PPO |
$16,940.78
|
| Rate for Payer: Wellcare Medicare |
$8,804.44
|
|
