|
CT Angiography Abdomen + Iliofemoral
|
Professional
|
$6,816.00
|
|
|
Service Code
|
CPT 75635 TC
|
| Hospital Charge Code |
6182045
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$301.75 |
| Max. Negotiated Rate |
$6,475.20 |
| Rate for Payer: Aetna Commercial |
$6,475.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,861.76
|
| Rate for Payer: Aetna Managed Medicare |
$301.75
|
| Rate for Payer: Anthem Medicare Advantage |
$301.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$301.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$301.75
|
| Rate for Payer: Cash Price |
$2,044.80
|
| Rate for Payer: Cash Price |
$2,044.80
|
| Rate for Payer: Cigna Commercial |
$6,475.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,408.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$301.75
|
| Rate for Payer: Health EOS Commercial |
$6,202.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.34
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,115.34
|
| Rate for Payer: Independent Care Health Plan Medicare |
$301.75
|
| Rate for Payer: Multiplan Commercial |
$5,452.80
|
| Rate for Payer: Preferred Network Access Commercial |
$6,475.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,999.04
|
| Rate for Payer: Quartz Commercial |
$3,885.12
|
| Rate for Payer: Quartz Medicare Advantage |
$301.75
|
| Rate for Payer: The Alliance Commercial |
$1,146.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$301.75
|
| Rate for Payer: WEA Trust Commercial |
$3,748.80
|
| Rate for Payer: WPS Commercial |
$1,508.75
|
|
|
CT Angiography Abdomen + Iliofemoral
|
Facility
OP
|
$6,816.00
|
|
|
Service Code
|
CPT 75635 TC
|
| Hospital Charge Code |
6182045
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,908.48 |
| Max. Negotiated Rate |
$27,264.00 |
| Rate for Payer: Aetna Commercial |
$6,134.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,861.76
|
| Rate for Payer: Aetna Managed Medicare |
$1,908.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,612.48
|
| Rate for Payer: Cash Price |
$2,044.80
|
| Rate for Payer: Cash Price |
$2,044.80
|
| Rate for Payer: Cash Price |
$2,044.80
|
| Rate for Payer: Cash Price |
$2,044.80
|
| Rate for Payer: Cigna Commercial |
$6,270.72
|
| Rate for Payer: Health EOS Commercial |
$6,066.24
|
| Rate for Payer: HFN Commercial |
$6,270.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,112.00
|
| Rate for Payer: Multiplan Commercial |
$5,452.80
|
| Rate for Payer: NAPHCARE Commercial |
$4,089.60
|
| Rate for Payer: Preferred Network Access Commercial |
$6,270.72
|
| Rate for Payer: Quartz Beloit One Network |
$3,339.84
|
| Rate for Payer: Quartz Commercial |
$4,430.40
|
| Rate for Payer: Quartz Medicare Advantage |
$4,089.60
|
| Rate for Payer: The Alliance Commercial |
$27,264.00
|
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: WEA Trust Commercial |
$3,748.80
|
| Rate for Payer: WPS Commercial |
$2,112.25
|
|
|
CT Angiography Abdomen + Iliofemoral
|
Facility
IP
|
$6,816.00
|
|
|
Service Code
|
CPT 75635 TC
|
| Hospital Charge Code |
6182045
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$3,339.84 |
| Max. Negotiated Rate |
$6,270.72 |
| Rate for Payer: Aetna Commercial |
$6,134.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,612.48
|
| Rate for Payer: Cash Price |
$2,044.80
|
| Rate for Payer: Cigna Commercial |
$6,270.72
|
| Rate for Payer: Health EOS Commercial |
$6,066.24
|
| Rate for Payer: HFN Commercial |
$6,270.72
|
| Rate for Payer: Multiplan Commercial |
$5,452.80
|
| Rate for Payer: NAPHCARE Commercial |
$4,089.60
|
| Rate for Payer: Preferred Network Access Commercial |
$6,270.72
|
| Rate for Payer: Quartz Beloit One Network |
$3,339.84
|
| Rate for Payer: Quartz Commercial |
$4,089.60
|
| Rate for Payer: WEA Trust Commercial |
$3,748.80
|
| Rate for Payer: WPS Commercial |
$5,048.61
|
|
|
CT Angiography Abdomen, Pelvis
|
Facility
OP
|
$8,355.00
|
|
|
Service Code
|
CPT 74174 TC
|
| Hospital Charge Code |
5426649
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,970.29 |
| Max. Negotiated Rate |
$33,420.00 |
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: Aetna Commercial |
$7,519.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,185.30
|
| Rate for Payer: Aetna Managed Medicare |
$2,339.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,428.15
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cigna Commercial |
$7,686.60
|
| Rate for Payer: Health EOS Commercial |
$7,435.95
|
| Rate for Payer: HFN Commercial |
$7,686.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,266.25
|
| Rate for Payer: Multiplan Commercial |
$6,684.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,013.00
|
| Rate for Payer: Preferred Network Access Commercial |
$7,686.60
|
| Rate for Payer: Quartz Beloit One Network |
$4,093.95
|
| Rate for Payer: Quartz Commercial |
$5,430.75
|
| Rate for Payer: Quartz Medicare Advantage |
$5,013.00
|
| Rate for Payer: The Alliance Commercial |
$33,420.00
|
| Rate for Payer: WEA Trust Commercial |
$4,595.25
|
| Rate for Payer: WPS Commercial |
$1,970.29
|
|
|
CT Angiography Abdomen, Pelvis
|
Facility
OP
|
$7,922.00
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
1220810
|
| Min. Negotiated Rate |
$62.72 |
| Max. Negotiated Rate |
$7,288.24 |
| Rate for Payer: Aetna Commercial |
$7,129.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,812.92
|
| Rate for Payer: Aetna Managed Medicare |
$380.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,149.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,961.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,802.56
|
| Rate for Payer: Anthem Medicare Advantage |
$380.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,198.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$380.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$380.12
|
| Rate for Payer: Cash Price |
$2,376.60
|
| Rate for Payer: Cash Price |
$2,376.60
|
| Rate for Payer: Cigna Commercial |
$7,288.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$380.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$380.12
|
| Rate for Payer: Health EOS Commercial |
$7,050.58
|
| Rate for Payer: HFN Commercial |
$7,288.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,414.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$380.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$380.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$380.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$380.12
|
| Rate for Payer: Multiplan Commercial |
$6,337.60
|
| Rate for Payer: NAPHCARE Commercial |
$570.18
|
| Rate for Payer: Preferred Network Access Commercial |
$7,288.24
|
| Rate for Payer: Quartz Beloit One Network |
$3,881.78
|
| Rate for Payer: Quartz Commercial |
$5,149.30
|
| Rate for Payer: Quartz Medicare Advantage |
$380.12
|
| Rate for Payer: The Alliance Commercial |
$62.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$380.12
|
| Rate for Payer: WEA Trust Commercial |
$4,357.10
|
| Rate for Payer: Wellcare Medicare |
$380.12
|
| Rate for Payer: WPS Commercial |
$5,867.83
|
|
|
CT Angiography Abdomen, Pelvis
|
Professional
|
$7,922.00
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
1220810
|
| Min. Negotiated Rate |
$382.09 |
| Max. Negotiated Rate |
$7,525.90 |
| Rate for Payer: Aetna Commercial |
$7,525.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,812.92
|
| Rate for Payer: Aetna Managed Medicare |
$382.09
|
| Rate for Payer: Anthem Medicare Advantage |
$382.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$382.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$382.09
|
| Rate for Payer: Cash Price |
$2,376.60
|
| Rate for Payer: Cash Price |
$2,376.60
|
| Rate for Payer: Cigna Commercial |
$7,525.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,961.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$382.09
|
| Rate for Payer: Health EOS Commercial |
$7,209.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,394.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,394.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$382.09
|
| Rate for Payer: Multiplan Commercial |
$6,337.60
|
| Rate for Payer: Preferred Network Access Commercial |
$7,525.90
|
| Rate for Payer: Quartz Beloit One Network |
$3,485.68
|
| Rate for Payer: Quartz Commercial |
$4,515.54
|
| Rate for Payer: Quartz Medicare Advantage |
$382.09
|
| Rate for Payer: The Alliance Commercial |
$1,451.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$382.09
|
| Rate for Payer: WEA Trust Commercial |
$4,357.10
|
| Rate for Payer: WPS Commercial |
$1,910.45
|
|
|
CT Angiography Abdomen, Pelvis
|
Facility
IP
|
$8,355.00
|
|
|
Service Code
|
CPT 74174 TC
|
| Hospital Charge Code |
5426649
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$4,093.95 |
| Max. Negotiated Rate |
$7,686.60 |
| Rate for Payer: Aetna Commercial |
$7,519.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,428.15
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cigna Commercial |
$7,686.60
|
| Rate for Payer: Health EOS Commercial |
$7,435.95
|
| Rate for Payer: HFN Commercial |
$7,686.60
|
| Rate for Payer: Multiplan Commercial |
$6,684.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,013.00
|
| Rate for Payer: Preferred Network Access Commercial |
$7,686.60
|
| Rate for Payer: Quartz Beloit One Network |
$4,093.95
|
| Rate for Payer: Quartz Commercial |
$5,013.00
|
| Rate for Payer: WEA Trust Commercial |
$4,595.25
|
| Rate for Payer: WPS Commercial |
$6,188.55
|
|
|
CT Angiography Abdomen, Pelvis
|
Professional
|
$8,355.00
|
|
|
Service Code
|
CPT 74174 TC
|
| Hospital Charge Code |
5426649
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$281.47 |
| Max. Negotiated Rate |
$7,937.25 |
| Rate for Payer: Aetna Commercial |
$7,937.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,185.30
|
| Rate for Payer: Aetna Managed Medicare |
$281.47
|
| Rate for Payer: Anthem Medicare Advantage |
$281.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$281.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$281.47
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cigna Commercial |
$7,937.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,177.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$281.47
|
| Rate for Payer: Health EOS Commercial |
$7,603.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,031.78
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,031.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$281.47
|
| Rate for Payer: Multiplan Commercial |
$6,684.00
|
| Rate for Payer: Preferred Network Access Commercial |
$7,937.25
|
| Rate for Payer: Quartz Beloit One Network |
$3,676.20
|
| Rate for Payer: Quartz Commercial |
$4,762.35
|
| Rate for Payer: Quartz Medicare Advantage |
$281.47
|
| Rate for Payer: The Alliance Commercial |
$1,069.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$281.47
|
| Rate for Payer: WEA Trust Commercial |
$4,595.25
|
| Rate for Payer: WPS Commercial |
$1,407.35
|
|
|
CT Angiography Abdomen, Pelvis
|
Facility
IP
|
$7,922.00
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
1220810
|
| Min. Negotiated Rate |
$3,881.78 |
| Max. Negotiated Rate |
$7,288.24 |
| Rate for Payer: Aetna Commercial |
$7,129.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,198.66
|
| Rate for Payer: Cash Price |
$2,376.60
|
| Rate for Payer: Cigna Commercial |
$7,288.24
|
| Rate for Payer: Health EOS Commercial |
$7,050.58
|
| Rate for Payer: HFN Commercial |
$7,288.24
|
| Rate for Payer: Multiplan Commercial |
$6,337.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,753.20
|
| Rate for Payer: Preferred Network Access Commercial |
$7,288.24
|
| Rate for Payer: Quartz Beloit One Network |
$3,881.78
|
| Rate for Payer: Quartz Commercial |
$4,753.20
|
| Rate for Payer: WEA Trust Commercial |
$4,357.10
|
| Rate for Payer: WPS Commercial |
$5,867.83
|
|
|
CT Angiography Abdomen, Pelvis w/Cont
|
Facility
OP
|
$8,355.00
|
|
|
Service Code
|
CPT 74174 TC
|
| Hospital Charge Code |
1240823
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,970.29 |
| Max. Negotiated Rate |
$33,420.00 |
| Rate for Payer: Aetna Commercial |
$7,519.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,185.30
|
| Rate for Payer: Aetna Managed Medicare |
$2,339.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,428.15
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cigna Commercial |
$7,686.60
|
| Rate for Payer: Health EOS Commercial |
$7,435.95
|
| Rate for Payer: HFN Commercial |
$7,686.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,266.25
|
| Rate for Payer: Multiplan Commercial |
$6,684.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,013.00
|
| Rate for Payer: Preferred Network Access Commercial |
$7,686.60
|
| Rate for Payer: Quartz Beloit One Network |
$4,093.95
|
| Rate for Payer: Quartz Commercial |
$5,430.75
|
| Rate for Payer: Quartz Medicare Advantage |
$5,013.00
|
| Rate for Payer: The Alliance Commercial |
$33,420.00
|
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: WEA Trust Commercial |
$4,595.25
|
| Rate for Payer: WPS Commercial |
$1,970.29
|
|
|
CT Angiography Abdomen, Pelvis w/Cont
|
Facility
IP
|
$8,355.00
|
|
|
Service Code
|
CPT 74174 TC
|
| Hospital Charge Code |
1240823
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$4,093.95 |
| Max. Negotiated Rate |
$7,686.60 |
| Rate for Payer: Aetna Commercial |
$7,519.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,428.15
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cigna Commercial |
$7,686.60
|
| Rate for Payer: Health EOS Commercial |
$7,435.95
|
| Rate for Payer: HFN Commercial |
$7,686.60
|
| Rate for Payer: Multiplan Commercial |
$6,684.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,013.00
|
| Rate for Payer: Preferred Network Access Commercial |
$7,686.60
|
| Rate for Payer: Quartz Beloit One Network |
$4,093.95
|
| Rate for Payer: Quartz Commercial |
$5,013.00
|
| Rate for Payer: WEA Trust Commercial |
$4,595.25
|
| Rate for Payer: WPS Commercial |
$6,188.55
|
|
|
CT Angiography Abdomen, Pelvis w/Cont
|
Professional
|
$8,355.00
|
|
|
Service Code
|
CPT 74174 TC
|
| Hospital Charge Code |
1240823
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$281.47 |
| Max. Negotiated Rate |
$7,937.25 |
| Rate for Payer: Aetna Commercial |
$7,937.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,185.30
|
| Rate for Payer: Aetna Managed Medicare |
$281.47
|
| Rate for Payer: Anthem Medicare Advantage |
$281.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$281.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$281.47
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cash Price |
$2,506.50
|
| Rate for Payer: Cigna Commercial |
$7,937.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4,177.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$281.47
|
| Rate for Payer: Health EOS Commercial |
$7,603.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,031.78
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,031.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$281.47
|
| Rate for Payer: Multiplan Commercial |
$6,684.00
|
| Rate for Payer: Preferred Network Access Commercial |
$7,937.25
|
| Rate for Payer: Quartz Beloit One Network |
$3,676.20
|
| Rate for Payer: Quartz Commercial |
$4,762.35
|
| Rate for Payer: Quartz Medicare Advantage |
$281.47
|
| Rate for Payer: The Alliance Commercial |
$1,069.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$281.47
|
| Rate for Payer: WEA Trust Commercial |
$4,595.25
|
| Rate for Payer: WPS Commercial |
$1,407.35
|
|
|
CT Angiography Chest
|
Facility
OP
|
$6,641.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
629700
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$6,109.72 |
| Rate for Payer: Aetna Commercial |
$5,976.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,711.26
|
| Rate for Payer: Aetna Managed Medicare |
$181.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,316.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,320.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,187.68
|
| Rate for Payer: Anthem Medicare Advantage |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,519.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.60
|
| Rate for Payer: Cash Price |
$1,992.30
|
| Rate for Payer: Cash Price |
$1,992.30
|
| Rate for Payer: Cigna Commercial |
$6,109.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$181.60
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$181.60
|
| Rate for Payer: Health EOS Commercial |
$5,910.49
|
| Rate for Payer: HFN Commercial |
$6,109.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$675.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$181.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$181.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$181.60
|
| Rate for Payer: Multiplan Commercial |
$5,312.80
|
| Rate for Payer: NAPHCARE Commercial |
$272.40
|
| Rate for Payer: Preferred Network Access Commercial |
$6,109.72
|
| Rate for Payer: Quartz Beloit One Network |
$3,254.09
|
| Rate for Payer: Quartz Commercial |
$4,316.65
|
| Rate for Payer: Quartz Medicare Advantage |
$181.60
|
| Rate for Payer: The Alliance Commercial |
$711.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.60
|
| Rate for Payer: WEA Trust Commercial |
$3,652.55
|
| Rate for Payer: Wellcare Medicare |
$181.60
|
| Rate for Payer: WPS Commercial |
$4,918.99
|
|
|
CT Angiography Chest
|
Facility
IP
|
$6,641.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
629700
|
| Min. Negotiated Rate |
$3,254.09 |
| Max. Negotiated Rate |
$6,109.72 |
| Rate for Payer: Aetna Commercial |
$5,976.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,519.73
|
| Rate for Payer: Cash Price |
$1,992.30
|
| Rate for Payer: Cigna Commercial |
$6,109.72
|
| Rate for Payer: Health EOS Commercial |
$5,910.49
|
| Rate for Payer: HFN Commercial |
$6,109.72
|
| Rate for Payer: Multiplan Commercial |
$5,312.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,984.60
|
| Rate for Payer: Preferred Network Access Commercial |
$6,109.72
|
| Rate for Payer: Quartz Beloit One Network |
$3,254.09
|
| Rate for Payer: Quartz Commercial |
$3,984.60
|
| Rate for Payer: WEA Trust Commercial |
$3,652.55
|
| Rate for Payer: WPS Commercial |
$4,918.99
|
|
|
CT Angiography Chest
|
Professional
|
$6,641.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
629700
|
| Min. Negotiated Rate |
$281.75 |
| Max. Negotiated Rate |
$6,308.95 |
| Rate for Payer: Aetna Commercial |
$6,308.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,711.26
|
| Rate for Payer: Aetna Managed Medicare |
$281.75
|
| Rate for Payer: Anthem Medicare Advantage |
$281.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$281.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$281.75
|
| Rate for Payer: Cash Price |
$1,992.30
|
| Rate for Payer: Cash Price |
$1,992.30
|
| Rate for Payer: Cigna Commercial |
$6,308.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,320.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$281.75
|
| Rate for Payer: Health EOS Commercial |
$6,043.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,029.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,029.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$281.75
|
| Rate for Payer: Multiplan Commercial |
$5,312.80
|
| Rate for Payer: Preferred Network Access Commercial |
$6,308.95
|
| Rate for Payer: Quartz Beloit One Network |
$2,922.04
|
| Rate for Payer: Quartz Commercial |
$3,785.37
|
| Rate for Payer: Quartz Medicare Advantage |
$281.75
|
| Rate for Payer: The Alliance Commercial |
$1,070.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$281.75
|
| Rate for Payer: WEA Trust Commercial |
$3,652.55
|
| Rate for Payer: WPS Commercial |
$1,408.75
|
|
|
CT Angiography Chest, Abd + Iliofemoral
|
Professional
|
$7,387.00
|
|
|
Service Code
|
CPT 71275 TC
|
| Hospital Charge Code |
6182015
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$198.09 |
| Max. Negotiated Rate |
$7,017.65 |
| Rate for Payer: Aetna Commercial |
$7,017.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,352.82
|
| Rate for Payer: Aetna Managed Medicare |
$198.09
|
| Rate for Payer: Anthem Medicare Advantage |
$198.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$198.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$198.09
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cigna Commercial |
$7,017.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,693.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$198.09
|
| Rate for Payer: Health EOS Commercial |
$6,722.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$727.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$727.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$198.09
|
| Rate for Payer: Multiplan Commercial |
$5,909.60
|
| Rate for Payer: Preferred Network Access Commercial |
$7,017.65
|
| Rate for Payer: Quartz Beloit One Network |
$3,250.28
|
| Rate for Payer: Quartz Commercial |
$4,210.59
|
| Rate for Payer: Quartz Medicare Advantage |
$198.09
|
| Rate for Payer: The Alliance Commercial |
$752.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$198.09
|
| Rate for Payer: WEA Trust Commercial |
$4,062.85
|
| Rate for Payer: WPS Commercial |
$990.45
|
|
|
CT Angiography Chest, Abd + Iliofemoral
|
Facility
IP
|
$7,387.00
|
|
|
Service Code
|
CPT 71275 TC
|
| Hospital Charge Code |
6182015
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$3,619.63 |
| Max. Negotiated Rate |
$6,796.04 |
| Rate for Payer: Aetna Commercial |
$6,648.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,915.11
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cigna Commercial |
$6,796.04
|
| Rate for Payer: Health EOS Commercial |
$6,574.43
|
| Rate for Payer: HFN Commercial |
$6,796.04
|
| Rate for Payer: Multiplan Commercial |
$5,909.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,432.20
|
| Rate for Payer: Preferred Network Access Commercial |
$6,796.04
|
| Rate for Payer: Quartz Beloit One Network |
$3,619.63
|
| Rate for Payer: Quartz Commercial |
$4,432.20
|
| Rate for Payer: WEA Trust Commercial |
$4,062.85
|
| Rate for Payer: WPS Commercial |
$5,471.55
|
|
|
CT Angiography Chest, Abd + Iliofemoral
|
Facility
OP
|
$7,387.00
|
|
|
Service Code
|
CPT 71275 TC
|
| Hospital Charge Code |
6182015
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,386.63 |
| Max. Negotiated Rate |
$29,548.00 |
| Rate for Payer: Aetna Commercial |
$6,648.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,352.82
|
| Rate for Payer: Aetna Managed Medicare |
$2,068.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,915.11
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cigna Commercial |
$6,796.04
|
| Rate for Payer: Health EOS Commercial |
$6,574.43
|
| Rate for Payer: HFN Commercial |
$6,796.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,540.25
|
| Rate for Payer: Multiplan Commercial |
$5,909.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,432.20
|
| Rate for Payer: Preferred Network Access Commercial |
$6,796.04
|
| Rate for Payer: Quartz Beloit One Network |
$3,619.63
|
| Rate for Payer: Quartz Commercial |
$4,801.55
|
| Rate for Payer: Quartz Medicare Advantage |
$4,432.20
|
| Rate for Payer: The Alliance Commercial |
$29,548.00
|
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: WEA Trust Commercial |
$4,062.85
|
| Rate for Payer: WPS Commercial |
$1,386.63
|
|
|
CT Angiography Chest, Abdomen w/ Con
|
Facility
OP
|
$4,863.00
|
|
|
Service Code
|
CPT 71275 TC
|
| Hospital Charge Code |
1240830
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,361.64 |
| Max. Negotiated Rate |
$19,452.00 |
| Rate for Payer: Aetna Commercial |
$4,376.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,182.18
|
| Rate for Payer: Aetna Managed Medicare |
$1,361.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,577.39
|
| Rate for Payer: Cash Price |
$1,458.90
|
| Rate for Payer: Cash Price |
$1,458.90
|
| Rate for Payer: Cash Price |
$1,458.90
|
| Rate for Payer: Cash Price |
$1,458.90
|
| Rate for Payer: Cigna Commercial |
$4,473.96
|
| Rate for Payer: Health EOS Commercial |
$4,328.07
|
| Rate for Payer: HFN Commercial |
$4,473.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,647.25
|
| Rate for Payer: Multiplan Commercial |
$3,890.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,917.80
|
| Rate for Payer: Preferred Network Access Commercial |
$4,473.96
|
| Rate for Payer: Quartz Beloit One Network |
$2,382.87
|
| Rate for Payer: Quartz Commercial |
$3,160.95
|
| Rate for Payer: Quartz Medicare Advantage |
$2,917.80
|
| Rate for Payer: The Alliance Commercial |
$19,452.00
|
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: WEA Trust Commercial |
$2,674.65
|
| Rate for Payer: WPS Commercial |
$1,386.63
|
|
|
CT Angiography Chest, Abdomen w/ Con
|
Facility
IP
|
$4,863.00
|
|
|
Service Code
|
CPT 71275 TC
|
| Hospital Charge Code |
1240830
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$2,382.87 |
| Max. Negotiated Rate |
$4,473.96 |
| Rate for Payer: Aetna Commercial |
$4,376.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,577.39
|
| Rate for Payer: Cash Price |
$1,458.90
|
| Rate for Payer: Cigna Commercial |
$4,473.96
|
| Rate for Payer: Health EOS Commercial |
$4,328.07
|
| Rate for Payer: HFN Commercial |
$4,473.96
|
| Rate for Payer: Multiplan Commercial |
$3,890.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,917.80
|
| Rate for Payer: Preferred Network Access Commercial |
$4,473.96
|
| Rate for Payer: Quartz Beloit One Network |
$2,382.87
|
| Rate for Payer: Quartz Commercial |
$2,917.80
|
| Rate for Payer: WEA Trust Commercial |
$2,674.65
|
| Rate for Payer: WPS Commercial |
$3,602.02
|
|
|
CT Angiography Chest, Abdomen w/ Con
|
Professional
|
$4,863.00
|
|
|
Service Code
|
CPT 71275 TC
|
| Hospital Charge Code |
1240830
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$198.09 |
| Max. Negotiated Rate |
$4,619.85 |
| Rate for Payer: Aetna Commercial |
$4,619.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,182.18
|
| Rate for Payer: Aetna Managed Medicare |
$198.09
|
| Rate for Payer: Anthem Medicare Advantage |
$198.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$198.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$198.09
|
| Rate for Payer: Cash Price |
$1,458.90
|
| Rate for Payer: Cash Price |
$1,458.90
|
| Rate for Payer: Cigna Commercial |
$4,619.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,431.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$198.09
|
| Rate for Payer: Health EOS Commercial |
$4,425.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$727.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$727.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$198.09
|
| Rate for Payer: Multiplan Commercial |
$3,890.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,619.85
|
| Rate for Payer: Quartz Beloit One Network |
$2,139.72
|
| Rate for Payer: Quartz Commercial |
$2,771.91
|
| Rate for Payer: Quartz Medicare Advantage |
$198.09
|
| Rate for Payer: The Alliance Commercial |
$752.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$198.09
|
| Rate for Payer: WEA Trust Commercial |
$2,674.65
|
| Rate for Payer: WPS Commercial |
$990.45
|
|
|
CT Angiography Chest w/ + w/o Contrast
|
Facility
OP
|
$7,387.00
|
|
|
Service Code
|
CPT 71275 TC
|
| Hospital Charge Code |
1240828
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,386.63 |
| Max. Negotiated Rate |
$29,548.00 |
| Rate for Payer: Aetna Commercial |
$6,648.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,352.82
|
| Rate for Payer: Aetna Managed Medicare |
$2,068.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,915.11
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cigna Commercial |
$6,796.04
|
| Rate for Payer: Health EOS Commercial |
$6,574.43
|
| Rate for Payer: HFN Commercial |
$6,796.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,540.25
|
| Rate for Payer: Multiplan Commercial |
$5,909.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,432.20
|
| Rate for Payer: Preferred Network Access Commercial |
$6,796.04
|
| Rate for Payer: Quartz Beloit One Network |
$3,619.63
|
| Rate for Payer: Quartz Commercial |
$4,801.55
|
| Rate for Payer: Quartz Medicare Advantage |
$4,432.20
|
| Rate for Payer: The Alliance Commercial |
$29,548.00
|
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: WEA Trust Commercial |
$4,062.85
|
| Rate for Payer: WPS Commercial |
$1,386.63
|
|
|
CT Angiography Chest w/ + w/o Contrast
|
Facility
IP
|
$7,387.00
|
|
|
Service Code
|
CPT 71275 TC
|
| Hospital Charge Code |
1240828
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$3,619.63 |
| Max. Negotiated Rate |
$6,796.04 |
| Rate for Payer: Aetna Commercial |
$6,648.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,915.11
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cigna Commercial |
$6,796.04
|
| Rate for Payer: Health EOS Commercial |
$6,574.43
|
| Rate for Payer: HFN Commercial |
$6,796.04
|
| Rate for Payer: Multiplan Commercial |
$5,909.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,432.20
|
| Rate for Payer: Preferred Network Access Commercial |
$6,796.04
|
| Rate for Payer: Quartz Beloit One Network |
$3,619.63
|
| Rate for Payer: Quartz Commercial |
$4,432.20
|
| Rate for Payer: WEA Trust Commercial |
$4,062.85
|
| Rate for Payer: WPS Commercial |
$5,471.55
|
|
|
CT Angiography Chest w/ + w/o Contrast
|
Professional
|
$7,387.00
|
|
|
Service Code
|
CPT 71275 TC
|
| Hospital Charge Code |
1240828
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$198.09 |
| Max. Negotiated Rate |
$7,017.65 |
| Rate for Payer: Aetna Commercial |
$7,017.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,352.82
|
| Rate for Payer: Aetna Managed Medicare |
$198.09
|
| Rate for Payer: Anthem Medicare Advantage |
$198.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$198.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$198.09
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cash Price |
$2,216.10
|
| Rate for Payer: Cigna Commercial |
$7,017.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$3,693.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$198.09
|
| Rate for Payer: Health EOS Commercial |
$6,722.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$727.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$727.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$198.09
|
| Rate for Payer: Multiplan Commercial |
$5,909.60
|
| Rate for Payer: Preferred Network Access Commercial |
$7,017.65
|
| Rate for Payer: Quartz Beloit One Network |
$3,250.28
|
| Rate for Payer: Quartz Commercial |
$4,210.59
|
| Rate for Payer: Quartz Medicare Advantage |
$198.09
|
| Rate for Payer: The Alliance Commercial |
$752.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$198.09
|
| Rate for Payer: WEA Trust Commercial |
$4,062.85
|
| Rate for Payer: WPS Commercial |
$990.45
|
|
|
CT Angiography Coronary Artery w/ Eval
|
Facility
OP
|
$4,883.00
|
|
|
Service Code
|
CPT 75574 TC
|
| Hospital Charge Code |
1240833
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,367.24 |
| Max. Negotiated Rate |
$19,532.00 |
| Rate for Payer: Aetna Commercial |
$4,394.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,199.38
|
| Rate for Payer: Aetna Managed Medicare |
$1,367.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,587.99
|
| Rate for Payer: Cash Price |
$1,464.90
|
| Rate for Payer: Cash Price |
$1,464.90
|
| Rate for Payer: Cash Price |
$1,464.90
|
| Rate for Payer: Cash Price |
$1,464.90
|
| Rate for Payer: Cigna Commercial |
$4,492.36
|
| Rate for Payer: Health EOS Commercial |
$4,345.87
|
| Rate for Payer: HFN Commercial |
$4,492.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,662.25
|
| Rate for Payer: Multiplan Commercial |
$3,906.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,929.80
|
| Rate for Payer: Preferred Network Access Commercial |
$4,492.36
|
| Rate for Payer: Quartz Beloit One Network |
$2,392.67
|
| Rate for Payer: Quartz Commercial |
$3,173.95
|
| Rate for Payer: Quartz Medicare Advantage |
$2,929.80
|
| Rate for Payer: The Alliance Commercial |
$19,532.00
|
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: WEA Trust Commercial |
$2,685.65
|
| Rate for Payer: WPS Commercial |
$1,474.48
|
|
