|
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$55,941.82
|
|
|
Service Code
|
APR-DRG 1664
|
| Min. Negotiated Rate |
$49,691.01 |
| Max. Negotiated Rate |
$55,941.82 |
| Rate for Payer: Anthem Medicaid |
$53,567.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$53,567.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$53,567.37
|
| Rate for Payer: Dean Health Medicaid |
$53,567.37
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$49,691.01
|
| Rate for Payer: Managed Health Services Medicaid |
$55,941.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$53,567.37
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$53,567.37
|
| Rate for Payer: United Healthcare Medicaid |
$53,567.37
|
|
|
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$162,928.48
|
|
|
Service Code
|
MSDRG 235
|
| Min. Negotiated Rate |
$45,449.68 |
| Max. Negotiated Rate |
$162,928.48 |
| Rate for Payer: Aetna Managed Medicare |
$45,449.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$128,048.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$98,147.87
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$93,246.89
|
| Rate for Payer: Anthem Medicare Advantage |
$45,449.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$45,449.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$45,449.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$45,449.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$103,512.60
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$45,449.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$119,258.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$45,449.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$45,449.68
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$45,449.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$45,449.68
|
| Rate for Payer: NAPHCARE Commercial |
$68,174.53
|
| Rate for Payer: Quartz Medicare Advantage |
$45,449.68
|
| Rate for Payer: The Alliance Commercial |
$162,928.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45,449.68
|
| Rate for Payer: United Healthcare PPO |
$92,844.33
|
| Rate for Payer: Wellcare Medicare |
$45,449.68
|
|
|
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$112,070.40
|
|
|
Service Code
|
MSDRG 236
|
| Min. Negotiated Rate |
$32,585.44 |
| Max. Negotiated Rate |
$112,070.40 |
| Rate for Payer: Aetna Managed Medicare |
$32,585.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$91,396.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$70,054.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$66,556.35
|
| Rate for Payer: Anthem Medicare Advantage |
$32,585.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$32,585.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$32,585.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$32,585.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$73,883.65
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$32,585.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$81,955.54
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$32,585.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$32,585.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$32,585.44
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$32,585.44
|
| Rate for Payer: NAPHCARE Commercial |
$48,878.15
|
| Rate for Payer: Quartz Medicare Advantage |
$32,585.44
|
| Rate for Payer: The Alliance Commercial |
$112,070.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,585.44
|
| Rate for Payer: United Healthcare PPO |
$63,803.44
|
| Rate for Payer: Wellcare Medicare |
$32,585.44
|
|
|
CORONARY BYPASS WITH PTCA WITH MCC
|
Facility
|
IP
|
$224,713.84
|
|
|
Service Code
|
MSDRG 231
|
| Min. Negotiated Rate |
$65,064.62 |
| Max. Negotiated Rate |
$224,713.84 |
| Rate for Payer: Aetna Managed Medicare |
$65,064.62
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$183,933.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$140,983.67
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$133,943.69
|
| Rate for Payer: Anthem Medicare Advantage |
$65,064.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$65,064.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$65,064.62
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$65,064.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$148,689.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$65,064.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$164,576.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$65,064.62
|
| Rate for Payer: Independent Care Health Plan Medicare |
$65,064.62
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$65,064.62
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$65,064.62
|
| Rate for Payer: NAPHCARE Commercial |
$97,596.92
|
| Rate for Payer: Quartz Medicare Advantage |
$65,064.62
|
| Rate for Payer: The Alliance Commercial |
$224,713.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$65,064.62
|
| Rate for Payer: United Healthcare PPO |
$128,124.72
|
| Rate for Payer: Wellcare Medicare |
$65,064.62
|
|
|
CORONARY BYPASS WITH PTCA WITHOUT MCC
|
Facility
|
IP
|
$164,808.80
|
|
|
Service Code
|
MSDRG 232
|
| Min. Negotiated Rate |
$46,935.36 |
| Max. Negotiated Rate |
$164,808.80 |
| Rate for Payer: Aetna Managed Medicare |
$46,935.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$132,281.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$101,392.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$96,329.38
|
| Rate for Payer: Anthem Medicare Advantage |
$46,935.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$46,935.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$46,935.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$46,935.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$106,934.44
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$46,935.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$120,637.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$46,935.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$46,935.36
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$46,935.36
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$46,935.36
|
| Rate for Payer: NAPHCARE Commercial |
$70,403.03
|
| Rate for Payer: Quartz Medicare Advantage |
$46,935.36
|
| Rate for Payer: The Alliance Commercial |
$164,808.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$46,935.36
|
| Rate for Payer: United Healthcare PPO |
$93,917.93
|
| Rate for Payer: Wellcare Medicare |
$46,935.36
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$114,801.44
|
|
|
Service Code
|
MSDRG 323
|
| Min. Negotiated Rate |
$33,646.87 |
| Max. Negotiated Rate |
$114,801.44 |
| Rate for Payer: Aetna Managed Medicare |
$33,646.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$94,420.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$72,372.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$68,758.58
|
| Rate for Payer: Anthem Medicare Advantage |
$33,646.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$33,646.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$33,646.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$33,646.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$76,328.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$33,646.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$83,959.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$33,646.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$33,646.87
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$33,646.87
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$33,646.87
|
| Rate for Payer: NAPHCARE Commercial |
$50,470.31
|
| Rate for Payer: Quartz Medicare Advantage |
$33,646.87
|
| Rate for Payer: The Alliance Commercial |
$114,801.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,646.87
|
| Rate for Payer: United Healthcare PPO |
$65,363.31
|
| Rate for Payer: Wellcare Medicare |
$33,646.87
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$82,413.76
|
|
|
Service Code
|
MSDRG 324
|
| Min. Negotiated Rate |
$24,637.76 |
| Max. Negotiated Rate |
$82,413.76 |
| Rate for Payer: Aetna Managed Medicare |
$24,637.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$68,752.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$52,698.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$50,066.62
|
| Rate for Payer: Anthem Medicare Advantage |
$24,637.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24,637.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24,637.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$24,637.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$55,578.54
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$24,637.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$60,203.21
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$24,637.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24,637.76
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$24,637.76
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$24,637.76
|
| Rate for Payer: NAPHCARE Commercial |
$36,956.63
|
| Rate for Payer: Quartz Medicare Advantage |
$24,637.76
|
| Rate for Payer: The Alliance Commercial |
$82,413.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,637.76
|
| Rate for Payer: United Healthcare PPO |
$46,868.97
|
| Rate for Payer: Wellcare Medicare |
$24,637.76
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE
|
Facility
|
IP
|
$73,446.88
|
|
|
Service Code
|
MSDRG 325
|
| Min. Negotiated Rate |
$25,092.64 |
| Max. Negotiated Rate |
$73,446.88 |
| Rate for Payer: Aetna Managed Medicare |
$25,092.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$70,048.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$53,691.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$51,010.43
|
| Rate for Payer: Anthem Medicare Advantage |
$25,092.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$25,092.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$25,092.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$25,092.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$56,626.26
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$25,092.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53,626.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$25,092.64
|
| Rate for Payer: Independent Care Health Plan Medicare |
$25,092.64
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$25,092.64
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$25,092.64
|
| Rate for Payer: NAPHCARE Commercial |
$37,638.96
|
| Rate for Payer: Quartz Medicare Advantage |
$25,092.64
|
| Rate for Payer: The Alliance Commercial |
$73,446.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25,092.64
|
| Rate for Payer: United Healthcare PPO |
$41,748.84
|
| Rate for Payer: Wellcare Medicare |
$25,092.64
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH DISTAL METATARSAL OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 28296
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH DOUBLE OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$30,545.47
|
|
|
Service Code
|
CPT 28299
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,636.37 |
| Max. Negotiated Rate |
$30,545.47 |
| Rate for Payer: Aetna Managed Medicare |
$7,636.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29,092.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26,282.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24,968.32
|
| Rate for Payer: Anthem Medicare Advantage |
$7,636.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,636.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,636.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,636.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,673.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,636.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28,407.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,636.37
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,636.37
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,636.37
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,636.37
|
| Rate for Payer: NAPHCARE Commercial |
$11,454.55
|
| Rate for Payer: Quartz Medicare Advantage |
$7,636.37
|
| Rate for Payer: The Alliance Commercial |
$30,545.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,636.37
|
| Rate for Payer: United Healthcare PPO |
$14,223.04
|
| Rate for Payer: Wellcare Medicare |
$7,636.37
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH FIRST METATARSAL AND MEDIAL CUNEIFORM JOINT ARTHRODESIS, ANY METHOD
|
Facility
|
OP
|
$54,045.18
|
|
|
Service Code
|
CPT 28297
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,807.99 |
| Max. Negotiated Rate |
$54,045.18 |
| Rate for Payer: Aetna Managed Medicare |
$13,511.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,182.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,724.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,889.12
|
| Rate for Payer: Anthem Medicare Advantage |
$13,511.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,511.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,511.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,511.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,511.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50,262.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,511.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,511.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,511.30
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,511.30
|
| Rate for Payer: NAPHCARE Commercial |
$20,266.94
|
| Rate for Payer: Quartz Medicare Advantage |
$13,511.30
|
| Rate for Payer: The Alliance Commercial |
$54,045.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,511.30
|
| Rate for Payer: United Healthcare PPO |
$8,790.08
|
| Rate for Payer: Wellcare Medicare |
$13,511.30
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH PROXIMAL PHALANX OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$30,545.47
|
|
|
Service Code
|
CPT 28298
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,807.99 |
| Max. Negotiated Rate |
$30,545.47 |
| Rate for Payer: Aetna Managed Medicare |
$7,636.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,182.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,724.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,889.12
|
| Rate for Payer: Anthem Medicare Advantage |
$7,636.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,636.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,636.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,636.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,636.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28,407.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,636.37
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,636.37
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,636.37
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,636.37
|
| Rate for Payer: NAPHCARE Commercial |
$11,454.55
|
| Rate for Payer: Quartz Medicare Advantage |
$7,636.37
|
| Rate for Payer: The Alliance Commercial |
$30,545.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,636.37
|
| Rate for Payer: United Healthcare PPO |
$8,790.08
|
| Rate for Payer: Wellcare Medicare |
$7,636.37
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH RESECTION OF PROXIMAL PHALANX BASE, WHEN PERFORMED, ANY METHOD
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 28292
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
CORRECTION, HAMMERTOE (EG, INTERPHALANGEAL FUSION, PARTIAL OR TOTAL PHALANGECTOMY)
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 28285
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
CORRECTION OF BUNION 28292
|
Professional
|
Both
|
$2,739.00
|
|
|
Service Code
|
CPT 28292
|
| Hospital Charge Code |
3014234
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$451.20 |
| Max. Negotiated Rate |
$2,706.13 |
| Rate for Payer: Aetna Commercial |
$2,706.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,449.76
|
| Rate for Payer: Aetna Managed Medicare |
$451.20
|
| Rate for Payer: Anthem Medicare Advantage |
$451.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$451.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$451.20
|
| Rate for Payer: Cash Price |
$821.70
|
| Rate for Payer: Cash Price |
$821.70
|
| Rate for Payer: Cash Price |
$821.70
|
| Rate for Payer: Cigna Commercial |
$2,706.13
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$506.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$451.20
|
| Rate for Payer: Health EOS Commercial |
$2,592.19
|
| Rate for Payer: HFN Commercial |
$2,706.13
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,689.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,689.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$451.20
|
| Rate for Payer: Multiplan Commercial |
$2,278.85
|
| Rate for Payer: NAPHCARE Commercial |
$676.81
|
| Rate for Payer: Preferred Network Access Commercial |
$2,706.13
|
| Rate for Payer: Quartz Beloit One Network |
$1,253.37
|
| Rate for Payer: Quartz Commercial |
$1,623.68
|
| Rate for Payer: Quartz Medicare Advantage |
$451.20
|
| Rate for Payer: The Alliance Commercial |
$1,917.62
|
| Rate for Payer: United Healthcare Medicaid |
$506.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$451.20
|
| Rate for Payer: WEA Trust Commercial |
$1,566.71
|
| Rate for Payer: WPS Commercial |
$2,030.42
|
|
|
Correction of Bunion 2829250
|
Professional
|
Both
|
$5,480.00
|
|
|
Service Code
|
CPT 28292 50
|
| Hospital Charge Code |
5170621
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$506.19 |
| Max. Negotiated Rate |
$5,414.24 |
| Rate for Payer: Aetna Commercial |
$5,414.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,901.31
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cigna Commercial |
$5,414.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$506.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,419.52
|
| Rate for Payer: Health EOS Commercial |
$5,186.27
|
| Rate for Payer: HFN Commercial |
$5,414.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,689.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,689.52
|
| Rate for Payer: Multiplan Commercial |
$4,559.36
|
| Rate for Payer: Preferred Network Access Commercial |
$5,414.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,507.65
|
| Rate for Payer: Quartz Commercial |
$3,248.54
|
| Rate for Payer: The Alliance Commercial |
$2,849.60
|
| Rate for Payer: United Healthcare Medicaid |
$506.19
|
| Rate for Payer: WEA Trust Commercial |
$3,134.56
|
| Rate for Payer: WPS Commercial |
$4,221.24
|
|
|
CORRECTION OF BUNION 28293
|
Professional
|
Both
|
$4,712.00
|
|
| Hospital Charge Code |
3014235
|
| Min. Negotiated Rate |
$2,156.21 |
| Max. Negotiated Rate |
$4,655.46 |
| Rate for Payer: Aetna Commercial |
$4,655.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,214.41
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cigna Commercial |
$4,655.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,450.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,940.29
|
| Rate for Payer: Health EOS Commercial |
$4,459.44
|
| Rate for Payer: HFN Commercial |
$4,655.46
|
| Rate for Payer: Multiplan Commercial |
$3,920.38
|
| Rate for Payer: Preferred Network Access Commercial |
$4,655.46
|
| Rate for Payer: Quartz Beloit One Network |
$2,156.21
|
| Rate for Payer: Quartz Commercial |
$2,793.27
|
| Rate for Payer: The Alliance Commercial |
$2,450.24
|
| Rate for Payer: WEA Trust Commercial |
$2,695.26
|
| Rate for Payer: WPS Commercial |
$3,629.65
|
|
|
CORRECTION OF BUNION 28296
|
Professional
|
Both
|
$3,143.00
|
|
|
Service Code
|
CPT 28296
|
| Hospital Charge Code |
3014236
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$475.75 |
| Max. Negotiated Rate |
$3,105.28 |
| Rate for Payer: Aetna Commercial |
$3,105.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,811.10
|
| Rate for Payer: Aetna Managed Medicare |
$475.75
|
| Rate for Payer: Anthem Medicare Advantage |
$475.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$475.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$475.75
|
| Rate for Payer: Cash Price |
$942.90
|
| Rate for Payer: Cash Price |
$942.90
|
| Rate for Payer: Cash Price |
$942.90
|
| Rate for Payer: Cigna Commercial |
$3,105.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$630.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$475.75
|
| Rate for Payer: Health EOS Commercial |
$2,974.54
|
| Rate for Payer: HFN Commercial |
$3,105.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,801.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,801.64
|
| Rate for Payer: Independent Care Health Plan Medicare |
$475.75
|
| Rate for Payer: Multiplan Commercial |
$2,614.98
|
| Rate for Payer: NAPHCARE Commercial |
$713.62
|
| Rate for Payer: Preferred Network Access Commercial |
$3,105.28
|
| Rate for Payer: Quartz Beloit One Network |
$1,438.24
|
| Rate for Payer: Quartz Commercial |
$1,863.17
|
| Rate for Payer: Quartz Medicare Advantage |
$475.75
|
| Rate for Payer: The Alliance Commercial |
$2,021.93
|
| Rate for Payer: United Healthcare Medicaid |
$630.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$475.75
|
| Rate for Payer: WEA Trust Commercial |
$1,797.80
|
| Rate for Payer: WPS Commercial |
$2,140.87
|
|
|
CORRECTION OF BUNION 28297
|
Professional
|
Both
|
$4,115.00
|
|
|
Service Code
|
CPT 28297
|
| Hospital Charge Code |
3014237
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$547.66 |
| Max. Negotiated Rate |
$4,065.62 |
| Rate for Payer: Aetna Commercial |
$4,065.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,680.46
|
| Rate for Payer: Aetna Managed Medicare |
$547.66
|
| Rate for Payer: Anthem Medicare Advantage |
$547.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$547.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$547.66
|
| Rate for Payer: Cash Price |
$1,234.50
|
| Rate for Payer: Cash Price |
$1,234.50
|
| Rate for Payer: Cash Price |
$1,234.50
|
| Rate for Payer: Cigna Commercial |
$4,065.62
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$706.79
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$547.66
|
| Rate for Payer: Health EOS Commercial |
$3,894.44
|
| Rate for Payer: HFN Commercial |
$4,065.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,105.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,105.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$547.66
|
| Rate for Payer: Multiplan Commercial |
$3,423.68
|
| Rate for Payer: NAPHCARE Commercial |
$821.50
|
| Rate for Payer: Preferred Network Access Commercial |
$4,065.62
|
| Rate for Payer: Quartz Beloit One Network |
$1,883.02
|
| Rate for Payer: Quartz Commercial |
$2,439.37
|
| Rate for Payer: Quartz Medicare Advantage |
$547.66
|
| Rate for Payer: The Alliance Commercial |
$2,327.57
|
| Rate for Payer: United Healthcare Medicaid |
$706.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$547.66
|
| Rate for Payer: WEA Trust Commercial |
$2,353.78
|
| Rate for Payer: WPS Commercial |
$2,464.49
|
|
|
CORRECTION OF BUNION 28298
|
Professional
|
Both
|
$3,464.00
|
|
|
Service Code
|
CPT 28298
|
| Hospital Charge Code |
3014238
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$470.08 |
| Max. Negotiated Rate |
$3,422.43 |
| Rate for Payer: Aetna Commercial |
$3,422.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,098.20
|
| Rate for Payer: Aetna Managed Medicare |
$470.20
|
| Rate for Payer: Anthem Medicare Advantage |
$470.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$470.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$470.20
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cigna Commercial |
$3,422.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$470.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$470.20
|
| Rate for Payer: Health EOS Commercial |
$3,278.33
|
| Rate for Payer: HFN Commercial |
$3,422.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,749.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,749.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$470.20
|
| Rate for Payer: Multiplan Commercial |
$2,882.05
|
| Rate for Payer: NAPHCARE Commercial |
$705.31
|
| Rate for Payer: Preferred Network Access Commercial |
$3,422.43
|
| Rate for Payer: Quartz Beloit One Network |
$1,585.13
|
| Rate for Payer: Quartz Commercial |
$2,053.46
|
| Rate for Payer: Quartz Medicare Advantage |
$470.20
|
| Rate for Payer: The Alliance Commercial |
$1,998.37
|
| Rate for Payer: United Healthcare Medicaid |
$470.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$470.20
|
| Rate for Payer: WEA Trust Commercial |
$1,981.41
|
| Rate for Payer: WPS Commercial |
$2,115.92
|
|
|
Correction of Bunion 28299
|
Professional
|
Both
|
$4,378.00
|
|
|
Service Code
|
CPT 28299
|
| Hospital Charge Code |
3215479
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$549.10 |
| Max. Negotiated Rate |
$4,325.46 |
| Rate for Payer: Aetna Commercial |
$4,325.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,915.68
|
| Rate for Payer: Aetna Managed Medicare |
$549.10
|
| Rate for Payer: Anthem Medicare Advantage |
$549.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$549.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$549.10
|
| Rate for Payer: Cash Price |
$1,313.40
|
| Rate for Payer: Cash Price |
$1,313.40
|
| Rate for Payer: Cash Price |
$1,313.40
|
| Rate for Payer: Cigna Commercial |
$4,325.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$707.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$549.10
|
| Rate for Payer: Health EOS Commercial |
$4,143.34
|
| Rate for Payer: HFN Commercial |
$4,325.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,050.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,050.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$549.10
|
| Rate for Payer: Multiplan Commercial |
$3,642.50
|
| Rate for Payer: NAPHCARE Commercial |
$823.65
|
| Rate for Payer: Preferred Network Access Commercial |
$4,325.46
|
| Rate for Payer: Quartz Beloit One Network |
$2,003.37
|
| Rate for Payer: Quartz Commercial |
$2,595.28
|
| Rate for Payer: Quartz Medicare Advantage |
$549.10
|
| Rate for Payer: The Alliance Commercial |
$2,333.67
|
| Rate for Payer: United Healthcare Medicaid |
$707.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$549.10
|
| Rate for Payer: WEA Trust Commercial |
$2,504.22
|
| Rate for Payer: WPS Commercial |
$2,470.95
|
|
|
COR STEMI/AMI URGENT
|
Facility
|
IP
|
$28,855.00
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
3052468
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,704.51 |
| Max. Negotiated Rate |
$27,608.46 |
| Rate for Payer: Aetna Commercial |
$27,008.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$25,807.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$15,904.88
|
| Rate for Payer: Cash Price |
$8,656.50
|
| Rate for Payer: Cigna Commercial |
$27,608.46
|
| Rate for Payer: Health EOS Commercial |
$26,708.19
|
| Rate for Payer: HFN Commercial |
$27,608.46
|
| Rate for Payer: Multiplan Commercial |
$24,007.36
|
| Rate for Payer: Preferred Network Access Commercial |
$27,608.46
|
| Rate for Payer: Quartz Beloit One Network |
$14,704.51
|
| Rate for Payer: Quartz Commercial |
$18,005.52
|
| Rate for Payer: WEA Trust Commercial |
$16,505.06
|
| Rate for Payer: WPS Commercial |
$22,227.01
|
|
|
COR STEMI/AMI URGENT
|
Facility
|
OP
|
$28,855.00
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
3052468
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,159.87 |
| Max. Negotiated Rate |
$27,608.46 |
| Rate for Payer: Aetna Commercial |
$27,008.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$25,807.91
|
| Rate for Payer: Aetna Managed Medicare |
$8,402.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24,243.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21,503.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20,428.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$15,904.88
|
| Rate for Payer: Cash Price |
$8,656.50
|
| Rate for Payer: Cash Price |
$8,656.50
|
| Rate for Payer: Cash Price |
$8,656.50
|
| Rate for Payer: Cigna Commercial |
$27,608.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Health EOS Commercial |
$26,708.19
|
| Rate for Payer: HFN Commercial |
$27,608.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22,506.90
|
| Rate for Payer: Multiplan Commercial |
$24,007.36
|
| Rate for Payer: NAPHCARE Commercial |
$18,005.52
|
| Rate for Payer: Preferred Network Access Commercial |
$27,608.46
|
| Rate for Payer: Quartz Beloit One Network |
$14,704.51
|
| Rate for Payer: Quartz Commercial |
$19,505.98
|
| Rate for Payer: Quartz Medicare Advantage |
$18,005.52
|
| Rate for Payer: The Alliance Commercial |
$2,159.87
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$16,505.06
|
| Rate for Payer: WPS Commercial |
$22,227.01
|
|
|
Cor Stent W/PTCA Ea Add Branch +
|
Facility
|
OP
|
$17,288.00
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
3052465
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,034.27 |
| Max. Negotiated Rate |
$24,243.44 |
| Rate for Payer: Aetna Commercial |
$16,181.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$15,462.39
|
| Rate for Payer: Aetna Managed Medicare |
$5,034.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24,243.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21,503.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20,428.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,529.15
|
| Rate for Payer: Cash Price |
$5,186.40
|
| Rate for Payer: Cash Price |
$5,186.40
|
| Rate for Payer: Cash Price |
$5,186.40
|
| Rate for Payer: Cigna Commercial |
$16,541.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Health EOS Commercial |
$16,001.77
|
| Rate for Payer: HFN Commercial |
$16,541.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13,484.64
|
| Rate for Payer: Multiplan Commercial |
$14,383.62
|
| Rate for Payer: NAPHCARE Commercial |
$10,787.71
|
| Rate for Payer: Preferred Network Access Commercial |
$16,541.16
|
| Rate for Payer: Quartz Beloit One Network |
$8,809.96
|
| Rate for Payer: Quartz Commercial |
$11,686.69
|
| Rate for Payer: Quartz Medicare Advantage |
$10,787.71
|
| Rate for Payer: The Alliance Commercial |
$8,989.76
|
| Rate for Payer: WEA Trust Commercial |
$9,888.74
|
| Rate for Payer: WPS Commercial |
$13,316.95
|
|
|
Cor Stent W/PTCA Ea Add Branch +
|
Facility
|
IP
|
$17,288.00
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
3052465
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,809.96 |
| Max. Negotiated Rate |
$16,541.16 |
| Rate for Payer: Aetna Commercial |
$16,181.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$15,462.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,529.15
|
| Rate for Payer: Cash Price |
$5,186.40
|
| Rate for Payer: Cigna Commercial |
$16,541.16
|
| Rate for Payer: Health EOS Commercial |
$16,001.77
|
| Rate for Payer: HFN Commercial |
$16,541.16
|
| Rate for Payer: Multiplan Commercial |
$14,383.62
|
| Rate for Payer: Preferred Network Access Commercial |
$16,541.16
|
| Rate for Payer: Quartz Beloit One Network |
$8,809.96
|
| Rate for Payer: Quartz Commercial |
$10,787.71
|
| Rate for Payer: WEA Trust Commercial |
$9,888.74
|
| Rate for Payer: WPS Commercial |
$13,316.95
|
|
