|
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
|
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
|
|
|
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 Primary
|
Facility
|
IP
|
$25,059.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
3052464
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,770.07 |
| Max. Negotiated Rate |
$23,976.45 |
| Rate for Payer: Aetna Commercial |
$23,455.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22,412.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13,812.52
|
| Rate for Payer: Cash Price |
$7,517.70
|
| Rate for Payer: Cigna Commercial |
$23,976.45
|
| Rate for Payer: Health EOS Commercial |
$23,194.61
|
| Rate for Payer: HFN Commercial |
$23,976.45
|
| Rate for Payer: Multiplan Commercial |
$20,849.09
|
| Rate for Payer: Preferred Network Access Commercial |
$23,976.45
|
| Rate for Payer: Quartz Beloit One Network |
$12,770.07
|
| Rate for Payer: Quartz Commercial |
$15,636.82
|
| Rate for Payer: WEA Trust Commercial |
$14,333.75
|
| Rate for Payer: WPS Commercial |
$19,302.95
|
|
|
COR Stent W/PTCA Primary
|
Facility
|
OP
|
$25,059.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
3052464
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,979.84 |
| Max. Negotiated Rate |
$48,595.91 |
| Rate for Payer: Aetna Commercial |
$23,455.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22,412.77
|
| Rate for Payer: Aetna Managed Medicare |
$12,148.98
|
| 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: Anthem Medicare Advantage |
$12,148.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13,812.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,148.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,148.98
|
| Rate for Payer: Cash Price |
$7,517.70
|
| Rate for Payer: Cash Price |
$7,517.70
|
| Rate for Payer: Cash Price |
$7,517.70
|
| Rate for Payer: Cigna Commercial |
$23,976.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,148.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12,349.86
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,148.98
|
| Rate for Payer: Health EOS Commercial |
$23,194.61
|
| Rate for Payer: HFN Commercial |
$23,976.45
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$45,194.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,148.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,148.98
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,148.98
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,148.98
|
| Rate for Payer: Multiplan Commercial |
$20,849.09
|
| Rate for Payer: NAPHCARE Commercial |
$18,223.47
|
| Rate for Payer: Preferred Network Access Commercial |
$23,976.45
|
| Rate for Payer: Quartz Beloit One Network |
$12,770.07
|
| Rate for Payer: Quartz Commercial |
$16,939.88
|
| Rate for Payer: Quartz Medicare Advantage |
$12,148.98
|
| Rate for Payer: The Alliance Commercial |
$48,595.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,148.98
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$14,333.75
|
| Rate for Payer: Wellcare Medicare |
$12,148.98
|
| Rate for Payer: WPS Commercial |
$19,302.95
|
|
|
Cor Thrombectomy Mechanical +
|
Facility
|
IP
|
$10,014.00
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
3052470
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,103.13 |
| Max. Negotiated Rate |
$9,581.40 |
| Rate for Payer: Aetna Commercial |
$9,373.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,956.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,519.72
|
| Rate for Payer: Cash Price |
$3,004.20
|
| Rate for Payer: Cigna Commercial |
$9,581.40
|
| Rate for Payer: Health EOS Commercial |
$9,268.96
|
| Rate for Payer: HFN Commercial |
$9,581.40
|
| Rate for Payer: Multiplan Commercial |
$8,331.65
|
| Rate for Payer: Preferred Network Access Commercial |
$9,581.40
|
| Rate for Payer: Quartz Beloit One Network |
$5,103.13
|
| Rate for Payer: Quartz Commercial |
$6,248.74
|
| Rate for Payer: WEA Trust Commercial |
$5,728.01
|
| Rate for Payer: WPS Commercial |
$7,713.78
|
|
|
Cor Thrombectomy Mechanical +
|
Facility
|
OP
|
$10,014.00
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
3052470
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$298.65 |
| Max. Negotiated Rate |
$9,581.40 |
| Rate for Payer: Aetna Commercial |
$9,373.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,956.52
|
| Rate for Payer: Aetna Managed Medicare |
$2,916.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,769.46
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,207.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,998.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,519.72
|
| Rate for Payer: Cash Price |
$3,004.20
|
| Rate for Payer: Cash Price |
$3,004.20
|
| Rate for Payer: Cigna Commercial |
$9,581.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,828.15
|
| Rate for Payer: Health EOS Commercial |
$9,268.96
|
| Rate for Payer: HFN Commercial |
$9,581.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,810.92
|
| Rate for Payer: Multiplan Commercial |
$8,331.65
|
| Rate for Payer: NAPHCARE Commercial |
$6,248.74
|
| Rate for Payer: Preferred Network Access Commercial |
$9,581.40
|
| Rate for Payer: Quartz Beloit One Network |
$5,103.13
|
| Rate for Payer: Quartz Commercial |
$6,769.46
|
| Rate for Payer: Quartz Medicare Advantage |
$6,248.74
|
| Rate for Payer: The Alliance Commercial |
$298.65
|
| Rate for Payer: WEA Trust Commercial |
$5,728.01
|
| Rate for Payer: WPS Commercial |
$7,713.78
|
|
|
CORTICAL/CANCELLOUS STRUT 10CM X 12MM 400607
|
Facility
|
OP
|
$3,463.00
|
|
| Hospital Charge Code |
4494290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,008.43 |
| Max. Negotiated Rate |
$3,313.40 |
| Rate for Payer: Aetna Commercial |
$3,241.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,097.31
|
| Rate for Payer: Aetna Managed Medicare |
$1,008.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,340.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,800.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,728.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,908.81
|
| Rate for Payer: Cash Price |
$1,038.90
|
| Rate for Payer: Cigna Commercial |
$3,313.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,015.47
|
| Rate for Payer: Health EOS Commercial |
$3,205.35
|
| Rate for Payer: HFN Commercial |
$3,313.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,701.14
|
| Rate for Payer: Multiplan Commercial |
$2,881.22
|
| Rate for Payer: NAPHCARE Commercial |
$2,160.91
|
| Rate for Payer: Preferred Network Access Commercial |
$3,313.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,764.74
|
| Rate for Payer: Quartz Commercial |
$2,340.99
|
| Rate for Payer: Quartz Medicare Advantage |
$2,160.91
|
| Rate for Payer: The Alliance Commercial |
$1,800.76
|
| Rate for Payer: WEA Trust Commercial |
$1,980.84
|
| Rate for Payer: WPS Commercial |
$2,667.55
|
|
|
CORTICAL/CANCELLOUS STRUT 10CM X 12MM 400607
|
Facility
|
IP
|
$3,463.00
|
|
| Hospital Charge Code |
4494290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,764.74 |
| Max. Negotiated Rate |
$3,313.40 |
| Rate for Payer: Aetna Commercial |
$3,241.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,097.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,908.81
|
| Rate for Payer: Cash Price |
$1,038.90
|
| Rate for Payer: Cigna Commercial |
$3,313.40
|
| Rate for Payer: Health EOS Commercial |
$3,205.35
|
| Rate for Payer: HFN Commercial |
$3,313.40
|
| Rate for Payer: Multiplan Commercial |
$2,881.22
|
| Rate for Payer: Preferred Network Access Commercial |
$3,313.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,764.74
|
| Rate for Payer: Quartz Commercial |
$2,160.91
|
| Rate for Payer: WEA Trust Commercial |
$1,980.84
|
| Rate for Payer: WPS Commercial |
$2,667.55
|
|
|
CORTICAL OPENER 4.5MM 700354
|
Facility
|
IP
|
$1,526.00
|
|
| Hospital Charge Code |
6175233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$777.65 |
| Max. Negotiated Rate |
$1,460.08 |
| Rate for Payer: Aetna Commercial |
$1,428.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,364.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$841.13
|
| Rate for Payer: Cash Price |
$457.80
|
| Rate for Payer: Cigna Commercial |
$1,460.08
|
| Rate for Payer: Health EOS Commercial |
$1,412.47
|
| Rate for Payer: HFN Commercial |
$1,460.08
|
| Rate for Payer: Multiplan Commercial |
$1,269.63
|
| Rate for Payer: Preferred Network Access Commercial |
$1,460.08
|
| Rate for Payer: Quartz Beloit One Network |
$777.65
|
| Rate for Payer: Quartz Commercial |
$952.22
|
| Rate for Payer: WEA Trust Commercial |
$872.87
|
| Rate for Payer: WPS Commercial |
$1,175.48
|
|
|
CORTICAL OPENER 4.5MM 700354
|
Facility
|
OP
|
$1,526.00
|
|
| Hospital Charge Code |
6175233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$444.37 |
| Max. Negotiated Rate |
$1,460.08 |
| Rate for Payer: Aetna Commercial |
$1,428.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,364.85
|
| Rate for Payer: Aetna Managed Medicare |
$444.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,031.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$793.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$761.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$841.13
|
| Rate for Payer: Cash Price |
$457.80
|
| Rate for Payer: Cigna Commercial |
$1,460.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$888.13
|
| Rate for Payer: Health EOS Commercial |
$1,412.47
|
| Rate for Payer: HFN Commercial |
$1,460.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,190.28
|
| Rate for Payer: Multiplan Commercial |
$1,269.63
|
| Rate for Payer: NAPHCARE Commercial |
$952.22
|
| Rate for Payer: Preferred Network Access Commercial |
$1,460.08
|
| Rate for Payer: Quartz Beloit One Network |
$777.65
|
| Rate for Payer: Quartz Commercial |
$1,031.58
|
| Rate for Payer: Quartz Medicare Advantage |
$952.22
|
| Rate for Payer: The Alliance Commercial |
$793.52
|
| Rate for Payer: WEA Trust Commercial |
$872.87
|
| Rate for Payer: WPS Commercial |
$1,175.48
|
|
|
Corticorelin 1 mcg Charge
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS J0795
|
| Hospital Charge Code |
2958970
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.68 |
| Max. Negotiated Rate |
$48.41 |
| Rate for Payer: Aetna Commercial |
$48.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$48.41
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30.58
|
| Rate for Payer: Health EOS Commercial |
$46.37
|
| Rate for Payer: HFN Commercial |
$48.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.68
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: Preferred Network Access Commercial |
$48.41
|
| Rate for Payer: Quartz Beloit One Network |
$22.42
|
| Rate for Payer: Quartz Commercial |
$29.05
|
| Rate for Payer: The Alliance Commercial |
$25.48
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$37.74
|
|
|
Corticorelin 1 mcg Charge
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
HCPCS J0795
|
| Hospital Charge Code |
2958970
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$46.88 |
| Rate for Payer: Aetna Commercial |
$45.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.01
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$46.88
|
| Rate for Payer: Health EOS Commercial |
$45.35
|
| Rate for Payer: HFN Commercial |
$46.88
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: Preferred Network Access Commercial |
$46.88
|
| Rate for Payer: Quartz Beloit One Network |
$24.97
|
| Rate for Payer: Quartz Commercial |
$30.58
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$37.74
|
|
|
Corticorelin 1 mcg Charge
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
HCPCS J0795
|
| Hospital Charge Code |
2958970
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.27 |
| Max. Negotiated Rate |
$46.88 |
| Rate for Payer: Aetna Commercial |
$45.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Aetna Managed Medicare |
$14.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$33.12
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.01
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$46.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$28.52
|
| Rate for Payer: Health EOS Commercial |
$45.35
|
| Rate for Payer: HFN Commercial |
$46.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$38.22
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: NAPHCARE Commercial |
$30.58
|
| Rate for Payer: Preferred Network Access Commercial |
$46.88
|
| Rate for Payer: Quartz Beloit One Network |
$24.97
|
| Rate for Payer: Quartz Commercial |
$33.12
|
| Rate for Payer: Quartz Medicare Advantage |
$30.58
|
| Rate for Payer: The Alliance Commercial |
$25.48
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$37.74
|
|
|
Cortisol Evening
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
977913
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$172.75 |
| Max. Negotiated Rate |
$324.36 |
| Rate for Payer: Aetna Commercial |
$317.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$303.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$186.86
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cigna Commercial |
$324.36
|
| Rate for Payer: Health EOS Commercial |
$313.78
|
| Rate for Payer: HFN Commercial |
$324.36
|
| Rate for Payer: Multiplan Commercial |
$282.05
|
| Rate for Payer: Preferred Network Access Commercial |
$324.36
|
| Rate for Payer: Quartz Beloit One Network |
$172.75
|
| Rate for Payer: Quartz Commercial |
$211.54
|
| Rate for Payer: WEA Trust Commercial |
$193.91
|
| Rate for Payer: WPS Commercial |
$261.13
|
|
|
Cortisol Evening
|
Professional
|
Both
|
$339.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
977913
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.95 |
| Max. Negotiated Rate |
$334.93 |
| Rate for Payer: Aetna Commercial |
$334.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$303.20
|
| Rate for Payer: Aetna Managed Medicare |
$16.95
|
| Rate for Payer: Anthem Medicare Advantage |
$16.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.95
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cigna Commercial |
$334.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$176.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.95
|
| Rate for Payer: Health EOS Commercial |
$320.83
|
| Rate for Payer: HFN Commercial |
$334.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$59.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$59.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.95
|
| Rate for Payer: Multiplan Commercial |
$282.05
|
| Rate for Payer: NAPHCARE Commercial |
$25.43
|
| Rate for Payer: Preferred Network Access Commercial |
$334.93
|
| Rate for Payer: Quartz Beloit One Network |
$155.13
|
| Rate for Payer: Quartz Commercial |
$200.96
|
| Rate for Payer: Quartz Medicare Advantage |
$16.95
|
| Rate for Payer: The Alliance Commercial |
$66.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.95
|
| Rate for Payer: WEA Trust Commercial |
$193.91
|
| Rate for Payer: WPS Commercial |
$74.59
|
|
|
Cortisol Evening
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
977913
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.95 |
| Max. Negotiated Rate |
$324.36 |
| Rate for Payer: Aetna Commercial |
$317.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$303.20
|
| Rate for Payer: Aetna Managed Medicare |
$16.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$63.57
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$29.67
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28.14
|
| Rate for Payer: Anthem Medicare Advantage |
$16.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$186.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.95
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cigna Commercial |
$324.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$197.30
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.95
|
| Rate for Payer: Health EOS Commercial |
$313.78
|
| Rate for Payer: HFN Commercial |
$324.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.95
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.95
|
| Rate for Payer: Multiplan Commercial |
$282.05
|
| Rate for Payer: NAPHCARE Commercial |
$25.43
|
| Rate for Payer: Preferred Network Access Commercial |
$324.36
|
| Rate for Payer: Quartz Beloit One Network |
$172.75
|
| Rate for Payer: Quartz Commercial |
$229.16
|
| Rate for Payer: Quartz Medicare Advantage |
$16.95
|
| Rate for Payer: The Alliance Commercial |
$67.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.95
|
| Rate for Payer: United Healthcare PPO |
$264.42
|
| Rate for Payer: WEA Trust Commercial |
$193.91
|
| Rate for Payer: Wellcare Medicare |
$16.95
|
| Rate for Payer: WPS Commercial |
$261.13
|
|
|
Cortisol Free 24 Hour Urine
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
977912
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$717.29 |
| Rate for Payer: Aetna Commercial |
$717.29
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$649.33
|
| Rate for Payer: Aetna Managed Medicare |
$17.38
|
| Rate for Payer: Anthem Medicare Advantage |
$17.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.38
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cigna Commercial |
$717.29
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$377.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.38
|
| Rate for Payer: Health EOS Commercial |
$687.09
|
| Rate for Payer: HFN Commercial |
$717.29
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.35
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$61.35
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.38
|
| Rate for Payer: Multiplan Commercial |
$604.03
|
| Rate for Payer: NAPHCARE Commercial |
$26.07
|
| Rate for Payer: Preferred Network Access Commercial |
$717.29
|
| Rate for Payer: Quartz Beloit One Network |
$332.22
|
| Rate for Payer: Quartz Commercial |
$430.37
|
| Rate for Payer: Quartz Medicare Advantage |
$17.38
|
| Rate for Payer: The Alliance Commercial |
$68.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.38
|
| Rate for Payer: WEA Trust Commercial |
$415.27
|
| Rate for Payer: WPS Commercial |
$76.46
|
|
|
Cortisol Free 24 Hour Urine
|
Facility
|
IP
|
$726.00
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
977912
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$369.97 |
| Max. Negotiated Rate |
$694.64 |
| Rate for Payer: Aetna Commercial |
$679.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$649.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$400.17
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cigna Commercial |
$694.64
|
| Rate for Payer: Health EOS Commercial |
$671.99
|
| Rate for Payer: HFN Commercial |
$694.64
|
| Rate for Payer: Multiplan Commercial |
$604.03
|
| Rate for Payer: Preferred Network Access Commercial |
$694.64
|
| Rate for Payer: Quartz Beloit One Network |
$369.97
|
| Rate for Payer: Quartz Commercial |
$453.02
|
| Rate for Payer: WEA Trust Commercial |
$415.27
|
| Rate for Payer: WPS Commercial |
$559.24
|
|
|
Cortisol Free 24 Hour Urine
|
Facility
|
OP
|
$726.00
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
977912
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$694.64 |
| Rate for Payer: United Healthcare PPO |
$566.28
|
| Rate for Payer: WEA Trust Commercial |
$415.27
|
| Rate for Payer: Aetna Commercial |
$679.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$649.33
|
| Rate for Payer: Aetna Managed Medicare |
$17.38
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$65.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.41
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28.85
|
| Rate for Payer: Anthem Medicare Advantage |
$17.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$400.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.38
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cigna Commercial |
$694.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.38
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$422.53
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.38
|
| Rate for Payer: Health EOS Commercial |
$671.99
|
| Rate for Payer: HFN Commercial |
$694.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.38
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.38
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.38
|
| Rate for Payer: Multiplan Commercial |
$604.03
|
| Rate for Payer: NAPHCARE Commercial |
$26.07
|
| Rate for Payer: Preferred Network Access Commercial |
$694.64
|
| Rate for Payer: Quartz Beloit One Network |
$369.97
|
| Rate for Payer: Quartz Commercial |
$490.78
|
| Rate for Payer: Quartz Medicare Advantage |
$17.38
|
| Rate for Payer: The Alliance Commercial |
$69.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.38
|
| Rate for Payer: Wellcare Medicare |
$17.38
|
| Rate for Payer: WPS Commercial |
$559.24
|
|
|
Cortisol Free & Total Level
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
1038906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$119.60 |
| Rate for Payer: Aetna Commercial |
$117.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$111.80
|
| Rate for Payer: Aetna Managed Medicare |
$17.38
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$65.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.41
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28.85
|
| Rate for Payer: Anthem Medicare Advantage |
$17.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$68.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.38
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cigna Commercial |
$119.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.38
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$72.75
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.38
|
| Rate for Payer: Health EOS Commercial |
$115.70
|
| Rate for Payer: HFN Commercial |
$119.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.38
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.38
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.38
|
| Rate for Payer: Multiplan Commercial |
$104.00
|
| Rate for Payer: NAPHCARE Commercial |
$26.07
|
| Rate for Payer: Preferred Network Access Commercial |
$119.60
|
| Rate for Payer: Quartz Beloit One Network |
$63.70
|
| Rate for Payer: Quartz Commercial |
$84.50
|
| Rate for Payer: Quartz Medicare Advantage |
$17.38
|
| Rate for Payer: The Alliance Commercial |
$69.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.38
|
| Rate for Payer: United Healthcare PPO |
$97.50
|
| Rate for Payer: WEA Trust Commercial |
$71.50
|
| Rate for Payer: Wellcare Medicare |
$17.38
|
| Rate for Payer: WPS Commercial |
$96.29
|
|
