|
Cryoglobulin
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
633717
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.27 |
| Max. Negotiated Rate |
$126.30 |
| Rate for Payer: Aetna Commercial |
$123.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.76
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna Commercial |
$126.30
|
| Rate for Payer: Health EOS Commercial |
$122.18
|
| Rate for Payer: HFN Commercial |
$126.30
|
| Rate for Payer: Multiplan Commercial |
$109.82
|
| Rate for Payer: Preferred Network Access Commercial |
$126.30
|
| Rate for Payer: Quartz Beloit One Network |
$67.27
|
| Rate for Payer: Quartz Commercial |
$82.37
|
| Rate for Payer: WEA Trust Commercial |
$75.50
|
| Rate for Payer: WPS Commercial |
$101.68
|
|
|
Cryoglobulin
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
3595600
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$23.92 |
| Rate for Payer: Aetna Commercial |
$23.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13.78
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$23.92
|
| Rate for Payer: Health EOS Commercial |
$23.14
|
| Rate for Payer: HFN Commercial |
$23.92
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Preferred Network Access Commercial |
$23.92
|
| Rate for Payer: Quartz Beloit One Network |
$12.74
|
| Rate for Payer: Quartz Commercial |
$15.60
|
| Rate for Payer: WEA Trust Commercial |
$14.30
|
| Rate for Payer: WPS Commercial |
$19.26
|
|
|
Cryoglobulin
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
633717
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$130.42 |
| Rate for Payer: Aetna Commercial |
$130.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.06
|
| Rate for Payer: Aetna Managed Medicare |
$6.73
|
| Rate for Payer: Anthem Medicare Advantage |
$6.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.73
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna Commercial |
$130.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$68.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.73
|
| Rate for Payer: Health EOS Commercial |
$124.92
|
| Rate for Payer: HFN Commercial |
$130.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.73
|
| Rate for Payer: Multiplan Commercial |
$109.82
|
| Rate for Payer: NAPHCARE Commercial |
$10.09
|
| Rate for Payer: Preferred Network Access Commercial |
$130.42
|
| Rate for Payer: Quartz Beloit One Network |
$60.40
|
| Rate for Payer: Quartz Commercial |
$78.25
|
| Rate for Payer: Quartz Medicare Advantage |
$6.73
|
| Rate for Payer: The Alliance Commercial |
$26.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.73
|
| Rate for Payer: WEA Trust Commercial |
$75.50
|
| Rate for Payer: WPS Commercial |
$29.61
|
|
|
Cryoglobulin Immunofixation
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
5605697
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.23 |
| Max. Negotiated Rate |
$100.46 |
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Aetna Managed Medicare |
$23.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$87.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$40.66
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$38.57
|
| Rate for Payer: Anthem Medicare Advantage |
$23.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.23
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$100.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$61.11
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23.23
|
| Rate for Payer: Health EOS Commercial |
$97.19
|
| Rate for Payer: HFN Commercial |
$100.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$86.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.23
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23.23
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23.23
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: NAPHCARE Commercial |
$34.85
|
| Rate for Payer: Preferred Network Access Commercial |
$100.46
|
| Rate for Payer: Quartz Beloit One Network |
$53.51
|
| Rate for Payer: Quartz Commercial |
$70.98
|
| Rate for Payer: Quartz Medicare Advantage |
$23.23
|
| Rate for Payer: The Alliance Commercial |
$92.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.23
|
| Rate for Payer: United Healthcare PPO |
$81.90
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: Wellcare Medicare |
$23.23
|
| Rate for Payer: WPS Commercial |
$80.88
|
|
|
Cryoglobulin Immunofixation
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
5605697
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$103.74 |
| Rate for Payer: Aetna Commercial |
$103.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Aetna Managed Medicare |
$23.23
|
| Rate for Payer: Anthem Commercial |
$17.27
|
| Rate for Payer: Anthem Medicare Advantage |
$23.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.23
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$103.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$54.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.23
|
| Rate for Payer: Health EOS Commercial |
$99.37
|
| Rate for Payer: HFN Commercial |
$103.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$82.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$82.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.23
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: NAPHCARE Commercial |
$34.85
|
| Rate for Payer: Preferred Network Access Commercial |
$103.74
|
| Rate for Payer: Quartz Beloit One Network |
$48.05
|
| Rate for Payer: Quartz Commercial |
$62.24
|
| Rate for Payer: Quartz Medicare Advantage |
$23.23
|
| Rate for Payer: The Alliance Commercial |
$91.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.23
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: WPS Commercial |
$102.23
|
|
|
Cryoglobulin Immunofixation
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
5605697
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.51 |
| Max. Negotiated Rate |
$100.46 |
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.88
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$100.46
|
| Rate for Payer: Health EOS Commercial |
$97.19
|
| Rate for Payer: HFN Commercial |
$100.46
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: Preferred Network Access Commercial |
$100.46
|
| Rate for Payer: Quartz Beloit One Network |
$53.51
|
| Rate for Payer: Quartz Commercial |
$65.52
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: WPS Commercial |
$80.88
|
|
|
.Cryoglobulin Reflex
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
CPT 86329
|
| Hospital Charge Code |
5582868
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.61 |
| Max. Negotiated Rate |
$103.74 |
| Rate for Payer: Aetna Commercial |
$103.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Aetna Managed Medicare |
$14.61
|
| Rate for Payer: Anthem Medicare Advantage |
$14.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.61
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$103.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$54.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.61
|
| Rate for Payer: Health EOS Commercial |
$99.37
|
| Rate for Payer: HFN Commercial |
$103.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$51.58
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$51.58
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.61
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: NAPHCARE Commercial |
$21.92
|
| Rate for Payer: Preferred Network Access Commercial |
$103.74
|
| Rate for Payer: Quartz Beloit One Network |
$48.05
|
| Rate for Payer: Quartz Commercial |
$62.24
|
| Rate for Payer: Quartz Medicare Advantage |
$14.61
|
| Rate for Payer: The Alliance Commercial |
$57.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.61
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: WPS Commercial |
$64.29
|
|
|
.Cryoglobulin Reflex
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 86329
|
| Hospital Charge Code |
5582868
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.61 |
| Max. Negotiated Rate |
$100.46 |
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Aetna Managed Medicare |
$14.61
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$54.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.57
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24.26
|
| Rate for Payer: Anthem Medicare Advantage |
$14.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.61
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$100.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14.61
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$61.11
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.61
|
| Rate for Payer: Health EOS Commercial |
$97.19
|
| Rate for Payer: HFN Commercial |
$100.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$54.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.61
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.61
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.61
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.61
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: NAPHCARE Commercial |
$21.92
|
| Rate for Payer: Preferred Network Access Commercial |
$100.46
|
| Rate for Payer: Quartz Beloit One Network |
$53.51
|
| Rate for Payer: Quartz Commercial |
$70.98
|
| Rate for Payer: Quartz Medicare Advantage |
$14.61
|
| Rate for Payer: The Alliance Commercial |
$58.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.61
|
| Rate for Payer: United Healthcare PPO |
$81.90
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: Wellcare Medicare |
$14.61
|
| Rate for Payer: WPS Commercial |
$80.88
|
|
|
.Cryoglobulin Reflex
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 86329
|
| Hospital Charge Code |
5582868
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.51 |
| Max. Negotiated Rate |
$100.46 |
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$93.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.88
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna Commercial |
$100.46
|
| Rate for Payer: Health EOS Commercial |
$97.19
|
| Rate for Payer: HFN Commercial |
$100.46
|
| Rate for Payer: Multiplan Commercial |
$87.36
|
| Rate for Payer: Preferred Network Access Commercial |
$100.46
|
| Rate for Payer: Quartz Beloit One Network |
$53.51
|
| Rate for Payer: Quartz Commercial |
$65.52
|
| Rate for Payer: WEA Trust Commercial |
$60.06
|
| Rate for Payer: WPS Commercial |
$80.88
|
|
|
Cryoglobulin Screen w/ Reflex Cryoglobulin Profile
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
4075452
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$32.53 |
| Rate for Payer: Aetna Commercial |
$31.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$30.41
|
| Rate for Payer: Aetna Managed Medicare |
$6.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$25.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11.78
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$11.17
|
| Rate for Payer: Anthem Medicare Advantage |
$6.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$18.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.73
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cigna Commercial |
$32.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19.79
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.73
|
| Rate for Payer: Health EOS Commercial |
$31.47
|
| Rate for Payer: HFN Commercial |
$32.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.73
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.73
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.73
|
| Rate for Payer: Multiplan Commercial |
$28.29
|
| Rate for Payer: NAPHCARE Commercial |
$10.09
|
| Rate for Payer: Preferred Network Access Commercial |
$32.53
|
| Rate for Payer: Quartz Beloit One Network |
$17.33
|
| Rate for Payer: Quartz Commercial |
$22.98
|
| Rate for Payer: Quartz Medicare Advantage |
$6.73
|
| Rate for Payer: The Alliance Commercial |
$26.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.73
|
| Rate for Payer: United Healthcare PPO |
$26.52
|
| Rate for Payer: WEA Trust Commercial |
$19.45
|
| Rate for Payer: Wellcare Medicare |
$6.73
|
| Rate for Payer: WPS Commercial |
$26.19
|
|
|
Cryoglobulin Screen w/ Reflex Cryoglobulin Profile
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
4075452
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.33 |
| Max. Negotiated Rate |
$32.53 |
| Rate for Payer: Aetna Commercial |
$31.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$30.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$18.74
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cigna Commercial |
$32.53
|
| Rate for Payer: Health EOS Commercial |
$31.47
|
| Rate for Payer: HFN Commercial |
$32.53
|
| Rate for Payer: Multiplan Commercial |
$28.29
|
| Rate for Payer: Preferred Network Access Commercial |
$32.53
|
| Rate for Payer: Quartz Beloit One Network |
$17.33
|
| Rate for Payer: Quartz Commercial |
$21.22
|
| Rate for Payer: WEA Trust Commercial |
$19.45
|
| Rate for Payer: WPS Commercial |
$26.19
|
|
|
Cryoglobulin Screen w/ Reflex Cryoglobulin Profile
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
4075452
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$33.59 |
| Rate for Payer: Aetna Commercial |
$33.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$30.41
|
| Rate for Payer: Aetna Managed Medicare |
$6.73
|
| Rate for Payer: Anthem Medicare Advantage |
$6.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.73
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cigna Commercial |
$33.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.73
|
| Rate for Payer: Health EOS Commercial |
$32.18
|
| Rate for Payer: HFN Commercial |
$33.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.73
|
| Rate for Payer: Multiplan Commercial |
$28.29
|
| Rate for Payer: NAPHCARE Commercial |
$10.09
|
| Rate for Payer: Preferred Network Access Commercial |
$33.59
|
| Rate for Payer: Quartz Beloit One Network |
$15.56
|
| Rate for Payer: Quartz Commercial |
$20.16
|
| Rate for Payer: Quartz Medicare Advantage |
$6.73
|
| Rate for Payer: The Alliance Commercial |
$26.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.73
|
| Rate for Payer: WEA Trust Commercial |
$19.45
|
| Rate for Payer: WPS Commercial |
$29.61
|
|
|
CRYOPROBE 2.4MM V-PROBE VARIAN CRYO-207-V
|
Facility
|
IP
|
$5,228.67
|
|
| Hospital Charge Code |
6246139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,664.53 |
| Max. Negotiated Rate |
$5,002.79 |
| Rate for Payer: Aetna Commercial |
$4,894.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,676.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,882.04
|
| Rate for Payer: Cash Price |
$1,568.60
|
| Rate for Payer: Cigna Commercial |
$5,002.79
|
| Rate for Payer: Health EOS Commercial |
$4,839.66
|
| Rate for Payer: HFN Commercial |
$5,002.79
|
| Rate for Payer: Multiplan Commercial |
$4,350.25
|
| Rate for Payer: Preferred Network Access Commercial |
$5,002.79
|
| Rate for Payer: Quartz Beloit One Network |
$2,664.53
|
| Rate for Payer: Quartz Commercial |
$3,262.69
|
| Rate for Payer: WEA Trust Commercial |
$2,990.80
|
| Rate for Payer: WPS Commercial |
$4,027.64
|
|
|
CRYOPROBE 2.4MM V-PROBE VARIAN CRYO-207-V
|
Facility
|
OP
|
$5,228.67
|
|
| Hospital Charge Code |
6246139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,522.59 |
| Max. Negotiated Rate |
$5,002.79 |
| Rate for Payer: Aetna Commercial |
$4,894.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,676.52
|
| Rate for Payer: Aetna Managed Medicare |
$1,522.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,534.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,718.91
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,610.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,882.04
|
| Rate for Payer: Cash Price |
$1,568.60
|
| Rate for Payer: Cigna Commercial |
$5,002.79
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,043.09
|
| Rate for Payer: Health EOS Commercial |
$4,839.66
|
| Rate for Payer: HFN Commercial |
$5,002.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,078.36
|
| Rate for Payer: Multiplan Commercial |
$4,350.25
|
| Rate for Payer: NAPHCARE Commercial |
$3,262.69
|
| Rate for Payer: Preferred Network Access Commercial |
$5,002.79
|
| Rate for Payer: Quartz Beloit One Network |
$2,664.53
|
| Rate for Payer: Quartz Commercial |
$3,534.58
|
| Rate for Payer: Quartz Medicare Advantage |
$3,262.69
|
| Rate for Payer: The Alliance Commercial |
$2,718.91
|
| Rate for Payer: WEA Trust Commercial |
$2,990.80
|
| Rate for Payer: WPS Commercial |
$4,027.64
|
|
|
CRYOSURGICAL ABLATION OF THE PROSTATE (INCLUDES ULTRASONIC GUIDANCE AND MONITORING)
|
Facility
|
OP
|
$39,849.60
|
|
|
Service Code
|
CPT 55873
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,107.14 |
| Max. Negotiated Rate |
$39,849.60 |
| Rate for Payer: Aetna Managed Medicare |
$9,962.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,394.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,394.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,919.20
|
| Rate for Payer: Anthem Medicare Advantage |
$9,962.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,962.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,962.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,962.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,107.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,962.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37,060.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,962.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,962.40
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,962.40
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,962.40
|
| Rate for Payer: NAPHCARE Commercial |
$14,943.60
|
| Rate for Payer: Quartz Medicare Advantage |
$9,962.40
|
| Rate for Payer: The Alliance Commercial |
$39,849.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,962.40
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: Wellcare Medicare |
$9,962.40
|
|
|
CRYOTHERAPY OF SKIN 17340
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
CPT 17340
|
| Hospital Charge Code |
3013673
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.02 |
| Max. Negotiated Rate |
$186.50 |
| Rate for Payer: Aetna Commercial |
$170.92
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$154.73
|
| Rate for Payer: Aetna Managed Medicare |
$41.44
|
| Rate for Payer: Anthem Medicare Advantage |
$41.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$41.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$41.44
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cigna Commercial |
$170.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$41.44
|
| Rate for Payer: Health EOS Commercial |
$163.73
|
| Rate for Payer: HFN Commercial |
$170.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$170.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$170.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$41.44
|
| Rate for Payer: Multiplan Commercial |
$143.94
|
| Rate for Payer: NAPHCARE Commercial |
$62.17
|
| Rate for Payer: Preferred Network Access Commercial |
$170.92
|
| Rate for Payer: Quartz Beloit One Network |
$79.16
|
| Rate for Payer: Quartz Commercial |
$102.55
|
| Rate for Payer: Quartz Medicare Advantage |
$41.44
|
| Rate for Payer: The Alliance Commercial |
$176.14
|
| Rate for Payer: United Healthcare Medicaid |
$21.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41.44
|
| Rate for Payer: WEA Trust Commercial |
$98.96
|
| Rate for Payer: WPS Commercial |
$186.50
|
|
|
CRYOVEIN SAPHENOUS VEIN V010
|
Facility
|
OP
|
$41,836.00
|
|
| Hospital Charge Code |
3669501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,182.64 |
| Max. Negotiated Rate |
$40,028.68 |
| Rate for Payer: Aetna Commercial |
$39,158.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$37,418.12
|
| Rate for Payer: Aetna Managed Medicare |
$12,182.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$28,281.14
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21,754.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20,884.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$23,060.00
|
| Rate for Payer: Cash Price |
$12,550.80
|
| Rate for Payer: Cigna Commercial |
$40,028.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24,348.55
|
| Rate for Payer: Health EOS Commercial |
$38,723.40
|
| Rate for Payer: HFN Commercial |
$40,028.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,632.08
|
| Rate for Payer: Multiplan Commercial |
$34,807.55
|
| Rate for Payer: NAPHCARE Commercial |
$26,105.66
|
| Rate for Payer: Preferred Network Access Commercial |
$40,028.68
|
| Rate for Payer: Quartz Beloit One Network |
$21,319.63
|
| Rate for Payer: Quartz Commercial |
$28,281.14
|
| Rate for Payer: Quartz Medicare Advantage |
$26,105.66
|
| Rate for Payer: The Alliance Commercial |
$21,754.72
|
| Rate for Payer: WEA Trust Commercial |
$23,930.19
|
| Rate for Payer: WPS Commercial |
$32,226.27
|
|
|
CRYOVEIN SAPHENOUS VEIN V010
|
Facility
|
IP
|
$41,836.00
|
|
| Hospital Charge Code |
3669501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,319.63 |
| Max. Negotiated Rate |
$40,028.68 |
| Rate for Payer: Aetna Commercial |
$39,158.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$37,418.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$23,060.00
|
| Rate for Payer: Cash Price |
$12,550.80
|
| Rate for Payer: Cigna Commercial |
$40,028.68
|
| Rate for Payer: Health EOS Commercial |
$38,723.40
|
| Rate for Payer: HFN Commercial |
$40,028.68
|
| Rate for Payer: Multiplan Commercial |
$34,807.55
|
| Rate for Payer: Preferred Network Access Commercial |
$40,028.68
|
| Rate for Payer: Quartz Beloit One Network |
$21,319.63
|
| Rate for Payer: Quartz Commercial |
$26,105.66
|
| Rate for Payer: WEA Trust Commercial |
$23,930.19
|
| Rate for Payer: WPS Commercial |
$32,226.27
|
|
|
.Cryptococcal Ag Latex Titer
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
CPT 86406
|
| Hospital Charge Code |
4614609
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.27 |
| Max. Negotiated Rate |
$126.30 |
| Rate for Payer: Aetna Commercial |
$123.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.76
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna Commercial |
$126.30
|
| Rate for Payer: Health EOS Commercial |
$122.18
|
| Rate for Payer: HFN Commercial |
$126.30
|
| Rate for Payer: Multiplan Commercial |
$109.82
|
| Rate for Payer: Preferred Network Access Commercial |
$126.30
|
| Rate for Payer: Quartz Beloit One Network |
$67.27
|
| Rate for Payer: Quartz Commercial |
$82.37
|
| Rate for Payer: WEA Trust Commercial |
$75.50
|
| Rate for Payer: WPS Commercial |
$101.68
|
|
|
.Cryptococcal Ag Latex Titer
|
Facility
|
OP
|
$132.00
|
|
|
Service Code
|
CPT 86406
|
| Hospital Charge Code |
4614609
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$126.30 |
| Rate for Payer: Aetna Commercial |
$123.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.06
|
| Rate for Payer: Aetna Managed Medicare |
$11.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$41.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18.37
|
| Rate for Payer: Anthem Medicare Advantage |
$11.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.07
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna Commercial |
$126.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$11.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$76.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$11.07
|
| Rate for Payer: Health EOS Commercial |
$122.18
|
| Rate for Payer: HFN Commercial |
$126.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$41.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$11.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.07
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$11.07
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$109.82
|
| Rate for Payer: NAPHCARE Commercial |
$16.60
|
| Rate for Payer: Preferred Network Access Commercial |
$126.30
|
| Rate for Payer: Quartz Beloit One Network |
$67.27
|
| Rate for Payer: Quartz Commercial |
$89.23
|
| Rate for Payer: Quartz Medicare Advantage |
$11.07
|
| Rate for Payer: The Alliance Commercial |
$44.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.07
|
| Rate for Payer: United Healthcare PPO |
$102.96
|
| Rate for Payer: WEA Trust Commercial |
$75.50
|
| Rate for Payer: Wellcare Medicare |
$11.07
|
| Rate for Payer: WPS Commercial |
$101.68
|
|
|
.Cryptococcal Ag Latex Titer
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
CPT 86406
|
| Hospital Charge Code |
4614609
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$130.42 |
| Rate for Payer: Aetna Commercial |
$130.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.06
|
| Rate for Payer: Aetna Managed Medicare |
$11.07
|
| Rate for Payer: Anthem Medicare Advantage |
$11.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$11.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$11.07
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna Commercial |
$130.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$68.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11.07
|
| Rate for Payer: Health EOS Commercial |
$124.92
|
| Rate for Payer: HFN Commercial |
$130.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$39.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$109.82
|
| Rate for Payer: NAPHCARE Commercial |
$16.60
|
| Rate for Payer: Preferred Network Access Commercial |
$130.42
|
| Rate for Payer: Quartz Beloit One Network |
$60.40
|
| Rate for Payer: Quartz Commercial |
$78.25
|
| Rate for Payer: Quartz Medicare Advantage |
$11.07
|
| Rate for Payer: The Alliance Commercial |
$43.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.07
|
| Rate for Payer: WEA Trust Commercial |
$75.50
|
| Rate for Payer: WPS Commercial |
$48.69
|
|
|
Cryptococcal Antigen, Screen w/ Rfx Titer
|
Facility
|
IP
|
$285.00
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
977916
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$145.24 |
| Max. Negotiated Rate |
$272.69 |
| Rate for Payer: Aetna Commercial |
$266.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$254.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$157.09
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cigna Commercial |
$272.69
|
| Rate for Payer: Health EOS Commercial |
$263.80
|
| Rate for Payer: HFN Commercial |
$272.69
|
| Rate for Payer: Multiplan Commercial |
$237.12
|
| Rate for Payer: Preferred Network Access Commercial |
$272.69
|
| Rate for Payer: Quartz Beloit One Network |
$145.24
|
| Rate for Payer: Quartz Commercial |
$177.84
|
| Rate for Payer: WEA Trust Commercial |
$163.02
|
| Rate for Payer: WPS Commercial |
$219.54
|
|
|
Cryptococcal Antigen, Screen w/ Rfx Titer
|
Facility
|
OP
|
$285.00
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
977916
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$272.69 |
| Rate for Payer: Aetna Commercial |
$266.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$254.90
|
| Rate for Payer: Aetna Managed Medicare |
$13.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$52.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.42
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.17
|
| Rate for Payer: Anthem Medicare Advantage |
$13.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$157.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.96
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cigna Commercial |
$272.69
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$165.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.96
|
| Rate for Payer: Health EOS Commercial |
$263.80
|
| Rate for Payer: HFN Commercial |
$272.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$51.92
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.96
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.96
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.96
|
| Rate for Payer: Multiplan Commercial |
$237.12
|
| Rate for Payer: NAPHCARE Commercial |
$20.94
|
| Rate for Payer: Preferred Network Access Commercial |
$272.69
|
| Rate for Payer: Quartz Beloit One Network |
$145.24
|
| Rate for Payer: Quartz Commercial |
$192.66
|
| Rate for Payer: Quartz Medicare Advantage |
$13.96
|
| Rate for Payer: The Alliance Commercial |
$55.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.96
|
| Rate for Payer: United Healthcare PPO |
$222.30
|
| Rate for Payer: WEA Trust Commercial |
$163.02
|
| Rate for Payer: Wellcare Medicare |
$13.96
|
| Rate for Payer: WPS Commercial |
$219.54
|
|
|
Cryptococcal Antigen, Screen w/ Rfx Titer
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
977916
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$281.58 |
| Rate for Payer: Aetna Commercial |
$281.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$254.90
|
| Rate for Payer: Aetna Managed Medicare |
$13.96
|
| Rate for Payer: Anthem Medicare Advantage |
$13.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.96
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cigna Commercial |
$281.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$148.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.96
|
| Rate for Payer: Health EOS Commercial |
$269.72
|
| Rate for Payer: HFN Commercial |
$281.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$49.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$49.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.96
|
| Rate for Payer: Multiplan Commercial |
$237.12
|
| Rate for Payer: NAPHCARE Commercial |
$20.94
|
| Rate for Payer: Preferred Network Access Commercial |
$281.58
|
| Rate for Payer: Quartz Beloit One Network |
$130.42
|
| Rate for Payer: Quartz Commercial |
$168.95
|
| Rate for Payer: Quartz Medicare Advantage |
$13.96
|
| Rate for Payer: The Alliance Commercial |
$55.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.96
|
| Rate for Payer: WEA Trust Commercial |
$163.02
|
| Rate for Payer: WPS Commercial |
$61.41
|
|
|
Cryptosp Ag
|
Facility
|
OP
|
$159.00
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
979860
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.37 |
| Max. Negotiated Rate |
$152.13 |
| Rate for Payer: Aetna Commercial |
$148.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$142.21
|
| Rate for Payer: Aetna Managed Medicare |
$14.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.15
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.86
|
| Rate for Payer: Anthem Medicare Advantage |
$14.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$87.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.37
|
| Rate for Payer: Cash Price |
$47.70
|
| Rate for Payer: Cash Price |
$47.70
|
| Rate for Payer: Cigna Commercial |
$152.13
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$92.54
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.37
|
| Rate for Payer: Health EOS Commercial |
$147.17
|
| Rate for Payer: HFN Commercial |
$152.13
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$53.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.37
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.37
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.37
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.37
|
| Rate for Payer: Multiplan Commercial |
$132.29
|
| Rate for Payer: NAPHCARE Commercial |
$21.56
|
| Rate for Payer: Preferred Network Access Commercial |
$152.13
|
| Rate for Payer: Quartz Beloit One Network |
$81.03
|
| Rate for Payer: Quartz Commercial |
$107.48
|
| Rate for Payer: Quartz Medicare Advantage |
$14.37
|
| Rate for Payer: The Alliance Commercial |
$57.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.37
|
| Rate for Payer: United Healthcare PPO |
$124.02
|
| Rate for Payer: WEA Trust Commercial |
$90.95
|
| Rate for Payer: Wellcare Medicare |
$14.37
|
| Rate for Payer: WPS Commercial |
$122.48
|
|
