|
Creatine Kinase
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633712
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$109.08 |
| Rate for Payer: Aetna Commercial |
$106.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.96
|
| Rate for Payer: Aetna Managed Medicare |
$6.77
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$25.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11.85
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$11.24
|
| Rate for Payer: Anthem Medicare Advantage |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$62.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.77
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$109.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$66.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.77
|
| Rate for Payer: Health EOS Commercial |
$105.52
|
| Rate for Payer: HFN Commercial |
$109.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.77
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.77
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.77
|
| Rate for Payer: Multiplan Commercial |
$94.85
|
| Rate for Payer: NAPHCARE Commercial |
$10.16
|
| Rate for Payer: Preferred Network Access Commercial |
$109.08
|
| Rate for Payer: Quartz Beloit One Network |
$58.09
|
| Rate for Payer: Quartz Commercial |
$77.06
|
| Rate for Payer: Quartz Medicare Advantage |
$6.77
|
| Rate for Payer: The Alliance Commercial |
$27.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.77
|
| Rate for Payer: United Healthcare PPO |
$88.92
|
| Rate for Payer: WEA Trust Commercial |
$65.21
|
| Rate for Payer: Wellcare Medicare |
$6.77
|
| Rate for Payer: WPS Commercial |
$87.81
|
|
|
Creatine Kinase
|
Facility
|
IP
|
$114.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633712
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.09 |
| Max. Negotiated Rate |
$109.08 |
| Rate for Payer: Aetna Commercial |
$106.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$62.84
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$109.08
|
| Rate for Payer: Health EOS Commercial |
$105.52
|
| Rate for Payer: HFN Commercial |
$109.08
|
| Rate for Payer: Multiplan Commercial |
$94.85
|
| Rate for Payer: Preferred Network Access Commercial |
$109.08
|
| Rate for Payer: Quartz Beloit One Network |
$58.09
|
| Rate for Payer: Quartz Commercial |
$71.14
|
| Rate for Payer: WEA Trust Commercial |
$65.21
|
| Rate for Payer: WPS Commercial |
$87.81
|
|
|
Creatine Kinase
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633712
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$112.63 |
| Rate for Payer: Aetna Commercial |
$112.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.96
|
| Rate for Payer: Aetna Managed Medicare |
$6.77
|
| Rate for Payer: Anthem Medicare Advantage |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.77
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$112.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$59.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.77
|
| Rate for Payer: Health EOS Commercial |
$107.89
|
| Rate for Payer: HFN Commercial |
$112.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.77
|
| Rate for Payer: Multiplan Commercial |
$94.85
|
| Rate for Payer: NAPHCARE Commercial |
$10.16
|
| Rate for Payer: Preferred Network Access Commercial |
$112.63
|
| Rate for Payer: Quartz Beloit One Network |
$52.17
|
| Rate for Payer: Quartz Commercial |
$67.58
|
| Rate for Payer: Quartz Medicare Advantage |
$6.77
|
| Rate for Payer: The Alliance Commercial |
$26.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.77
|
| Rate for Payer: WEA Trust Commercial |
$65.21
|
| Rate for Payer: WPS Commercial |
$29.79
|
|
|
Creatine Kinase Interpretation
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 82552
|
| Hospital Charge Code |
2942881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$103.96 |
| Max. Negotiated Rate |
$195.19 |
| Rate for Payer: Aetna Commercial |
$190.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$182.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$112.44
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$195.19
|
| Rate for Payer: Health EOS Commercial |
$188.82
|
| Rate for Payer: HFN Commercial |
$195.19
|
| Rate for Payer: Multiplan Commercial |
$169.73
|
| Rate for Payer: Preferred Network Access Commercial |
$195.19
|
| Rate for Payer: Quartz Beloit One Network |
$103.96
|
| Rate for Payer: Quartz Commercial |
$127.30
|
| Rate for Payer: WEA Trust Commercial |
$116.69
|
| Rate for Payer: WPS Commercial |
$157.14
|
|
|
Creatine Kinase Interpretation
|
Facility
|
OP
|
$204.00
|
|
|
Service Code
|
CPT 82552
|
| Hospital Charge Code |
2942881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$195.19 |
| Rate for Payer: Quartz Commercial |
$137.90
|
| Rate for Payer: Aetna Commercial |
$190.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$182.46
|
| Rate for Payer: Aetna Managed Medicare |
$13.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$52.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.37
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.12
|
| Rate for Payer: Anthem Medicare Advantage |
$13.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$112.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.93
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$195.19
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$118.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.93
|
| Rate for Payer: Health EOS Commercial |
$188.82
|
| Rate for Payer: HFN Commercial |
$195.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$51.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.93
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.93
|
| Rate for Payer: Multiplan Commercial |
$169.73
|
| Rate for Payer: NAPHCARE Commercial |
$20.89
|
| Rate for Payer: Preferred Network Access Commercial |
$195.19
|
| Rate for Payer: Quartz Beloit One Network |
$103.96
|
| Rate for Payer: Quartz Medicare Advantage |
$13.93
|
| Rate for Payer: The Alliance Commercial |
$55.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.93
|
| Rate for Payer: United Healthcare PPO |
$159.12
|
| Rate for Payer: WEA Trust Commercial |
$116.69
|
| Rate for Payer: Wellcare Medicare |
$13.93
|
| Rate for Payer: WPS Commercial |
$157.14
|
|
|
Creatine Kinase Interpretation
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
CPT 82552
|
| Hospital Charge Code |
2942881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$201.55 |
| Rate for Payer: Aetna Commercial |
$201.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$182.46
|
| Rate for Payer: Aetna Managed Medicare |
$13.93
|
| Rate for Payer: Anthem Medicare Advantage |
$13.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.93
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$201.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$106.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.93
|
| Rate for Payer: Health EOS Commercial |
$193.07
|
| Rate for Payer: HFN Commercial |
$201.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$49.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$49.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.93
|
| Rate for Payer: Multiplan Commercial |
$169.73
|
| Rate for Payer: NAPHCARE Commercial |
$20.89
|
| Rate for Payer: Preferred Network Access Commercial |
$201.55
|
| Rate for Payer: Quartz Beloit One Network |
$93.35
|
| Rate for Payer: Quartz Commercial |
$120.93
|
| Rate for Payer: Quartz Medicare Advantage |
$13.93
|
| Rate for Payer: The Alliance Commercial |
$55.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.93
|
| Rate for Payer: WEA Trust Commercial |
$116.69
|
| Rate for Payer: WPS Commercial |
$61.27
|
|
|
Creatine Kinase Isoenzymes
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633714
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$101.92 |
| Max. Negotiated Rate |
$191.36 |
| Rate for Payer: Aetna Commercial |
$187.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$178.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$110.24
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$191.36
|
| Rate for Payer: Health EOS Commercial |
$185.12
|
| Rate for Payer: HFN Commercial |
$191.36
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: Preferred Network Access Commercial |
$191.36
|
| Rate for Payer: Quartz Beloit One Network |
$101.92
|
| Rate for Payer: Quartz Commercial |
$124.80
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: WPS Commercial |
$154.06
|
|
|
Creatine Kinase Isoenzymes
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633714
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$197.60 |
| Rate for Payer: Aetna Commercial |
$197.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$178.88
|
| Rate for Payer: Aetna Managed Medicare |
$6.77
|
| Rate for Payer: Anthem Medicare Advantage |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.77
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$197.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$104.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.77
|
| Rate for Payer: Health EOS Commercial |
$189.28
|
| Rate for Payer: HFN Commercial |
$197.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.77
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: NAPHCARE Commercial |
$10.16
|
| Rate for Payer: Preferred Network Access Commercial |
$197.60
|
| Rate for Payer: Quartz Beloit One Network |
$91.52
|
| Rate for Payer: Quartz Commercial |
$118.56
|
| Rate for Payer: Quartz Medicare Advantage |
$6.77
|
| Rate for Payer: The Alliance Commercial |
$26.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.77
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: WPS Commercial |
$29.79
|
|
|
Creatine Kinase Isoenzymes
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
633714
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$191.36 |
| Rate for Payer: Aetna Commercial |
$187.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$178.88
|
| Rate for Payer: Aetna Managed Medicare |
$6.77
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$25.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11.85
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$11.24
|
| Rate for Payer: Anthem Medicare Advantage |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$110.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.77
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$191.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$116.40
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.77
|
| Rate for Payer: Health EOS Commercial |
$185.12
|
| Rate for Payer: HFN Commercial |
$191.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.77
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.77
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.77
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: NAPHCARE Commercial |
$10.16
|
| Rate for Payer: Preferred Network Access Commercial |
$191.36
|
| Rate for Payer: Quartz Beloit One Network |
$101.92
|
| Rate for Payer: Quartz Commercial |
$135.20
|
| Rate for Payer: Quartz Medicare Advantage |
$6.77
|
| Rate for Payer: The Alliance Commercial |
$27.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.77
|
| Rate for Payer: United Healthcare PPO |
$156.00
|
| Rate for Payer: WEA Trust Commercial |
$114.40
|
| Rate for Payer: Wellcare Medicare |
$6.77
|
| Rate for Payer: WPS Commercial |
$154.06
|
|
|
Creatine Kinase only, No Reflex
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
979893
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$112.63 |
| Rate for Payer: Aetna Commercial |
$112.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.96
|
| Rate for Payer: Aetna Managed Medicare |
$6.77
|
| Rate for Payer: Anthem Medicare Advantage |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.77
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$112.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$59.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6.77
|
| Rate for Payer: Health EOS Commercial |
$107.89
|
| Rate for Payer: HFN Commercial |
$112.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$23.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.77
|
| Rate for Payer: Multiplan Commercial |
$94.85
|
| Rate for Payer: NAPHCARE Commercial |
$10.16
|
| Rate for Payer: Preferred Network Access Commercial |
$112.63
|
| Rate for Payer: Quartz Beloit One Network |
$52.17
|
| Rate for Payer: Quartz Commercial |
$67.58
|
| Rate for Payer: Quartz Medicare Advantage |
$6.77
|
| Rate for Payer: The Alliance Commercial |
$26.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.77
|
| Rate for Payer: WEA Trust Commercial |
$65.21
|
| Rate for Payer: WPS Commercial |
$29.79
|
|
|
Creatine Kinase only, No Reflex
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
979893
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$109.08 |
| Rate for Payer: Quartz Commercial |
$77.06
|
| Rate for Payer: Aetna Commercial |
$106.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.96
|
| Rate for Payer: Aetna Managed Medicare |
$6.77
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$25.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11.85
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$11.24
|
| Rate for Payer: Anthem Medicare Advantage |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$62.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.77
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$109.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$66.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.77
|
| Rate for Payer: Health EOS Commercial |
$105.52
|
| Rate for Payer: HFN Commercial |
$109.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.77
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.77
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.77
|
| Rate for Payer: Multiplan Commercial |
$94.85
|
| Rate for Payer: NAPHCARE Commercial |
$10.16
|
| Rate for Payer: Preferred Network Access Commercial |
$109.08
|
| Rate for Payer: Quartz Beloit One Network |
$58.09
|
| Rate for Payer: Quartz Medicare Advantage |
$6.77
|
| Rate for Payer: The Alliance Commercial |
$27.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.77
|
| Rate for Payer: United Healthcare PPO |
$88.92
|
| Rate for Payer: WEA Trust Commercial |
$65.21
|
| Rate for Payer: Wellcare Medicare |
$6.77
|
| Rate for Payer: WPS Commercial |
$87.81
|
|
|
Creatine Kinase only, No Reflex
|
Facility
|
IP
|
$114.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
979893
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.09 |
| Max. Negotiated Rate |
$109.08 |
| Rate for Payer: Aetna Commercial |
$106.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$101.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$62.84
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$109.08
|
| Rate for Payer: Health EOS Commercial |
$105.52
|
| Rate for Payer: HFN Commercial |
$109.08
|
| Rate for Payer: Multiplan Commercial |
$94.85
|
| Rate for Payer: Preferred Network Access Commercial |
$109.08
|
| Rate for Payer: Quartz Beloit One Network |
$58.09
|
| Rate for Payer: Quartz Commercial |
$71.14
|
| Rate for Payer: WEA Trust Commercial |
$65.21
|
| Rate for Payer: WPS Commercial |
$87.81
|
|
|
Creatinine
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
633606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$92.87 |
| Rate for Payer: Aetna Commercial |
$92.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$84.07
|
| Rate for Payer: Aetna Managed Medicare |
$5.32
|
| Rate for Payer: Anthem Medicare Advantage |
$5.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.32
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cigna Commercial |
$92.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$48.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.32
|
| Rate for Payer: Health EOS Commercial |
$88.96
|
| Rate for Payer: HFN Commercial |
$92.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.32
|
| Rate for Payer: Multiplan Commercial |
$78.21
|
| Rate for Payer: NAPHCARE Commercial |
$7.99
|
| Rate for Payer: Preferred Network Access Commercial |
$92.87
|
| Rate for Payer: Quartz Beloit One Network |
$43.01
|
| Rate for Payer: Quartz Commercial |
$55.72
|
| Rate for Payer: Quartz Medicare Advantage |
$5.32
|
| Rate for Payer: The Alliance Commercial |
$21.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.32
|
| Rate for Payer: WEA Trust Commercial |
$53.77
|
| Rate for Payer: WPS Commercial |
$23.43
|
|
|
Creatinine
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
633606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$47.90 |
| Max. Negotiated Rate |
$89.94 |
| Rate for Payer: Aetna Commercial |
$87.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$84.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$51.81
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cigna Commercial |
$89.94
|
| Rate for Payer: Health EOS Commercial |
$87.01
|
| Rate for Payer: HFN Commercial |
$89.94
|
| Rate for Payer: Multiplan Commercial |
$78.21
|
| Rate for Payer: Preferred Network Access Commercial |
$89.94
|
| Rate for Payer: Quartz Beloit One Network |
$47.90
|
| Rate for Payer: Quartz Commercial |
$58.66
|
| Rate for Payer: WEA Trust Commercial |
$53.77
|
| Rate for Payer: WPS Commercial |
$72.41
|
|
|
Creatinine
|
Facility
|
OP
|
$94.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
633606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$89.94 |
| Rate for Payer: Aetna Commercial |
$87.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$84.07
|
| Rate for Payer: Aetna Managed Medicare |
$5.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.84
|
| Rate for Payer: Anthem Medicare Advantage |
$5.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$51.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.32
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cigna Commercial |
$89.94
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$54.71
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.32
|
| Rate for Payer: Health EOS Commercial |
$87.01
|
| Rate for Payer: HFN Commercial |
$89.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.32
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.32
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.32
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.32
|
| Rate for Payer: Multiplan Commercial |
$78.21
|
| Rate for Payer: NAPHCARE Commercial |
$7.99
|
| Rate for Payer: Preferred Network Access Commercial |
$89.94
|
| Rate for Payer: Quartz Beloit One Network |
$47.90
|
| Rate for Payer: Quartz Commercial |
$63.54
|
| Rate for Payer: Quartz Medicare Advantage |
$5.32
|
| Rate for Payer: The Alliance Commercial |
$21.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.32
|
| Rate for Payer: United Healthcare PPO |
$73.32
|
| Rate for Payer: WEA Trust Commercial |
$53.77
|
| Rate for Payer: Wellcare Medicare |
$5.32
|
| Rate for Payer: WPS Commercial |
$72.41
|
|
|
Creatinine 24 Hour Urine
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2943023
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$55.33 |
| Rate for Payer: Aetna Commercial |
$55.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Aetna Managed Medicare |
$5.39
|
| Rate for Payer: Anthem Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.39
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$55.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$29.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.39
|
| Rate for Payer: Health EOS Commercial |
$53.00
|
| Rate for Payer: HFN Commercial |
$55.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$55.33
|
| Rate for Payer: Quartz Beloit One Network |
$25.63
|
| Rate for Payer: Quartz Commercial |
$33.20
|
| Rate for Payer: Quartz Medicare Advantage |
$5.39
|
| Rate for Payer: The Alliance Commercial |
$21.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: WPS Commercial |
$23.70
|
|
|
Creatinine 24 Hour Urine
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2943023
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$53.58 |
| Rate for Payer: Aetna Commercial |
$52.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Aetna Managed Medicare |
$5.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.94
|
| Rate for Payer: Anthem Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$30.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.39
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$53.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.39
|
| Rate for Payer: Health EOS Commercial |
$51.83
|
| Rate for Payer: HFN Commercial |
$53.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$53.58
|
| Rate for Payer: Quartz Beloit One Network |
$28.54
|
| Rate for Payer: Quartz Commercial |
$37.86
|
| Rate for Payer: Quartz Medicare Advantage |
$5.39
|
| Rate for Payer: The Alliance Commercial |
$21.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: United Healthcare PPO |
$43.68
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: Wellcare Medicare |
$5.39
|
| Rate for Payer: WPS Commercial |
$43.14
|
|
|
Creatinine 24 Hour Urine
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2943023
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$53.58 |
| Rate for Payer: Aetna Commercial |
$52.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$50.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$30.87
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$53.58
|
| Rate for Payer: Health EOS Commercial |
$51.83
|
| Rate for Payer: HFN Commercial |
$53.58
|
| Rate for Payer: Multiplan Commercial |
$46.59
|
| Rate for Payer: Preferred Network Access Commercial |
$53.58
|
| Rate for Payer: Quartz Beloit One Network |
$28.54
|
| Rate for Payer: Quartz Commercial |
$34.94
|
| Rate for Payer: WEA Trust Commercial |
$32.03
|
| Rate for Payer: WPS Commercial |
$43.14
|
|
|
Creatinine BF to Mayo
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
4552627
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.75 |
| Max. Negotiated Rate |
$74.63 |
| Rate for Payer: Aetna Commercial |
$73.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$69.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$42.99
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$74.63
|
| Rate for Payer: Health EOS Commercial |
$72.20
|
| Rate for Payer: HFN Commercial |
$74.63
|
| Rate for Payer: Multiplan Commercial |
$64.90
|
| Rate for Payer: Preferred Network Access Commercial |
$74.63
|
| Rate for Payer: Quartz Beloit One Network |
$39.75
|
| Rate for Payer: Quartz Commercial |
$48.67
|
| Rate for Payer: WEA Trust Commercial |
$44.62
|
| Rate for Payer: WPS Commercial |
$60.08
|
|
|
Creatinine BF to Mayo
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
4552627
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$77.06 |
| Rate for Payer: Aetna Commercial |
$77.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$69.76
|
| Rate for Payer: Aetna Managed Medicare |
$5.39
|
| Rate for Payer: Anthem Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.39
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$77.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$40.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.39
|
| Rate for Payer: Health EOS Commercial |
$73.82
|
| Rate for Payer: HFN Commercial |
$77.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$64.90
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$77.06
|
| Rate for Payer: Quartz Beloit One Network |
$35.69
|
| Rate for Payer: Quartz Commercial |
$46.24
|
| Rate for Payer: Quartz Medicare Advantage |
$5.39
|
| Rate for Payer: The Alliance Commercial |
$21.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: WEA Trust Commercial |
$44.62
|
| Rate for Payer: WPS Commercial |
$23.70
|
|
|
Creatinine BF to Mayo
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
4552627
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$74.63 |
| Rate for Payer: Aetna Commercial |
$73.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$69.76
|
| Rate for Payer: Aetna Managed Medicare |
$5.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.94
|
| Rate for Payer: Anthem Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$42.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.39
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$74.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$45.40
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.39
|
| Rate for Payer: Health EOS Commercial |
$72.20
|
| Rate for Payer: HFN Commercial |
$74.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.04
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$64.90
|
| Rate for Payer: NAPHCARE Commercial |
$8.08
|
| Rate for Payer: Preferred Network Access Commercial |
$74.63
|
| Rate for Payer: Quartz Beloit One Network |
$39.75
|
| Rate for Payer: Quartz Commercial |
$52.73
|
| Rate for Payer: Quartz Medicare Advantage |
$5.39
|
| Rate for Payer: The Alliance Commercial |
$21.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: United Healthcare PPO |
$60.84
|
| Rate for Payer: WEA Trust Commercial |
$44.62
|
| Rate for Payer: Wellcare Medicare |
$5.39
|
| Rate for Payer: WPS Commercial |
$60.08
|
|
|
Creatinine Clearance 24 Hour Urine
|
Facility
|
IP
|
$229.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
633609
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$116.70 |
| Max. Negotiated Rate |
$219.11 |
| Rate for Payer: Aetna Commercial |
$214.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$204.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$126.22
|
| Rate for Payer: Cash Price |
$68.70
|
| Rate for Payer: Cigna Commercial |
$219.11
|
| Rate for Payer: Health EOS Commercial |
$211.96
|
| Rate for Payer: HFN Commercial |
$219.11
|
| Rate for Payer: Multiplan Commercial |
$190.53
|
| Rate for Payer: Preferred Network Access Commercial |
$219.11
|
| Rate for Payer: Quartz Beloit One Network |
$116.70
|
| Rate for Payer: Quartz Commercial |
$142.90
|
| Rate for Payer: WEA Trust Commercial |
$130.99
|
| Rate for Payer: WPS Commercial |
$176.40
|
|
|
Creatinine Clearance 24 Hour Urine
|
Facility
|
OP
|
$229.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
633609
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.84 |
| Max. Negotiated Rate |
$219.11 |
| Rate for Payer: Aetna Commercial |
$214.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$204.82
|
| Rate for Payer: Aetna Managed Medicare |
$9.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$36.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16.33
|
| Rate for Payer: Anthem Medicare Advantage |
$9.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.84
|
| Rate for Payer: Cash Price |
$68.70
|
| Rate for Payer: Cash Price |
$68.70
|
| Rate for Payer: Cigna Commercial |
$219.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$133.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9.84
|
| Rate for Payer: Health EOS Commercial |
$211.96
|
| Rate for Payer: HFN Commercial |
$219.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$36.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.84
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9.84
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9.84
|
| Rate for Payer: Multiplan Commercial |
$190.53
|
| Rate for Payer: NAPHCARE Commercial |
$14.76
|
| Rate for Payer: Preferred Network Access Commercial |
$219.11
|
| Rate for Payer: Quartz Beloit One Network |
$116.70
|
| Rate for Payer: Quartz Commercial |
$154.80
|
| Rate for Payer: Quartz Medicare Advantage |
$9.84
|
| Rate for Payer: The Alliance Commercial |
$39.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.84
|
| Rate for Payer: United Healthcare PPO |
$178.62
|
| Rate for Payer: WEA Trust Commercial |
$130.99
|
| Rate for Payer: Wellcare Medicare |
$9.84
|
| Rate for Payer: WPS Commercial |
$176.40
|
|
|
Creatinine Clearance 24 Hour Urine
|
Professional
|
Both
|
$229.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
633609
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.84 |
| Max. Negotiated Rate |
$226.25 |
| Rate for Payer: Aetna Commercial |
$226.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$204.82
|
| Rate for Payer: Aetna Managed Medicare |
$9.84
|
| Rate for Payer: Anthem Medicare Advantage |
$9.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.84
|
| Rate for Payer: Cash Price |
$68.70
|
| Rate for Payer: Cash Price |
$68.70
|
| Rate for Payer: Cigna Commercial |
$226.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$119.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.84
|
| Rate for Payer: Health EOS Commercial |
$216.73
|
| Rate for Payer: HFN Commercial |
$226.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$34.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$34.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.84
|
| Rate for Payer: Multiplan Commercial |
$190.53
|
| Rate for Payer: NAPHCARE Commercial |
$14.76
|
| Rate for Payer: Preferred Network Access Commercial |
$226.25
|
| Rate for Payer: Quartz Beloit One Network |
$104.79
|
| Rate for Payer: Quartz Commercial |
$135.75
|
| Rate for Payer: Quartz Medicare Advantage |
$9.84
|
| Rate for Payer: The Alliance Commercial |
$38.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.84
|
| Rate for Payer: WEA Trust Commercial |
$130.99
|
| Rate for Payer: WPS Commercial |
$43.29
|
|
|
Creatinine, PDI Fluid
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
3872092
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.22 |
| Max. Negotiated Rate |
$71.76 |
| Rate for Payer: Aetna Commercial |
$70.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$67.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$41.34
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna Commercial |
$71.76
|
| Rate for Payer: Health EOS Commercial |
$69.42
|
| Rate for Payer: HFN Commercial |
$71.76
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Preferred Network Access Commercial |
$71.76
|
| Rate for Payer: Quartz Beloit One Network |
$38.22
|
| Rate for Payer: Quartz Commercial |
$46.80
|
| Rate for Payer: WEA Trust Commercial |
$42.90
|
| Rate for Payer: WPS Commercial |
$57.77
|
|
