|
CT Soft Tissue Neck w/ Contrast
|
Professional
|
$3,314.00
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
630158
|
| Min. Negotiated Rate |
$185.19 |
| Max. Negotiated Rate |
$3,148.30 |
| Rate for Payer: Aetna Commercial |
$3,148.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,850.04
|
| Rate for Payer: Aetna Managed Medicare |
$185.19
|
| Rate for Payer: Anthem Medicare Advantage |
$185.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$185.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$185.19
|
| Rate for Payer: Cash Price |
$994.20
|
| Rate for Payer: Cash Price |
$994.20
|
| Rate for Payer: Cigna Commercial |
$3,148.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,657.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$185.19
|
| Rate for Payer: Health EOS Commercial |
$3,015.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$683.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$683.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$185.19
|
| Rate for Payer: Multiplan Commercial |
$2,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,148.30
|
| Rate for Payer: Quartz Beloit One Network |
$1,458.16
|
| Rate for Payer: Quartz Commercial |
$1,888.98
|
| Rate for Payer: Quartz Medicare Advantage |
$185.19
|
| Rate for Payer: The Alliance Commercial |
$703.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$185.19
|
| Rate for Payer: WEA Trust Commercial |
$1,822.70
|
| Rate for Payer: WPS Commercial |
$925.95
|
|
|
CT Soft Tissue Neck w/ Contrast
|
Facility
OP
|
$3,389.00
|
|
|
Service Code
|
CPT 70491 TC
|
| Hospital Charge Code |
1241241
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$848.82 |
| Max. Negotiated Rate |
$13,556.00 |
| Rate for Payer: Aetna Commercial |
$3,050.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,914.54
|
| Rate for Payer: Aetna Managed Medicare |
$948.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,796.17
|
| Rate for Payer: Cash Price |
$1,016.70
|
| Rate for Payer: Cash Price |
$1,016.70
|
| Rate for Payer: Cash Price |
$1,016.70
|
| Rate for Payer: Cash Price |
$1,016.70
|
| Rate for Payer: Cigna Commercial |
$3,117.88
|
| Rate for Payer: Health EOS Commercial |
$3,016.21
|
| Rate for Payer: HFN Commercial |
$3,117.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,541.75
|
| Rate for Payer: Multiplan Commercial |
$2,711.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,033.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,117.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,660.61
|
| Rate for Payer: Quartz Commercial |
$2,202.85
|
| Rate for Payer: Quartz Medicare Advantage |
$2,033.40
|
| Rate for Payer: The Alliance Commercial |
$13,556.00
|
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: WEA Trust Commercial |
$1,863.95
|
| Rate for Payer: WPS Commercial |
$848.82
|
|
|
CT Soft Tissue Neck w/ Contrast
|
Facility
OP
|
$3,314.00
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
630158
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$69,039.40 |
| Rate for Payer: Aetna Commercial |
$2,982.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,850.04
|
| Rate for Payer: Aetna Managed Medicare |
$181.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,154.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,657.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,590.72
|
| Rate for Payer: Anthem Medicare Advantage |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,756.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.60
|
| Rate for Payer: Cash Price |
$994.20
|
| Rate for Payer: Cash Price |
$994.20
|
| Rate for Payer: Cigna Commercial |
$3,048.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$181.60
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$181.60
|
| Rate for Payer: Health EOS Commercial |
$2,949.46
|
| Rate for Payer: HFN Commercial |
$3,048.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$675.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$181.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$181.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$181.60
|
| Rate for Payer: Multiplan Commercial |
$2,651.20
|
| Rate for Payer: NAPHCARE Commercial |
$272.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,048.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,623.86
|
| Rate for Payer: Quartz Commercial |
$2,154.10
|
| Rate for Payer: Quartz Medicare Advantage |
$181.60
|
| Rate for Payer: The Alliance Commercial |
$69,039.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.60
|
| Rate for Payer: WEA Trust Commercial |
$1,822.70
|
| Rate for Payer: Wellcare Medicare |
$181.60
|
| Rate for Payer: WPS Commercial |
$2,454.68
|
|
|
CT Soft Tissue Neck w/ Contrast
|
Facility
IP
|
$3,314.00
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
630158
|
| Min. Negotiated Rate |
$1,623.86 |
| Max. Negotiated Rate |
$3,048.88 |
| Rate for Payer: Aetna Commercial |
$2,982.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,756.42
|
| Rate for Payer: Cash Price |
$994.20
|
| Rate for Payer: Cigna Commercial |
$3,048.88
|
| Rate for Payer: Health EOS Commercial |
$2,949.46
|
| Rate for Payer: HFN Commercial |
$3,048.88
|
| Rate for Payer: Multiplan Commercial |
$2,651.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,988.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,048.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,623.86
|
| Rate for Payer: Quartz Commercial |
$1,988.40
|
| Rate for Payer: WEA Trust Commercial |
$1,822.70
|
| Rate for Payer: WPS Commercial |
$2,454.68
|
|
|
CT Soft Tissue Neck w/ Contrast
|
Facility
IP
|
$3,389.00
|
|
|
Service Code
|
CPT 70491 TC
|
| Hospital Charge Code |
1241241
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,660.61 |
| Max. Negotiated Rate |
$3,117.88 |
| Rate for Payer: Aetna Commercial |
$3,050.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,796.17
|
| Rate for Payer: Cash Price |
$1,016.70
|
| Rate for Payer: Cigna Commercial |
$3,117.88
|
| Rate for Payer: Health EOS Commercial |
$3,016.21
|
| Rate for Payer: HFN Commercial |
$3,117.88
|
| Rate for Payer: Multiplan Commercial |
$2,711.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,033.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,117.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,660.61
|
| Rate for Payer: Quartz Commercial |
$2,033.40
|
| Rate for Payer: WEA Trust Commercial |
$1,863.95
|
| Rate for Payer: WPS Commercial |
$2,510.23
|
|
|
CT Soft Tissue Neck w/ Contrast
|
Professional
|
$3,389.00
|
|
|
Service Code
|
CPT 70491 TC
|
| Hospital Charge Code |
1241241
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$121.26 |
| Max. Negotiated Rate |
$3,219.55 |
| Rate for Payer: Aetna Commercial |
$3,219.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,914.54
|
| Rate for Payer: Aetna Managed Medicare |
$121.26
|
| Rate for Payer: Anthem Medicare Advantage |
$121.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$121.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$121.26
|
| Rate for Payer: Cash Price |
$1,016.70
|
| Rate for Payer: Cash Price |
$1,016.70
|
| Rate for Payer: Cigna Commercial |
$3,219.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,694.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$121.26
|
| Rate for Payer: Health EOS Commercial |
$3,083.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$454.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$454.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$121.26
|
| Rate for Payer: Multiplan Commercial |
$2,711.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,219.55
|
| Rate for Payer: Quartz Beloit One Network |
$1,491.16
|
| Rate for Payer: Quartz Commercial |
$1,931.73
|
| Rate for Payer: Quartz Medicare Advantage |
$121.26
|
| Rate for Payer: The Alliance Commercial |
$460.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$121.26
|
| Rate for Payer: WEA Trust Commercial |
$1,863.95
|
| Rate for Payer: WPS Commercial |
$606.30
|
|
|
CT Soft Tissue Neck w/o Contrast
|
Facility
IP
|
$2,696.00
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
630160
|
| Min. Negotiated Rate |
$1,321.04 |
| Max. Negotiated Rate |
$2,480.32 |
| Rate for Payer: Aetna Commercial |
$2,426.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,428.88
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cigna Commercial |
$2,480.32
|
| Rate for Payer: Health EOS Commercial |
$2,399.44
|
| Rate for Payer: HFN Commercial |
$2,480.32
|
| Rate for Payer: Multiplan Commercial |
$2,156.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,617.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,480.32
|
| Rate for Payer: Quartz Beloit One Network |
$1,321.04
|
| Rate for Payer: Quartz Commercial |
$1,617.60
|
| Rate for Payer: WEA Trust Commercial |
$1,482.80
|
| Rate for Payer: WPS Commercial |
$1,996.93
|
|
|
CT Soft Tissue Neck w/o Contrast
|
Facility
OP
|
$2,696.00
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
630160
|
| Min. Negotiated Rate |
$108.67 |
| Max. Negotiated Rate |
$16,626.28 |
| Rate for Payer: Aetna Commercial |
$2,426.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,318.56
|
| Rate for Payer: Aetna Managed Medicare |
$108.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,752.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,348.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,294.08
|
| Rate for Payer: Anthem Medicare Advantage |
$108.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,428.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$108.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$108.67
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cigna Commercial |
$2,480.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$108.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$108.67
|
| Rate for Payer: Health EOS Commercial |
$2,399.44
|
| Rate for Payer: HFN Commercial |
$2,480.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$404.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$108.67
|
| Rate for Payer: Independent Care Health Plan Medicare |
$108.67
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$108.67
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$108.67
|
| Rate for Payer: Multiplan Commercial |
$2,156.80
|
| Rate for Payer: NAPHCARE Commercial |
$163.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,480.32
|
| Rate for Payer: Quartz Beloit One Network |
$1,321.04
|
| Rate for Payer: Quartz Commercial |
$1,752.40
|
| Rate for Payer: Quartz Medicare Advantage |
$108.67
|
| Rate for Payer: The Alliance Commercial |
$16,626.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$108.67
|
| Rate for Payer: WEA Trust Commercial |
$1,482.80
|
| Rate for Payer: Wellcare Medicare |
$108.67
|
| Rate for Payer: WPS Commercial |
$1,996.93
|
|
|
CT Soft Tissue Neck w/o Contrast
|
Facility
IP
|
$2,945.00
|
|
|
Service Code
|
CPT 70490 TC
|
| Hospital Charge Code |
1241243
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,443.05 |
| Max. Negotiated Rate |
$2,709.40 |
| Rate for Payer: Aetna Commercial |
$2,650.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,560.85
|
| Rate for Payer: Cash Price |
$883.50
|
| Rate for Payer: Cigna Commercial |
$2,709.40
|
| Rate for Payer: Health EOS Commercial |
$2,621.05
|
| Rate for Payer: HFN Commercial |
$2,709.40
|
| Rate for Payer: Multiplan Commercial |
$2,356.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,767.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,709.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,443.05
|
| Rate for Payer: Quartz Commercial |
$1,767.00
|
| Rate for Payer: WEA Trust Commercial |
$1,619.75
|
| Rate for Payer: WPS Commercial |
$2,181.36
|
|
|
CT Soft Tissue Neck w/o Contrast
|
Professional
|
$2,696.00
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
630160
|
| Min. Negotiated Rate |
$150.46 |
| Max. Negotiated Rate |
$2,561.20 |
| Rate for Payer: Aetna Commercial |
$2,561.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,318.56
|
| Rate for Payer: Aetna Managed Medicare |
$150.46
|
| Rate for Payer: Anthem Medicare Advantage |
$150.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$150.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$150.46
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cigna Commercial |
$2,561.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,348.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$150.46
|
| Rate for Payer: Health EOS Commercial |
$2,453.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$552.02
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$552.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$150.46
|
| Rate for Payer: Multiplan Commercial |
$2,156.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,561.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,186.24
|
| Rate for Payer: Quartz Commercial |
$1,536.72
|
| Rate for Payer: Quartz Medicare Advantage |
$150.46
|
| Rate for Payer: The Alliance Commercial |
$571.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$150.46
|
| Rate for Payer: WEA Trust Commercial |
$1,482.80
|
| Rate for Payer: WPS Commercial |
$752.30
|
|
|
CT Soft Tissue Neck w/o Contrast
|
Facility
OP
|
$2,945.00
|
|
|
Service Code
|
CPT 70490 TC
|
| Hospital Charge Code |
1241243
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$638.47 |
| Max. Negotiated Rate |
$11,780.00 |
| Rate for Payer: Aetna Commercial |
$2,650.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,532.70
|
| Rate for Payer: Aetna Managed Medicare |
$824.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,560.85
|
| Rate for Payer: Cash Price |
$883.50
|
| Rate for Payer: Cash Price |
$883.50
|
| Rate for Payer: Cash Price |
$883.50
|
| Rate for Payer: Cash Price |
$883.50
|
| Rate for Payer: Cigna Commercial |
$2,709.40
|
| Rate for Payer: Health EOS Commercial |
$2,621.05
|
| Rate for Payer: HFN Commercial |
$2,709.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,208.75
|
| Rate for Payer: Multiplan Commercial |
$2,356.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,767.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,709.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,443.05
|
| Rate for Payer: Quartz Commercial |
$1,914.25
|
| Rate for Payer: Quartz Medicare Advantage |
$1,767.00
|
| Rate for Payer: The Alliance Commercial |
$11,780.00
|
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: WEA Trust Commercial |
$1,619.75
|
| Rate for Payer: WPS Commercial |
$638.47
|
|
|
CT Soft Tissue Neck w/o Contrast
|
Professional
|
$2,945.00
|
|
|
Service Code
|
CPT 70490 TC
|
| Hospital Charge Code |
1241243
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$91.21 |
| Max. Negotiated Rate |
$2,797.75 |
| Rate for Payer: Aetna Commercial |
$2,797.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,532.70
|
| Rate for Payer: Aetna Managed Medicare |
$91.21
|
| Rate for Payer: Anthem Medicare Advantage |
$91.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$91.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$91.21
|
| Rate for Payer: Cash Price |
$883.50
|
| Rate for Payer: Cash Price |
$883.50
|
| Rate for Payer: Cigna Commercial |
$2,797.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,472.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$91.21
|
| Rate for Payer: Health EOS Commercial |
$2,679.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$339.16
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$339.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$91.21
|
| Rate for Payer: Multiplan Commercial |
$2,356.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,797.75
|
| Rate for Payer: Quartz Beloit One Network |
$1,295.80
|
| Rate for Payer: Quartz Commercial |
$1,678.65
|
| Rate for Payer: Quartz Medicare Advantage |
$91.21
|
| Rate for Payer: The Alliance Commercial |
$346.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91.21
|
| Rate for Payer: WEA Trust Commercial |
$1,619.75
|
| Rate for Payer: WPS Commercial |
$456.05
|
|
|
CT Soft Tissue Neck w/ + w/o Contrast
|
Facility
IP
|
$3,510.00
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
630154
|
| Min. Negotiated Rate |
$1,719.90 |
| Max. Negotiated Rate |
$3,229.20 |
| Rate for Payer: Aetna Commercial |
$3,159.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,860.30
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Cigna Commercial |
$3,229.20
|
| Rate for Payer: Health EOS Commercial |
$3,123.90
|
| Rate for Payer: HFN Commercial |
$3,229.20
|
| Rate for Payer: Multiplan Commercial |
$2,808.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,106.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,229.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,719.90
|
| Rate for Payer: Quartz Commercial |
$2,106.00
|
| Rate for Payer: WEA Trust Commercial |
$1,930.50
|
| Rate for Payer: WPS Commercial |
$2,599.86
|
|
|
CT Soft Tissue Neck w/ + w/o Contrast
|
Facility
IP
|
$4,064.00
|
|
|
Service Code
|
CPT 70492 TC
|
| Hospital Charge Code |
1241239
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,991.36 |
| Max. Negotiated Rate |
$3,738.88 |
| Rate for Payer: Aetna Commercial |
$3,657.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,153.92
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cigna Commercial |
$3,738.88
|
| Rate for Payer: Health EOS Commercial |
$3,616.96
|
| Rate for Payer: HFN Commercial |
$3,738.88
|
| Rate for Payer: Multiplan Commercial |
$3,251.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,438.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,738.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,991.36
|
| Rate for Payer: Quartz Commercial |
$2,438.40
|
| Rate for Payer: WEA Trust Commercial |
$2,235.20
|
| Rate for Payer: WPS Commercial |
$3,010.20
|
|
|
CT Soft Tissue Neck w/ + w/o Contrast
|
Professional
|
$3,510.00
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
630154
|
| Min. Negotiated Rate |
$222.72 |
| Max. Negotiated Rate |
$3,334.50 |
| Rate for Payer: Aetna Commercial |
$3,334.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,018.60
|
| Rate for Payer: Aetna Managed Medicare |
$222.72
|
| Rate for Payer: Anthem Medicare Advantage |
$222.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$222.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$222.72
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Cigna Commercial |
$3,334.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,755.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$222.72
|
| Rate for Payer: Health EOS Commercial |
$3,194.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$826.27
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$826.27
|
| Rate for Payer: Independent Care Health Plan Medicare |
$222.72
|
| Rate for Payer: Multiplan Commercial |
$2,808.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,334.50
|
| Rate for Payer: Quartz Beloit One Network |
$1,544.40
|
| Rate for Payer: Quartz Commercial |
$2,000.70
|
| Rate for Payer: Quartz Medicare Advantage |
$222.72
|
| Rate for Payer: The Alliance Commercial |
$846.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$222.72
|
| Rate for Payer: WEA Trust Commercial |
$1,930.50
|
| Rate for Payer: WPS Commercial |
$1,113.60
|
|
|
CT Soft Tissue Neck w/ + w/o Contrast
|
Facility
OP
|
$4,064.00
|
|
|
Service Code
|
CPT 70492 TC
|
| Hospital Charge Code |
1241239
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,038.10 |
| Max. Negotiated Rate |
$16,256.00 |
| Rate for Payer: Aetna Commercial |
$3,657.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,495.04
|
| Rate for Payer: Aetna Managed Medicare |
$1,137.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,153.92
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cigna Commercial |
$3,738.88
|
| Rate for Payer: Health EOS Commercial |
$3,616.96
|
| Rate for Payer: HFN Commercial |
$3,738.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,048.00
|
| Rate for Payer: Multiplan Commercial |
$3,251.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,438.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,738.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,991.36
|
| Rate for Payer: Quartz Commercial |
$2,641.60
|
| Rate for Payer: Quartz Medicare Advantage |
$2,438.40
|
| Rate for Payer: The Alliance Commercial |
$16,256.00
|
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: WEA Trust Commercial |
$2,235.20
|
| Rate for Payer: WPS Commercial |
$1,038.10
|
|
|
CT Soft Tissue Neck w/ + w/o Contrast
|
Professional
|
$4,064.00
|
|
|
Service Code
|
CPT 70492 TC
|
| Hospital Charge Code |
1241239
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$148.30 |
| Max. Negotiated Rate |
$3,860.80 |
| Rate for Payer: Aetna Commercial |
$3,860.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,495.04
|
| Rate for Payer: Aetna Managed Medicare |
$148.30
|
| Rate for Payer: Anthem Medicare Advantage |
$148.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$148.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$148.30
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cigna Commercial |
$3,860.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,032.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$148.30
|
| Rate for Payer: Health EOS Commercial |
$3,698.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$556.15
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$556.15
|
| Rate for Payer: Independent Care Health Plan Medicare |
$148.30
|
| Rate for Payer: Multiplan Commercial |
$3,251.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,860.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,788.16
|
| Rate for Payer: Quartz Commercial |
$2,316.48
|
| Rate for Payer: Quartz Medicare Advantage |
$148.30
|
| Rate for Payer: The Alliance Commercial |
$563.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$148.30
|
| Rate for Payer: WEA Trust Commercial |
$2,235.20
|
| Rate for Payer: WPS Commercial |
$741.50
|
|
|
CT Soft Tissue Neck w/ + w/o Contrast
|
Facility
OP
|
$3,510.00
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
630154
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$3,229.20 |
| Rate for Payer: Aetna Commercial |
$3,159.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,018.60
|
| Rate for Payer: Aetna Managed Medicare |
$181.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,281.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,755.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,684.80
|
| Rate for Payer: Anthem Medicare Advantage |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,860.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$181.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$181.60
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Cigna Commercial |
$3,229.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$181.60
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$181.60
|
| Rate for Payer: Health EOS Commercial |
$3,123.90
|
| Rate for Payer: HFN Commercial |
$3,229.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$675.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$181.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$181.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$181.60
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$181.60
|
| Rate for Payer: Multiplan Commercial |
$2,808.00
|
| Rate for Payer: NAPHCARE Commercial |
$272.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,229.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,719.90
|
| Rate for Payer: Quartz Commercial |
$2,281.50
|
| Rate for Payer: Quartz Medicare Advantage |
$181.60
|
| Rate for Payer: The Alliance Commercial |
$647.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$181.60
|
| Rate for Payer: WEA Trust Commercial |
$1,930.50
|
| Rate for Payer: Wellcare Medicare |
$181.60
|
| Rate for Payer: WPS Commercial |
$2,599.86
|
|
|
CT Spine Cervical w/ Contrast
|
Facility
IP
|
$4,364.00
|
|
|
Service Code
|
CPT 72126 TC
|
| Hospital Charge Code |
1241253
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$2,138.36 |
| Max. Negotiated Rate |
$4,014.88 |
| Rate for Payer: Aetna Commercial |
$3,927.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,312.92
|
| Rate for Payer: Cash Price |
$1,309.20
|
| Rate for Payer: Cigna Commercial |
$4,014.88
|
| Rate for Payer: Health EOS Commercial |
$3,883.96
|
| Rate for Payer: HFN Commercial |
$4,014.88
|
| Rate for Payer: Multiplan Commercial |
$3,491.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,618.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,014.88
|
| Rate for Payer: Quartz Beloit One Network |
$2,138.36
|
| Rate for Payer: Quartz Commercial |
$2,618.40
|
| Rate for Payer: WEA Trust Commercial |
$2,400.20
|
| Rate for Payer: WPS Commercial |
$3,232.41
|
|
|
CT Spine Cervical w/ Contrast
|
Facility
OP
|
$4,283.00
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
629608
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$3,940.36 |
| Rate for Payer: Aetna Commercial |
$3,854.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,683.38
|
| Rate for Payer: Aetna Managed Medicare |
$380.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,783.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,141.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,055.84
|
| Rate for Payer: Anthem Medicare Advantage |
$380.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,269.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$380.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$380.12
|
| Rate for Payer: Cash Price |
$1,284.90
|
| Rate for Payer: Cash Price |
$1,284.90
|
| Rate for Payer: Cigna Commercial |
$3,940.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$380.12
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$380.12
|
| Rate for Payer: Health EOS Commercial |
$3,811.87
|
| Rate for Payer: HFN Commercial |
$3,940.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,414.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$380.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$380.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$380.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$380.12
|
| Rate for Payer: Multiplan Commercial |
$3,426.40
|
| Rate for Payer: NAPHCARE Commercial |
$570.18
|
| Rate for Payer: Preferred Network Access Commercial |
$3,940.36
|
| Rate for Payer: Quartz Beloit One Network |
$2,098.67
|
| Rate for Payer: Quartz Commercial |
$2,783.95
|
| Rate for Payer: Quartz Medicare Advantage |
$380.12
|
| Rate for Payer: The Alliance Commercial |
$6.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$380.12
|
| Rate for Payer: WEA Trust Commercial |
$2,355.65
|
| Rate for Payer: Wellcare Medicare |
$380.12
|
| Rate for Payer: WPS Commercial |
$3,172.42
|
|
|
CT Spine Cervical w/ Contrast
|
Professional
|
$4,283.00
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
629608
|
| Min. Negotiated Rate |
$169.03 |
| Max. Negotiated Rate |
$4,068.85 |
| Rate for Payer: Aetna Commercial |
$4,068.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,683.38
|
| Rate for Payer: Aetna Managed Medicare |
$169.03
|
| Rate for Payer: Anthem Medicare Advantage |
$169.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$169.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$169.03
|
| Rate for Payer: Cash Price |
$1,284.90
|
| Rate for Payer: Cash Price |
$1,284.90
|
| Rate for Payer: Cigna Commercial |
$4,068.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,141.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$169.03
|
| Rate for Payer: Health EOS Commercial |
$3,897.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$623.54
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$623.54
|
| Rate for Payer: Independent Care Health Plan Medicare |
$169.03
|
| Rate for Payer: Multiplan Commercial |
$3,426.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,068.85
|
| Rate for Payer: Quartz Beloit One Network |
$1,884.52
|
| Rate for Payer: Quartz Commercial |
$2,441.31
|
| Rate for Payer: Quartz Medicare Advantage |
$169.03
|
| Rate for Payer: The Alliance Commercial |
$642.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$169.03
|
| Rate for Payer: WEA Trust Commercial |
$2,355.65
|
| Rate for Payer: WPS Commercial |
$845.15
|
|
|
CT Spine Cervical w/ Contrast
|
Facility
OP
|
$4,364.00
|
|
|
Service Code
|
CPT 72126 TC
|
| Hospital Charge Code |
1241253
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$790.23 |
| Max. Negotiated Rate |
$17,456.00 |
| Rate for Payer: Aetna Commercial |
$3,927.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,753.04
|
| Rate for Payer: Aetna Managed Medicare |
$1,221.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,205.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,454.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,312.92
|
| Rate for Payer: Cash Price |
$1,309.20
|
| Rate for Payer: Cash Price |
$1,309.20
|
| Rate for Payer: Cash Price |
$1,309.20
|
| Rate for Payer: Cash Price |
$1,309.20
|
| Rate for Payer: Cigna Commercial |
$4,014.88
|
| Rate for Payer: Health EOS Commercial |
$3,883.96
|
| Rate for Payer: HFN Commercial |
$4,014.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,273.00
|
| Rate for Payer: Multiplan Commercial |
$3,491.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,618.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,014.88
|
| Rate for Payer: Quartz Beloit One Network |
$2,138.36
|
| Rate for Payer: Quartz Commercial |
$2,836.60
|
| Rate for Payer: Quartz Medicare Advantage |
$2,618.40
|
| Rate for Payer: The Alliance Commercial |
$17,456.00
|
| Rate for Payer: United Healthcare PPO |
$2,065.00
|
| Rate for Payer: WEA Trust Commercial |
$2,400.20
|
| Rate for Payer: WPS Commercial |
$790.23
|
|
|
CT Spine Cervical w/ Contrast
|
Facility
IP
|
$4,283.00
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
629608
|
| Min. Negotiated Rate |
$2,098.67 |
| Max. Negotiated Rate |
$3,940.36 |
| Rate for Payer: Aetna Commercial |
$3,854.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,269.99
|
| Rate for Payer: Cash Price |
$1,284.90
|
| Rate for Payer: Cigna Commercial |
$3,940.36
|
| Rate for Payer: Health EOS Commercial |
$3,811.87
|
| Rate for Payer: HFN Commercial |
$3,940.36
|
| Rate for Payer: Multiplan Commercial |
$3,426.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,569.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,940.36
|
| Rate for Payer: Quartz Beloit One Network |
$2,098.67
|
| Rate for Payer: Quartz Commercial |
$2,569.80
|
| Rate for Payer: WEA Trust Commercial |
$2,355.65
|
| Rate for Payer: WPS Commercial |
$3,172.42
|
|
|
CT Spine Cervical w/ Contrast
|
Professional
|
$4,364.00
|
|
|
Service Code
|
CPT 72126 TC
|
| Hospital Charge Code |
1241253
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$112.89 |
| Max. Negotiated Rate |
$4,145.80 |
| Rate for Payer: Aetna Commercial |
$4,145.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,753.04
|
| Rate for Payer: Aetna Managed Medicare |
$112.89
|
| Rate for Payer: Anthem Medicare Advantage |
$112.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$112.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$112.89
|
| Rate for Payer: Cash Price |
$1,309.20
|
| Rate for Payer: Cash Price |
$1,309.20
|
| Rate for Payer: Cigna Commercial |
$4,145.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,182.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$112.89
|
| Rate for Payer: Health EOS Commercial |
$3,971.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$420.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$420.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$112.89
|
| Rate for Payer: Multiplan Commercial |
$3,491.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,145.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,920.16
|
| Rate for Payer: Quartz Commercial |
$2,487.48
|
| Rate for Payer: Quartz Medicare Advantage |
$112.89
|
| Rate for Payer: The Alliance Commercial |
$428.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$112.89
|
| Rate for Payer: WEA Trust Commercial |
$2,400.20
|
| Rate for Payer: WPS Commercial |
$564.45
|
|
|
CT Spine Cervical w/o Contrast
|
Facility
IP
|
$3,338.00
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
629610
|
| Min. Negotiated Rate |
$1,635.62 |
| Max. Negotiated Rate |
$3,070.96 |
| Rate for Payer: Aetna Commercial |
$3,004.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,769.14
|
| Rate for Payer: Cash Price |
$1,001.40
|
| Rate for Payer: Cigna Commercial |
$3,070.96
|
| Rate for Payer: Health EOS Commercial |
$2,970.82
|
| Rate for Payer: HFN Commercial |
$3,070.96
|
| Rate for Payer: Multiplan Commercial |
$2,670.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,002.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,070.96
|
| Rate for Payer: Quartz Beloit One Network |
$1,635.62
|
| Rate for Payer: Quartz Commercial |
$2,002.80
|
| Rate for Payer: WEA Trust Commercial |
$1,835.90
|
| Rate for Payer: WPS Commercial |
$2,472.46
|
|
