|
CT TMJ w/ Contrast Right
|
Professional
|
Both
|
$3,089.00
|
|
|
Service Code
|
CPT 70487 RT,TC
|
| Hospital Charge Code |
1241323
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$583.87 |
| Max. Negotiated Rate |
$3,051.93 |
| Rate for Payer: Aetna Commercial |
$3,051.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,762.80
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cigna Commercial |
$3,051.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,606.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,927.54
|
| Rate for Payer: Health EOS Commercial |
$2,923.43
|
| Rate for Payer: HFN Commercial |
$3,051.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$583.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$583.87
|
| Rate for Payer: Multiplan Commercial |
$2,570.05
|
| Rate for Payer: Preferred Network Access Commercial |
$3,051.93
|
| Rate for Payer: Quartz Beloit One Network |
$1,413.53
|
| Rate for Payer: Quartz Commercial |
$1,831.16
|
| Rate for Payer: The Alliance Commercial |
$1,606.28
|
| Rate for Payer: WEA Trust Commercial |
$1,766.91
|
| Rate for Payer: WPS Commercial |
$2,379.46
|
|
|
CT TMJ w/ Contrast Right
|
Facility
|
IP
|
$3,089.00
|
|
|
Service Code
|
CPT 70487 TC,RT
|
| Hospital Charge Code |
2979988
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,574.15 |
| Max. Negotiated Rate |
$2,955.56 |
| Rate for Payer: Aetna Commercial |
$2,891.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,762.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,702.66
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cigna Commercial |
$2,955.56
|
| Rate for Payer: Health EOS Commercial |
$2,859.18
|
| Rate for Payer: HFN Commercial |
$2,955.56
|
| Rate for Payer: Multiplan Commercial |
$2,570.05
|
| Rate for Payer: Preferred Network Access Commercial |
$2,955.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,574.15
|
| Rate for Payer: Quartz Commercial |
$1,927.54
|
| Rate for Payer: WEA Trust Commercial |
$1,766.91
|
| Rate for Payer: WPS Commercial |
$2,379.46
|
|
|
CT TMJ w/ Contrast Right
|
Facility
|
IP
|
$3,148.00
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
711757
|
| Min. Negotiated Rate |
$1,604.22 |
| Max. Negotiated Rate |
$3,012.01 |
| Rate for Payer: Aetna Commercial |
$2,946.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,815.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,735.18
|
| Rate for Payer: Cash Price |
$944.40
|
| Rate for Payer: Cigna Commercial |
$3,012.01
|
| Rate for Payer: Health EOS Commercial |
$2,913.79
|
| Rate for Payer: HFN Commercial |
$3,012.01
|
| Rate for Payer: Multiplan Commercial |
$2,619.14
|
| Rate for Payer: Preferred Network Access Commercial |
$3,012.01
|
| Rate for Payer: Quartz Beloit One Network |
$1,604.22
|
| Rate for Payer: Quartz Commercial |
$1,964.35
|
| Rate for Payer: WEA Trust Commercial |
$1,800.66
|
| Rate for Payer: WPS Commercial |
$2,424.90
|
|
|
CT TMJ w/ Contrast Right
|
Facility
|
OP
|
$3,089.00
|
|
|
Service Code
|
CPT 70487 RT,TC
|
| Hospital Charge Code |
1241323
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$3,333.20 |
| Rate for Payer: Aetna Commercial |
$2,891.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,762.80
|
| Rate for Payer: Aetna Managed Medicare |
$899.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,333.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,689.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,552.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,702.66
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cigna Commercial |
$2,955.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,797.80
|
| Rate for Payer: Health EOS Commercial |
$2,859.18
|
| Rate for Payer: HFN Commercial |
$2,955.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,409.42
|
| Rate for Payer: Multiplan Commercial |
$2,570.05
|
| Rate for Payer: NAPHCARE Commercial |
$1,927.54
|
| Rate for Payer: Preferred Network Access Commercial |
$2,955.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,574.15
|
| Rate for Payer: Quartz Commercial |
$2,088.16
|
| Rate for Payer: Quartz Medicare Advantage |
$1,927.54
|
| Rate for Payer: The Alliance Commercial |
$1,606.28
|
| Rate for Payer: United Healthcare PPO |
$2,147.60
|
| Rate for Payer: WEA Trust Commercial |
$1,766.91
|
| Rate for Payer: WPS Commercial |
$2,379.46
|
|
|
CT TMJ w/ Contrast Right
|
Facility
|
OP
|
$3,089.00
|
|
|
Service Code
|
CPT 70487 TC,RT
|
| Hospital Charge Code |
2979988
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$3,333.20 |
| Rate for Payer: Aetna Commercial |
$2,891.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,762.80
|
| Rate for Payer: Aetna Managed Medicare |
$899.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,333.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,689.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,552.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,702.66
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cigna Commercial |
$2,955.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,797.80
|
| Rate for Payer: Health EOS Commercial |
$2,859.18
|
| Rate for Payer: HFN Commercial |
$2,955.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,409.42
|
| Rate for Payer: Multiplan Commercial |
$2,570.05
|
| Rate for Payer: NAPHCARE Commercial |
$1,927.54
|
| Rate for Payer: Preferred Network Access Commercial |
$2,955.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,574.15
|
| Rate for Payer: Quartz Commercial |
$2,088.16
|
| Rate for Payer: Quartz Medicare Advantage |
$1,927.54
|
| Rate for Payer: The Alliance Commercial |
$1,606.28
|
| Rate for Payer: United Healthcare PPO |
$2,147.60
|
| Rate for Payer: WEA Trust Commercial |
$1,766.91
|
| Rate for Payer: WPS Commercial |
$2,379.46
|
|
|
CT TMJ w/ Contrast Right
|
Professional
|
Both
|
$3,089.00
|
|
|
Service Code
|
CPT 70487 TC,RT
|
| Hospital Charge Code |
2979988
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$583.87 |
| Max. Negotiated Rate |
$3,051.93 |
| Rate for Payer: Aetna Commercial |
$3,051.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,762.80
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cigna Commercial |
$3,051.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,606.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,927.54
|
| Rate for Payer: Health EOS Commercial |
$2,923.43
|
| Rate for Payer: HFN Commercial |
$3,051.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$583.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$583.87
|
| Rate for Payer: Multiplan Commercial |
$2,570.05
|
| Rate for Payer: Preferred Network Access Commercial |
$3,051.93
|
| Rate for Payer: Quartz Beloit One Network |
$1,413.53
|
| Rate for Payer: Quartz Commercial |
$1,831.16
|
| Rate for Payer: The Alliance Commercial |
$1,606.28
|
| Rate for Payer: WEA Trust Commercial |
$1,766.91
|
| Rate for Payer: WPS Commercial |
$2,379.46
|
|
|
CT TMJ w/ Contrast Right
|
Professional
|
Both
|
$3,148.00
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
711757
|
| Min. Negotiated Rate |
$150.65 |
| Max. Negotiated Rate |
$3,110.22 |
| Rate for Payer: Aetna Commercial |
$3,110.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,815.57
|
| Rate for Payer: Aetna Managed Medicare |
$150.65
|
| Rate for Payer: Anthem Medicare Advantage |
$150.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$150.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$150.65
|
| Rate for Payer: Cash Price |
$944.40
|
| Rate for Payer: Cash Price |
$944.40
|
| Rate for Payer: Cash Price |
$944.40
|
| Rate for Payer: Cigna Commercial |
$3,110.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,636.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$150.65
|
| Rate for Payer: Health EOS Commercial |
$2,979.27
|
| Rate for Payer: HFN Commercial |
$3,110.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$583.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$583.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$150.65
|
| Rate for Payer: Multiplan Commercial |
$2,619.14
|
| Rate for Payer: NAPHCARE Commercial |
$225.98
|
| Rate for Payer: Preferred Network Access Commercial |
$3,110.22
|
| Rate for Payer: Quartz Beloit One Network |
$1,440.52
|
| Rate for Payer: Quartz Commercial |
$1,866.13
|
| Rate for Payer: Quartz Medicare Advantage |
$150.65
|
| Rate for Payer: The Alliance Commercial |
$572.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$150.65
|
| Rate for Payer: WEA Trust Commercial |
$1,800.66
|
| Rate for Payer: WPS Commercial |
$753.27
|
|
|
CT TMJ w/ Contrast Right
|
Facility
|
OP
|
$3,148.00
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
711757
|
| Min. Negotiated Rate |
$184.59 |
| Max. Negotiated Rate |
$3,012.01 |
| Rate for Payer: Aetna Commercial |
$2,946.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,815.57
|
| Rate for Payer: Aetna Managed Medicare |
$184.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,128.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,636.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,571.48
|
| Rate for Payer: Anthem Medicare Advantage |
$184.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,735.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$184.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$184.59
|
| Rate for Payer: Cash Price |
$944.40
|
| Rate for Payer: Cash Price |
$944.40
|
| Rate for Payer: Cigna Commercial |
$3,012.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$184.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,832.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$184.59
|
| Rate for Payer: Health EOS Commercial |
$2,913.79
|
| Rate for Payer: HFN Commercial |
$3,012.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$686.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$184.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$184.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$184.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$184.59
|
| Rate for Payer: Multiplan Commercial |
$2,619.14
|
| Rate for Payer: NAPHCARE Commercial |
$276.88
|
| Rate for Payer: Preferred Network Access Commercial |
$3,012.01
|
| Rate for Payer: Quartz Beloit One Network |
$1,604.22
|
| Rate for Payer: Quartz Commercial |
$2,128.05
|
| Rate for Payer: Quartz Medicare Advantage |
$184.59
|
| Rate for Payer: The Alliance Commercial |
$738.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$184.59
|
| Rate for Payer: WEA Trust Commercial |
$1,800.66
|
| Rate for Payer: Wellcare Medicare |
$184.59
|
| Rate for Payer: WPS Commercial |
$2,424.90
|
|
|
CT TMJ w/ Contrast Right
|
Facility
|
IP
|
$3,089.00
|
|
|
Service Code
|
CPT 70487 RT,TC
|
| Hospital Charge Code |
1241323
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,574.15 |
| Max. Negotiated Rate |
$2,955.56 |
| Rate for Payer: Aetna Commercial |
$2,891.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,762.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,702.66
|
| Rate for Payer: Cash Price |
$926.70
|
| Rate for Payer: Cigna Commercial |
$2,955.56
|
| Rate for Payer: Health EOS Commercial |
$2,859.18
|
| Rate for Payer: HFN Commercial |
$2,955.56
|
| Rate for Payer: Multiplan Commercial |
$2,570.05
|
| Rate for Payer: Preferred Network Access Commercial |
$2,955.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,574.15
|
| Rate for Payer: Quartz Commercial |
$1,927.54
|
| Rate for Payer: WEA Trust Commercial |
$1,766.91
|
| Rate for Payer: WPS Commercial |
$2,379.46
|
|
|
CT TMJ w/o Contrast Bilateral
|
Facility
|
OP
|
$2,760.00
|
|
|
Service Code
|
CPT 70486 LT,TC
|
| Hospital Charge Code |
1241326
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$803.71 |
| Max. Negotiated Rate |
$3,333.20 |
| Rate for Payer: Aetna Commercial |
$2,583.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,468.54
|
| Rate for Payer: Aetna Managed Medicare |
$803.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,333.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,689.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,552.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,521.31
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cigna Commercial |
$2,640.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,606.32
|
| Rate for Payer: Health EOS Commercial |
$2,554.66
|
| Rate for Payer: HFN Commercial |
$2,640.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,152.80
|
| Rate for Payer: Multiplan Commercial |
$2,296.32
|
| Rate for Payer: NAPHCARE Commercial |
$1,722.24
|
| Rate for Payer: Preferred Network Access Commercial |
$2,640.77
|
| Rate for Payer: Quartz Beloit One Network |
$1,406.50
|
| Rate for Payer: Quartz Commercial |
$1,865.76
|
| Rate for Payer: Quartz Medicare Advantage |
$1,722.24
|
| Rate for Payer: The Alliance Commercial |
$1,435.20
|
| Rate for Payer: United Healthcare PPO |
$2,147.60
|
| Rate for Payer: WEA Trust Commercial |
$1,578.72
|
| Rate for Payer: WPS Commercial |
$2,126.03
|
|
|
CT TMJ w/o Contrast Bilateral
|
Professional
|
Both
|
$5,225.00
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
711758
|
| Min. Negotiated Rate |
$127.64 |
| Max. Negotiated Rate |
$5,162.30 |
| Rate for Payer: Aetna Commercial |
$5,162.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,673.24
|
| Rate for Payer: Aetna Managed Medicare |
$127.64
|
| Rate for Payer: Anthem Medicare Advantage |
$127.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$127.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$127.64
|
| Rate for Payer: Cash Price |
$1,567.50
|
| Rate for Payer: Cash Price |
$1,567.50
|
| Rate for Payer: Cash Price |
$1,567.50
|
| Rate for Payer: Cigna Commercial |
$5,162.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2,717.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$127.64
|
| Rate for Payer: Health EOS Commercial |
$4,944.94
|
| Rate for Payer: HFN Commercial |
$5,162.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$488.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$488.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$127.64
|
| Rate for Payer: Multiplan Commercial |
$4,347.20
|
| Rate for Payer: NAPHCARE Commercial |
$191.46
|
| Rate for Payer: Preferred Network Access Commercial |
$5,162.30
|
| Rate for Payer: Quartz Beloit One Network |
$2,390.96
|
| Rate for Payer: Quartz Commercial |
$3,097.38
|
| Rate for Payer: Quartz Medicare Advantage |
$127.64
|
| Rate for Payer: The Alliance Commercial |
$485.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$127.64
|
| Rate for Payer: WEA Trust Commercial |
$2,988.70
|
| Rate for Payer: WPS Commercial |
$638.20
|
|
|
CT TMJ w/o Contrast Bilateral
|
Facility
|
IP
|
$5,225.00
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
711758
|
| Min. Negotiated Rate |
$2,662.66 |
| Max. Negotiated Rate |
$4,999.28 |
| Rate for Payer: Aetna Commercial |
$4,890.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,673.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,880.02
|
| Rate for Payer: Cash Price |
$1,567.50
|
| Rate for Payer: Cigna Commercial |
$4,999.28
|
| Rate for Payer: Health EOS Commercial |
$4,836.26
|
| Rate for Payer: HFN Commercial |
$4,999.28
|
| Rate for Payer: Multiplan Commercial |
$4,347.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,999.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,662.66
|
| Rate for Payer: Quartz Commercial |
$3,260.40
|
| Rate for Payer: WEA Trust Commercial |
$2,988.70
|
| Rate for Payer: WPS Commercial |
$4,024.82
|
|
|
CT TMJ w/o Contrast Bilateral
|
Facility
|
OP
|
$5,225.00
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
711758
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$4,999.28 |
| Rate for Payer: Aetna Commercial |
$4,890.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,673.24
|
| Rate for Payer: Aetna Managed Medicare |
$110.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,532.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,717.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,608.32
|
| Rate for Payer: Anthem Medicare Advantage |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,880.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$110.02
|
| Rate for Payer: Cash Price |
$1,567.50
|
| Rate for Payer: Cash Price |
$1,567.50
|
| Rate for Payer: Cigna Commercial |
$4,999.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$110.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,040.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$110.02
|
| Rate for Payer: Health EOS Commercial |
$4,836.26
|
| Rate for Payer: HFN Commercial |
$4,999.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$409.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$110.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$110.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$110.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$110.02
|
| Rate for Payer: Multiplan Commercial |
$4,347.20
|
| Rate for Payer: NAPHCARE Commercial |
$165.03
|
| Rate for Payer: Preferred Network Access Commercial |
$4,999.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,662.66
|
| Rate for Payer: Quartz Commercial |
$3,532.10
|
| Rate for Payer: Quartz Medicare Advantage |
$110.02
|
| Rate for Payer: The Alliance Commercial |
$440.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110.02
|
| Rate for Payer: WEA Trust Commercial |
$2,988.70
|
| Rate for Payer: Wellcare Medicare |
$110.02
|
| Rate for Payer: WPS Commercial |
$4,024.82
|
|
|
CT TMJ w/o Contrast Bilateral
|
Facility
|
IP
|
$2,760.00
|
|
|
Service Code
|
CPT 70486 LT,TC
|
| Hospital Charge Code |
1241326
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,406.50 |
| Max. Negotiated Rate |
$2,640.77 |
| Rate for Payer: Aetna Commercial |
$2,583.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,468.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,521.31
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cigna Commercial |
$2,640.77
|
| Rate for Payer: Health EOS Commercial |
$2,554.66
|
| Rate for Payer: HFN Commercial |
$2,640.77
|
| Rate for Payer: Multiplan Commercial |
$2,296.32
|
| Rate for Payer: Preferred Network Access Commercial |
$2,640.77
|
| Rate for Payer: Quartz Beloit One Network |
$1,406.50
|
| Rate for Payer: Quartz Commercial |
$1,722.24
|
| Rate for Payer: WEA Trust Commercial |
$1,578.72
|
| Rate for Payer: WPS Commercial |
$2,126.03
|
|
|
CT TMJ w/o Contrast Bilateral
|
Professional
|
Both
|
$2,760.00
|
|
|
Service Code
|
CPT 70486 LT,TC
|
| Hospital Charge Code |
1241326
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$488.49 |
| Max. Negotiated Rate |
$2,726.88 |
| Rate for Payer: Aetna Commercial |
$2,726.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,468.54
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cigna Commercial |
$2,726.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,435.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,722.24
|
| Rate for Payer: Health EOS Commercial |
$2,612.06
|
| Rate for Payer: HFN Commercial |
$2,726.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$488.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$488.49
|
| Rate for Payer: Multiplan Commercial |
$2,296.32
|
| Rate for Payer: Preferred Network Access Commercial |
$2,726.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,262.98
|
| Rate for Payer: Quartz Commercial |
$1,636.13
|
| Rate for Payer: The Alliance Commercial |
$1,435.20
|
| Rate for Payer: WEA Trust Commercial |
$1,578.72
|
| Rate for Payer: WPS Commercial |
$2,126.03
|
|
|
CT TMJ w/o Contrast Left
|
Facility
|
IP
|
$2,612.00
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
711759
|
| Min. Negotiated Rate |
$1,331.08 |
| Max. Negotiated Rate |
$2,499.16 |
| Rate for Payer: Aetna Commercial |
$2,444.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,336.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,439.73
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cigna Commercial |
$2,499.16
|
| Rate for Payer: Health EOS Commercial |
$2,417.67
|
| Rate for Payer: HFN Commercial |
$2,499.16
|
| Rate for Payer: Multiplan Commercial |
$2,173.18
|
| Rate for Payer: Preferred Network Access Commercial |
$2,499.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,331.08
|
| Rate for Payer: Quartz Commercial |
$1,629.89
|
| Rate for Payer: WEA Trust Commercial |
$1,494.06
|
| Rate for Payer: WPS Commercial |
$2,012.02
|
|
|
CT TMJ w/o Contrast Left
|
Facility
|
OP
|
$2,612.00
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
711759
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$2,499.16 |
| Rate for Payer: Aetna Commercial |
$2,444.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,336.17
|
| Rate for Payer: Aetna Managed Medicare |
$110.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,765.71
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,358.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,303.91
|
| Rate for Payer: Anthem Medicare Advantage |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,439.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$110.02
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cigna Commercial |
$2,499.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$110.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,520.18
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$110.02
|
| Rate for Payer: Health EOS Commercial |
$2,417.67
|
| Rate for Payer: HFN Commercial |
$2,499.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$409.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$110.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$110.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$110.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$110.02
|
| Rate for Payer: Multiplan Commercial |
$2,173.18
|
| Rate for Payer: NAPHCARE Commercial |
$165.03
|
| Rate for Payer: Preferred Network Access Commercial |
$2,499.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,331.08
|
| Rate for Payer: Quartz Commercial |
$1,765.71
|
| Rate for Payer: Quartz Medicare Advantage |
$110.02
|
| Rate for Payer: The Alliance Commercial |
$440.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110.02
|
| Rate for Payer: WEA Trust Commercial |
$1,494.06
|
| Rate for Payer: Wellcare Medicare |
$110.02
|
| Rate for Payer: WPS Commercial |
$2,012.02
|
|
|
CT TMJ w/o Contrast Left
|
Professional
|
Both
|
$2,612.00
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
711759
|
| Min. Negotiated Rate |
$127.64 |
| Max. Negotiated Rate |
$2,580.66 |
| Rate for Payer: Aetna Commercial |
$2,580.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,336.17
|
| Rate for Payer: Aetna Managed Medicare |
$127.64
|
| Rate for Payer: Anthem Medicare Advantage |
$127.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$127.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$127.64
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cigna Commercial |
$2,580.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,358.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$127.64
|
| Rate for Payer: Health EOS Commercial |
$2,472.00
|
| Rate for Payer: HFN Commercial |
$2,580.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$488.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$488.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$127.64
|
| Rate for Payer: Multiplan Commercial |
$2,173.18
|
| Rate for Payer: NAPHCARE Commercial |
$191.46
|
| Rate for Payer: Preferred Network Access Commercial |
$2,580.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,195.25
|
| Rate for Payer: Quartz Commercial |
$1,548.39
|
| Rate for Payer: Quartz Medicare Advantage |
$127.64
|
| Rate for Payer: The Alliance Commercial |
$485.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$127.64
|
| Rate for Payer: WEA Trust Commercial |
$1,494.06
|
| Rate for Payer: WPS Commercial |
$638.20
|
|
|
CT TMJ w/o Contrast Left
|
Facility
|
IP
|
$2,760.00
|
|
|
Service Code
|
CPT 70486 LT,TC
|
| Hospital Charge Code |
1241329
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,406.50 |
| Max. Negotiated Rate |
$2,640.77 |
| Rate for Payer: Aetna Commercial |
$2,583.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,468.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,521.31
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cigna Commercial |
$2,640.77
|
| Rate for Payer: Health EOS Commercial |
$2,554.66
|
| Rate for Payer: HFN Commercial |
$2,640.77
|
| Rate for Payer: Multiplan Commercial |
$2,296.32
|
| Rate for Payer: Preferred Network Access Commercial |
$2,640.77
|
| Rate for Payer: Quartz Beloit One Network |
$1,406.50
|
| Rate for Payer: Quartz Commercial |
$1,722.24
|
| Rate for Payer: WEA Trust Commercial |
$1,578.72
|
| Rate for Payer: WPS Commercial |
$2,126.03
|
|
|
CT TMJ w/o Contrast Left
|
Facility
|
OP
|
$2,760.00
|
|
|
Service Code
|
CPT 70486 LT,TC
|
| Hospital Charge Code |
1241329
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$803.71 |
| Max. Negotiated Rate |
$3,333.20 |
| Rate for Payer: Aetna Commercial |
$2,583.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,468.54
|
| Rate for Payer: Aetna Managed Medicare |
$803.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,333.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,689.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,552.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,521.31
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cigna Commercial |
$2,640.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,606.32
|
| Rate for Payer: Health EOS Commercial |
$2,554.66
|
| Rate for Payer: HFN Commercial |
$2,640.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,152.80
|
| Rate for Payer: Multiplan Commercial |
$2,296.32
|
| Rate for Payer: NAPHCARE Commercial |
$1,722.24
|
| Rate for Payer: Preferred Network Access Commercial |
$2,640.77
|
| Rate for Payer: Quartz Beloit One Network |
$1,406.50
|
| Rate for Payer: Quartz Commercial |
$1,865.76
|
| Rate for Payer: Quartz Medicare Advantage |
$1,722.24
|
| Rate for Payer: The Alliance Commercial |
$1,435.20
|
| Rate for Payer: United Healthcare PPO |
$2,147.60
|
| Rate for Payer: WEA Trust Commercial |
$1,578.72
|
| Rate for Payer: WPS Commercial |
$2,126.03
|
|
|
CT TMJ w/o Contrast Left
|
Professional
|
Both
|
$2,760.00
|
|
|
Service Code
|
CPT 70486 LT,TC
|
| Hospital Charge Code |
1241329
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$488.49 |
| Max. Negotiated Rate |
$2,726.88 |
| Rate for Payer: Aetna Commercial |
$2,726.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,468.54
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cigna Commercial |
$2,726.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,435.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,722.24
|
| Rate for Payer: Health EOS Commercial |
$2,612.06
|
| Rate for Payer: HFN Commercial |
$2,726.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$488.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$488.49
|
| Rate for Payer: Multiplan Commercial |
$2,296.32
|
| Rate for Payer: Preferred Network Access Commercial |
$2,726.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,262.98
|
| Rate for Payer: Quartz Commercial |
$1,636.13
|
| Rate for Payer: The Alliance Commercial |
$1,435.20
|
| Rate for Payer: WEA Trust Commercial |
$1,578.72
|
| Rate for Payer: WPS Commercial |
$2,126.03
|
|
|
CT TMJ w/o Contrast Right
|
Professional
|
Both
|
$2,612.00
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
711760
|
| Min. Negotiated Rate |
$127.64 |
| Max. Negotiated Rate |
$2,580.66 |
| Rate for Payer: Aetna Commercial |
$2,580.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,336.17
|
| Rate for Payer: Aetna Managed Medicare |
$127.64
|
| Rate for Payer: Anthem Medicare Advantage |
$127.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$127.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$127.64
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cigna Commercial |
$2,580.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,358.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$127.64
|
| Rate for Payer: Health EOS Commercial |
$2,472.00
|
| Rate for Payer: HFN Commercial |
$2,580.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$488.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$488.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$127.64
|
| Rate for Payer: Multiplan Commercial |
$2,173.18
|
| Rate for Payer: NAPHCARE Commercial |
$191.46
|
| Rate for Payer: Preferred Network Access Commercial |
$2,580.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,195.25
|
| Rate for Payer: Quartz Commercial |
$1,548.39
|
| Rate for Payer: Quartz Medicare Advantage |
$127.64
|
| Rate for Payer: The Alliance Commercial |
$485.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$127.64
|
| Rate for Payer: WEA Trust Commercial |
$1,494.06
|
| Rate for Payer: WPS Commercial |
$638.20
|
|
|
CT TMJ w/o Contrast Right
|
Facility
|
IP
|
$2,612.00
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
711760
|
| Min. Negotiated Rate |
$1,331.08 |
| Max. Negotiated Rate |
$2,499.16 |
| Rate for Payer: Aetna Commercial |
$2,444.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,336.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,439.73
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cigna Commercial |
$2,499.16
|
| Rate for Payer: Health EOS Commercial |
$2,417.67
|
| Rate for Payer: HFN Commercial |
$2,499.16
|
| Rate for Payer: Multiplan Commercial |
$2,173.18
|
| Rate for Payer: Preferred Network Access Commercial |
$2,499.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,331.08
|
| Rate for Payer: Quartz Commercial |
$1,629.89
|
| Rate for Payer: WEA Trust Commercial |
$1,494.06
|
| Rate for Payer: WPS Commercial |
$2,012.02
|
|
|
CT TMJ w/o Contrast Right
|
Professional
|
Both
|
$2,760.00
|
|
|
Service Code
|
CPT 70486 RT,TC
|
| Hospital Charge Code |
1241332
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$488.49 |
| Max. Negotiated Rate |
$2,726.88 |
| Rate for Payer: Aetna Commercial |
$2,726.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,468.54
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cigna Commercial |
$2,726.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,435.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,722.24
|
| Rate for Payer: Health EOS Commercial |
$2,612.06
|
| Rate for Payer: HFN Commercial |
$2,726.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$488.49
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$488.49
|
| Rate for Payer: Multiplan Commercial |
$2,296.32
|
| Rate for Payer: Preferred Network Access Commercial |
$2,726.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,262.98
|
| Rate for Payer: Quartz Commercial |
$1,636.13
|
| Rate for Payer: The Alliance Commercial |
$1,435.20
|
| Rate for Payer: WEA Trust Commercial |
$1,578.72
|
| Rate for Payer: WPS Commercial |
$2,126.03
|
|
|
CT TMJ w/o Contrast Right
|
Facility
|
OP
|
$2,612.00
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
711760
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$2,499.16 |
| Rate for Payer: Aetna Commercial |
$2,444.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,336.17
|
| Rate for Payer: Aetna Managed Medicare |
$110.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,765.71
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,358.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,303.91
|
| Rate for Payer: Anthem Medicare Advantage |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,439.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$110.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$110.02
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cigna Commercial |
$2,499.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$110.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,520.18
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$110.02
|
| Rate for Payer: Health EOS Commercial |
$2,417.67
|
| Rate for Payer: HFN Commercial |
$2,499.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$409.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$110.02
|
| Rate for Payer: Independent Care Health Plan Medicare |
$110.02
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$110.02
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$110.02
|
| Rate for Payer: Multiplan Commercial |
$2,173.18
|
| Rate for Payer: NAPHCARE Commercial |
$165.03
|
| Rate for Payer: Preferred Network Access Commercial |
$2,499.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,331.08
|
| Rate for Payer: Quartz Commercial |
$1,765.71
|
| Rate for Payer: Quartz Medicare Advantage |
$110.02
|
| Rate for Payer: The Alliance Commercial |
$440.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$110.02
|
| Rate for Payer: WEA Trust Commercial |
$1,494.06
|
| Rate for Payer: Wellcare Medicare |
$110.02
|
| Rate for Payer: WPS Commercial |
$2,012.02
|
|
