|
Cytogenetics and Molec Cyto
|
Professional
|
Both
|
$619.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
2798802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$611.57 |
| Rate for Payer: Aetna Commercial |
$611.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$553.63
|
| Rate for Payer: Aetna Managed Medicare |
$33.24
|
| Rate for Payer: Anthem Commercial |
$5.89
|
| Rate for Payer: Anthem Medicare Advantage |
$33.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$33.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$33.24
|
| Rate for Payer: Cash Price |
$185.70
|
| Rate for Payer: Cash Price |
$185.70
|
| Rate for Payer: Cigna Commercial |
$611.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$321.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$33.24
|
| Rate for Payer: Health EOS Commercial |
$585.82
|
| Rate for Payer: HFN Commercial |
$611.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$117.59
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$117.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$33.24
|
| Rate for Payer: Multiplan Commercial |
$515.01
|
| Rate for Payer: NAPHCARE Commercial |
$49.86
|
| Rate for Payer: Preferred Network Access Commercial |
$611.57
|
| Rate for Payer: Quartz Beloit One Network |
$283.25
|
| Rate for Payer: Quartz Commercial |
$366.94
|
| Rate for Payer: Quartz Medicare Advantage |
$33.24
|
| Rate for Payer: The Alliance Commercial |
$131.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33.24
|
| Rate for Payer: WEA Trust Commercial |
$354.07
|
| Rate for Payer: WPS Commercial |
$146.25
|
|
|
Cytogenetics and Molec Cyto
|
Facility
|
IP
|
$619.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
2798802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$315.44 |
| Max. Negotiated Rate |
$592.26 |
| Rate for Payer: Aetna Commercial |
$579.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$553.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$341.19
|
| Rate for Payer: Cash Price |
$185.70
|
| Rate for Payer: Cigna Commercial |
$592.26
|
| Rate for Payer: Health EOS Commercial |
$572.95
|
| Rate for Payer: HFN Commercial |
$592.26
|
| Rate for Payer: Multiplan Commercial |
$515.01
|
| Rate for Payer: Preferred Network Access Commercial |
$592.26
|
| Rate for Payer: Quartz Beloit One Network |
$315.44
|
| Rate for Payer: Quartz Commercial |
$386.26
|
| Rate for Payer: WEA Trust Commercial |
$354.07
|
| Rate for Payer: WPS Commercial |
$476.82
|
|
|
Cytogenetics and Molec Cyto
|
Facility
|
OP
|
$619.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
2798802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$132.95 |
| Max. Negotiated Rate |
$592.26 |
| Rate for Payer: Aetna Commercial |
$579.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$553.63
|
| Rate for Payer: Aetna Managed Medicare |
$180.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$418.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$321.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$309.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$341.19
|
| Rate for Payer: Cash Price |
$185.70
|
| Rate for Payer: Cash Price |
$185.70
|
| Rate for Payer: Cigna Commercial |
$592.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$360.26
|
| Rate for Payer: Health EOS Commercial |
$572.95
|
| Rate for Payer: HFN Commercial |
$592.26
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$482.82
|
| Rate for Payer: Multiplan Commercial |
$515.01
|
| Rate for Payer: NAPHCARE Commercial |
$386.26
|
| Rate for Payer: Preferred Network Access Commercial |
$592.26
|
| Rate for Payer: Quartz Beloit One Network |
$315.44
|
| Rate for Payer: Quartz Commercial |
$418.44
|
| Rate for Payer: Quartz Medicare Advantage |
$386.26
|
| Rate for Payer: The Alliance Commercial |
$132.95
|
| Rate for Payer: United Healthcare PPO |
$482.82
|
| Rate for Payer: WEA Trust Commercial |
$354.07
|
| Rate for Payer: WPS Commercial |
$476.82
|
|
|
Cytogenetics Interp & Report
|
Facility
|
IP
|
$619.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
2798803
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$315.44 |
| Max. Negotiated Rate |
$592.26 |
| Rate for Payer: Aetna Commercial |
$579.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$553.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$341.19
|
| Rate for Payer: Cash Price |
$185.70
|
| Rate for Payer: Cigna Commercial |
$592.26
|
| Rate for Payer: Health EOS Commercial |
$572.95
|
| Rate for Payer: HFN Commercial |
$592.26
|
| Rate for Payer: Multiplan Commercial |
$515.01
|
| Rate for Payer: Preferred Network Access Commercial |
$592.26
|
| Rate for Payer: Quartz Beloit One Network |
$315.44
|
| Rate for Payer: Quartz Commercial |
$386.26
|
| Rate for Payer: WEA Trust Commercial |
$354.07
|
| Rate for Payer: WPS Commercial |
$476.82
|
|
|
Cytogenetics Interp & Report
|
Facility
|
OP
|
$619.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
2798803
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$132.95 |
| Max. Negotiated Rate |
$592.26 |
| Rate for Payer: Aetna Commercial |
$579.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$553.63
|
| Rate for Payer: Aetna Managed Medicare |
$180.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$418.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$321.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$309.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$341.19
|
| Rate for Payer: Cash Price |
$185.70
|
| Rate for Payer: Cash Price |
$185.70
|
| Rate for Payer: Cigna Commercial |
$592.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$360.26
|
| Rate for Payer: Health EOS Commercial |
$572.95
|
| Rate for Payer: HFN Commercial |
$592.26
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$482.82
|
| Rate for Payer: Multiplan Commercial |
$515.01
|
| Rate for Payer: NAPHCARE Commercial |
$386.26
|
| Rate for Payer: Preferred Network Access Commercial |
$592.26
|
| Rate for Payer: Quartz Beloit One Network |
$315.44
|
| Rate for Payer: Quartz Commercial |
$418.44
|
| Rate for Payer: Quartz Medicare Advantage |
$386.26
|
| Rate for Payer: The Alliance Commercial |
$132.95
|
| Rate for Payer: United Healthcare PPO |
$482.82
|
| Rate for Payer: WEA Trust Commercial |
$354.07
|
| Rate for Payer: WPS Commercial |
$476.82
|
|
|
Cytogenetics Interp & Report
|
Professional
|
Both
|
$619.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
2798803
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$611.57 |
| Rate for Payer: Aetna Commercial |
$611.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$553.63
|
| Rate for Payer: Aetna Managed Medicare |
$33.24
|
| Rate for Payer: Anthem Commercial |
$5.89
|
| Rate for Payer: Anthem Medicare Advantage |
$33.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$33.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$33.24
|
| Rate for Payer: Cash Price |
$185.70
|
| Rate for Payer: Cash Price |
$185.70
|
| Rate for Payer: Cigna Commercial |
$611.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$321.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$33.24
|
| Rate for Payer: Health EOS Commercial |
$585.82
|
| Rate for Payer: HFN Commercial |
$611.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$117.59
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$117.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$33.24
|
| Rate for Payer: Multiplan Commercial |
$515.01
|
| Rate for Payer: NAPHCARE Commercial |
$49.86
|
| Rate for Payer: Preferred Network Access Commercial |
$611.57
|
| Rate for Payer: Quartz Beloit One Network |
$283.25
|
| Rate for Payer: Quartz Commercial |
$366.94
|
| Rate for Payer: Quartz Medicare Advantage |
$33.24
|
| Rate for Payer: The Alliance Commercial |
$131.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33.24
|
| Rate for Payer: WEA Trust Commercial |
$354.07
|
| Rate for Payer: WPS Commercial |
$146.25
|
|
|
Cytology Body Fluid to Quest
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
3781364
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$107.02 |
| Max. Negotiated Rate |
$200.93 |
| Rate for Payer: Aetna Commercial |
$196.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$187.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$115.75
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Cigna Commercial |
$200.93
|
| Rate for Payer: Health EOS Commercial |
$194.38
|
| Rate for Payer: HFN Commercial |
$200.93
|
| Rate for Payer: Multiplan Commercial |
$174.72
|
| Rate for Payer: Preferred Network Access Commercial |
$200.93
|
| Rate for Payer: Quartz Beloit One Network |
$107.02
|
| Rate for Payer: Quartz Commercial |
$131.04
|
| Rate for Payer: WEA Trust Commercial |
$120.12
|
| Rate for Payer: WPS Commercial |
$161.76
|
|
|
Cytology Body Fluid to Quest
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
3781364
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.31 |
| Max. Negotiated Rate |
$200.93 |
| Rate for Payer: Aetna Commercial |
$196.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$187.82
|
| Rate for Payer: Aetna Managed Medicare |
$39.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$154.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$72.14
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$68.43
|
| Rate for Payer: Anthem Medicare Advantage |
$39.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$115.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.31
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Cigna Commercial |
$200.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$122.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.31
|
| Rate for Payer: Health EOS Commercial |
$194.38
|
| Rate for Payer: HFN Commercial |
$200.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.31
|
| Rate for Payer: Multiplan Commercial |
$174.72
|
| Rate for Payer: NAPHCARE Commercial |
$58.97
|
| Rate for Payer: Preferred Network Access Commercial |
$200.93
|
| Rate for Payer: Quartz Beloit One Network |
$107.02
|
| Rate for Payer: Quartz Commercial |
$141.96
|
| Rate for Payer: Quartz Medicare Advantage |
$39.31
|
| Rate for Payer: The Alliance Commercial |
$157.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.31
|
| Rate for Payer: United Healthcare PPO |
$163.80
|
| Rate for Payer: WEA Trust Commercial |
$120.12
|
| Rate for Payer: Wellcare Medicare |
$39.31
|
| Rate for Payer: WPS Commercial |
$161.76
|
|
|
Cytology Body Fluid to Quest
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
3781364
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.61 |
| Max. Negotiated Rate |
$302.43 |
| Rate for Payer: Aetna Commercial |
$207.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$187.82
|
| Rate for Payer: Aetna Managed Medicare |
$68.73
|
| Rate for Payer: Anthem Commercial |
$21.61
|
| Rate for Payer: Anthem Medicare Advantage |
$68.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$68.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$68.73
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Cigna Commercial |
$207.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$109.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$68.73
|
| Rate for Payer: Health EOS Commercial |
$198.74
|
| Rate for Payer: HFN Commercial |
$207.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$222.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$222.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$68.73
|
| Rate for Payer: Multiplan Commercial |
$174.72
|
| Rate for Payer: NAPHCARE Commercial |
$103.10
|
| Rate for Payer: Preferred Network Access Commercial |
$207.48
|
| Rate for Payer: Quartz Beloit One Network |
$96.10
|
| Rate for Payer: Quartz Commercial |
$124.49
|
| Rate for Payer: Quartz Medicare Advantage |
$68.73
|
| Rate for Payer: The Alliance Commercial |
$271.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$68.73
|
| Rate for Payer: WEA Trust Commercial |
$120.12
|
| Rate for Payer: WPS Commercial |
$302.43
|
|
|
CYTOLOGY BRUSH 1.7MM 1601
|
Facility
|
IP
|
$291.00
|
|
| Hospital Charge Code |
2964807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$148.29 |
| Max. Negotiated Rate |
$278.43 |
| Rate for Payer: Aetna Commercial |
$272.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$260.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$160.40
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Cigna Commercial |
$278.43
|
| Rate for Payer: Health EOS Commercial |
$269.35
|
| Rate for Payer: HFN Commercial |
$278.43
|
| Rate for Payer: Multiplan Commercial |
$242.11
|
| Rate for Payer: Preferred Network Access Commercial |
$278.43
|
| Rate for Payer: Quartz Beloit One Network |
$148.29
|
| Rate for Payer: Quartz Commercial |
$181.58
|
| Rate for Payer: WEA Trust Commercial |
$166.45
|
| Rate for Payer: WPS Commercial |
$224.16
|
|
|
CYTOLOGY BRUSH 1.7MM 1601
|
Facility
|
OP
|
$291.00
|
|
| Hospital Charge Code |
2964807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.74 |
| Max. Negotiated Rate |
$278.43 |
| Rate for Payer: Aetna Commercial |
$272.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$260.27
|
| Rate for Payer: Aetna Managed Medicare |
$84.74
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$196.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$151.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$145.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$160.40
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Cigna Commercial |
$278.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$169.36
|
| Rate for Payer: Health EOS Commercial |
$269.35
|
| Rate for Payer: HFN Commercial |
$278.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$226.98
|
| Rate for Payer: Multiplan Commercial |
$242.11
|
| Rate for Payer: NAPHCARE Commercial |
$181.58
|
| Rate for Payer: Preferred Network Access Commercial |
$278.43
|
| Rate for Payer: Quartz Beloit One Network |
$148.29
|
| Rate for Payer: Quartz Commercial |
$196.72
|
| Rate for Payer: Quartz Medicare Advantage |
$181.58
|
| Rate for Payer: The Alliance Commercial |
$151.32
|
| Rate for Payer: WEA Trust Commercial |
$166.45
|
| Rate for Payer: WPS Commercial |
$224.16
|
|
|
Cytology, Non-Gynecological
|
Facility
|
IP
|
$191.00
|
|
|
Service Code
|
CPT 88161
|
| Hospital Charge Code |
4522715
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$97.33 |
| Max. Negotiated Rate |
$182.75 |
| Rate for Payer: Aetna Commercial |
$178.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$170.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$105.28
|
| Rate for Payer: Cash Price |
$57.30
|
| Rate for Payer: Cigna Commercial |
$182.75
|
| Rate for Payer: Health EOS Commercial |
$176.79
|
| Rate for Payer: HFN Commercial |
$182.75
|
| Rate for Payer: Multiplan Commercial |
$158.91
|
| Rate for Payer: Preferred Network Access Commercial |
$182.75
|
| Rate for Payer: Quartz Beloit One Network |
$97.33
|
| Rate for Payer: Quartz Commercial |
$119.18
|
| Rate for Payer: WEA Trust Commercial |
$109.25
|
| Rate for Payer: WPS Commercial |
$147.13
|
|
|
Cytology, Non-Gynecological
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
CPT 88161
|
| Hospital Charge Code |
4522715
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.88 |
| Max. Negotiated Rate |
$363.29 |
| Rate for Payer: Aetna Commercial |
$188.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$170.83
|
| Rate for Payer: Aetna Managed Medicare |
$82.57
|
| Rate for Payer: Anthem Commercial |
$23.88
|
| Rate for Payer: Anthem Medicare Advantage |
$82.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$82.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$82.57
|
| Rate for Payer: Cash Price |
$57.30
|
| Rate for Payer: Cash Price |
$57.30
|
| Rate for Payer: Cigna Commercial |
$188.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$99.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$82.57
|
| Rate for Payer: Health EOS Commercial |
$180.76
|
| Rate for Payer: HFN Commercial |
$188.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$250.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$250.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$82.57
|
| Rate for Payer: Multiplan Commercial |
$158.91
|
| Rate for Payer: NAPHCARE Commercial |
$123.85
|
| Rate for Payer: Preferred Network Access Commercial |
$188.71
|
| Rate for Payer: Quartz Beloit One Network |
$87.40
|
| Rate for Payer: Quartz Commercial |
$113.22
|
| Rate for Payer: Quartz Medicare Advantage |
$82.57
|
| Rate for Payer: The Alliance Commercial |
$326.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$82.57
|
| Rate for Payer: WEA Trust Commercial |
$109.25
|
| Rate for Payer: WPS Commercial |
$363.29
|
|
|
Cytology, Non-Gynecological
|
Facility
|
OP
|
$191.00
|
|
|
Service Code
|
CPT 88161
|
| Hospital Charge Code |
4522715
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.44 |
| Max. Negotiated Rate |
$182.75 |
| Rate for Payer: Aetna Commercial |
$178.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$170.83
|
| Rate for Payer: Aetna Managed Medicare |
$30.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$114.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$53.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$50.81
|
| Rate for Payer: Anthem Medicare Advantage |
$30.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$105.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$30.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$30.44
|
| Rate for Payer: Cash Price |
$57.30
|
| Rate for Payer: Cash Price |
$57.30
|
| Rate for Payer: Cigna Commercial |
$182.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$30.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$111.16
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$30.44
|
| Rate for Payer: Health EOS Commercial |
$176.79
|
| Rate for Payer: HFN Commercial |
$182.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$113.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$30.44
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$30.44
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$30.44
|
| Rate for Payer: Multiplan Commercial |
$158.91
|
| Rate for Payer: NAPHCARE Commercial |
$45.66
|
| Rate for Payer: Preferred Network Access Commercial |
$182.75
|
| Rate for Payer: Quartz Beloit One Network |
$97.33
|
| Rate for Payer: Quartz Commercial |
$129.12
|
| Rate for Payer: Quartz Medicare Advantage |
$30.44
|
| Rate for Payer: The Alliance Commercial |
$121.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30.44
|
| Rate for Payer: United Healthcare PPO |
$148.98
|
| Rate for Payer: WEA Trust Commercial |
$109.25
|
| Rate for Payer: Wellcare Medicare |
$30.44
|
| Rate for Payer: WPS Commercial |
$147.13
|
|
|
Cytomegalovirus Antibody IgG
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
977906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.97 |
| Max. Negotiated Rate |
$337.75 |
| Rate for Payer: Aetna Commercial |
$330.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$315.72
|
| Rate for Payer: Aetna Managed Medicare |
$14.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.12
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$26.19
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24.84
|
| Rate for Payer: Anthem Medicare Advantage |
$14.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$194.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.97
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cigna Commercial |
$337.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$205.45
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14.97
|
| Rate for Payer: Health EOS Commercial |
$326.74
|
| Rate for Payer: HFN Commercial |
$337.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$55.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.97
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14.97
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14.97
|
| Rate for Payer: Multiplan Commercial |
$293.70
|
| Rate for Payer: NAPHCARE Commercial |
$22.45
|
| Rate for Payer: Preferred Network Access Commercial |
$337.75
|
| Rate for Payer: Quartz Beloit One Network |
$179.89
|
| Rate for Payer: Quartz Commercial |
$238.63
|
| Rate for Payer: Quartz Medicare Advantage |
$14.97
|
| Rate for Payer: The Alliance Commercial |
$59.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.97
|
| Rate for Payer: United Healthcare PPO |
$275.34
|
| Rate for Payer: WEA Trust Commercial |
$201.92
|
| Rate for Payer: Wellcare Medicare |
$14.97
|
| Rate for Payer: WPS Commercial |
$271.92
|
|
|
Cytomegalovirus Antibody IgG
|
Professional
|
Both
|
$353.00
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
977906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.97 |
| Max. Negotiated Rate |
$348.76 |
| Rate for Payer: Aetna Commercial |
$348.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$315.72
|
| Rate for Payer: Aetna Managed Medicare |
$14.97
|
| Rate for Payer: Anthem Medicare Advantage |
$14.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14.97
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cigna Commercial |
$348.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$183.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.97
|
| Rate for Payer: Health EOS Commercial |
$334.08
|
| Rate for Payer: HFN Commercial |
$348.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$52.83
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$52.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14.97
|
| Rate for Payer: Multiplan Commercial |
$293.70
|
| Rate for Payer: NAPHCARE Commercial |
$22.45
|
| Rate for Payer: Preferred Network Access Commercial |
$348.76
|
| Rate for Payer: Quartz Beloit One Network |
$161.53
|
| Rate for Payer: Quartz Commercial |
$209.26
|
| Rate for Payer: Quartz Medicare Advantage |
$14.97
|
| Rate for Payer: The Alliance Commercial |
$59.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.97
|
| Rate for Payer: WEA Trust Commercial |
$201.92
|
| Rate for Payer: WPS Commercial |
$65.85
|
|
|
Cytomegalovirus Antibody IgG
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
977906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$179.89 |
| Max. Negotiated Rate |
$337.75 |
| Rate for Payer: Aetna Commercial |
$330.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$315.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$194.57
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cigna Commercial |
$337.75
|
| Rate for Payer: Health EOS Commercial |
$326.74
|
| Rate for Payer: HFN Commercial |
$337.75
|
| Rate for Payer: Multiplan Commercial |
$293.70
|
| Rate for Payer: Preferred Network Access Commercial |
$337.75
|
| Rate for Payer: Quartz Beloit One Network |
$179.89
|
| Rate for Payer: Quartz Commercial |
$220.27
|
| Rate for Payer: WEA Trust Commercial |
$201.92
|
| Rate for Payer: WPS Commercial |
$271.92
|
|
|
Cytomegalovirus Antibody IgM
|
Facility
|
OP
|
$148.00
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
978112
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.52 |
| Max. Negotiated Rate |
$141.61 |
| Rate for Payer: Aetna Commercial |
$138.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$132.37
|
| Rate for Payer: Aetna Managed Medicare |
$17.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$65.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.67
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.09
|
| Rate for Payer: Anthem Medicare Advantage |
$17.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$81.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.52
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cigna Commercial |
$141.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$86.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.52
|
| Rate for Payer: Health EOS Commercial |
$136.99
|
| Rate for Payer: HFN Commercial |
$141.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.52
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.52
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.52
|
| Rate for Payer: Multiplan Commercial |
$123.14
|
| Rate for Payer: NAPHCARE Commercial |
$26.29
|
| Rate for Payer: Preferred Network Access Commercial |
$141.61
|
| Rate for Payer: Quartz Beloit One Network |
$75.42
|
| Rate for Payer: Quartz Commercial |
$100.05
|
| Rate for Payer: Quartz Medicare Advantage |
$17.52
|
| Rate for Payer: The Alliance Commercial |
$70.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.52
|
| Rate for Payer: United Healthcare PPO |
$115.44
|
| Rate for Payer: WEA Trust Commercial |
$84.66
|
| Rate for Payer: Wellcare Medicare |
$17.52
|
| Rate for Payer: WPS Commercial |
$114.00
|
|
|
Cytomegalovirus Antibody IgM
|
Facility
|
IP
|
$148.00
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
978112
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$75.42 |
| Max. Negotiated Rate |
$141.61 |
| Rate for Payer: Aetna Commercial |
$138.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$132.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$81.58
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cigna Commercial |
$141.61
|
| Rate for Payer: Health EOS Commercial |
$136.99
|
| Rate for Payer: HFN Commercial |
$141.61
|
| Rate for Payer: Multiplan Commercial |
$123.14
|
| Rate for Payer: Preferred Network Access Commercial |
$141.61
|
| Rate for Payer: Quartz Beloit One Network |
$75.42
|
| Rate for Payer: Quartz Commercial |
$92.35
|
| Rate for Payer: WEA Trust Commercial |
$84.66
|
| Rate for Payer: WPS Commercial |
$114.00
|
|
|
Cytomegalovirus Antibody IgM
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
978112
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.52 |
| Max. Negotiated Rate |
$146.22 |
| Rate for Payer: Aetna Commercial |
$146.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$132.37
|
| Rate for Payer: Aetna Managed Medicare |
$17.52
|
| Rate for Payer: Anthem Medicare Advantage |
$17.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.52
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cigna Commercial |
$146.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$76.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.52
|
| Rate for Payer: Health EOS Commercial |
$140.07
|
| Rate for Payer: HFN Commercial |
$146.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$61.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$61.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.52
|
| Rate for Payer: Multiplan Commercial |
$123.14
|
| Rate for Payer: NAPHCARE Commercial |
$26.29
|
| Rate for Payer: Preferred Network Access Commercial |
$146.22
|
| Rate for Payer: Quartz Beloit One Network |
$67.72
|
| Rate for Payer: Quartz Commercial |
$87.73
|
| Rate for Payer: Quartz Medicare Advantage |
$17.52
|
| Rate for Payer: The Alliance Commercial |
$69.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.52
|
| Rate for Payer: WEA Trust Commercial |
$84.66
|
| Rate for Payer: WPS Commercial |
$77.11
|
|
|
Cytomegalovirus DNA by PCR, Qualitative
|
Professional
|
Both
|
$601.00
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
1038881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.49 |
| Max. Negotiated Rate |
$593.79 |
| Rate for Payer: Aetna Commercial |
$593.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$537.53
|
| Rate for Payer: Aetna Managed Medicare |
$36.49
|
| Rate for Payer: Anthem Medicare Advantage |
$36.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$36.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$36.49
|
| Rate for Payer: Cash Price |
$180.30
|
| Rate for Payer: Cash Price |
$180.30
|
| Rate for Payer: Cigna Commercial |
$593.79
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$312.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$36.49
|
| Rate for Payer: Health EOS Commercial |
$568.79
|
| Rate for Payer: HFN Commercial |
$593.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$128.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$128.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$36.49
|
| Rate for Payer: Multiplan Commercial |
$500.03
|
| Rate for Payer: NAPHCARE Commercial |
$54.74
|
| Rate for Payer: Preferred Network Access Commercial |
$593.79
|
| Rate for Payer: Quartz Beloit One Network |
$275.02
|
| Rate for Payer: Quartz Commercial |
$356.27
|
| Rate for Payer: Quartz Medicare Advantage |
$36.49
|
| Rate for Payer: The Alliance Commercial |
$144.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.49
|
| Rate for Payer: WEA Trust Commercial |
$343.77
|
| Rate for Payer: WPS Commercial |
$160.57
|
|
|
Cytomegalovirus DNA by PCR, Qualitative
|
Facility
|
OP
|
$601.00
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
1038881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.49 |
| Max. Negotiated Rate |
$575.04 |
| Rate for Payer: Aetna Commercial |
$562.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$537.53
|
| Rate for Payer: Aetna Managed Medicare |
$36.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$136.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$63.86
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$60.58
|
| Rate for Payer: Anthem Medicare Advantage |
$36.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$331.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$36.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$36.49
|
| Rate for Payer: Cash Price |
$180.30
|
| Rate for Payer: Cash Price |
$180.30
|
| Rate for Payer: Cigna Commercial |
$575.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$36.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$349.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$36.49
|
| Rate for Payer: Health EOS Commercial |
$556.29
|
| Rate for Payer: HFN Commercial |
$575.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$135.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$36.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$36.49
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$36.49
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$36.49
|
| Rate for Payer: Multiplan Commercial |
$500.03
|
| Rate for Payer: NAPHCARE Commercial |
$54.74
|
| Rate for Payer: Preferred Network Access Commercial |
$575.04
|
| Rate for Payer: Quartz Beloit One Network |
$306.27
|
| Rate for Payer: Quartz Commercial |
$406.28
|
| Rate for Payer: Quartz Medicare Advantage |
$36.49
|
| Rate for Payer: The Alliance Commercial |
$145.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.49
|
| Rate for Payer: United Healthcare PPO |
$468.78
|
| Rate for Payer: WEA Trust Commercial |
$343.77
|
| Rate for Payer: Wellcare Medicare |
$36.49
|
| Rate for Payer: WPS Commercial |
$462.95
|
|
|
Cytomegalovirus DNA by PCR, Qualitative
|
Facility
|
IP
|
$601.00
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
1038881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$306.27 |
| Max. Negotiated Rate |
$575.04 |
| Rate for Payer: Aetna Commercial |
$562.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$537.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$331.27
|
| Rate for Payer: Cash Price |
$180.30
|
| Rate for Payer: Cigna Commercial |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$556.29
|
| Rate for Payer: HFN Commercial |
$575.04
|
| Rate for Payer: Multiplan Commercial |
$500.03
|
| Rate for Payer: Preferred Network Access Commercial |
$575.04
|
| Rate for Payer: Quartz Beloit One Network |
$306.27
|
| Rate for Payer: Quartz Commercial |
$375.02
|
| Rate for Payer: WEA Trust Commercial |
$343.77
|
| Rate for Payer: WPS Commercial |
$462.95
|
|
|
Cytomegalovirus DNA by PCR, Quantitative
|
Facility
|
IP
|
$755.00
|
|
|
Service Code
|
CPT 87497
|
| Hospital Charge Code |
1038882
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$384.75 |
| Max. Negotiated Rate |
$722.38 |
| Rate for Payer: Aetna Commercial |
$706.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$675.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$416.16
|
| Rate for Payer: Cash Price |
$226.50
|
| Rate for Payer: Cigna Commercial |
$722.38
|
| Rate for Payer: Health EOS Commercial |
$698.83
|
| Rate for Payer: HFN Commercial |
$722.38
|
| Rate for Payer: Multiplan Commercial |
$628.16
|
| Rate for Payer: Preferred Network Access Commercial |
$722.38
|
| Rate for Payer: Quartz Beloit One Network |
$384.75
|
| Rate for Payer: Quartz Commercial |
$471.12
|
| Rate for Payer: WEA Trust Commercial |
$431.86
|
| Rate for Payer: WPS Commercial |
$581.58
|
|
|
Cytomegalovirus DNA by PCR, Quantitative
|
Facility
|
OP
|
$755.00
|
|
|
Service Code
|
CPT 87497
|
| Hospital Charge Code |
1038882
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.55 |
| Max. Negotiated Rate |
$722.38 |
| Rate for Payer: Aetna Commercial |
$706.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$675.27
|
| Rate for Payer: Aetna Managed Medicare |
$44.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$167.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$77.97
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$73.96
|
| Rate for Payer: Anthem Medicare Advantage |
$44.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$416.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$44.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$44.55
|
| Rate for Payer: Cash Price |
$226.50
|
| Rate for Payer: Cash Price |
$226.50
|
| Rate for Payer: Cigna Commercial |
$722.38
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$44.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$439.41
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$44.55
|
| Rate for Payer: Health EOS Commercial |
$698.83
|
| Rate for Payer: HFN Commercial |
$722.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$165.74
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$44.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$44.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$44.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$44.55
|
| Rate for Payer: Multiplan Commercial |
$628.16
|
| Rate for Payer: NAPHCARE Commercial |
$66.83
|
| Rate for Payer: Preferred Network Access Commercial |
$722.38
|
| Rate for Payer: Quartz Beloit One Network |
$384.75
|
| Rate for Payer: Quartz Commercial |
$510.38
|
| Rate for Payer: Quartz Medicare Advantage |
$44.55
|
| Rate for Payer: The Alliance Commercial |
$178.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$44.55
|
| Rate for Payer: United Healthcare PPO |
$588.90
|
| Rate for Payer: WEA Trust Commercial |
$431.86
|
| Rate for Payer: Wellcare Medicare |
$44.55
|
| Rate for Payer: WPS Commercial |
$581.58
|
|
