|
ED Avulsion of Nail Plate
|
Facility
IP
|
$97.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
6173146
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$47.53 |
| Max. Negotiated Rate |
$89.24 |
| Rate for Payer: Aetna Commercial |
$87.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$51.41
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$89.24
|
| Rate for Payer: Health EOS Commercial |
$86.33
|
| Rate for Payer: HFN Commercial |
$89.24
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: NAPHCARE Commercial |
$58.20
|
| Rate for Payer: Preferred Network Access Commercial |
$89.24
|
| Rate for Payer: Quartz Beloit One Network |
$47.53
|
| Rate for Payer: Quartz Commercial |
$58.20
|
| Rate for Payer: WEA Trust Commercial |
$53.35
|
| Rate for Payer: WPS Commercial |
$71.85
|
|
|
ED Avulsion of Nail Plate
|
Facility
OP
|
$97.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
6173146
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$46.56 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$87.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$83.42
|
| Rate for Payer: Aetna Managed Medicare |
$197.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$63.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$48.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$46.56
|
| Rate for Payer: Anthem Medicare Advantage |
$197.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$51.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$197.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$197.88
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$89.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$197.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$197.88
|
| Rate for Payer: Health EOS Commercial |
$86.33
|
| Rate for Payer: HFN Commercial |
$89.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$736.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$197.88
|
| Rate for Payer: Independent Care Health Plan Medicare |
$197.88
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$197.88
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$197.88
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: NAPHCARE Commercial |
$296.82
|
| Rate for Payer: Preferred Network Access Commercial |
$89.24
|
| Rate for Payer: Quartz Beloit One Network |
$47.53
|
| Rate for Payer: Quartz Commercial |
$63.05
|
| Rate for Payer: Quartz Medicare Advantage |
$197.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$197.88
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$53.35
|
| Rate for Payer: Wellcare Medicare |
$197.88
|
| Rate for Payer: WPS Commercial |
$71.85
|
|
|
ED Avulsion of Nail Plate, Additional
|
Facility
IP
|
$49.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
6173147
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$24.01 |
| Max. Negotiated Rate |
$45.08 |
| Rate for Payer: Aetna Commercial |
$44.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$25.97
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$45.08
|
| Rate for Payer: Health EOS Commercial |
$43.61
|
| Rate for Payer: HFN Commercial |
$45.08
|
| Rate for Payer: Multiplan Commercial |
$39.20
|
| Rate for Payer: NAPHCARE Commercial |
$29.40
|
| Rate for Payer: Preferred Network Access Commercial |
$45.08
|
| Rate for Payer: Quartz Beloit One Network |
$24.01
|
| Rate for Payer: Quartz Commercial |
$29.40
|
| Rate for Payer: WEA Trust Commercial |
$26.95
|
| Rate for Payer: WPS Commercial |
$36.29
|
|
|
ED Avulsion of Nail Plate, Additional
|
Facility
OP
|
$49.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
6173147
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$44.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$42.14
|
| Rate for Payer: Aetna Managed Medicare |
$13.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$24.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$23.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$25.97
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$45.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Health EOS Commercial |
$43.61
|
| Rate for Payer: HFN Commercial |
$45.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$36.75
|
| Rate for Payer: Multiplan Commercial |
$39.20
|
| Rate for Payer: NAPHCARE Commercial |
$29.40
|
| Rate for Payer: Preferred Network Access Commercial |
$45.08
|
| Rate for Payer: Quartz Beloit One Network |
$24.01
|
| Rate for Payer: Quartz Commercial |
$31.85
|
| Rate for Payer: Quartz Medicare Advantage |
$29.40
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$26.95
|
| Rate for Payer: WPS Commercial |
$36.29
|
|
|
ED Biopsy Of Cervix, Single Or Multiple
|
Facility
OP
|
$401.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
6174401
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.48 |
| Max. Negotiated Rate |
$8,905.92 |
| Rate for Payer: Aetna Commercial |
$360.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$344.86
|
| Rate for Payer: Aetna Managed Medicare |
$794.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$260.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$200.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$192.48
|
| Rate for Payer: Anthem Medicare Advantage |
$794.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$212.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$794.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$794.59
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cigna Commercial |
$368.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$794.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$794.59
|
| Rate for Payer: Health EOS Commercial |
$356.89
|
| Rate for Payer: HFN Commercial |
$368.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,955.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$794.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$794.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$794.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$794.59
|
| Rate for Payer: Multiplan Commercial |
$320.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,191.88
|
| Rate for Payer: Preferred Network Access Commercial |
$368.92
|
| Rate for Payer: Quartz Beloit One Network |
$196.49
|
| Rate for Payer: Quartz Commercial |
$260.65
|
| Rate for Payer: Quartz Medicare Advantage |
$794.59
|
| Rate for Payer: The Alliance Commercial |
$8,905.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$794.59
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$220.55
|
| Rate for Payer: Wellcare Medicare |
$794.59
|
| Rate for Payer: WPS Commercial |
$297.02
|
|
|
ED Biopsy Of Cervix, Single Or Multiple
|
Facility
IP
|
$401.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
6174401
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$196.49 |
| Max. Negotiated Rate |
$368.92 |
| Rate for Payer: Aetna Commercial |
$360.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$212.53
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cigna Commercial |
$368.92
|
| Rate for Payer: Health EOS Commercial |
$356.89
|
| Rate for Payer: HFN Commercial |
$368.92
|
| Rate for Payer: Multiplan Commercial |
$320.80
|
| Rate for Payer: NAPHCARE Commercial |
$240.60
|
| Rate for Payer: Preferred Network Access Commercial |
$368.92
|
| Rate for Payer: Quartz Beloit One Network |
$196.49
|
| Rate for Payer: Quartz Commercial |
$240.60
|
| Rate for Payer: WEA Trust Commercial |
$220.55
|
| Rate for Payer: WPS Commercial |
$297.02
|
|
|
ED Biopsy of External Ear
|
Facility
OP
|
$649.00
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
6174443
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$33.44 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$584.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$558.14
|
| Rate for Payer: Aetna Managed Medicare |
$241.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$421.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$324.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$311.52
|
| Rate for Payer: Anthem Medicare Advantage |
$241.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$343.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$241.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$241.43
|
| Rate for Payer: Cash Price |
$194.70
|
| Rate for Payer: Cash Price |
$194.70
|
| Rate for Payer: Cash Price |
$194.70
|
| Rate for Payer: Cigna Commercial |
$597.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$241.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$241.43
|
| Rate for Payer: Health EOS Commercial |
$577.61
|
| Rate for Payer: HFN Commercial |
$597.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$898.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$241.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$241.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$241.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$241.43
|
| Rate for Payer: Multiplan Commercial |
$519.20
|
| Rate for Payer: NAPHCARE Commercial |
$362.14
|
| Rate for Payer: Preferred Network Access Commercial |
$597.08
|
| Rate for Payer: Quartz Beloit One Network |
$318.01
|
| Rate for Payer: Quartz Commercial |
$421.85
|
| Rate for Payer: Quartz Medicare Advantage |
$241.43
|
| Rate for Payer: The Alliance Commercial |
$33.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$241.43
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$356.95
|
| Rate for Payer: Wellcare Medicare |
$241.43
|
| Rate for Payer: WPS Commercial |
$480.71
|
|
|
ED Biopsy of External Ear
|
Facility
IP
|
$649.00
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
6174443
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$318.01 |
| Max. Negotiated Rate |
$597.08 |
| Rate for Payer: Aetna Commercial |
$584.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$343.97
|
| Rate for Payer: Cash Price |
$194.70
|
| Rate for Payer: Cigna Commercial |
$597.08
|
| Rate for Payer: Health EOS Commercial |
$577.61
|
| Rate for Payer: HFN Commercial |
$597.08
|
| Rate for Payer: Multiplan Commercial |
$519.20
|
| Rate for Payer: NAPHCARE Commercial |
$389.40
|
| Rate for Payer: Preferred Network Access Commercial |
$597.08
|
| Rate for Payer: Quartz Beloit One Network |
$318.01
|
| Rate for Payer: Quartz Commercial |
$389.40
|
| Rate for Payer: WEA Trust Commercial |
$356.95
|
| Rate for Payer: WPS Commercial |
$480.71
|
|
|
ED Biopsy Of Eye Lid
|
Facility
IP
|
$348.00
|
|
|
Service Code
|
CPT 67810
|
| Hospital Charge Code |
6174423
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$170.52 |
| Max. Negotiated Rate |
$320.16 |
| Rate for Payer: Aetna Commercial |
$313.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$184.44
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cigna Commercial |
$320.16
|
| Rate for Payer: Health EOS Commercial |
$309.72
|
| Rate for Payer: HFN Commercial |
$320.16
|
| Rate for Payer: Multiplan Commercial |
$278.40
|
| Rate for Payer: NAPHCARE Commercial |
$208.80
|
| Rate for Payer: Preferred Network Access Commercial |
$320.16
|
| Rate for Payer: Quartz Beloit One Network |
$170.52
|
| Rate for Payer: Quartz Commercial |
$208.80
|
| Rate for Payer: WEA Trust Commercial |
$191.40
|
| Rate for Payer: WPS Commercial |
$257.76
|
|
|
ED Biopsy Of Eye Lid
|
Facility
OP
|
$348.00
|
|
|
Service Code
|
CPT 67810
|
| Hospital Charge Code |
6174423
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$313.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$299.28
|
| Rate for Payer: Aetna Managed Medicare |
$287.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$226.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$174.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$167.04
|
| Rate for Payer: Anthem Medicare Advantage |
$287.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$184.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$287.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$287.94
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cigna Commercial |
$320.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$287.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$287.94
|
| Rate for Payer: Health EOS Commercial |
$309.72
|
| Rate for Payer: HFN Commercial |
$320.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,071.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$287.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$287.94
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$287.94
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$287.94
|
| Rate for Payer: Multiplan Commercial |
$278.40
|
| Rate for Payer: NAPHCARE Commercial |
$431.91
|
| Rate for Payer: Preferred Network Access Commercial |
$320.16
|
| Rate for Payer: Quartz Beloit One Network |
$170.52
|
| Rate for Payer: Quartz Commercial |
$226.20
|
| Rate for Payer: Quartz Medicare Advantage |
$287.94
|
| Rate for Payer: The Alliance Commercial |
$20.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$287.94
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$191.40
|
| Rate for Payer: Wellcare Medicare |
$287.94
|
| Rate for Payer: WPS Commercial |
$257.76
|
|
|
ED Biopsy of Lip
|
Facility
OP
|
$224.00
|
|
|
Service Code
|
CPT 40490
|
| Hospital Charge Code |
6173897
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$107.52 |
| Max. Negotiated Rate |
$21,990.36 |
| Rate for Payer: Aetna Commercial |
$201.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$192.64
|
| Rate for Payer: Aetna Managed Medicare |
$241.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$145.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$112.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$107.52
|
| Rate for Payer: Anthem Medicare Advantage |
$241.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$118.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$241.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$241.43
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cigna Commercial |
$206.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$241.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$241.43
|
| Rate for Payer: Health EOS Commercial |
$199.36
|
| Rate for Payer: HFN Commercial |
$206.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$898.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$241.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$241.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$241.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$241.43
|
| Rate for Payer: Multiplan Commercial |
$179.20
|
| Rate for Payer: NAPHCARE Commercial |
$362.14
|
| Rate for Payer: Preferred Network Access Commercial |
$206.08
|
| Rate for Payer: Quartz Beloit One Network |
$109.76
|
| Rate for Payer: Quartz Commercial |
$145.60
|
| Rate for Payer: Quartz Medicare Advantage |
$241.43
|
| Rate for Payer: The Alliance Commercial |
$21,990.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$241.43
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$123.20
|
| Rate for Payer: Wellcare Medicare |
$241.43
|
| Rate for Payer: WPS Commercial |
$165.92
|
|
|
ED Biopsy of Lip
|
Facility
IP
|
$224.00
|
|
|
Service Code
|
CPT 40490
|
| Hospital Charge Code |
6173897
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$109.76 |
| Max. Negotiated Rate |
$206.08 |
| Rate for Payer: Aetna Commercial |
$201.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$118.72
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cigna Commercial |
$206.08
|
| Rate for Payer: Health EOS Commercial |
$199.36
|
| Rate for Payer: HFN Commercial |
$206.08
|
| Rate for Payer: Multiplan Commercial |
$179.20
|
| Rate for Payer: NAPHCARE Commercial |
$134.40
|
| Rate for Payer: Preferred Network Access Commercial |
$206.08
|
| Rate for Payer: Quartz Beloit One Network |
$109.76
|
| Rate for Payer: Quartz Commercial |
$134.40
|
| Rate for Payer: WEA Trust Commercial |
$123.20
|
| Rate for Payer: WPS Commercial |
$165.92
|
|
|
ED Biopsy Of Penis
|
Facility
OP
|
$401.00
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
6174108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.48 |
| Max. Negotiated Rate |
$28,799.20 |
| Rate for Payer: Aetna Commercial |
$360.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$344.86
|
| Rate for Payer: Aetna Managed Medicare |
$1,602.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$260.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$200.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$192.48
|
| Rate for Payer: Anthem Medicare Advantage |
$1,602.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$212.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,602.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,602.49
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cigna Commercial |
$368.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,602.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,602.49
|
| Rate for Payer: Health EOS Commercial |
$356.89
|
| Rate for Payer: HFN Commercial |
$368.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,961.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,602.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,602.49
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,602.49
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,602.49
|
| Rate for Payer: Multiplan Commercial |
$320.80
|
| Rate for Payer: NAPHCARE Commercial |
$2,403.74
|
| Rate for Payer: Preferred Network Access Commercial |
$368.92
|
| Rate for Payer: Quartz Beloit One Network |
$196.49
|
| Rate for Payer: Quartz Commercial |
$260.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,602.49
|
| Rate for Payer: The Alliance Commercial |
$28,799.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,602.49
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$220.55
|
| Rate for Payer: Wellcare Medicare |
$1,602.49
|
| Rate for Payer: WPS Commercial |
$297.02
|
|
|
ED Biopsy Of Penis
|
Facility
IP
|
$401.00
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
6174108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$196.49 |
| Max. Negotiated Rate |
$368.92 |
| Rate for Payer: Aetna Commercial |
$360.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$212.53
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cigna Commercial |
$368.92
|
| Rate for Payer: Health EOS Commercial |
$356.89
|
| Rate for Payer: HFN Commercial |
$368.92
|
| Rate for Payer: Multiplan Commercial |
$320.80
|
| Rate for Payer: NAPHCARE Commercial |
$240.60
|
| Rate for Payer: Preferred Network Access Commercial |
$368.92
|
| Rate for Payer: Quartz Beloit One Network |
$196.49
|
| Rate for Payer: Quartz Commercial |
$240.60
|
| Rate for Payer: WEA Trust Commercial |
$220.55
|
| Rate for Payer: WPS Commercial |
$297.02
|
|
|
ED Biopsy of Tongue; Anterior Two-Thirds
|
Facility
OP
|
$462.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
6174075
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$221.76 |
| Max. Negotiated Rate |
$5,812.20 |
| Rate for Payer: Aetna Commercial |
$415.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$397.32
|
| Rate for Payer: Aetna Managed Medicare |
$543.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$300.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$231.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$221.76
|
| Rate for Payer: Anthem Medicare Advantage |
$543.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$543.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$543.83
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cigna Commercial |
$425.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$543.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$543.83
|
| Rate for Payer: Health EOS Commercial |
$411.18
|
| Rate for Payer: HFN Commercial |
$425.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,023.05
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$543.83
|
| Rate for Payer: Independent Care Health Plan Medicare |
$543.83
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$543.83
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$543.83
|
| Rate for Payer: Multiplan Commercial |
$369.60
|
| Rate for Payer: NAPHCARE Commercial |
$815.74
|
| Rate for Payer: Preferred Network Access Commercial |
$425.04
|
| Rate for Payer: Quartz Beloit One Network |
$226.38
|
| Rate for Payer: Quartz Commercial |
$300.30
|
| Rate for Payer: Quartz Medicare Advantage |
$543.83
|
| Rate for Payer: The Alliance Commercial |
$5,812.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$543.83
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$254.10
|
| Rate for Payer: Wellcare Medicare |
$543.83
|
| Rate for Payer: WPS Commercial |
$342.20
|
|
|
ED Biopsy of Tongue; Anterior Two-Thirds
|
Facility
IP
|
$462.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
6174075
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$226.38 |
| Max. Negotiated Rate |
$425.04 |
| Rate for Payer: Aetna Commercial |
$415.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.86
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cigna Commercial |
$425.04
|
| Rate for Payer: Health EOS Commercial |
$411.18
|
| Rate for Payer: HFN Commercial |
$425.04
|
| Rate for Payer: Multiplan Commercial |
$369.60
|
| Rate for Payer: NAPHCARE Commercial |
$277.20
|
| Rate for Payer: Preferred Network Access Commercial |
$425.04
|
| Rate for Payer: Quartz Beloit One Network |
$226.38
|
| Rate for Payer: Quartz Commercial |
$277.20
|
| Rate for Payer: WEA Trust Commercial |
$254.10
|
| Rate for Payer: WPS Commercial |
$342.20
|
|
|
ED Biopsy Of Vagina
|
Facility
OP
|
$156.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
6174396
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$74.88 |
| Max. Negotiated Rate |
$25,387.88 |
| Rate for Payer: Aetna Commercial |
$140.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$134.16
|
| Rate for Payer: Aetna Managed Medicare |
$794.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$101.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$78.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$74.88
|
| Rate for Payer: Anthem Medicare Advantage |
$794.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$82.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$794.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$794.59
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cigna Commercial |
$143.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$794.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$794.59
|
| Rate for Payer: Health EOS Commercial |
$138.84
|
| Rate for Payer: HFN Commercial |
$143.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,955.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$794.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$794.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$794.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$794.59
|
| Rate for Payer: Multiplan Commercial |
$124.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,191.88
|
| Rate for Payer: Preferred Network Access Commercial |
$143.52
|
| Rate for Payer: Quartz Beloit One Network |
$76.44
|
| Rate for Payer: Quartz Commercial |
$101.40
|
| Rate for Payer: Quartz Medicare Advantage |
$794.59
|
| Rate for Payer: The Alliance Commercial |
$25,387.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$794.59
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$85.80
|
| Rate for Payer: Wellcare Medicare |
$794.59
|
| Rate for Payer: WPS Commercial |
$115.55
|
|
|
ED Biopsy Of Vagina
|
Facility
IP
|
$156.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
6174396
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$76.44 |
| Max. Negotiated Rate |
$143.52 |
| Rate for Payer: Aetna Commercial |
$140.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$82.68
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cigna Commercial |
$143.52
|
| Rate for Payer: Health EOS Commercial |
$138.84
|
| Rate for Payer: HFN Commercial |
$143.52
|
| Rate for Payer: Multiplan Commercial |
$124.80
|
| Rate for Payer: NAPHCARE Commercial |
$93.60
|
| Rate for Payer: Preferred Network Access Commercial |
$143.52
|
| Rate for Payer: Quartz Beloit One Network |
$76.44
|
| Rate for Payer: Quartz Commercial |
$93.60
|
| Rate for Payer: WEA Trust Commercial |
$85.80
|
| Rate for Payer: WPS Commercial |
$115.55
|
|
|
ED Biopsy Of Vulva/Perineum, 1 Lesion
|
Facility
IP
|
$241.00
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
6174393
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$118.09 |
| Max. Negotiated Rate |
$221.72 |
| Rate for Payer: Aetna Commercial |
$216.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$127.73
|
| Rate for Payer: Cash Price |
$72.30
|
| Rate for Payer: Cigna Commercial |
$221.72
|
| Rate for Payer: Health EOS Commercial |
$214.49
|
| Rate for Payer: HFN Commercial |
$221.72
|
| Rate for Payer: Multiplan Commercial |
$192.80
|
| Rate for Payer: NAPHCARE Commercial |
$144.60
|
| Rate for Payer: Preferred Network Access Commercial |
$221.72
|
| Rate for Payer: Quartz Beloit One Network |
$118.09
|
| Rate for Payer: Quartz Commercial |
$144.60
|
| Rate for Payer: WEA Trust Commercial |
$132.55
|
| Rate for Payer: WPS Commercial |
$178.51
|
|
|
ED Biopsy Of Vulva/Perineum, 1 Lesion
|
Facility
OP
|
$241.00
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
6174393
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.68 |
| Max. Negotiated Rate |
$7,358.52 |
| Rate for Payer: Aetna Commercial |
$216.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$207.26
|
| Rate for Payer: Aetna Managed Medicare |
$794.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$156.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$120.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$115.68
|
| Rate for Payer: Anthem Medicare Advantage |
$794.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$127.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$794.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$794.59
|
| Rate for Payer: Cash Price |
$72.30
|
| Rate for Payer: Cash Price |
$72.30
|
| Rate for Payer: Cash Price |
$72.30
|
| Rate for Payer: Cigna Commercial |
$221.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$794.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$794.59
|
| Rate for Payer: Health EOS Commercial |
$214.49
|
| Rate for Payer: HFN Commercial |
$221.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,955.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$794.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$794.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$794.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$794.59
|
| Rate for Payer: Multiplan Commercial |
$192.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,191.88
|
| Rate for Payer: Preferred Network Access Commercial |
$221.72
|
| Rate for Payer: Quartz Beloit One Network |
$118.09
|
| Rate for Payer: Quartz Commercial |
$156.65
|
| Rate for Payer: Quartz Medicare Advantage |
$794.59
|
| Rate for Payer: The Alliance Commercial |
$7,358.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$794.59
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$132.55
|
| Rate for Payer: Wellcare Medicare |
$794.59
|
| Rate for Payer: WPS Commercial |
$178.51
|
|
|
ED Biopsy of Vulva/Perineum Each Add'l Lesion
|
Facility
IP
|
$64.00
|
|
|
Service Code
|
CPT 56606
|
| Hospital Charge Code |
6174394
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$31.36 |
| Max. Negotiated Rate |
$58.88 |
| Rate for Payer: Aetna Commercial |
$57.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$33.92
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cigna Commercial |
$58.88
|
| Rate for Payer: Health EOS Commercial |
$56.96
|
| Rate for Payer: HFN Commercial |
$58.88
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: NAPHCARE Commercial |
$38.40
|
| Rate for Payer: Preferred Network Access Commercial |
$58.88
|
| Rate for Payer: Quartz Beloit One Network |
$31.36
|
| Rate for Payer: Quartz Commercial |
$38.40
|
| Rate for Payer: WEA Trust Commercial |
$35.20
|
| Rate for Payer: WPS Commercial |
$47.40
|
|
|
ED Biopsy of Vulva/Perineum Each Add'l Lesion
|
Facility
OP
|
$64.00
|
|
|
Service Code
|
CPT 56606
|
| Hospital Charge Code |
6174394
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$17.92 |
| Max. Negotiated Rate |
$7,358.52 |
| Rate for Payer: Aetna Commercial |
$57.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$55.04
|
| Rate for Payer: Aetna Managed Medicare |
$17.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$41.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$32.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$33.92
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cigna Commercial |
$58.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Health EOS Commercial |
$56.96
|
| Rate for Payer: HFN Commercial |
$58.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.00
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: NAPHCARE Commercial |
$38.40
|
| Rate for Payer: Preferred Network Access Commercial |
$58.88
|
| Rate for Payer: Quartz Beloit One Network |
$31.36
|
| Rate for Payer: Quartz Commercial |
$41.60
|
| Rate for Payer: Quartz Medicare Advantage |
$38.40
|
| Rate for Payer: The Alliance Commercial |
$7,358.52
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$35.20
|
| Rate for Payer: WPS Commercial |
$47.40
|
|
|
ED Biopsy or Excision of Lymph Node(s); Open, Superficial
|
Facility
OP
|
$697.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
6173896
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$14,015.29 |
| Rate for Payer: Aetna Commercial |
$627.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$599.42
|
| Rate for Payer: Aetna Managed Medicare |
$3,767.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$453.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$348.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$334.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,767.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$369.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,767.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,767.55
|
| Rate for Payer: Cash Price |
$209.10
|
| Rate for Payer: Cash Price |
$209.10
|
| Rate for Payer: Cash Price |
$209.10
|
| Rate for Payer: Cigna Commercial |
$641.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,767.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,767.55
|
| Rate for Payer: Health EOS Commercial |
$620.33
|
| Rate for Payer: HFN Commercial |
$641.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,015.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,767.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,767.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,767.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,767.55
|
| Rate for Payer: Multiplan Commercial |
$557.60
|
| Rate for Payer: NAPHCARE Commercial |
$5,651.32
|
| Rate for Payer: Preferred Network Access Commercial |
$641.24
|
| Rate for Payer: Quartz Beloit One Network |
$341.53
|
| Rate for Payer: Quartz Commercial |
$453.05
|
| Rate for Payer: Quartz Medicare Advantage |
$3,767.55
|
| Rate for Payer: The Alliance Commercial |
$13,286.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,767.55
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$383.35
|
| Rate for Payer: Wellcare Medicare |
$3,767.55
|
| Rate for Payer: WPS Commercial |
$516.27
|
|
|
ED Biopsy or Excision of Lymph Node(s); Open, Superficial
|
Facility
IP
|
$697.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
6173896
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$341.53 |
| Max. Negotiated Rate |
$641.24 |
| Rate for Payer: Aetna Commercial |
$627.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$369.41
|
| Rate for Payer: Cash Price |
$209.10
|
| Rate for Payer: Cigna Commercial |
$641.24
|
| Rate for Payer: Health EOS Commercial |
$620.33
|
| Rate for Payer: HFN Commercial |
$641.24
|
| Rate for Payer: Multiplan Commercial |
$557.60
|
| Rate for Payer: NAPHCARE Commercial |
$418.20
|
| Rate for Payer: Preferred Network Access Commercial |
$641.24
|
| Rate for Payer: Quartz Beloit One Network |
$341.53
|
| Rate for Payer: Quartz Commercial |
$418.20
|
| Rate for Payer: WEA Trust Commercial |
$383.35
|
| Rate for Payer: WPS Commercial |
$516.27
|
|
|
ED Biopsy: Oropharynx
|
Facility
OP
|
$414.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
6174082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$198.72 |
| Max. Negotiated Rate |
$7,251.96 |
| Rate for Payer: Aetna Commercial |
$372.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$356.04
|
| Rate for Payer: Aetna Managed Medicare |
$1,507.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$269.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$207.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$198.72
|
| Rate for Payer: Anthem Medicare Advantage |
$1,507.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$219.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,507.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,507.37
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$380.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,507.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,507.37
|
| Rate for Payer: Health EOS Commercial |
$368.46
|
| Rate for Payer: HFN Commercial |
$380.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,607.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,507.37
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,507.37
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,507.37
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,507.37
|
| Rate for Payer: Multiplan Commercial |
$331.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,261.06
|
| Rate for Payer: Preferred Network Access Commercial |
$380.88
|
| Rate for Payer: Quartz Beloit One Network |
$202.86
|
| Rate for Payer: Quartz Commercial |
$269.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,507.37
|
| Rate for Payer: The Alliance Commercial |
$7,251.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,507.37
|
| Rate for Payer: WEA Trust Commercial |
$227.70
|
| Rate for Payer: Wellcare Medicare |
$1,507.37
|
| Rate for Payer: WPS Commercial |
$306.65
|
|
