|
ECG/Review,Interpret Only 93272
|
Professional
|
Both
|
$671.00
|
|
|
Service Code
|
CPT 93272
|
| Hospital Charge Code |
3219490
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.92 |
| Max. Negotiated Rate |
$662.95 |
| Rate for Payer: Aetna Commercial |
$662.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$600.14
|
| Rate for Payer: Aetna Managed Medicare |
$23.92
|
| Rate for Payer: Anthem Medicare Advantage |
$23.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.92
|
| Rate for Payer: Cash Price |
$201.30
|
| Rate for Payer: Cash Price |
$201.30
|
| Rate for Payer: Cash Price |
$201.30
|
| Rate for Payer: Cigna Commercial |
$662.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$28.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23.92
|
| Rate for Payer: Health EOS Commercial |
$635.03
|
| Rate for Payer: HFN Commercial |
$662.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$89.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$89.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.92
|
| Rate for Payer: Multiplan Commercial |
$558.27
|
| Rate for Payer: NAPHCARE Commercial |
$35.88
|
| Rate for Payer: Preferred Network Access Commercial |
$662.95
|
| Rate for Payer: Quartz Beloit One Network |
$307.05
|
| Rate for Payer: Quartz Commercial |
$397.77
|
| Rate for Payer: Quartz Medicare Advantage |
$23.92
|
| Rate for Payer: The Alliance Commercial |
$90.90
|
| Rate for Payer: United Healthcare Medicaid |
$28.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.92
|
| Rate for Payer: WEA Trust Commercial |
$383.81
|
| Rate for Payer: WPS Commercial |
$95.68
|
|
|
Echinococcus Antibody
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
977931
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$170.92 |
| Rate for Payer: Aetna Commercial |
$170.92
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$154.73
|
| Rate for Payer: Aetna Managed Medicare |
$13.53
|
| Rate for Payer: Anthem Medicare Advantage |
$13.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.53
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cigna Commercial |
$170.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$89.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.53
|
| Rate for Payer: Health EOS Commercial |
$163.73
|
| Rate for Payer: HFN Commercial |
$170.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$47.77
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$47.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.53
|
| Rate for Payer: Multiplan Commercial |
$143.94
|
| Rate for Payer: NAPHCARE Commercial |
$20.30
|
| Rate for Payer: Preferred Network Access Commercial |
$170.92
|
| Rate for Payer: Quartz Beloit One Network |
$79.16
|
| Rate for Payer: Quartz Commercial |
$102.55
|
| Rate for Payer: Quartz Medicare Advantage |
$13.53
|
| Rate for Payer: The Alliance Commercial |
$53.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.53
|
| Rate for Payer: WEA Trust Commercial |
$98.96
|
| Rate for Payer: WPS Commercial |
$59.53
|
|
|
Echinococcus Antibody
|
Facility
|
IP
|
$173.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
977931
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$88.16 |
| Max. Negotiated Rate |
$165.53 |
| Rate for Payer: Aetna Commercial |
$161.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$154.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$95.36
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cigna Commercial |
$165.53
|
| Rate for Payer: Health EOS Commercial |
$160.13
|
| Rate for Payer: HFN Commercial |
$165.53
|
| Rate for Payer: Multiplan Commercial |
$143.94
|
| Rate for Payer: Preferred Network Access Commercial |
$165.53
|
| Rate for Payer: Quartz Beloit One Network |
$88.16
|
| Rate for Payer: Quartz Commercial |
$107.95
|
| Rate for Payer: WEA Trust Commercial |
$98.96
|
| Rate for Payer: WPS Commercial |
$133.26
|
|
|
Echinococcus Antibody
|
Facility
|
OP
|
$173.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
977931
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$165.53 |
| Rate for Payer: Aetna Commercial |
$161.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$154.73
|
| Rate for Payer: Aetna Managed Medicare |
$13.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$50.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$23.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22.46
|
| Rate for Payer: Anthem Medicare Advantage |
$13.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$95.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.53
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cash Price |
$51.90
|
| Rate for Payer: Cigna Commercial |
$165.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$100.69
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.53
|
| Rate for Payer: Health EOS Commercial |
$160.13
|
| Rate for Payer: HFN Commercial |
$165.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$50.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.53
|
| Rate for Payer: Multiplan Commercial |
$143.94
|
| Rate for Payer: NAPHCARE Commercial |
$20.30
|
| Rate for Payer: Preferred Network Access Commercial |
$165.53
|
| Rate for Payer: Quartz Beloit One Network |
$88.16
|
| Rate for Payer: Quartz Commercial |
$116.95
|
| Rate for Payer: Quartz Medicare Advantage |
$13.53
|
| Rate for Payer: The Alliance Commercial |
$54.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.53
|
| Rate for Payer: United Healthcare PPO |
$134.94
|
| Rate for Payer: WEA Trust Commercial |
$98.96
|
| Rate for Payer: Wellcare Medicare |
$13.53
|
| Rate for Payer: WPS Commercial |
$133.26
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$6,243.00
|
|
|
Service Code
|
CPT 93318
|
| Hospital Charge Code |
5375703
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$5,973.30 |
| Rate for Payer: Aetna Commercial |
$5,843.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,583.74
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,220.27
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,246.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,116.51
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,441.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$575.04
|
| Rate for Payer: Cash Price |
$1,872.90
|
| Rate for Payer: Cash Price |
$1,872.90
|
| Rate for Payer: Cigna Commercial |
$5,973.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,633.43
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$5,778.52
|
| Rate for Payer: HFN Commercial |
$5,973.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,139.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$575.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$575.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$575.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$575.04
|
| Rate for Payer: Multiplan Commercial |
$5,194.18
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$5,973.30
|
| Rate for Payer: Quartz Beloit One Network |
$3,181.43
|
| Rate for Payer: Quartz Commercial |
$4,220.27
|
| Rate for Payer: Quartz Medicare Advantage |
$575.04
|
| Rate for Payer: The Alliance Commercial |
$2,300.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$575.04
|
| Rate for Payer: United Healthcare PPO |
$4,869.54
|
| Rate for Payer: WEA Trust Commercial |
$3,571.00
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$4,808.98
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$1,917.00
|
|
|
Service Code
|
CPT 93317
|
| Hospital Charge Code |
5375688
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$558.23 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Aetna Managed Medicare |
$558.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,295.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$996.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$956.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,115.69
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,495.26
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,196.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,295.89
|
| Rate for Payer: Quartz Medicare Advantage |
$1,196.21
|
| Rate for Payer: The Alliance Commercial |
$996.84
|
| Rate for Payer: United Healthcare PPO |
$1,495.26
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$2,458.00
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
5375653
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$2,351.81 |
| Rate for Payer: Aetna Commercial |
$2,300.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,198.44
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,661.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,278.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,227.03
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,354.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$575.04
|
| Rate for Payer: Cash Price |
$737.40
|
| Rate for Payer: Cash Price |
$737.40
|
| Rate for Payer: Cigna Commercial |
$2,351.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,430.56
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$2,275.12
|
| Rate for Payer: HFN Commercial |
$2,351.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,139.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$575.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$575.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$575.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$575.04
|
| Rate for Payer: Multiplan Commercial |
$2,045.06
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,351.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,252.60
|
| Rate for Payer: Quartz Commercial |
$1,661.61
|
| Rate for Payer: Quartz Medicare Advantage |
$575.04
|
| Rate for Payer: The Alliance Commercial |
$2,300.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$575.04
|
| Rate for Payer: United Healthcare PPO |
$1,917.24
|
| Rate for Payer: WEA Trust Commercial |
$1,405.98
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$1,893.40
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$4,666.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
5375700
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$4,464.43 |
| Rate for Payer: Aetna Commercial |
$4,367.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,173.27
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,154.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,426.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,329.27
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,571.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$575.04
|
| Rate for Payer: Cash Price |
$1,399.80
|
| Rate for Payer: Cash Price |
$1,399.80
|
| Rate for Payer: Cigna Commercial |
$4,464.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,715.61
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$4,318.85
|
| Rate for Payer: HFN Commercial |
$4,464.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,139.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$575.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$575.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$575.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$575.04
|
| Rate for Payer: Multiplan Commercial |
$3,882.11
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$4,464.43
|
| Rate for Payer: Quartz Beloit One Network |
$2,377.79
|
| Rate for Payer: Quartz Commercial |
$3,154.22
|
| Rate for Payer: Quartz Medicare Advantage |
$575.04
|
| Rate for Payer: The Alliance Commercial |
$2,300.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$575.04
|
| Rate for Payer: United Healthcare PPO |
$3,639.48
|
| Rate for Payer: WEA Trust Commercial |
$2,668.95
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$3,594.22
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$3,327.00
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
5375694
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,695.44 |
| Max. Negotiated Rate |
$3,183.27 |
| Rate for Payer: Aetna Commercial |
$3,114.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,975.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,833.84
|
| Rate for Payer: Cash Price |
$998.10
|
| Rate for Payer: Cigna Commercial |
$3,183.27
|
| Rate for Payer: Health EOS Commercial |
$3,079.47
|
| Rate for Payer: HFN Commercial |
$3,183.27
|
| Rate for Payer: Multiplan Commercial |
$2,768.06
|
| Rate for Payer: Preferred Network Access Commercial |
$3,183.27
|
| Rate for Payer: Quartz Beloit One Network |
$1,695.44
|
| Rate for Payer: Quartz Commercial |
$2,076.05
|
| Rate for Payer: WEA Trust Commercial |
$1,903.04
|
| Rate for Payer: WPS Commercial |
$2,562.79
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$4,474.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
5375668
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$4,280.72 |
| Rate for Payer: Aetna Commercial |
$4,187.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,001.55
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,024.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,326.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,233.42
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,466.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$575.04
|
| Rate for Payer: Cash Price |
$1,342.20
|
| Rate for Payer: Cash Price |
$1,342.20
|
| Rate for Payer: Cigna Commercial |
$4,280.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,603.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$4,141.13
|
| Rate for Payer: HFN Commercial |
$4,280.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,139.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$575.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$575.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$575.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$575.04
|
| Rate for Payer: Multiplan Commercial |
$3,722.37
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$4,280.72
|
| Rate for Payer: Quartz Beloit One Network |
$2,279.95
|
| Rate for Payer: Quartz Commercial |
$3,024.42
|
| Rate for Payer: Quartz Medicare Advantage |
$575.04
|
| Rate for Payer: The Alliance Commercial |
$2,300.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$575.04
|
| Rate for Payer: United Healthcare PPO |
$3,489.72
|
| Rate for Payer: WEA Trust Commercial |
$2,559.13
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$3,446.32
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$1,753.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
5375659
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$510.47 |
| Max. Negotiated Rate |
$1,677.27 |
| Rate for Payer: Aetna Commercial |
$1,640.81
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,567.88
|
| Rate for Payer: Aetna Managed Medicare |
$510.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,185.03
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$911.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$875.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$966.25
|
| Rate for Payer: Cash Price |
$525.90
|
| Rate for Payer: Cigna Commercial |
$1,677.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,020.25
|
| Rate for Payer: Health EOS Commercial |
$1,622.58
|
| Rate for Payer: HFN Commercial |
$1,677.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,367.34
|
| Rate for Payer: Multiplan Commercial |
$1,458.50
|
| Rate for Payer: NAPHCARE Commercial |
$1,093.87
|
| Rate for Payer: Preferred Network Access Commercial |
$1,677.27
|
| Rate for Payer: Quartz Beloit One Network |
$893.33
|
| Rate for Payer: Quartz Commercial |
$1,185.03
|
| Rate for Payer: Quartz Medicare Advantage |
$1,093.87
|
| Rate for Payer: The Alliance Commercial |
$911.56
|
| Rate for Payer: United Healthcare PPO |
$1,367.34
|
| Rate for Payer: WEA Trust Commercial |
$1,002.72
|
| Rate for Payer: WPS Commercial |
$1,350.34
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$2,579.00
|
|
|
Service Code
|
CPT 93313
|
| Hospital Charge Code |
5375706
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$2,467.59 |
| Rate for Payer: Aetna Commercial |
$2,413.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,306.66
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,743.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,341.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,287.44
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,421.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$575.04
|
| Rate for Payer: Cash Price |
$773.70
|
| Rate for Payer: Cash Price |
$773.70
|
| Rate for Payer: Cigna Commercial |
$2,467.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,500.98
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$2,387.12
|
| Rate for Payer: HFN Commercial |
$2,467.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,139.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$575.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$575.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$575.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$575.04
|
| Rate for Payer: Multiplan Commercial |
$2,145.73
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,467.59
|
| Rate for Payer: Quartz Beloit One Network |
$1,314.26
|
| Rate for Payer: Quartz Commercial |
$1,743.40
|
| Rate for Payer: Quartz Medicare Advantage |
$575.04
|
| Rate for Payer: The Alliance Commercial |
$2,300.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$575.04
|
| Rate for Payer: United Healthcare PPO |
$2,011.62
|
| Rate for Payer: WEA Trust Commercial |
$1,475.19
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$1,986.60
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$1,917.00
|
|
|
Service Code
|
CPT 93314
|
| Hospital Charge Code |
5375685
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$976.90 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,196.21
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$4,474.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
5375677
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$2,279.95 |
| Max. Negotiated Rate |
$4,280.72 |
| Rate for Payer: Aetna Commercial |
$4,187.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,001.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,466.07
|
| Rate for Payer: Cash Price |
$1,342.20
|
| Rate for Payer: Cigna Commercial |
$4,280.72
|
| Rate for Payer: Health EOS Commercial |
$4,141.13
|
| Rate for Payer: HFN Commercial |
$4,280.72
|
| Rate for Payer: Multiplan Commercial |
$3,722.37
|
| Rate for Payer: Preferred Network Access Commercial |
$4,280.72
|
| Rate for Payer: Quartz Beloit One Network |
$2,279.95
|
| Rate for Payer: Quartz Commercial |
$2,791.78
|
| Rate for Payer: WEA Trust Commercial |
$2,559.13
|
| Rate for Payer: WPS Commercial |
$3,446.32
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$3,701.00
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
5375650
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$3,541.12 |
| Rate for Payer: Aetna Commercial |
$3,464.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,310.17
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,501.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,924.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,847.54
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,039.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$575.04
|
| Rate for Payer: Cash Price |
$1,110.30
|
| Rate for Payer: Cash Price |
$1,110.30
|
| Rate for Payer: Cigna Commercial |
$3,541.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,153.98
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$3,425.65
|
| Rate for Payer: HFN Commercial |
$3,541.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,139.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$575.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$575.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$575.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$575.04
|
| Rate for Payer: Multiplan Commercial |
$3,079.23
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$3,541.12
|
| Rate for Payer: Quartz Beloit One Network |
$1,886.03
|
| Rate for Payer: Quartz Commercial |
$2,501.88
|
| Rate for Payer: Quartz Medicare Advantage |
$575.04
|
| Rate for Payer: The Alliance Commercial |
$2,300.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$575.04
|
| Rate for Payer: United Healthcare PPO |
$2,886.78
|
| Rate for Payer: WEA Trust Commercial |
$2,116.97
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$2,850.88
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$3,327.00
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
5375691
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,695.44 |
| Max. Negotiated Rate |
$3,183.27 |
| Rate for Payer: Aetna Commercial |
$3,114.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,975.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,833.84
|
| Rate for Payer: Cash Price |
$998.10
|
| Rate for Payer: Cigna Commercial |
$3,183.27
|
| Rate for Payer: Health EOS Commercial |
$3,079.47
|
| Rate for Payer: HFN Commercial |
$3,183.27
|
| Rate for Payer: Multiplan Commercial |
$2,768.06
|
| Rate for Payer: Preferred Network Access Commercial |
$3,183.27
|
| Rate for Payer: Quartz Beloit One Network |
$1,695.44
|
| Rate for Payer: Quartz Commercial |
$2,076.05
|
| Rate for Payer: WEA Trust Commercial |
$1,903.04
|
| Rate for Payer: WPS Commercial |
$2,562.79
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$1,516.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
5375712
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$772.55 |
| Max. Negotiated Rate |
$1,450.51 |
| Rate for Payer: Aetna Commercial |
$1,418.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,355.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$835.62
|
| Rate for Payer: Cash Price |
$454.80
|
| Rate for Payer: Cigna Commercial |
$1,450.51
|
| Rate for Payer: Health EOS Commercial |
$1,403.21
|
| Rate for Payer: HFN Commercial |
$1,450.51
|
| Rate for Payer: Multiplan Commercial |
$1,261.31
|
| Rate for Payer: Preferred Network Access Commercial |
$1,450.51
|
| Rate for Payer: Quartz Beloit One Network |
$772.55
|
| Rate for Payer: Quartz Commercial |
$945.98
|
| Rate for Payer: WEA Trust Commercial |
$867.15
|
| Rate for Payer: WPS Commercial |
$1,167.77
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$4,412.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
5375673
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$2,248.36 |
| Max. Negotiated Rate |
$4,221.40 |
| Rate for Payer: Aetna Commercial |
$4,129.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,946.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,431.89
|
| Rate for Payer: Cash Price |
$1,323.60
|
| Rate for Payer: Cigna Commercial |
$4,221.40
|
| Rate for Payer: Health EOS Commercial |
$4,083.75
|
| Rate for Payer: HFN Commercial |
$4,221.40
|
| Rate for Payer: Multiplan Commercial |
$3,670.78
|
| Rate for Payer: Preferred Network Access Commercial |
$4,221.40
|
| Rate for Payer: Quartz Beloit One Network |
$2,248.36
|
| Rate for Payer: Quartz Commercial |
$2,753.09
|
| Rate for Payer: WEA Trust Commercial |
$2,523.66
|
| Rate for Payer: WPS Commercial |
$3,398.56
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$4,474.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
5375668
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$2,279.95 |
| Max. Negotiated Rate |
$4,280.72 |
| Rate for Payer: Aetna Commercial |
$4,187.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,001.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,466.07
|
| Rate for Payer: Cash Price |
$1,342.20
|
| Rate for Payer: Cigna Commercial |
$4,280.72
|
| Rate for Payer: Health EOS Commercial |
$4,141.13
|
| Rate for Payer: HFN Commercial |
$4,280.72
|
| Rate for Payer: Multiplan Commercial |
$3,722.37
|
| Rate for Payer: Preferred Network Access Commercial |
$4,280.72
|
| Rate for Payer: Quartz Beloit One Network |
$2,279.95
|
| Rate for Payer: Quartz Commercial |
$2,791.78
|
| Rate for Payer: WEA Trust Commercial |
$2,559.13
|
| Rate for Payer: WPS Commercial |
$3,446.32
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$1,753.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
5375659
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$893.33 |
| Max. Negotiated Rate |
$1,677.27 |
| Rate for Payer: Aetna Commercial |
$1,640.81
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,567.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$966.25
|
| Rate for Payer: Cash Price |
$525.90
|
| Rate for Payer: Cigna Commercial |
$1,677.27
|
| Rate for Payer: Health EOS Commercial |
$1,622.58
|
| Rate for Payer: HFN Commercial |
$1,677.27
|
| Rate for Payer: Multiplan Commercial |
$1,458.50
|
| Rate for Payer: Preferred Network Access Commercial |
$1,677.27
|
| Rate for Payer: Quartz Beloit One Network |
$893.33
|
| Rate for Payer: Quartz Commercial |
$1,093.87
|
| Rate for Payer: WEA Trust Commercial |
$1,002.72
|
| Rate for Payer: WPS Commercial |
$1,350.34
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$1,756.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
5375662
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$251.10 |
| Max. Negotiated Rate |
$1,680.14 |
| Rate for Payer: Aetna Commercial |
$1,643.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,570.57
|
| Rate for Payer: Aetna Managed Medicare |
$251.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,187.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$913.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$876.60
|
| Rate for Payer: Anthem Medicare Advantage |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$967.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$251.10
|
| Rate for Payer: Cash Price |
$526.80
|
| Rate for Payer: Cash Price |
$526.80
|
| Rate for Payer: Cigna Commercial |
$1,680.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$251.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,021.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$251.10
|
| Rate for Payer: Health EOS Commercial |
$1,625.35
|
| Rate for Payer: HFN Commercial |
$1,680.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$934.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$251.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$251.10
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$251.10
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$251.10
|
| Rate for Payer: Multiplan Commercial |
$1,460.99
|
| Rate for Payer: NAPHCARE Commercial |
$376.65
|
| Rate for Payer: Preferred Network Access Commercial |
$1,680.14
|
| Rate for Payer: Quartz Beloit One Network |
$894.86
|
| Rate for Payer: Quartz Commercial |
$1,187.06
|
| Rate for Payer: Quartz Medicare Advantage |
$251.10
|
| Rate for Payer: The Alliance Commercial |
$1,004.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$251.10
|
| Rate for Payer: United Healthcare PPO |
$1,369.68
|
| Rate for Payer: WEA Trust Commercial |
$1,004.43
|
| Rate for Payer: Wellcare Medicare |
$251.10
|
| Rate for Payer: WPS Commercial |
$1,352.65
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$3,327.00
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
5375694
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$3,183.27 |
| Rate for Payer: Aetna Commercial |
$3,114.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,975.67
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,249.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,730.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,660.84
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,833.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$575.04
|
| Rate for Payer: Cash Price |
$998.10
|
| Rate for Payer: Cash Price |
$998.10
|
| Rate for Payer: Cigna Commercial |
$3,183.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,936.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$3,079.47
|
| Rate for Payer: HFN Commercial |
$3,183.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,139.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$575.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$575.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$575.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$575.04
|
| Rate for Payer: Multiplan Commercial |
$2,768.06
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$3,183.27
|
| Rate for Payer: Quartz Beloit One Network |
$1,695.44
|
| Rate for Payer: Quartz Commercial |
$2,249.05
|
| Rate for Payer: Quartz Medicare Advantage |
$575.04
|
| Rate for Payer: The Alliance Commercial |
$2,300.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$575.04
|
| Rate for Payer: United Healthcare PPO |
$2,595.06
|
| Rate for Payer: WEA Trust Commercial |
$1,903.04
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$2,562.79
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$1,917.00
|
|
|
Service Code
|
CPT 93314
|
| Hospital Charge Code |
5375685
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$558.23 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Aetna Managed Medicare |
$558.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,295.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$996.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$956.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,115.69
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,495.26
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,196.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,295.89
|
| Rate for Payer: Quartz Medicare Advantage |
$1,196.21
|
| Rate for Payer: The Alliance Commercial |
$916.70
|
| Rate for Payer: United Healthcare PPO |
$1,495.26
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$1,516.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
5375712
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$251.10 |
| Max. Negotiated Rate |
$1,450.51 |
| Rate for Payer: Aetna Commercial |
$1,418.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,355.91
|
| Rate for Payer: Aetna Managed Medicare |
$251.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,024.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$788.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$756.79
|
| Rate for Payer: Anthem Medicare Advantage |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$835.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$251.10
|
| Rate for Payer: Cash Price |
$454.80
|
| Rate for Payer: Cash Price |
$454.80
|
| Rate for Payer: Cigna Commercial |
$1,450.51
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$251.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$882.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$251.10
|
| Rate for Payer: Health EOS Commercial |
$1,403.21
|
| Rate for Payer: HFN Commercial |
$1,450.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$934.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$251.10
|
| Rate for Payer: Independent Care Health Plan Medicare |
$251.10
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$251.10
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$251.10
|
| Rate for Payer: Multiplan Commercial |
$1,261.31
|
| Rate for Payer: NAPHCARE Commercial |
$376.65
|
| Rate for Payer: Preferred Network Access Commercial |
$1,450.51
|
| Rate for Payer: Quartz Beloit One Network |
$772.55
|
| Rate for Payer: Quartz Commercial |
$1,024.82
|
| Rate for Payer: Quartz Medicare Advantage |
$251.10
|
| Rate for Payer: The Alliance Commercial |
$1,004.39
|
| Rate for Payer: United Healthcare Medicare Advantage |
$251.10
|
| Rate for Payer: United Healthcare PPO |
$1,182.48
|
| Rate for Payer: WEA Trust Commercial |
$867.15
|
| Rate for Payer: Wellcare Medicare |
$251.10
|
| Rate for Payer: WPS Commercial |
$1,167.77
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$4,474.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
5375677
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$4,280.72 |
| Rate for Payer: Aetna Commercial |
$4,187.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,001.55
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,024.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,326.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,233.42
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,466.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$575.04
|
| Rate for Payer: Cash Price |
$1,342.20
|
| Rate for Payer: Cash Price |
$1,342.20
|
| Rate for Payer: Cigna Commercial |
$4,280.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,603.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$4,141.13
|
| Rate for Payer: HFN Commercial |
$4,280.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,139.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$575.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$575.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$575.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$575.04
|
| Rate for Payer: Multiplan Commercial |
$3,722.37
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$4,280.72
|
| Rate for Payer: Quartz Beloit One Network |
$2,279.95
|
| Rate for Payer: Quartz Commercial |
$3,024.42
|
| Rate for Payer: Quartz Medicare Advantage |
$575.04
|
| Rate for Payer: The Alliance Commercial |
$2,300.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$575.04
|
| Rate for Payer: United Healthcare PPO |
$3,489.72
|
| Rate for Payer: WEA Trust Commercial |
$2,559.13
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$3,446.32
|
|
