|
Echo Acquisition
|
Facility
|
IP
|
$2,579.00
|
|
|
Service Code
|
CPT 93313
|
| Hospital Charge Code |
5375706
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,314.26 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,421.54
|
| Rate for Payer: Cash Price |
$773.70
|
| Rate for Payer: Cigna Commercial |
$2,467.59
|
| Rate for Payer: Health EOS Commercial |
$2,387.12
|
| Rate for Payer: HFN Commercial |
$2,467.59
|
| Rate for Payer: Multiplan Commercial |
$2,145.73
|
| 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 |
$1,609.30
|
| Rate for Payer: WEA Trust Commercial |
$1,475.19
|
| Rate for Payer: WPS Commercial |
$1,986.60
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$6,243.00
|
|
|
Service Code
|
CPT 93318
|
| Hospital Charge Code |
5375703
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$3,181.43 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,441.14
|
| Rate for Payer: Cash Price |
$1,872.90
|
| Rate for Payer: Cigna Commercial |
$5,973.30
|
| Rate for Payer: Health EOS Commercial |
$5,778.52
|
| Rate for Payer: HFN Commercial |
$5,973.30
|
| Rate for Payer: Multiplan Commercial |
$5,194.18
|
| 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 |
$3,895.63
|
| Rate for Payer: WEA Trust Commercial |
$3,571.00
|
| Rate for Payer: WPS Commercial |
$4,808.98
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$2,458.00
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
5375653
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,252.60 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,354.85
|
| Rate for Payer: Cash Price |
$737.40
|
| Rate for Payer: Cigna Commercial |
$2,351.81
|
| Rate for Payer: Health EOS Commercial |
$2,275.12
|
| Rate for Payer: HFN Commercial |
$2,351.81
|
| Rate for Payer: Multiplan Commercial |
$2,045.06
|
| 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 |
$1,533.79
|
| Rate for Payer: WEA Trust Commercial |
$1,405.98
|
| Rate for Payer: WPS Commercial |
$1,893.40
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$3,327.00
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
5375691
|
|
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
|
$3,539.00
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
5375715
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$3,386.12 |
| Rate for Payer: Aetna Commercial |
$3,312.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,165.28
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,392.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,840.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,766.67
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,950.70
|
| 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 |
$1,061.70
|
| Rate for Payer: Cash Price |
$1,061.70
|
| Rate for Payer: Cigna Commercial |
$3,386.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,059.70
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$3,275.70
|
| Rate for Payer: HFN Commercial |
$3,386.12
|
| 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 |
$2,944.45
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$3,386.12
|
| Rate for Payer: Quartz Beloit One Network |
$1,803.47
|
| Rate for Payer: Quartz Commercial |
$2,392.36
|
| 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 |
$2,760.42
|
| Rate for Payer: WEA Trust Commercial |
$2,024.31
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$2,726.09
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$4,666.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
5375697
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$2,377.79 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,571.90
|
| Rate for Payer: Cash Price |
$1,399.80
|
| Rate for Payer: Cigna Commercial |
$4,464.43
|
| Rate for Payer: Health EOS Commercial |
$4,318.85
|
| Rate for Payer: HFN Commercial |
$4,464.43
|
| Rate for Payer: Multiplan Commercial |
$3,882.11
|
| 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 |
$2,911.58
|
| Rate for Payer: WEA Trust Commercial |
$2,668.95
|
| Rate for Payer: WPS Commercial |
$3,594.22
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$1,756.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
5375662
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$894.86 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$967.91
|
| Rate for Payer: Cash Price |
$526.80
|
| Rate for Payer: Cigna Commercial |
$1,680.14
|
| Rate for Payer: Health EOS Commercial |
$1,625.35
|
| Rate for Payer: HFN Commercial |
$1,680.14
|
| Rate for Payer: Multiplan Commercial |
$1,460.99
|
| Rate for Payer: Preferred Network Access Commercial |
$1,680.14
|
| Rate for Payer: Quartz Beloit One Network |
$894.86
|
| Rate for Payer: Quartz Commercial |
$1,095.74
|
| Rate for Payer: WEA Trust Commercial |
$1,004.43
|
| Rate for Payer: WPS Commercial |
$1,352.65
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$4,412.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
5375681
|
|
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
|
$4,666.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
5375700
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$2,377.79 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,571.90
|
| Rate for Payer: Cash Price |
$1,399.80
|
| Rate for Payer: Cigna Commercial |
$4,464.43
|
| Rate for Payer: Health EOS Commercial |
$4,318.85
|
| Rate for Payer: HFN Commercial |
$4,464.43
|
| Rate for Payer: Multiplan Commercial |
$3,882.11
|
| 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 |
$2,911.58
|
| Rate for Payer: WEA Trust Commercial |
$2,668.95
|
| Rate for Payer: WPS Commercial |
$3,594.22
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$2,579.00
|
|
|
Service Code
|
CPT 93316
|
| Hospital Charge Code |
5375709
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,314.26 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,421.54
|
| Rate for Payer: Cash Price |
$773.70
|
| Rate for Payer: Cigna Commercial |
$2,467.59
|
| Rate for Payer: Health EOS Commercial |
$2,387.12
|
| Rate for Payer: HFN Commercial |
$2,467.59
|
| Rate for Payer: Multiplan Commercial |
$2,145.73
|
| 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 |
$1,609.30
|
| Rate for Payer: WEA Trust Commercial |
$1,475.19
|
| Rate for Payer: WPS Commercial |
$1,986.60
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$4,412.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
5375681
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| 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: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,982.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,294.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,202.47
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,431.89
|
| 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 |
$1,323.60
|
| Rate for Payer: Cash Price |
$1,323.60
|
| Rate for Payer: Cigna Commercial |
$4,221.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,567.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$4,083.75
|
| Rate for Payer: HFN Commercial |
$4,221.40
|
| 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 |
$3,670.78
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| 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 |
$2,982.51
|
| 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 |
$3,441.36
|
| Rate for Payer: WEA Trust Commercial |
$2,523.66
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$3,398.56
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$2,579.00
|
|
|
Service Code
|
CPT 93316
|
| Hospital Charge Code |
5375709
|
|
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
|
OP
|
$4,666.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
5375697
|
|
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
|
OP
|
$1,889.00
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
5375656
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$2,300.15 |
| Rate for Payer: Aetna Commercial |
$1,768.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,689.52
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,276.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$982.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$942.99
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,041.22
|
| 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 |
$566.70
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,807.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,099.40
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$1,748.46
|
| Rate for Payer: HFN Commercial |
$1,807.40
|
| 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 |
$1,571.65
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$1,807.40
|
| Rate for Payer: Quartz Beloit One Network |
$962.63
|
| Rate for Payer: Quartz Commercial |
$1,276.96
|
| 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 |
$1,473.42
|
| Rate for Payer: WEA Trust Commercial |
$1,080.51
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$1,455.10
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$1,917.00
|
|
|
Service Code
|
CPT 93317
|
| Hospital Charge Code |
5375688
|
|
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
|
$3,701.00
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
5375650
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,886.03 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,039.99
|
| Rate for Payer: Cash Price |
$1,110.30
|
| Rate for Payer: Cigna Commercial |
$3,541.12
|
| Rate for Payer: Health EOS Commercial |
$3,425.65
|
| Rate for Payer: HFN Commercial |
$3,541.12
|
| Rate for Payer: Multiplan Commercial |
$3,079.23
|
| 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 |
$2,309.42
|
| Rate for Payer: WEA Trust Commercial |
$2,116.97
|
| Rate for Payer: WPS Commercial |
$2,850.88
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$3,539.00
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
5375715
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,803.47 |
| Max. Negotiated Rate |
$3,386.12 |
| Rate for Payer: Aetna Commercial |
$3,312.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,165.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,950.70
|
| Rate for Payer: Cash Price |
$1,061.70
|
| Rate for Payer: Cigna Commercial |
$3,386.12
|
| Rate for Payer: Health EOS Commercial |
$3,275.70
|
| Rate for Payer: HFN Commercial |
$3,386.12
|
| Rate for Payer: Multiplan Commercial |
$2,944.45
|
| Rate for Payer: Preferred Network Access Commercial |
$3,386.12
|
| Rate for Payer: Quartz Beloit One Network |
$1,803.47
|
| Rate for Payer: Quartz Commercial |
$2,208.34
|
| Rate for Payer: WEA Trust Commercial |
$2,024.31
|
| Rate for Payer: WPS Commercial |
$2,726.09
|
|
|
Echo Acquisition
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
5375656
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$962.63 |
| Max. Negotiated Rate |
$1,807.40 |
| Rate for Payer: Aetna Commercial |
$1,768.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,689.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,041.22
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,807.40
|
| Rate for Payer: Health EOS Commercial |
$1,748.46
|
| Rate for Payer: HFN Commercial |
$1,807.40
|
| Rate for Payer: Multiplan Commercial |
$1,571.65
|
| Rate for Payer: Preferred Network Access Commercial |
$1,807.40
|
| Rate for Payer: Quartz Beloit One Network |
$962.63
|
| Rate for Payer: Quartz Commercial |
$1,178.74
|
| Rate for Payer: WEA Trust Commercial |
$1,080.51
|
| Rate for Payer: WPS Commercial |
$1,455.10
|
|
|
Echo Acquisition
|
Facility
|
OP
|
$4,412.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
5375673
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| 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: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,982.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,294.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,202.47
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,431.89
|
| 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 |
$1,323.60
|
| Rate for Payer: Cash Price |
$1,323.60
|
| Rate for Payer: Cigna Commercial |
$4,221.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,567.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$4,083.75
|
| Rate for Payer: HFN Commercial |
$4,221.40
|
| 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 |
$3,670.78
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| 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 |
$2,982.51
|
| 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 |
$3,441.36
|
| Rate for Payer: WEA Trust Commercial |
$2,523.66
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$3,398.56
|
|
|
ECHO ACQUISITION - 93308
|
Facility
|
OP
|
$1,756.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
6033628
|
|
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 - 93308
|
Facility
|
IP
|
$1,756.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
6033628
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$894.86 |
| 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: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$967.91
|
| Rate for Payer: Cash Price |
$526.80
|
| Rate for Payer: Cigna Commercial |
$1,680.14
|
| Rate for Payer: Health EOS Commercial |
$1,625.35
|
| Rate for Payer: HFN Commercial |
$1,680.14
|
| Rate for Payer: Multiplan Commercial |
$1,460.99
|
| Rate for Payer: Preferred Network Access Commercial |
$1,680.14
|
| Rate for Payer: Quartz Beloit One Network |
$894.86
|
| Rate for Payer: Quartz Commercial |
$1,095.74
|
| Rate for Payer: WEA Trust Commercial |
$1,004.43
|
| Rate for Payer: WPS Commercial |
$1,352.65
|
|
|
Echocardiograph Complete 93306
|
Professional
|
Both
|
$1,426.00
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
4568799
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$196.27 |
| Max. Negotiated Rate |
$1,408.89 |
| Rate for Payer: Aetna Commercial |
$1,408.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,275.41
|
| Rate for Payer: Aetna Managed Medicare |
$196.27
|
| Rate for Payer: Anthem Medicare Advantage |
$196.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$196.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$196.27
|
| Rate for Payer: Cash Price |
$427.80
|
| Rate for Payer: Cash Price |
$427.80
|
| Rate for Payer: Cash Price |
$427.80
|
| Rate for Payer: Cigna Commercial |
$1,408.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$227.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$196.27
|
| Rate for Payer: Health EOS Commercial |
$1,349.57
|
| Rate for Payer: HFN Commercial |
$1,408.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$724.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$724.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$196.27
|
| Rate for Payer: Multiplan Commercial |
$1,186.43
|
| Rate for Payer: NAPHCARE Commercial |
$294.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,408.89
|
| Rate for Payer: Quartz Beloit One Network |
$652.54
|
| Rate for Payer: Quartz Commercial |
$845.33
|
| Rate for Payer: Quartz Medicare Advantage |
$196.27
|
| Rate for Payer: The Alliance Commercial |
$745.82
|
| Rate for Payer: United Healthcare Medicaid |
$227.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$196.27
|
| Rate for Payer: WEA Trust Commercial |
$815.67
|
| Rate for Payer: WPS Commercial |
$785.08
|
|
|
ECHOCARDIOGRAPH COMPLETE 9330626
|
Professional
|
Both
|
$1,531.00
|
|
|
Service Code
|
CPT 93306 26
|
| Hospital Charge Code |
3015369
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$64.65 |
| Max. Negotiated Rate |
$1,512.63 |
| Rate for Payer: Aetna Commercial |
$1,512.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,369.33
|
| Rate for Payer: Aetna Managed Medicare |
$68.16
|
| Rate for Payer: Anthem Medicare Advantage |
$68.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$68.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$68.16
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,512.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$64.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$68.16
|
| Rate for Payer: Health EOS Commercial |
$1,448.94
|
| Rate for Payer: HFN Commercial |
$1,512.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$251.66
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$251.66
|
| Rate for Payer: Independent Care Health Plan Medicare |
$68.16
|
| Rate for Payer: Multiplan Commercial |
$1,273.79
|
| Rate for Payer: NAPHCARE Commercial |
$102.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,512.63
|
| Rate for Payer: Quartz Beloit One Network |
$700.59
|
| Rate for Payer: Quartz Commercial |
$907.58
|
| Rate for Payer: Quartz Medicare Advantage |
$68.16
|
| Rate for Payer: The Alliance Commercial |
$259.01
|
| Rate for Payer: United Healthcare Medicaid |
$64.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$68.16
|
| Rate for Payer: WEA Trust Commercial |
$875.73
|
| Rate for Payer: WPS Commercial |
$272.65
|
|
|
ECHOCARDIOGRAPHIC AGENT DURING STRESS ECHO 93352
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
CPT 93352
|
| Hospital Charge Code |
3015382
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.09 |
| Max. Negotiated Rate |
$141.73 |
| Rate for Payer: Aetna Commercial |
$106.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$96.60
|
| Rate for Payer: Aetna Managed Medicare |
$35.43
|
| Rate for Payer: Anthem Medicare Advantage |
$35.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35.43
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$106.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$33.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35.43
|
| Rate for Payer: Health EOS Commercial |
$102.21
|
| Rate for Payer: HFN Commercial |
$106.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$118.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$118.03
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35.43
|
| Rate for Payer: Multiplan Commercial |
$89.86
|
| Rate for Payer: NAPHCARE Commercial |
$53.15
|
| Rate for Payer: Preferred Network Access Commercial |
$106.70
|
| Rate for Payer: Quartz Beloit One Network |
$49.42
|
| Rate for Payer: Quartz Commercial |
$64.02
|
| Rate for Payer: Quartz Medicare Advantage |
$35.43
|
| Rate for Payer: The Alliance Commercial |
$134.64
|
| Rate for Payer: United Healthcare Medicaid |
$33.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.43
|
| Rate for Payer: WEA Trust Commercial |
$61.78
|
| Rate for Payer: WPS Commercial |
$141.73
|
|
|
ECHOCARDIOGRAPHY
|
Facility
|
OP
|
$231.92
|
|
|
Service Code
|
EAPG 00081
|
| Min. Negotiated Rate |
$223.00 |
| Max. Negotiated Rate |
$231.92 |
| Rate for Payer: Anthem Medicaid |
$223.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$223.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$223.00
|
| Rate for Payer: Dean Health Medicaid |
$223.00
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$223.00
|
| Rate for Payer: Managed Health Services Medicaid |
$231.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$223.00
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$223.00
|
| Rate for Payer: United Healthcare Medicaid |
$223.00
|
|
