|
ED Avulsion of Nail Plate
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
6173146
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$49.43 |
| Max. Negotiated Rate |
$92.81 |
| Rate for Payer: Aetna Commercial |
$90.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$53.47
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$92.81
|
| Rate for Payer: Health EOS Commercial |
$89.78
|
| Rate for Payer: HFN Commercial |
$92.81
|
| Rate for Payer: Multiplan Commercial |
$80.70
|
| Rate for Payer: Preferred Network Access Commercial |
$92.81
|
| Rate for Payer: Quartz Beloit One Network |
$49.43
|
| Rate for Payer: Quartz Commercial |
$60.53
|
| Rate for Payer: WEA Trust Commercial |
$55.48
|
| Rate for Payer: WPS Commercial |
$74.72
|
|
|
ED Avulsion of Nail Plate
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
6173146
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$90.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.76
|
| Rate for Payer: Aetna Managed Medicare |
$211.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$65.57
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$50.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$48.42
|
| Rate for Payer: Anthem Medicare Advantage |
$211.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$53.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$211.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$211.14
|
| 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 |
$92.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$211.14
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$211.14
|
| Rate for Payer: Health EOS Commercial |
$89.78
|
| Rate for Payer: HFN Commercial |
$92.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$785.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$211.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$211.14
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$211.14
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$211.14
|
| Rate for Payer: Multiplan Commercial |
$80.70
|
| Rate for Payer: NAPHCARE Commercial |
$316.71
|
| Rate for Payer: Preferred Network Access Commercial |
$92.81
|
| Rate for Payer: Quartz Beloit One Network |
$49.43
|
| Rate for Payer: Quartz Commercial |
$65.57
|
| Rate for Payer: Quartz Medicare Advantage |
$211.14
|
| Rate for Payer: The Alliance Commercial |
$844.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$211.14
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$55.48
|
| Rate for Payer: Wellcare Medicare |
$211.14
|
| Rate for Payer: WPS Commercial |
$74.72
|
|
|
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 |
$24.97 |
| Max. Negotiated Rate |
$46.88 |
| Rate for Payer: Aetna Commercial |
$45.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.01
|
| Rate for Payer: Cash Price |
$14.70
|
| Rate for Payer: Cigna Commercial |
$46.88
|
| Rate for Payer: Health EOS Commercial |
$45.35
|
| Rate for Payer: HFN Commercial |
$46.88
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: Preferred Network Access Commercial |
$46.88
|
| Rate for Payer: Quartz Beloit One Network |
$24.97
|
| Rate for Payer: Quartz Commercial |
$30.58
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$37.74
|
|
|
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 |
$14.27 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$45.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.83
|
| Rate for Payer: Aetna Managed Medicare |
$14.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$33.12
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$27.01
|
| 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 |
$46.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Health EOS Commercial |
$45.35
|
| Rate for Payer: HFN Commercial |
$46.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$38.22
|
| Rate for Payer: Multiplan Commercial |
$40.77
|
| Rate for Payer: NAPHCARE Commercial |
$30.58
|
| Rate for Payer: Preferred Network Access Commercial |
$46.88
|
| Rate for Payer: Quartz Beloit One Network |
$24.97
|
| Rate for Payer: Quartz Commercial |
$33.12
|
| Rate for Payer: Quartz Medicare Advantage |
$30.58
|
| Rate for Payer: The Alliance Commercial |
$59.36
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$28.03
|
| Rate for Payer: WPS Commercial |
$37.74
|
|
|
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 |
$204.35 |
| Max. Negotiated Rate |
$383.68 |
| Rate for Payer: Aetna Commercial |
$375.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$358.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$221.03
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cigna Commercial |
$383.68
|
| Rate for Payer: Health EOS Commercial |
$371.17
|
| Rate for Payer: HFN Commercial |
$383.68
|
| Rate for Payer: Multiplan Commercial |
$333.63
|
| Rate for Payer: Preferred Network Access Commercial |
$383.68
|
| Rate for Payer: Quartz Beloit One Network |
$204.35
|
| Rate for Payer: Quartz Commercial |
$250.22
|
| Rate for Payer: WEA Trust Commercial |
$229.37
|
| Rate for Payer: WPS Commercial |
$308.89
|
|
|
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 |
$200.18 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$375.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$358.65
|
| Rate for Payer: Aetna Managed Medicare |
$969.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$271.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$208.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$200.18
|
| Rate for Payer: Anthem Medicare Advantage |
$969.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$221.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$969.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$969.30
|
| 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 |
$383.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$969.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$969.30
|
| Rate for Payer: Health EOS Commercial |
$371.17
|
| Rate for Payer: HFN Commercial |
$383.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,605.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$969.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$969.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$969.30
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$969.30
|
| Rate for Payer: Multiplan Commercial |
$333.63
|
| Rate for Payer: NAPHCARE Commercial |
$1,453.95
|
| Rate for Payer: Preferred Network Access Commercial |
$383.68
|
| Rate for Payer: Quartz Beloit One Network |
$204.35
|
| Rate for Payer: Quartz Commercial |
$271.08
|
| Rate for Payer: Quartz Medicare Advantage |
$969.30
|
| Rate for Payer: The Alliance Commercial |
$3,877.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$969.30
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$229.37
|
| Rate for Payer: Wellcare Medicare |
$969.30
|
| Rate for Payer: WPS Commercial |
$308.89
|
|
|
ED Biopsy of External Ear
|
Facility
|
OP
|
$649.00
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
6174443
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$249.26 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$607.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$580.47
|
| Rate for Payer: Aetna Managed Medicare |
$249.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$438.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$337.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$323.98
|
| Rate for Payer: Anthem Medicare Advantage |
$249.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$357.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$249.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$249.26
|
| 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 |
$620.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$249.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$249.26
|
| Rate for Payer: Health EOS Commercial |
$600.71
|
| Rate for Payer: HFN Commercial |
$620.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$927.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$249.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$249.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$249.26
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$249.26
|
| Rate for Payer: Multiplan Commercial |
$539.97
|
| Rate for Payer: NAPHCARE Commercial |
$373.89
|
| Rate for Payer: Preferred Network Access Commercial |
$620.96
|
| Rate for Payer: Quartz Beloit One Network |
$330.73
|
| Rate for Payer: Quartz Commercial |
$438.72
|
| Rate for Payer: Quartz Medicare Advantage |
$249.26
|
| Rate for Payer: The Alliance Commercial |
$997.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$249.26
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$371.23
|
| Rate for Payer: Wellcare Medicare |
$249.26
|
| Rate for Payer: WPS Commercial |
$499.92
|
|
|
ED Biopsy of External Ear
|
Facility
|
IP
|
$649.00
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
6174443
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$330.73 |
| Max. Negotiated Rate |
$620.96 |
| Rate for Payer: Aetna Commercial |
$607.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$580.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$357.73
|
| Rate for Payer: Cash Price |
$194.70
|
| Rate for Payer: Cigna Commercial |
$620.96
|
| Rate for Payer: Health EOS Commercial |
$600.71
|
| Rate for Payer: HFN Commercial |
$620.96
|
| Rate for Payer: Multiplan Commercial |
$539.97
|
| Rate for Payer: Preferred Network Access Commercial |
$620.96
|
| Rate for Payer: Quartz Beloit One Network |
$330.73
|
| Rate for Payer: Quartz Commercial |
$404.98
|
| Rate for Payer: WEA Trust Commercial |
$371.23
|
| Rate for Payer: WPS Commercial |
$499.92
|
|
|
ED Biopsy Of Eye Lid
|
Facility
|
OP
|
$348.00
|
|
|
Service Code
|
CPT 67810
|
| Hospital Charge Code |
6174423
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$173.72 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$325.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$311.25
|
| Rate for Payer: Aetna Managed Medicare |
$334.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$235.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$180.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$173.72
|
| Rate for Payer: Anthem Medicare Advantage |
$334.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$191.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$334.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$334.04
|
| 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 |
$332.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$334.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$334.04
|
| Rate for Payer: Health EOS Commercial |
$322.11
|
| Rate for Payer: HFN Commercial |
$332.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,242.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$334.04
|
| Rate for Payer: Independent Care Health Plan Medicare |
$334.04
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$334.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$334.04
|
| Rate for Payer: Multiplan Commercial |
$289.54
|
| Rate for Payer: NAPHCARE Commercial |
$501.06
|
| Rate for Payer: Preferred Network Access Commercial |
$332.97
|
| Rate for Payer: Quartz Beloit One Network |
$177.34
|
| Rate for Payer: Quartz Commercial |
$235.25
|
| Rate for Payer: Quartz Medicare Advantage |
$334.04
|
| Rate for Payer: The Alliance Commercial |
$1,336.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$334.04
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$199.06
|
| Rate for Payer: Wellcare Medicare |
$334.04
|
| Rate for Payer: WPS Commercial |
$268.06
|
|
|
ED Biopsy Of Eye Lid
|
Facility
|
IP
|
$348.00
|
|
|
Service Code
|
CPT 67810
|
| Hospital Charge Code |
6174423
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.34 |
| Max. Negotiated Rate |
$332.97 |
| Rate for Payer: Aetna Commercial |
$325.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$311.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$191.82
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cigna Commercial |
$332.97
|
| Rate for Payer: Health EOS Commercial |
$322.11
|
| Rate for Payer: HFN Commercial |
$332.97
|
| Rate for Payer: Multiplan Commercial |
$289.54
|
| Rate for Payer: Preferred Network Access Commercial |
$332.97
|
| Rate for Payer: Quartz Beloit One Network |
$177.34
|
| Rate for Payer: Quartz Commercial |
$217.15
|
| Rate for Payer: WEA Trust Commercial |
$199.06
|
| Rate for Payer: WPS Commercial |
$268.06
|
|
|
ED Biopsy of Lip
|
Facility
|
OP
|
$224.00
|
|
|
Service Code
|
CPT 40490
|
| Hospital Charge Code |
6173897
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.82 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$209.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$200.35
|
| Rate for Payer: Aetna Managed Medicare |
$249.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$151.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$116.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$111.82
|
| Rate for Payer: Anthem Medicare Advantage |
$249.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$123.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$249.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$249.26
|
| 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 |
$214.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$249.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$249.26
|
| Rate for Payer: Health EOS Commercial |
$207.33
|
| Rate for Payer: HFN Commercial |
$214.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$927.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$249.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$249.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$249.26
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$249.26
|
| Rate for Payer: Multiplan Commercial |
$186.37
|
| Rate for Payer: NAPHCARE Commercial |
$373.89
|
| Rate for Payer: Preferred Network Access Commercial |
$214.32
|
| Rate for Payer: Quartz Beloit One Network |
$114.15
|
| Rate for Payer: Quartz Commercial |
$151.42
|
| Rate for Payer: Quartz Medicare Advantage |
$249.26
|
| Rate for Payer: The Alliance Commercial |
$997.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$249.26
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$128.13
|
| Rate for Payer: Wellcare Medicare |
$249.26
|
| Rate for Payer: WPS Commercial |
$172.55
|
|
|
ED Biopsy of Lip
|
Facility
|
IP
|
$224.00
|
|
|
Service Code
|
CPT 40490
|
| Hospital Charge Code |
6173897
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$114.15 |
| Max. Negotiated Rate |
$214.32 |
| Rate for Payer: Aetna Commercial |
$209.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$200.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$123.47
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cigna Commercial |
$214.32
|
| Rate for Payer: Health EOS Commercial |
$207.33
|
| Rate for Payer: HFN Commercial |
$214.32
|
| Rate for Payer: Multiplan Commercial |
$186.37
|
| Rate for Payer: Preferred Network Access Commercial |
$214.32
|
| Rate for Payer: Quartz Beloit One Network |
$114.15
|
| Rate for Payer: Quartz Commercial |
$139.78
|
| Rate for Payer: WEA Trust Commercial |
$128.13
|
| Rate for Payer: WPS Commercial |
$172.55
|
|
|
ED Biopsy Of Penis
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
6174108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$204.35 |
| Max. Negotiated Rate |
$383.68 |
| Rate for Payer: Aetna Commercial |
$375.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$358.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$221.03
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Cigna Commercial |
$383.68
|
| Rate for Payer: Health EOS Commercial |
$371.17
|
| Rate for Payer: HFN Commercial |
$383.68
|
| Rate for Payer: Multiplan Commercial |
$333.63
|
| Rate for Payer: Preferred Network Access Commercial |
$383.68
|
| Rate for Payer: Quartz Beloit One Network |
$204.35
|
| Rate for Payer: Quartz Commercial |
$250.22
|
| Rate for Payer: WEA Trust Commercial |
$229.37
|
| Rate for Payer: WPS Commercial |
$308.89
|
|
|
ED Biopsy Of Penis
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
6174108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$200.18 |
| Max. Negotiated Rate |
$6,952.48 |
| Rate for Payer: Aetna Commercial |
$375.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$358.65
|
| Rate for Payer: Aetna Managed Medicare |
$1,738.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$271.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$208.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$200.18
|
| Rate for Payer: Anthem Medicare Advantage |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$221.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,738.12
|
| 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 |
$383.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,738.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,738.12
|
| Rate for Payer: Health EOS Commercial |
$371.17
|
| Rate for Payer: HFN Commercial |
$383.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,465.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,738.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,738.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,738.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,738.12
|
| Rate for Payer: Multiplan Commercial |
$333.63
|
| Rate for Payer: NAPHCARE Commercial |
$2,607.18
|
| Rate for Payer: Preferred Network Access Commercial |
$383.68
|
| Rate for Payer: Quartz Beloit One Network |
$204.35
|
| Rate for Payer: Quartz Commercial |
$271.08
|
| Rate for Payer: Quartz Medicare Advantage |
$1,738.12
|
| Rate for Payer: The Alliance Commercial |
$6,952.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,738.12
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$229.37
|
| Rate for Payer: Wellcare Medicare |
$1,738.12
|
| Rate for Payer: WPS Commercial |
$308.89
|
|
|
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 |
$230.63 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$432.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$413.21
|
| Rate for Payer: Aetna Managed Medicare |
$567.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$312.31
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$240.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$230.63
|
| Rate for Payer: Anthem Medicare Advantage |
$567.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$254.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$567.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$567.58
|
| 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 |
$442.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$567.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$567.58
|
| Rate for Payer: Health EOS Commercial |
$427.63
|
| Rate for Payer: HFN Commercial |
$442.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,111.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$567.58
|
| Rate for Payer: Independent Care Health Plan Medicare |
$567.58
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$567.58
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$567.58
|
| Rate for Payer: Multiplan Commercial |
$384.38
|
| Rate for Payer: NAPHCARE Commercial |
$851.37
|
| Rate for Payer: Preferred Network Access Commercial |
$442.04
|
| Rate for Payer: Quartz Beloit One Network |
$235.44
|
| Rate for Payer: Quartz Commercial |
$312.31
|
| Rate for Payer: Quartz Medicare Advantage |
$567.58
|
| Rate for Payer: The Alliance Commercial |
$2,270.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$567.58
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$264.26
|
| Rate for Payer: Wellcare Medicare |
$567.58
|
| Rate for Payer: WPS Commercial |
$355.88
|
|
|
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 |
$235.44 |
| Max. Negotiated Rate |
$442.04 |
| Rate for Payer: Aetna Commercial |
$432.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$413.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$254.65
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cigna Commercial |
$442.04
|
| Rate for Payer: Health EOS Commercial |
$427.63
|
| Rate for Payer: HFN Commercial |
$442.04
|
| Rate for Payer: Multiplan Commercial |
$384.38
|
| Rate for Payer: Preferred Network Access Commercial |
$442.04
|
| Rate for Payer: Quartz Beloit One Network |
$235.44
|
| Rate for Payer: Quartz Commercial |
$288.29
|
| Rate for Payer: WEA Trust Commercial |
$264.26
|
| Rate for Payer: WPS Commercial |
$355.88
|
|
|
ED Biopsy Of Vagina
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
6174396
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$149.26 |
| Rate for Payer: Aetna Commercial |
$146.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$139.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$85.99
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cigna Commercial |
$149.26
|
| Rate for Payer: Health EOS Commercial |
$144.39
|
| Rate for Payer: HFN Commercial |
$149.26
|
| Rate for Payer: Multiplan Commercial |
$129.79
|
| Rate for Payer: Preferred Network Access Commercial |
$149.26
|
| Rate for Payer: Quartz Beloit One Network |
$79.50
|
| Rate for Payer: Quartz Commercial |
$97.34
|
| Rate for Payer: WEA Trust Commercial |
$89.23
|
| Rate for Payer: WPS Commercial |
$120.17
|
|
|
ED Biopsy Of Vagina
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
6174396
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$77.88 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$146.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$139.53
|
| Rate for Payer: Aetna Managed Medicare |
$969.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$105.46
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$81.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$77.88
|
| Rate for Payer: Anthem Medicare Advantage |
$969.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$85.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$969.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$969.30
|
| 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 |
$149.26
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$969.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$969.30
|
| Rate for Payer: Health EOS Commercial |
$144.39
|
| Rate for Payer: HFN Commercial |
$149.26
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,605.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$969.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$969.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$969.30
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$969.30
|
| Rate for Payer: Multiplan Commercial |
$129.79
|
| Rate for Payer: NAPHCARE Commercial |
$1,453.95
|
| Rate for Payer: Preferred Network Access Commercial |
$149.26
|
| Rate for Payer: Quartz Beloit One Network |
$79.50
|
| Rate for Payer: Quartz Commercial |
$105.46
|
| Rate for Payer: Quartz Medicare Advantage |
$969.30
|
| Rate for Payer: The Alliance Commercial |
$3,877.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$969.30
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$89.23
|
| Rate for Payer: Wellcare Medicare |
$969.30
|
| Rate for Payer: WPS Commercial |
$120.17
|
|
|
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 |
$120.31 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$225.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$215.55
|
| Rate for Payer: Aetna Managed Medicare |
$969.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$162.92
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$125.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$120.31
|
| Rate for Payer: Anthem Medicare Advantage |
$969.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$132.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$969.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$969.30
|
| 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 |
$230.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$969.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$969.30
|
| Rate for Payer: Health EOS Commercial |
$223.07
|
| Rate for Payer: HFN Commercial |
$230.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,605.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$969.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$969.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$969.30
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$969.30
|
| Rate for Payer: Multiplan Commercial |
$200.51
|
| Rate for Payer: NAPHCARE Commercial |
$1,453.95
|
| Rate for Payer: Preferred Network Access Commercial |
$230.59
|
| Rate for Payer: Quartz Beloit One Network |
$122.81
|
| Rate for Payer: Quartz Commercial |
$162.92
|
| Rate for Payer: Quartz Medicare Advantage |
$969.30
|
| Rate for Payer: The Alliance Commercial |
$3,877.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$969.30
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$137.85
|
| Rate for Payer: Wellcare Medicare |
$969.30
|
| Rate for Payer: WPS Commercial |
$185.64
|
|
|
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 |
$122.81 |
| Max. Negotiated Rate |
$230.59 |
| Rate for Payer: Aetna Commercial |
$225.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$215.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$132.84
|
| Rate for Payer: Cash Price |
$72.30
|
| Rate for Payer: Cigna Commercial |
$230.59
|
| Rate for Payer: Health EOS Commercial |
$223.07
|
| Rate for Payer: HFN Commercial |
$230.59
|
| Rate for Payer: Multiplan Commercial |
$200.51
|
| Rate for Payer: Preferred Network Access Commercial |
$230.59
|
| Rate for Payer: Quartz Beloit One Network |
$122.81
|
| Rate for Payer: Quartz Commercial |
$150.38
|
| Rate for Payer: WEA Trust Commercial |
$137.85
|
| Rate for Payer: WPS Commercial |
$185.64
|
|
|
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 |
$18.64 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$59.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$57.24
|
| Rate for Payer: Aetna Managed Medicare |
$18.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$43.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$33.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$31.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$35.28
|
| 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 |
$61.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Health EOS Commercial |
$59.24
|
| Rate for Payer: HFN Commercial |
$61.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$49.92
|
| Rate for Payer: Multiplan Commercial |
$53.25
|
| Rate for Payer: NAPHCARE Commercial |
$39.94
|
| Rate for Payer: Preferred Network Access Commercial |
$61.24
|
| Rate for Payer: Quartz Beloit One Network |
$32.61
|
| Rate for Payer: Quartz Commercial |
$43.26
|
| Rate for Payer: Quartz Medicare Advantage |
$39.94
|
| Rate for Payer: The Alliance Commercial |
$96.18
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$36.61
|
| Rate for Payer: WPS Commercial |
$49.30
|
|
|
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 |
$32.61 |
| Max. Negotiated Rate |
$61.24 |
| Rate for Payer: Aetna Commercial |
$59.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$57.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$35.28
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cigna Commercial |
$61.24
|
| Rate for Payer: Health EOS Commercial |
$59.24
|
| Rate for Payer: HFN Commercial |
$61.24
|
| Rate for Payer: Multiplan Commercial |
$53.25
|
| Rate for Payer: Preferred Network Access Commercial |
$61.24
|
| Rate for Payer: Quartz Beloit One Network |
$32.61
|
| Rate for Payer: Quartz Commercial |
$39.94
|
| Rate for Payer: WEA Trust Commercial |
$36.61
|
| Rate for Payer: WPS Commercial |
$49.30
|
|
|
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 |
$313.04 |
| Max. Negotiated Rate |
$16,482.25 |
| Rate for Payer: Aetna Commercial |
$652.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$623.40
|
| Rate for Payer: Aetna Managed Medicare |
$4,120.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$471.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$362.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$347.94
|
| Rate for Payer: Anthem Medicare Advantage |
$4,120.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$384.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4,120.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4,120.56
|
| 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 |
$666.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4,120.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4,120.56
|
| Rate for Payer: Health EOS Commercial |
$645.14
|
| Rate for Payer: HFN Commercial |
$666.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15,328.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4,120.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4,120.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4,120.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4,120.56
|
| Rate for Payer: Multiplan Commercial |
$579.90
|
| Rate for Payer: NAPHCARE Commercial |
$6,180.84
|
| Rate for Payer: Preferred Network Access Commercial |
$666.89
|
| Rate for Payer: Quartz Beloit One Network |
$355.19
|
| Rate for Payer: Quartz Commercial |
$471.17
|
| Rate for Payer: Quartz Medicare Advantage |
$4,120.56
|
| Rate for Payer: The Alliance Commercial |
$16,482.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,120.56
|
| Rate for Payer: United Healthcare PPO |
$313.04
|
| Rate for Payer: WEA Trust Commercial |
$398.68
|
| Rate for Payer: Wellcare Medicare |
$4,120.56
|
| Rate for Payer: WPS Commercial |
$536.90
|
|
|
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 |
$355.19 |
| Max. Negotiated Rate |
$666.89 |
| Rate for Payer: Aetna Commercial |
$652.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$623.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$384.19
|
| Rate for Payer: Cash Price |
$209.10
|
| Rate for Payer: Cigna Commercial |
$666.89
|
| Rate for Payer: Health EOS Commercial |
$645.14
|
| Rate for Payer: HFN Commercial |
$666.89
|
| Rate for Payer: Multiplan Commercial |
$579.90
|
| Rate for Payer: Preferred Network Access Commercial |
$666.89
|
| Rate for Payer: Quartz Beloit One Network |
$355.19
|
| Rate for Payer: Quartz Commercial |
$434.93
|
| Rate for Payer: WEA Trust Commercial |
$398.68
|
| Rate for Payer: WPS Commercial |
$536.90
|
|
|
ED Biopsy: Oropharynx
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
6174082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$206.67 |
| Max. Negotiated Rate |
$6,531.49 |
| Rate for Payer: Aetna Commercial |
$387.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$370.28
|
| Rate for Payer: Aetna Managed Medicare |
$1,632.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$279.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$215.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$206.67
|
| Rate for Payer: Anthem Medicare Advantage |
$1,632.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$228.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,632.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,632.87
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$396.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,632.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,632.87
|
| Rate for Payer: Health EOS Commercial |
$383.20
|
| Rate for Payer: HFN Commercial |
$396.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,074.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,632.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,632.87
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,632.87
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,632.87
|
| Rate for Payer: Multiplan Commercial |
$344.45
|
| Rate for Payer: NAPHCARE Commercial |
$2,449.31
|
| Rate for Payer: Preferred Network Access Commercial |
$396.12
|
| Rate for Payer: Quartz Beloit One Network |
$210.97
|
| Rate for Payer: Quartz Commercial |
$279.86
|
| Rate for Payer: Quartz Medicare Advantage |
$1,632.87
|
| Rate for Payer: The Alliance Commercial |
$6,531.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,632.87
|
| Rate for Payer: WEA Trust Commercial |
$236.81
|
| Rate for Payer: Wellcare Medicare |
$1,632.87
|
| Rate for Payer: WPS Commercial |
$318.90
|
|
