|
EDEMA GLOVES 3/4 FINGER (OPEN) #55659501
|
Facility
OP
|
$394.00
|
|
| Hospital Charge Code |
2970249
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$110.32 |
| Max. Negotiated Rate |
$1,576.00 |
| Rate for Payer: Aetna Commercial |
$354.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$338.84
|
| Rate for Payer: Aetna Managed Medicare |
$110.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$256.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$197.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$189.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$208.82
|
| Rate for Payer: Cash Price |
$118.20
|
| Rate for Payer: Cigna Commercial |
$362.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$220.48
|
| Rate for Payer: Health EOS Commercial |
$350.66
|
| Rate for Payer: HFN Commercial |
$362.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$295.50
|
| Rate for Payer: Multiplan Commercial |
$315.20
|
| Rate for Payer: NAPHCARE Commercial |
$236.40
|
| Rate for Payer: Preferred Network Access Commercial |
$362.48
|
| Rate for Payer: Quartz Beloit One Network |
$193.06
|
| Rate for Payer: Quartz Commercial |
$256.10
|
| Rate for Payer: Quartz Medicare Advantage |
$236.40
|
| Rate for Payer: The Alliance Commercial |
$1,576.00
|
| Rate for Payer: WEA Trust Commercial |
$216.70
|
| Rate for Payer: WPS Commercial |
$291.84
|
|
|
EDEMA GLOVES 3/4 FINGER (OPEN) #55659501
|
Facility
IP
|
$394.00
|
|
| Hospital Charge Code |
2970249
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$193.06 |
| Max. Negotiated Rate |
$362.48 |
| Rate for Payer: Aetna Commercial |
$354.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$208.82
|
| Rate for Payer: Cash Price |
$118.20
|
| Rate for Payer: Cigna Commercial |
$362.48
|
| Rate for Payer: Health EOS Commercial |
$350.66
|
| Rate for Payer: HFN Commercial |
$362.48
|
| Rate for Payer: Multiplan Commercial |
$315.20
|
| Rate for Payer: NAPHCARE Commercial |
$236.40
|
| Rate for Payer: Preferred Network Access Commercial |
$362.48
|
| Rate for Payer: Quartz Beloit One Network |
$193.06
|
| Rate for Payer: Quartz Commercial |
$236.40
|
| Rate for Payer: WEA Trust Commercial |
$216.70
|
| Rate for Payer: WPS Commercial |
$291.84
|
|
|
ED Endocervical Curettage
|
Facility
OP
|
$316.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
6174402
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$151.68 |
| Max. Negotiated Rate |
$14,735.44 |
| Rate for Payer: Aetna Commercial |
$284.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$271.76
|
| Rate for Payer: Aetna Managed Medicare |
$794.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$205.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$158.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$151.68
|
| Rate for Payer: Anthem Medicare Advantage |
$794.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$167.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$794.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$794.59
|
| Rate for Payer: Cash Price |
$94.80
|
| Rate for Payer: Cash Price |
$94.80
|
| Rate for Payer: Cash Price |
$94.80
|
| Rate for Payer: Cigna Commercial |
$290.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$794.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$794.59
|
| Rate for Payer: Health EOS Commercial |
$281.24
|
| Rate for Payer: HFN Commercial |
$290.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,955.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$794.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$794.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$794.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$794.59
|
| Rate for Payer: Multiplan Commercial |
$252.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,191.88
|
| Rate for Payer: Preferred Network Access Commercial |
$290.72
|
| Rate for Payer: Quartz Beloit One Network |
$154.84
|
| Rate for Payer: Quartz Commercial |
$205.40
|
| Rate for Payer: Quartz Medicare Advantage |
$794.59
|
| Rate for Payer: The Alliance Commercial |
$14,735.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$794.59
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$173.80
|
| Rate for Payer: Wellcare Medicare |
$794.59
|
| Rate for Payer: WPS Commercial |
$234.06
|
|
|
ED Endocervical Curettage
|
Facility
IP
|
$316.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
6174402
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$154.84 |
| Max. Negotiated Rate |
$290.72 |
| Rate for Payer: Aetna Commercial |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$167.48
|
| Rate for Payer: Cash Price |
$94.80
|
| Rate for Payer: Cigna Commercial |
$290.72
|
| Rate for Payer: Health EOS Commercial |
$281.24
|
| Rate for Payer: HFN Commercial |
$290.72
|
| Rate for Payer: Multiplan Commercial |
$252.80
|
| Rate for Payer: NAPHCARE Commercial |
$189.60
|
| Rate for Payer: Preferred Network Access Commercial |
$290.72
|
| Rate for Payer: Quartz Beloit One Network |
$154.84
|
| Rate for Payer: Quartz Commercial |
$189.60
|
| Rate for Payer: WEA Trust Commercial |
$173.80
|
| Rate for Payer: WPS Commercial |
$234.06
|
|
|
ED Endometrial Aspiration
|
Facility
OP
|
$376.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
6174407
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$180.48 |
| Max. Negotiated Rate |
$15,495.60 |
| Rate for Payer: Aetna Commercial |
$338.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$323.36
|
| Rate for Payer: Aetna Managed Medicare |
$196.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$244.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$188.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$180.48
|
| Rate for Payer: Anthem Medicare Advantage |
$196.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$199.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$196.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$196.96
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cigna Commercial |
$345.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$196.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$196.96
|
| Rate for Payer: Health EOS Commercial |
$334.64
|
| Rate for Payer: HFN Commercial |
$345.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$732.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$196.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$196.96
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$196.96
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$196.96
|
| Rate for Payer: Multiplan Commercial |
$300.80
|
| Rate for Payer: NAPHCARE Commercial |
$295.44
|
| Rate for Payer: Preferred Network Access Commercial |
$345.92
|
| Rate for Payer: Quartz Beloit One Network |
$184.24
|
| Rate for Payer: Quartz Commercial |
$244.40
|
| Rate for Payer: Quartz Medicare Advantage |
$196.96
|
| Rate for Payer: The Alliance Commercial |
$15,495.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$196.96
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$206.80
|
| Rate for Payer: Wellcare Medicare |
$196.96
|
| Rate for Payer: WPS Commercial |
$278.50
|
|
|
ED Endometrial Aspiration
|
Facility
IP
|
$376.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
6174407
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$184.24 |
| Max. Negotiated Rate |
$345.92 |
| Rate for Payer: Aetna Commercial |
$338.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$199.28
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cigna Commercial |
$345.92
|
| Rate for Payer: Health EOS Commercial |
$334.64
|
| Rate for Payer: HFN Commercial |
$345.92
|
| Rate for Payer: Multiplan Commercial |
$300.80
|
| Rate for Payer: NAPHCARE Commercial |
$225.60
|
| Rate for Payer: Preferred Network Access Commercial |
$345.92
|
| Rate for Payer: Quartz Beloit One Network |
$184.24
|
| Rate for Payer: Quartz Commercial |
$225.60
|
| Rate for Payer: WEA Trust Commercial |
$206.80
|
| Rate for Payer: WPS Commercial |
$278.50
|
|
|
ED Esophageal Motility Study With Interpretation
|
Facility
OP
|
$1,320.00
|
|
|
Service Code
|
CPT 91010
|
| Hospital Charge Code |
6174448
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$1,970.74 |
| Rate for Payer: Aetna Commercial |
$1,188.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,135.20
|
| Rate for Payer: Aetna Managed Medicare |
$529.77
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$858.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$660.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$633.60
|
| Rate for Payer: Anthem Medicare Advantage |
$529.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$699.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$529.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$529.77
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cigna Commercial |
$1,214.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$529.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$738.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$529.77
|
| Rate for Payer: Health EOS Commercial |
$1,174.80
|
| Rate for Payer: HFN Commercial |
$1,214.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,970.74
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$529.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$529.77
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$529.77
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$529.77
|
| Rate for Payer: Multiplan Commercial |
$1,056.00
|
| Rate for Payer: NAPHCARE Commercial |
$794.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,214.40
|
| Rate for Payer: Quartz Beloit One Network |
$646.80
|
| Rate for Payer: Quartz Commercial |
$858.00
|
| Rate for Payer: Quartz Medicare Advantage |
$529.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$529.77
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$726.00
|
| Rate for Payer: Wellcare Medicare |
$529.77
|
| Rate for Payer: WPS Commercial |
$977.72
|
|
|
ED Esophageal Motility Study With Interpretation
|
Facility
IP
|
$1,320.00
|
|
|
Service Code
|
CPT 91010
|
| Hospital Charge Code |
6174448
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$646.80 |
| Max. Negotiated Rate |
$1,214.40 |
| Rate for Payer: Aetna Commercial |
$1,188.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$699.60
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cigna Commercial |
$1,214.40
|
| Rate for Payer: Health EOS Commercial |
$1,174.80
|
| Rate for Payer: HFN Commercial |
$1,214.40
|
| Rate for Payer: Multiplan Commercial |
$1,056.00
|
| Rate for Payer: NAPHCARE Commercial |
$792.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,214.40
|
| Rate for Payer: Quartz Beloit One Network |
$646.80
|
| Rate for Payer: Quartz Commercial |
$792.00
|
| Rate for Payer: WEA Trust Commercial |
$726.00
|
| Rate for Payer: WPS Commercial |
$977.72
|
|
|
ED Esophagogastroduodenoscopy, flexible, transoral; w/ biopsy, single or multiple
|
Facility
IP
|
$1,119.00
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
6172943
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$548.31 |
| Max. Negotiated Rate |
$1,029.48 |
| Rate for Payer: Aetna Commercial |
$1,007.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$593.07
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Cigna Commercial |
$1,029.48
|
| Rate for Payer: Health EOS Commercial |
$995.91
|
| Rate for Payer: HFN Commercial |
$1,029.48
|
| Rate for Payer: Multiplan Commercial |
$895.20
|
| Rate for Payer: NAPHCARE Commercial |
$671.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,029.48
|
| Rate for Payer: Quartz Beloit One Network |
$548.31
|
| Rate for Payer: Quartz Commercial |
$671.40
|
| Rate for Payer: WEA Trust Commercial |
$615.45
|
| Rate for Payer: WPS Commercial |
$828.84
|
|
|
ED Esophagogastroduodenoscopy, flexible, transoral; w/ biopsy, single or multiple
|
Facility
OP
|
$1,119.00
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
6172943
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$21,990.36 |
| Rate for Payer: Aetna Commercial |
$1,007.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$962.34
|
| Rate for Payer: Aetna Managed Medicare |
$895.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$727.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$559.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$537.12
|
| Rate for Payer: Anthem Medicare Advantage |
$895.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$593.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$895.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$895.97
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Cigna Commercial |
$1,029.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$895.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$895.97
|
| Rate for Payer: Health EOS Commercial |
$995.91
|
| Rate for Payer: HFN Commercial |
$1,029.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,333.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$895.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$895.97
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$895.97
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$895.97
|
| Rate for Payer: Multiplan Commercial |
$895.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,343.96
|
| Rate for Payer: Preferred Network Access Commercial |
$1,029.48
|
| Rate for Payer: Quartz Beloit One Network |
$548.31
|
| Rate for Payer: Quartz Commercial |
$727.35
|
| Rate for Payer: Quartz Medicare Advantage |
$895.97
|
| Rate for Payer: The Alliance Commercial |
$21,990.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$895.97
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$615.45
|
| Rate for Payer: Wellcare Medicare |
$895.97
|
| Rate for Payer: WPS Commercial |
$828.84
|
|
|
ED Esophagogastroduodenoscopy, Flexible, transoral; w/conrol of bleeding, any method
|
Facility
IP
|
$1,253.00
|
|
|
Service Code
|
CPT 43255
|
| Hospital Charge Code |
6243713
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$613.97 |
| Max. Negotiated Rate |
$1,152.76 |
| Rate for Payer: Aetna Commercial |
$1,127.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$664.09
|
| Rate for Payer: Cash Price |
$375.90
|
| Rate for Payer: Cigna Commercial |
$1,152.76
|
| Rate for Payer: Health EOS Commercial |
$1,115.17
|
| Rate for Payer: HFN Commercial |
$1,152.76
|
| Rate for Payer: Multiplan Commercial |
$1,002.40
|
| Rate for Payer: NAPHCARE Commercial |
$751.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,152.76
|
| Rate for Payer: Quartz Beloit One Network |
$613.97
|
| Rate for Payer: Quartz Commercial |
$751.80
|
| Rate for Payer: WEA Trust Commercial |
$689.15
|
| Rate for Payer: WPS Commercial |
$928.10
|
|
|
ED Esophagogastroduodenoscopy, Flexible, transoral; w/conrol of bleeding, any method
|
Facility
OP
|
$1,253.00
|
|
|
Service Code
|
CPT 43255
|
| Hospital Charge Code |
6243713
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$7,251.96 |
| Rate for Payer: Aetna Commercial |
$1,127.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,077.58
|
| Rate for Payer: Aetna Managed Medicare |
$1,880.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$814.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$626.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$601.44
|
| Rate for Payer: Anthem Medicare Advantage |
$1,880.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$664.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,880.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,880.76
|
| Rate for Payer: Cash Price |
$375.90
|
| Rate for Payer: Cash Price |
$375.90
|
| Rate for Payer: Cash Price |
$375.90
|
| Rate for Payer: Cigna Commercial |
$1,152.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,880.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,880.76
|
| Rate for Payer: Health EOS Commercial |
$1,115.17
|
| Rate for Payer: HFN Commercial |
$1,152.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,996.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,880.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,880.76
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,880.76
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,880.76
|
| Rate for Payer: Multiplan Commercial |
$1,002.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,821.14
|
| Rate for Payer: Preferred Network Access Commercial |
$1,152.76
|
| Rate for Payer: Quartz Beloit One Network |
$613.97
|
| Rate for Payer: Quartz Commercial |
$814.45
|
| Rate for Payer: Quartz Medicare Advantage |
$1,880.76
|
| Rate for Payer: The Alliance Commercial |
$7,251.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,880.76
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$689.15
|
| Rate for Payer: Wellcare Medicare |
$1,880.76
|
| Rate for Payer: WPS Commercial |
$928.10
|
|
|
ED Evacuation of a subungual Hematoma
|
Facility
IP
|
$150.00
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
6172926
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Aetna Commercial |
$135.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$79.50
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cigna Commercial |
$138.00
|
| Rate for Payer: Health EOS Commercial |
$133.50
|
| Rate for Payer: HFN Commercial |
$138.00
|
| Rate for Payer: Multiplan Commercial |
$120.00
|
| Rate for Payer: NAPHCARE Commercial |
$90.00
|
| Rate for Payer: Preferred Network Access Commercial |
$138.00
|
| Rate for Payer: Quartz Beloit One Network |
$73.50
|
| Rate for Payer: Quartz Commercial |
$90.00
|
| Rate for Payer: WEA Trust Commercial |
$82.50
|
| Rate for Payer: WPS Commercial |
$111.10
|
|
|
ED Evacuation of a subungual Hematoma
|
Facility
OP
|
$150.00
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
6172926
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$135.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$129.00
|
| Rate for Payer: Aetna Managed Medicare |
$126.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$97.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$75.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$72.00
|
| Rate for Payer: Anthem Medicare Advantage |
$126.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$79.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$126.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$126.26
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cigna Commercial |
$138.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$126.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$126.26
|
| Rate for Payer: Health EOS Commercial |
$133.50
|
| Rate for Payer: HFN Commercial |
$138.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$469.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$126.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$126.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$126.26
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$126.26
|
| Rate for Payer: Multiplan Commercial |
$120.00
|
| Rate for Payer: NAPHCARE Commercial |
$189.39
|
| Rate for Payer: Preferred Network Access Commercial |
$138.00
|
| Rate for Payer: Quartz Beloit One Network |
$73.50
|
| Rate for Payer: Quartz Commercial |
$97.50
|
| Rate for Payer: Quartz Medicare Advantage |
$126.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.26
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$82.50
|
| Rate for Payer: Wellcare Medicare |
$126.26
|
| Rate for Payer: WPS Commercial |
$111.10
|
|
|
ED Excision, Destruction with simple repair
|
Facility
OP
|
$733.00
|
|
|
Service Code
|
CPT 40812
|
| Hospital Charge Code |
6174073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$22,318.84 |
| Rate for Payer: Aetna Commercial |
$659.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$630.38
|
| Rate for Payer: Aetna Managed Medicare |
$1,507.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$476.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$366.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$351.84
|
| Rate for Payer: Anthem Medicare Advantage |
$1,507.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$388.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,507.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,507.37
|
| Rate for Payer: Cash Price |
$219.90
|
| Rate for Payer: Cash Price |
$219.90
|
| Rate for Payer: Cash Price |
$219.90
|
| Rate for Payer: Cigna Commercial |
$674.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,507.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,507.37
|
| Rate for Payer: Health EOS Commercial |
$652.37
|
| Rate for Payer: HFN Commercial |
$674.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,607.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,507.37
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,507.37
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,507.37
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,507.37
|
| Rate for Payer: Multiplan Commercial |
$586.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,261.06
|
| Rate for Payer: Preferred Network Access Commercial |
$674.36
|
| Rate for Payer: Quartz Beloit One Network |
$359.17
|
| Rate for Payer: Quartz Commercial |
$476.45
|
| Rate for Payer: Quartz Medicare Advantage |
$1,507.37
|
| Rate for Payer: The Alliance Commercial |
$22,318.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,507.37
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$403.15
|
| Rate for Payer: Wellcare Medicare |
$1,507.37
|
| Rate for Payer: WPS Commercial |
$542.93
|
|
|
ED Excision, Destruction with simple repair
|
Facility
IP
|
$733.00
|
|
|
Service Code
|
CPT 40812
|
| Hospital Charge Code |
6174073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$359.17 |
| Max. Negotiated Rate |
$674.36 |
| Rate for Payer: Aetna Commercial |
$659.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$388.49
|
| Rate for Payer: Cash Price |
$219.90
|
| Rate for Payer: Cigna Commercial |
$674.36
|
| Rate for Payer: Health EOS Commercial |
$652.37
|
| Rate for Payer: HFN Commercial |
$674.36
|
| Rate for Payer: Multiplan Commercial |
$586.40
|
| Rate for Payer: NAPHCARE Commercial |
$439.80
|
| Rate for Payer: Preferred Network Access Commercial |
$674.36
|
| Rate for Payer: Quartz Beloit One Network |
$359.17
|
| Rate for Payer: Quartz Commercial |
$439.80
|
| Rate for Payer: WEA Trust Commercial |
$403.15
|
| Rate for Payer: WPS Commercial |
$542.93
|
|
|
ED Excision of benign oral lesion 0.6-1.0cm
|
Facility
OP
|
$676.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
6174079
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$241.43 |
| Max. Negotiated Rate |
$22,318.84 |
| Rate for Payer: Aetna Commercial |
$608.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$581.36
|
| Rate for Payer: Aetna Managed Medicare |
$241.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$439.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$338.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$324.48
|
| Rate for Payer: Anthem Medicare Advantage |
$241.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$358.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$241.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$241.43
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$621.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$241.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$241.43
|
| Rate for Payer: Health EOS Commercial |
$601.64
|
| Rate for Payer: HFN Commercial |
$621.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$898.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$241.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$241.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$241.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$241.43
|
| Rate for Payer: Multiplan Commercial |
$540.80
|
| Rate for Payer: NAPHCARE Commercial |
$362.14
|
| Rate for Payer: Preferred Network Access Commercial |
$621.92
|
| Rate for Payer: Quartz Beloit One Network |
$331.24
|
| Rate for Payer: Quartz Commercial |
$439.40
|
| Rate for Payer: Quartz Medicare Advantage |
$241.43
|
| Rate for Payer: The Alliance Commercial |
$22,318.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$241.43
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$371.80
|
| Rate for Payer: Wellcare Medicare |
$241.43
|
| Rate for Payer: WPS Commercial |
$500.71
|
|
|
ED Excision of benign oral lesion 0.6-1.0cm
|
Facility
IP
|
$676.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
6174079
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$331.24 |
| Max. Negotiated Rate |
$621.92 |
| Rate for Payer: Aetna Commercial |
$608.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$358.28
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$621.92
|
| Rate for Payer: Health EOS Commercial |
$601.64
|
| Rate for Payer: HFN Commercial |
$621.92
|
| Rate for Payer: Multiplan Commercial |
$540.80
|
| Rate for Payer: NAPHCARE Commercial |
$405.60
|
| Rate for Payer: Preferred Network Access Commercial |
$621.92
|
| Rate for Payer: Quartz Beloit One Network |
$331.24
|
| Rate for Payer: Quartz Commercial |
$405.60
|
| Rate for Payer: WEA Trust Commercial |
$371.80
|
| Rate for Payer: WPS Commercial |
$500.71
|
|
|
ED Excision Of Lesion; Eyelid Repair
|
Facility
OP
|
$780.00
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
6174426
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$702.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$670.80
|
| Rate for Payer: Aetna Managed Medicare |
$1,000.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$507.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$390.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$374.40
|
| Rate for Payer: Anthem Medicare Advantage |
$1,000.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$413.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,000.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,000.70
|
| Rate for Payer: Cash Price |
$234.00
|
| Rate for Payer: Cash Price |
$234.00
|
| Rate for Payer: Cash Price |
$234.00
|
| Rate for Payer: Cigna Commercial |
$717.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,000.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,000.70
|
| Rate for Payer: Health EOS Commercial |
$694.20
|
| Rate for Payer: HFN Commercial |
$717.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,722.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,000.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,000.70
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,000.70
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,000.70
|
| Rate for Payer: Multiplan Commercial |
$624.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,501.05
|
| Rate for Payer: Preferred Network Access Commercial |
$717.60
|
| Rate for Payer: Quartz Beloit One Network |
$382.20
|
| Rate for Payer: Quartz Commercial |
$507.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,000.70
|
| Rate for Payer: The Alliance Commercial |
$3.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,000.70
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$429.00
|
| Rate for Payer: Wellcare Medicare |
$1,000.70
|
| Rate for Payer: WPS Commercial |
$577.75
|
|
|
ED Excision Of Lesion; Eyelid Repair
|
Facility
IP
|
$780.00
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
6174426
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$382.20 |
| Max. Negotiated Rate |
$717.60 |
| Rate for Payer: Aetna Commercial |
$702.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$413.40
|
| Rate for Payer: Cash Price |
$234.00
|
| Rate for Payer: Cigna Commercial |
$717.60
|
| Rate for Payer: Health EOS Commercial |
$694.20
|
| Rate for Payer: HFN Commercial |
$717.60
|
| Rate for Payer: Multiplan Commercial |
$624.00
|
| Rate for Payer: NAPHCARE Commercial |
$468.00
|
| Rate for Payer: Preferred Network Access Commercial |
$717.60
|
| Rate for Payer: Quartz Beloit One Network |
$382.20
|
| Rate for Payer: Quartz Commercial |
$468.00
|
| Rate for Payer: WEA Trust Commercial |
$429.00
|
| Rate for Payer: WPS Commercial |
$577.75
|
|
|
ED Excision Of Lesion; Eyelid Repair Margin
|
Facility
OP
|
$2,440.00
|
|
|
Service Code
|
CPT 67961
|
| Hospital Charge Code |
6174432
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$8,592.12 |
| Rate for Payer: Aetna Commercial |
$2,196.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,098.40
|
| Rate for Payer: Aetna Managed Medicare |
$2,309.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,586.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,220.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,171.20
|
| Rate for Payer: Anthem Medicare Advantage |
$2,309.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,293.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,309.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,309.71
|
| Rate for Payer: Cash Price |
$732.00
|
| Rate for Payer: Cash Price |
$732.00
|
| Rate for Payer: Cash Price |
$732.00
|
| Rate for Payer: Cigna Commercial |
$2,244.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,309.71
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,546.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,309.71
|
| Rate for Payer: Health EOS Commercial |
$2,171.60
|
| Rate for Payer: HFN Commercial |
$2,244.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,592.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,309.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,309.71
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,309.71
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,309.71
|
| Rate for Payer: Multiplan Commercial |
$1,952.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,464.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,244.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,195.60
|
| Rate for Payer: Quartz Commercial |
$1,586.00
|
| Rate for Payer: Quartz Medicare Advantage |
$2,309.71
|
| Rate for Payer: The Alliance Commercial |
$0.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,309.71
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$1,342.00
|
| Rate for Payer: Wellcare Medicare |
$2,309.71
|
| Rate for Payer: WPS Commercial |
$1,807.31
|
|
|
ED Excision Of Lesion; Eyelid Repair Margin
|
Facility
IP
|
$2,440.00
|
|
|
Service Code
|
CPT 67961
|
| Hospital Charge Code |
6174432
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,195.60 |
| Max. Negotiated Rate |
$2,244.80 |
| Rate for Payer: Aetna Commercial |
$2,196.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,293.20
|
| Rate for Payer: Cash Price |
$732.00
|
| Rate for Payer: Cigna Commercial |
$2,244.80
|
| Rate for Payer: Health EOS Commercial |
$2,171.60
|
| Rate for Payer: HFN Commercial |
$2,244.80
|
| Rate for Payer: Multiplan Commercial |
$1,952.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,464.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,244.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,195.60
|
| Rate for Payer: Quartz Commercial |
$1,464.00
|
| Rate for Payer: WEA Trust Commercial |
$1,342.00
|
| Rate for Payer: WPS Commercial |
$1,807.31
|
|
|
ED Excision Of Lesion Of Tongue With Closure; Anterior Two-Thirds
|
Facility
IP
|
$756.00
|
|
|
Service Code
|
CPT 41112
|
| Hospital Charge Code |
6174076
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$370.44 |
| Max. Negotiated Rate |
$695.52 |
| Rate for Payer: Aetna Commercial |
$680.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$400.68
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cigna Commercial |
$695.52
|
| Rate for Payer: Health EOS Commercial |
$672.84
|
| Rate for Payer: HFN Commercial |
$695.52
|
| Rate for Payer: Multiplan Commercial |
$604.80
|
| Rate for Payer: NAPHCARE Commercial |
$453.60
|
| Rate for Payer: Preferred Network Access Commercial |
$695.52
|
| Rate for Payer: Quartz Beloit One Network |
$370.44
|
| Rate for Payer: Quartz Commercial |
$453.60
|
| Rate for Payer: WEA Trust Commercial |
$415.80
|
| Rate for Payer: WPS Commercial |
$559.97
|
|
|
ED Excision Of Lesion Of Tongue With Closure; Anterior Two-Thirds
|
Facility
OP
|
$756.00
|
|
|
Service Code
|
CPT 41112
|
| Hospital Charge Code |
6174076
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$11,838.12 |
| Rate for Payer: Aetna Commercial |
$680.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$650.16
|
| Rate for Payer: Aetna Managed Medicare |
$3,182.29
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$491.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$378.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$362.88
|
| Rate for Payer: Anthem Medicare Advantage |
$3,182.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$400.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,182.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,182.29
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cigna Commercial |
$695.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,182.29
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,182.29
|
| Rate for Payer: Health EOS Commercial |
$672.84
|
| Rate for Payer: HFN Commercial |
$695.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,838.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,182.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,182.29
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,182.29
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,182.29
|
| Rate for Payer: Multiplan Commercial |
$604.80
|
| Rate for Payer: NAPHCARE Commercial |
$4,773.44
|
| Rate for Payer: Preferred Network Access Commercial |
$695.52
|
| Rate for Payer: Quartz Beloit One Network |
$370.44
|
| Rate for Payer: Quartz Commercial |
$491.40
|
| Rate for Payer: Quartz Medicare Advantage |
$3,182.29
|
| Rate for Payer: The Alliance Commercial |
$5,812.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,182.29
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$415.80
|
| Rate for Payer: Wellcare Medicare |
$3,182.29
|
| Rate for Payer: WPS Commercial |
$559.97
|
|
|
ED Excision of Lesion of Tongue Without Closure
|
Facility
OP
|
$721.00
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
6174074
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$12,270.48 |
| Rate for Payer: Aetna Commercial |
$648.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$620.06
|
| Rate for Payer: Aetna Managed Medicare |
$1,507.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$468.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$360.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$346.08
|
| Rate for Payer: Anthem Medicare Advantage |
$1,507.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$382.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,507.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,507.37
|
| Rate for Payer: Cash Price |
$216.30
|
| Rate for Payer: Cash Price |
$216.30
|
| Rate for Payer: Cash Price |
$216.30
|
| Rate for Payer: Cigna Commercial |
$663.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,507.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,507.37
|
| Rate for Payer: Health EOS Commercial |
$641.69
|
| Rate for Payer: HFN Commercial |
$663.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,607.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,507.37
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,507.37
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,507.37
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,507.37
|
| Rate for Payer: Multiplan Commercial |
$576.80
|
| Rate for Payer: NAPHCARE Commercial |
$2,261.06
|
| Rate for Payer: Preferred Network Access Commercial |
$663.32
|
| Rate for Payer: Quartz Beloit One Network |
$353.29
|
| Rate for Payer: Quartz Commercial |
$468.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,507.37
|
| Rate for Payer: The Alliance Commercial |
$12,270.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,507.37
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$396.55
|
| Rate for Payer: Wellcare Medicare |
$1,507.37
|
| Rate for Payer: WPS Commercial |
$534.04
|
|
