|
ECHO EXAM OF HEART 9330726
|
Professional
|
Both
|
$525.00
|
|
|
Service Code
|
CPT 93307 26
|
| Hospital Charge Code |
3015370
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$43.57 |
| Max. Negotiated Rate |
$518.70 |
| Rate for Payer: Aetna Commercial |
$518.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$469.56
|
| Rate for Payer: Aetna Managed Medicare |
$43.57
|
| Rate for Payer: Anthem Medicare Advantage |
$43.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$43.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$43.57
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna Commercial |
$518.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$49.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$43.57
|
| Rate for Payer: Health EOS Commercial |
$496.86
|
| Rate for Payer: HFN Commercial |
$518.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$160.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$160.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$43.57
|
| Rate for Payer: Multiplan Commercial |
$436.80
|
| Rate for Payer: NAPHCARE Commercial |
$65.35
|
| Rate for Payer: Preferred Network Access Commercial |
$518.70
|
| Rate for Payer: Quartz Beloit One Network |
$240.24
|
| Rate for Payer: Quartz Commercial |
$311.22
|
| Rate for Payer: Quartz Medicare Advantage |
$43.57
|
| Rate for Payer: The Alliance Commercial |
$165.55
|
| Rate for Payer: United Healthcare Medicaid |
$49.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$43.57
|
| Rate for Payer: WEA Trust Commercial |
$300.30
|
| Rate for Payer: WPS Commercial |
$174.26
|
|
|
ECHO EXAM OF HEART 93308
|
Professional
|
Both
|
$382.00
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
3015372
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$100.69 |
| Max. Negotiated Rate |
$402.77 |
| Rate for Payer: Aetna Commercial |
$377.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$341.66
|
| Rate for Payer: Aetna Managed Medicare |
$100.69
|
| Rate for Payer: Anthem Medicare Advantage |
$100.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$100.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$100.69
|
| Rate for Payer: Cash Price |
$114.60
|
| Rate for Payer: Cash Price |
$114.60
|
| Rate for Payer: Cash Price |
$114.60
|
| Rate for Payer: Cigna Commercial |
$377.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$104.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$100.69
|
| Rate for Payer: Health EOS Commercial |
$361.52
|
| Rate for Payer: HFN Commercial |
$377.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$357.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$357.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$100.69
|
| Rate for Payer: Multiplan Commercial |
$317.82
|
| Rate for Payer: NAPHCARE Commercial |
$151.04
|
| Rate for Payer: Preferred Network Access Commercial |
$377.42
|
| Rate for Payer: Quartz Beloit One Network |
$174.80
|
| Rate for Payer: Quartz Commercial |
$226.45
|
| Rate for Payer: Quartz Medicare Advantage |
$100.69
|
| Rate for Payer: The Alliance Commercial |
$382.63
|
| Rate for Payer: United Healthcare Medicaid |
$104.58
|
| Rate for Payer: United Healthcare Medicare Advantage |
$100.69
|
| Rate for Payer: WEA Trust Commercial |
$218.50
|
| Rate for Payer: WPS Commercial |
$402.77
|
|
|
Echo Guide for Biopsy 76942PP50
|
Professional
|
Both
|
$3,744.00
|
|
|
Service Code
|
CPT 76942 50
|
| Hospital Charge Code |
3856733
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$204.78 |
| Max. Negotiated Rate |
$3,699.07 |
| Rate for Payer: Aetna Commercial |
$3,699.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,348.63
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cigna Commercial |
$3,699.07
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,946.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,336.26
|
| Rate for Payer: Health EOS Commercial |
$3,543.32
|
| Rate for Payer: HFN Commercial |
$3,699.07
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$204.78
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$204.78
|
| Rate for Payer: Multiplan Commercial |
$3,115.01
|
| Rate for Payer: Preferred Network Access Commercial |
$3,699.07
|
| Rate for Payer: Quartz Beloit One Network |
$1,713.25
|
| Rate for Payer: Quartz Commercial |
$2,219.44
|
| Rate for Payer: The Alliance Commercial |
$1,946.88
|
| Rate for Payer: WEA Trust Commercial |
$2,141.57
|
| Rate for Payer: WPS Commercial |
$2,884.00
|
|
|
Echo Guide for Heart Biopsy 7693226
|
Professional
|
Both
|
$480.00
|
|
|
Service Code
|
CPT 76932 26
|
| Hospital Charge Code |
4125286
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$34.44 |
| Max. Negotiated Rate |
$474.24 |
| Rate for Payer: Aetna Commercial |
$474.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$429.31
|
| Rate for Payer: Aetna Managed Medicare |
$34.44
|
| Rate for Payer: Anthem Medicare Advantage |
$34.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$34.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$34.44
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$474.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$249.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$34.44
|
| Rate for Payer: Health EOS Commercial |
$454.27
|
| Rate for Payer: HFN Commercial |
$474.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$121.51
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$121.51
|
| Rate for Payer: Independent Care Health Plan Medicare |
$34.44
|
| Rate for Payer: Multiplan Commercial |
$399.36
|
| Rate for Payer: NAPHCARE Commercial |
$51.67
|
| Rate for Payer: Preferred Network Access Commercial |
$474.24
|
| Rate for Payer: Quartz Beloit One Network |
$219.65
|
| Rate for Payer: Quartz Commercial |
$284.54
|
| Rate for Payer: Quartz Medicare Advantage |
$34.44
|
| Rate for Payer: The Alliance Commercial |
$130.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34.44
|
| Rate for Payer: WEA Trust Commercial |
$274.56
|
| Rate for Payer: WPS Commercial |
$172.22
|
|
|
Echo Interpretation
|
Facility
|
OP
|
$1,408.00
|
|
|
Service Code
|
CPT 93314 26
|
| Hospital Charge Code |
5375705
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$349.69 |
| Max. Negotiated Rate |
$1,347.17 |
| Rate for Payer: Aetna Commercial |
$1,317.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,259.32
|
| Rate for Payer: Aetna Managed Medicare |
$410.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$951.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$732.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$702.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$776.09
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cigna Commercial |
$1,347.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$819.46
|
| Rate for Payer: Health EOS Commercial |
$1,303.24
|
| Rate for Payer: HFN Commercial |
$1,347.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,098.24
|
| Rate for Payer: Multiplan Commercial |
$1,171.46
|
| Rate for Payer: NAPHCARE Commercial |
$878.59
|
| Rate for Payer: Preferred Network Access Commercial |
$1,347.17
|
| Rate for Payer: Quartz Beloit One Network |
$717.52
|
| Rate for Payer: Quartz Commercial |
$951.81
|
| Rate for Payer: Quartz Medicare Advantage |
$878.59
|
| Rate for Payer: The Alliance Commercial |
$349.69
|
| Rate for Payer: WEA Trust Commercial |
$805.38
|
| Rate for Payer: WPS Commercial |
$1,084.58
|
|
|
Echo Interpretation
|
Facility
|
OP
|
$186.00
|
|
|
Service Code
|
CPT 93350 26
|
| Hospital Charge Code |
5375675
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$54.16 |
| Max. Negotiated Rate |
$272.65 |
| Rate for Payer: Aetna Commercial |
$174.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$166.36
|
| Rate for Payer: Aetna Managed Medicare |
$54.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$125.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$96.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$92.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$102.52
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cigna Commercial |
$177.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$108.25
|
| Rate for Payer: Health EOS Commercial |
$172.16
|
| Rate for Payer: HFN Commercial |
$177.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$145.08
|
| Rate for Payer: Multiplan Commercial |
$154.75
|
| Rate for Payer: NAPHCARE Commercial |
$116.06
|
| Rate for Payer: Preferred Network Access Commercial |
$177.96
|
| Rate for Payer: Quartz Beloit One Network |
$94.79
|
| Rate for Payer: Quartz Commercial |
$125.74
|
| Rate for Payer: Quartz Medicare Advantage |
$116.06
|
| Rate for Payer: The Alliance Commercial |
$272.65
|
| Rate for Payer: WEA Trust Commercial |
$106.39
|
| Rate for Payer: WPS Commercial |
$143.28
|
|
|
Echo Interpretation
|
Facility
|
IP
|
$1,348.00
|
|
|
Service Code
|
CPT 93312 26
|
| Hospital Charge Code |
5375696
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$686.94 |
| Max. Negotiated Rate |
$1,289.77 |
| Rate for Payer: Aetna Commercial |
$1,261.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,205.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$743.02
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cigna Commercial |
$1,289.77
|
| Rate for Payer: Health EOS Commercial |
$1,247.71
|
| Rate for Payer: HFN Commercial |
$1,289.77
|
| Rate for Payer: Multiplan Commercial |
$1,121.54
|
| Rate for Payer: Preferred Network Access Commercial |
$1,289.77
|
| Rate for Payer: Quartz Beloit One Network |
$686.94
|
| Rate for Payer: Quartz Commercial |
$841.15
|
| Rate for Payer: WEA Trust Commercial |
$771.06
|
| Rate for Payer: WPS Commercial |
$1,038.36
|
|
|
Echo Interpretation
|
Facility
|
IP
|
$1,348.00
|
|
|
Service Code
|
CPT 93312 26
|
| Hospital Charge Code |
5375693
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$686.94 |
| Max. Negotiated Rate |
$1,289.77 |
| Rate for Payer: Aetna Commercial |
$1,261.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,205.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$743.02
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cigna Commercial |
$1,289.77
|
| Rate for Payer: Health EOS Commercial |
$1,247.71
|
| Rate for Payer: HFN Commercial |
$1,289.77
|
| Rate for Payer: Multiplan Commercial |
$1,121.54
|
| Rate for Payer: Preferred Network Access Commercial |
$1,289.77
|
| Rate for Payer: Quartz Beloit One Network |
$686.94
|
| Rate for Payer: Quartz Commercial |
$841.15
|
| Rate for Payer: WEA Trust Commercial |
$771.06
|
| Rate for Payer: WPS Commercial |
$1,038.36
|
|
|
Echo Interpretation
|
Facility
|
OP
|
$1,348.00
|
|
|
Service Code
|
CPT 93312 26
|
| Hospital Charge Code |
5375693
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$392.54 |
| Max. Negotiated Rate |
$1,289.77 |
| Rate for Payer: Aetna Commercial |
$1,261.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,205.65
|
| Rate for Payer: Aetna Managed Medicare |
$392.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$911.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$700.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$672.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$743.02
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cigna Commercial |
$1,289.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$784.54
|
| Rate for Payer: Health EOS Commercial |
$1,247.71
|
| Rate for Payer: HFN Commercial |
$1,289.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,051.44
|
| Rate for Payer: Multiplan Commercial |
$1,121.54
|
| Rate for Payer: NAPHCARE Commercial |
$841.15
|
| Rate for Payer: Preferred Network Access Commercial |
$1,289.77
|
| Rate for Payer: Quartz Beloit One Network |
$686.94
|
| Rate for Payer: Quartz Commercial |
$911.25
|
| Rate for Payer: Quartz Medicare Advantage |
$841.15
|
| Rate for Payer: The Alliance Commercial |
$426.07
|
| Rate for Payer: WEA Trust Commercial |
$771.06
|
| Rate for Payer: WPS Commercial |
$1,038.36
|
|
|
Echo Interpretation
|
Facility
|
OP
|
$1,348.00
|
|
|
Service Code
|
CPT 93312 26
|
| Hospital Charge Code |
5375696
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$392.54 |
| Max. Negotiated Rate |
$1,289.77 |
| Rate for Payer: Aetna Commercial |
$1,261.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,205.65
|
| Rate for Payer: Aetna Managed Medicare |
$392.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$911.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$700.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$672.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$743.02
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cigna Commercial |
$1,289.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$784.54
|
| Rate for Payer: Health EOS Commercial |
$1,247.71
|
| Rate for Payer: HFN Commercial |
$1,289.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,051.44
|
| Rate for Payer: Multiplan Commercial |
$1,121.54
|
| Rate for Payer: NAPHCARE Commercial |
$841.15
|
| Rate for Payer: Preferred Network Access Commercial |
$1,289.77
|
| Rate for Payer: Quartz Beloit One Network |
$686.94
|
| Rate for Payer: Quartz Commercial |
$911.25
|
| Rate for Payer: Quartz Medicare Advantage |
$841.15
|
| Rate for Payer: The Alliance Commercial |
$426.07
|
| Rate for Payer: WEA Trust Commercial |
$771.06
|
| Rate for Payer: WPS Commercial |
$1,038.36
|
|
|
Echo Interpretation
|
Facility
|
IP
|
$1,408.00
|
|
|
Service Code
|
CPT 93314 26
|
| Hospital Charge Code |
5375705
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$717.52 |
| Max. Negotiated Rate |
$1,347.17 |
| Rate for Payer: Aetna Commercial |
$1,317.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,259.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$776.09
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cigna Commercial |
$1,347.17
|
| Rate for Payer: Health EOS Commercial |
$1,303.24
|
| Rate for Payer: HFN Commercial |
$1,347.17
|
| Rate for Payer: Multiplan Commercial |
$1,171.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,347.17
|
| Rate for Payer: Quartz Beloit One Network |
$717.52
|
| Rate for Payer: Quartz Commercial |
$878.59
|
| Rate for Payer: WEA Trust Commercial |
$805.38
|
| Rate for Payer: WPS Commercial |
$1,084.58
|
|
|
Echo Interpretation
|
Facility
|
IP
|
$186.00
|
|
|
Service Code
|
CPT 93350 26
|
| Hospital Charge Code |
5375675
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$177.96 |
| Rate for Payer: Aetna Commercial |
$174.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$166.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$102.52
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cigna Commercial |
$177.96
|
| Rate for Payer: Health EOS Commercial |
$172.16
|
| Rate for Payer: HFN Commercial |
$177.96
|
| Rate for Payer: Multiplan Commercial |
$154.75
|
| Rate for Payer: Preferred Network Access Commercial |
$177.96
|
| Rate for Payer: Quartz Beloit One Network |
$94.79
|
| Rate for Payer: Quartz Commercial |
$116.06
|
| Rate for Payer: WEA Trust Commercial |
$106.39
|
| Rate for Payer: WPS Commercial |
$143.28
|
|
|
Echo Stress Test 93350
|
Facility
|
OP
|
$4,308.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
5381792
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$575.04 |
| Max. Negotiated Rate |
$4,121.89 |
| Rate for Payer: Aetna Commercial |
$4,032.29
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,853.08
|
| Rate for Payer: Aetna Managed Medicare |
$575.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,912.21
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,240.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,150.55
|
| Rate for Payer: Anthem Medicare Advantage |
$575.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,374.57
|
| 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 |
$1,292.40
|
| Rate for Payer: Cash Price |
$1,292.40
|
| Rate for Payer: Cigna Commercial |
$4,121.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$575.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,507.26
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$575.04
|
| Rate for Payer: Health EOS Commercial |
$3,987.48
|
| Rate for Payer: HFN Commercial |
$4,121.89
|
| 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 |
$3,584.26
|
| Rate for Payer: NAPHCARE Commercial |
$862.56
|
| Rate for Payer: Preferred Network Access Commercial |
$4,121.89
|
| Rate for Payer: Quartz Beloit One Network |
$2,195.36
|
| Rate for Payer: Quartz Commercial |
$2,912.21
|
| 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 |
$3,360.24
|
| Rate for Payer: WEA Trust Commercial |
$2,464.18
|
| Rate for Payer: Wellcare Medicare |
$575.04
|
| Rate for Payer: WPS Commercial |
$3,318.45
|
|
|
Echo Stress Test 93350
|
Facility
|
IP
|
$4,308.00
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
5381792
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$2,195.36 |
| Max. Negotiated Rate |
$4,121.89 |
| Rate for Payer: Aetna Commercial |
$4,032.29
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,853.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,374.57
|
| Rate for Payer: Cash Price |
$1,292.40
|
| Rate for Payer: Cigna Commercial |
$4,121.89
|
| Rate for Payer: Health EOS Commercial |
$3,987.48
|
| Rate for Payer: HFN Commercial |
$4,121.89
|
| Rate for Payer: Multiplan Commercial |
$3,584.26
|
| Rate for Payer: Preferred Network Access Commercial |
$4,121.89
|
| Rate for Payer: Quartz Beloit One Network |
$2,195.36
|
| Rate for Payer: Quartz Commercial |
$2,688.19
|
| Rate for Payer: WEA Trust Commercial |
$2,464.18
|
| Rate for Payer: WPS Commercial |
$3,318.45
|
|
|
Echo Transeophag Congen Probe Plcmt 9331526
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
CPT 93315 26
|
| Hospital Charge Code |
4834611
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$125.14 |
| Max. Negotiated Rate |
$2,099.50 |
| Rate for Payer: Aetna Commercial |
$2,099.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,900.60
|
| Rate for Payer: Aetna Managed Medicare |
$125.14
|
| Rate for Payer: Anthem Medicare Advantage |
$125.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$125.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$125.14
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cigna Commercial |
$2,099.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$150.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$125.14
|
| Rate for Payer: Health EOS Commercial |
$2,011.10
|
| Rate for Payer: HFN Commercial |
$2,099.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$457.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$457.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$125.14
|
| Rate for Payer: Multiplan Commercial |
$1,768.00
|
| Rate for Payer: NAPHCARE Commercial |
$187.71
|
| Rate for Payer: Preferred Network Access Commercial |
$2,099.50
|
| Rate for Payer: Quartz Beloit One Network |
$972.40
|
| Rate for Payer: Quartz Commercial |
$1,259.70
|
| Rate for Payer: Quartz Medicare Advantage |
$125.14
|
| Rate for Payer: The Alliance Commercial |
$475.54
|
| Rate for Payer: United Healthcare Medicaid |
$150.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$125.14
|
| Rate for Payer: WEA Trust Commercial |
$1,215.50
|
| Rate for Payer: WPS Commercial |
$500.57
|
|
|
ECHO TRANSESOPHAGEAL 9331226
|
Professional
|
Both
|
$1,458.00
|
|
|
Service Code
|
CPT 93312 26
|
| Hospital Charge Code |
3015375
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$106.52 |
| Max. Negotiated Rate |
$1,440.50 |
| Rate for Payer: Aetna Commercial |
$1,440.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,304.04
|
| Rate for Payer: Aetna Managed Medicare |
$106.52
|
| Rate for Payer: Anthem Medicare Advantage |
$106.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$106.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$106.52
|
| Rate for Payer: Cash Price |
$437.40
|
| Rate for Payer: Cash Price |
$437.40
|
| Rate for Payer: Cash Price |
$437.40
|
| Rate for Payer: Cigna Commercial |
$1,440.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$118.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$106.52
|
| Rate for Payer: Health EOS Commercial |
$1,379.85
|
| Rate for Payer: HFN Commercial |
$1,440.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$387.35
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$387.35
|
| Rate for Payer: Independent Care Health Plan Medicare |
$106.52
|
| Rate for Payer: Multiplan Commercial |
$1,213.06
|
| Rate for Payer: NAPHCARE Commercial |
$159.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,440.50
|
| Rate for Payer: Quartz Beloit One Network |
$667.18
|
| Rate for Payer: Quartz Commercial |
$864.30
|
| Rate for Payer: Quartz Medicare Advantage |
$106.52
|
| Rate for Payer: The Alliance Commercial |
$404.76
|
| Rate for Payer: United Healthcare Medicaid |
$118.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$106.52
|
| Rate for Payer: WEA Trust Commercial |
$833.98
|
| Rate for Payer: WPS Commercial |
$426.07
|
|
|
Echo Transthoracic 9330326
|
Professional
|
Both
|
$815.00
|
|
|
Service Code
|
CPT 93303 26
|
| Hospital Charge Code |
4075841
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$60.85 |
| Max. Negotiated Rate |
$805.22 |
| Rate for Payer: Aetna Commercial |
$805.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$728.94
|
| Rate for Payer: Aetna Managed Medicare |
$60.85
|
| Rate for Payer: Anthem Medicare Advantage |
$60.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$60.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$60.85
|
| Rate for Payer: Cash Price |
$244.50
|
| Rate for Payer: Cash Price |
$244.50
|
| Rate for Payer: Cash Price |
$244.50
|
| Rate for Payer: Cigna Commercial |
$805.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$69.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$60.85
|
| Rate for Payer: Health EOS Commercial |
$771.32
|
| Rate for Payer: HFN Commercial |
$805.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$223.54
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$223.54
|
| Rate for Payer: Independent Care Health Plan Medicare |
$60.85
|
| Rate for Payer: Multiplan Commercial |
$678.08
|
| Rate for Payer: NAPHCARE Commercial |
$91.28
|
| Rate for Payer: Preferred Network Access Commercial |
$805.22
|
| Rate for Payer: Quartz Beloit One Network |
$372.94
|
| Rate for Payer: Quartz Commercial |
$483.13
|
| Rate for Payer: Quartz Medicare Advantage |
$60.85
|
| Rate for Payer: The Alliance Commercial |
$231.23
|
| Rate for Payer: United Healthcare Medicaid |
$69.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$60.85
|
| Rate for Payer: WEA Trust Commercial |
$466.18
|
| Rate for Payer: WPS Commercial |
$243.40
|
|
|
ECHO TRANSTHORACIC 9330826
|
Professional
|
Both
|
$382.00
|
|
|
Service Code
|
CPT 93308 26
|
| Hospital Charge Code |
3015373
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.93 |
| Max. Negotiated Rate |
$377.42 |
| Rate for Payer: Aetna Commercial |
$377.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$341.66
|
| Rate for Payer: Aetna Managed Medicare |
$24.93
|
| Rate for Payer: Anthem Medicare Advantage |
$24.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.93
|
| Rate for Payer: Cash Price |
$114.60
|
| Rate for Payer: Cash Price |
$114.60
|
| Rate for Payer: Cash Price |
$114.60
|
| Rate for Payer: Cigna Commercial |
$377.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$29.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24.93
|
| Rate for Payer: Health EOS Commercial |
$361.52
|
| Rate for Payer: HFN Commercial |
$377.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$90.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$90.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.93
|
| Rate for Payer: Multiplan Commercial |
$317.82
|
| Rate for Payer: NAPHCARE Commercial |
$37.39
|
| Rate for Payer: Preferred Network Access Commercial |
$377.42
|
| Rate for Payer: Quartz Beloit One Network |
$174.80
|
| Rate for Payer: Quartz Commercial |
$226.45
|
| Rate for Payer: Quartz Medicare Advantage |
$24.93
|
| Rate for Payer: The Alliance Commercial |
$94.73
|
| Rate for Payer: United Healthcare Medicaid |
$29.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.93
|
| Rate for Payer: WEA Trust Commercial |
$218.50
|
| Rate for Payer: WPS Commercial |
$99.72
|
|
|
ECHO TRANSTHORACIC 9335026
|
Professional
|
Both
|
$1,017.00
|
|
|
Service Code
|
CPT 93350 26
|
| Hospital Charge Code |
3015380
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$68.16 |
| Max. Negotiated Rate |
$1,004.80 |
| Rate for Payer: Aetna Commercial |
$1,004.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$909.60
|
| 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 |
$305.10
|
| Rate for Payer: Cash Price |
$305.10
|
| Rate for Payer: Cash Price |
$305.10
|
| Rate for Payer: Cigna Commercial |
$1,004.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$79.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$68.16
|
| Rate for Payer: Health EOS Commercial |
$962.49
|
| Rate for Payer: HFN Commercial |
$1,004.80
|
| 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 |
$846.14
|
| Rate for Payer: NAPHCARE Commercial |
$102.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,004.80
|
| Rate for Payer: Quartz Beloit One Network |
$465.38
|
| Rate for Payer: Quartz Commercial |
$602.88
|
| Rate for Payer: Quartz Medicare Advantage |
$68.16
|
| Rate for Payer: The Alliance Commercial |
$259.01
|
| Rate for Payer: United Healthcare Medicaid |
$79.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$68.16
|
| Rate for Payer: WEA Trust Commercial |
$581.72
|
| Rate for Payer: WPS Commercial |
$272.65
|
|
|
ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP -93307
|
Facility
|
IP
|
$1,035.00
|
|
|
Service Code
|
CPT 93307
|
| Hospital Charge Code |
5927629
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$527.44 |
| Max. Negotiated Rate |
$990.29 |
| Rate for Payer: Aetna Commercial |
$968.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$925.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$570.49
|
| Rate for Payer: Cash Price |
$310.50
|
| Rate for Payer: Cigna Commercial |
$990.29
|
| Rate for Payer: Health EOS Commercial |
$958.00
|
| Rate for Payer: HFN Commercial |
$990.29
|
| Rate for Payer: Multiplan Commercial |
$861.12
|
| Rate for Payer: Preferred Network Access Commercial |
$990.29
|
| Rate for Payer: Quartz Beloit One Network |
$527.44
|
| Rate for Payer: Quartz Commercial |
$645.84
|
| Rate for Payer: WEA Trust Commercial |
$592.02
|
| Rate for Payer: WPS Commercial |
$797.26
|
|
|
ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP -93307
|
Facility
|
OP
|
$1,035.00
|
|
|
Service Code
|
CPT 93307
|
| Hospital Charge Code |
5927629
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$251.10 |
| Max. Negotiated Rate |
$1,004.39 |
| Rate for Payer: Aetna Commercial |
$968.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$925.70
|
| Rate for Payer: Aetna Managed Medicare |
$251.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$699.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$538.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$516.67
|
| Rate for Payer: Anthem Medicare Advantage |
$251.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$570.49
|
| 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 |
$310.50
|
| Rate for Payer: Cash Price |
$310.50
|
| Rate for Payer: Cigna Commercial |
$990.29
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$251.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$602.37
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$251.10
|
| Rate for Payer: Health EOS Commercial |
$958.00
|
| Rate for Payer: HFN Commercial |
$990.29
|
| 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 |
$861.12
|
| Rate for Payer: NAPHCARE Commercial |
$376.65
|
| Rate for Payer: Preferred Network Access Commercial |
$990.29
|
| Rate for Payer: Quartz Beloit One Network |
$527.44
|
| Rate for Payer: Quartz Commercial |
$699.66
|
| 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 |
$807.30
|
| Rate for Payer: WEA Trust Commercial |
$592.02
|
| Rate for Payer: Wellcare Medicare |
$251.10
|
| Rate for Payer: WPS Commercial |
$797.26
|
|
|
ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES
|
Facility
|
IP
|
$589,826.64
|
|
|
Service Code
|
MSDRG 003
|
| Min. Negotiated Rate |
$163,053.53 |
| Max. Negotiated Rate |
$589,826.64 |
| Rate for Payer: Aetna Managed Medicare |
$163,053.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$463,116.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$354,975.34
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$337,249.75
|
| Rate for Payer: Anthem Medicare Advantage |
$163,053.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$163,053.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$163,053.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$163,053.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$374,378.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$163,053.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$432,375.74
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$163,053.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$163,053.53
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$163,053.53
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$163,053.53
|
| Rate for Payer: NAPHCARE Commercial |
$244,580.29
|
| Rate for Payer: Quartz Medicare Advantage |
$163,053.53
|
| Rate for Payer: The Alliance Commercial |
$589,826.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$163,053.53
|
| Rate for Payer: United Healthcare PPO |
$336,610.01
|
| Rate for Payer: Wellcare Medicare |
$163,053.53
|
|
|
ECTOPIC PREGNANCY PROCEDURES
|
Facility
|
OP
|
$768.78
|
|
|
Service Code
|
EAPG 00179
|
| Min. Negotiated Rate |
$739.21 |
| Max. Negotiated Rate |
$768.78 |
| Rate for Payer: Anthem Medicaid |
$739.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$739.21
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$739.21
|
| Rate for Payer: Dean Health Medicaid |
$739.21
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$739.21
|
| Rate for Payer: Managed Health Services Medicaid |
$768.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$739.21
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$739.21
|
| Rate for Payer: United Healthcare Medicaid |
$739.21
|
|
|
ECTROPION/ENTROPION REPAIR
|
Facility
|
IP
|
$1,084.00
|
|
| Hospital Charge Code |
2960011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$552.41 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$676.42
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
|
ECTROPION/ENTROPION REPAIR
|
Facility
|
OP
|
$1,084.00
|
|
| Hospital Charge Code |
2960011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$315.66 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Aetna Managed Medicare |
$315.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$732.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$563.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$541.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$630.89
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$845.52
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: NAPHCARE Commercial |
$676.42
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$732.78
|
| Rate for Payer: Quartz Medicare Advantage |
$676.42
|
| Rate for Payer: The Alliance Commercial |
$563.68
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
