|
ED Fine Needle Aspiration Without Imaging
|
Facility
OP
|
$231.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
6173135
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$110.88 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$207.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$198.66
|
| Rate for Payer: Aetna Managed Medicare |
$394.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$150.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$115.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$110.88
|
| Rate for Payer: Anthem Medicare Advantage |
$394.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$122.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$394.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$394.12
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cigna Commercial |
$212.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$394.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$394.12
|
| Rate for Payer: Health EOS Commercial |
$205.59
|
| Rate for Payer: HFN Commercial |
$212.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,466.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$394.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$394.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$394.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$394.12
|
| Rate for Payer: Multiplan Commercial |
$184.80
|
| Rate for Payer: NAPHCARE Commercial |
$591.18
|
| Rate for Payer: Preferred Network Access Commercial |
$212.52
|
| Rate for Payer: Quartz Beloit One Network |
$113.19
|
| Rate for Payer: Quartz Commercial |
$150.15
|
| Rate for Payer: Quartz Medicare Advantage |
$394.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$394.12
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$127.05
|
| Rate for Payer: Wellcare Medicare |
$394.12
|
| Rate for Payer: WPS Commercial |
$171.10
|
|
|
ED Fine Needle Aspiration Without Imaging
|
Facility
IP
|
$231.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
6173135
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.19 |
| Max. Negotiated Rate |
$212.52 |
| Rate for Payer: Aetna Commercial |
$207.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$122.43
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cigna Commercial |
$212.52
|
| Rate for Payer: Health EOS Commercial |
$205.59
|
| Rate for Payer: HFN Commercial |
$212.52
|
| Rate for Payer: Multiplan Commercial |
$184.80
|
| Rate for Payer: NAPHCARE Commercial |
$138.60
|
| Rate for Payer: Preferred Network Access Commercial |
$212.52
|
| Rate for Payer: Quartz Beloit One Network |
$113.19
|
| Rate for Payer: Quartz Commercial |
$138.60
|
| Rate for Payer: WEA Trust Commercial |
$127.05
|
| Rate for Payer: WPS Commercial |
$171.10
|
|
|
ED Fitting And Insertion Of Pessary
|
Facility
IP
|
$213.00
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
6174398
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$104.37 |
| Max. Negotiated Rate |
$195.96 |
| Rate for Payer: Aetna Commercial |
$191.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$112.89
|
| Rate for Payer: Cash Price |
$63.90
|
| Rate for Payer: Cigna Commercial |
$195.96
|
| Rate for Payer: Health EOS Commercial |
$189.57
|
| Rate for Payer: HFN Commercial |
$195.96
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: NAPHCARE Commercial |
$127.80
|
| Rate for Payer: Preferred Network Access Commercial |
$195.96
|
| Rate for Payer: Quartz Beloit One Network |
$104.37
|
| Rate for Payer: Quartz Commercial |
$127.80
|
| Rate for Payer: WEA Trust Commercial |
$117.15
|
| Rate for Payer: WPS Commercial |
$157.77
|
|
|
ED Fitting And Insertion Of Pessary
|
Facility
OP
|
$213.00
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
6174398
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$102.24 |
| Max. Negotiated Rate |
$25,387.88 |
| Rate for Payer: Aetna Commercial |
$191.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$183.18
|
| Rate for Payer: Aetna Managed Medicare |
$196.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$138.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$106.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$102.24
|
| Rate for Payer: Anthem Medicare Advantage |
$196.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$112.89
|
| 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 |
$63.90
|
| Rate for Payer: Cash Price |
$63.90
|
| Rate for Payer: Cash Price |
$63.90
|
| Rate for Payer: Cigna Commercial |
$195.96
|
| 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 |
$189.57
|
| Rate for Payer: HFN Commercial |
$195.96
|
| 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 |
$170.40
|
| Rate for Payer: NAPHCARE Commercial |
$295.44
|
| Rate for Payer: Preferred Network Access Commercial |
$195.96
|
| Rate for Payer: Quartz Beloit One Network |
$104.37
|
| Rate for Payer: Quartz Commercial |
$138.45
|
| Rate for Payer: Quartz Medicare Advantage |
$196.96
|
| Rate for Payer: The Alliance Commercial |
$25,387.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$196.96
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$117.15
|
| Rate for Payer: Wellcare Medicare |
$196.96
|
| Rate for Payer: WPS Commercial |
$157.77
|
|
|
ED Fluoro Central Venous Access Dev Placement
|
Facility
IP
|
$179.00
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
6181794
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$87.71 |
| Max. Negotiated Rate |
$164.68 |
| Rate for Payer: Aetna Commercial |
$161.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$94.87
|
| Rate for Payer: Cash Price |
$53.70
|
| Rate for Payer: Cigna Commercial |
$164.68
|
| Rate for Payer: Health EOS Commercial |
$159.31
|
| Rate for Payer: HFN Commercial |
$164.68
|
| Rate for Payer: Multiplan Commercial |
$143.20
|
| Rate for Payer: NAPHCARE Commercial |
$107.40
|
| Rate for Payer: Preferred Network Access Commercial |
$164.68
|
| Rate for Payer: Quartz Beloit One Network |
$87.71
|
| Rate for Payer: Quartz Commercial |
$107.40
|
| Rate for Payer: WEA Trust Commercial |
$98.45
|
| Rate for Payer: WPS Commercial |
$132.59
|
|
|
ED Fluoro Central Venous Access Dev Placement
|
Facility
OP
|
$179.00
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
6181794
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$50.12 |
| Max. Negotiated Rate |
$14,914.20 |
| Rate for Payer: Aetna Commercial |
$161.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$153.94
|
| Rate for Payer: Aetna Managed Medicare |
$50.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$116.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$89.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$85.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$94.87
|
| Rate for Payer: Cash Price |
$53.70
|
| Rate for Payer: Cash Price |
$53.70
|
| Rate for Payer: Cash Price |
$53.70
|
| Rate for Payer: Cigna Commercial |
$164.68
|
| Rate for Payer: Health EOS Commercial |
$159.31
|
| Rate for Payer: HFN Commercial |
$164.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$134.25
|
| Rate for Payer: Multiplan Commercial |
$143.20
|
| Rate for Payer: NAPHCARE Commercial |
$107.40
|
| Rate for Payer: Preferred Network Access Commercial |
$164.68
|
| Rate for Payer: Quartz Beloit One Network |
$87.71
|
| Rate for Payer: Quartz Commercial |
$116.35
|
| Rate for Payer: Quartz Medicare Advantage |
$107.40
|
| Rate for Payer: The Alliance Commercial |
$14,914.20
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$98.45
|
| Rate for Payer: WPS Commercial |
$132.59
|
|
|
ED Foreskin Manipulation including Lysis Of Prepubital Adhesions & Stretching
|
Facility
OP
|
$121.00
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
6174109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$58.08 |
| Max. Negotiated Rate |
$6,179.00 |
| Rate for Payer: Aetna Commercial |
$108.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$104.06
|
| Rate for Payer: Aetna Managed Medicare |
$244.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$78.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$60.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$58.08
|
| Rate for Payer: Anthem Medicare Advantage |
$244.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$64.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$244.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$244.28
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna Commercial |
$111.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$244.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$244.28
|
| Rate for Payer: Health EOS Commercial |
$107.69
|
| Rate for Payer: HFN Commercial |
$111.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$908.72
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$244.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$244.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$244.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$244.28
|
| Rate for Payer: Multiplan Commercial |
$96.80
|
| Rate for Payer: NAPHCARE Commercial |
$366.42
|
| Rate for Payer: Preferred Network Access Commercial |
$111.32
|
| Rate for Payer: Quartz Beloit One Network |
$59.29
|
| Rate for Payer: Quartz Commercial |
$78.65
|
| Rate for Payer: Quartz Medicare Advantage |
$244.28
|
| Rate for Payer: The Alliance Commercial |
$6,179.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$244.28
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$66.55
|
| Rate for Payer: Wellcare Medicare |
$244.28
|
| Rate for Payer: WPS Commercial |
$89.62
|
|
|
ED Foreskin Manipulation including Lysis Of Prepubital Adhesions & Stretching
|
Facility
IP
|
$121.00
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
6174109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$59.29 |
| Max. Negotiated Rate |
$111.32 |
| Rate for Payer: Aetna Commercial |
$108.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$64.13
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna Commercial |
$111.32
|
| Rate for Payer: Health EOS Commercial |
$107.69
|
| Rate for Payer: HFN Commercial |
$111.32
|
| Rate for Payer: Multiplan Commercial |
$96.80
|
| Rate for Payer: NAPHCARE Commercial |
$72.60
|
| Rate for Payer: Preferred Network Access Commercial |
$111.32
|
| Rate for Payer: Quartz Beloit One Network |
$59.29
|
| Rate for Payer: Quartz Commercial |
$72.60
|
| Rate for Payer: WEA Trust Commercial |
$66.55
|
| Rate for Payer: WPS Commercial |
$89.62
|
|
|
ED GASTRIC INTUBATION & ASPIRATION W/PHYS SKILL/LAVAGE
|
Facility
OP
|
$74.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
6177977
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$35.52 |
| Max. Negotiated Rate |
$10,700.96 |
| Rate for Payer: Aetna Commercial |
$66.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$63.64
|
| Rate for Payer: Aetna Managed Medicare |
$310.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$48.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$37.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$35.52
|
| Rate for Payer: Anthem Medicare Advantage |
$310.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$39.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$310.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$310.24
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$68.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$310.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$310.24
|
| Rate for Payer: Health EOS Commercial |
$65.86
|
| Rate for Payer: HFN Commercial |
$68.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,154.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$310.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$310.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$310.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$310.24
|
| Rate for Payer: Multiplan Commercial |
$59.20
|
| Rate for Payer: NAPHCARE Commercial |
$465.36
|
| Rate for Payer: Preferred Network Access Commercial |
$68.08
|
| Rate for Payer: Quartz Beloit One Network |
$36.26
|
| Rate for Payer: Quartz Commercial |
$48.10
|
| Rate for Payer: Quartz Medicare Advantage |
$310.24
|
| Rate for Payer: The Alliance Commercial |
$10,700.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$310.24
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$40.70
|
| Rate for Payer: Wellcare Medicare |
$310.24
|
| Rate for Payer: WPS Commercial |
$54.81
|
|
|
ED GASTRIC INTUBATION & ASPIRATION W/PHYS SKILL/LAVAGE
|
Facility
IP
|
$74.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
6177977
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$36.26 |
| Max. Negotiated Rate |
$68.08 |
| Rate for Payer: Aetna Commercial |
$66.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$39.22
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$68.08
|
| Rate for Payer: Health EOS Commercial |
$65.86
|
| Rate for Payer: HFN Commercial |
$68.08
|
| Rate for Payer: Multiplan Commercial |
$59.20
|
| Rate for Payer: NAPHCARE Commercial |
$44.40
|
| Rate for Payer: Preferred Network Access Commercial |
$68.08
|
| Rate for Payer: Quartz Beloit One Network |
$36.26
|
| Rate for Payer: Quartz Commercial |
$44.40
|
| Rate for Payer: WEA Trust Commercial |
$40.70
|
| Rate for Payer: WPS Commercial |
$54.81
|
|
|
ED Gastrointestinal Tract Imaging, Intraluminal
|
Facility
IP
|
$5,618.00
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
6174449
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,752.82 |
| Max. Negotiated Rate |
$5,168.56 |
| Rate for Payer: Aetna Commercial |
$5,056.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,977.54
|
| Rate for Payer: Cash Price |
$1,685.40
|
| Rate for Payer: Cigna Commercial |
$5,168.56
|
| Rate for Payer: Health EOS Commercial |
$5,000.02
|
| Rate for Payer: HFN Commercial |
$5,168.56
|
| Rate for Payer: Multiplan Commercial |
$4,494.40
|
| Rate for Payer: NAPHCARE Commercial |
$3,370.80
|
| Rate for Payer: Preferred Network Access Commercial |
$5,168.56
|
| Rate for Payer: Quartz Beloit One Network |
$2,752.82
|
| Rate for Payer: Quartz Commercial |
$3,370.80
|
| Rate for Payer: WEA Trust Commercial |
$3,089.90
|
| Rate for Payer: WPS Commercial |
$4,161.25
|
|
|
ED Gastrointestinal Tract Imaging, Intraluminal
|
Facility
OP
|
$5,618.00
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
6174449
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$5,168.56 |
| Rate for Payer: Aetna Commercial |
$5,056.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,831.48
|
| Rate for Payer: Aetna Managed Medicare |
$895.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,651.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,809.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,696.64
|
| Rate for Payer: Anthem Medicare Advantage |
$895.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,977.54
|
| 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 |
$1,685.40
|
| Rate for Payer: Cash Price |
$1,685.40
|
| Rate for Payer: Cash Price |
$1,685.40
|
| Rate for Payer: Cigna Commercial |
$5,168.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$895.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,143.83
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$895.97
|
| Rate for Payer: Health EOS Commercial |
$5,000.02
|
| Rate for Payer: HFN Commercial |
$5,168.56
|
| 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 |
$4,494.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,343.96
|
| Rate for Payer: Preferred Network Access Commercial |
$5,168.56
|
| Rate for Payer: Quartz Beloit One Network |
$2,752.82
|
| Rate for Payer: Quartz Commercial |
$3,651.70
|
| Rate for Payer: Quartz Medicare Advantage |
$895.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$895.97
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$3,089.90
|
| Rate for Payer: Wellcare Medicare |
$895.97
|
| Rate for Payer: WPS Commercial |
$4,161.25
|
|
|
ED Glossectomy; Less Than One-Half Tongue
|
Facility
IP
|
$2,106.00
|
|
|
Service Code
|
CPT 41120
|
| Hospital Charge Code |
6174077
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,031.94 |
| Max. Negotiated Rate |
$1,937.52 |
| Rate for Payer: Aetna Commercial |
$1,895.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,116.18
|
| Rate for Payer: Cash Price |
$631.80
|
| Rate for Payer: Cigna Commercial |
$1,937.52
|
| Rate for Payer: Health EOS Commercial |
$1,874.34
|
| Rate for Payer: HFN Commercial |
$1,937.52
|
| Rate for Payer: Multiplan Commercial |
$1,684.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,263.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,937.52
|
| Rate for Payer: Quartz Beloit One Network |
$1,031.94
|
| Rate for Payer: Quartz Commercial |
$1,263.60
|
| Rate for Payer: WEA Trust Commercial |
$1,158.30
|
| Rate for Payer: WPS Commercial |
$1,559.91
|
|
|
ED Glossectomy; Less Than One-Half Tongue
|
Facility
OP
|
$2,106.00
|
|
|
Service Code
|
CPT 41120
|
| Hospital Charge Code |
6174077
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$21,532.40 |
| Rate for Payer: Aetna Commercial |
$1,895.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,811.16
|
| Rate for Payer: Aetna Managed Medicare |
$5,788.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,368.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,053.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,010.88
|
| Rate for Payer: Anthem Medicare Advantage |
$5,788.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,116.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5,788.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5,788.28
|
| Rate for Payer: Cash Price |
$631.80
|
| Rate for Payer: Cash Price |
$631.80
|
| Rate for Payer: Cash Price |
$631.80
|
| Rate for Payer: Cigna Commercial |
$1,937.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5,788.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,339.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5,788.28
|
| Rate for Payer: Health EOS Commercial |
$1,874.34
|
| Rate for Payer: HFN Commercial |
$1,937.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$21,532.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5,788.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5,788.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5,788.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5,788.28
|
| Rate for Payer: Multiplan Commercial |
$1,684.80
|
| Rate for Payer: NAPHCARE Commercial |
$8,682.42
|
| Rate for Payer: Preferred Network Access Commercial |
$1,937.52
|
| Rate for Payer: Quartz Beloit One Network |
$1,031.94
|
| Rate for Payer: Quartz Commercial |
$1,368.90
|
| Rate for Payer: Quartz Medicare Advantage |
$5,788.28
|
| Rate for Payer: The Alliance Commercial |
$5,812.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,788.28
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$1,158.30
|
| Rate for Payer: Wellcare Medicare |
$5,788.28
|
| Rate for Payer: WPS Commercial |
$1,559.91
|
|
|
ED Hemorrhoidectomy, Internal, By Rubber Band Ligation
|
Facility
IP
|
$694.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
6174085
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.06 |
| Max. Negotiated Rate |
$638.48 |
| Rate for Payer: Aetna Commercial |
$624.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$367.82
|
| Rate for Payer: Cash Price |
$208.20
|
| Rate for Payer: Cigna Commercial |
$638.48
|
| Rate for Payer: Health EOS Commercial |
$617.66
|
| Rate for Payer: HFN Commercial |
$638.48
|
| Rate for Payer: Multiplan Commercial |
$555.20
|
| Rate for Payer: NAPHCARE Commercial |
$416.40
|
| Rate for Payer: Preferred Network Access Commercial |
$638.48
|
| Rate for Payer: Quartz Beloit One Network |
$340.06
|
| Rate for Payer: Quartz Commercial |
$416.40
|
| Rate for Payer: WEA Trust Commercial |
$381.70
|
| Rate for Payer: WPS Commercial |
$514.05
|
|
|
ED Hemorrhoidectomy, Internal, By Rubber Band Ligation
|
Facility
OP
|
$694.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
6174085
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$13,286.32 |
| Rate for Payer: Aetna Commercial |
$624.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$596.84
|
| Rate for Payer: Aetna Managed Medicare |
$903.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$451.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$347.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$333.12
|
| Rate for Payer: Anthem Medicare Advantage |
$903.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$367.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$903.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$903.36
|
| Rate for Payer: Cash Price |
$208.20
|
| Rate for Payer: Cash Price |
$208.20
|
| Rate for Payer: Cash Price |
$208.20
|
| Rate for Payer: Cigna Commercial |
$638.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$903.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$903.36
|
| Rate for Payer: Health EOS Commercial |
$617.66
|
| Rate for Payer: HFN Commercial |
$638.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,360.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$903.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$903.36
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$903.36
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$903.36
|
| Rate for Payer: Multiplan Commercial |
$555.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,355.04
|
| Rate for Payer: Preferred Network Access Commercial |
$638.48
|
| Rate for Payer: Quartz Beloit One Network |
$340.06
|
| Rate for Payer: Quartz Commercial |
$451.10
|
| Rate for Payer: Quartz Medicare Advantage |
$903.36
|
| Rate for Payer: The Alliance Commercial |
$13,286.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$903.36
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$381.70
|
| Rate for Payer: Wellcare Medicare |
$903.36
|
| Rate for Payer: WPS Commercial |
$514.05
|
|
|
ED I&D abscess complicated or multiple
|
Facility
OP
|
$360.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
6172911
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$172.80 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$324.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$309.60
|
| Rate for Payer: Aetna Managed Medicare |
$394.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$234.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$180.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$172.80
|
| Rate for Payer: Anthem Medicare Advantage |
$394.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$190.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$394.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$394.12
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cigna Commercial |
$331.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$394.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$394.12
|
| Rate for Payer: Health EOS Commercial |
$320.40
|
| Rate for Payer: HFN Commercial |
$331.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,466.13
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$394.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$394.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$394.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$394.12
|
| Rate for Payer: Multiplan Commercial |
$288.00
|
| Rate for Payer: NAPHCARE Commercial |
$591.18
|
| Rate for Payer: Preferred Network Access Commercial |
$331.20
|
| Rate for Payer: Quartz Beloit One Network |
$176.40
|
| Rate for Payer: Quartz Commercial |
$234.00
|
| Rate for Payer: Quartz Medicare Advantage |
$394.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$394.12
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$198.00
|
| Rate for Payer: Wellcare Medicare |
$394.12
|
| Rate for Payer: WPS Commercial |
$266.65
|
|
|
ED I&D abscess complicated or multiple
|
Facility
IP
|
$360.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
6172911
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$331.20 |
| Rate for Payer: Aetna Commercial |
$324.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$190.80
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cigna Commercial |
$331.20
|
| Rate for Payer: Health EOS Commercial |
$320.40
|
| Rate for Payer: HFN Commercial |
$331.20
|
| Rate for Payer: Multiplan Commercial |
$288.00
|
| Rate for Payer: NAPHCARE Commercial |
$216.00
|
| Rate for Payer: Preferred Network Access Commercial |
$331.20
|
| Rate for Payer: Quartz Beloit One Network |
$176.40
|
| Rate for Payer: Quartz Commercial |
$216.00
|
| Rate for Payer: WEA Trust Commercial |
$198.00
|
| Rate for Payer: WPS Commercial |
$266.65
|
|
|
ED I&D abscess simple or single
|
Facility
OP
|
$310.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
6172842
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$279.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$266.60
|
| Rate for Payer: Aetna Managed Medicare |
$197.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$201.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$155.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$148.80
|
| Rate for Payer: Anthem Medicare Advantage |
$197.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$164.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$197.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$197.88
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cigna Commercial |
$285.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$197.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$197.88
|
| Rate for Payer: Health EOS Commercial |
$275.90
|
| Rate for Payer: HFN Commercial |
$285.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$736.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$197.88
|
| Rate for Payer: Independent Care Health Plan Medicare |
$197.88
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$197.88
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$197.88
|
| Rate for Payer: Multiplan Commercial |
$248.00
|
| Rate for Payer: NAPHCARE Commercial |
$296.82
|
| Rate for Payer: Preferred Network Access Commercial |
$285.20
|
| Rate for Payer: Quartz Beloit One Network |
$151.90
|
| Rate for Payer: Quartz Commercial |
$201.50
|
| Rate for Payer: Quartz Medicare Advantage |
$197.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$197.88
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$170.50
|
| Rate for Payer: Wellcare Medicare |
$197.88
|
| Rate for Payer: WPS Commercial |
$229.62
|
|
|
ED I&D abscess simple or single
|
Facility
IP
|
$310.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
6172842
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$151.90 |
| Max. Negotiated Rate |
$285.20 |
| Rate for Payer: Aetna Commercial |
$279.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$164.30
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cigna Commercial |
$285.20
|
| Rate for Payer: Health EOS Commercial |
$275.90
|
| Rate for Payer: HFN Commercial |
$285.20
|
| Rate for Payer: Multiplan Commercial |
$248.00
|
| Rate for Payer: NAPHCARE Commercial |
$186.00
|
| Rate for Payer: Preferred Network Access Commercial |
$285.20
|
| Rate for Payer: Quartz Beloit One Network |
$151.90
|
| Rate for Payer: Quartz Commercial |
$186.00
|
| Rate for Payer: WEA Trust Commercial |
$170.50
|
| Rate for Payer: WPS Commercial |
$229.62
|
|
|
ED I&D below fascia, w or w/o tendon sheath involvement, foot, multiple areas
|
Facility
IP
|
$620.00
|
|
|
Service Code
|
CPT 28002
|
| Hospital Charge Code |
6173876
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$303.80 |
| Max. Negotiated Rate |
$570.40 |
| Rate for Payer: Aetna Commercial |
$558.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$328.60
|
| Rate for Payer: Cash Price |
$186.00
|
| Rate for Payer: Cigna Commercial |
$570.40
|
| Rate for Payer: Health EOS Commercial |
$551.80
|
| Rate for Payer: HFN Commercial |
$570.40
|
| Rate for Payer: Multiplan Commercial |
$496.00
|
| Rate for Payer: NAPHCARE Commercial |
$372.00
|
| Rate for Payer: Preferred Network Access Commercial |
$570.40
|
| Rate for Payer: Quartz Beloit One Network |
$303.80
|
| Rate for Payer: Quartz Commercial |
$372.00
|
| Rate for Payer: WEA Trust Commercial |
$341.00
|
| Rate for Payer: WPS Commercial |
$459.23
|
|
|
ED I&D below fascia, w or w/o tendon sheath involvement, foot, multiple areas
|
Facility
OP
|
$620.00
|
|
|
Service Code
|
CPT 28002
|
| Hospital Charge Code |
6173876
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$297.60 |
| Max. Negotiated Rate |
$12,336.12 |
| Rate for Payer: Aetna Commercial |
$558.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$533.20
|
| Rate for Payer: Aetna Managed Medicare |
$1,588.57
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$403.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$310.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$297.60
|
| Rate for Payer: Anthem Medicare Advantage |
$1,588.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$328.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,588.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,588.57
|
| Rate for Payer: Cash Price |
$186.00
|
| Rate for Payer: Cash Price |
$186.00
|
| Rate for Payer: Cash Price |
$186.00
|
| Rate for Payer: Cigna Commercial |
$570.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,588.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,546.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,588.57
|
| Rate for Payer: Health EOS Commercial |
$551.80
|
| Rate for Payer: HFN Commercial |
$570.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,909.48
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,588.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,588.57
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,588.57
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,588.57
|
| Rate for Payer: Multiplan Commercial |
$496.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,382.86
|
| Rate for Payer: Preferred Network Access Commercial |
$570.40
|
| Rate for Payer: Quartz Beloit One Network |
$303.80
|
| Rate for Payer: Quartz Commercial |
$403.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,588.57
|
| Rate for Payer: The Alliance Commercial |
$12,336.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,588.57
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$341.00
|
| Rate for Payer: Wellcare Medicare |
$1,588.57
|
| Rate for Payer: WPS Commercial |
$459.23
|
|
|
ED I&D bursa, foot
|
Facility
OP
|
$321.00
|
|
|
Service Code
|
CPT 28001
|
| Hospital Charge Code |
6173875
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$154.08 |
| Max. Negotiated Rate |
$12,336.12 |
| Rate for Payer: Aetna Commercial |
$288.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$276.06
|
| Rate for Payer: Aetna Managed Medicare |
$1,602.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$208.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$160.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$154.08
|
| Rate for Payer: Anthem Medicare Advantage |
$1,602.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$170.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,602.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,602.49
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cigna Commercial |
$295.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,602.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,602.49
|
| Rate for Payer: Health EOS Commercial |
$285.69
|
| Rate for Payer: HFN Commercial |
$295.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,961.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,602.49
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,602.49
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,602.49
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,602.49
|
| Rate for Payer: Multiplan Commercial |
$256.80
|
| Rate for Payer: NAPHCARE Commercial |
$2,403.74
|
| Rate for Payer: Preferred Network Access Commercial |
$295.32
|
| Rate for Payer: Quartz Beloit One Network |
$157.29
|
| Rate for Payer: Quartz Commercial |
$208.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,602.49
|
| Rate for Payer: The Alliance Commercial |
$12,336.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,602.49
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$176.55
|
| Rate for Payer: Wellcare Medicare |
$1,602.49
|
| Rate for Payer: WPS Commercial |
$237.76
|
|
|
ED I&D bursa, foot
|
Facility
IP
|
$321.00
|
|
|
Service Code
|
CPT 28001
|
| Hospital Charge Code |
6173875
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$157.29 |
| Max. Negotiated Rate |
$295.32 |
| Rate for Payer: Aetna Commercial |
$288.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$170.13
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cigna Commercial |
$295.32
|
| Rate for Payer: Health EOS Commercial |
$285.69
|
| Rate for Payer: HFN Commercial |
$295.32
|
| Rate for Payer: Multiplan Commercial |
$256.80
|
| Rate for Payer: NAPHCARE Commercial |
$192.60
|
| Rate for Payer: Preferred Network Access Commercial |
$295.32
|
| Rate for Payer: Quartz Beloit One Network |
$157.29
|
| Rate for Payer: Quartz Commercial |
$192.60
|
| Rate for Payer: WEA Trust Commercial |
$176.55
|
| Rate for Payer: WPS Commercial |
$237.76
|
|
|
ED I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Facility
OP
|
$1,432.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
6181611
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$10,447.81 |
| Rate for Payer: Aetna Commercial |
$1,288.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,231.52
|
| Rate for Payer: Aetna Managed Medicare |
$2,808.55
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$930.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$716.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$687.36
|
| Rate for Payer: Anthem Medicare Advantage |
$2,808.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$758.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,808.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,808.55
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cigna Commercial |
$1,317.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,808.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,546.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,808.55
|
| Rate for Payer: Health EOS Commercial |
$1,274.48
|
| Rate for Payer: HFN Commercial |
$1,317.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,447.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,808.55
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,808.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,808.55
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,808.55
|
| Rate for Payer: Multiplan Commercial |
$1,145.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,212.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,317.44
|
| Rate for Payer: Quartz Beloit One Network |
$701.68
|
| Rate for Payer: Quartz Commercial |
$930.80
|
| Rate for Payer: Quartz Medicare Advantage |
$2,808.55
|
| Rate for Payer: The Alliance Commercial |
$6,125.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,808.55
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$787.60
|
| Rate for Payer: Wellcare Medicare |
$2,808.55
|
| Rate for Payer: WPS Commercial |
$1,060.68
|
|
