|
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: The Alliance Commercial |
$505.04
|
| 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 |
$6,029.48 |
| 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 |
$6,029.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,507.37
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$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: Aetna Gatekeeper/Not Gatekeeper |
$630.38
|
| 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
|
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: Aetna Gatekeeper/Not Gatekeeper |
$581.36
|
| 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 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 |
$4,218.22 |
| 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 |
$965.72
|
| 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 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: Aetna Gatekeeper/Not Gatekeeper |
$670.80
|
| 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
|
Facility
|
OP
|
$780.00
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
6174426
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| 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 |
$4,002.80
|
| 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 Margin
|
Facility
|
OP
|
$2,440.00
|
|
|
Service Code
|
CPT 67961
|
| Hospital Charge Code |
6174432
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$9,238.84 |
| 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 |
$9,238.84
|
| 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: Aetna Gatekeeper/Not Gatekeeper |
$2,098.40
|
| 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: Aetna Gatekeeper/Not Gatekeeper |
$650.16
|
| 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 |
$12,729.16 |
| 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 |
$12,729.16
|
| 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 |
$6,029.48 |
| 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 |
$6,029.48
|
| 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
|
|
|
ED Excision of Lesion of Tongue Without Closure
|
Facility
|
IP
|
$721.00
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
6174074
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$353.29 |
| Max. Negotiated Rate |
$663.32 |
| Rate for Payer: Aetna Commercial |
$648.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$620.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$382.13
|
| Rate for Payer: Cash Price |
$216.30
|
| Rate for Payer: Cigna Commercial |
$663.32
|
| Rate for Payer: Health EOS Commercial |
$641.69
|
| Rate for Payer: HFN Commercial |
$663.32
|
| Rate for Payer: Multiplan Commercial |
$576.80
|
| Rate for Payer: NAPHCARE Commercial |
$432.60
|
| Rate for Payer: Preferred Network Access Commercial |
$663.32
|
| Rate for Payer: Quartz Beloit One Network |
$353.29
|
| Rate for Payer: Quartz Commercial |
$432.60
|
| Rate for Payer: WEA Trust Commercial |
$396.55
|
| Rate for Payer: WPS Commercial |
$534.04
|
|
|
ED Excision of Lesion or Tumor (except listed above) dentalalveolar structures; without repair
|
Facility
|
OP
|
$383.00
|
|
|
Service Code
|
CPT 41825
|
| Hospital Charge Code |
6174078
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$183.84 |
| Max. Negotiated Rate |
$12,729.16 |
| Rate for Payer: Aetna Commercial |
$344.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$329.38
|
| Rate for Payer: Aetna Managed Medicare |
$3,182.29
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$248.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$191.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$183.84
|
| Rate for Payer: Anthem Medicare Advantage |
$3,182.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$202.99
|
| 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 |
$114.90
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cigna Commercial |
$352.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,182.29
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,182.29
|
| Rate for Payer: Health EOS Commercial |
$340.87
|
| Rate for Payer: HFN Commercial |
$352.36
|
| 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 |
$306.40
|
| Rate for Payer: NAPHCARE Commercial |
$4,773.44
|
| Rate for Payer: Preferred Network Access Commercial |
$352.36
|
| Rate for Payer: Quartz Beloit One Network |
$187.67
|
| Rate for Payer: Quartz Commercial |
$248.95
|
| Rate for Payer: Quartz Medicare Advantage |
$3,182.29
|
| Rate for Payer: The Alliance Commercial |
$12,729.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,182.29
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$210.65
|
| Rate for Payer: Wellcare Medicare |
$3,182.29
|
| Rate for Payer: WPS Commercial |
$283.69
|
|
|
ED Excision of Lesion or Tumor (except listed above) dentalalveolar structures; without repair
|
Facility
|
IP
|
$383.00
|
|
|
Service Code
|
CPT 41825
|
| Hospital Charge Code |
6174078
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$187.67 |
| Max. Negotiated Rate |
$352.36 |
| Rate for Payer: Aetna Commercial |
$344.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$329.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$202.99
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cigna Commercial |
$352.36
|
| Rate for Payer: Health EOS Commercial |
$340.87
|
| Rate for Payer: HFN Commercial |
$352.36
|
| Rate for Payer: Multiplan Commercial |
$306.40
|
| Rate for Payer: NAPHCARE Commercial |
$229.80
|
| Rate for Payer: Preferred Network Access Commercial |
$352.36
|
| Rate for Payer: Quartz Beloit One Network |
$187.67
|
| Rate for Payer: Quartz Commercial |
$229.80
|
| Rate for Payer: WEA Trust Commercial |
$210.65
|
| Rate for Payer: WPS Commercial |
$283.69
|
|
|
ED Excision of Multiple External Papillae or tags, anus
|
Facility
|
OP
|
$409.00
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
6174086
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$196.32 |
| Max. Negotiated Rate |
$11,100.96 |
| Rate for Payer: Aetna Commercial |
$368.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$351.74
|
| Rate for Payer: Aetna Managed Medicare |
$2,775.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$265.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$204.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$196.32
|
| Rate for Payer: Anthem Medicare Advantage |
$2,775.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$216.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,775.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,775.24
|
| Rate for Payer: Cash Price |
$122.70
|
| Rate for Payer: Cash Price |
$122.70
|
| Rate for Payer: Cash Price |
$122.70
|
| Rate for Payer: Cigna Commercial |
$376.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,775.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,775.24
|
| Rate for Payer: Health EOS Commercial |
$364.01
|
| Rate for Payer: HFN Commercial |
$376.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,323.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,775.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,775.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,775.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,775.24
|
| Rate for Payer: Multiplan Commercial |
$327.20
|
| Rate for Payer: NAPHCARE Commercial |
$4,162.86
|
| Rate for Payer: Preferred Network Access Commercial |
$376.28
|
| Rate for Payer: Quartz Beloit One Network |
$200.41
|
| Rate for Payer: Quartz Commercial |
$265.85
|
| Rate for Payer: Quartz Medicare Advantage |
$2,775.24
|
| Rate for Payer: The Alliance Commercial |
$11,100.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,775.24
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$224.95
|
| Rate for Payer: Wellcare Medicare |
$2,775.24
|
| Rate for Payer: WPS Commercial |
$302.95
|
|
|
ED Excision of Multiple External Papillae or tags, anus
|
Facility
|
IP
|
$409.00
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
6174086
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$200.41 |
| Max. Negotiated Rate |
$376.28 |
| Rate for Payer: Aetna Commercial |
$368.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$351.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$216.77
|
| Rate for Payer: Cash Price |
$122.70
|
| Rate for Payer: Cigna Commercial |
$376.28
|
| Rate for Payer: Health EOS Commercial |
$364.01
|
| Rate for Payer: HFN Commercial |
$376.28
|
| Rate for Payer: Multiplan Commercial |
$327.20
|
| Rate for Payer: NAPHCARE Commercial |
$245.40
|
| Rate for Payer: Preferred Network Access Commercial |
$376.28
|
| Rate for Payer: Quartz Beloit One Network |
$200.41
|
| Rate for Payer: Quartz Commercial |
$245.40
|
| Rate for Payer: WEA Trust Commercial |
$224.95
|
| Rate for Payer: WPS Commercial |
$302.95
|
|
|
ED Excision of nail & nail matrix, partial or complete for permanent removal
|
Facility
|
IP
|
$621.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
6172930
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.29 |
| Max. Negotiated Rate |
$571.32 |
| Rate for Payer: Aetna Commercial |
$558.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$534.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$329.13
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cigna Commercial |
$571.32
|
| Rate for Payer: Health EOS Commercial |
$552.69
|
| Rate for Payer: HFN Commercial |
$571.32
|
| Rate for Payer: Multiplan Commercial |
$496.80
|
| Rate for Payer: NAPHCARE Commercial |
$372.60
|
| Rate for Payer: Preferred Network Access Commercial |
$571.32
|
| Rate for Payer: Quartz Beloit One Network |
$304.29
|
| Rate for Payer: Quartz Commercial |
$372.60
|
| Rate for Payer: WEA Trust Commercial |
$341.55
|
| Rate for Payer: WPS Commercial |
$459.97
|
|
|
ED Excision of nail & nail matrix, partial or complete for permanent removal
|
Facility
|
OP
|
$621.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
6172930
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$298.08 |
| Max. Negotiated Rate |
$4,218.22 |
| Rate for Payer: Aetna Commercial |
$558.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$534.06
|
| Rate for Payer: Aetna Managed Medicare |
$394.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$403.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$310.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$298.08
|
| Rate for Payer: Anthem Medicare Advantage |
$394.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$329.13
|
| 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 |
$186.30
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cigna Commercial |
$571.32
|
| 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 |
$552.69
|
| Rate for Payer: HFN Commercial |
$571.32
|
| 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 |
$496.80
|
| Rate for Payer: NAPHCARE Commercial |
$591.18
|
| Rate for Payer: Preferred Network Access Commercial |
$571.32
|
| Rate for Payer: Quartz Beloit One Network |
$304.29
|
| Rate for Payer: Quartz Commercial |
$403.65
|
| Rate for Payer: Quartz Medicare Advantage |
$394.12
|
| Rate for Payer: The Alliance Commercial |
$1,576.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$394.12
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$341.55
|
| Rate for Payer: Wellcare Medicare |
$394.12
|
| Rate for Payer: WPS Commercial |
$459.97
|
|
|
ED Excision Of Sublingual Salivary Cyst
|
Facility
|
OP
|
$890.00
|
|
|
Service Code
|
CPT 42408
|
| Hospital Charge Code |
6174080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$12,729.16 |
| Rate for Payer: Aetna Commercial |
$801.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$765.40
|
| Rate for Payer: Aetna Managed Medicare |
$3,182.29
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$578.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$445.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$427.20
|
| Rate for Payer: Anthem Medicare Advantage |
$3,182.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$471.70
|
| 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 |
$267.00
|
| Rate for Payer: Cash Price |
$267.00
|
| Rate for Payer: Cash Price |
$267.00
|
| Rate for Payer: Cigna Commercial |
$818.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,182.29
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,546.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,182.29
|
| Rate for Payer: Health EOS Commercial |
$792.10
|
| Rate for Payer: HFN Commercial |
$818.80
|
| 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 |
$712.00
|
| Rate for Payer: NAPHCARE Commercial |
$4,773.44
|
| Rate for Payer: Preferred Network Access Commercial |
$818.80
|
| Rate for Payer: Quartz Beloit One Network |
$436.10
|
| Rate for Payer: Quartz Commercial |
$578.50
|
| Rate for Payer: Quartz Medicare Advantage |
$3,182.29
|
| Rate for Payer: The Alliance Commercial |
$12,729.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,182.29
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$489.50
|
| Rate for Payer: Wellcare Medicare |
$3,182.29
|
| Rate for Payer: WPS Commercial |
$659.22
|
|
|
ED Excision Of Sublingual Salivary Cyst
|
Facility
|
IP
|
$890.00
|
|
|
Service Code
|
CPT 42408
|
| Hospital Charge Code |
6174080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$436.10 |
| Max. Negotiated Rate |
$818.80 |
| Rate for Payer: Aetna Commercial |
$801.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$765.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$471.70
|
| Rate for Payer: Cash Price |
$267.00
|
| Rate for Payer: Cigna Commercial |
$818.80
|
| Rate for Payer: Health EOS Commercial |
$792.10
|
| Rate for Payer: HFN Commercial |
$818.80
|
| Rate for Payer: Multiplan Commercial |
$712.00
|
| Rate for Payer: NAPHCARE Commercial |
$534.00
|
| Rate for Payer: Preferred Network Access Commercial |
$818.80
|
| Rate for Payer: Quartz Beloit One Network |
$436.10
|
| Rate for Payer: Quartz Commercial |
$534.00
|
| Rate for Payer: WEA Trust Commercial |
$489.50
|
| Rate for Payer: WPS Commercial |
$659.22
|
|
|
ED Excision of Thrombosed Hemorrhoid, external
|
Facility
|
OP
|
$422.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
6174087
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$4,665.56 |
| Rate for Payer: Aetna Commercial |
$379.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$362.92
|
| Rate for Payer: Aetna Managed Medicare |
$1,166.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$274.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$211.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$202.56
|
| Rate for Payer: Anthem Medicare Advantage |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$223.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,166.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,166.39
|
| Rate for Payer: Cash Price |
$126.60
|
| Rate for Payer: Cash Price |
$126.60
|
| Rate for Payer: Cash Price |
$126.60
|
| Rate for Payer: Cigna Commercial |
$388.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,166.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,166.39
|
| Rate for Payer: Health EOS Commercial |
$375.58
|
| Rate for Payer: HFN Commercial |
$388.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,338.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,166.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,166.39
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,166.39
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,166.39
|
| Rate for Payer: Multiplan Commercial |
$337.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,749.58
|
| Rate for Payer: Preferred Network Access Commercial |
$388.24
|
| Rate for Payer: Quartz Beloit One Network |
$206.78
|
| Rate for Payer: Quartz Commercial |
$274.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,166.39
|
| Rate for Payer: The Alliance Commercial |
$4,665.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,166.39
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$232.10
|
| Rate for Payer: Wellcare Medicare |
$1,166.39
|
| Rate for Payer: WPS Commercial |
$312.58
|
|
|
ED Excision of Thrombosed Hemorrhoid, external
|
Facility
|
IP
|
$422.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
6174087
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$206.78 |
| Max. Negotiated Rate |
$388.24 |
| Rate for Payer: Aetna Commercial |
$379.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$362.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$223.66
|
| Rate for Payer: Cash Price |
$126.60
|
| Rate for Payer: Cigna Commercial |
$388.24
|
| Rate for Payer: Health EOS Commercial |
$375.58
|
| Rate for Payer: HFN Commercial |
$388.24
|
| Rate for Payer: Multiplan Commercial |
$337.60
|
| Rate for Payer: NAPHCARE Commercial |
$253.20
|
| Rate for Payer: Preferred Network Access Commercial |
$388.24
|
| Rate for Payer: Quartz Beloit One Network |
$206.78
|
| Rate for Payer: Quartz Commercial |
$253.20
|
| Rate for Payer: WEA Trust Commercial |
$232.10
|
| Rate for Payer: WPS Commercial |
$312.58
|
|
|
ED Excision Of Vaginal Cyst Or Tumor
|
Facility
|
OP
|
$833.00
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
6174397
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$12,360.48 |
| Rate for Payer: Aetna Commercial |
$749.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$716.38
|
| Rate for Payer: Aetna Managed Medicare |
$3,090.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$541.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$416.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$399.84
|
| Rate for Payer: Anthem Medicare Advantage |
$3,090.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$441.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,090.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,090.12
|
| Rate for Payer: Cash Price |
$249.90
|
| Rate for Payer: Cash Price |
$249.90
|
| Rate for Payer: Cash Price |
$249.90
|
| Rate for Payer: Cigna Commercial |
$766.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,090.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,757.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,090.12
|
| Rate for Payer: Health EOS Commercial |
$741.37
|
| Rate for Payer: HFN Commercial |
$766.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,495.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,090.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,090.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,090.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,090.12
|
| Rate for Payer: Multiplan Commercial |
$666.40
|
| Rate for Payer: NAPHCARE Commercial |
$4,635.18
|
| Rate for Payer: Preferred Network Access Commercial |
$766.36
|
| Rate for Payer: Quartz Beloit One Network |
$408.17
|
| Rate for Payer: Quartz Commercial |
$541.45
|
| Rate for Payer: Quartz Medicare Advantage |
$3,090.12
|
| Rate for Payer: The Alliance Commercial |
$12,360.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,090.12
|
| Rate for Payer: United Healthcare PPO |
$301.00
|
| Rate for Payer: WEA Trust Commercial |
$458.15
|
| Rate for Payer: Wellcare Medicare |
$3,090.12
|
| Rate for Payer: WPS Commercial |
$617.00
|
|
|
ED Excision Of Vaginal Cyst Or Tumor
|
Facility
|
IP
|
$833.00
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
6174397
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$408.17 |
| Max. Negotiated Rate |
$766.36 |
| Rate for Payer: Aetna Commercial |
$749.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$716.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$441.49
|
| Rate for Payer: Cash Price |
$249.90
|
| Rate for Payer: Cigna Commercial |
$766.36
|
| Rate for Payer: Health EOS Commercial |
$741.37
|
| Rate for Payer: HFN Commercial |
$766.36
|
| Rate for Payer: Multiplan Commercial |
$666.40
|
| Rate for Payer: NAPHCARE Commercial |
$499.80
|
| Rate for Payer: Preferred Network Access Commercial |
$766.36
|
| Rate for Payer: Quartz Beloit One Network |
$408.17
|
| Rate for Payer: Quartz Commercial |
$499.80
|
| Rate for Payer: WEA Trust Commercial |
$458.15
|
| Rate for Payer: WPS Commercial |
$617.00
|
|
