|
EP Catheter-Ablation
|
Facility
|
IP
|
$6,979.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
4139319
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,556.50 |
| Max. Negotiated Rate |
$6,677.51 |
| Rate for Payer: Aetna Commercial |
$6,532.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,242.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,846.82
|
| Rate for Payer: Cash Price |
$2,093.70
|
| Rate for Payer: Cigna Commercial |
$6,677.51
|
| Rate for Payer: Health EOS Commercial |
$6,459.76
|
| Rate for Payer: HFN Commercial |
$6,677.51
|
| Rate for Payer: Multiplan Commercial |
$5,806.53
|
| Rate for Payer: Preferred Network Access Commercial |
$6,677.51
|
| Rate for Payer: Quartz Beloit One Network |
$3,556.50
|
| Rate for Payer: Quartz Commercial |
$4,354.90
|
| Rate for Payer: WEA Trust Commercial |
$3,991.99
|
| Rate for Payer: WPS Commercial |
$5,375.92
|
|
|
EP Catheter-Ablation
|
Facility
|
OP
|
$6,979.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
4139319
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,032.28 |
| Max. Negotiated Rate |
$6,677.51 |
| Rate for Payer: Aetna Commercial |
$6,532.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,242.02
|
| Rate for Payer: Aetna Managed Medicare |
$2,032.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,717.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,629.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,483.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,846.82
|
| Rate for Payer: Cash Price |
$2,093.70
|
| Rate for Payer: Cigna Commercial |
$6,677.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,061.78
|
| Rate for Payer: Health EOS Commercial |
$6,459.76
|
| Rate for Payer: HFN Commercial |
$6,677.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,443.62
|
| Rate for Payer: Multiplan Commercial |
$5,806.53
|
| Rate for Payer: NAPHCARE Commercial |
$4,354.90
|
| Rate for Payer: Preferred Network Access Commercial |
$6,677.51
|
| Rate for Payer: Quartz Beloit One Network |
$3,556.50
|
| Rate for Payer: Quartz Commercial |
$4,717.80
|
| Rate for Payer: Quartz Medicare Advantage |
$4,354.90
|
| Rate for Payer: The Alliance Commercial |
$3,629.08
|
| Rate for Payer: WEA Trust Commercial |
$3,991.99
|
| Rate for Payer: WPS Commercial |
$5,375.92
|
|
|
EP Catheter-Diagnostic
|
Facility
|
OP
|
$1,525.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
4139317
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$444.08 |
| Max. Negotiated Rate |
$1,459.12 |
| Rate for Payer: Aetna Commercial |
$1,427.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,363.96
|
| Rate for Payer: Aetna Managed Medicare |
$444.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,030.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$793.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$761.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$840.58
|
| Rate for Payer: Cash Price |
$457.50
|
| Rate for Payer: Cigna Commercial |
$1,459.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$887.55
|
| Rate for Payer: Health EOS Commercial |
$1,411.54
|
| Rate for Payer: HFN Commercial |
$1,459.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,189.50
|
| Rate for Payer: Multiplan Commercial |
$1,268.80
|
| Rate for Payer: NAPHCARE Commercial |
$951.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,459.12
|
| Rate for Payer: Quartz Beloit One Network |
$777.14
|
| Rate for Payer: Quartz Commercial |
$1,030.90
|
| Rate for Payer: Quartz Medicare Advantage |
$951.60
|
| Rate for Payer: The Alliance Commercial |
$793.00
|
| Rate for Payer: WEA Trust Commercial |
$872.30
|
| Rate for Payer: WPS Commercial |
$1,174.71
|
|
|
EP Catheter-Diagnostic
|
Facility
|
IP
|
$1,525.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
4139317
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$777.14 |
| Max. Negotiated Rate |
$1,459.12 |
| Rate for Payer: Aetna Commercial |
$1,427.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,363.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$840.58
|
| Rate for Payer: Cash Price |
$457.50
|
| Rate for Payer: Cigna Commercial |
$1,459.12
|
| Rate for Payer: Health EOS Commercial |
$1,411.54
|
| Rate for Payer: HFN Commercial |
$1,459.12
|
| Rate for Payer: Multiplan Commercial |
$1,268.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,459.12
|
| Rate for Payer: Quartz Beloit One Network |
$777.14
|
| Rate for Payer: Quartz Commercial |
$951.60
|
| Rate for Payer: WEA Trust Commercial |
$872.30
|
| Rate for Payer: WPS Commercial |
$1,174.71
|
|
|
EP Comprehensive Study w/Induction
|
Facility
|
IP
|
$18,016.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
3052508
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,180.95 |
| Max. Negotiated Rate |
$17,237.71 |
| Rate for Payer: Aetna Commercial |
$16,862.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16,113.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,930.42
|
| Rate for Payer: Cash Price |
$5,404.80
|
| Rate for Payer: Cigna Commercial |
$17,237.71
|
| Rate for Payer: Health EOS Commercial |
$16,675.61
|
| Rate for Payer: HFN Commercial |
$17,237.71
|
| Rate for Payer: Multiplan Commercial |
$14,989.31
|
| Rate for Payer: Preferred Network Access Commercial |
$17,237.71
|
| Rate for Payer: Quartz Beloit One Network |
$9,180.95
|
| Rate for Payer: Quartz Commercial |
$11,241.98
|
| Rate for Payer: WEA Trust Commercial |
$10,305.15
|
| Rate for Payer: WPS Commercial |
$13,877.72
|
|
|
EP Comprehensive Study w/Induction
|
Facility
|
OP
|
$18,016.00
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
3052508
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,208.28 |
| Max. Negotiated Rate |
$32,833.13 |
| Rate for Payer: Aetna Commercial |
$16,862.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16,113.51
|
| Rate for Payer: Aetna Managed Medicare |
$8,208.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$30,304.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27,476.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$26,104.00
|
| Rate for Payer: Anthem Medicare Advantage |
$8,208.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,930.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,208.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,208.28
|
| Rate for Payer: Cash Price |
$5,404.80
|
| Rate for Payer: Cash Price |
$5,404.80
|
| Rate for Payer: Cash Price |
$5,404.80
|
| Rate for Payer: Cigna Commercial |
$17,237.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,208.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10,485.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,208.28
|
| Rate for Payer: Health EOS Commercial |
$16,675.61
|
| Rate for Payer: HFN Commercial |
$17,237.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30,534.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,208.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,208.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,208.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,208.28
|
| Rate for Payer: Multiplan Commercial |
$14,989.31
|
| Rate for Payer: NAPHCARE Commercial |
$12,312.42
|
| Rate for Payer: Preferred Network Access Commercial |
$17,237.71
|
| Rate for Payer: Quartz Beloit One Network |
$9,180.95
|
| Rate for Payer: Quartz Commercial |
$12,178.82
|
| Rate for Payer: Quartz Medicare Advantage |
$8,208.28
|
| Rate for Payer: The Alliance Commercial |
$32,833.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,208.28
|
| Rate for Payer: WEA Trust Commercial |
$10,305.15
|
| Rate for Payer: Wellcare Medicare |
$8,208.28
|
| Rate for Payer: WPS Commercial |
$13,877.72
|
|
|
EP Comprehensive Study w/o Induction
|
Facility
|
IP
|
$18,016.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
3052507
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,180.95 |
| Max. Negotiated Rate |
$17,237.71 |
| Rate for Payer: Aetna Commercial |
$16,862.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16,113.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,930.42
|
| Rate for Payer: Cash Price |
$5,404.80
|
| Rate for Payer: Cigna Commercial |
$17,237.71
|
| Rate for Payer: Health EOS Commercial |
$16,675.61
|
| Rate for Payer: HFN Commercial |
$17,237.71
|
| Rate for Payer: Multiplan Commercial |
$14,989.31
|
| Rate for Payer: Preferred Network Access Commercial |
$17,237.71
|
| Rate for Payer: Quartz Beloit One Network |
$9,180.95
|
| Rate for Payer: Quartz Commercial |
$11,241.98
|
| Rate for Payer: WEA Trust Commercial |
$10,305.15
|
| Rate for Payer: WPS Commercial |
$13,877.72
|
|
|
EP Comprehensive Study w/o Induction
|
Facility
|
OP
|
$18,016.00
|
|
|
Service Code
|
CPT 93619
|
| Hospital Charge Code |
3052507
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,208.28 |
| Max. Negotiated Rate |
$32,833.13 |
| Rate for Payer: Aetna Commercial |
$16,862.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16,113.51
|
| Rate for Payer: Aetna Managed Medicare |
$8,208.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$30,304.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$27,476.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$26,104.00
|
| Rate for Payer: Anthem Medicare Advantage |
$8,208.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$9,930.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,208.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,208.28
|
| Rate for Payer: Cash Price |
$5,404.80
|
| Rate for Payer: Cash Price |
$5,404.80
|
| Rate for Payer: Cash Price |
$5,404.80
|
| Rate for Payer: Cigna Commercial |
$17,237.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,208.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10,485.31
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,208.28
|
| Rate for Payer: Health EOS Commercial |
$16,675.61
|
| Rate for Payer: HFN Commercial |
$17,237.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30,534.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,208.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,208.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,208.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,208.28
|
| Rate for Payer: Multiplan Commercial |
$14,989.31
|
| Rate for Payer: NAPHCARE Commercial |
$12,312.42
|
| Rate for Payer: Preferred Network Access Commercial |
$17,237.71
|
| Rate for Payer: Quartz Beloit One Network |
$9,180.95
|
| Rate for Payer: Quartz Commercial |
$12,178.82
|
| Rate for Payer: Quartz Medicare Advantage |
$8,208.28
|
| Rate for Payer: The Alliance Commercial |
$32,833.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,208.28
|
| Rate for Payer: WEA Trust Commercial |
$10,305.15
|
| Rate for Payer: Wellcare Medicare |
$8,208.28
|
| Rate for Payer: WPS Commercial |
$13,877.72
|
|
|
EP Eval Cardiovert-Defibrilato
|
Facility
|
IP
|
$542.00
|
|
| Hospital Charge Code |
3052574
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$276.20 |
| Max. Negotiated Rate |
$518.59 |
| Rate for Payer: Aetna Commercial |
$507.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$484.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$298.75
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cigna Commercial |
$518.59
|
| Rate for Payer: Health EOS Commercial |
$501.68
|
| Rate for Payer: HFN Commercial |
$518.59
|
| Rate for Payer: Multiplan Commercial |
$450.94
|
| Rate for Payer: Preferred Network Access Commercial |
$518.59
|
| Rate for Payer: Quartz Beloit One Network |
$276.20
|
| Rate for Payer: Quartz Commercial |
$338.21
|
| Rate for Payer: WEA Trust Commercial |
$310.02
|
| Rate for Payer: WPS Commercial |
$417.50
|
|
|
EP Eval Cardiovert-Defibrilato
|
Facility
|
OP
|
$542.00
|
|
| Hospital Charge Code |
3052574
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$157.83 |
| Max. Negotiated Rate |
$518.59 |
| Rate for Payer: Aetna Commercial |
$507.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$484.76
|
| Rate for Payer: Aetna Managed Medicare |
$157.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$366.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$281.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$270.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$298.75
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cigna Commercial |
$518.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$315.44
|
| Rate for Payer: Health EOS Commercial |
$501.68
|
| Rate for Payer: HFN Commercial |
$518.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$422.76
|
| Rate for Payer: Multiplan Commercial |
$450.94
|
| Rate for Payer: NAPHCARE Commercial |
$338.21
|
| Rate for Payer: Preferred Network Access Commercial |
$518.59
|
| Rate for Payer: Quartz Beloit One Network |
$276.20
|
| Rate for Payer: Quartz Commercial |
$366.39
|
| Rate for Payer: Quartz Medicare Advantage |
$338.21
|
| Rate for Payer: The Alliance Commercial |
$281.84
|
| Rate for Payer: United Healthcare PPO |
$422.76
|
| Rate for Payer: WEA Trust Commercial |
$310.02
|
| Rate for Payer: WPS Commercial |
$417.50
|
|
|
EP F/U Pace/Record Post Therapy
|
Facility
|
OP
|
$2,215.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
3052511
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,105.73 |
| Max. Negotiated Rate |
$32,833.13 |
| Rate for Payer: Aetna Commercial |
$2,073.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,981.10
|
| Rate for Payer: Aetna Managed Medicare |
$8,208.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,497.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,151.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,105.73
|
| Rate for Payer: Anthem Medicare Advantage |
$8,208.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,220.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,208.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,208.28
|
| Rate for Payer: Cash Price |
$664.50
|
| Rate for Payer: Cash Price |
$664.50
|
| Rate for Payer: Cigna Commercial |
$2,119.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,208.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,289.13
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,208.28
|
| Rate for Payer: Health EOS Commercial |
$2,050.20
|
| Rate for Payer: HFN Commercial |
$2,119.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30,534.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,208.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,208.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,208.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,208.28
|
| Rate for Payer: Multiplan Commercial |
$1,842.88
|
| Rate for Payer: NAPHCARE Commercial |
$12,312.42
|
| Rate for Payer: Preferred Network Access Commercial |
$2,119.31
|
| Rate for Payer: Quartz Beloit One Network |
$1,128.76
|
| Rate for Payer: Quartz Commercial |
$1,497.34
|
| Rate for Payer: Quartz Medicare Advantage |
$8,208.28
|
| Rate for Payer: The Alliance Commercial |
$32,833.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,208.28
|
| Rate for Payer: WEA Trust Commercial |
$1,266.98
|
| Rate for Payer: Wellcare Medicare |
$8,208.28
|
| Rate for Payer: WPS Commercial |
$1,706.21
|
|
|
EP F/U Pace/Record Post Therapy
|
Facility
|
IP
|
$2,215.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
3052511
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,128.76 |
| Max. Negotiated Rate |
$2,119.31 |
| Rate for Payer: Aetna Commercial |
$2,073.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,981.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,220.91
|
| Rate for Payer: Cash Price |
$664.50
|
| Rate for Payer: Cigna Commercial |
$2,119.31
|
| Rate for Payer: Health EOS Commercial |
$2,050.20
|
| Rate for Payer: HFN Commercial |
$2,119.31
|
| Rate for Payer: Multiplan Commercial |
$1,842.88
|
| Rate for Payer: Preferred Network Access Commercial |
$2,119.31
|
| Rate for Payer: Quartz Beloit One Network |
$1,128.76
|
| Rate for Payer: Quartz Commercial |
$1,382.16
|
| Rate for Payer: WEA Trust Commercial |
$1,266.98
|
| Rate for Payer: WPS Commercial |
$1,706.21
|
|
|
EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN 93641
|
Professional
|
Both
|
$3,427.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
5551964
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$605.84 |
| Max. Negotiated Rate |
$3,385.88 |
| Rate for Payer: Aetna Commercial |
$3,385.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,065.11
|
| Rate for Payer: Cash Price |
$1,028.10
|
| Rate for Payer: Cash Price |
$1,028.10
|
| Rate for Payer: Cash Price |
$1,028.10
|
| Rate for Payer: Cigna Commercial |
$3,385.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$605.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,138.45
|
| Rate for Payer: Health EOS Commercial |
$3,243.31
|
| Rate for Payer: HFN Commercial |
$3,385.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,119.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,119.57
|
| Rate for Payer: Multiplan Commercial |
$2,851.26
|
| Rate for Payer: Preferred Network Access Commercial |
$3,385.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,568.20
|
| Rate for Payer: Quartz Commercial |
$2,031.53
|
| Rate for Payer: The Alliance Commercial |
$1,782.04
|
| Rate for Payer: United Healthcare Medicaid |
$605.84
|
| Rate for Payer: WEA Trust Commercial |
$1,960.24
|
| Rate for Payer: WPS Commercial |
$2,639.82
|
|
|
EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN 9364126
|
Professional
|
Both
|
$3,427.00
|
|
|
Service Code
|
CPT 93641 26
|
| Hospital Charge Code |
5551965
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$282.84 |
| Max. Negotiated Rate |
$3,385.88 |
| Rate for Payer: Aetna Commercial |
$3,385.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,065.11
|
| Rate for Payer: Aetna Managed Medicare |
$282.84
|
| Rate for Payer: Anthem Medicare Advantage |
$282.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$282.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$282.84
|
| Rate for Payer: Cash Price |
$1,028.10
|
| Rate for Payer: Cash Price |
$1,028.10
|
| Rate for Payer: Cash Price |
$1,028.10
|
| Rate for Payer: Cigna Commercial |
$3,385.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$329.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$282.84
|
| Rate for Payer: Health EOS Commercial |
$3,243.31
|
| Rate for Payer: HFN Commercial |
$3,385.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,051.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,051.69
|
| Rate for Payer: Independent Care Health Plan Medicare |
$282.84
|
| Rate for Payer: Multiplan Commercial |
$2,851.26
|
| Rate for Payer: NAPHCARE Commercial |
$424.26
|
| Rate for Payer: Preferred Network Access Commercial |
$3,385.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,568.20
|
| Rate for Payer: Quartz Commercial |
$2,031.53
|
| Rate for Payer: Quartz Medicare Advantage |
$282.84
|
| Rate for Payer: The Alliance Commercial |
$1,074.79
|
| Rate for Payer: United Healthcare Medicaid |
$329.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$282.84
|
| Rate for Payer: WEA Trust Commercial |
$1,960.24
|
| Rate for Payer: WPS Commercial |
$1,131.35
|
|
|
EP ICD Threshold Eval@Ins/Rep
|
Facility
|
OP
|
$8,040.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
3052512
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,341.25 |
| Max. Negotiated Rate |
$7,692.67 |
| Rate for Payer: Aetna Commercial |
$7,525.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,190.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,341.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,435.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,180.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,013.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,431.65
|
| Rate for Payer: Cash Price |
$2,412.00
|
| Rate for Payer: Cigna Commercial |
$7,692.67
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,679.28
|
| Rate for Payer: Health EOS Commercial |
$7,441.82
|
| Rate for Payer: HFN Commercial |
$7,692.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,271.20
|
| Rate for Payer: Multiplan Commercial |
$6,689.28
|
| Rate for Payer: NAPHCARE Commercial |
$5,016.96
|
| Rate for Payer: Preferred Network Access Commercial |
$7,692.67
|
| Rate for Payer: Quartz Beloit One Network |
$4,097.18
|
| Rate for Payer: Quartz Commercial |
$5,435.04
|
| Rate for Payer: Quartz Medicare Advantage |
$5,016.96
|
| Rate for Payer: The Alliance Commercial |
$4,180.80
|
| Rate for Payer: WEA Trust Commercial |
$4,598.88
|
| Rate for Payer: WPS Commercial |
$6,193.21
|
|
|
EP ICD Threshold Eval@Ins/Rep
|
Facility
|
IP
|
$8,040.00
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
3052512
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,097.18 |
| Max. Negotiated Rate |
$7,692.67 |
| Rate for Payer: Aetna Commercial |
$7,525.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,190.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,431.65
|
| Rate for Payer: Cash Price |
$2,412.00
|
| Rate for Payer: Cigna Commercial |
$7,692.67
|
| Rate for Payer: Health EOS Commercial |
$7,441.82
|
| Rate for Payer: HFN Commercial |
$7,692.67
|
| Rate for Payer: Multiplan Commercial |
$6,689.28
|
| Rate for Payer: Preferred Network Access Commercial |
$7,692.67
|
| Rate for Payer: Quartz Beloit One Network |
$4,097.18
|
| Rate for Payer: Quartz Commercial |
$5,016.96
|
| Rate for Payer: WEA Trust Commercial |
$4,598.88
|
| Rate for Payer: WPS Commercial |
$6,193.21
|
|
|
EP ICD Threshold Eval Post Implant
|
Facility
|
OP
|
$8,131.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
3052513
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,367.75 |
| Max. Negotiated Rate |
$7,779.74 |
| Rate for Payer: Aetna Commercial |
$7,610.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,272.37
|
| Rate for Payer: Aetna Managed Medicare |
$2,367.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,496.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,228.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,059.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,481.81
|
| Rate for Payer: Cash Price |
$2,439.30
|
| Rate for Payer: Cigna Commercial |
$7,779.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,732.24
|
| Rate for Payer: Health EOS Commercial |
$7,526.05
|
| Rate for Payer: HFN Commercial |
$7,779.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,342.18
|
| Rate for Payer: Multiplan Commercial |
$6,764.99
|
| Rate for Payer: NAPHCARE Commercial |
$5,073.74
|
| Rate for Payer: Preferred Network Access Commercial |
$7,779.74
|
| Rate for Payer: Quartz Beloit One Network |
$4,143.56
|
| Rate for Payer: Quartz Commercial |
$5,496.56
|
| Rate for Payer: Quartz Medicare Advantage |
$5,073.74
|
| Rate for Payer: The Alliance Commercial |
$4,228.12
|
| Rate for Payer: WEA Trust Commercial |
$4,650.93
|
| Rate for Payer: WPS Commercial |
$6,263.31
|
|
|
EP ICD Threshold Eval Post Implant
|
Facility
|
IP
|
$8,131.00
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
3052513
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,143.56 |
| Max. Negotiated Rate |
$7,779.74 |
| Rate for Payer: Aetna Commercial |
$7,610.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,272.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,481.81
|
| Rate for Payer: Cash Price |
$2,439.30
|
| Rate for Payer: Cigna Commercial |
$7,779.74
|
| Rate for Payer: Health EOS Commercial |
$7,526.05
|
| Rate for Payer: HFN Commercial |
$7,779.74
|
| Rate for Payer: Multiplan Commercial |
$6,764.99
|
| Rate for Payer: Preferred Network Access Commercial |
$7,779.74
|
| Rate for Payer: Quartz Beloit One Network |
$4,143.56
|
| Rate for Payer: Quartz Commercial |
$5,073.74
|
| Rate for Payer: WEA Trust Commercial |
$4,650.93
|
| Rate for Payer: WPS Commercial |
$6,263.31
|
|
|
EP ICD Threshold Eval W/Reprogram
|
Facility
|
OP
|
$8,340.00
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
3052514
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,281.32 |
| Max. Negotiated Rate |
$7,979.71 |
| Rate for Payer: Aetna Commercial |
$7,806.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,459.30
|
| Rate for Payer: Aetna Managed Medicare |
$1,281.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,637.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,336.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,163.33
|
| Rate for Payer: Anthem Medicare Advantage |
$1,281.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,597.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,281.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,281.32
|
| Rate for Payer: Cash Price |
$2,502.00
|
| Rate for Payer: Cash Price |
$2,502.00
|
| Rate for Payer: Cigna Commercial |
$7,979.71
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,281.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,853.88
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,281.32
|
| Rate for Payer: Health EOS Commercial |
$7,719.50
|
| Rate for Payer: HFN Commercial |
$7,979.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,766.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,281.32
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,281.32
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,281.32
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,281.32
|
| Rate for Payer: Multiplan Commercial |
$6,938.88
|
| Rate for Payer: NAPHCARE Commercial |
$1,921.98
|
| Rate for Payer: Preferred Network Access Commercial |
$7,979.71
|
| Rate for Payer: Quartz Beloit One Network |
$4,250.06
|
| Rate for Payer: Quartz Commercial |
$5,637.84
|
| Rate for Payer: Quartz Medicare Advantage |
$1,281.32
|
| Rate for Payer: The Alliance Commercial |
$5,125.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,281.32
|
| Rate for Payer: WEA Trust Commercial |
$4,770.48
|
| Rate for Payer: Wellcare Medicare |
$1,281.32
|
| Rate for Payer: WPS Commercial |
$6,424.30
|
|
|
EP ICD Threshold Eval W/Reprogram
|
Facility
|
IP
|
$8,340.00
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
3052514
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,250.06 |
| Max. Negotiated Rate |
$7,979.71 |
| Rate for Payer: Aetna Commercial |
$7,806.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,459.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,597.01
|
| Rate for Payer: Cash Price |
$2,502.00
|
| Rate for Payer: Cigna Commercial |
$7,979.71
|
| Rate for Payer: Health EOS Commercial |
$7,719.50
|
| Rate for Payer: HFN Commercial |
$7,979.71
|
| Rate for Payer: Multiplan Commercial |
$6,938.88
|
| Rate for Payer: Preferred Network Access Commercial |
$7,979.71
|
| Rate for Payer: Quartz Beloit One Network |
$4,250.06
|
| Rate for Payer: Quartz Commercial |
$5,204.16
|
| Rate for Payer: WEA Trust Commercial |
$4,770.48
|
| Rate for Payer: WPS Commercial |
$6,424.30
|
|
|
EPICONDYLECTOMY, LATERAL/MEDIAL ELBOW
|
Facility
|
OP
|
$4,912.00
|
|
| Hospital Charge Code |
4494582
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,430.37 |
| Max. Negotiated Rate |
$4,699.80 |
| Rate for Payer: Aetna Commercial |
$4,597.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,393.29
|
| Rate for Payer: Aetna Managed Medicare |
$1,430.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,320.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,554.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,452.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,707.49
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cigna Commercial |
$4,699.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,858.78
|
| Rate for Payer: Health EOS Commercial |
$4,546.55
|
| Rate for Payer: HFN Commercial |
$4,699.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,831.36
|
| Rate for Payer: Multiplan Commercial |
$4,086.78
|
| Rate for Payer: NAPHCARE Commercial |
$3,065.09
|
| Rate for Payer: Preferred Network Access Commercial |
$4,699.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,503.16
|
| Rate for Payer: Quartz Commercial |
$3,320.51
|
| Rate for Payer: Quartz Medicare Advantage |
$3,065.09
|
| Rate for Payer: The Alliance Commercial |
$2,554.24
|
| Rate for Payer: WEA Trust Commercial |
$2,809.66
|
| Rate for Payer: WPS Commercial |
$3,783.71
|
|
|
EPICONDYLECTOMY, LATERAL/MEDIAL ELBOW
|
Facility
|
IP
|
$4,912.00
|
|
| Hospital Charge Code |
4494582
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,503.16 |
| Max. Negotiated Rate |
$4,699.80 |
| Rate for Payer: Aetna Commercial |
$4,597.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,393.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,707.49
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cigna Commercial |
$4,699.80
|
| Rate for Payer: Health EOS Commercial |
$4,546.55
|
| Rate for Payer: HFN Commercial |
$4,699.80
|
| Rate for Payer: Multiplan Commercial |
$4,086.78
|
| Rate for Payer: Preferred Network Access Commercial |
$4,699.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,503.16
|
| Rate for Payer: Quartz Commercial |
$3,065.09
|
| Rate for Payer: WEA Trust Commercial |
$2,809.66
|
| Rate for Payer: WPS Commercial |
$3,783.71
|
|
|
Epidermal Growth Factor Receptor (EGFR) Mutation, Blood
|
Facility
|
OP
|
$1,893.00
|
|
|
Service Code
|
CPT 81235
|
| Hospital Charge Code |
5276620
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$337.56 |
| Max. Negotiated Rate |
$1,811.22 |
| Rate for Payer: Aetna Commercial |
$1,771.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,693.10
|
| Rate for Payer: Aetna Managed Medicare |
$337.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,265.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$590.74
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$560.35
|
| Rate for Payer: Anthem Medicare Advantage |
$337.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,043.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$337.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$337.56
|
| Rate for Payer: Cash Price |
$567.90
|
| Rate for Payer: Cash Price |
$567.90
|
| Rate for Payer: Cigna Commercial |
$1,811.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$337.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,101.73
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$337.56
|
| Rate for Payer: Health EOS Commercial |
$1,752.16
|
| Rate for Payer: HFN Commercial |
$1,811.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,255.74
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$337.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$337.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$337.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$337.56
|
| Rate for Payer: Multiplan Commercial |
$1,574.98
|
| Rate for Payer: NAPHCARE Commercial |
$506.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,811.22
|
| Rate for Payer: Quartz Beloit One Network |
$964.67
|
| Rate for Payer: Quartz Commercial |
$1,279.67
|
| Rate for Payer: Quartz Medicare Advantage |
$337.56
|
| Rate for Payer: The Alliance Commercial |
$1,350.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$337.56
|
| Rate for Payer: United Healthcare PPO |
$1,476.54
|
| Rate for Payer: WEA Trust Commercial |
$1,082.80
|
| Rate for Payer: Wellcare Medicare |
$337.56
|
| Rate for Payer: WPS Commercial |
$1,458.18
|
|
|
Epidermal Growth Factor Receptor (EGFR) Mutation, Blood
|
Facility
|
IP
|
$1,893.00
|
|
|
Service Code
|
CPT 81235
|
| Hospital Charge Code |
5276620
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$964.67 |
| Max. Negotiated Rate |
$1,811.22 |
| Rate for Payer: Aetna Commercial |
$1,771.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,693.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,043.42
|
| Rate for Payer: Cash Price |
$567.90
|
| Rate for Payer: Cigna Commercial |
$1,811.22
|
| Rate for Payer: Health EOS Commercial |
$1,752.16
|
| Rate for Payer: HFN Commercial |
$1,811.22
|
| Rate for Payer: Multiplan Commercial |
$1,574.98
|
| Rate for Payer: Preferred Network Access Commercial |
$1,811.22
|
| Rate for Payer: Quartz Beloit One Network |
$964.67
|
| Rate for Payer: Quartz Commercial |
$1,181.23
|
| Rate for Payer: WEA Trust Commercial |
$1,082.80
|
| Rate for Payer: WPS Commercial |
$1,458.18
|
|
|
Epidermal Growth Factor Receptor (EGFR) Mutation, Blood
|
Professional
|
Both
|
$1,893.00
|
|
|
Service Code
|
CPT 81235
|
| Hospital Charge Code |
5276620
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$337.56 |
| Max. Negotiated Rate |
$1,870.28 |
| Rate for Payer: Aetna Commercial |
$1,870.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,693.10
|
| Rate for Payer: Aetna Managed Medicare |
$337.56
|
| Rate for Payer: Anthem Medicare Advantage |
$337.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$337.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$337.56
|
| Rate for Payer: Cash Price |
$567.90
|
| Rate for Payer: Cash Price |
$567.90
|
| Rate for Payer: Cigna Commercial |
$1,870.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$984.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$337.56
|
| Rate for Payer: Health EOS Commercial |
$1,791.54
|
| Rate for Payer: HFN Commercial |
$1,870.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,191.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,191.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$337.56
|
| Rate for Payer: Multiplan Commercial |
$1,574.98
|
| Rate for Payer: NAPHCARE Commercial |
$506.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,870.28
|
| Rate for Payer: Quartz Beloit One Network |
$866.24
|
| Rate for Payer: Quartz Commercial |
$1,122.17
|
| Rate for Payer: Quartz Medicare Advantage |
$337.56
|
| Rate for Payer: The Alliance Commercial |
$1,333.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$337.56
|
| Rate for Payer: WEA Trust Commercial |
$1,082.80
|
| Rate for Payer: WPS Commercial |
$1,485.28
|
|
