|
EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITH SIMPLE REPAIR
|
Facility
|
OP
|
$6,531.49
|
|
|
Service Code
|
CPT 40812
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,632.87 |
| Max. Negotiated Rate |
$6,531.49 |
| Rate for Payer: Aetna Managed Medicare |
$1,632.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,632.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,632.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,632.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,632.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,632.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,074.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,632.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,632.87
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,632.87
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,632.87
|
| Rate for Payer: NAPHCARE Commercial |
$2,449.31
|
| Rate for Payer: Quartz Medicare Advantage |
$1,632.87
|
| Rate for Payer: The Alliance Commercial |
$6,531.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,632.87
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,632.87
|
|
|
EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG, CYST OR GANGLION), LEG AND/OR ANKLE
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 27630
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
EXCISION OF LESION OF TENDON SHEATH OR JOINT CAPSULE (EG, CYST, MUCOUS CYST, OR GANGLION), HAND OR FINGER
|
Facility
|
OP
|
$6,807.99
|
|
|
Service Code
|
CPT 26160
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,692.24 |
| Max. Negotiated Rate |
$6,807.99 |
| Rate for Payer: Aetna Managed Medicare |
$1,692.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,692.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,692.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,692.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,692.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,692.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,295.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,692.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,692.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,692.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,692.24
|
| Rate for Payer: NAPHCARE Commercial |
$2,538.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,692.24
|
| Rate for Payer: The Alliance Commercial |
$6,768.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,692.24
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,692.24
|
|
|
Excision Of Lesion Of Tongue With Closure; Anterior Two-Thirds
|
Professional
|
Both
|
$647.00
|
|
|
Service Code
|
CPT 41112
|
| Hospital Charge Code |
1190857
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$991.83 |
| Rate for Payer: Aetna Commercial |
$639.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$578.68
|
| Rate for Payer: Aetna Managed Medicare |
$220.41
|
| Rate for Payer: Anthem Medicare Advantage |
$220.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$220.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$220.41
|
| Rate for Payer: Cash Price |
$194.10
|
| Rate for Payer: Cash Price |
$194.10
|
| Rate for Payer: Cash Price |
$194.10
|
| Rate for Payer: Cigna Commercial |
$639.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$144.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$220.41
|
| Rate for Payer: Health EOS Commercial |
$612.32
|
| Rate for Payer: HFN Commercial |
$639.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$853.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$853.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$220.41
|
| Rate for Payer: Multiplan Commercial |
$538.30
|
| Rate for Payer: NAPHCARE Commercial |
$330.61
|
| Rate for Payer: Preferred Network Access Commercial |
$639.24
|
| Rate for Payer: Quartz Beloit One Network |
$296.07
|
| Rate for Payer: Quartz Commercial |
$383.54
|
| Rate for Payer: Quartz Medicare Advantage |
$220.41
|
| Rate for Payer: The Alliance Commercial |
$936.73
|
| Rate for Payer: United Healthcare Medicaid |
$144.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$220.41
|
| Rate for Payer: WEA Trust Commercial |
$370.08
|
| Rate for Payer: WPS Commercial |
$991.83
|
|
|
EXCISION OF LESION OF TONGUE WITH CLOSURE; ANTERIOR TWO-THIRDS
|
Facility
|
OP
|
$13,956.63
|
|
|
Service Code
|
CPT 41112
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,835.04 |
| Max. Negotiated Rate |
$13,956.63 |
| Rate for Payer: Aetna Managed Medicare |
$3,489.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$3,489.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,489.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,489.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,489.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,489.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,979.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,489.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,489.16
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,489.16
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,489.16
|
| Rate for Payer: NAPHCARE Commercial |
$5,233.74
|
| Rate for Payer: Quartz Medicare Advantage |
$3,489.16
|
| Rate for Payer: The Alliance Commercial |
$13,956.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,489.16
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$3,489.16
|
|
|
Excision of Lesion of Tongue Without Closure
|
Professional
|
Both
|
$508.00
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
1190859
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$99.07 |
| Max. Negotiated Rate |
$501.90 |
| Rate for Payer: Aetna Commercial |
$501.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$454.36
|
| Rate for Payer: Aetna Managed Medicare |
$100.13
|
| Rate for Payer: Anthem Medicare Advantage |
$100.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$100.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$100.13
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cigna Commercial |
$501.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$99.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$100.13
|
| Rate for Payer: Health EOS Commercial |
$480.77
|
| Rate for Payer: HFN Commercial |
$501.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$380.78
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$380.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$100.13
|
| Rate for Payer: Multiplan Commercial |
$422.66
|
| Rate for Payer: NAPHCARE Commercial |
$150.20
|
| Rate for Payer: Preferred Network Access Commercial |
$501.90
|
| Rate for Payer: Quartz Beloit One Network |
$232.46
|
| Rate for Payer: Quartz Commercial |
$301.14
|
| Rate for Payer: Quartz Medicare Advantage |
$100.13
|
| Rate for Payer: The Alliance Commercial |
$425.56
|
| Rate for Payer: United Healthcare Medicaid |
$99.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$100.13
|
| Rate for Payer: WEA Trust Commercial |
$290.58
|
| Rate for Payer: WPS Commercial |
$450.59
|
|
|
EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE (INCLUDING SYNOVECTOMY) (EG, CYST OR GANGLION); FOOT
|
Facility
|
OP
|
$6,807.99
|
|
|
Service Code
|
CPT 28090
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,692.24 |
| Max. Negotiated Rate |
$6,807.99 |
| Rate for Payer: Aetna Managed Medicare |
$1,692.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,692.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,692.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,692.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,692.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,692.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,295.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,692.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,692.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,692.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,692.24
|
| Rate for Payer: NAPHCARE Commercial |
$2,538.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,692.24
|
| Rate for Payer: The Alliance Commercial |
$6,768.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,692.24
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,692.24
|
|
|
EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE (INCLUDING SYNOVECTOMY) (EG, CYST OR GANGLION); TOE(S), EACH
|
Facility
|
OP
|
$6,807.99
|
|
|
Service Code
|
CPT 28092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,692.24 |
| Max. Negotiated Rate |
$6,807.99 |
| Rate for Payer: Aetna Managed Medicare |
$1,692.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,692.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,692.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,692.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,692.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,692.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,295.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,692.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,692.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,692.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,692.24
|
| Rate for Payer: NAPHCARE Commercial |
$2,538.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,692.24
|
| Rate for Payer: The Alliance Commercial |
$6,768.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,692.24
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,692.24
|
|
|
EXCISION OF LIP; FULL THICKNESS, RECONSTRUCTION WITH LOCAL FLAP (EG, ESTLANDER OR FAN)
|
Facility
|
OP
|
$13,956.63
|
|
|
Service Code
|
CPT 40525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,835.04 |
| Max. Negotiated Rate |
$13,956.63 |
| Rate for Payer: Aetna Managed Medicare |
$3,489.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$3,489.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,489.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,489.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,489.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,489.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,979.67
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,489.16
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,489.16
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,489.16
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,489.16
|
| Rate for Payer: NAPHCARE Commercial |
$5,233.74
|
| Rate for Payer: Quartz Medicare Advantage |
$3,489.16
|
| Rate for Payer: The Alliance Commercial |
$13,956.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,489.16
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$3,489.16
|
|
|
Excision of Malignant Lesion (face, ears, eyelids, nose, lips, mucous membranes) <=0.5cm 11640
|
Professional
|
Both
|
$829.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
1152815
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.35 |
| Max. Negotiated Rate |
$819.05 |
| Rate for Payer: Aetna Commercial |
$819.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$741.46
|
| Rate for Payer: Aetna Managed Medicare |
$108.35
|
| Rate for Payer: Anthem Medicare Advantage |
$108.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$108.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$108.35
|
| Rate for Payer: Cash Price |
$248.70
|
| Rate for Payer: Cash Price |
$248.70
|
| Rate for Payer: Cash Price |
$248.70
|
| Rate for Payer: Cigna Commercial |
$819.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$204.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$108.35
|
| Rate for Payer: Health EOS Commercial |
$784.57
|
| Rate for Payer: HFN Commercial |
$819.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$437.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$437.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$108.35
|
| Rate for Payer: Multiplan Commercial |
$689.73
|
| Rate for Payer: NAPHCARE Commercial |
$162.52
|
| Rate for Payer: Preferred Network Access Commercial |
$819.05
|
| Rate for Payer: Quartz Beloit One Network |
$379.35
|
| Rate for Payer: Quartz Commercial |
$491.43
|
| Rate for Payer: Quartz Medicare Advantage |
$108.35
|
| Rate for Payer: The Alliance Commercial |
$460.48
|
| Rate for Payer: United Healthcare Medicaid |
$204.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$108.35
|
| Rate for Payer: WEA Trust Commercial |
$474.19
|
| Rate for Payer: WPS Commercial |
$487.56
|
|
|
Excision of malignant lesion (face, ears, eyelids, nose, lips, mucous membranes) 0.6-1.0cm 11641
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
3013566
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$131.33 |
| Max. Negotiated Rate |
$1,138.18 |
| Rate for Payer: Aetna Commercial |
$1,138.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Aetna Managed Medicare |
$131.33
|
| Rate for Payer: Anthem Medicare Advantage |
$131.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$131.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$131.33
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,138.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$263.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$131.33
|
| Rate for Payer: Health EOS Commercial |
$1,090.25
|
| Rate for Payer: HFN Commercial |
$1,138.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$537.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$537.61
|
| Rate for Payer: Independent Care Health Plan Medicare |
$131.33
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: NAPHCARE Commercial |
$197.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,138.18
|
| Rate for Payer: Quartz Beloit One Network |
$527.16
|
| Rate for Payer: Quartz Commercial |
$682.91
|
| Rate for Payer: Quartz Medicare Advantage |
$131.33
|
| Rate for Payer: The Alliance Commercial |
$558.16
|
| Rate for Payer: United Healthcare Medicaid |
$263.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$131.33
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$590.99
|
|
|
Excision of malignant lesion (face, ears, eyelids, nose, lips, mucous membranes) 1.1-2.0cm 11642
|
Professional
|
Both
|
$1,246.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
3013567
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$151.03 |
| Max. Negotiated Rate |
$1,231.05 |
| Rate for Payer: Aetna Commercial |
$1,231.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,114.42
|
| Rate for Payer: Aetna Managed Medicare |
$151.03
|
| Rate for Payer: Anthem Medicare Advantage |
$151.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$151.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$151.03
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: Cigna Commercial |
$1,231.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$233.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$151.03
|
| Rate for Payer: Health EOS Commercial |
$1,179.21
|
| Rate for Payer: HFN Commercial |
$1,231.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$629.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$629.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$151.03
|
| Rate for Payer: Multiplan Commercial |
$1,036.67
|
| Rate for Payer: NAPHCARE Commercial |
$226.54
|
| Rate for Payer: Preferred Network Access Commercial |
$1,231.05
|
| Rate for Payer: Quartz Beloit One Network |
$570.17
|
| Rate for Payer: Quartz Commercial |
$738.63
|
| Rate for Payer: Quartz Medicare Advantage |
$151.03
|
| Rate for Payer: The Alliance Commercial |
$641.87
|
| Rate for Payer: United Healthcare Medicaid |
$233.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$151.03
|
| Rate for Payer: WEA Trust Commercial |
$712.71
|
| Rate for Payer: WPS Commercial |
$679.63
|
|
|
Excision of malignant lesion (face, ears, eyelids, nose, lips, mucous membranes) 2.1-3.0cm 11643
|
Professional
|
Both
|
$2,211.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
3013568
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$187.82 |
| Max. Negotiated Rate |
$2,184.47 |
| Rate for Payer: Aetna Commercial |
$2,184.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,977.52
|
| Rate for Payer: Aetna Managed Medicare |
$187.82
|
| Rate for Payer: Anthem Medicare Advantage |
$187.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$187.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$187.82
|
| Rate for Payer: Cash Price |
$663.30
|
| Rate for Payer: Cash Price |
$663.30
|
| Rate for Payer: Cash Price |
$663.30
|
| Rate for Payer: Cigna Commercial |
$2,184.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$398.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$187.82
|
| Rate for Payer: Health EOS Commercial |
$2,092.49
|
| Rate for Payer: HFN Commercial |
$2,184.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$786.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$786.62
|
| Rate for Payer: Independent Care Health Plan Medicare |
$187.82
|
| Rate for Payer: Multiplan Commercial |
$1,839.55
|
| Rate for Payer: NAPHCARE Commercial |
$281.74
|
| Rate for Payer: Preferred Network Access Commercial |
$2,184.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,011.75
|
| Rate for Payer: Quartz Commercial |
$1,310.68
|
| Rate for Payer: Quartz Medicare Advantage |
$187.82
|
| Rate for Payer: The Alliance Commercial |
$798.25
|
| Rate for Payer: United Healthcare Medicaid |
$398.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$187.82
|
| Rate for Payer: WEA Trust Commercial |
$1,264.69
|
| Rate for Payer: WPS Commercial |
$845.21
|
|
|
Excision of malignant lesion (face, ears, eyelids, nose, lips, mucous membranes) 3.1-4.0cm 11644
|
Professional
|
Both
|
$2,959.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
3013569
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$231.78 |
| Max. Negotiated Rate |
$2,923.49 |
| Rate for Payer: Aetna Commercial |
$2,923.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,646.53
|
| Rate for Payer: Aetna Managed Medicare |
$231.78
|
| Rate for Payer: Anthem Medicare Advantage |
$231.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$231.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$231.78
|
| Rate for Payer: Cash Price |
$887.70
|
| Rate for Payer: Cash Price |
$887.70
|
| Rate for Payer: Cash Price |
$887.70
|
| Rate for Payer: Cigna Commercial |
$2,923.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$608.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$231.78
|
| Rate for Payer: Health EOS Commercial |
$2,800.40
|
| Rate for Payer: HFN Commercial |
$2,923.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$973.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$973.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$231.78
|
| Rate for Payer: Multiplan Commercial |
$2,461.89
|
| Rate for Payer: NAPHCARE Commercial |
$347.68
|
| Rate for Payer: Preferred Network Access Commercial |
$2,923.49
|
| Rate for Payer: Quartz Beloit One Network |
$1,354.04
|
| Rate for Payer: Quartz Commercial |
$1,754.10
|
| Rate for Payer: Quartz Medicare Advantage |
$231.78
|
| Rate for Payer: The Alliance Commercial |
$985.09
|
| Rate for Payer: United Healthcare Medicaid |
$608.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$231.78
|
| Rate for Payer: WEA Trust Commercial |
$1,692.55
|
| Rate for Payer: WPS Commercial |
$1,043.03
|
|
|
Excision of malignant lesion (face, ears, eyelids, nose, lips, mucous membranes) 4.1-5.0cm 11646
|
Professional
|
Both
|
$3,483.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
3013570
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$319.23 |
| Max. Negotiated Rate |
$3,441.20 |
| Rate for Payer: Aetna Commercial |
$3,441.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,115.20
|
| Rate for Payer: Aetna Managed Medicare |
$319.23
|
| Rate for Payer: Anthem Medicare Advantage |
$319.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$319.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$319.23
|
| Rate for Payer: Cash Price |
$1,044.90
|
| Rate for Payer: Cash Price |
$1,044.90
|
| Rate for Payer: Cash Price |
$1,044.90
|
| Rate for Payer: Cigna Commercial |
$3,441.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$697.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$319.23
|
| Rate for Payer: Health EOS Commercial |
$3,296.31
|
| Rate for Payer: HFN Commercial |
$3,441.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,345.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,345.20
|
| Rate for Payer: Independent Care Health Plan Medicare |
$319.23
|
| Rate for Payer: Multiplan Commercial |
$2,897.86
|
| Rate for Payer: NAPHCARE Commercial |
$478.84
|
| Rate for Payer: Preferred Network Access Commercial |
$3,441.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,593.82
|
| Rate for Payer: Quartz Commercial |
$2,064.72
|
| Rate for Payer: Quartz Medicare Advantage |
$319.23
|
| Rate for Payer: The Alliance Commercial |
$1,356.72
|
| Rate for Payer: United Healthcare Medicaid |
$697.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$319.23
|
| Rate for Payer: WEA Trust Commercial |
$1,992.28
|
| Rate for Payer: WPS Commercial |
$1,436.53
|
|
|
Excision of malignant lesion (scalp, neck, hands, feet, genitalia) <=0.5cm 11620
|
Professional
|
Both
|
$766.00
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
3013560
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$106.41 |
| Max. Negotiated Rate |
$756.81 |
| Rate for Payer: Aetna Commercial |
$756.81
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$685.11
|
| Rate for Payer: Aetna Managed Medicare |
$106.41
|
| Rate for Payer: Anthem Medicare Advantage |
$106.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$106.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$106.41
|
| Rate for Payer: Cash Price |
$229.80
|
| Rate for Payer: Cash Price |
$229.80
|
| Rate for Payer: Cash Price |
$229.80
|
| Rate for Payer: Cigna Commercial |
$756.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$124.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$106.41
|
| Rate for Payer: Health EOS Commercial |
$724.94
|
| Rate for Payer: HFN Commercial |
$756.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$426.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$426.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$106.41
|
| Rate for Payer: Multiplan Commercial |
$637.31
|
| Rate for Payer: NAPHCARE Commercial |
$159.62
|
| Rate for Payer: Preferred Network Access Commercial |
$756.81
|
| Rate for Payer: Quartz Beloit One Network |
$350.52
|
| Rate for Payer: Quartz Commercial |
$454.08
|
| Rate for Payer: Quartz Medicare Advantage |
$106.41
|
| Rate for Payer: The Alliance Commercial |
$452.25
|
| Rate for Payer: United Healthcare Medicaid |
$124.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$106.41
|
| Rate for Payer: WEA Trust Commercial |
$438.15
|
| Rate for Payer: WPS Commercial |
$478.86
|
|
|
Excision of malignant lesion (scalp, neck, hands, feet, genitalia) 0.6-1.0cm 11621
|
Professional
|
Both
|
$848.00
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
3013561
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$126.33 |
| Max. Negotiated Rate |
$837.82 |
| Rate for Payer: Aetna Commercial |
$837.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$758.45
|
| Rate for Payer: Aetna Managed Medicare |
$126.33
|
| Rate for Payer: Anthem Medicare Advantage |
$126.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$126.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$126.33
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cigna Commercial |
$837.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$209.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$126.33
|
| Rate for Payer: Health EOS Commercial |
$802.55
|
| Rate for Payer: HFN Commercial |
$837.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$516.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$516.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$126.33
|
| Rate for Payer: Multiplan Commercial |
$705.54
|
| Rate for Payer: NAPHCARE Commercial |
$189.49
|
| Rate for Payer: Preferred Network Access Commercial |
$837.82
|
| Rate for Payer: Quartz Beloit One Network |
$388.04
|
| Rate for Payer: Quartz Commercial |
$502.69
|
| Rate for Payer: Quartz Medicare Advantage |
$126.33
|
| Rate for Payer: The Alliance Commercial |
$536.90
|
| Rate for Payer: United Healthcare Medicaid |
$209.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$126.33
|
| Rate for Payer: WEA Trust Commercial |
$485.06
|
| Rate for Payer: WPS Commercial |
$568.48
|
|
|
Excision of malignant lesion (scalp, neck, hands, feet, genitalia) 1.1-2.0cm 11622
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
3013562
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$140.98 |
| Max. Negotiated Rate |
$1,216.23 |
| Rate for Payer: Aetna Commercial |
$1,216.23
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,101.01
|
| Rate for Payer: Aetna Managed Medicare |
$140.98
|
| Rate for Payer: Anthem Medicare Advantage |
$140.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$140.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$140.98
|
| Rate for Payer: Cash Price |
$369.30
|
| Rate for Payer: Cash Price |
$369.30
|
| Rate for Payer: Cash Price |
$369.30
|
| Rate for Payer: Cigna Commercial |
$1,216.23
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$257.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$140.98
|
| Rate for Payer: Health EOS Commercial |
$1,165.02
|
| Rate for Payer: HFN Commercial |
$1,216.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$586.48
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$586.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$140.98
|
| Rate for Payer: Multiplan Commercial |
$1,024.19
|
| Rate for Payer: NAPHCARE Commercial |
$211.47
|
| Rate for Payer: Preferred Network Access Commercial |
$1,216.23
|
| Rate for Payer: Quartz Beloit One Network |
$563.31
|
| Rate for Payer: Quartz Commercial |
$729.74
|
| Rate for Payer: Quartz Medicare Advantage |
$140.98
|
| Rate for Payer: The Alliance Commercial |
$599.18
|
| Rate for Payer: United Healthcare Medicaid |
$257.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$140.98
|
| Rate for Payer: WEA Trust Commercial |
$704.13
|
| Rate for Payer: WPS Commercial |
$634.42
|
|
|
Excision of malignant lesion (scalp, neck, hands, feet, genitalia) 2.1-3.0cm 11623
|
Professional
|
Both
|
$1,870.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
3013563
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$172.88 |
| Max. Negotiated Rate |
$1,847.56 |
| Rate for Payer: Aetna Commercial |
$1,847.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,672.53
|
| Rate for Payer: Aetna Managed Medicare |
$172.88
|
| Rate for Payer: Anthem Medicare Advantage |
$172.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$172.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$172.88
|
| Rate for Payer: Cash Price |
$561.00
|
| Rate for Payer: Cash Price |
$561.00
|
| Rate for Payer: Cash Price |
$561.00
|
| Rate for Payer: Cigna Commercial |
$1,847.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$294.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$172.88
|
| Rate for Payer: Health EOS Commercial |
$1,769.77
|
| Rate for Payer: HFN Commercial |
$1,847.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$725.32
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$725.32
|
| Rate for Payer: Independent Care Health Plan Medicare |
$172.88
|
| Rate for Payer: Multiplan Commercial |
$1,555.84
|
| Rate for Payer: NAPHCARE Commercial |
$259.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,847.56
|
| Rate for Payer: Quartz Beloit One Network |
$855.71
|
| Rate for Payer: Quartz Commercial |
$1,108.54
|
| Rate for Payer: Quartz Medicare Advantage |
$172.88
|
| Rate for Payer: The Alliance Commercial |
$734.74
|
| Rate for Payer: United Healthcare Medicaid |
$294.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$172.88
|
| Rate for Payer: WEA Trust Commercial |
$1,069.64
|
| Rate for Payer: WPS Commercial |
$777.96
|
|
|
Excision of malignant lesion (scalp, neck, hands, feet, genitalia) 3.1-4.0cm 11624
|
Professional
|
Both
|
$1,722.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
3013564
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$196.64 |
| Max. Negotiated Rate |
$1,701.34 |
| Rate for Payer: Aetna Commercial |
$1,701.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,540.16
|
| Rate for Payer: Aetna Managed Medicare |
$196.64
|
| Rate for Payer: Anthem Medicare Advantage |
$196.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$196.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$196.64
|
| Rate for Payer: Cash Price |
$516.60
|
| Rate for Payer: Cash Price |
$516.60
|
| Rate for Payer: Cash Price |
$516.60
|
| Rate for Payer: Cigna Commercial |
$1,701.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$398.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$196.64
|
| Rate for Payer: Health EOS Commercial |
$1,629.70
|
| Rate for Payer: HFN Commercial |
$1,701.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$819.78
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$819.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$196.64
|
| Rate for Payer: Multiplan Commercial |
$1,432.70
|
| Rate for Payer: NAPHCARE Commercial |
$294.96
|
| Rate for Payer: Preferred Network Access Commercial |
$1,701.34
|
| Rate for Payer: Quartz Beloit One Network |
$787.99
|
| Rate for Payer: Quartz Commercial |
$1,020.80
|
| Rate for Payer: Quartz Medicare Advantage |
$196.64
|
| Rate for Payer: The Alliance Commercial |
$835.73
|
| Rate for Payer: United Healthcare Medicaid |
$398.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$196.64
|
| Rate for Payer: WEA Trust Commercial |
$984.98
|
| Rate for Payer: WPS Commercial |
$884.89
|
|
|
Excision of malignant lesion (scalp, neck, hands, feet, genitalia) > 4.0cm 11626
|
Professional
|
Both
|
$2,614.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
3013565
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$242.63 |
| Max. Negotiated Rate |
$2,582.63 |
| Rate for Payer: Aetna Commercial |
$2,582.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,337.96
|
| Rate for Payer: Aetna Managed Medicare |
$242.63
|
| Rate for Payer: Anthem Medicare Advantage |
$242.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$242.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$242.63
|
| Rate for Payer: Cash Price |
$784.20
|
| Rate for Payer: Cash Price |
$784.20
|
| Rate for Payer: Cash Price |
$784.20
|
| Rate for Payer: Cigna Commercial |
$2,582.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$466.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$242.63
|
| Rate for Payer: Health EOS Commercial |
$2,473.89
|
| Rate for Payer: HFN Commercial |
$2,582.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,001.14
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,001.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$242.63
|
| Rate for Payer: Multiplan Commercial |
$2,174.85
|
| Rate for Payer: NAPHCARE Commercial |
$363.95
|
| Rate for Payer: Preferred Network Access Commercial |
$2,582.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,196.17
|
| Rate for Payer: Quartz Commercial |
$1,549.58
|
| Rate for Payer: Quartz Medicare Advantage |
$242.63
|
| Rate for Payer: The Alliance Commercial |
$1,031.19
|
| Rate for Payer: United Healthcare Medicaid |
$466.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$242.63
|
| Rate for Payer: WEA Trust Commercial |
$1,495.21
|
| Rate for Payer: WPS Commercial |
$1,091.84
|
|
|
Excision of malignant lesion (trunk, arms, legs) <=0.5cm 11600
|
Professional
|
Both
|
$518.00
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
1152814
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$94.00 |
| Max. Negotiated Rate |
$511.78 |
| Rate for Payer: Aetna Commercial |
$511.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$463.30
|
| Rate for Payer: Aetna Managed Medicare |
$105.73
|
| Rate for Payer: Anthem Medicare Advantage |
$105.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$105.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$105.73
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cigna Commercial |
$511.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$94.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$105.73
|
| Rate for Payer: Health EOS Commercial |
$490.24
|
| Rate for Payer: HFN Commercial |
$511.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$424.32
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$424.32
|
| Rate for Payer: Independent Care Health Plan Medicare |
$105.73
|
| Rate for Payer: Multiplan Commercial |
$430.98
|
| Rate for Payer: NAPHCARE Commercial |
$158.59
|
| Rate for Payer: Preferred Network Access Commercial |
$511.78
|
| Rate for Payer: Quartz Beloit One Network |
$237.04
|
| Rate for Payer: Quartz Commercial |
$307.07
|
| Rate for Payer: Quartz Medicare Advantage |
$105.73
|
| Rate for Payer: The Alliance Commercial |
$449.34
|
| Rate for Payer: United Healthcare Medicaid |
$94.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$105.73
|
| Rate for Payer: WEA Trust Commercial |
$296.30
|
| Rate for Payer: WPS Commercial |
$475.77
|
|
|
Excision of malignant lesion (trunk, arms, legs) 0.6-1.0cm 11601
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
3013555
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$125.32 |
| Max. Negotiated Rate |
$604.66 |
| Rate for Payer: Aetna Commercial |
$604.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$547.37
|
| Rate for Payer: Aetna Managed Medicare |
$125.32
|
| Rate for Payer: Anthem Medicare Advantage |
$125.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$125.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$125.32
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cigna Commercial |
$604.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$125.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$125.32
|
| Rate for Payer: Health EOS Commercial |
$579.20
|
| Rate for Payer: HFN Commercial |
$604.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$514.78
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$514.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$125.32
|
| Rate for Payer: Multiplan Commercial |
$509.18
|
| Rate for Payer: NAPHCARE Commercial |
$187.98
|
| Rate for Payer: Preferred Network Access Commercial |
$604.66
|
| Rate for Payer: Quartz Beloit One Network |
$280.05
|
| Rate for Payer: Quartz Commercial |
$362.79
|
| Rate for Payer: Quartz Medicare Advantage |
$125.32
|
| Rate for Payer: The Alliance Commercial |
$532.61
|
| Rate for Payer: United Healthcare Medicaid |
$125.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$125.32
|
| Rate for Payer: WEA Trust Commercial |
$350.06
|
| Rate for Payer: WPS Commercial |
$563.94
|
|
|
Excision of malignant lesion (trunk, arms, legs) 1.1-2.0cm 11602
|
Professional
|
Both
|
$758.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
3013556
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$134.14 |
| Max. Negotiated Rate |
$748.90 |
| Rate for Payer: Aetna Commercial |
$748.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$677.96
|
| Rate for Payer: Aetna Managed Medicare |
$134.14
|
| Rate for Payer: Anthem Medicare Advantage |
$134.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$134.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$134.14
|
| Rate for Payer: Cash Price |
$227.40
|
| Rate for Payer: Cash Price |
$227.40
|
| Rate for Payer: Cash Price |
$227.40
|
| Rate for Payer: Cigna Commercial |
$748.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$192.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$134.14
|
| Rate for Payer: Health EOS Commercial |
$717.37
|
| Rate for Payer: HFN Commercial |
$748.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$560.92
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$560.92
|
| Rate for Payer: Independent Care Health Plan Medicare |
$134.14
|
| Rate for Payer: Multiplan Commercial |
$630.66
|
| Rate for Payer: NAPHCARE Commercial |
$201.21
|
| Rate for Payer: Preferred Network Access Commercial |
$748.90
|
| Rate for Payer: Quartz Beloit One Network |
$346.86
|
| Rate for Payer: Quartz Commercial |
$449.34
|
| Rate for Payer: Quartz Medicare Advantage |
$134.14
|
| Rate for Payer: The Alliance Commercial |
$570.09
|
| Rate for Payer: United Healthcare Medicaid |
$192.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$134.14
|
| Rate for Payer: WEA Trust Commercial |
$433.58
|
| Rate for Payer: WPS Commercial |
$603.63
|
|
|
Excision of malignant lesion (trunk, arms, legs) 2.1-3.0cm 11603
|
Professional
|
Both
|
$1,113.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
3013557
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$159.29 |
| Max. Negotiated Rate |
$1,099.64 |
| Rate for Payer: Aetna Commercial |
$1,099.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$995.47
|
| Rate for Payer: Aetna Managed Medicare |
$159.29
|
| Rate for Payer: Anthem Medicare Advantage |
$159.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$159.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$159.29
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cigna Commercial |
$1,099.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$255.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$159.29
|
| Rate for Payer: Health EOS Commercial |
$1,053.34
|
| Rate for Payer: HFN Commercial |
$1,099.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$669.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$669.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$159.29
|
| Rate for Payer: Multiplan Commercial |
$926.02
|
| Rate for Payer: NAPHCARE Commercial |
$238.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,099.64
|
| Rate for Payer: Quartz Beloit One Network |
$509.31
|
| Rate for Payer: Quartz Commercial |
$659.79
|
| Rate for Payer: Quartz Medicare Advantage |
$159.29
|
| Rate for Payer: The Alliance Commercial |
$676.97
|
| Rate for Payer: United Healthcare Medicaid |
$255.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$159.29
|
| Rate for Payer: WEA Trust Commercial |
$636.64
|
| Rate for Payer: WPS Commercial |
$716.79
|
|
