|
Excision of malignant lesion (trunk, arms, legs) 3.1-4.0cm 11604
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
3013558
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$175.84 |
| Max. Negotiated Rate |
$1,191.53 |
| Rate for Payer: Aetna Commercial |
$1,191.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,078.65
|
| Rate for Payer: Aetna Managed Medicare |
$175.84
|
| Rate for Payer: Anthem Medicare Advantage |
$175.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$175.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$175.84
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cigna Commercial |
$1,191.53
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$376.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$175.84
|
| Rate for Payer: Health EOS Commercial |
$1,141.36
|
| Rate for Payer: HFN Commercial |
$1,191.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$735.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$735.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$175.84
|
| Rate for Payer: Multiplan Commercial |
$1,003.39
|
| Rate for Payer: NAPHCARE Commercial |
$263.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.53
|
| Rate for Payer: Quartz Beloit One Network |
$551.87
|
| Rate for Payer: Quartz Commercial |
$714.92
|
| Rate for Payer: Quartz Medicare Advantage |
$175.84
|
| Rate for Payer: The Alliance Commercial |
$747.33
|
| Rate for Payer: United Healthcare Medicaid |
$376.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$175.84
|
| Rate for Payer: WEA Trust Commercial |
$689.83
|
| Rate for Payer: WPS Commercial |
$791.29
|
|
|
Excision of malignant lesion (trunk, arms, legs) >4.0cm 11606
|
Professional
|
Both
|
$1,817.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
3013559
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$262.38 |
| Max. Negotiated Rate |
$1,795.20 |
| Rate for Payer: Aetna Commercial |
$1,795.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,625.12
|
| Rate for Payer: Aetna Managed Medicare |
$262.38
|
| Rate for Payer: Anthem Medicare Advantage |
$262.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$262.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$262.38
|
| Rate for Payer: Cash Price |
$545.10
|
| Rate for Payer: Cash Price |
$545.10
|
| Rate for Payer: Cash Price |
$545.10
|
| Rate for Payer: Cigna Commercial |
$1,795.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$448.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$262.38
|
| Rate for Payer: Health EOS Commercial |
$1,719.61
|
| Rate for Payer: HFN Commercial |
$1,795.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,086.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,086.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$262.38
|
| Rate for Payer: Multiplan Commercial |
$1,511.74
|
| Rate for Payer: NAPHCARE Commercial |
$393.57
|
| Rate for Payer: Preferred Network Access Commercial |
$1,795.20
|
| Rate for Payer: Quartz Beloit One Network |
$831.46
|
| Rate for Payer: Quartz Commercial |
$1,077.12
|
| Rate for Payer: Quartz Medicare Advantage |
$262.38
|
| Rate for Payer: The Alliance Commercial |
$1,115.12
|
| Rate for Payer: United Healthcare Medicaid |
$448.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$262.38
|
| Rate for Payer: WEA Trust Commercial |
$1,039.32
|
| Rate for Payer: WPS Commercial |
$1,180.72
|
|
|
Excision of Mouth Lesion 40810
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
3190222
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.99 |
| Max. Negotiated Rate |
$505.58 |
| Rate for Payer: Aetna Commercial |
$240.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$217.34
|
| Rate for Payer: Aetna Managed Medicare |
$112.35
|
| Rate for Payer: Anthem Medicare Advantage |
$112.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$112.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$112.35
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cigna Commercial |
$240.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$46.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$112.35
|
| Rate for Payer: Health EOS Commercial |
$229.98
|
| Rate for Payer: HFN Commercial |
$240.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$428.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$428.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$112.35
|
| Rate for Payer: Multiplan Commercial |
$202.18
|
| Rate for Payer: NAPHCARE Commercial |
$168.53
|
| Rate for Payer: Preferred Network Access Commercial |
$240.08
|
| Rate for Payer: Quartz Beloit One Network |
$111.20
|
| Rate for Payer: Quartz Commercial |
$144.05
|
| Rate for Payer: Quartz Medicare Advantage |
$112.35
|
| Rate for Payer: The Alliance Commercial |
$477.49
|
| Rate for Payer: United Healthcare Medicaid |
$46.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$112.35
|
| Rate for Payer: WEA Trust Commercial |
$139.00
|
| Rate for Payer: WPS Commercial |
$505.58
|
|
|
EXCISION OF MOUTH LESION 40816
|
Professional
|
Both
|
$1,522.00
|
|
|
Service Code
|
CPT 40816
|
| Hospital Charge Code |
3014608
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$217.72 |
| Max. Negotiated Rate |
$1,503.74 |
| Rate for Payer: Aetna Commercial |
$1,503.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,361.28
|
| Rate for Payer: Aetna Managed Medicare |
$273.18
|
| Rate for Payer: Anthem Medicare Advantage |
$273.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$273.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$273.18
|
| Rate for Payer: Cash Price |
$456.60
|
| Rate for Payer: Cash Price |
$456.60
|
| Rate for Payer: Cash Price |
$456.60
|
| Rate for Payer: Cigna Commercial |
$1,503.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$217.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$273.18
|
| Rate for Payer: Health EOS Commercial |
$1,440.42
|
| Rate for Payer: HFN Commercial |
$1,503.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,062.78
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,062.78
|
| Rate for Payer: Independent Care Health Plan Medicare |
$273.18
|
| Rate for Payer: Multiplan Commercial |
$1,266.30
|
| Rate for Payer: NAPHCARE Commercial |
$409.77
|
| Rate for Payer: Preferred Network Access Commercial |
$1,503.74
|
| Rate for Payer: Quartz Beloit One Network |
$696.47
|
| Rate for Payer: Quartz Commercial |
$902.24
|
| Rate for Payer: Quartz Medicare Advantage |
$273.18
|
| Rate for Payer: The Alliance Commercial |
$1,161.00
|
| Rate for Payer: United Healthcare Medicaid |
$217.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$273.18
|
| Rate for Payer: WEA Trust Commercial |
$870.58
|
| Rate for Payer: WPS Commercial |
$1,229.30
|
|
|
EXCISION OF MOUTH LESION 41116
|
Professional
|
Both
|
$617.00
|
|
|
Service Code
|
CPT 41116
|
| Hospital Charge Code |
3014616
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$196.12 |
| Max. Negotiated Rate |
$882.55 |
| Rate for Payer: Aetna Commercial |
$609.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$551.84
|
| Rate for Payer: Aetna Managed Medicare |
$196.12
|
| Rate for Payer: Anthem Medicare Advantage |
$196.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$196.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$196.12
|
| Rate for Payer: Cash Price |
$185.10
|
| Rate for Payer: Cash Price |
$185.10
|
| Rate for Payer: Cash Price |
$185.10
|
| Rate for Payer: Cigna Commercial |
$609.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$217.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$196.12
|
| Rate for Payer: Health EOS Commercial |
$583.93
|
| Rate for Payer: HFN Commercial |
$609.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$752.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$752.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$196.12
|
| Rate for Payer: Multiplan Commercial |
$513.34
|
| Rate for Payer: NAPHCARE Commercial |
$294.18
|
| Rate for Payer: Preferred Network Access Commercial |
$609.60
|
| Rate for Payer: Quartz Beloit One Network |
$282.34
|
| Rate for Payer: Quartz Commercial |
$365.76
|
| Rate for Payer: Quartz Medicare Advantage |
$196.12
|
| Rate for Payer: The Alliance Commercial |
$833.52
|
| Rate for Payer: United Healthcare Medicaid |
$217.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$196.12
|
| Rate for Payer: WEA Trust Commercial |
$352.92
|
| Rate for Payer: WPS Commercial |
$882.55
|
|
|
Excision of Multiple External Papillae or tags, anus
|
Professional
|
Both
|
$709.00
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
1190849
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.34 |
| Max. Negotiated Rate |
$713.75 |
| Rate for Payer: Aetna Commercial |
$700.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.13
|
| Rate for Payer: Aetna Managed Medicare |
$158.61
|
| Rate for Payer: Anthem Medicare Advantage |
$158.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$158.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$158.61
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cigna Commercial |
$700.49
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$78.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$158.61
|
| Rate for Payer: Health EOS Commercial |
$671.00
|
| Rate for Payer: HFN Commercial |
$700.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$596.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$596.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$158.61
|
| Rate for Payer: Multiplan Commercial |
$589.89
|
| Rate for Payer: NAPHCARE Commercial |
$237.92
|
| Rate for Payer: Preferred Network Access Commercial |
$700.49
|
| Rate for Payer: Quartz Beloit One Network |
$324.44
|
| Rate for Payer: Quartz Commercial |
$420.30
|
| Rate for Payer: Quartz Medicare Advantage |
$158.61
|
| Rate for Payer: The Alliance Commercial |
$674.09
|
| Rate for Payer: United Healthcare Medicaid |
$78.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$158.61
|
| Rate for Payer: WEA Trust Commercial |
$405.55
|
| Rate for Payer: WPS Commercial |
$713.75
|
|
|
EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (EG, INGROWN OR DEFORMED NAIL), FOR PERMANENT REMOVAL
|
Facility
|
OP
|
$4,386.95
|
|
|
Service Code
|
CPT 11750
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$427.81 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Managed Medicare |
$427.81
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,030.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,388.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,270.32
|
| Rate for Payer: Anthem Medicare Advantage |
$427.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$427.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$427.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$427.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$427.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,591.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$427.81
|
| Rate for Payer: Independent Care Health Plan Medicare |
$427.81
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$427.81
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$427.81
|
| Rate for Payer: NAPHCARE Commercial |
$641.72
|
| Rate for Payer: Quartz Medicare Advantage |
$427.81
|
| Rate for Payer: The Alliance Commercial |
$1,711.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$427.81
|
| Rate for Payer: United Healthcare PPO |
$2,347.28
|
| Rate for Payer: Wellcare Medicare |
$427.81
|
|
|
EXCISION OF NAIL FOLD, TOE 11765
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
3013575
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$88.56 |
| Max. Negotiated Rate |
$398.50 |
| Rate for Payer: Aetna Commercial |
$352.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$319.30
|
| Rate for Payer: Aetna Managed Medicare |
$88.56
|
| Rate for Payer: Anthem Medicare Advantage |
$88.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$88.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$88.56
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Commercial |
$352.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$113.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$88.56
|
| Rate for Payer: Health EOS Commercial |
$337.86
|
| Rate for Payer: HFN Commercial |
$352.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$325.37
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$325.37
|
| Rate for Payer: Independent Care Health Plan Medicare |
$88.56
|
| Rate for Payer: Multiplan Commercial |
$297.02
|
| Rate for Payer: NAPHCARE Commercial |
$132.83
|
| Rate for Payer: Preferred Network Access Commercial |
$352.72
|
| Rate for Payer: Quartz Beloit One Network |
$163.36
|
| Rate for Payer: Quartz Commercial |
$211.63
|
| Rate for Payer: Quartz Medicare Advantage |
$88.56
|
| Rate for Payer: The Alliance Commercial |
$376.36
|
| Rate for Payer: United Healthcare Medicaid |
$113.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$88.56
|
| Rate for Payer: WEA Trust Commercial |
$204.20
|
| Rate for Payer: WPS Commercial |
$398.50
|
|
|
Excision of nail & nail matrix, partial or complete for permanent removal 11750
|
Professional
|
Both
|
$853.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
2572801
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$92.93 |
| Max. Negotiated Rate |
$842.76 |
| Rate for Payer: Aetna Commercial |
$842.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$762.92
|
| Rate for Payer: Aetna Managed Medicare |
$92.93
|
| Rate for Payer: Anthem Medicare Advantage |
$92.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$92.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$92.93
|
| Rate for Payer: Cash Price |
$255.90
|
| Rate for Payer: Cash Price |
$255.90
|
| Rate for Payer: Cash Price |
$255.90
|
| Rate for Payer: Cigna Commercial |
$842.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$113.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$92.93
|
| Rate for Payer: Health EOS Commercial |
$807.28
|
| Rate for Payer: HFN Commercial |
$842.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$358.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$358.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$92.93
|
| Rate for Payer: Multiplan Commercial |
$709.70
|
| Rate for Payer: NAPHCARE Commercial |
$139.40
|
| Rate for Payer: Preferred Network Access Commercial |
$842.76
|
| Rate for Payer: Quartz Beloit One Network |
$390.33
|
| Rate for Payer: Quartz Commercial |
$505.66
|
| Rate for Payer: Quartz Medicare Advantage |
$92.93
|
| Rate for Payer: The Alliance Commercial |
$394.97
|
| Rate for Payer: United Healthcare Medicaid |
$113.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$92.93
|
| Rate for Payer: WEA Trust Commercial |
$487.92
|
| Rate for Payer: WPS Commercial |
$418.20
|
|
|
EXCISION OF NEUROMA; HAND OR FOOT, EXCEPT DIGITAL NERVE
|
Facility
|
OP
|
$8,220.12
|
|
|
Service Code
|
CPT 64782
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,055.03 |
| Max. Negotiated Rate |
$8,220.12 |
| Rate for Payer: Aetna Managed Medicare |
$2,055.03
|
| 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 |
$2,055.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,055.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,055.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,055.03
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,055.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,644.71
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,055.03
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,055.03
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,055.03
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,055.03
|
| Rate for Payer: NAPHCARE Commercial |
$3,082.54
|
| Rate for Payer: Quartz Medicare Advantage |
$2,055.03
|
| Rate for Payer: The Alliance Commercial |
$8,220.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,055.03
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$2,055.03
|
|
|
EXCISION OF PILONIDAL CYST OR SINUS; COMPLICATED
|
Facility
|
OP
|
$12,227.57
|
|
|
Service Code
|
CPT 11772
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,056.89 |
| Max. Negotiated Rate |
$12,227.57 |
| Rate for Payer: Aetna Managed Medicare |
$3,056.89
|
| 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 |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,056.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,056.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,056.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,371.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,056.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,056.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,056.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,056.89
|
| Rate for Payer: NAPHCARE Commercial |
$4,585.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3,056.89
|
| Rate for Payer: The Alliance Commercial |
$12,227.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,056.89
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,056.89
|
|
|
EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE
|
Facility
|
OP
|
$12,227.57
|
|
|
Service Code
|
CPT 11771
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,056.89 |
| Max. Negotiated Rate |
$12,227.57 |
| Rate for Payer: Aetna Managed Medicare |
$3,056.89
|
| 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 |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,056.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,056.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,056.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,371.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,056.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,056.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,056.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,056.89
|
| Rate for Payer: NAPHCARE Commercial |
$4,585.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3,056.89
|
| Rate for Payer: The Alliance Commercial |
$12,227.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,056.89
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,056.89
|
|
|
EXCISION OF PILONIDAL CYST OR SINUS; SIMPLE
|
Facility
|
OP
|
$12,227.57
|
|
|
Service Code
|
CPT 11770
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,056.89 |
| Max. Negotiated Rate |
$12,227.57 |
| Rate for Payer: Aetna Managed Medicare |
$3,056.89
|
| 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 |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,056.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,056.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,056.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,371.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,056.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,056.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,056.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,056.89
|
| Rate for Payer: NAPHCARE Commercial |
$4,585.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3,056.89
|
| Rate for Payer: The Alliance Commercial |
$12,227.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,056.89
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,056.89
|
|
|
EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; INCLUDING MUSCULARIS PROPRIA (IE, FULL THICKNESS)
|
Facility
|
OP
|
$11,684.32
|
|
|
Service Code
|
CPT 45172
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,835.04 |
| Max. Negotiated Rate |
$11,684.32 |
| Rate for Payer: Aetna Managed Medicare |
$2,921.08
|
| 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 |
$2,921.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,921.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,921.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,921.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,921.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,866.41
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,921.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,921.08
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,921.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,921.08
|
| Rate for Payer: NAPHCARE Commercial |
$4,381.62
|
| Rate for Payer: Quartz Medicare Advantage |
$2,921.08
|
| Rate for Payer: The Alliance Commercial |
$11,684.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,921.08
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$2,921.08
|
|
|
EXCISION OF SPERMATOCELE, WITH OR WITHOUT EPIDIDYMECTOMY
|
Facility
|
OP
|
$8,799.61
|
|
|
Service Code
|
CPT 54840
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,199.90 |
| Max. Negotiated Rate |
$8,799.61 |
| Rate for Payer: Aetna Managed Medicare |
$2,199.90
|
| 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 |
$2,199.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,199.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,199.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,199.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,107.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,199.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,183.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,199.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,199.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,199.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,199.90
|
| Rate for Payer: NAPHCARE Commercial |
$3,299.85
|
| Rate for Payer: Quartz Medicare Advantage |
$2,199.90
|
| Rate for Payer: The Alliance Commercial |
$8,799.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,199.90
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$2,199.90
|
|
|
Excision Of Sublingual Salivary Cyst
|
Professional
|
Both
|
$1,164.00
|
|
|
Service Code
|
CPT 42408
|
| Hospital Charge Code |
2846799
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$137.35 |
| Max. Negotiated Rate |
$1,417.85 |
| Rate for Payer: Aetna Commercial |
$1,150.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,041.08
|
| Rate for Payer: Aetna Managed Medicare |
$315.08
|
| Rate for Payer: Anthem Medicare Advantage |
$315.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$315.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$315.08
|
| Rate for Payer: Cash Price |
$349.20
|
| Rate for Payer: Cash Price |
$349.20
|
| Rate for Payer: Cash Price |
$349.20
|
| Rate for Payer: Cigna Commercial |
$1,150.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$137.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$315.08
|
| Rate for Payer: Health EOS Commercial |
$1,101.61
|
| Rate for Payer: HFN Commercial |
$1,150.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,230.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,230.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$315.08
|
| Rate for Payer: Multiplan Commercial |
$968.45
|
| Rate for Payer: NAPHCARE Commercial |
$472.62
|
| Rate for Payer: Preferred Network Access Commercial |
$1,150.03
|
| Rate for Payer: Quartz Beloit One Network |
$532.65
|
| Rate for Payer: Quartz Commercial |
$690.02
|
| Rate for Payer: Quartz Medicare Advantage |
$315.08
|
| Rate for Payer: The Alliance Commercial |
$1,339.08
|
| Rate for Payer: United Healthcare Medicaid |
$137.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$315.08
|
| Rate for Payer: WEA Trust Commercial |
$665.81
|
| Rate for Payer: WPS Commercial |
$1,417.85
|
|
|
EXCISION OF TENDON, FINGER, FLEXOR OR EXTENSOR, EACH TENDON
|
Facility
|
OP
|
$6,807.99
|
|
|
Service Code
|
CPT 26180
|
|
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 Thrombosed Hemorrhoid, external 46320
|
Professional
|
Both
|
$699.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
1190850
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$103.83 |
| Max. Negotiated Rate |
$690.61 |
| Rate for Payer: Aetna Commercial |
$690.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$625.19
|
| Rate for Payer: Aetna Managed Medicare |
$103.83
|
| Rate for Payer: Anthem Medicare Advantage |
$103.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$103.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$103.83
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cigna Commercial |
$690.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$168.38
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$103.83
|
| Rate for Payer: Health EOS Commercial |
$661.53
|
| Rate for Payer: HFN Commercial |
$690.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$389.63
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$389.63
|
| Rate for Payer: Independent Care Health Plan Medicare |
$103.83
|
| Rate for Payer: Multiplan Commercial |
$581.57
|
| Rate for Payer: NAPHCARE Commercial |
$155.75
|
| Rate for Payer: Preferred Network Access Commercial |
$690.61
|
| Rate for Payer: Quartz Beloit One Network |
$319.86
|
| Rate for Payer: Quartz Commercial |
$414.37
|
| Rate for Payer: Quartz Medicare Advantage |
$103.83
|
| Rate for Payer: The Alliance Commercial |
$441.29
|
| Rate for Payer: United Healthcare Medicaid |
$168.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$103.83
|
| Rate for Payer: WEA Trust Commercial |
$399.83
|
| Rate for Payer: WPS Commercial |
$467.25
|
|
|
EXCISION OF TONGUE FOLD 41115
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
3014615
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.86 |
| Max. Negotiated Rate |
$583.60 |
| Rate for Payer: Aetna Commercial |
$335.92
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$304.10
|
| Rate for Payer: Aetna Managed Medicare |
$129.69
|
| Rate for Payer: Anthem Medicare Advantage |
$129.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$129.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$129.69
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cigna Commercial |
$335.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$108.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$129.69
|
| Rate for Payer: Health EOS Commercial |
$321.78
|
| Rate for Payer: HFN Commercial |
$335.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$507.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$507.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$129.69
|
| Rate for Payer: Multiplan Commercial |
$282.88
|
| Rate for Payer: NAPHCARE Commercial |
$194.53
|
| Rate for Payer: Preferred Network Access Commercial |
$335.92
|
| Rate for Payer: Quartz Beloit One Network |
$155.58
|
| Rate for Payer: Quartz Commercial |
$201.55
|
| Rate for Payer: Quartz Medicare Advantage |
$129.69
|
| Rate for Payer: The Alliance Commercial |
$551.17
|
| Rate for Payer: United Healthcare Medicaid |
$108.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.69
|
| Rate for Payer: WEA Trust Commercial |
$194.48
|
| Rate for Payer: WPS Commercial |
$583.60
|
|
|
EXCISION OF TONGUE LESION 41110
|
Professional
|
Both
|
$417.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
3014613
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$521.77 |
| Rate for Payer: Aetna Commercial |
$412.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$372.96
|
| Rate for Payer: Aetna Managed Medicare |
$115.95
|
| Rate for Payer: Anthem Medicare Advantage |
$115.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$115.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$115.95
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cigna Commercial |
$412.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$63.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$115.95
|
| Rate for Payer: Health EOS Commercial |
$394.65
|
| Rate for Payer: HFN Commercial |
$412.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$452.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$452.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$115.95
|
| Rate for Payer: Multiplan Commercial |
$346.94
|
| Rate for Payer: NAPHCARE Commercial |
$173.92
|
| Rate for Payer: Preferred Network Access Commercial |
$412.00
|
| Rate for Payer: Quartz Beloit One Network |
$190.82
|
| Rate for Payer: Quartz Commercial |
$247.20
|
| Rate for Payer: Quartz Medicare Advantage |
$115.95
|
| Rate for Payer: The Alliance Commercial |
$492.79
|
| Rate for Payer: United Healthcare Medicaid |
$63.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$115.95
|
| Rate for Payer: WEA Trust Commercial |
$238.52
|
| Rate for Payer: WPS Commercial |
$521.77
|
|
|
Excision Of Vaginal Cyst Or Tumor
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
1190838
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$161.17 |
| Max. Negotiated Rate |
$1,340.72 |
| Rate for Payer: Aetna Commercial |
$1,340.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,213.70
|
| Rate for Payer: Aetna Managed Medicare |
$161.17
|
| Rate for Payer: Anthem Medicare Advantage |
$161.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$161.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$161.17
|
| Rate for Payer: Cash Price |
$407.10
|
| Rate for Payer: Cash Price |
$407.10
|
| Rate for Payer: Cash Price |
$407.10
|
| Rate for Payer: Cigna Commercial |
$1,340.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$217.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$161.17
|
| Rate for Payer: Health EOS Commercial |
$1,284.26
|
| Rate for Payer: HFN Commercial |
$1,340.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$645.77
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$645.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$161.17
|
| Rate for Payer: Multiplan Commercial |
$1,129.02
|
| Rate for Payer: NAPHCARE Commercial |
$241.75
|
| Rate for Payer: Preferred Network Access Commercial |
$1,340.72
|
| Rate for Payer: Quartz Beloit One Network |
$620.96
|
| Rate for Payer: Quartz Commercial |
$804.43
|
| Rate for Payer: Quartz Medicare Advantage |
$161.17
|
| Rate for Payer: The Alliance Commercial |
$684.97
|
| Rate for Payer: United Healthcare Medicaid |
$217.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$161.17
|
| Rate for Payer: WEA Trust Commercial |
$776.20
|
| Rate for Payer: WPS Commercial |
$725.26
|
|
|
EXCISION OF VAGINAL CYST OR TUMOR
|
Facility
|
OP
|
$13,626.87
|
|
|
Service Code
|
CPT 57135
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,835.04 |
| Max. Negotiated Rate |
$13,626.87 |
| Rate for Payer: Aetna Managed Medicare |
$3,406.72
|
| 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 |
$3,406.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,406.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,406.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,406.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,406.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,672.99
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,406.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,406.72
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,406.72
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,406.72
|
| Rate for Payer: NAPHCARE Commercial |
$5,110.08
|
| Rate for Payer: Quartz Medicare Advantage |
$3,406.72
|
| Rate for Payer: The Alliance Commercial |
$13,626.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,406.72
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$3,406.72
|
|
|
EXCISION, OLECRANON BURSA
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 24105
|
|
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 ORAL LESION
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2960170
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.66 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$627.74
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
EXCISION ORAL LESION
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2960170
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$292.95 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Aetna Managed Medicare |
$292.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$680.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$523.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$502.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$585.49
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$784.68
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: NAPHCARE Commercial |
$627.74
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$680.06
|
| Rate for Payer: Quartz Medicare Advantage |
$627.74
|
| Rate for Payer: The Alliance Commercial |
$523.12
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
