|
Excision Lesion, Mouth Roof 42107
|
Professional
|
Both
|
$1,823.00
|
|
|
Service Code
|
CPT 42107
|
| Hospital Charge Code |
3990002
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$296.67 |
| Max. Negotiated Rate |
$1,801.12 |
| Rate for Payer: Aetna Commercial |
$1,801.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,630.49
|
| Rate for Payer: Aetna Managed Medicare |
$296.67
|
| Rate for Payer: Anthem Medicare Advantage |
$296.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$296.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$296.67
|
| Rate for Payer: Cash Price |
$546.90
|
| Rate for Payer: Cash Price |
$546.90
|
| Rate for Payer: Cash Price |
$546.90
|
| Rate for Payer: Cigna Commercial |
$1,801.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$910.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$296.67
|
| Rate for Payer: Health EOS Commercial |
$1,725.29
|
| Rate for Payer: HFN Commercial |
$1,801.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,177.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,177.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$296.67
|
| Rate for Payer: Multiplan Commercial |
$1,516.74
|
| Rate for Payer: NAPHCARE Commercial |
$445.01
|
| Rate for Payer: Preferred Network Access Commercial |
$1,801.12
|
| Rate for Payer: Quartz Beloit One Network |
$834.20
|
| Rate for Payer: Quartz Commercial |
$1,080.67
|
| Rate for Payer: Quartz Medicare Advantage |
$296.67
|
| Rate for Payer: The Alliance Commercial |
$1,260.85
|
| Rate for Payer: United Healthcare Medicaid |
$910.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$296.67
|
| Rate for Payer: WEA Trust Commercial |
$1,042.76
|
| Rate for Payer: WPS Commercial |
$1,335.02
|
|
|
EXCISION, LOOSE BODIES
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2960029
|
|
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
|
|
|
EXCISION, LOOSE BODIES
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2960029
|
|
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, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm
|
Facility
|
OP
|
$4,386.95
|
|
|
Service Code
|
CPT 11642
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$745.23 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Managed Medicare |
$745.23
|
| 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 |
$745.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$745.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$745.23
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$745.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$745.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,772.27
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$745.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$745.23
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$745.23
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$745.23
|
| Rate for Payer: NAPHCARE Commercial |
$1,117.85
|
| Rate for Payer: Quartz Medicare Advantage |
$745.23
|
| Rate for Payer: The Alliance Commercial |
$2,980.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$745.23
|
| Rate for Payer: United Healthcare PPO |
$2,347.28
|
| Rate for Payer: Wellcare Medicare |
$745.23
|
|
|
Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm
|
Facility
|
OP
|
$6,952.48
|
|
|
Service Code
|
CPT 11643
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,738.12 |
| Max. Negotiated Rate |
$6,952.48 |
| Rate for Payer: Aetna Managed Medicare |
$1,738.12
|
| 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 |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,738.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,738.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,738.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,465.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,738.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,738.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,738.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,738.12
|
| Rate for Payer: NAPHCARE Commercial |
$2,607.18
|
| Rate for Payer: Quartz Medicare Advantage |
$1,738.12
|
| Rate for Payer: The Alliance Commercial |
$6,952.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,738.12
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,738.12
|
|
|
Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm
|
Facility
|
OP
|
$12,227.57
|
|
|
Service Code
|
CPT 11646
|
|
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 |
$4,947.89
|
| 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, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less
|
Facility
|
OP
|
$6,952.48
|
|
|
Service Code
|
CPT 11620
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,738.12 |
| Max. Negotiated Rate |
$6,952.48 |
| Rate for Payer: Aetna Managed Medicare |
$1,738.12
|
| 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 |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,738.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,738.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,738.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,465.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,738.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,738.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,738.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,738.12
|
| Rate for Payer: NAPHCARE Commercial |
$2,607.18
|
| Rate for Payer: Quartz Medicare Advantage |
$1,738.12
|
| Rate for Payer: The Alliance Commercial |
$6,952.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,738.12
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,738.12
|
|
|
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm
|
Facility
|
OP
|
$6,952.48
|
|
|
Service Code
|
CPT 11623
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,738.12 |
| Max. Negotiated Rate |
$6,952.48 |
| Rate for Payer: Aetna Managed Medicare |
$1,738.12
|
| 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 |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,738.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,738.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,738.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,465.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,738.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,738.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,738.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,738.12
|
| Rate for Payer: NAPHCARE Commercial |
$2,607.18
|
| Rate for Payer: Quartz Medicare Advantage |
$1,738.12
|
| Rate for Payer: The Alliance Commercial |
$6,952.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,738.12
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,738.12
|
|
|
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm
|
Facility
|
OP
|
$12,227.57
|
|
|
Service Code
|
CPT 11626
|
|
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 |
$4,947.89
|
| 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, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm
|
Facility
|
OP
|
$6,952.48
|
|
|
Service Code
|
CPT 11606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,738.12 |
| Max. Negotiated Rate |
$6,952.48 |
| Rate for Payer: Aetna Managed Medicare |
$1,738.12
|
| 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 |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,738.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,738.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,738.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,465.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,738.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,738.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,738.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,738.12
|
| Rate for Payer: NAPHCARE Commercial |
$2,607.18
|
| Rate for Payer: Quartz Medicare Advantage |
$1,738.12
|
| Rate for Payer: The Alliance Commercial |
$6,952.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,738.12
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,738.12
|
|
|
EXCISION, MANDIBLE TUMOR
|
Facility
|
OP
|
$3,935.00
|
|
| Hospital Charge Code |
2960455
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,145.87 |
| Max. Negotiated Rate |
$3,765.01 |
| Rate for Payer: Aetna Commercial |
$3,683.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,519.46
|
| Rate for Payer: Aetna Managed Medicare |
$1,145.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,660.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,046.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,964.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,168.97
|
| Rate for Payer: Cash Price |
$1,180.50
|
| Rate for Payer: Cigna Commercial |
$3,765.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,290.17
|
| Rate for Payer: Health EOS Commercial |
$3,642.24
|
| Rate for Payer: HFN Commercial |
$3,765.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,069.30
|
| Rate for Payer: Multiplan Commercial |
$3,273.92
|
| Rate for Payer: NAPHCARE Commercial |
$2,455.44
|
| Rate for Payer: Preferred Network Access Commercial |
$3,765.01
|
| Rate for Payer: Quartz Beloit One Network |
$2,005.28
|
| Rate for Payer: Quartz Commercial |
$2,660.06
|
| Rate for Payer: Quartz Medicare Advantage |
$2,455.44
|
| Rate for Payer: The Alliance Commercial |
$2,046.20
|
| Rate for Payer: WEA Trust Commercial |
$2,250.82
|
| Rate for Payer: WPS Commercial |
$3,031.13
|
|
|
EXCISION, MANDIBLE TUMOR
|
Facility
|
IP
|
$3,935.00
|
|
| Hospital Charge Code |
2960455
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,005.28 |
| Max. Negotiated Rate |
$3,765.01 |
| Rate for Payer: Aetna Commercial |
$3,683.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,519.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,168.97
|
| Rate for Payer: Cash Price |
$1,180.50
|
| Rate for Payer: Cigna Commercial |
$3,765.01
|
| Rate for Payer: Health EOS Commercial |
$3,642.24
|
| Rate for Payer: HFN Commercial |
$3,765.01
|
| Rate for Payer: Multiplan Commercial |
$3,273.92
|
| Rate for Payer: Preferred Network Access Commercial |
$3,765.01
|
| Rate for Payer: Quartz Beloit One Network |
$2,005.28
|
| Rate for Payer: Quartz Commercial |
$2,455.44
|
| Rate for Payer: WEA Trust Commercial |
$2,250.82
|
| Rate for Payer: WPS Commercial |
$3,031.13
|
|
|
EXCISION OF ANAL LESION(S) 46922
|
Professional
|
Both
|
$971.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
3014848
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.34 |
| Max. Negotiated Rate |
$959.35 |
| Rate for Payer: Aetna Commercial |
$959.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$868.46
|
| Rate for Payer: Aetna Managed Medicare |
$128.37
|
| Rate for Payer: Anthem Medicare Advantage |
$128.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$128.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$128.37
|
| Rate for Payer: Cash Price |
$291.30
|
| Rate for Payer: Cash Price |
$291.30
|
| Rate for Payer: Cash Price |
$291.30
|
| Rate for Payer: Cigna Commercial |
$959.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$78.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$128.37
|
| Rate for Payer: Health EOS Commercial |
$918.95
|
| Rate for Payer: HFN Commercial |
$959.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$469.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$469.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$128.37
|
| Rate for Payer: Multiplan Commercial |
$807.87
|
| Rate for Payer: NAPHCARE Commercial |
$192.55
|
| Rate for Payer: Preferred Network Access Commercial |
$959.35
|
| Rate for Payer: Quartz Beloit One Network |
$444.33
|
| Rate for Payer: Quartz Commercial |
$575.61
|
| Rate for Payer: Quartz Medicare Advantage |
$128.37
|
| Rate for Payer: The Alliance Commercial |
$545.56
|
| Rate for Payer: United Healthcare Medicaid |
$78.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$128.37
|
| Rate for Payer: WEA Trust Commercial |
$555.41
|
| Rate for Payer: WPS Commercial |
$577.65
|
|
|
EXCISION OF BARTHOLIN'S GLAND OR CYST
|
Facility
|
OP
|
$13,626.87
|
|
|
Service Code
|
CPT 56740
|
|
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 |
$6,807.99
|
| 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 of benign lesion 0.6-1.0cm 41899 -11441
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
5313634
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$297.44 |
| Max. Negotiated Rate |
$642.20 |
| Rate for Payer: Aetna Commercial |
$642.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$581.36
|
| Rate for Payer: Cash Price |
$195.00
|
| Rate for Payer: Cash Price |
$195.00
|
| Rate for Payer: Cigna Commercial |
$642.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$338.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$405.60
|
| Rate for Payer: Health EOS Commercial |
$615.16
|
| Rate for Payer: HFN Commercial |
$642.20
|
| Rate for Payer: Multiplan Commercial |
$540.80
|
| Rate for Payer: Preferred Network Access Commercial |
$642.20
|
| Rate for Payer: Quartz Beloit One Network |
$297.44
|
| Rate for Payer: Quartz Commercial |
$385.32
|
| Rate for Payer: The Alliance Commercial |
$338.00
|
| Rate for Payer: WEA Trust Commercial |
$371.80
|
| Rate for Payer: WPS Commercial |
$500.69
|
|
|
Excision of benign lesion (face, ears, eyelids, nose, lips, mucous membrane) <=0.5cm 11440
|
Professional
|
Both
|
$442.00
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
1188921
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$84.51 |
| Max. Negotiated Rate |
$436.70 |
| Rate for Payer: Aetna Commercial |
$436.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$395.32
|
| Rate for Payer: Aetna Managed Medicare |
$96.51
|
| Rate for Payer: Anthem Medicare Advantage |
$96.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$96.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$96.51
|
| Rate for Payer: Cash Price |
$132.60
|
| Rate for Payer: Cash Price |
$132.60
|
| Rate for Payer: Cash Price |
$132.60
|
| Rate for Payer: Cigna Commercial |
$436.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$84.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$96.51
|
| Rate for Payer: Health EOS Commercial |
$418.31
|
| Rate for Payer: HFN Commercial |
$436.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$364.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$364.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$96.51
|
| Rate for Payer: Multiplan Commercial |
$367.74
|
| Rate for Payer: NAPHCARE Commercial |
$144.77
|
| Rate for Payer: Preferred Network Access Commercial |
$436.70
|
| Rate for Payer: Quartz Beloit One Network |
$202.26
|
| Rate for Payer: Quartz Commercial |
$262.02
|
| Rate for Payer: Quartz Medicare Advantage |
$96.51
|
| Rate for Payer: The Alliance Commercial |
$410.18
|
| Rate for Payer: United Healthcare Medicaid |
$84.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$96.51
|
| Rate for Payer: WEA Trust Commercial |
$252.82
|
| Rate for Payer: WPS Commercial |
$434.30
|
|
|
Excision of benign lesion (face, ears, eyelids, nose, lips, mucous membrane) 0.6-1.0cm 11441
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
1188922
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$117.69 |
| Max. Negotiated Rate |
$643.19 |
| Rate for Payer: Aetna Commercial |
$643.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$582.25
|
| Rate for Payer: Aetna Managed Medicare |
$117.69
|
| Rate for Payer: Anthem Medicare Advantage |
$117.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$117.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$117.69
|
| Rate for Payer: Cash Price |
$195.30
|
| Rate for Payer: Cash Price |
$195.30
|
| Rate for Payer: Cash Price |
$195.30
|
| Rate for Payer: Cigna Commercial |
$643.19
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$119.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$117.69
|
| Rate for Payer: Health EOS Commercial |
$616.11
|
| Rate for Payer: HFN Commercial |
$643.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$456.59
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$456.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$117.69
|
| Rate for Payer: Multiplan Commercial |
$541.63
|
| Rate for Payer: NAPHCARE Commercial |
$176.53
|
| Rate for Payer: Preferred Network Access Commercial |
$643.19
|
| Rate for Payer: Quartz Beloit One Network |
$297.90
|
| Rate for Payer: Quartz Commercial |
$385.91
|
| Rate for Payer: Quartz Medicare Advantage |
$117.69
|
| Rate for Payer: The Alliance Commercial |
$500.17
|
| Rate for Payer: United Healthcare Medicaid |
$119.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$117.69
|
| Rate for Payer: WEA Trust Commercial |
$372.37
|
| Rate for Payer: WPS Commercial |
$529.59
|
|
|
Excision of benign lesion (face, ears, eyelids, nose, lips, mucous membranes) 1.1-2.0cm 11442
|
Professional
|
Both
|
$551.00
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
3013547
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$129.00 |
| Max. Negotiated Rate |
$580.51 |
| Rate for Payer: Aetna Commercial |
$544.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$492.81
|
| Rate for Payer: Aetna Managed Medicare |
$129.00
|
| Rate for Payer: Anthem Medicare Advantage |
$129.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$129.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$129.00
|
| Rate for Payer: Cash Price |
$165.30
|
| Rate for Payer: Cash Price |
$165.30
|
| Rate for Payer: Cash Price |
$165.30
|
| Rate for Payer: Cigna Commercial |
$544.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$157.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$129.00
|
| Rate for Payer: Health EOS Commercial |
$521.47
|
| Rate for Payer: HFN Commercial |
$544.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$503.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$503.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$458.43
|
| Rate for Payer: NAPHCARE Commercial |
$193.50
|
| Rate for Payer: Preferred Network Access Commercial |
$544.39
|
| Rate for Payer: Quartz Beloit One Network |
$252.14
|
| Rate for Payer: Quartz Commercial |
$326.63
|
| Rate for Payer: Quartz Medicare Advantage |
$129.00
|
| Rate for Payer: The Alliance Commercial |
$548.26
|
| Rate for Payer: United Healthcare Medicaid |
$157.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.00
|
| Rate for Payer: WEA Trust Commercial |
$315.17
|
| Rate for Payer: WPS Commercial |
$580.51
|
|
|
Excision of benign lesion (face, ears, eyelids, nose, lips, mucous membranes) 2.1-3.0cm 11443
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
3013548
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$155.29 |
| 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 |
$155.29
|
| Rate for Payer: Anthem Medicare Advantage |
$155.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$155.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$155.29
|
| 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 |
$235.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$155.29
|
| 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 |
$615.99
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$615.99
|
| Rate for Payer: Independent Care Health Plan Medicare |
$155.29
|
| Rate for Payer: Multiplan Commercial |
$1,003.39
|
| Rate for Payer: NAPHCARE Commercial |
$232.94
|
| 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 |
$155.29
|
| Rate for Payer: The Alliance Commercial |
$659.99
|
| Rate for Payer: United Healthcare Medicaid |
$235.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$155.29
|
| Rate for Payer: WEA Trust Commercial |
$689.83
|
| Rate for Payer: WPS Commercial |
$698.82
|
|
|
Excision of benign lesion (face, ears, eyelids, nose, lips, mucous membranes) 3.1-4.0cm 11444
|
Professional
|
Both
|
$1,585.00
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
3013549
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$194.17 |
| Max. Negotiated Rate |
$1,565.98 |
| Rate for Payer: Aetna Commercial |
$1,565.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,417.62
|
| Rate for Payer: Aetna Managed Medicare |
$194.17
|
| Rate for Payer: Anthem Medicare Advantage |
$194.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$194.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$194.17
|
| Rate for Payer: Cash Price |
$475.50
|
| Rate for Payer: Cash Price |
$475.50
|
| Rate for Payer: Cash Price |
$475.50
|
| Rate for Payer: Cigna Commercial |
$1,565.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$344.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$194.17
|
| Rate for Payer: Health EOS Commercial |
$1,500.04
|
| Rate for Payer: HFN Commercial |
$1,565.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$780.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$780.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$194.17
|
| Rate for Payer: Multiplan Commercial |
$1,318.72
|
| Rate for Payer: NAPHCARE Commercial |
$291.25
|
| Rate for Payer: Preferred Network Access Commercial |
$1,565.98
|
| Rate for Payer: Quartz Beloit One Network |
$725.30
|
| Rate for Payer: Quartz Commercial |
$939.59
|
| Rate for Payer: Quartz Medicare Advantage |
$194.17
|
| Rate for Payer: The Alliance Commercial |
$825.21
|
| Rate for Payer: United Healthcare Medicaid |
$344.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$194.17
|
| Rate for Payer: WEA Trust Commercial |
$906.62
|
| Rate for Payer: WPS Commercial |
$873.76
|
|
|
Excision of benign lesion (face, ears, eyelids, nose, lips, mucous membranes) >4.0cm 11446
|
Professional
|
Both
|
$2,269.00
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
3013550
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$273.01 |
| Max. Negotiated Rate |
$2,241.77 |
| Rate for Payer: Aetna Commercial |
$2,241.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,029.39
|
| Rate for Payer: Aetna Managed Medicare |
$273.01
|
| Rate for Payer: Anthem Medicare Advantage |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$273.01
|
| Rate for Payer: Cash Price |
$680.70
|
| Rate for Payer: Cash Price |
$680.70
|
| Rate for Payer: Cash Price |
$680.70
|
| Rate for Payer: Cigna Commercial |
$2,241.77
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$327.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$273.01
|
| Rate for Payer: Health EOS Commercial |
$2,147.38
|
| Rate for Payer: HFN Commercial |
$2,241.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,111.71
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,111.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$273.01
|
| Rate for Payer: Multiplan Commercial |
$1,887.81
|
| Rate for Payer: NAPHCARE Commercial |
$409.52
|
| Rate for Payer: Preferred Network Access Commercial |
$2,241.77
|
| Rate for Payer: Quartz Beloit One Network |
$1,038.29
|
| Rate for Payer: Quartz Commercial |
$1,345.06
|
| Rate for Payer: Quartz Medicare Advantage |
$273.01
|
| Rate for Payer: The Alliance Commercial |
$1,160.29
|
| Rate for Payer: United Healthcare Medicaid |
$327.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$273.01
|
| Rate for Payer: WEA Trust Commercial |
$1,297.87
|
| Rate for Payer: WPS Commercial |
$1,228.55
|
|
|
Excision of benign lesion (scalp, neck, hands, feet, genitalia) <=0.5cm 11420
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
3013541
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$71.71 |
| Max. Negotiated Rate |
$395.20 |
| Rate for Payer: Aetna Commercial |
$395.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$357.76
|
| Rate for Payer: Aetna Managed Medicare |
$74.85
|
| Rate for Payer: Anthem Medicare Advantage |
$74.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$74.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$74.85
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna Commercial |
$395.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$71.71
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$74.85
|
| Rate for Payer: Health EOS Commercial |
$378.56
|
| Rate for Payer: HFN Commercial |
$395.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$286.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$286.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$74.85
|
| Rate for Payer: Multiplan Commercial |
$332.80
|
| Rate for Payer: NAPHCARE Commercial |
$112.27
|
| Rate for Payer: Preferred Network Access Commercial |
$395.20
|
| Rate for Payer: Quartz Beloit One Network |
$183.04
|
| Rate for Payer: Quartz Commercial |
$237.12
|
| Rate for Payer: Quartz Medicare Advantage |
$74.85
|
| Rate for Payer: The Alliance Commercial |
$318.11
|
| Rate for Payer: United Healthcare Medicaid |
$71.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$74.85
|
| Rate for Payer: WEA Trust Commercial |
$228.80
|
| Rate for Payer: WPS Commercial |
$336.82
|
|
|
Excision of benign lesion (scalp, neck, hands, feet, genitalia) 0.6-1.0cm 11421
|
Professional
|
Both
|
$566.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
3013542
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$95.13 |
| Max. Negotiated Rate |
$559.21 |
| Rate for Payer: Aetna Commercial |
$559.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$506.23
|
| Rate for Payer: Aetna Managed Medicare |
$96.75
|
| Rate for Payer: Anthem Medicare Advantage |
$96.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$96.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$96.75
|
| Rate for Payer: Cash Price |
$169.80
|
| Rate for Payer: Cash Price |
$169.80
|
| Rate for Payer: Cash Price |
$169.80
|
| Rate for Payer: Cigna Commercial |
$559.21
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$95.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$96.75
|
| Rate for Payer: Health EOS Commercial |
$535.66
|
| Rate for Payer: HFN Commercial |
$559.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$380.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$380.19
|
| Rate for Payer: Independent Care Health Plan Medicare |
$96.75
|
| Rate for Payer: Multiplan Commercial |
$470.91
|
| Rate for Payer: NAPHCARE Commercial |
$145.13
|
| Rate for Payer: Preferred Network Access Commercial |
$559.21
|
| Rate for Payer: Quartz Beloit One Network |
$259.00
|
| Rate for Payer: Quartz Commercial |
$335.52
|
| Rate for Payer: Quartz Medicare Advantage |
$96.75
|
| Rate for Payer: The Alliance Commercial |
$411.19
|
| Rate for Payer: United Healthcare Medicaid |
$95.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$96.75
|
| Rate for Payer: WEA Trust Commercial |
$323.75
|
| Rate for Payer: WPS Commercial |
$435.38
|
|
|
Excision of benign lesion (scalp, neck, hands, feet, genitalia) 1.1-2.0cm 11422
|
Professional
|
Both
|
$641.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
3013543
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$121.44 |
| Max. Negotiated Rate |
$633.31 |
| Rate for Payer: Aetna Commercial |
$633.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$573.31
|
| Rate for Payer: Aetna Managed Medicare |
$121.44
|
| Rate for Payer: Anthem Medicare Advantage |
$121.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$121.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$121.44
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cash Price |
$192.30
|
| Rate for Payer: Cigna Commercial |
$633.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$146.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$121.44
|
| Rate for Payer: Health EOS Commercial |
$606.64
|
| Rate for Payer: HFN Commercial |
$633.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$469.33
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$469.33
|
| Rate for Payer: Independent Care Health Plan Medicare |
$121.44
|
| Rate for Payer: Multiplan Commercial |
$533.31
|
| Rate for Payer: NAPHCARE Commercial |
$182.16
|
| Rate for Payer: Preferred Network Access Commercial |
$633.31
|
| Rate for Payer: Quartz Beloit One Network |
$293.32
|
| Rate for Payer: Quartz Commercial |
$379.98
|
| Rate for Payer: Quartz Medicare Advantage |
$121.44
|
| Rate for Payer: The Alliance Commercial |
$516.12
|
| Rate for Payer: United Healthcare Medicaid |
$146.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$121.44
|
| Rate for Payer: WEA Trust Commercial |
$366.65
|
| Rate for Payer: WPS Commercial |
$546.48
|
|
|
Excision of benign lesion (scalp, neck, hands, feet, genitalia) 2.1-3.0cm 11423
|
Professional
|
Both
|
$766.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
3013544
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$139.93 |
| 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 |
$139.93
|
| Rate for Payer: Anthem Medicare Advantage |
$139.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$139.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$139.93
|
| 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 |
$170.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$139.93
|
| Rate for Payer: Health EOS Commercial |
$724.94
|
| Rate for Payer: HFN Commercial |
$756.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$538.38
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$538.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$139.93
|
| Rate for Payer: Multiplan Commercial |
$637.31
|
| Rate for Payer: NAPHCARE Commercial |
$209.90
|
| 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 |
$139.93
|
| Rate for Payer: The Alliance Commercial |
$594.71
|
| Rate for Payer: United Healthcare Medicaid |
$170.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$139.93
|
| Rate for Payer: WEA Trust Commercial |
$438.15
|
| Rate for Payer: WPS Commercial |
$629.69
|
|
