|
Flow Cytometry CD5+
|
Facility
|
IP
|
$545.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
2800799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$267.05 |
| Max. Negotiated Rate |
$501.40 |
| Rate for Payer: Aetna Commercial |
$490.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$468.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$288.85
|
| Rate for Payer: Cash Price |
$163.50
|
| Rate for Payer: Cigna Commercial |
$501.40
|
| Rate for Payer: Health EOS Commercial |
$485.05
|
| Rate for Payer: HFN Commercial |
$501.40
|
| Rate for Payer: Multiplan Commercial |
$436.00
|
| Rate for Payer: NAPHCARE Commercial |
$327.00
|
| Rate for Payer: Preferred Network Access Commercial |
$501.40
|
| Rate for Payer: Quartz Beloit One Network |
$267.05
|
| Rate for Payer: Quartz Commercial |
$327.00
|
| Rate for Payer: WEA Trust Commercial |
$299.75
|
| Rate for Payer: WPS Commercial |
$403.68
|
|
|
Flow Cytometry CD5+
|
Professional
|
Both
|
$545.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
2800799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$230.47 |
| Max. Negotiated Rate |
$517.75 |
| Rate for Payer: Aetna Commercial |
$517.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$468.70
|
| Rate for Payer: Cash Price |
$163.50
|
| Rate for Payer: Cash Price |
$163.50
|
| Rate for Payer: Cigna Commercial |
$517.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$272.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$327.00
|
| Rate for Payer: Health EOS Commercial |
$495.95
|
| Rate for Payer: HFN Commercial |
$517.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$230.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$230.47
|
| Rate for Payer: Multiplan Commercial |
$436.00
|
| Rate for Payer: Preferred Network Access Commercial |
$517.75
|
| Rate for Payer: Quartz Beloit One Network |
$239.80
|
| Rate for Payer: Quartz Commercial |
$310.65
|
| Rate for Payer: The Alliance Commercial |
$272.50
|
| Rate for Payer: WEA Trust Commercial |
$299.75
|
| Rate for Payer: WPS Commercial |
$403.68
|
|
|
Flow Cytometry, DNA Analysis
|
Facility
|
IP
|
$716.00
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
2802801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$350.84 |
| Max. Negotiated Rate |
$658.72 |
| Rate for Payer: Aetna Commercial |
$644.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$615.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$379.48
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cigna Commercial |
$658.72
|
| Rate for Payer: Health EOS Commercial |
$637.24
|
| Rate for Payer: HFN Commercial |
$658.72
|
| Rate for Payer: Multiplan Commercial |
$572.80
|
| Rate for Payer: NAPHCARE Commercial |
$429.60
|
| Rate for Payer: Preferred Network Access Commercial |
$658.72
|
| Rate for Payer: Quartz Beloit One Network |
$350.84
|
| Rate for Payer: Quartz Commercial |
$429.60
|
| Rate for Payer: WEA Trust Commercial |
$393.80
|
| Rate for Payer: WPS Commercial |
$530.34
|
|
|
Flow Cytometry, DNA Analysis
|
Facility
|
OP
|
$716.00
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
2802801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.56 |
| Max. Negotiated Rate |
$658.72 |
| Rate for Payer: Aetna Commercial |
$644.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$615.76
|
| Rate for Payer: Aetna Managed Medicare |
$53.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$200.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$93.73
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$88.91
|
| Rate for Payer: Anthem Medicare Advantage |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$379.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$53.56
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cigna Commercial |
$658.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$53.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$400.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$53.56
|
| Rate for Payer: Health EOS Commercial |
$637.24
|
| Rate for Payer: HFN Commercial |
$658.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$199.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$53.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$53.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$53.56
|
| Rate for Payer: Multiplan Commercial |
$572.80
|
| Rate for Payer: NAPHCARE Commercial |
$80.34
|
| Rate for Payer: Preferred Network Access Commercial |
$658.72
|
| Rate for Payer: Quartz Beloit One Network |
$350.84
|
| Rate for Payer: Quartz Commercial |
$465.40
|
| Rate for Payer: Quartz Medicare Advantage |
$53.56
|
| Rate for Payer: The Alliance Commercial |
$214.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.56
|
| Rate for Payer: United Healthcare PPO |
$537.00
|
| Rate for Payer: WEA Trust Commercial |
$393.80
|
| Rate for Payer: Wellcare Medicare |
$53.56
|
| Rate for Payer: WPS Commercial |
$530.34
|
|
|
Flow Cytometry, DNA Analysis
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
2802801
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.30 |
| Max. Negotiated Rate |
$680.20 |
| Rate for Payer: Aetna Commercial |
$680.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$615.76
|
| Rate for Payer: Anthem Commercial |
$33.30
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cigna Commercial |
$680.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$358.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$429.60
|
| Rate for Payer: Health EOS Commercial |
$651.56
|
| Rate for Payer: HFN Commercial |
$680.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$469.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$469.10
|
| Rate for Payer: Multiplan Commercial |
$572.80
|
| Rate for Payer: Preferred Network Access Commercial |
$680.20
|
| Rate for Payer: Quartz Beloit One Network |
$315.04
|
| Rate for Payer: Quartz Commercial |
$408.12
|
| Rate for Payer: The Alliance Commercial |
$358.00
|
| Rate for Payer: WEA Trust Commercial |
$393.80
|
| Rate for Payer: WPS Commercial |
$530.34
|
|
|
Flow Cytometry - Ea. Addtnl Marker
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
2956820
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.63 |
| Max. Negotiated Rate |
$80.04 |
| Rate for Payer: Aetna Commercial |
$78.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.11
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna Commercial |
$80.04
|
| Rate for Payer: Health EOS Commercial |
$77.43
|
| Rate for Payer: HFN Commercial |
$80.04
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: NAPHCARE Commercial |
$52.20
|
| Rate for Payer: Preferred Network Access Commercial |
$80.04
|
| Rate for Payer: Quartz Beloit One Network |
$42.63
|
| Rate for Payer: Quartz Commercial |
$52.20
|
| Rate for Payer: WEA Trust Commercial |
$47.85
|
| Rate for Payer: WPS Commercial |
$64.44
|
|
|
Flow Cytometry - Ea. Addtnl Marker
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
2956820
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.36 |
| Max. Negotiated Rate |
$348.00 |
| Rate for Payer: Aetna Commercial |
$78.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.82
|
| Rate for Payer: Aetna Managed Medicare |
$24.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$56.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.11
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna Commercial |
$80.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.69
|
| Rate for Payer: Health EOS Commercial |
$77.43
|
| Rate for Payer: HFN Commercial |
$80.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.25
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: NAPHCARE Commercial |
$52.20
|
| Rate for Payer: Preferred Network Access Commercial |
$80.04
|
| Rate for Payer: Quartz Beloit One Network |
$42.63
|
| Rate for Payer: Quartz Commercial |
$56.55
|
| Rate for Payer: Quartz Medicare Advantage |
$52.20
|
| Rate for Payer: The Alliance Commercial |
$348.00
|
| Rate for Payer: United Healthcare PPO |
$65.25
|
| Rate for Payer: WEA Trust Commercial |
$47.85
|
| Rate for Payer: WPS Commercial |
$64.44
|
|
|
Flow Cytometry - Ea. Addtnl Marker
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
2956820
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.28 |
| Max. Negotiated Rate |
$82.65 |
| Rate for Payer: Aetna Commercial |
$82.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.82
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna Commercial |
$82.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$52.20
|
| Rate for Payer: Health EOS Commercial |
$79.17
|
| Rate for Payer: HFN Commercial |
$82.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$76.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$76.57
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: Preferred Network Access Commercial |
$82.65
|
| Rate for Payer: Quartz Beloit One Network |
$38.28
|
| Rate for Payer: Quartz Commercial |
$49.59
|
| Rate for Payer: The Alliance Commercial |
$43.50
|
| Rate for Payer: WEA Trust Commercial |
$47.85
|
| Rate for Payer: WPS Commercial |
$64.44
|
|
|
Flow Cytometry - First Marker
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
2956818
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.63 |
| Max. Negotiated Rate |
$80.04 |
| Rate for Payer: Aetna Commercial |
$78.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.11
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna Commercial |
$80.04
|
| Rate for Payer: Health EOS Commercial |
$77.43
|
| Rate for Payer: HFN Commercial |
$80.04
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: NAPHCARE Commercial |
$52.20
|
| Rate for Payer: Preferred Network Access Commercial |
$80.04
|
| Rate for Payer: Quartz Beloit One Network |
$42.63
|
| Rate for Payer: Quartz Commercial |
$52.20
|
| Rate for Payer: WEA Trust Commercial |
$47.85
|
| Rate for Payer: WPS Commercial |
$64.44
|
|
|
Flow Cytometry - First Marker
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
2956818
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.28 |
| Max. Negotiated Rate |
$230.47 |
| Rate for Payer: Aetna Commercial |
$82.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.82
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna Commercial |
$82.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$52.20
|
| Rate for Payer: Health EOS Commercial |
$79.17
|
| Rate for Payer: HFN Commercial |
$82.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$230.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$230.47
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: Preferred Network Access Commercial |
$82.65
|
| Rate for Payer: Quartz Beloit One Network |
$38.28
|
| Rate for Payer: Quartz Commercial |
$49.59
|
| Rate for Payer: The Alliance Commercial |
$43.50
|
| Rate for Payer: WEA Trust Commercial |
$47.85
|
| Rate for Payer: WPS Commercial |
$64.44
|
|
|
Flow Cytometry - First Marker
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
2956818
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.63 |
| Max. Negotiated Rate |
$1,421.12 |
| Rate for Payer: Aetna Commercial |
$78.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$74.82
|
| Rate for Payer: Aetna Managed Medicare |
$355.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,332.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$621.74
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$589.76
|
| Rate for Payer: Anthem Medicare Advantage |
$355.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$355.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$355.28
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna Commercial |
$80.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$355.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.69
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$355.28
|
| Rate for Payer: Health EOS Commercial |
$77.43
|
| Rate for Payer: HFN Commercial |
$80.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,321.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$355.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$355.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$355.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$355.28
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: NAPHCARE Commercial |
$532.92
|
| Rate for Payer: Preferred Network Access Commercial |
$80.04
|
| Rate for Payer: Quartz Beloit One Network |
$42.63
|
| Rate for Payer: Quartz Commercial |
$56.55
|
| Rate for Payer: Quartz Medicare Advantage |
$355.28
|
| Rate for Payer: The Alliance Commercial |
$1,421.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$355.28
|
| Rate for Payer: United Healthcare PPO |
$65.25
|
| Rate for Payer: WEA Trust Commercial |
$47.85
|
| Rate for Payer: Wellcare Medicare |
$355.28
|
| Rate for Payer: WPS Commercial |
$64.44
|
|
|
Flow Cytometry Interp
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 88187
|
| Hospital Charge Code |
2956819
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$392.00 |
| Rate for Payer: Aetna Commercial |
$88.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$84.28
|
| Rate for Payer: Aetna Managed Medicare |
$27.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$63.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$49.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$47.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$51.94
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cigna Commercial |
$90.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$54.84
|
| Rate for Payer: Health EOS Commercial |
$87.22
|
| Rate for Payer: HFN Commercial |
$90.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: NAPHCARE Commercial |
$58.80
|
| Rate for Payer: Preferred Network Access Commercial |
$90.16
|
| Rate for Payer: Quartz Beloit One Network |
$48.02
|
| Rate for Payer: Quartz Commercial |
$63.70
|
| Rate for Payer: Quartz Medicare Advantage |
$58.80
|
| Rate for Payer: The Alliance Commercial |
$392.00
|
| Rate for Payer: United Healthcare PPO |
$73.50
|
| Rate for Payer: WEA Trust Commercial |
$53.90
|
| Rate for Payer: WPS Commercial |
$72.59
|
|
|
Flow Cytometry Interp
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
CPT 88187
|
| Hospital Charge Code |
2956819
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.12 |
| Max. Negotiated Rate |
$123.94 |
| Rate for Payer: Aetna Commercial |
$93.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$84.28
|
| Rate for Payer: Anthem Commercial |
$68.28
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cigna Commercial |
$93.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$49.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$58.80
|
| Rate for Payer: Health EOS Commercial |
$89.18
|
| Rate for Payer: HFN Commercial |
$93.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$123.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$123.94
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Preferred Network Access Commercial |
$93.10
|
| Rate for Payer: Quartz Beloit One Network |
$43.12
|
| Rate for Payer: Quartz Commercial |
$55.86
|
| Rate for Payer: The Alliance Commercial |
$49.00
|
| Rate for Payer: WEA Trust Commercial |
$53.90
|
| Rate for Payer: WPS Commercial |
$72.59
|
|
|
Flow Cytometry Interp
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 88187
|
| Hospital Charge Code |
2956819
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.02 |
| Max. Negotiated Rate |
$90.16 |
| Rate for Payer: Aetna Commercial |
$88.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$84.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$51.94
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cigna Commercial |
$90.16
|
| Rate for Payer: Health EOS Commercial |
$87.22
|
| Rate for Payer: HFN Commercial |
$90.16
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: NAPHCARE Commercial |
$58.80
|
| Rate for Payer: Preferred Network Access Commercial |
$90.16
|
| Rate for Payer: Quartz Beloit One Network |
$48.02
|
| Rate for Payer: Quartz Commercial |
$58.80
|
| Rate for Payer: WEA Trust Commercial |
$53.90
|
| Rate for Payer: WPS Commercial |
$72.59
|
|
|
Flow Cytometry Interp 28 Markers
|
Professional
|
Both
|
$953.00
|
|
|
Service Code
|
CPT 88187
|
| Hospital Charge Code |
2800805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$68.28 |
| Max. Negotiated Rate |
$905.35 |
| Rate for Payer: Aetna Commercial |
$905.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$819.58
|
| Rate for Payer: Anthem Commercial |
$68.28
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cigna Commercial |
$905.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$476.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$571.80
|
| Rate for Payer: Health EOS Commercial |
$867.23
|
| Rate for Payer: HFN Commercial |
$905.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$123.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$123.94
|
| Rate for Payer: Multiplan Commercial |
$762.40
|
| Rate for Payer: Preferred Network Access Commercial |
$905.35
|
| Rate for Payer: Quartz Beloit One Network |
$419.32
|
| Rate for Payer: Quartz Commercial |
$543.21
|
| Rate for Payer: The Alliance Commercial |
$476.50
|
| Rate for Payer: WEA Trust Commercial |
$524.15
|
| Rate for Payer: WPS Commercial |
$705.89
|
|
|
Flow Cytometry Interp 28 Markers
|
Facility
|
IP
|
$953.00
|
|
|
Service Code
|
CPT 88187
|
| Hospital Charge Code |
2800805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$466.97 |
| Max. Negotiated Rate |
$876.76 |
| Rate for Payer: Aetna Commercial |
$857.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$819.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$505.09
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cigna Commercial |
$876.76
|
| Rate for Payer: Health EOS Commercial |
$848.17
|
| Rate for Payer: HFN Commercial |
$876.76
|
| Rate for Payer: Multiplan Commercial |
$762.40
|
| Rate for Payer: NAPHCARE Commercial |
$571.80
|
| Rate for Payer: Preferred Network Access Commercial |
$876.76
|
| Rate for Payer: Quartz Beloit One Network |
$466.97
|
| Rate for Payer: Quartz Commercial |
$571.80
|
| Rate for Payer: WEA Trust Commercial |
$524.15
|
| Rate for Payer: WPS Commercial |
$705.89
|
|
|
Flow Cytometry Interp 28 Markers
|
Facility
|
OP
|
$953.00
|
|
|
Service Code
|
CPT 88187
|
| Hospital Charge Code |
2800805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$266.84 |
| Max. Negotiated Rate |
$3,812.00 |
| Rate for Payer: Aetna Commercial |
$857.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$819.58
|
| Rate for Payer: Aetna Managed Medicare |
$266.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$619.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$476.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$457.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$505.09
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cigna Commercial |
$876.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$533.30
|
| Rate for Payer: Health EOS Commercial |
$848.17
|
| Rate for Payer: HFN Commercial |
$876.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$714.75
|
| Rate for Payer: Multiplan Commercial |
$762.40
|
| Rate for Payer: NAPHCARE Commercial |
$571.80
|
| Rate for Payer: Preferred Network Access Commercial |
$876.76
|
| Rate for Payer: Quartz Beloit One Network |
$466.97
|
| Rate for Payer: Quartz Commercial |
$619.45
|
| Rate for Payer: Quartz Medicare Advantage |
$571.80
|
| Rate for Payer: The Alliance Commercial |
$3,812.00
|
| Rate for Payer: United Healthcare PPO |
$714.75
|
| Rate for Payer: WEA Trust Commercial |
$524.15
|
| Rate for Payer: WPS Commercial |
$705.89
|
|
|
Flow Cytometry, Interp & Report
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 88189
|
| Hospital Charge Code |
2802802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.52 |
| Max. Negotiated Rate |
$336.00 |
| Rate for Payer: Aetna Commercial |
$75.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$72.24
|
| Rate for Payer: Aetna Managed Medicare |
$23.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$54.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$42.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$40.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$44.52
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$77.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$47.01
|
| Rate for Payer: Health EOS Commercial |
$74.76
|
| Rate for Payer: HFN Commercial |
$77.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: NAPHCARE Commercial |
$50.40
|
| Rate for Payer: Preferred Network Access Commercial |
$77.28
|
| Rate for Payer: Quartz Beloit One Network |
$41.16
|
| Rate for Payer: Quartz Commercial |
$54.60
|
| Rate for Payer: Quartz Medicare Advantage |
$50.40
|
| Rate for Payer: The Alliance Commercial |
$336.00
|
| Rate for Payer: United Healthcare PPO |
$63.00
|
| Rate for Payer: WEA Trust Commercial |
$46.20
|
| Rate for Payer: WPS Commercial |
$62.22
|
|
|
Flow Cytometry, Interp & Report
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 88189
|
| Hospital Charge Code |
2802802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$41.16 |
| Max. Negotiated Rate |
$77.28 |
| Rate for Payer: Aetna Commercial |
$75.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$72.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$44.52
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$77.28
|
| Rate for Payer: Health EOS Commercial |
$74.76
|
| Rate for Payer: HFN Commercial |
$77.28
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: NAPHCARE Commercial |
$50.40
|
| Rate for Payer: Preferred Network Access Commercial |
$77.28
|
| Rate for Payer: Quartz Beloit One Network |
$41.16
|
| Rate for Payer: Quartz Commercial |
$50.40
|
| Rate for Payer: WEA Trust Commercial |
$46.20
|
| Rate for Payer: WPS Commercial |
$62.22
|
|
|
Flow Cytometry, Interp & Report
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
CPT 88189
|
| Hospital Charge Code |
2802802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.96 |
| Max. Negotiated Rate |
$288.08 |
| Rate for Payer: Aetna Commercial |
$79.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$72.24
|
| Rate for Payer: Anthem Commercial |
$112.18
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna Commercial |
$79.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$42.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$50.40
|
| Rate for Payer: Health EOS Commercial |
$76.44
|
| Rate for Payer: HFN Commercial |
$79.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$288.08
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$288.08
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: Preferred Network Access Commercial |
$79.80
|
| Rate for Payer: Quartz Beloit One Network |
$36.96
|
| Rate for Payer: Quartz Commercial |
$47.88
|
| Rate for Payer: The Alliance Commercial |
$42.00
|
| Rate for Payer: WEA Trust Commercial |
$46.20
|
| Rate for Payer: WPS Commercial |
$62.22
|
|
|
Flow Cytometry - PNH
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
2798806
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$46.00 |
| Rate for Payer: Aetna Commercial |
$45.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$26.50
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cigna Commercial |
$46.00
|
| Rate for Payer: Health EOS Commercial |
$44.50
|
| Rate for Payer: HFN Commercial |
$46.00
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: NAPHCARE Commercial |
$30.00
|
| Rate for Payer: Preferred Network Access Commercial |
$46.00
|
| Rate for Payer: Quartz Beloit One Network |
$24.50
|
| Rate for Payer: Quartz Commercial |
$30.00
|
| Rate for Payer: WEA Trust Commercial |
$27.50
|
| Rate for Payer: WPS Commercial |
$37.04
|
|
|
Flow Cytometry - PNH
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
2798806
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: Aetna Commercial |
$45.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.00
|
| Rate for Payer: Aetna Managed Medicare |
$14.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$32.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$25.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$24.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$26.50
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cigna Commercial |
$46.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$27.98
|
| Rate for Payer: Health EOS Commercial |
$44.50
|
| Rate for Payer: HFN Commercial |
$46.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37.50
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: NAPHCARE Commercial |
$30.00
|
| Rate for Payer: Preferred Network Access Commercial |
$46.00
|
| Rate for Payer: Quartz Beloit One Network |
$24.50
|
| Rate for Payer: Quartz Commercial |
$32.50
|
| Rate for Payer: Quartz Medicare Advantage |
$30.00
|
| Rate for Payer: The Alliance Commercial |
$200.00
|
| Rate for Payer: United Healthcare PPO |
$37.50
|
| Rate for Payer: WEA Trust Commercial |
$27.50
|
| Rate for Payer: WPS Commercial |
$37.04
|
|
|
Flow Cytometry - PNH
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
2798806
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$76.57 |
| Rate for Payer: Aetna Commercial |
$47.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$43.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cigna Commercial |
$47.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$25.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$30.00
|
| Rate for Payer: Health EOS Commercial |
$45.50
|
| Rate for Payer: HFN Commercial |
$47.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$76.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$76.57
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Preferred Network Access Commercial |
$47.50
|
| Rate for Payer: Quartz Beloit One Network |
$22.00
|
| Rate for Payer: Quartz Commercial |
$28.50
|
| Rate for Payer: The Alliance Commercial |
$25.00
|
| Rate for Payer: WEA Trust Commercial |
$27.50
|
| Rate for Payer: WPS Commercial |
$37.04
|
|
|
Flow Cytometry - PNH, 1 Marker
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
2950377
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$47.53 |
| Max. Negotiated Rate |
$89.24 |
| Rate for Payer: Aetna Commercial |
$87.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$83.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$51.41
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$89.24
|
| Rate for Payer: Health EOS Commercial |
$86.33
|
| Rate for Payer: HFN Commercial |
$89.24
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: NAPHCARE Commercial |
$58.20
|
| Rate for Payer: Preferred Network Access Commercial |
$89.24
|
| Rate for Payer: Quartz Beloit One Network |
$47.53
|
| Rate for Payer: Quartz Commercial |
$58.20
|
| Rate for Payer: WEA Trust Commercial |
$53.35
|
| Rate for Payer: WPS Commercial |
$71.85
|
|
|
Flow Cytometry - PNH, 1 Marker
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
2950377
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.68 |
| Max. Negotiated Rate |
$230.47 |
| Rate for Payer: Aetna Commercial |
$92.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$83.42
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$92.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$48.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$58.20
|
| Rate for Payer: Health EOS Commercial |
$88.27
|
| Rate for Payer: HFN Commercial |
$92.15
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$230.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$230.47
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: Preferred Network Access Commercial |
$92.15
|
| Rate for Payer: Quartz Beloit One Network |
$42.68
|
| Rate for Payer: Quartz Commercial |
$55.29
|
| Rate for Payer: The Alliance Commercial |
$48.50
|
| Rate for Payer: WEA Trust Commercial |
$53.35
|
| Rate for Payer: WPS Commercial |
$71.85
|
|
