|
Glucose 3 Hr
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
1090803
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$73.11 |
| Rate for Payer: Aetna Commercial |
$73.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.19
|
| Rate for Payer: Aetna Managed Medicare |
$4.08
|
| Rate for Payer: Anthem Medicare Advantage |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.08
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$73.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$38.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.08
|
| Rate for Payer: Health EOS Commercial |
$70.03
|
| Rate for Payer: HFN Commercial |
$73.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.08
|
| Rate for Payer: Multiplan Commercial |
$61.57
|
| Rate for Payer: NAPHCARE Commercial |
$6.12
|
| Rate for Payer: Preferred Network Access Commercial |
$73.11
|
| Rate for Payer: Quartz Beloit One Network |
$33.86
|
| Rate for Payer: Quartz Commercial |
$43.87
|
| Rate for Payer: Quartz Medicare Advantage |
$4.08
|
| Rate for Payer: The Alliance Commercial |
$16.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.08
|
| Rate for Payer: WEA Trust Commercial |
$42.33
|
| Rate for Payer: WPS Commercial |
$17.94
|
|
|
Glucose 3 Hr
|
Facility
|
OP
|
$74.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
1090803
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$70.80 |
| Rate for Payer: Aetna Commercial |
$69.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.19
|
| Rate for Payer: Aetna Managed Medicare |
$4.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.13
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.77
|
| Rate for Payer: Anthem Medicare Advantage |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$40.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.08
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$70.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$43.07
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.08
|
| Rate for Payer: Health EOS Commercial |
$68.49
|
| Rate for Payer: HFN Commercial |
$70.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.08
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.08
|
| Rate for Payer: Multiplan Commercial |
$61.57
|
| Rate for Payer: NAPHCARE Commercial |
$6.12
|
| Rate for Payer: Preferred Network Access Commercial |
$70.80
|
| Rate for Payer: Quartz Beloit One Network |
$37.71
|
| Rate for Payer: Quartz Commercial |
$50.02
|
| Rate for Payer: Quartz Medicare Advantage |
$4.08
|
| Rate for Payer: The Alliance Commercial |
$16.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.08
|
| Rate for Payer: United Healthcare PPO |
$57.72
|
| Rate for Payer: WEA Trust Commercial |
$42.33
|
| Rate for Payer: Wellcare Medicare |
$4.08
|
| Rate for Payer: WPS Commercial |
$57.00
|
|
|
Glucose 3 Hr
|
Facility
|
IP
|
$74.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
1090803
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.71 |
| Max. Negotiated Rate |
$70.80 |
| Rate for Payer: Aetna Commercial |
$69.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$40.79
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$70.80
|
| Rate for Payer: Health EOS Commercial |
$68.49
|
| Rate for Payer: HFN Commercial |
$70.80
|
| Rate for Payer: Multiplan Commercial |
$61.57
|
| Rate for Payer: Preferred Network Access Commercial |
$70.80
|
| Rate for Payer: Quartz Beloit One Network |
$37.71
|
| Rate for Payer: Quartz Commercial |
$46.18
|
| Rate for Payer: WEA Trust Commercial |
$42.33
|
| Rate for Payer: WPS Commercial |
$57.00
|
|
|
Glucose 4 Hr
|
Facility
|
OP
|
$74.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
1090804
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$70.80 |
| Rate for Payer: Aetna Commercial |
$69.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.19
|
| Rate for Payer: Aetna Managed Medicare |
$4.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.13
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.77
|
| Rate for Payer: Anthem Medicare Advantage |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$40.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.08
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$70.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$43.07
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.08
|
| Rate for Payer: Health EOS Commercial |
$68.49
|
| Rate for Payer: HFN Commercial |
$70.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.08
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.08
|
| Rate for Payer: Multiplan Commercial |
$61.57
|
| Rate for Payer: NAPHCARE Commercial |
$6.12
|
| Rate for Payer: Preferred Network Access Commercial |
$70.80
|
| Rate for Payer: Quartz Beloit One Network |
$37.71
|
| Rate for Payer: Quartz Commercial |
$50.02
|
| Rate for Payer: Quartz Medicare Advantage |
$4.08
|
| Rate for Payer: The Alliance Commercial |
$16.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.08
|
| Rate for Payer: United Healthcare PPO |
$57.72
|
| Rate for Payer: WEA Trust Commercial |
$42.33
|
| Rate for Payer: Wellcare Medicare |
$4.08
|
| Rate for Payer: WPS Commercial |
$57.00
|
|
|
Glucose 4 Hr
|
Facility
|
IP
|
$74.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
1090804
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.71 |
| Max. Negotiated Rate |
$70.80 |
| Rate for Payer: Aetna Commercial |
$69.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$40.79
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$70.80
|
| Rate for Payer: Health EOS Commercial |
$68.49
|
| Rate for Payer: HFN Commercial |
$70.80
|
| Rate for Payer: Multiplan Commercial |
$61.57
|
| Rate for Payer: Preferred Network Access Commercial |
$70.80
|
| Rate for Payer: Quartz Beloit One Network |
$37.71
|
| Rate for Payer: Quartz Commercial |
$46.18
|
| Rate for Payer: WEA Trust Commercial |
$42.33
|
| Rate for Payer: WPS Commercial |
$57.00
|
|
|
Glucose 4 Hr
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
1090804
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$73.11 |
| Rate for Payer: Aetna Commercial |
$73.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.19
|
| Rate for Payer: Aetna Managed Medicare |
$4.08
|
| Rate for Payer: Anthem Medicare Advantage |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.08
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$73.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$38.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.08
|
| Rate for Payer: Health EOS Commercial |
$70.03
|
| Rate for Payer: HFN Commercial |
$73.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.08
|
| Rate for Payer: Multiplan Commercial |
$61.57
|
| Rate for Payer: NAPHCARE Commercial |
$6.12
|
| Rate for Payer: Preferred Network Access Commercial |
$73.11
|
| Rate for Payer: Quartz Beloit One Network |
$33.86
|
| Rate for Payer: Quartz Commercial |
$43.87
|
| Rate for Payer: Quartz Medicare Advantage |
$4.08
|
| Rate for Payer: The Alliance Commercial |
$16.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.08
|
| Rate for Payer: WEA Trust Commercial |
$42.33
|
| Rate for Payer: WPS Commercial |
$17.94
|
|
|
Glucose 5 Hr
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
1090805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.67 |
| Max. Negotiated Rate |
$66.98 |
| Rate for Payer: Aetna Commercial |
$65.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$62.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$38.58
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$66.98
|
| Rate for Payer: Health EOS Commercial |
$64.79
|
| Rate for Payer: HFN Commercial |
$66.98
|
| Rate for Payer: Multiplan Commercial |
$58.24
|
| Rate for Payer: Preferred Network Access Commercial |
$66.98
|
| Rate for Payer: Quartz Beloit One Network |
$35.67
|
| Rate for Payer: Quartz Commercial |
$43.68
|
| Rate for Payer: WEA Trust Commercial |
$40.04
|
| Rate for Payer: WPS Commercial |
$53.92
|
|
|
Glucose 5 Hr
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
1090805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$69.16 |
| Rate for Payer: Aetna Commercial |
$69.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$62.61
|
| Rate for Payer: Aetna Managed Medicare |
$4.08
|
| Rate for Payer: Anthem Medicare Advantage |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.08
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$69.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$36.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.08
|
| Rate for Payer: Health EOS Commercial |
$66.25
|
| Rate for Payer: HFN Commercial |
$69.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.08
|
| Rate for Payer: Multiplan Commercial |
$58.24
|
| Rate for Payer: NAPHCARE Commercial |
$6.12
|
| Rate for Payer: Preferred Network Access Commercial |
$69.16
|
| Rate for Payer: Quartz Beloit One Network |
$32.03
|
| Rate for Payer: Quartz Commercial |
$41.50
|
| Rate for Payer: Quartz Medicare Advantage |
$4.08
|
| Rate for Payer: The Alliance Commercial |
$16.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.08
|
| Rate for Payer: WEA Trust Commercial |
$40.04
|
| Rate for Payer: WPS Commercial |
$17.94
|
|
|
Glucose 5 Hr
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
1090805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$66.98 |
| Rate for Payer: Aetna Commercial |
$65.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$62.61
|
| Rate for Payer: Aetna Managed Medicare |
$4.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.13
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.77
|
| Rate for Payer: Anthem Medicare Advantage |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$38.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.08
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$66.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40.74
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.08
|
| Rate for Payer: Health EOS Commercial |
$64.79
|
| Rate for Payer: HFN Commercial |
$66.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.08
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.08
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.08
|
| Rate for Payer: Multiplan Commercial |
$58.24
|
| Rate for Payer: NAPHCARE Commercial |
$6.12
|
| Rate for Payer: Preferred Network Access Commercial |
$66.98
|
| Rate for Payer: Quartz Beloit One Network |
$35.67
|
| Rate for Payer: Quartz Commercial |
$47.32
|
| Rate for Payer: Quartz Medicare Advantage |
$4.08
|
| Rate for Payer: The Alliance Commercial |
$16.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.08
|
| Rate for Payer: United Healthcare PPO |
$54.60
|
| Rate for Payer: WEA Trust Commercial |
$40.04
|
| Rate for Payer: Wellcare Medicare |
$4.08
|
| Rate for Payer: WPS Commercial |
$53.92
|
|
|
Glucose-6-PD Quantitative
|
Facility
|
IP
|
$388.00
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
977958
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$197.72 |
| Max. Negotiated Rate |
$371.24 |
| Rate for Payer: Aetna Commercial |
$363.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$347.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$213.87
|
| Rate for Payer: Cash Price |
$116.40
|
| Rate for Payer: Cigna Commercial |
$371.24
|
| Rate for Payer: Health EOS Commercial |
$359.13
|
| Rate for Payer: HFN Commercial |
$371.24
|
| Rate for Payer: Multiplan Commercial |
$322.82
|
| Rate for Payer: Preferred Network Access Commercial |
$371.24
|
| Rate for Payer: Quartz Beloit One Network |
$197.72
|
| Rate for Payer: Quartz Commercial |
$242.11
|
| Rate for Payer: WEA Trust Commercial |
$221.94
|
| Rate for Payer: WPS Commercial |
$298.88
|
|
|
Glucose-6-PD Quantitative
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
977958
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$383.34 |
| Rate for Payer: Aetna Commercial |
$383.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$347.03
|
| Rate for Payer: Aetna Managed Medicare |
$10.09
|
| Rate for Payer: Anthem Medicare Advantage |
$10.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.09
|
| Rate for Payer: Cash Price |
$116.40
|
| Rate for Payer: Cash Price |
$116.40
|
| Rate for Payer: Cigna Commercial |
$383.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$201.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10.09
|
| Rate for Payer: Health EOS Commercial |
$367.20
|
| Rate for Payer: HFN Commercial |
$383.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$35.61
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.09
|
| Rate for Payer: Multiplan Commercial |
$322.82
|
| Rate for Payer: NAPHCARE Commercial |
$15.13
|
| Rate for Payer: Preferred Network Access Commercial |
$383.34
|
| Rate for Payer: Quartz Beloit One Network |
$177.55
|
| Rate for Payer: Quartz Commercial |
$230.01
|
| Rate for Payer: Quartz Medicare Advantage |
$10.09
|
| Rate for Payer: The Alliance Commercial |
$39.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.09
|
| Rate for Payer: WEA Trust Commercial |
$221.94
|
| Rate for Payer: WPS Commercial |
$44.39
|
|
|
Glucose-6-PD Quantitative
|
Facility
|
OP
|
$388.00
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
977958
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$371.24 |
| Rate for Payer: Aetna Commercial |
$363.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$347.03
|
| Rate for Payer: Aetna Managed Medicare |
$10.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$37.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17.65
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16.75
|
| Rate for Payer: Anthem Medicare Advantage |
$10.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$213.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.09
|
| Rate for Payer: Cash Price |
$116.40
|
| Rate for Payer: Cash Price |
$116.40
|
| Rate for Payer: Cigna Commercial |
$371.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$225.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10.09
|
| Rate for Payer: Health EOS Commercial |
$359.13
|
| Rate for Payer: HFN Commercial |
$371.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10.09
|
| Rate for Payer: Multiplan Commercial |
$322.82
|
| Rate for Payer: NAPHCARE Commercial |
$15.13
|
| Rate for Payer: Preferred Network Access Commercial |
$371.24
|
| Rate for Payer: Quartz Beloit One Network |
$197.72
|
| Rate for Payer: Quartz Commercial |
$262.29
|
| Rate for Payer: Quartz Medicare Advantage |
$10.09
|
| Rate for Payer: The Alliance Commercial |
$40.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.09
|
| Rate for Payer: United Healthcare PPO |
$302.64
|
| Rate for Payer: WEA Trust Commercial |
$221.94
|
| Rate for Payer: Wellcare Medicare |
$10.09
|
| Rate for Payer: WPS Commercial |
$298.88
|
|
|
Glucose Cerebrospinal Fluid
|
Facility
|
OP
|
$74.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
633604
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$70.80 |
| Rate for Payer: Aetna Commercial |
$69.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.19
|
| Rate for Payer: Aetna Managed Medicare |
$4.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.15
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.78
|
| Rate for Payer: Anthem Medicare Advantage |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$40.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.09
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$70.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$43.07
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.09
|
| Rate for Payer: Health EOS Commercial |
$68.49
|
| Rate for Payer: HFN Commercial |
$70.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.09
|
| Rate for Payer: Multiplan Commercial |
$61.57
|
| Rate for Payer: NAPHCARE Commercial |
$6.13
|
| Rate for Payer: Preferred Network Access Commercial |
$70.80
|
| Rate for Payer: Quartz Beloit One Network |
$37.71
|
| Rate for Payer: Quartz Commercial |
$50.02
|
| Rate for Payer: Quartz Medicare Advantage |
$4.09
|
| Rate for Payer: The Alliance Commercial |
$16.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.09
|
| Rate for Payer: United Healthcare PPO |
$57.72
|
| Rate for Payer: WEA Trust Commercial |
$42.33
|
| Rate for Payer: Wellcare Medicare |
$4.09
|
| Rate for Payer: WPS Commercial |
$57.00
|
|
|
Glucose Cerebrospinal Fluid
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
633604
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$73.11 |
| Rate for Payer: Aetna Commercial |
$73.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.19
|
| Rate for Payer: Aetna Managed Medicare |
$4.09
|
| Rate for Payer: Anthem Medicare Advantage |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.09
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$73.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$38.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.09
|
| Rate for Payer: Health EOS Commercial |
$70.03
|
| Rate for Payer: HFN Commercial |
$73.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.09
|
| Rate for Payer: Multiplan Commercial |
$61.57
|
| Rate for Payer: NAPHCARE Commercial |
$6.13
|
| Rate for Payer: Preferred Network Access Commercial |
$73.11
|
| Rate for Payer: Quartz Beloit One Network |
$33.86
|
| Rate for Payer: Quartz Commercial |
$43.87
|
| Rate for Payer: Quartz Medicare Advantage |
$4.09
|
| Rate for Payer: The Alliance Commercial |
$16.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.09
|
| Rate for Payer: WEA Trust Commercial |
$42.33
|
| Rate for Payer: WPS Commercial |
$17.98
|
|
|
Glucose Cerebrospinal Fluid
|
Facility
|
IP
|
$74.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
633604
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.71 |
| Max. Negotiated Rate |
$70.80 |
| Rate for Payer: Aetna Commercial |
$69.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$66.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$40.79
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$70.80
|
| Rate for Payer: Health EOS Commercial |
$68.49
|
| Rate for Payer: HFN Commercial |
$70.80
|
| Rate for Payer: Multiplan Commercial |
$61.57
|
| Rate for Payer: Preferred Network Access Commercial |
$70.80
|
| Rate for Payer: Quartz Beloit One Network |
$37.71
|
| Rate for Payer: Quartz Commercial |
$46.18
|
| Rate for Payer: WEA Trust Commercial |
$42.33
|
| Rate for Payer: WPS Commercial |
$57.00
|
|
|
Glucose Fingerstick
|
Facility
|
IP
|
$224.00
|
|
|
Service Code
|
CPT 82948
|
| Hospital Charge Code |
1090799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$114.15 |
| Max. Negotiated Rate |
$214.32 |
| Rate for Payer: Aetna Commercial |
$209.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$200.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$123.47
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cigna Commercial |
$214.32
|
| Rate for Payer: Health EOS Commercial |
$207.33
|
| Rate for Payer: HFN Commercial |
$214.32
|
| Rate for Payer: Multiplan Commercial |
$186.37
|
| Rate for Payer: Preferred Network Access Commercial |
$214.32
|
| Rate for Payer: Quartz Beloit One Network |
$114.15
|
| Rate for Payer: Quartz Commercial |
$139.78
|
| Rate for Payer: WEA Trust Commercial |
$128.13
|
| Rate for Payer: WPS Commercial |
$172.55
|
|
|
Glucose Fingerstick
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
CPT 82948
|
| Hospital Charge Code |
1090799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$221.31 |
| Rate for Payer: Aetna Commercial |
$221.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$200.35
|
| Rate for Payer: Aetna Managed Medicare |
$5.24
|
| Rate for Payer: Anthem Medicare Advantage |
$5.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.24
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cigna Commercial |
$221.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$116.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.24
|
| Rate for Payer: Health EOS Commercial |
$211.99
|
| Rate for Payer: HFN Commercial |
$221.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.24
|
| Rate for Payer: Multiplan Commercial |
$186.37
|
| Rate for Payer: NAPHCARE Commercial |
$7.86
|
| Rate for Payer: Preferred Network Access Commercial |
$221.31
|
| Rate for Payer: Quartz Beloit One Network |
$102.50
|
| Rate for Payer: Quartz Commercial |
$132.79
|
| Rate for Payer: Quartz Medicare Advantage |
$5.24
|
| Rate for Payer: The Alliance Commercial |
$20.70
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.24
|
| Rate for Payer: WEA Trust Commercial |
$128.13
|
| Rate for Payer: WPS Commercial |
$23.06
|
|
|
Glucose Fingerstick
|
Facility
|
OP
|
$224.00
|
|
|
Service Code
|
CPT 82948
|
| Hospital Charge Code |
1090799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$214.32 |
| Rate for Payer: Aetna Commercial |
$209.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$200.35
|
| Rate for Payer: Aetna Managed Medicare |
$5.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.17
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.70
|
| Rate for Payer: Anthem Medicare Advantage |
$5.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$123.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.24
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cigna Commercial |
$214.32
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$130.37
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.24
|
| Rate for Payer: Health EOS Commercial |
$207.33
|
| Rate for Payer: HFN Commercial |
$214.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.50
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.24
|
| Rate for Payer: Multiplan Commercial |
$186.37
|
| Rate for Payer: NAPHCARE Commercial |
$7.86
|
| Rate for Payer: Preferred Network Access Commercial |
$214.32
|
| Rate for Payer: Quartz Beloit One Network |
$114.15
|
| Rate for Payer: Quartz Commercial |
$151.42
|
| Rate for Payer: Quartz Medicare Advantage |
$5.24
|
| Rate for Payer: The Alliance Commercial |
$20.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.24
|
| Rate for Payer: United Healthcare PPO |
$174.72
|
| Rate for Payer: WEA Trust Commercial |
$128.13
|
| Rate for Payer: Wellcare Medicare |
$5.24
|
| Rate for Payer: WPS Commercial |
$172.55
|
|
|
Glucose (FS)
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
4538805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$7.65 |
| Rate for Payer: Aetna Commercial |
$7.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4.41
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cigna Commercial |
$7.65
|
| Rate for Payer: Health EOS Commercial |
$7.40
|
| Rate for Payer: HFN Commercial |
$7.65
|
| Rate for Payer: Multiplan Commercial |
$6.66
|
| Rate for Payer: Preferred Network Access Commercial |
$7.65
|
| Rate for Payer: Quartz Beloit One Network |
$4.08
|
| Rate for Payer: Quartz Commercial |
$4.99
|
| Rate for Payer: WEA Trust Commercial |
$4.58
|
| Rate for Payer: WPS Commercial |
$6.16
|
|
|
Glucose (FS)
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
4538805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$16.35 |
| Rate for Payer: Aetna Commercial |
$7.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7.16
|
| Rate for Payer: Aetna Managed Medicare |
$4.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.15
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.78
|
| Rate for Payer: Anthem Medicare Advantage |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.09
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cigna Commercial |
$7.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.66
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.09
|
| Rate for Payer: Health EOS Commercial |
$7.40
|
| Rate for Payer: HFN Commercial |
$7.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.09
|
| Rate for Payer: Multiplan Commercial |
$6.66
|
| Rate for Payer: NAPHCARE Commercial |
$6.13
|
| Rate for Payer: Preferred Network Access Commercial |
$7.65
|
| Rate for Payer: Quartz Beloit One Network |
$4.08
|
| Rate for Payer: Quartz Commercial |
$5.41
|
| Rate for Payer: Quartz Medicare Advantage |
$4.09
|
| Rate for Payer: The Alliance Commercial |
$16.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.09
|
| Rate for Payer: United Healthcare PPO |
$6.24
|
| Rate for Payer: WEA Trust Commercial |
$4.58
|
| Rate for Payer: Wellcare Medicare |
$4.09
|
| Rate for Payer: WPS Commercial |
$6.16
|
|
|
Glucose (FS)
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
4538805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.66 |
| Max. Negotiated Rate |
$17.98 |
| Rate for Payer: Aetna Commercial |
$7.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7.16
|
| Rate for Payer: Aetna Managed Medicare |
$4.09
|
| Rate for Payer: Anthem Medicare Advantage |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.09
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cigna Commercial |
$7.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.09
|
| Rate for Payer: Health EOS Commercial |
$7.57
|
| Rate for Payer: HFN Commercial |
$7.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.09
|
| Rate for Payer: Multiplan Commercial |
$6.66
|
| Rate for Payer: NAPHCARE Commercial |
$6.13
|
| Rate for Payer: Preferred Network Access Commercial |
$7.90
|
| Rate for Payer: Quartz Beloit One Network |
$3.66
|
| Rate for Payer: Quartz Commercial |
$4.74
|
| Rate for Payer: Quartz Medicare Advantage |
$4.09
|
| Rate for Payer: The Alliance Commercial |
$16.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.09
|
| Rate for Payer: WEA Trust Commercial |
$4.58
|
| Rate for Payer: WPS Commercial |
$17.98
|
|
|
Glucose Level
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
993772
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.16 |
| Max. Negotiated Rate |
$66.02 |
| Rate for Payer: Aetna Commercial |
$64.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$61.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$38.03
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$66.02
|
| Rate for Payer: Health EOS Commercial |
$63.87
|
| Rate for Payer: HFN Commercial |
$66.02
|
| Rate for Payer: Multiplan Commercial |
$57.41
|
| Rate for Payer: Preferred Network Access Commercial |
$66.02
|
| Rate for Payer: Quartz Beloit One Network |
$35.16
|
| Rate for Payer: Quartz Commercial |
$43.06
|
| Rate for Payer: WEA Trust Commercial |
$39.47
|
| Rate for Payer: WPS Commercial |
$53.15
|
|
|
Glucose Level
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
993772
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$66.02 |
| Rate for Payer: Aetna Commercial |
$64.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$61.71
|
| Rate for Payer: Aetna Managed Medicare |
$4.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$15.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7.15
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.78
|
| Rate for Payer: Anthem Medicare Advantage |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$38.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.09
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$66.02
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$4.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40.16
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$4.09
|
| Rate for Payer: Health EOS Commercial |
$63.87
|
| Rate for Payer: HFN Commercial |
$66.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$15.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$4.09
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.09
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$4.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$4.09
|
| Rate for Payer: Multiplan Commercial |
$57.41
|
| Rate for Payer: NAPHCARE Commercial |
$6.13
|
| Rate for Payer: Preferred Network Access Commercial |
$66.02
|
| Rate for Payer: Quartz Beloit One Network |
$35.16
|
| Rate for Payer: Quartz Commercial |
$46.64
|
| Rate for Payer: Quartz Medicare Advantage |
$4.09
|
| Rate for Payer: The Alliance Commercial |
$16.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.09
|
| Rate for Payer: United Healthcare PPO |
$53.82
|
| Rate for Payer: WEA Trust Commercial |
$39.47
|
| Rate for Payer: Wellcare Medicare |
$4.09
|
| Rate for Payer: WPS Commercial |
$53.15
|
|
|
Glucose Level
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
993772
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$68.17 |
| Rate for Payer: Aetna Commercial |
$68.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$61.71
|
| Rate for Payer: Aetna Managed Medicare |
$4.09
|
| Rate for Payer: Anthem Medicare Advantage |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$4.09
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$68.17
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$35.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.09
|
| Rate for Payer: Health EOS Commercial |
$65.30
|
| Rate for Payer: HFN Commercial |
$68.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$4.09
|
| Rate for Payer: Multiplan Commercial |
$57.41
|
| Rate for Payer: NAPHCARE Commercial |
$6.13
|
| Rate for Payer: Preferred Network Access Commercial |
$68.17
|
| Rate for Payer: Quartz Beloit One Network |
$31.57
|
| Rate for Payer: Quartz Commercial |
$40.90
|
| Rate for Payer: Quartz Medicare Advantage |
$4.09
|
| Rate for Payer: The Alliance Commercial |
$16.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.09
|
| Rate for Payer: WEA Trust Commercial |
$39.47
|
| Rate for Payer: WPS Commercial |
$17.98
|
|
|
Glucose, PDI Fluid
|
Facility
|
IP
|
$145.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3768168
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$73.89 |
| Max. Negotiated Rate |
$138.74 |
| Rate for Payer: Aetna Commercial |
$135.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$129.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$79.92
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cigna Commercial |
$138.74
|
| Rate for Payer: Health EOS Commercial |
$134.21
|
| Rate for Payer: HFN Commercial |
$138.74
|
| Rate for Payer: Multiplan Commercial |
$120.64
|
| Rate for Payer: Preferred Network Access Commercial |
$138.74
|
| Rate for Payer: Quartz Beloit One Network |
$73.89
|
| Rate for Payer: Quartz Commercial |
$90.48
|
| Rate for Payer: WEA Trust Commercial |
$82.94
|
| Rate for Payer: WPS Commercial |
$111.69
|
|
