|
Glucose Cerebrospinal Fluid
|
Facility
|
IP
|
$74.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
633604
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.26 |
| Max. Negotiated Rate |
$68.08 |
| Rate for Payer: Aetna Commercial |
$66.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$63.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$39.22
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$68.08
|
| Rate for Payer: Health EOS Commercial |
$65.86
|
| Rate for Payer: HFN Commercial |
$68.08
|
| Rate for Payer: Multiplan Commercial |
$59.20
|
| Rate for Payer: NAPHCARE Commercial |
$44.40
|
| Rate for Payer: Preferred Network Access Commercial |
$68.08
|
| Rate for Payer: Quartz Beloit One Network |
$36.26
|
| Rate for Payer: Quartz Commercial |
$44.40
|
| Rate for Payer: WEA Trust Commercial |
$40.70
|
| Rate for Payer: WPS Commercial |
$54.81
|
|
|
Glucose Cerebrospinal Fluid
|
Facility
|
OP
|
$74.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
633604
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$68.08 |
| Rate for Payer: Aetna Commercial |
$66.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$63.64
|
| Rate for Payer: Aetna Managed Medicare |
$3.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.52
|
| Rate for Payer: Anthem Medicaid |
$4.06
|
| Rate for Payer: Anthem Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$39.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.93
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$68.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$41.41
|
| Rate for Payer: Dean Health Medicaid |
$4.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.93
|
| Rate for Payer: Health EOS Commercial |
$65.86
|
| Rate for Payer: HFN Commercial |
$68.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.93
|
| Rate for Payer: Managed Health Services Medicaid |
$4.22
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$59.20
|
| Rate for Payer: NAPHCARE Commercial |
$5.90
|
| Rate for Payer: Preferred Network Access Commercial |
$68.08
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.06
|
| Rate for Payer: Quartz Beloit One Network |
$36.26
|
| Rate for Payer: Quartz Commercial |
$48.10
|
| Rate for Payer: Quartz Medicare Advantage |
$3.93
|
| Rate for Payer: The Alliance Commercial |
$15.72
|
| Rate for Payer: United Healthcare Medicaid |
$4.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare PPO |
$55.50
|
| Rate for Payer: WEA Trust Commercial |
$40.70
|
| Rate for Payer: Wellcare Medicare |
$3.93
|
| Rate for Payer: WMAP Medicaid |
$4.06
|
| Rate for Payer: WPS Commercial |
$54.81
|
|
|
Glucose Cerebrospinal Fluid
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
633604
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$70.30 |
| Rate for Payer: Aetna Commercial |
$70.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$63.64
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cigna Commercial |
$70.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$37.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$44.40
|
| Rate for Payer: Health EOS Commercial |
$67.34
|
| Rate for Payer: HFN Commercial |
$70.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$59.20
|
| Rate for Payer: Preferred Network Access Commercial |
$70.30
|
| Rate for Payer: Quartz Beloit One Network |
$32.56
|
| Rate for Payer: Quartz Commercial |
$42.18
|
| Rate for Payer: The Alliance Commercial |
$37.00
|
| Rate for Payer: WEA Trust Commercial |
$40.70
|
| Rate for Payer: WPS Commercial |
$54.81
|
|
|
Glucose Fingerstick
|
Facility
|
OP
|
$224.00
|
|
|
Service Code
|
CPT 82948
|
| Hospital Charge Code |
1090799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$206.08 |
| Rate for Payer: Aetna Commercial |
$201.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$192.64
|
| Rate for Payer: Aetna Managed Medicare |
$5.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8.82
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.37
|
| Rate for Payer: Anthem Medicaid |
$4.45
|
| Rate for Payer: Anthem Medicare Advantage |
$5.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$118.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.04
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cigna Commercial |
$206.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.45
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$125.35
|
| Rate for Payer: Dean Health Medicaid |
$4.45
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.04
|
| Rate for Payer: Health EOS Commercial |
$199.36
|
| Rate for Payer: HFN Commercial |
$206.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.04
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.45
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.04
|
| Rate for Payer: Managed Health Services Medicaid |
$4.63
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.04
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.04
|
| Rate for Payer: Multiplan Commercial |
$179.20
|
| Rate for Payer: NAPHCARE Commercial |
$7.56
|
| Rate for Payer: Preferred Network Access Commercial |
$206.08
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.45
|
| Rate for Payer: Quartz Beloit One Network |
$109.76
|
| Rate for Payer: Quartz Commercial |
$145.60
|
| Rate for Payer: Quartz Medicare Advantage |
$5.04
|
| Rate for Payer: The Alliance Commercial |
$20.16
|
| Rate for Payer: United Healthcare Medicaid |
$4.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.04
|
| Rate for Payer: United Healthcare PPO |
$168.00
|
| Rate for Payer: WEA Trust Commercial |
$123.20
|
| Rate for Payer: Wellcare Medicare |
$5.04
|
| Rate for Payer: WMAP Medicaid |
$4.45
|
| Rate for Payer: WPS Commercial |
$165.92
|
|
|
Glucose Fingerstick
|
Facility
|
IP
|
$224.00
|
|
|
Service Code
|
CPT 82948
|
| Hospital Charge Code |
1090799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$109.76 |
| Max. Negotiated Rate |
$206.08 |
| Rate for Payer: Aetna Commercial |
$201.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$192.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$118.72
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cigna Commercial |
$206.08
|
| Rate for Payer: Health EOS Commercial |
$199.36
|
| Rate for Payer: HFN Commercial |
$206.08
|
| Rate for Payer: Multiplan Commercial |
$179.20
|
| Rate for Payer: NAPHCARE Commercial |
$134.40
|
| Rate for Payer: Preferred Network Access Commercial |
$206.08
|
| Rate for Payer: Quartz Beloit One Network |
$109.76
|
| Rate for Payer: Quartz Commercial |
$134.40
|
| Rate for Payer: WEA Trust Commercial |
$123.20
|
| Rate for Payer: WPS Commercial |
$165.92
|
|
|
Glucose Fingerstick
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
CPT 82948
|
| Hospital Charge Code |
1090799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.79 |
| Max. Negotiated Rate |
$212.80 |
| Rate for Payer: Aetna Commercial |
$212.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$192.64
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cigna Commercial |
$212.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$112.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$134.40
|
| Rate for Payer: Health EOS Commercial |
$203.84
|
| Rate for Payer: HFN Commercial |
$212.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$17.79
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.79
|
| Rate for Payer: Multiplan Commercial |
$179.20
|
| Rate for Payer: Preferred Network Access Commercial |
$212.80
|
| Rate for Payer: Quartz Beloit One Network |
$98.56
|
| Rate for Payer: Quartz Commercial |
$127.68
|
| Rate for Payer: The Alliance Commercial |
$112.00
|
| Rate for Payer: WEA Trust Commercial |
$123.20
|
| Rate for Payer: WPS Commercial |
$165.92
|
|
|
Glucose (FS)
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
4538805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.52 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$7.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.88
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cigna Commercial |
$7.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.80
|
| Rate for Payer: Health EOS Commercial |
$7.28
|
| Rate for Payer: HFN Commercial |
$7.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$6.40
|
| Rate for Payer: Preferred Network Access Commercial |
$7.60
|
| Rate for Payer: Quartz Beloit One Network |
$3.52
|
| Rate for Payer: Quartz Commercial |
$4.56
|
| Rate for Payer: The Alliance Commercial |
$4.00
|
| Rate for Payer: WEA Trust Commercial |
$4.40
|
| Rate for Payer: WPS Commercial |
$5.93
|
|
|
Glucose (FS)
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
4538805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.92 |
| Max. Negotiated Rate |
$7.36 |
| Rate for Payer: Aetna Commercial |
$7.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4.24
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cigna Commercial |
$7.36
|
| Rate for Payer: Health EOS Commercial |
$7.12
|
| Rate for Payer: HFN Commercial |
$7.36
|
| Rate for Payer: Multiplan Commercial |
$6.40
|
| Rate for Payer: NAPHCARE Commercial |
$4.80
|
| Rate for Payer: Preferred Network Access Commercial |
$7.36
|
| Rate for Payer: Quartz Beloit One Network |
$3.92
|
| Rate for Payer: Quartz Commercial |
$4.80
|
| Rate for Payer: WEA Trust Commercial |
$4.40
|
| Rate for Payer: WPS Commercial |
$5.93
|
|
|
Glucose (FS)
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
4538805
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.92 |
| Max. Negotiated Rate |
$15.72 |
| Rate for Payer: Aetna Commercial |
$7.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6.88
|
| Rate for Payer: Aetna Managed Medicare |
$3.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.52
|
| Rate for Payer: Anthem Medicaid |
$4.06
|
| Rate for Payer: Anthem Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.93
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cigna Commercial |
$7.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4.48
|
| Rate for Payer: Dean Health Medicaid |
$4.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.93
|
| Rate for Payer: Health EOS Commercial |
$7.12
|
| Rate for Payer: HFN Commercial |
$7.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.93
|
| Rate for Payer: Managed Health Services Medicaid |
$4.22
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$6.40
|
| Rate for Payer: NAPHCARE Commercial |
$5.90
|
| Rate for Payer: Preferred Network Access Commercial |
$7.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.06
|
| Rate for Payer: Quartz Beloit One Network |
$3.92
|
| Rate for Payer: Quartz Commercial |
$5.20
|
| Rate for Payer: Quartz Medicare Advantage |
$3.93
|
| Rate for Payer: The Alliance Commercial |
$15.72
|
| Rate for Payer: United Healthcare Medicaid |
$4.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare PPO |
$6.00
|
| Rate for Payer: WEA Trust Commercial |
$4.40
|
| Rate for Payer: Wellcare Medicare |
$3.93
|
| Rate for Payer: WMAP Medicaid |
$4.06
|
| Rate for Payer: WPS Commercial |
$5.93
|
|
|
Glucose Level
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
993772
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$63.48 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$36.57
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$63.48
|
| Rate for Payer: Health EOS Commercial |
$61.41
|
| Rate for Payer: HFN Commercial |
$63.48
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: NAPHCARE Commercial |
$41.40
|
| Rate for Payer: Preferred Network Access Commercial |
$63.48
|
| Rate for Payer: Quartz Beloit One Network |
$33.81
|
| Rate for Payer: Quartz Commercial |
$41.40
|
| Rate for Payer: WEA Trust Commercial |
$37.95
|
| Rate for Payer: WPS Commercial |
$51.11
|
|
|
Glucose Level
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
993772
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$63.48 |
| Rate for Payer: The Alliance Commercial |
$15.72
|
| Rate for Payer: United Healthcare Medicaid |
$4.06
|
| Rate for Payer: Quartz Beloit One Network |
$33.81
|
| Rate for Payer: Quartz Commercial |
$44.85
|
| Rate for Payer: Quartz Medicare Advantage |
$3.93
|
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.34
|
| Rate for Payer: Aetna Managed Medicare |
$3.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.52
|
| Rate for Payer: Anthem Medicaid |
$4.06
|
| Rate for Payer: Anthem Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$36.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.93
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$63.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$38.61
|
| Rate for Payer: Dean Health Medicaid |
$4.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.93
|
| Rate for Payer: Health EOS Commercial |
$61.41
|
| Rate for Payer: HFN Commercial |
$63.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.93
|
| Rate for Payer: Managed Health Services Medicaid |
$4.22
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: NAPHCARE Commercial |
$5.90
|
| Rate for Payer: Preferred Network Access Commercial |
$63.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare PPO |
$51.75
|
| Rate for Payer: WEA Trust Commercial |
$37.95
|
| Rate for Payer: Wellcare Medicare |
$3.93
|
| Rate for Payer: WMAP Medicaid |
$4.06
|
| Rate for Payer: WPS Commercial |
$51.11
|
|
|
Glucose Level
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
993772
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.34
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cigna Commercial |
$65.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$34.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$41.40
|
| Rate for Payer: Health EOS Commercial |
$62.79
|
| Rate for Payer: HFN Commercial |
$65.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: Preferred Network Access Commercial |
$65.55
|
| Rate for Payer: Quartz Beloit One Network |
$30.36
|
| Rate for Payer: Quartz Commercial |
$39.33
|
| Rate for Payer: The Alliance Commercial |
$34.50
|
| Rate for Payer: WEA Trust Commercial |
$37.95
|
| Rate for Payer: WPS Commercial |
$51.11
|
|
|
Glucose, PDI Fluid
|
Facility
|
OP
|
$145.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3768168
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$133.40 |
| Rate for Payer: Aetna Commercial |
$130.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$124.70
|
| Rate for Payer: Aetna Managed Medicare |
$3.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.52
|
| Rate for Payer: Anthem Medicaid |
$4.06
|
| Rate for Payer: Anthem Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$76.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.93
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cigna Commercial |
$133.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$81.14
|
| Rate for Payer: Dean Health Medicaid |
$4.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.93
|
| Rate for Payer: Health EOS Commercial |
$129.05
|
| Rate for Payer: HFN Commercial |
$133.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.93
|
| Rate for Payer: Managed Health Services Medicaid |
$4.22
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$116.00
|
| Rate for Payer: NAPHCARE Commercial |
$5.90
|
| Rate for Payer: Preferred Network Access Commercial |
$133.40
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.06
|
| Rate for Payer: Quartz Beloit One Network |
$71.05
|
| Rate for Payer: Quartz Commercial |
$94.25
|
| Rate for Payer: Quartz Medicare Advantage |
$3.93
|
| Rate for Payer: The Alliance Commercial |
$15.72
|
| Rate for Payer: United Healthcare Medicaid |
$4.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare PPO |
$108.75
|
| Rate for Payer: WEA Trust Commercial |
$79.75
|
| Rate for Payer: Wellcare Medicare |
$3.93
|
| Rate for Payer: WMAP Medicaid |
$4.06
|
| Rate for Payer: WPS Commercial |
$107.40
|
|
|
Glucose, PDI Fluid
|
Facility
|
IP
|
$145.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3768168
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$71.05 |
| Max. Negotiated Rate |
$133.40 |
| Rate for Payer: Aetna Commercial |
$130.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$124.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$76.85
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cigna Commercial |
$133.40
|
| Rate for Payer: Health EOS Commercial |
$129.05
|
| Rate for Payer: HFN Commercial |
$133.40
|
| Rate for Payer: Multiplan Commercial |
$116.00
|
| Rate for Payer: NAPHCARE Commercial |
$87.00
|
| Rate for Payer: Preferred Network Access Commercial |
$133.40
|
| Rate for Payer: Quartz Beloit One Network |
$71.05
|
| Rate for Payer: Quartz Commercial |
$87.00
|
| Rate for Payer: WEA Trust Commercial |
$79.75
|
| Rate for Payer: WPS Commercial |
$107.40
|
|
|
Glucose, PDI Fluid
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3768168
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$137.75 |
| Rate for Payer: Aetna Commercial |
$137.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$124.70
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cigna Commercial |
$137.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$72.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$87.00
|
| Rate for Payer: Health EOS Commercial |
$131.95
|
| Rate for Payer: HFN Commercial |
$137.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$116.00
|
| Rate for Payer: Preferred Network Access Commercial |
$137.75
|
| Rate for Payer: Quartz Beloit One Network |
$63.80
|
| Rate for Payer: Quartz Commercial |
$82.65
|
| Rate for Payer: The Alliance Commercial |
$72.50
|
| Rate for Payer: WEA Trust Commercial |
$79.75
|
| Rate for Payer: WPS Commercial |
$107.40
|
|
|
Glucose, Pericardial Fluid
|
Facility
|
IP
|
$114.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3154861
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.86 |
| Max. Negotiated Rate |
$104.88 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$68.40
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$68.40
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Glucose, Pericardial Fluid
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3154861
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$104.88 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Aetna Managed Medicare |
$3.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.52
|
| Rate for Payer: Anthem Medicaid |
$4.06
|
| Rate for Payer: Anthem Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.93
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$63.79
|
| Rate for Payer: Dean Health Medicaid |
$4.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.93
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.93
|
| Rate for Payer: Managed Health Services Medicaid |
$4.22
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$5.90
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.06
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$74.10
|
| Rate for Payer: Quartz Medicare Advantage |
$3.93
|
| Rate for Payer: The Alliance Commercial |
$15.72
|
| Rate for Payer: United Healthcare Medicaid |
$4.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare PPO |
$85.50
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: Wellcare Medicare |
$3.93
|
| Rate for Payer: WMAP Medicaid |
$4.06
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Glucose, Pericardial Fluid
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3154861
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$108.30 |
| Rate for Payer: Aetna Commercial |
$108.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$108.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$57.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$68.40
|
| Rate for Payer: Health EOS Commercial |
$103.74
|
| Rate for Payer: HFN Commercial |
$108.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: Preferred Network Access Commercial |
$108.30
|
| Rate for Payer: Quartz Beloit One Network |
$50.16
|
| Rate for Payer: Quartz Commercial |
$64.98
|
| Rate for Payer: The Alliance Commercial |
$57.00
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Glucose, Peritoneal Fluid
|
Facility
|
IP
|
$114.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3154863
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.86 |
| Max. Negotiated Rate |
$104.88 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$68.40
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$68.40
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Glucose, Peritoneal Fluid
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3154863
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$108.30 |
| Rate for Payer: Aetna Commercial |
$108.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$108.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$57.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$68.40
|
| Rate for Payer: Health EOS Commercial |
$103.74
|
| Rate for Payer: HFN Commercial |
$108.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: Preferred Network Access Commercial |
$108.30
|
| Rate for Payer: Quartz Beloit One Network |
$50.16
|
| Rate for Payer: Quartz Commercial |
$64.98
|
| Rate for Payer: The Alliance Commercial |
$57.00
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Glucose, Peritoneal Fluid
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3154863
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$104.88 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Aetna Managed Medicare |
$3.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.52
|
| Rate for Payer: Anthem Medicaid |
$4.06
|
| Rate for Payer: Anthem Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.93
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$63.79
|
| Rate for Payer: Dean Health Medicaid |
$4.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.93
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.93
|
| Rate for Payer: Managed Health Services Medicaid |
$4.22
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$5.90
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.06
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$74.10
|
| Rate for Payer: Quartz Medicare Advantage |
$3.93
|
| Rate for Payer: The Alliance Commercial |
$15.72
|
| Rate for Payer: United Healthcare Medicaid |
$4.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare PPO |
$85.50
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: Wellcare Medicare |
$3.93
|
| Rate for Payer: WMAP Medicaid |
$4.06
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Glucose, Pleural Fluid
|
Facility
|
IP
|
$114.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3154862
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.86 |
| Max. Negotiated Rate |
$104.88 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$68.40
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$68.40
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Glucose, Pleural Fluid
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3154862
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$104.88 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Aetna Managed Medicare |
$3.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.52
|
| Rate for Payer: Anthem Medicaid |
$4.06
|
| Rate for Payer: Anthem Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$60.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.93
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$104.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$63.79
|
| Rate for Payer: Dean Health Medicaid |
$4.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.93
|
| Rate for Payer: Health EOS Commercial |
$101.46
|
| Rate for Payer: HFN Commercial |
$104.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.62
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.06
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.93
|
| Rate for Payer: Managed Health Services Medicaid |
$4.22
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: NAPHCARE Commercial |
$5.90
|
| Rate for Payer: Preferred Network Access Commercial |
$104.88
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.06
|
| Rate for Payer: Quartz Beloit One Network |
$55.86
|
| Rate for Payer: Quartz Commercial |
$74.10
|
| Rate for Payer: Quartz Medicare Advantage |
$3.93
|
| Rate for Payer: The Alliance Commercial |
$15.72
|
| Rate for Payer: United Healthcare Medicaid |
$4.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare PPO |
$85.50
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: Wellcare Medicare |
$3.93
|
| Rate for Payer: WMAP Medicaid |
$4.06
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Glucose, Pleural Fluid
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3154862
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$108.30 |
| Rate for Payer: Aetna Commercial |
$108.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$108.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$57.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$68.40
|
| Rate for Payer: Health EOS Commercial |
$103.74
|
| Rate for Payer: HFN Commercial |
$108.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: Preferred Network Access Commercial |
$108.30
|
| Rate for Payer: Quartz Beloit One Network |
$50.16
|
| Rate for Payer: Quartz Commercial |
$64.98
|
| Rate for Payer: The Alliance Commercial |
$57.00
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
|
Glucose, Synovial Fluid
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3154864
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$108.30 |
| Rate for Payer: Aetna Commercial |
$108.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$98.04
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cigna Commercial |
$108.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$57.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$68.40
|
| Rate for Payer: Health EOS Commercial |
$103.74
|
| Rate for Payer: HFN Commercial |
$108.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: Preferred Network Access Commercial |
$108.30
|
| Rate for Payer: Quartz Beloit One Network |
$50.16
|
| Rate for Payer: Quartz Commercial |
$64.98
|
| Rate for Payer: The Alliance Commercial |
$57.00
|
| Rate for Payer: WEA Trust Commercial |
$62.70
|
| Rate for Payer: WPS Commercial |
$84.44
|
|
