|
.Allergy Panel, Egg Component
|
Facility
OP
|
$14.04
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163584
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.88 |
| Max. Negotiated Rate |
$67.24 |
| Rate for Payer: Aetna Commercial |
$12.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$12.07
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.76
|
| Rate for Payer: Anthem Medicaid |
$17.71
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cigna Commercial |
$12.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17.71
|
| Rate for Payer: Dean Health Medicaid |
$17.71
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$12.50
|
| Rate for Payer: HFN Commercial |
$12.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Managed Health Services Medicaid |
$18.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$11.23
|
| Rate for Payer: NAPHCARE Commercial |
$26.90
|
| Rate for Payer: Preferred Network Access Commercial |
$12.92
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17.71
|
| Rate for Payer: Quartz Beloit One Network |
$6.88
|
| Rate for Payer: Quartz Commercial |
$9.13
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$56.16
|
| Rate for Payer: United Healthcare Medicaid |
$17.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Healthcare PPO |
$10.53
|
| Rate for Payer: WEA Trust Commercial |
$7.72
|
| Rate for Payer: Wellcare Medicare |
$17.93
|
| Rate for Payer: WMAP Medicaid |
$17.71
|
| Rate for Payer: WPS Commercial |
$10.40
|
|
|
.Allergy Panel, Egg Component
|
Facility
IP
|
$14.04
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163584
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.88 |
| Max. Negotiated Rate |
$12.92 |
| Rate for Payer: Aetna Commercial |
$12.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7.44
|
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cigna Commercial |
$12.92
|
| Rate for Payer: Health EOS Commercial |
$12.50
|
| Rate for Payer: HFN Commercial |
$12.92
|
| Rate for Payer: Multiplan Commercial |
$11.23
|
| Rate for Payer: NAPHCARE Commercial |
$8.42
|
| Rate for Payer: Preferred Network Access Commercial |
$12.92
|
| Rate for Payer: Quartz Beloit One Network |
$6.88
|
| Rate for Payer: Quartz Commercial |
$8.42
|
| Rate for Payer: WEA Trust Commercial |
$7.72
|
| Rate for Payer: WPS Commercial |
$10.40
|
|
|
Allergy Panel, Food
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2770799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$22.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$21.50
|
| Rate for Payer: Aetna Managed Medicare |
$5.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.14
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.67
|
| Rate for Payer: Anthem Medicaid |
$4.57
|
| Rate for Payer: Anthem Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.22
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$23.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$22.25
|
| Rate for Payer: HFN Commercial |
$23.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.22
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.22
|
| Rate for Payer: Managed Health Services Medicaid |
$4.75
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.22
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: NAPHCARE Commercial |
$7.83
|
| Rate for Payer: Preferred Network Access Commercial |
$23.00
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.57
|
| Rate for Payer: Quartz Beloit One Network |
$12.25
|
| Rate for Payer: Quartz Commercial |
$16.25
|
| Rate for Payer: Quartz Medicare Advantage |
$5.22
|
| Rate for Payer: The Alliance Commercial |
$100.00
|
| Rate for Payer: United Healthcare Medicaid |
$4.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare PPO |
$18.75
|
| Rate for Payer: WEA Trust Commercial |
$13.75
|
| Rate for Payer: Wellcare Medicare |
$5.22
|
| Rate for Payer: WMAP Medicaid |
$4.57
|
| Rate for Payer: WPS Commercial |
$18.52
|
|
|
Allergy Panel, Food
|
Professional
|
$25.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2770799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$23.75 |
| Rate for Payer: Aetna Commercial |
$23.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$21.50
|
| Rate for Payer: Aetna Managed Medicare |
$5.22
|
| Rate for Payer: Anthem Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.22
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$23.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$22.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Preferred Network Access Commercial |
$23.75
|
| Rate for Payer: Quartz Beloit One Network |
$11.00
|
| Rate for Payer: Quartz Commercial |
$14.25
|
| Rate for Payer: Quartz Medicare Advantage |
$5.22
|
| Rate for Payer: The Alliance Commercial |
$20.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: WEA Trust Commercial |
$13.75
|
| Rate for Payer: WPS Commercial |
$22.97
|
|
|
Allergy Panel, Food
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2770799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$23.00 |
| Rate for Payer: Aetna Commercial |
$22.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13.25
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$23.00
|
| Rate for Payer: Health EOS Commercial |
$22.25
|
| Rate for Payer: HFN Commercial |
$23.00
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: NAPHCARE Commercial |
$15.00
|
| Rate for Payer: Preferred Network Access Commercial |
$23.00
|
| Rate for Payer: Quartz Beloit One Network |
$12.25
|
| Rate for Payer: Quartz Commercial |
$15.00
|
| Rate for Payer: WEA Trust Commercial |
$13.75
|
| Rate for Payer: WPS Commercial |
$18.52
|
|
|
Allergy Panel, Food (Pediatric)
|
Facility
IP
|
$22.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4754606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.78 |
| Max. Negotiated Rate |
$20.24 |
| Rate for Payer: Aetna Commercial |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.66
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$20.24
|
| Rate for Payer: Health EOS Commercial |
$19.58
|
| Rate for Payer: HFN Commercial |
$20.24
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: NAPHCARE Commercial |
$13.20
|
| Rate for Payer: Preferred Network Access Commercial |
$20.24
|
| Rate for Payer: Quartz Beloit One Network |
$10.78
|
| Rate for Payer: Quartz Commercial |
$13.20
|
| Rate for Payer: WEA Trust Commercial |
$12.10
|
| Rate for Payer: WPS Commercial |
$16.30
|
|
|
Allergy Panel, Food (Pediatric)
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4754606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$88.00 |
| Rate for Payer: Aetna Commercial |
$19.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.92
|
| Rate for Payer: Aetna Managed Medicare |
$7.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$13.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12.98
|
| Rate for Payer: Anthem Medicaid |
$4.57
|
| Rate for Payer: Anthem Medicare Advantage |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.82
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$20.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7.82
|
| Rate for Payer: Health EOS Commercial |
$19.58
|
| Rate for Payer: HFN Commercial |
$20.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7.82
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.82
|
| Rate for Payer: Managed Health Services Medicaid |
$4.75
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7.82
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: NAPHCARE Commercial |
$11.73
|
| Rate for Payer: Preferred Network Access Commercial |
$20.24
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.57
|
| Rate for Payer: Quartz Beloit One Network |
$10.78
|
| Rate for Payer: Quartz Commercial |
$14.30
|
| Rate for Payer: Quartz Medicare Advantage |
$7.82
|
| Rate for Payer: The Alliance Commercial |
$88.00
|
| Rate for Payer: United Healthcare Medicaid |
$4.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.82
|
| Rate for Payer: United Healthcare PPO |
$16.50
|
| Rate for Payer: WEA Trust Commercial |
$12.10
|
| Rate for Payer: Wellcare Medicare |
$7.82
|
| Rate for Payer: WMAP Medicaid |
$4.57
|
| Rate for Payer: WPS Commercial |
$16.30
|
|
|
Allergy Panel, Food (Pediatric)
|
Professional
|
$22.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4754606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.82 |
| Max. Negotiated Rate |
$34.41 |
| Rate for Payer: Aetna Commercial |
$20.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.92
|
| Rate for Payer: Aetna Managed Medicare |
$7.82
|
| Rate for Payer: Anthem Medicare Advantage |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.82
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$20.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7.82
|
| Rate for Payer: Health EOS Commercial |
$20.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$27.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$27.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.82
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: Preferred Network Access Commercial |
$20.90
|
| Rate for Payer: Quartz Beloit One Network |
$9.68
|
| Rate for Payer: Quartz Commercial |
$12.54
|
| Rate for Payer: Quartz Medicare Advantage |
$7.82
|
| Rate for Payer: The Alliance Commercial |
$30.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.82
|
| Rate for Payer: WEA Trust Commercial |
$12.10
|
| Rate for Payer: WPS Commercial |
$34.41
|
|
|
Allergy Panel, Food (Pediatric) IgG
|
Facility
OP
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4752606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: Aetna Commercial |
$17.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.34
|
| Rate for Payer: Aetna Managed Medicare |
$7.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$29.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$13.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12.98
|
| Rate for Payer: Anthem Medicaid |
$4.57
|
| Rate for Payer: Anthem Medicare Advantage |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.82
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$17.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7.82
|
| Rate for Payer: Health EOS Commercial |
$16.91
|
| Rate for Payer: HFN Commercial |
$17.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.09
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7.82
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.82
|
| Rate for Payer: Managed Health Services Medicaid |
$4.75
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7.82
|
| Rate for Payer: Multiplan Commercial |
$15.20
|
| Rate for Payer: NAPHCARE Commercial |
$11.73
|
| Rate for Payer: Preferred Network Access Commercial |
$17.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.57
|
| Rate for Payer: Quartz Beloit One Network |
$9.31
|
| Rate for Payer: Quartz Commercial |
$12.35
|
| Rate for Payer: Quartz Medicare Advantage |
$7.82
|
| Rate for Payer: The Alliance Commercial |
$76.00
|
| Rate for Payer: United Healthcare Medicaid |
$4.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.82
|
| Rate for Payer: United Healthcare PPO |
$14.25
|
| Rate for Payer: WEA Trust Commercial |
$10.45
|
| Rate for Payer: Wellcare Medicare |
$7.82
|
| Rate for Payer: WMAP Medicaid |
$4.57
|
| Rate for Payer: WPS Commercial |
$14.07
|
|
|
Allergy Panel, Food (Pediatric) IgG
|
Professional
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4752606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.82 |
| Max. Negotiated Rate |
$34.41 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.34
|
| Rate for Payer: Aetna Managed Medicare |
$7.82
|
| Rate for Payer: Anthem Medicare Advantage |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.82
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$18.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7.82
|
| Rate for Payer: Health EOS Commercial |
$17.29
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$27.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$27.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.82
|
| Rate for Payer: Multiplan Commercial |
$15.20
|
| Rate for Payer: Preferred Network Access Commercial |
$18.05
|
| Rate for Payer: Quartz Beloit One Network |
$8.36
|
| Rate for Payer: Quartz Commercial |
$10.83
|
| Rate for Payer: Quartz Medicare Advantage |
$7.82
|
| Rate for Payer: The Alliance Commercial |
$30.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.82
|
| Rate for Payer: WEA Trust Commercial |
$10.45
|
| Rate for Payer: WPS Commercial |
$34.41
|
|
|
Allergy Panel, Food (Pediatric) IgG
|
Facility
IP
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4752606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$17.48 |
| Rate for Payer: Aetna Commercial |
$17.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10.07
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$17.48
|
| Rate for Payer: Health EOS Commercial |
$16.91
|
| Rate for Payer: HFN Commercial |
$17.48
|
| Rate for Payer: Multiplan Commercial |
$15.20
|
| Rate for Payer: NAPHCARE Commercial |
$11.40
|
| Rate for Payer: Preferred Network Access Commercial |
$17.48
|
| Rate for Payer: Quartz Beloit One Network |
$9.31
|
| Rate for Payer: Quartz Commercial |
$11.40
|
| Rate for Payer: WEA Trust Commercial |
$10.45
|
| Rate for Payer: WPS Commercial |
$14.07
|
|
|
Allergy Panel Food w/ Rfx
|
Facility
OP
|
$8.78
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
6230792
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$35.12 |
| Rate for Payer: Aetna Commercial |
$7.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7.55
|
| Rate for Payer: Aetna Managed Medicare |
$5.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.14
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.67
|
| Rate for Payer: Anthem Medicaid |
$4.57
|
| Rate for Payer: Anthem Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.22
|
| Rate for Payer: Cash Price |
$2.63
|
| Rate for Payer: Cash Price |
$2.63
|
| Rate for Payer: Cigna Commercial |
$8.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$7.81
|
| Rate for Payer: HFN Commercial |
$8.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.22
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.22
|
| Rate for Payer: Managed Health Services Medicaid |
$4.75
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.22
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$7.02
|
| Rate for Payer: NAPHCARE Commercial |
$7.83
|
| Rate for Payer: Preferred Network Access Commercial |
$8.08
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.57
|
| Rate for Payer: Quartz Beloit One Network |
$4.30
|
| Rate for Payer: Quartz Commercial |
$5.71
|
| Rate for Payer: Quartz Medicare Advantage |
$5.22
|
| Rate for Payer: The Alliance Commercial |
$35.12
|
| Rate for Payer: United Healthcare Medicaid |
$4.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare PPO |
$6.58
|
| Rate for Payer: WEA Trust Commercial |
$4.83
|
| Rate for Payer: Wellcare Medicare |
$5.22
|
| Rate for Payer: WMAP Medicaid |
$4.57
|
| Rate for Payer: WPS Commercial |
$6.50
|
|
|
Allergy Panel Food w/ Rfx
|
Professional
|
$8.78
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
6230792
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$22.97 |
| Rate for Payer: Aetna Commercial |
$8.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7.55
|
| Rate for Payer: Aetna Managed Medicare |
$5.22
|
| Rate for Payer: Anthem Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.22
|
| Rate for Payer: Cash Price |
$2.63
|
| Rate for Payer: Cash Price |
$2.63
|
| Rate for Payer: Cigna Commercial |
$8.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$7.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$7.02
|
| Rate for Payer: Preferred Network Access Commercial |
$8.34
|
| Rate for Payer: Quartz Beloit One Network |
$3.86
|
| Rate for Payer: Quartz Commercial |
$5.00
|
| Rate for Payer: Quartz Medicare Advantage |
$5.22
|
| Rate for Payer: The Alliance Commercial |
$20.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: WEA Trust Commercial |
$4.83
|
| Rate for Payer: WPS Commercial |
$22.97
|
|
|
Allergy Panel Food w/ Rfx
|
Facility
IP
|
$8.78
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
6230792
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$8.08 |
| Rate for Payer: Aetna Commercial |
$7.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4.65
|
| Rate for Payer: Cash Price |
$2.63
|
| Rate for Payer: Cigna Commercial |
$8.08
|
| Rate for Payer: Health EOS Commercial |
$7.81
|
| Rate for Payer: HFN Commercial |
$8.08
|
| Rate for Payer: Multiplan Commercial |
$7.02
|
| Rate for Payer: NAPHCARE Commercial |
$5.27
|
| Rate for Payer: Preferred Network Access Commercial |
$8.08
|
| Rate for Payer: Quartz Beloit One Network |
$4.30
|
| Rate for Payer: Quartz Commercial |
$5.27
|
| Rate for Payer: WEA Trust Commercial |
$4.83
|
| Rate for Payer: WPS Commercial |
$6.50
|
|
|
.Allergy Panel, Milk Component
|
Facility
OP
|
$21.06
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163582
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$84.24 |
| Rate for Payer: Aetna Commercial |
$18.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.11
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.76
|
| Rate for Payer: Anthem Medicaid |
$17.71
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$6.32
|
| Rate for Payer: Cash Price |
$6.32
|
| Rate for Payer: Cigna Commercial |
$19.38
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17.71
|
| Rate for Payer: Dean Health Medicaid |
$17.71
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$18.74
|
| Rate for Payer: HFN Commercial |
$19.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Managed Health Services Medicaid |
$18.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$16.85
|
| Rate for Payer: NAPHCARE Commercial |
$26.90
|
| Rate for Payer: Preferred Network Access Commercial |
$19.38
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17.71
|
| Rate for Payer: Quartz Beloit One Network |
$10.32
|
| Rate for Payer: Quartz Commercial |
$13.69
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$84.24
|
| Rate for Payer: United Healthcare Medicaid |
$17.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Healthcare PPO |
$15.80
|
| Rate for Payer: WEA Trust Commercial |
$11.58
|
| Rate for Payer: Wellcare Medicare |
$17.93
|
| Rate for Payer: WMAP Medicaid |
$17.71
|
| Rate for Payer: WPS Commercial |
$15.60
|
|
|
.Allergy Panel, Milk Component
|
Facility
IP
|
$21.06
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163582
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$19.38 |
| Rate for Payer: Aetna Commercial |
$18.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.16
|
| Rate for Payer: Cash Price |
$6.32
|
| Rate for Payer: Cigna Commercial |
$19.38
|
| Rate for Payer: Health EOS Commercial |
$18.74
|
| Rate for Payer: HFN Commercial |
$19.38
|
| Rate for Payer: Multiplan Commercial |
$16.85
|
| Rate for Payer: NAPHCARE Commercial |
$12.64
|
| Rate for Payer: Preferred Network Access Commercial |
$19.38
|
| Rate for Payer: Quartz Beloit One Network |
$10.32
|
| Rate for Payer: Quartz Commercial |
$12.64
|
| Rate for Payer: WEA Trust Commercial |
$11.58
|
| Rate for Payer: WPS Commercial |
$15.60
|
|
|
.Allergy Panel, Milk Component
|
Professional
|
$21.06
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163582
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.27 |
| Max. Negotiated Rate |
$78.89 |
| Rate for Payer: Aetna Commercial |
$20.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.11
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$6.32
|
| Rate for Payer: Cash Price |
$6.32
|
| Rate for Payer: Cigna Commercial |
$20.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$10.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$19.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$16.85
|
| Rate for Payer: Preferred Network Access Commercial |
$20.01
|
| Rate for Payer: Quartz Beloit One Network |
$9.27
|
| Rate for Payer: Quartz Commercial |
$12.00
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$70.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: WEA Trust Commercial |
$11.58
|
| Rate for Payer: WPS Commercial |
$78.89
|
|
|
Allergy Panel, Nut Mix Group
|
Facility
OP
|
$23.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3620169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$92.00 |
| Rate for Payer: Aetna Commercial |
$20.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$19.78
|
| Rate for Payer: Aetna Managed Medicare |
$5.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.14
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.67
|
| Rate for Payer: Anthem Medicaid |
$4.57
|
| Rate for Payer: Anthem Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$12.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.22
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cigna Commercial |
$21.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$20.47
|
| Rate for Payer: HFN Commercial |
$21.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.22
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.22
|
| Rate for Payer: Managed Health Services Medicaid |
$4.75
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.22
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: NAPHCARE Commercial |
$7.83
|
| Rate for Payer: Preferred Network Access Commercial |
$21.16
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.57
|
| Rate for Payer: Quartz Beloit One Network |
$11.27
|
| Rate for Payer: Quartz Commercial |
$14.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5.22
|
| Rate for Payer: The Alliance Commercial |
$92.00
|
| Rate for Payer: United Healthcare Medicaid |
$4.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare PPO |
$17.25
|
| Rate for Payer: WEA Trust Commercial |
$12.65
|
| Rate for Payer: Wellcare Medicare |
$5.22
|
| Rate for Payer: WMAP Medicaid |
$4.57
|
| Rate for Payer: WPS Commercial |
$17.04
|
|
|
Allergy Panel, Nut Mix Group
|
Facility
IP
|
$23.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3620169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$21.16 |
| Rate for Payer: Aetna Commercial |
$20.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$12.19
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cigna Commercial |
$21.16
|
| Rate for Payer: Health EOS Commercial |
$20.47
|
| Rate for Payer: HFN Commercial |
$21.16
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: NAPHCARE Commercial |
$13.80
|
| Rate for Payer: Preferred Network Access Commercial |
$21.16
|
| Rate for Payer: Quartz Beloit One Network |
$11.27
|
| Rate for Payer: Quartz Commercial |
$13.80
|
| Rate for Payer: WEA Trust Commercial |
$12.65
|
| Rate for Payer: WPS Commercial |
$17.04
|
|
|
Allergy Panel, Nut Mix Group
|
Professional
|
$23.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3620169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$22.97 |
| Rate for Payer: Aetna Commercial |
$21.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$19.78
|
| Rate for Payer: Aetna Managed Medicare |
$5.22
|
| Rate for Payer: Anthem Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.22
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cigna Commercial |
$21.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$20.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: Preferred Network Access Commercial |
$21.85
|
| Rate for Payer: Quartz Beloit One Network |
$10.12
|
| Rate for Payer: Quartz Commercial |
$13.11
|
| Rate for Payer: Quartz Medicare Advantage |
$5.22
|
| Rate for Payer: The Alliance Commercial |
$20.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: WEA Trust Commercial |
$12.65
|
| Rate for Payer: WPS Commercial |
$22.97
|
|
|
.Allergy Panel, Peanut Component
|
Facility
IP
|
$53.72
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163583
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.32 |
| Max. Negotiated Rate |
$49.42 |
| Rate for Payer: Aetna Commercial |
$48.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$28.47
|
| Rate for Payer: Cash Price |
$16.12
|
| Rate for Payer: Cigna Commercial |
$49.42
|
| Rate for Payer: Health EOS Commercial |
$47.81
|
| Rate for Payer: HFN Commercial |
$49.42
|
| Rate for Payer: Multiplan Commercial |
$42.98
|
| Rate for Payer: NAPHCARE Commercial |
$32.23
|
| Rate for Payer: Preferred Network Access Commercial |
$49.42
|
| Rate for Payer: Quartz Beloit One Network |
$26.32
|
| Rate for Payer: Quartz Commercial |
$32.23
|
| Rate for Payer: WEA Trust Commercial |
$29.55
|
| Rate for Payer: WPS Commercial |
$39.79
|
|
|
.Allergy Panel, Peanut Component
|
Facility
OP
|
$53.72
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163583
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.71 |
| Max. Negotiated Rate |
$214.88 |
| Rate for Payer: Aetna Commercial |
$48.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$46.20
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.76
|
| Rate for Payer: Anthem Medicaid |
$17.71
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$28.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$16.12
|
| Rate for Payer: Cash Price |
$16.12
|
| Rate for Payer: Cigna Commercial |
$49.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17.71
|
| Rate for Payer: Dean Health Medicaid |
$17.71
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$47.81
|
| Rate for Payer: HFN Commercial |
$49.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.93
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Managed Health Services Medicaid |
$18.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$42.98
|
| Rate for Payer: NAPHCARE Commercial |
$26.90
|
| Rate for Payer: Preferred Network Access Commercial |
$49.42
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17.71
|
| Rate for Payer: Quartz Beloit One Network |
$26.32
|
| Rate for Payer: Quartz Commercial |
$34.92
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$214.88
|
| Rate for Payer: United Healthcare Medicaid |
$17.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Healthcare PPO |
$40.29
|
| Rate for Payer: WEA Trust Commercial |
$29.55
|
| Rate for Payer: Wellcare Medicare |
$17.93
|
| Rate for Payer: WMAP Medicaid |
$17.71
|
| Rate for Payer: WPS Commercial |
$39.79
|
|
|
.Allergy Panel, Peanut Component
|
Professional
|
$53.72
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163583
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$78.89 |
| Rate for Payer: Aetna Commercial |
$51.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$46.20
|
| Rate for Payer: Aetna Managed Medicare |
$17.93
|
| Rate for Payer: Anthem Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.93
|
| Rate for Payer: Cash Price |
$16.12
|
| Rate for Payer: Cash Price |
$16.12
|
| Rate for Payer: Cigna Commercial |
$51.03
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$26.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.93
|
| Rate for Payer: Health EOS Commercial |
$48.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.29
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.93
|
| Rate for Payer: Multiplan Commercial |
$42.98
|
| Rate for Payer: Preferred Network Access Commercial |
$51.03
|
| Rate for Payer: Quartz Beloit One Network |
$23.64
|
| Rate for Payer: Quartz Commercial |
$30.62
|
| Rate for Payer: Quartz Medicare Advantage |
$17.93
|
| Rate for Payer: The Alliance Commercial |
$70.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: WEA Trust Commercial |
$29.55
|
| Rate for Payer: WPS Commercial |
$78.89
|
|
|
Allergy Panel, Region 3, Grasses
|
Facility
OP
|
$35.01
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
4510604
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$140.04 |
| Rate for Payer: Aetna Commercial |
$31.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$30.11
|
| Rate for Payer: Aetna Managed Medicare |
$5.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.14
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$8.67
|
| Rate for Payer: Anthem Medicaid |
$4.57
|
| Rate for Payer: Anthem Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$18.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.22
|
| Rate for Payer: Cash Price |
$10.50
|
| Rate for Payer: Cash Price |
$10.50
|
| Rate for Payer: Cigna Commercial |
$32.21
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.22
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicaid |
$4.57
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$31.16
|
| Rate for Payer: HFN Commercial |
$32.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.42
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.22
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.57
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.22
|
| Rate for Payer: Managed Health Services Medicaid |
$4.75
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.22
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$28.01
|
| Rate for Payer: NAPHCARE Commercial |
$7.83
|
| Rate for Payer: Preferred Network Access Commercial |
$32.21
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.57
|
| Rate for Payer: Quartz Beloit One Network |
$17.15
|
| Rate for Payer: Quartz Commercial |
$22.76
|
| Rate for Payer: Quartz Medicare Advantage |
$5.22
|
| Rate for Payer: The Alliance Commercial |
$140.04
|
| Rate for Payer: United Healthcare Medicaid |
$4.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare PPO |
$26.26
|
| Rate for Payer: WEA Trust Commercial |
$19.26
|
| Rate for Payer: Wellcare Medicare |
$5.22
|
| Rate for Payer: WMAP Medicaid |
$4.57
|
| Rate for Payer: WPS Commercial |
$25.93
|
|
|
Allergy Panel, Region 3, Grasses
|
Professional
|
$35.01
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
4510604
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$33.26 |
| Rate for Payer: Aetna Commercial |
$33.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$30.11
|
| Rate for Payer: Aetna Managed Medicare |
$5.22
|
| Rate for Payer: Anthem Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.22
|
| Rate for Payer: Cash Price |
$10.50
|
| Rate for Payer: Cash Price |
$10.50
|
| Rate for Payer: Cigna Commercial |
$33.26
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.22
|
| Rate for Payer: Health EOS Commercial |
$31.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$18.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$28.01
|
| Rate for Payer: Preferred Network Access Commercial |
$33.26
|
| Rate for Payer: Quartz Beloit One Network |
$15.40
|
| Rate for Payer: Quartz Commercial |
$19.96
|
| Rate for Payer: Quartz Medicare Advantage |
$5.22
|
| Rate for Payer: The Alliance Commercial |
$20.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: WEA Trust Commercial |
$19.26
|
| Rate for Payer: WPS Commercial |
$22.97
|
|
