|
Hemoglobin Fetal Qualitative
|
Professional
|
Both
|
$418.00
|
|
|
Service Code
|
CPT 83021
|
| Hospital Charge Code |
978119
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$397.10 |
| Rate for Payer: Health EOS Commercial |
$380.38
|
| Rate for Payer: HFN Commercial |
$397.10
|
| Rate for Payer: Aetna Commercial |
$397.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$359.48
|
| Rate for Payer: Cash Price |
$125.40
|
| Rate for Payer: Cash Price |
$125.40
|
| Rate for Payer: Cigna Commercial |
$397.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$209.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$250.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.75
|
| Rate for Payer: Multiplan Commercial |
$334.40
|
| Rate for Payer: Preferred Network Access Commercial |
$397.10
|
| Rate for Payer: Quartz Beloit One Network |
$183.92
|
| Rate for Payer: Quartz Commercial |
$238.26
|
| Rate for Payer: The Alliance Commercial |
$209.00
|
| Rate for Payer: WEA Trust Commercial |
$229.90
|
| Rate for Payer: WPS Commercial |
$309.61
|
|
|
Hemoglobin Fetal Qualitative
|
Facility
|
IP
|
$418.00
|
|
|
Service Code
|
CPT 83021
|
| Hospital Charge Code |
978119
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$204.82 |
| Max. Negotiated Rate |
$384.56 |
| Rate for Payer: Aetna Commercial |
$376.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$359.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$221.54
|
| Rate for Payer: Cash Price |
$125.40
|
| Rate for Payer: Cigna Commercial |
$384.56
|
| Rate for Payer: Health EOS Commercial |
$372.02
|
| Rate for Payer: HFN Commercial |
$384.56
|
| Rate for Payer: Multiplan Commercial |
$334.40
|
| Rate for Payer: NAPHCARE Commercial |
$250.80
|
| Rate for Payer: Preferred Network Access Commercial |
$384.56
|
| Rate for Payer: Quartz Beloit One Network |
$204.82
|
| Rate for Payer: Quartz Commercial |
$250.80
|
| Rate for Payer: WEA Trust Commercial |
$229.90
|
| Rate for Payer: WPS Commercial |
$309.61
|
|
|
Hemoglobin Free, Plasma
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
3256229
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$61.64 |
| Rate for Payer: Aetna Commercial |
$60.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$57.62
|
| Rate for Payer: Aetna Managed Medicare |
$7.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$27.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$12.79
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$12.13
|
| Rate for Payer: Anthem Medicaid |
$4.90
|
| Rate for Payer: Anthem Medicare Advantage |
$7.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7.31
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$61.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$37.49
|
| Rate for Payer: Dean Health Medicaid |
$4.90
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7.31
|
| Rate for Payer: Health EOS Commercial |
$59.63
|
| Rate for Payer: HFN Commercial |
$61.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$27.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7.31
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7.31
|
| Rate for Payer: Managed Health Services Medicaid |
$5.10
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7.31
|
| Rate for Payer: Multiplan Commercial |
$53.60
|
| Rate for Payer: NAPHCARE Commercial |
$10.96
|
| Rate for Payer: Preferred Network Access Commercial |
$61.64
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.90
|
| Rate for Payer: Quartz Beloit One Network |
$32.83
|
| Rate for Payer: Quartz Commercial |
$43.55
|
| Rate for Payer: Quartz Medicare Advantage |
$7.31
|
| Rate for Payer: The Alliance Commercial |
$29.24
|
| Rate for Payer: United Healthcare Medicaid |
$4.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.31
|
| Rate for Payer: United Healthcare PPO |
$50.25
|
| Rate for Payer: WEA Trust Commercial |
$36.85
|
| Rate for Payer: Wellcare Medicare |
$7.31
|
| Rate for Payer: WMAP Medicaid |
$4.90
|
| Rate for Payer: WPS Commercial |
$49.63
|
|
|
Hemoglobin Free, Plasma
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
3256229
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.83 |
| Max. Negotiated Rate |
$61.64 |
| Rate for Payer: Aetna Commercial |
$60.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$57.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$35.51
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$61.64
|
| Rate for Payer: Health EOS Commercial |
$59.63
|
| Rate for Payer: HFN Commercial |
$61.64
|
| Rate for Payer: Multiplan Commercial |
$53.60
|
| Rate for Payer: NAPHCARE Commercial |
$40.20
|
| Rate for Payer: Preferred Network Access Commercial |
$61.64
|
| Rate for Payer: Quartz Beloit One Network |
$32.83
|
| Rate for Payer: Quartz Commercial |
$40.20
|
| Rate for Payer: WEA Trust Commercial |
$36.85
|
| Rate for Payer: WPS Commercial |
$49.63
|
|
|
Hemoglobin Free, Plasma
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
3256229
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.80 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Aetna Commercial |
$63.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$57.62
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$63.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$33.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40.20
|
| Rate for Payer: Health EOS Commercial |
$60.97
|
| Rate for Payer: HFN Commercial |
$63.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$25.80
|
| Rate for Payer: Multiplan Commercial |
$53.60
|
| Rate for Payer: Preferred Network Access Commercial |
$63.65
|
| Rate for Payer: Quartz Beloit One Network |
$29.48
|
| Rate for Payer: Quartz Commercial |
$38.19
|
| Rate for Payer: The Alliance Commercial |
$33.50
|
| Rate for Payer: WEA Trust Commercial |
$36.85
|
| Rate for Payer: WPS Commercial |
$49.63
|
|
|
Hemoglobin Free Urine
|
Facility
|
IP
|
$138.00
|
|
|
Service Code
|
CPT 83069
|
| Hospital Charge Code |
977967
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.62 |
| Max. Negotiated Rate |
$126.96 |
| Rate for Payer: Aetna Commercial |
$124.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$73.14
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cigna Commercial |
$126.96
|
| Rate for Payer: Health EOS Commercial |
$122.82
|
| Rate for Payer: HFN Commercial |
$126.96
|
| Rate for Payer: Multiplan Commercial |
$110.40
|
| Rate for Payer: NAPHCARE Commercial |
$82.80
|
| Rate for Payer: Preferred Network Access Commercial |
$126.96
|
| Rate for Payer: Quartz Beloit One Network |
$67.62
|
| Rate for Payer: Quartz Commercial |
$82.80
|
| Rate for Payer: WEA Trust Commercial |
$75.90
|
| Rate for Payer: WPS Commercial |
$102.22
|
|
|
Hemoglobin Free Urine
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
CPT 83069
|
| Hospital Charge Code |
977967
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.94 |
| Max. Negotiated Rate |
$131.10 |
| Rate for Payer: Aetna Commercial |
$131.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.68
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cigna Commercial |
$131.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$69.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$82.80
|
| Rate for Payer: Health EOS Commercial |
$125.58
|
| Rate for Payer: HFN Commercial |
$131.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.94
|
| Rate for Payer: Multiplan Commercial |
$110.40
|
| Rate for Payer: Preferred Network Access Commercial |
$131.10
|
| Rate for Payer: Quartz Beloit One Network |
$60.72
|
| Rate for Payer: Quartz Commercial |
$78.66
|
| Rate for Payer: The Alliance Commercial |
$69.00
|
| Rate for Payer: WEA Trust Commercial |
$75.90
|
| Rate for Payer: WPS Commercial |
$102.22
|
|
|
Hemoglobin Free Urine
|
Facility
|
OP
|
$138.00
|
|
|
Service Code
|
CPT 83069
|
| Hospital Charge Code |
977967
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$126.96 |
| Rate for Payer: Aetna Commercial |
$124.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.68
|
| Rate for Payer: Aetna Managed Medicare |
$3.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.91
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.56
|
| Rate for Payer: Anthem Medicaid |
$4.08
|
| Rate for Payer: Anthem Medicare Advantage |
$3.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$73.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.95
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cigna Commercial |
$126.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$4.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$77.22
|
| Rate for Payer: Dean Health Medicaid |
$4.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.95
|
| Rate for Payer: Health EOS Commercial |
$122.82
|
| Rate for Payer: HFN Commercial |
$126.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.95
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$4.08
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.95
|
| Rate for Payer: Managed Health Services Medicaid |
$4.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.95
|
| Rate for Payer: Multiplan Commercial |
$110.40
|
| Rate for Payer: NAPHCARE Commercial |
$5.92
|
| Rate for Payer: Preferred Network Access Commercial |
$126.96
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$4.08
|
| Rate for Payer: Quartz Beloit One Network |
$67.62
|
| Rate for Payer: Quartz Commercial |
$89.70
|
| Rate for Payer: Quartz Medicare Advantage |
$3.95
|
| Rate for Payer: The Alliance Commercial |
$15.80
|
| Rate for Payer: United Healthcare Medicaid |
$4.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.95
|
| Rate for Payer: United Healthcare PPO |
$103.50
|
| Rate for Payer: WEA Trust Commercial |
$75.90
|
| Rate for Payer: Wellcare Medicare |
$3.95
|
| Rate for Payer: WMAP Medicaid |
$4.08
|
| Rate for Payer: WPS Commercial |
$102.22
|
|
|
Hemoglobin POC
|
Facility
|
IP
|
$38.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
2580821
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.62 |
| Max. Negotiated Rate |
$34.96 |
| Rate for Payer: Aetna Commercial |
$34.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$32.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$20.14
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cigna Commercial |
$34.96
|
| Rate for Payer: Health EOS Commercial |
$33.82
|
| Rate for Payer: HFN Commercial |
$34.96
|
| Rate for Payer: Multiplan Commercial |
$30.40
|
| Rate for Payer: NAPHCARE Commercial |
$22.80
|
| Rate for Payer: Preferred Network Access Commercial |
$34.96
|
| Rate for Payer: Quartz Beloit One Network |
$18.62
|
| Rate for Payer: Quartz Commercial |
$22.80
|
| Rate for Payer: WEA Trust Commercial |
$20.90
|
| Rate for Payer: WPS Commercial |
$28.15
|
|
|
Hemoglobin POC
|
Facility
|
OP
|
$38.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
2580821
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$34.96 |
| Rate for Payer: Aetna Commercial |
$34.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$32.68
|
| Rate for Payer: Aetna Managed Medicare |
$2.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$8.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4.15
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3.93
|
| Rate for Payer: Anthem Medicaid |
$2.45
|
| Rate for Payer: Anthem Medicare Advantage |
$2.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$20.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2.37
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cigna Commercial |
$34.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$2.45
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$21.26
|
| Rate for Payer: Dean Health Medicaid |
$2.45
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2.37
|
| Rate for Payer: Health EOS Commercial |
$33.82
|
| Rate for Payer: HFN Commercial |
$34.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2.37
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$2.45
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2.37
|
| Rate for Payer: Managed Health Services Medicaid |
$2.55
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2.37
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2.37
|
| Rate for Payer: Multiplan Commercial |
$30.40
|
| Rate for Payer: NAPHCARE Commercial |
$3.56
|
| Rate for Payer: Preferred Network Access Commercial |
$34.96
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$2.45
|
| Rate for Payer: Quartz Beloit One Network |
$18.62
|
| Rate for Payer: Quartz Commercial |
$24.70
|
| Rate for Payer: Quartz Medicare Advantage |
$2.37
|
| Rate for Payer: The Alliance Commercial |
$9.48
|
| Rate for Payer: United Healthcare Medicaid |
$2.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2.37
|
| Rate for Payer: United Healthcare PPO |
$28.50
|
| Rate for Payer: WEA Trust Commercial |
$20.90
|
| Rate for Payer: Wellcare Medicare |
$2.37
|
| Rate for Payer: WMAP Medicaid |
$2.45
|
| Rate for Payer: WPS Commercial |
$28.15
|
|
|
Hemoglobin POC
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
2580821
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$36.10 |
| Rate for Payer: Aetna Commercial |
$36.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$32.68
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cigna Commercial |
$36.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$22.80
|
| Rate for Payer: Health EOS Commercial |
$34.58
|
| Rate for Payer: HFN Commercial |
$36.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8.37
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.37
|
| Rate for Payer: Multiplan Commercial |
$30.40
|
| Rate for Payer: Preferred Network Access Commercial |
$36.10
|
| Rate for Payer: Quartz Beloit One Network |
$16.72
|
| Rate for Payer: Quartz Commercial |
$21.66
|
| Rate for Payer: The Alliance Commercial |
$19.00
|
| Rate for Payer: WEA Trust Commercial |
$20.90
|
| Rate for Payer: WPS Commercial |
$28.15
|
|
|
Hemogram
|
Facility
|
IP
|
$174.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
979866
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$85.26 |
| Max. Negotiated Rate |
$160.08 |
| Rate for Payer: Multiplan Commercial |
$139.20
|
| Rate for Payer: NAPHCARE Commercial |
$104.40
|
| Rate for Payer: Aetna Commercial |
$156.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$149.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$92.22
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cigna Commercial |
$160.08
|
| Rate for Payer: Health EOS Commercial |
$154.86
|
| Rate for Payer: HFN Commercial |
$160.08
|
| Rate for Payer: Preferred Network Access Commercial |
$160.08
|
| Rate for Payer: Quartz Beloit One Network |
$85.26
|
| Rate for Payer: Quartz Commercial |
$104.40
|
| Rate for Payer: WEA Trust Commercial |
$95.70
|
| Rate for Payer: WPS Commercial |
$128.88
|
|
|
Hemogram
|
Facility
|
OP
|
$174.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
979866
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$160.08 |
| Rate for Payer: Aetna Commercial |
$156.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$149.64
|
| Rate for Payer: Aetna Managed Medicare |
$6.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.74
|
| Rate for Payer: Anthem Medicaid |
$6.69
|
| Rate for Payer: Anthem Medicare Advantage |
$6.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$92.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.47
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cigna Commercial |
$160.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$97.37
|
| Rate for Payer: Dean Health Medicaid |
$6.69
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.47
|
| Rate for Payer: Health EOS Commercial |
$154.86
|
| Rate for Payer: HFN Commercial |
$160.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.47
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6.69
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.47
|
| Rate for Payer: Managed Health Services Medicaid |
$6.96
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.47
|
| Rate for Payer: Multiplan Commercial |
$139.20
|
| Rate for Payer: NAPHCARE Commercial |
$9.70
|
| Rate for Payer: Preferred Network Access Commercial |
$160.08
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6.69
|
| Rate for Payer: Quartz Beloit One Network |
$85.26
|
| Rate for Payer: Quartz Commercial |
$113.10
|
| Rate for Payer: Quartz Medicare Advantage |
$6.47
|
| Rate for Payer: The Alliance Commercial |
$25.88
|
| Rate for Payer: United Healthcare Medicaid |
$6.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.47
|
| Rate for Payer: United Healthcare PPO |
$130.50
|
| Rate for Payer: WEA Trust Commercial |
$95.70
|
| Rate for Payer: Wellcare Medicare |
$6.47
|
| Rate for Payer: WMAP Medicaid |
$6.69
|
| Rate for Payer: WPS Commercial |
$128.88
|
|
|
Hemogram
|
Facility
|
IP
|
$151.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
2975837
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$73.99 |
| Max. Negotiated Rate |
$138.92 |
| Rate for Payer: Aetna Commercial |
$135.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$129.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$80.03
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cigna Commercial |
$138.92
|
| Rate for Payer: Health EOS Commercial |
$134.39
|
| Rate for Payer: HFN Commercial |
$138.92
|
| Rate for Payer: Multiplan Commercial |
$120.80
|
| Rate for Payer: NAPHCARE Commercial |
$90.60
|
| Rate for Payer: Preferred Network Access Commercial |
$138.92
|
| Rate for Payer: Quartz Beloit One Network |
$73.99
|
| Rate for Payer: Quartz Commercial |
$90.60
|
| Rate for Payer: WEA Trust Commercial |
$83.05
|
| Rate for Payer: WPS Commercial |
$111.85
|
|
|
Hemogram
|
Facility
|
OP
|
$151.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
2975837
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$138.92 |
| Rate for Payer: Aetna Commercial |
$135.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$129.86
|
| Rate for Payer: Aetna Managed Medicare |
$6.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$24.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$11.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.74
|
| Rate for Payer: Anthem Medicaid |
$6.69
|
| Rate for Payer: Anthem Medicare Advantage |
$6.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$80.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6.47
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cigna Commercial |
$138.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$84.50
|
| Rate for Payer: Dean Health Medicaid |
$6.69
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6.47
|
| Rate for Payer: Health EOS Commercial |
$134.39
|
| Rate for Payer: HFN Commercial |
$138.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24.07
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6.47
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6.69
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6.47
|
| Rate for Payer: Managed Health Services Medicaid |
$6.96
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6.47
|
| Rate for Payer: Multiplan Commercial |
$120.80
|
| Rate for Payer: NAPHCARE Commercial |
$9.70
|
| Rate for Payer: Preferred Network Access Commercial |
$138.92
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6.69
|
| Rate for Payer: Quartz Beloit One Network |
$73.99
|
| Rate for Payer: Quartz Commercial |
$98.15
|
| Rate for Payer: Quartz Medicare Advantage |
$6.47
|
| Rate for Payer: The Alliance Commercial |
$25.88
|
| Rate for Payer: United Healthcare Medicaid |
$6.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.47
|
| Rate for Payer: United Healthcare PPO |
$113.25
|
| Rate for Payer: WEA Trust Commercial |
$83.05
|
| Rate for Payer: Wellcare Medicare |
$6.47
|
| Rate for Payer: WMAP Medicaid |
$6.69
|
| Rate for Payer: WPS Commercial |
$111.85
|
|
|
Hemogram
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
2975837
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.84 |
| Max. Negotiated Rate |
$143.45 |
| Rate for Payer: Aetna Commercial |
$143.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$129.86
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cigna Commercial |
$143.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$75.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$90.60
|
| Rate for Payer: Health EOS Commercial |
$137.41
|
| Rate for Payer: HFN Commercial |
$143.45
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22.84
|
| Rate for Payer: Multiplan Commercial |
$120.80
|
| Rate for Payer: Preferred Network Access Commercial |
$143.45
|
| Rate for Payer: Quartz Beloit One Network |
$66.44
|
| Rate for Payer: Quartz Commercial |
$86.07
|
| Rate for Payer: The Alliance Commercial |
$75.50
|
| Rate for Payer: WEA Trust Commercial |
$83.05
|
| Rate for Payer: WPS Commercial |
$111.85
|
|
|
Hemogram
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
979866
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.84 |
| Max. Negotiated Rate |
$165.30 |
| Rate for Payer: Aetna Commercial |
$165.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$149.64
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cigna Commercial |
$165.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$87.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$104.40
|
| Rate for Payer: Health EOS Commercial |
$158.34
|
| Rate for Payer: HFN Commercial |
$165.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$22.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$22.84
|
| Rate for Payer: Multiplan Commercial |
$139.20
|
| Rate for Payer: Preferred Network Access Commercial |
$165.30
|
| Rate for Payer: Quartz Beloit One Network |
$76.56
|
| Rate for Payer: Quartz Commercial |
$99.18
|
| Rate for Payer: The Alliance Commercial |
$87.00
|
| Rate for Payer: WEA Trust Commercial |
$95.70
|
| Rate for Payer: WPS Commercial |
$128.88
|
|
|
HEMORRHOIDECTOMY 46250
|
Professional
|
Both
|
$2,001.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
3014829
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$301.31 |
| Max. Negotiated Rate |
$1,900.95 |
| Rate for Payer: Aetna Commercial |
$1,900.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,720.86
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Cigna Commercial |
$1,900.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$301.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,200.60
|
| Rate for Payer: Health EOS Commercial |
$1,820.91
|
| Rate for Payer: HFN Commercial |
$1,900.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,067.15
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,067.15
|
| Rate for Payer: Multiplan Commercial |
$1,600.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,900.95
|
| Rate for Payer: Quartz Beloit One Network |
$880.44
|
| Rate for Payer: Quartz Commercial |
$1,140.57
|
| Rate for Payer: The Alliance Commercial |
$1,000.50
|
| Rate for Payer: United Healthcare Medicaid |
$301.31
|
| Rate for Payer: WEA Trust Commercial |
$1,100.55
|
| Rate for Payer: WPS Commercial |
$1,482.14
|
|
|
HEMORRHOIDECTOMY 46255
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
3014830
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$390.84 |
| Max. Negotiated Rate |
$2,289.50 |
| Rate for Payer: Aetna Commercial |
$2,289.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,072.60
|
| Rate for Payer: Cash Price |
$723.00
|
| Rate for Payer: Cash Price |
$723.00
|
| Rate for Payer: Cash Price |
$723.00
|
| Rate for Payer: Cigna Commercial |
$2,289.50
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$390.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,446.00
|
| Rate for Payer: Health EOS Commercial |
$2,193.10
|
| Rate for Payer: HFN Commercial |
$2,289.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,189.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,189.43
|
| Rate for Payer: Multiplan Commercial |
$1,928.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,289.50
|
| Rate for Payer: Quartz Beloit One Network |
$1,060.40
|
| Rate for Payer: Quartz Commercial |
$1,373.70
|
| Rate for Payer: The Alliance Commercial |
$1,205.00
|
| Rate for Payer: United Healthcare Medicaid |
$390.84
|
| Rate for Payer: WEA Trust Commercial |
$1,325.50
|
| Rate for Payer: WPS Commercial |
$1,785.09
|
|
|
HEMORRHOIDECTOMY 46999-46250
|
Professional
|
Both
|
$2,001.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
6210064
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$880.44 |
| Max. Negotiated Rate |
$1,900.95 |
| Rate for Payer: Aetna Commercial |
$1,900.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,720.86
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Cigna Commercial |
$1,900.95
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,000.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,200.60
|
| Rate for Payer: Health EOS Commercial |
$1,820.91
|
| Rate for Payer: HFN Commercial |
$1,900.95
|
| Rate for Payer: Multiplan Commercial |
$1,600.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,900.95
|
| Rate for Payer: Quartz Beloit One Network |
$880.44
|
| Rate for Payer: Quartz Commercial |
$1,140.57
|
| Rate for Payer: The Alliance Commercial |
$1,000.50
|
| Rate for Payer: WEA Trust Commercial |
$1,100.55
|
| Rate for Payer: WPS Commercial |
$1,482.14
|
|
|
HEMORRHOIDECTOMY, EXTERNAL, 2 OR MORE COLUMNS/GROUPS
|
Facility
|
OP
|
$11,100.96
|
|
|
Service Code
|
CPT 46250
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,726.00 |
| Max. Negotiated Rate |
$11,100.96 |
| Rate for Payer: Aetna Managed Medicare |
$2,775.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$2,775.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,775.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,775.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,775.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,546.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,775.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,323.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,775.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,775.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,775.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,775.24
|
| Rate for Payer: NAPHCARE Commercial |
$4,162.86
|
| Rate for Payer: Quartz Medicare Advantage |
$2,775.24
|
| Rate for Payer: The Alliance Commercial |
$11,100.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,775.24
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$2,775.24
|
|
|
HEMORRHOIDECTOMY/HEMORRHOIDPEXY
|
Facility
|
OP
|
$1,084.00
|
|
| Hospital Charge Code |
2960104
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$303.52 |
| Max. Negotiated Rate |
$4,336.00 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$932.24
|
| Rate for Payer: Aetna Managed Medicare |
$303.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$704.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$542.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$520.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$574.52
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$997.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$606.61
|
| Rate for Payer: Health EOS Commercial |
$964.76
|
| Rate for Payer: HFN Commercial |
$997.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$813.00
|
| Rate for Payer: Multiplan Commercial |
$867.20
|
| Rate for Payer: NAPHCARE Commercial |
$650.40
|
| Rate for Payer: Preferred Network Access Commercial |
$997.28
|
| Rate for Payer: Quartz Beloit One Network |
$531.16
|
| Rate for Payer: Quartz Commercial |
$704.60
|
| Rate for Payer: Quartz Medicare Advantage |
$650.40
|
| Rate for Payer: The Alliance Commercial |
$4,336.00
|
| Rate for Payer: WEA Trust Commercial |
$596.20
|
| Rate for Payer: WPS Commercial |
$802.92
|
|
|
HEMORRHOIDECTOMY/HEMORRHOIDPEXY
|
Facility
|
IP
|
$1,084.00
|
|
| Hospital Charge Code |
2960104
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$531.16 |
| Max. Negotiated Rate |
$997.28 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$932.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$574.52
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$997.28
|
| Rate for Payer: Health EOS Commercial |
$964.76
|
| Rate for Payer: HFN Commercial |
$997.28
|
| Rate for Payer: Multiplan Commercial |
$867.20
|
| Rate for Payer: NAPHCARE Commercial |
$650.40
|
| Rate for Payer: Preferred Network Access Commercial |
$997.28
|
| Rate for Payer: Quartz Beloit One Network |
$531.16
|
| Rate for Payer: Quartz Commercial |
$650.40
|
| Rate for Payer: WEA Trust Commercial |
$596.20
|
| Rate for Payer: WPS Commercial |
$802.92
|
|
|
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS;
|
Facility
|
OP
|
$11,100.96
|
|
|
Service Code
|
CPT 46260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,726.00 |
| Max. Negotiated Rate |
$11,100.96 |
| Rate for Payer: Aetna Managed Medicare |
$2,775.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,496.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,871.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,726.00
|
| Rate for Payer: Anthem Medicare Advantage |
$2,775.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,775.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,775.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,775.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,546.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,775.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$10,323.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,775.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,775.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,775.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,775.24
|
| Rate for Payer: NAPHCARE Commercial |
$4,162.86
|
| Rate for Payer: Quartz Medicare Advantage |
$2,775.24
|
| Rate for Payer: The Alliance Commercial |
$11,100.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,775.24
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: Wellcare Medicare |
$2,775.24
|
|
|
Hemorrhoidectomy, Internal, By Rubber Band Ligation 46221
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Professional
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Both
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$738.00
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|
|
Service Code
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CPT 46221
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| Hospital Charge Code |
1190848
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|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.18 |
| Max. Negotiated Rate |
$701.10 |
| Rate for Payer: Aetna Commercial |
$701.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.68
|
| Rate for Payer: Cash Price |
$221.40
|
| Rate for Payer: Cash Price |
$221.40
|
| Rate for Payer: Cash Price |
$221.40
|
| Rate for Payer: Cigna Commercial |
$701.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$45.18
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$442.80
|
| Rate for Payer: Health EOS Commercial |
$671.58
|
| Rate for Payer: HFN Commercial |
$701.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$654.29
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$654.29
|
| Rate for Payer: Multiplan Commercial |
$590.40
|
| Rate for Payer: Preferred Network Access Commercial |
$701.10
|
| Rate for Payer: Quartz Beloit One Network |
$324.72
|
| Rate for Payer: Quartz Commercial |
$420.66
|
| Rate for Payer: The Alliance Commercial |
$369.00
|
| Rate for Payer: United Healthcare Medicaid |
$45.18
|
| Rate for Payer: WEA Trust Commercial |
$405.90
|
| Rate for Payer: WPS Commercial |
$546.64
|
|
