|
Allergy Panel 18, Nut Mix Group
|
Facility
|
OP
|
$19.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3610762
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$21.72 |
| Rate for Payer: Aetna Commercial |
$17.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.99
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.01
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$18.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$17.59
|
| Rate for Payer: HFN Commercial |
$18.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$18.18
|
| Rate for Payer: Quartz Beloit One Network |
$9.68
|
| Rate for Payer: Quartz Commercial |
$12.84
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: United Healthcare PPO |
$14.82
|
| Rate for Payer: WEA Trust Commercial |
$10.87
|
| Rate for Payer: Wellcare Medicare |
$5.43
|
| Rate for Payer: WPS Commercial |
$14.64
|
|
|
Allergy Panel 18, Nut Mix Group
|
Facility
|
IP
|
$19.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3610762
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.68 |
| Max. Negotiated Rate |
$18.18 |
| Rate for Payer: Aetna Commercial |
$17.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10.47
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$18.18
|
| Rate for Payer: Health EOS Commercial |
$17.59
|
| Rate for Payer: HFN Commercial |
$18.18
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: Preferred Network Access Commercial |
$18.18
|
| Rate for Payer: Quartz Beloit One Network |
$9.68
|
| Rate for Payer: Quartz Commercial |
$11.86
|
| Rate for Payer: WEA Trust Commercial |
$10.87
|
| Rate for Payer: WPS Commercial |
$14.64
|
|
|
Allergy Panel 18, Nut Mix Group
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3610762
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$23.89 |
| Rate for Payer: Aetna Commercial |
$18.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.99
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$18.77
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$17.98
|
| Rate for Payer: HFN Commercial |
$18.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$18.77
|
| Rate for Payer: Quartz Beloit One Network |
$8.69
|
| Rate for Payer: Quartz Commercial |
$11.26
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: WEA Trust Commercial |
$10.87
|
| Rate for Payer: WPS Commercial |
$23.89
|
|
|
Allergy Panel 19, Seafood Group
|
Facility
|
OP
|
$19.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3610761
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$21.72 |
| Rate for Payer: Aetna Commercial |
$17.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.99
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.01
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$18.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$17.59
|
| Rate for Payer: HFN Commercial |
$18.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$18.18
|
| Rate for Payer: Quartz Beloit One Network |
$9.68
|
| Rate for Payer: Quartz Commercial |
$12.84
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: United Healthcare PPO |
$14.82
|
| Rate for Payer: WEA Trust Commercial |
$10.87
|
| Rate for Payer: Wellcare Medicare |
$5.43
|
| Rate for Payer: WPS Commercial |
$14.64
|
|
|
Allergy Panel 19, Seafood Group
|
Facility
|
IP
|
$19.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3610761
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.68 |
| Max. Negotiated Rate |
$18.18 |
| Rate for Payer: Aetna Commercial |
$17.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10.47
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$18.18
|
| Rate for Payer: Health EOS Commercial |
$17.59
|
| Rate for Payer: HFN Commercial |
$18.18
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: Preferred Network Access Commercial |
$18.18
|
| Rate for Payer: Quartz Beloit One Network |
$9.68
|
| Rate for Payer: Quartz Commercial |
$11.86
|
| Rate for Payer: WEA Trust Commercial |
$10.87
|
| Rate for Payer: WPS Commercial |
$14.64
|
|
|
Allergy Panel 19, Seafood Group
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3610761
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$23.89 |
| Rate for Payer: Aetna Commercial |
$18.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.99
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$18.77
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$17.98
|
| Rate for Payer: HFN Commercial |
$18.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$18.77
|
| Rate for Payer: Quartz Beloit One Network |
$8.69
|
| Rate for Payer: Quartz Commercial |
$11.26
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: WEA Trust Commercial |
$10.87
|
| Rate for Payer: WPS Commercial |
$23.89
|
|
|
Allergy Panel, Childhood (Food & Environ)
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2766799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$23.92 |
| Rate for Payer: Aetna Commercial |
$23.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13.78
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$23.92
|
| Rate for Payer: Health EOS Commercial |
$23.14
|
| Rate for Payer: HFN Commercial |
$23.92
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Preferred Network Access Commercial |
$23.92
|
| Rate for Payer: Quartz Beloit One Network |
$12.74
|
| Rate for Payer: Quartz Commercial |
$15.60
|
| Rate for Payer: WEA Trust Commercial |
$14.30
|
| Rate for Payer: WPS Commercial |
$19.26
|
|
|
Allergy Panel, Childhood (Food & Environ)
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2766799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$24.70 |
| Rate for Payer: Aetna Commercial |
$24.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22.36
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$24.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$23.66
|
| Rate for Payer: HFN Commercial |
$24.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$24.70
|
| Rate for Payer: Quartz Beloit One Network |
$11.44
|
| Rate for Payer: Quartz Commercial |
$14.82
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: WEA Trust Commercial |
$14.30
|
| Rate for Payer: WPS Commercial |
$23.89
|
|
|
Allergy Panel, Childhood (Food & Environ)
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2766799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$23.92 |
| Rate for Payer: Aetna Commercial |
$23.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22.36
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.01
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$23.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$23.14
|
| Rate for Payer: HFN Commercial |
$23.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$23.92
|
| Rate for Payer: Quartz Beloit One Network |
$12.74
|
| Rate for Payer: Quartz Commercial |
$16.90
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: United Healthcare PPO |
$19.50
|
| Rate for Payer: WEA Trust Commercial |
$14.30
|
| Rate for Payer: Wellcare Medicare |
$5.43
|
| Rate for Payer: WPS Commercial |
$19.26
|
|
|
Allergy Panel, Childhood (Food & Environ)
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
1043059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$22.01 |
| Rate for Payer: Aetna Commercial |
$21.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$20.57
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.01
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cigna Commercial |
$22.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.39
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$21.29
|
| Rate for Payer: HFN Commercial |
$22.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$19.14
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$22.01
|
| Rate for Payer: Quartz Beloit One Network |
$11.72
|
| Rate for Payer: Quartz Commercial |
$15.55
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: United Healthcare PPO |
$17.94
|
| Rate for Payer: WEA Trust Commercial |
$13.16
|
| Rate for Payer: Wellcare Medicare |
$5.43
|
| Rate for Payer: WPS Commercial |
$17.72
|
|
|
Allergy Panel, Childhood (Food & Environ)
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
1043059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$23.89 |
| Rate for Payer: Aetna Commercial |
$22.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$20.57
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cigna Commercial |
$22.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$21.77
|
| Rate for Payer: HFN Commercial |
$22.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$19.14
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$22.72
|
| Rate for Payer: Quartz Beloit One Network |
$10.52
|
| Rate for Payer: Quartz Commercial |
$13.63
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: WEA Trust Commercial |
$13.16
|
| Rate for Payer: WPS Commercial |
$23.89
|
|
|
Allergy Panel, Childhood (Food & Environ)
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
1043059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$22.01 |
| Rate for Payer: Aetna Commercial |
$21.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$20.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$12.68
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cigna Commercial |
$22.01
|
| Rate for Payer: Health EOS Commercial |
$21.29
|
| Rate for Payer: HFN Commercial |
$22.01
|
| Rate for Payer: Multiplan Commercial |
$19.14
|
| Rate for Payer: Preferred Network Access Commercial |
$22.01
|
| Rate for Payer: Quartz Beloit One Network |
$11.72
|
| Rate for Payer: Quartz Commercial |
$14.35
|
| Rate for Payer: WEA Trust Commercial |
$13.16
|
| Rate for Payer: WPS Commercial |
$17.72
|
|
|
.Allergy Panel, Egg Component
|
Facility
|
IP
|
$14.04
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163584
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$13.43 |
| Rate for Payer: Aetna Commercial |
$13.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$12.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7.74
|
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cigna Commercial |
$13.43
|
| Rate for Payer: Health EOS Commercial |
$13.00
|
| Rate for Payer: HFN Commercial |
$13.43
|
| Rate for Payer: Multiplan Commercial |
$11.68
|
| Rate for Payer: Preferred Network Access Commercial |
$13.43
|
| Rate for Payer: Quartz Beloit One Network |
$7.15
|
| Rate for Payer: Quartz Commercial |
$8.76
|
| Rate for Payer: WEA Trust Commercial |
$8.03
|
| Rate for Payer: WPS Commercial |
$10.82
|
|
|
.Allergy Panel, Egg Component
|
Professional
|
Both
|
$14.04
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163584
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$82.05 |
| Rate for Payer: Aetna Commercial |
$13.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$12.56
|
| Rate for Payer: Aetna Managed Medicare |
$18.65
|
| Rate for Payer: Anthem Medicare Advantage |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.65
|
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cigna Commercial |
$13.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$18.65
|
| Rate for Payer: Health EOS Commercial |
$13.29
|
| Rate for Payer: HFN Commercial |
$13.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.82
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$65.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$11.68
|
| Rate for Payer: NAPHCARE Commercial |
$27.97
|
| Rate for Payer: Preferred Network Access Commercial |
$13.87
|
| Rate for Payer: Quartz Beloit One Network |
$6.42
|
| Rate for Payer: Quartz Commercial |
$8.32
|
| Rate for Payer: Quartz Medicare Advantage |
$18.65
|
| Rate for Payer: The Alliance Commercial |
$73.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.65
|
| Rate for Payer: WEA Trust Commercial |
$8.03
|
| Rate for Payer: WPS Commercial |
$82.05
|
|
|
.Allergy Panel, Egg Component
|
Facility
|
OP
|
$14.04
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
4163584
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$74.59 |
| Rate for Payer: Aetna Commercial |
$13.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$12.56
|
| Rate for Payer: Aetna Managed Medicare |
$18.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$69.93
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$32.63
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30.95
|
| Rate for Payer: Anthem Medicare Advantage |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.65
|
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cigna Commercial |
$13.43
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18.65
|
| Rate for Payer: Health EOS Commercial |
$13.00
|
| Rate for Payer: HFN Commercial |
$13.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$69.37
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$11.68
|
| Rate for Payer: NAPHCARE Commercial |
$27.97
|
| Rate for Payer: Preferred Network Access Commercial |
$13.43
|
| Rate for Payer: Quartz Beloit One Network |
$7.15
|
| Rate for Payer: Quartz Commercial |
$9.49
|
| Rate for Payer: Quartz Medicare Advantage |
$18.65
|
| Rate for Payer: The Alliance Commercial |
$74.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.65
|
| Rate for Payer: United Healthcare PPO |
$10.95
|
| Rate for Payer: WEA Trust Commercial |
$8.03
|
| Rate for Payer: Wellcare Medicare |
$18.65
|
| Rate for Payer: WPS Commercial |
$10.82
|
|
|
Allergy Panel, Food
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2770799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$23.92 |
| Rate for Payer: Aetna Commercial |
$23.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13.78
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$23.92
|
| Rate for Payer: Health EOS Commercial |
$23.14
|
| Rate for Payer: HFN Commercial |
$23.92
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Preferred Network Access Commercial |
$23.92
|
| Rate for Payer: Quartz Beloit One Network |
$12.74
|
| Rate for Payer: Quartz Commercial |
$15.60
|
| Rate for Payer: WEA Trust Commercial |
$14.30
|
| Rate for Payer: WPS Commercial |
$19.26
|
|
|
Allergy Panel, Food
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2770799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$24.70 |
| Rate for Payer: Aetna Commercial |
$24.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22.36
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$24.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$23.66
|
| Rate for Payer: HFN Commercial |
$24.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$24.70
|
| Rate for Payer: Quartz Beloit One Network |
$11.44
|
| Rate for Payer: Quartz Commercial |
$14.82
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: WEA Trust Commercial |
$14.30
|
| Rate for Payer: WPS Commercial |
$23.89
|
|
|
Allergy Panel, Food
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2770799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$23.92 |
| Rate for Payer: Aetna Commercial |
$23.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$22.36
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.01
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$13.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna Commercial |
$23.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$14.55
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$23.14
|
| Rate for Payer: HFN Commercial |
$23.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$23.92
|
| Rate for Payer: Quartz Beloit One Network |
$12.74
|
| Rate for Payer: Quartz Commercial |
$16.90
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: United Healthcare PPO |
$19.50
|
| Rate for Payer: WEA Trust Commercial |
$14.30
|
| Rate for Payer: Wellcare Medicare |
$5.43
|
| Rate for Payer: WPS Commercial |
$19.26
|
|
|
Allergy Panel, Food (Pediatric)
|
Facility
|
IP
|
$22.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4754606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.21 |
| Max. Negotiated Rate |
$21.05 |
| Rate for Payer: Aetna Commercial |
$20.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$19.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$12.13
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$21.05
|
| Rate for Payer: Health EOS Commercial |
$20.36
|
| Rate for Payer: HFN Commercial |
$21.05
|
| Rate for Payer: Multiplan Commercial |
$18.30
|
| Rate for Payer: Preferred Network Access Commercial |
$21.05
|
| Rate for Payer: Quartz Beloit One Network |
$11.21
|
| Rate for Payer: Quartz Commercial |
$13.73
|
| Rate for Payer: WEA Trust Commercial |
$12.58
|
| Rate for Payer: WPS Commercial |
$16.95
|
|
|
Allergy Panel, Food (Pediatric)
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4754606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$32.53 |
| Rate for Payer: Aetna Commercial |
$20.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$19.68
|
| Rate for Payer: Aetna Managed Medicare |
$8.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$30.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14.23
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$13.50
|
| Rate for Payer: Anthem Medicare Advantage |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$12.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.13
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$21.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.80
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8.13
|
| Rate for Payer: Health EOS Commercial |
$20.36
|
| Rate for Payer: HFN Commercial |
$21.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.13
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8.13
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8.13
|
| Rate for Payer: Multiplan Commercial |
$18.30
|
| Rate for Payer: NAPHCARE Commercial |
$12.20
|
| Rate for Payer: Preferred Network Access Commercial |
$21.05
|
| Rate for Payer: Quartz Beloit One Network |
$11.21
|
| Rate for Payer: Quartz Commercial |
$14.87
|
| Rate for Payer: Quartz Medicare Advantage |
$8.13
|
| Rate for Payer: The Alliance Commercial |
$32.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.13
|
| Rate for Payer: United Healthcare PPO |
$17.16
|
| Rate for Payer: WEA Trust Commercial |
$12.58
|
| Rate for Payer: Wellcare Medicare |
$8.13
|
| Rate for Payer: WPS Commercial |
$16.95
|
|
|
Allergy Panel, Food (Pediatric)
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4754606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$35.78 |
| Rate for Payer: Aetna Commercial |
$21.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$19.68
|
| Rate for Payer: Aetna Managed Medicare |
$8.13
|
| Rate for Payer: Anthem Medicare Advantage |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.13
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna Commercial |
$21.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.13
|
| Rate for Payer: Health EOS Commercial |
$20.82
|
| Rate for Payer: HFN Commercial |
$21.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$28.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.13
|
| Rate for Payer: Multiplan Commercial |
$18.30
|
| Rate for Payer: NAPHCARE Commercial |
$12.20
|
| Rate for Payer: Preferred Network Access Commercial |
$21.74
|
| Rate for Payer: Quartz Beloit One Network |
$10.07
|
| Rate for Payer: Quartz Commercial |
$13.04
|
| Rate for Payer: Quartz Medicare Advantage |
$8.13
|
| Rate for Payer: The Alliance Commercial |
$32.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.13
|
| Rate for Payer: WEA Trust Commercial |
$12.58
|
| Rate for Payer: WPS Commercial |
$35.78
|
|
|
Allergy Panel, Food (Pediatric) IgG
|
Facility
|
OP
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4752606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$32.53 |
| Rate for Payer: Aetna Commercial |
$17.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.99
|
| Rate for Payer: Aetna Managed Medicare |
$8.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$30.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14.23
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$13.50
|
| Rate for Payer: Anthem Medicare Advantage |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.13
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$18.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11.06
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8.13
|
| Rate for Payer: Health EOS Commercial |
$17.59
|
| Rate for Payer: HFN Commercial |
$18.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.13
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8.13
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8.13
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: NAPHCARE Commercial |
$12.20
|
| Rate for Payer: Preferred Network Access Commercial |
$18.18
|
| Rate for Payer: Quartz Beloit One Network |
$9.68
|
| Rate for Payer: Quartz Commercial |
$12.84
|
| Rate for Payer: Quartz Medicare Advantage |
$8.13
|
| Rate for Payer: The Alliance Commercial |
$32.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.13
|
| Rate for Payer: United Healthcare PPO |
$14.82
|
| Rate for Payer: WEA Trust Commercial |
$10.87
|
| Rate for Payer: Wellcare Medicare |
$8.13
|
| Rate for Payer: WPS Commercial |
$14.64
|
|
|
Allergy Panel, Food (Pediatric) IgG
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4752606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$35.78 |
| Rate for Payer: Aetna Commercial |
$18.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.99
|
| Rate for Payer: Aetna Managed Medicare |
$8.13
|
| Rate for Payer: Anthem Medicare Advantage |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.13
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$18.77
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.13
|
| Rate for Payer: Health EOS Commercial |
$17.98
|
| Rate for Payer: HFN Commercial |
$18.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$28.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.13
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: NAPHCARE Commercial |
$12.20
|
| Rate for Payer: Preferred Network Access Commercial |
$18.77
|
| Rate for Payer: Quartz Beloit One Network |
$8.69
|
| Rate for Payer: Quartz Commercial |
$11.26
|
| Rate for Payer: Quartz Medicare Advantage |
$8.13
|
| Rate for Payer: The Alliance Commercial |
$32.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.13
|
| Rate for Payer: WEA Trust Commercial |
$10.87
|
| Rate for Payer: WPS Commercial |
$35.78
|
|
|
Allergy Panel, Food (Pediatric) IgG
|
Facility
|
IP
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
4752606
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.68 |
| Max. Negotiated Rate |
$18.18 |
| Rate for Payer: Aetna Commercial |
$17.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$16.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$10.47
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cigna Commercial |
$18.18
|
| Rate for Payer: Health EOS Commercial |
$17.59
|
| Rate for Payer: HFN Commercial |
$18.18
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: Preferred Network Access Commercial |
$18.18
|
| Rate for Payer: Quartz Beloit One Network |
$9.68
|
| Rate for Payer: Quartz Commercial |
$11.86
|
| Rate for Payer: WEA Trust Commercial |
$10.87
|
| Rate for Payer: WPS Commercial |
$14.64
|
|
|
Allergy Panel Food w/ Rfx
|
Facility
|
IP
|
$8.78
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
6230792
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.47 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: Aetna Commercial |
$8.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4.84
|
| Rate for Payer: Cash Price |
$2.63
|
| Rate for Payer: Cigna Commercial |
$8.40
|
| Rate for Payer: Health EOS Commercial |
$8.13
|
| Rate for Payer: HFN Commercial |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$7.30
|
| Rate for Payer: Preferred Network Access Commercial |
$8.40
|
| Rate for Payer: Quartz Beloit One Network |
$4.47
|
| Rate for Payer: Quartz Commercial |
$5.48
|
| Rate for Payer: WEA Trust Commercial |
$5.02
|
| Rate for Payer: WPS Commercial |
$6.76
|
|
