|
Hep B Vaccine, Adult,IM 90746VFC
|
Professional
|
Both
|
$20.83
|
|
|
Service Code
|
CPT 90746
|
| Hospital Charge Code |
5100629
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.53 |
| Max. Negotiated Rate |
$195.39 |
| Rate for Payer: Aetna Commercial |
$20.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.63
|
| Rate for Payer: Aetna Managed Medicare |
$78.16
|
| Rate for Payer: Anthem Medicare Advantage |
$78.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$78.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$78.16
|
| Rate for Payer: Cash Price |
$6.25
|
| Rate for Payer: Cash Price |
$6.25
|
| Rate for Payer: Cigna Commercial |
$20.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$75.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$73.19
|
| Rate for Payer: Health EOS Commercial |
$19.71
|
| Rate for Payer: HFN Commercial |
$20.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$105.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$105.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$78.16
|
| Rate for Payer: Multiplan Commercial |
$17.33
|
| Rate for Payer: NAPHCARE Commercial |
$117.23
|
| Rate for Payer: Preferred Network Access Commercial |
$20.58
|
| Rate for Payer: Quartz Beloit One Network |
$9.53
|
| Rate for Payer: Quartz Commercial |
$12.35
|
| Rate for Payer: Quartz Medicare Advantage |
$78.16
|
| Rate for Payer: The Alliance Commercial |
$195.39
|
| Rate for Payer: United Healthcare Medicaid |
$75.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$78.16
|
| Rate for Payer: WEA Trust Commercial |
$11.91
|
| Rate for Payer: WPS Commercial |
$182.98
|
|
|
Hep B Vaccine, Adult,IM 90746VFC
|
Facility
|
OP
|
$20.83
|
|
|
Service Code
|
CPT 90746
|
| Hospital Charge Code |
5100629
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$312.62 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.63
|
| Rate for Payer: Aetna Managed Medicare |
$6.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.83
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.48
|
| Rate for Payer: Cash Price |
$6.25
|
| Rate for Payer: Cash Price |
$6.25
|
| Rate for Payer: Cigna Commercial |
$19.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$96.83
|
| Rate for Payer: Health EOS Commercial |
$19.28
|
| Rate for Payer: HFN Commercial |
$19.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$16.25
|
| Rate for Payer: Multiplan Commercial |
$17.33
|
| Rate for Payer: NAPHCARE Commercial |
$13.00
|
| Rate for Payer: Preferred Network Access Commercial |
$19.93
|
| Rate for Payer: Quartz Beloit One Network |
$10.61
|
| Rate for Payer: Quartz Commercial |
$14.08
|
| Rate for Payer: Quartz Medicare Advantage |
$13.00
|
| Rate for Payer: The Alliance Commercial |
$312.62
|
| Rate for Payer: WEA Trust Commercial |
$11.91
|
| Rate for Payer: WPS Commercial |
$182.98
|
|
|
Hep B Vaccine, Adult,IM 90746VFC
|
Facility
|
IP
|
$20.83
|
|
|
Service Code
|
CPT 90746
|
| Hospital Charge Code |
5100629
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.48
|
| Rate for Payer: Cash Price |
$6.25
|
| Rate for Payer: Cigna Commercial |
$19.93
|
| Rate for Payer: Health EOS Commercial |
$19.28
|
| Rate for Payer: HFN Commercial |
$19.93
|
| Rate for Payer: Multiplan Commercial |
$17.33
|
| Rate for Payer: Preferred Network Access Commercial |
$19.93
|
| Rate for Payer: Quartz Beloit One Network |
$10.61
|
| Rate for Payer: Quartz Commercial |
$13.00
|
| Rate for Payer: WEA Trust Commercial |
$11.91
|
| Rate for Payer: WPS Commercial |
$16.05
|
|
|
HEPB Vacc Ped/Adol 3 Dose IM 90744
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
3455575
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.34 |
| Max. Negotiated Rate |
$139.69 |
| Rate for Payer: Aetna Commercial |
$136.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$130.58
|
| Rate for Payer: Aetna Managed Medicare |
$42.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$98.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$75.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$72.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$80.48
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cigna Commercial |
$139.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$42.34
|
| Rate for Payer: Health EOS Commercial |
$135.14
|
| Rate for Payer: HFN Commercial |
$139.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$113.88
|
| Rate for Payer: Multiplan Commercial |
$121.47
|
| Rate for Payer: NAPHCARE Commercial |
$91.10
|
| Rate for Payer: Preferred Network Access Commercial |
$139.69
|
| Rate for Payer: Quartz Beloit One Network |
$74.40
|
| Rate for Payer: Quartz Commercial |
$98.70
|
| Rate for Payer: Quartz Medicare Advantage |
$91.10
|
| Rate for Payer: The Alliance Commercial |
$138.11
|
| Rate for Payer: WEA Trust Commercial |
$83.51
|
| Rate for Payer: WPS Commercial |
$80.00
|
|
|
HEPB Vacc Ped/Adol 3 Dose IM 90744
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
3455575
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.44 |
| Max. Negotiated Rate |
$144.25 |
| Rate for Payer: Aetna Commercial |
$144.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$130.58
|
| Rate for Payer: Aetna Managed Medicare |
$34.53
|
| Rate for Payer: Anthem Medicare Advantage |
$34.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$34.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$34.53
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cigna Commercial |
$144.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$30.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32.00
|
| Rate for Payer: Health EOS Commercial |
$138.17
|
| Rate for Payer: HFN Commercial |
$144.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$42.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$34.53
|
| Rate for Payer: Multiplan Commercial |
$121.47
|
| Rate for Payer: NAPHCARE Commercial |
$51.79
|
| Rate for Payer: Preferred Network Access Commercial |
$144.25
|
| Rate for Payer: Quartz Beloit One Network |
$66.81
|
| Rate for Payer: Quartz Commercial |
$86.55
|
| Rate for Payer: Quartz Medicare Advantage |
$34.53
|
| Rate for Payer: The Alliance Commercial |
$86.32
|
| Rate for Payer: United Healthcare Medicaid |
$30.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34.53
|
| Rate for Payer: WEA Trust Commercial |
$83.51
|
| Rate for Payer: WPS Commercial |
$80.00
|
|
|
HEPB Vacc Ped/Adol 3 Dose IM 90744
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
3455575
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.40 |
| Max. Negotiated Rate |
$139.69 |
| Rate for Payer: Aetna Commercial |
$136.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$130.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$80.48
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cigna Commercial |
$139.69
|
| Rate for Payer: Health EOS Commercial |
$135.14
|
| Rate for Payer: HFN Commercial |
$139.69
|
| Rate for Payer: Multiplan Commercial |
$121.47
|
| Rate for Payer: Preferred Network Access Commercial |
$139.69
|
| Rate for Payer: Quartz Beloit One Network |
$74.40
|
| Rate for Payer: Quartz Commercial |
$91.10
|
| Rate for Payer: WEA Trust Commercial |
$83.51
|
| Rate for Payer: WPS Commercial |
$112.46
|
|
|
Hep B Vacc Ped/Adol 90744VFC
|
Professional
|
Both
|
$20.83
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
5096655
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.53 |
| Max. Negotiated Rate |
$86.32 |
| Rate for Payer: Aetna Commercial |
$20.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.63
|
| Rate for Payer: Aetna Managed Medicare |
$34.53
|
| Rate for Payer: Anthem Medicare Advantage |
$34.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$34.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$34.53
|
| Rate for Payer: Cash Price |
$6.25
|
| Rate for Payer: Cash Price |
$6.25
|
| Rate for Payer: Cigna Commercial |
$20.58
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$30.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32.00
|
| Rate for Payer: Health EOS Commercial |
$19.71
|
| Rate for Payer: HFN Commercial |
$20.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$42.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$34.53
|
| Rate for Payer: Multiplan Commercial |
$17.33
|
| Rate for Payer: NAPHCARE Commercial |
$51.79
|
| Rate for Payer: Preferred Network Access Commercial |
$20.58
|
| Rate for Payer: Quartz Beloit One Network |
$9.53
|
| Rate for Payer: Quartz Commercial |
$12.35
|
| Rate for Payer: Quartz Medicare Advantage |
$34.53
|
| Rate for Payer: The Alliance Commercial |
$86.32
|
| Rate for Payer: United Healthcare Medicaid |
$30.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34.53
|
| Rate for Payer: WEA Trust Commercial |
$11.91
|
| Rate for Payer: WPS Commercial |
$80.00
|
|
|
Hep B Vacc Ped/Adol 90744VFC
|
Facility
|
OP
|
$20.83
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
5096655
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$138.11 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.63
|
| Rate for Payer: Aetna Managed Medicare |
$6.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$10.83
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$10.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.48
|
| Rate for Payer: Cash Price |
$6.25
|
| Rate for Payer: Cash Price |
$6.25
|
| Rate for Payer: Cigna Commercial |
$19.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$42.34
|
| Rate for Payer: Health EOS Commercial |
$19.28
|
| Rate for Payer: HFN Commercial |
$19.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$16.25
|
| Rate for Payer: Multiplan Commercial |
$17.33
|
| Rate for Payer: NAPHCARE Commercial |
$13.00
|
| Rate for Payer: Preferred Network Access Commercial |
$19.93
|
| Rate for Payer: Quartz Beloit One Network |
$10.61
|
| Rate for Payer: Quartz Commercial |
$14.08
|
| Rate for Payer: Quartz Medicare Advantage |
$13.00
|
| Rate for Payer: The Alliance Commercial |
$138.11
|
| Rate for Payer: WEA Trust Commercial |
$11.91
|
| Rate for Payer: WPS Commercial |
$80.00
|
|
|
Hep B Vacc Ped/Adol 90744VFC
|
Facility
|
IP
|
$20.83
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
5096655
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$18.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$11.48
|
| Rate for Payer: Cash Price |
$6.25
|
| Rate for Payer: Cigna Commercial |
$19.93
|
| Rate for Payer: Health EOS Commercial |
$19.28
|
| Rate for Payer: HFN Commercial |
$19.93
|
| Rate for Payer: Multiplan Commercial |
$17.33
|
| Rate for Payer: Preferred Network Access Commercial |
$19.93
|
| Rate for Payer: Quartz Beloit One Network |
$10.61
|
| Rate for Payer: Quartz Commercial |
$13.00
|
| Rate for Payer: WEA Trust Commercial |
$11.91
|
| Rate for Payer: WPS Commercial |
$16.05
|
|
|
Heper (CD4)/Supressor (CD8) Ratio
|
Facility
|
IP
|
$517.00
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
2942945
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$263.46 |
| Max. Negotiated Rate |
$494.67 |
| Rate for Payer: Aetna Commercial |
$483.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$462.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$284.97
|
| Rate for Payer: Cash Price |
$155.10
|
| Rate for Payer: Cigna Commercial |
$494.67
|
| Rate for Payer: Health EOS Commercial |
$478.54
|
| Rate for Payer: HFN Commercial |
$494.67
|
| Rate for Payer: Multiplan Commercial |
$430.14
|
| Rate for Payer: Preferred Network Access Commercial |
$494.67
|
| Rate for Payer: Quartz Beloit One Network |
$263.46
|
| Rate for Payer: Quartz Commercial |
$322.61
|
| Rate for Payer: WEA Trust Commercial |
$295.72
|
| Rate for Payer: WPS Commercial |
$398.25
|
|
|
Heper (CD4)/Supressor (CD8) Ratio
|
Facility
|
OP
|
$517.00
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
2942945
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.86 |
| Max. Negotiated Rate |
$494.67 |
| Rate for Payer: Aetna Commercial |
$483.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$462.40
|
| Rate for Payer: Aetna Managed Medicare |
$48.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$183.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$85.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$81.11
|
| Rate for Payer: Anthem Medicare Advantage |
$48.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$284.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$48.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$48.86
|
| Rate for Payer: Cash Price |
$155.10
|
| Rate for Payer: Cash Price |
$155.10
|
| Rate for Payer: Cigna Commercial |
$494.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$48.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$300.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$48.86
|
| Rate for Payer: Health EOS Commercial |
$478.54
|
| Rate for Payer: HFN Commercial |
$494.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$181.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$48.86
|
| Rate for Payer: Independent Care Health Plan Medicare |
$48.86
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$48.86
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$48.86
|
| Rate for Payer: Multiplan Commercial |
$430.14
|
| Rate for Payer: NAPHCARE Commercial |
$73.29
|
| Rate for Payer: Preferred Network Access Commercial |
$494.67
|
| Rate for Payer: Quartz Beloit One Network |
$263.46
|
| Rate for Payer: Quartz Commercial |
$349.49
|
| Rate for Payer: Quartz Medicare Advantage |
$48.86
|
| Rate for Payer: The Alliance Commercial |
$195.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48.86
|
| Rate for Payer: United Healthcare PPO |
$403.26
|
| Rate for Payer: WEA Trust Commercial |
$295.72
|
| Rate for Payer: Wellcare Medicare |
$48.86
|
| Rate for Payer: WPS Commercial |
$398.25
|
|
|
Heper (CD4)/Supressor (CD8) Ratio
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
2942945
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.86 |
| Max. Negotiated Rate |
$510.80 |
| Rate for Payer: Aetna Commercial |
$510.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$462.40
|
| Rate for Payer: Aetna Managed Medicare |
$48.86
|
| Rate for Payer: Anthem Medicare Advantage |
$48.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$48.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$48.86
|
| Rate for Payer: Cash Price |
$155.10
|
| Rate for Payer: Cash Price |
$155.10
|
| Rate for Payer: Cigna Commercial |
$510.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$268.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.86
|
| Rate for Payer: Health EOS Commercial |
$489.29
|
| Rate for Payer: HFN Commercial |
$510.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$172.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$172.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$48.86
|
| Rate for Payer: Multiplan Commercial |
$430.14
|
| Rate for Payer: NAPHCARE Commercial |
$73.29
|
| Rate for Payer: Preferred Network Access Commercial |
$510.80
|
| Rate for Payer: Quartz Beloit One Network |
$236.58
|
| Rate for Payer: Quartz Commercial |
$306.48
|
| Rate for Payer: Quartz Medicare Advantage |
$48.86
|
| Rate for Payer: The Alliance Commercial |
$192.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48.86
|
| Rate for Payer: WEA Trust Commercial |
$295.72
|
| Rate for Payer: WPS Commercial |
$214.98
|
|
|
Hep Func Panel
|
Facility
|
IP
|
$281.00
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
633744
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$143.20 |
| Max. Negotiated Rate |
$268.86 |
| Rate for Payer: Aetna Commercial |
$263.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$154.89
|
| Rate for Payer: Cash Price |
$84.30
|
| Rate for Payer: Cigna Commercial |
$268.86
|
| Rate for Payer: Health EOS Commercial |
$260.09
|
| Rate for Payer: HFN Commercial |
$268.86
|
| Rate for Payer: Multiplan Commercial |
$233.79
|
| Rate for Payer: Preferred Network Access Commercial |
$268.86
|
| Rate for Payer: Quartz Beloit One Network |
$143.20
|
| Rate for Payer: Quartz Commercial |
$175.34
|
| Rate for Payer: WEA Trust Commercial |
$160.73
|
| Rate for Payer: WPS Commercial |
$216.45
|
|
|
Hep Func Panel
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
633744
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$277.63 |
| Rate for Payer: Aetna Commercial |
$277.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.33
|
| Rate for Payer: Aetna Managed Medicare |
$8.50
|
| Rate for Payer: Anthem Medicare Advantage |
$8.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.50
|
| Rate for Payer: Cash Price |
$84.30
|
| Rate for Payer: Cash Price |
$84.30
|
| Rate for Payer: Cigna Commercial |
$277.63
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$146.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.50
|
| Rate for Payer: Health EOS Commercial |
$265.94
|
| Rate for Payer: HFN Commercial |
$277.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$29.99
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$29.99
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.50
|
| Rate for Payer: Multiplan Commercial |
$233.79
|
| Rate for Payer: NAPHCARE Commercial |
$12.75
|
| Rate for Payer: Preferred Network Access Commercial |
$277.63
|
| Rate for Payer: Quartz Beloit One Network |
$128.59
|
| Rate for Payer: Quartz Commercial |
$166.58
|
| Rate for Payer: Quartz Medicare Advantage |
$8.50
|
| Rate for Payer: The Alliance Commercial |
$33.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.50
|
| Rate for Payer: WEA Trust Commercial |
$160.73
|
| Rate for Payer: WPS Commercial |
$37.39
|
|
|
Hep Func Panel
|
Facility
|
OP
|
$281.00
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
633744
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$268.86 |
| Rate for Payer: Aetna Commercial |
$263.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.33
|
| Rate for Payer: Aetna Managed Medicare |
$8.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14.87
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14.10
|
| Rate for Payer: Anthem Medicare Advantage |
$8.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$154.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.50
|
| Rate for Payer: Cash Price |
$84.30
|
| Rate for Payer: Cash Price |
$84.30
|
| Rate for Payer: Cigna Commercial |
$268.86
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$163.54
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8.50
|
| Rate for Payer: Health EOS Commercial |
$260.09
|
| Rate for Payer: HFN Commercial |
$268.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8.50
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8.50
|
| Rate for Payer: Multiplan Commercial |
$233.79
|
| Rate for Payer: NAPHCARE Commercial |
$12.75
|
| Rate for Payer: Preferred Network Access Commercial |
$268.86
|
| Rate for Payer: Quartz Beloit One Network |
$143.20
|
| Rate for Payer: Quartz Commercial |
$189.96
|
| Rate for Payer: Quartz Medicare Advantage |
$8.50
|
| Rate for Payer: The Alliance Commercial |
$33.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.50
|
| Rate for Payer: United Healthcare PPO |
$219.18
|
| Rate for Payer: WEA Trust Commercial |
$160.73
|
| Rate for Payer: Wellcare Medicare |
$8.50
|
| Rate for Payer: WPS Commercial |
$216.45
|
|
|
Herceptin 10 mg Charge
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS J9355
|
| Hospital Charge Code |
2958862
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$306.28 |
| Rate for Payer: Aetna Commercial |
$306.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$277.26
|
| Rate for Payer: Aetna Managed Medicare |
$76.42
|
| Rate for Payer: Anthem Medicare Advantage |
$76.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$76.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$76.42
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cigna Commercial |
$306.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$76.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$83.25
|
| Rate for Payer: Health EOS Commercial |
$293.38
|
| Rate for Payer: HFN Commercial |
$306.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$142.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$142.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$76.42
|
| Rate for Payer: Multiplan Commercial |
$257.92
|
| Rate for Payer: NAPHCARE Commercial |
$114.63
|
| Rate for Payer: Preferred Network Access Commercial |
$306.28
|
| Rate for Payer: Quartz Beloit One Network |
$141.86
|
| Rate for Payer: Quartz Commercial |
$183.77
|
| Rate for Payer: Quartz Medicare Advantage |
$76.42
|
| Rate for Payer: The Alliance Commercial |
$210.15
|
| Rate for Payer: United Healthcare Medicaid |
$76.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$76.42
|
| Rate for Payer: WEA Trust Commercial |
$177.32
|
| Rate for Payer: WPS Commercial |
$208.12
|
|
|
Herceptin 10 mg Charge
|
Facility
|
IP
|
$310.00
|
|
|
Service Code
|
HCPCS J9355
|
| Hospital Charge Code |
2958862
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$157.98 |
| Max. Negotiated Rate |
$296.61 |
| Rate for Payer: Aetna Commercial |
$290.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$277.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$170.87
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cigna Commercial |
$296.61
|
| Rate for Payer: Health EOS Commercial |
$286.94
|
| Rate for Payer: HFN Commercial |
$296.61
|
| Rate for Payer: Multiplan Commercial |
$257.92
|
| Rate for Payer: Preferred Network Access Commercial |
$296.61
|
| Rate for Payer: Quartz Beloit One Network |
$157.98
|
| Rate for Payer: Quartz Commercial |
$193.44
|
| Rate for Payer: WEA Trust Commercial |
$177.32
|
| Rate for Payer: WPS Commercial |
$238.79
|
|
|
Herceptin 10 mg Charge
|
Facility
|
OP
|
$310.00
|
|
|
Service Code
|
HCPCS J9355
|
| Hospital Charge Code |
2958862
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$305.68 |
| Rate for Payer: Aetna Commercial |
$290.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$277.26
|
| Rate for Payer: Aetna Managed Medicare |
$76.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$209.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$161.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$154.75
|
| Rate for Payer: Anthem Medicare Advantage |
$76.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$170.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$76.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$76.42
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cigna Commercial |
$296.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$76.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$110.14
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$76.42
|
| Rate for Payer: Health EOS Commercial |
$286.94
|
| Rate for Payer: HFN Commercial |
$296.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$284.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$76.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$76.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$76.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$76.42
|
| Rate for Payer: Multiplan Commercial |
$257.92
|
| Rate for Payer: NAPHCARE Commercial |
$114.63
|
| Rate for Payer: Preferred Network Access Commercial |
$296.61
|
| Rate for Payer: Quartz Beloit One Network |
$157.98
|
| Rate for Payer: Quartz Commercial |
$209.56
|
| Rate for Payer: Quartz Medicare Advantage |
$76.42
|
| Rate for Payer: The Alliance Commercial |
$305.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$76.42
|
| Rate for Payer: WEA Trust Commercial |
$177.32
|
| Rate for Payer: Wellcare Medicare |
$76.42
|
| Rate for Payer: WPS Commercial |
$208.12
|
|
|
Hereditary Erythrocytosis Mutations
|
Facility
|
OP
|
$1,282.00
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
4606696
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$373.32 |
| Max. Negotiated Rate |
$1,226.62 |
| Rate for Payer: Aetna Commercial |
$1,199.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,146.62
|
| Rate for Payer: Aetna Managed Medicare |
$373.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$866.63
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$666.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$639.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$706.64
|
| Rate for Payer: Cash Price |
$384.60
|
| Rate for Payer: Cigna Commercial |
$1,226.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$746.12
|
| Rate for Payer: Health EOS Commercial |
$1,186.62
|
| Rate for Payer: HFN Commercial |
$1,226.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$999.96
|
| Rate for Payer: Multiplan Commercial |
$1,066.62
|
| Rate for Payer: NAPHCARE Commercial |
$799.97
|
| Rate for Payer: Preferred Network Access Commercial |
$1,226.62
|
| Rate for Payer: Quartz Beloit One Network |
$653.31
|
| Rate for Payer: Quartz Commercial |
$866.63
|
| Rate for Payer: Quartz Medicare Advantage |
$799.97
|
| Rate for Payer: The Alliance Commercial |
$666.64
|
| Rate for Payer: United Healthcare PPO |
$999.96
|
| Rate for Payer: WEA Trust Commercial |
$733.30
|
| Rate for Payer: WPS Commercial |
$987.52
|
|
|
Hereditary Erythrocytosis Mutations
|
Facility
|
IP
|
$1,282.00
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
4606696
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$653.31 |
| Max. Negotiated Rate |
$1,226.62 |
| Rate for Payer: Aetna Commercial |
$1,199.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,146.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$706.64
|
| Rate for Payer: Cash Price |
$384.60
|
| Rate for Payer: Cigna Commercial |
$1,226.62
|
| Rate for Payer: Health EOS Commercial |
$1,186.62
|
| Rate for Payer: HFN Commercial |
$1,226.62
|
| Rate for Payer: Multiplan Commercial |
$1,066.62
|
| Rate for Payer: Preferred Network Access Commercial |
$1,226.62
|
| Rate for Payer: Quartz Beloit One Network |
$653.31
|
| Rate for Payer: Quartz Commercial |
$799.97
|
| Rate for Payer: WEA Trust Commercial |
$733.30
|
| Rate for Payer: WPS Commercial |
$987.52
|
|
|
Hereditary Erythrocytosis Mutations
|
Professional
|
Both
|
$1,282.00
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
4606696
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$586.64 |
| Max. Negotiated Rate |
$1,266.62 |
| Rate for Payer: Aetna Commercial |
$1,266.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,146.62
|
| Rate for Payer: Cash Price |
$384.60
|
| Rate for Payer: Cigna Commercial |
$1,266.62
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$666.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$799.97
|
| Rate for Payer: Health EOS Commercial |
$1,213.28
|
| Rate for Payer: HFN Commercial |
$1,266.62
|
| Rate for Payer: Multiplan Commercial |
$1,066.62
|
| Rate for Payer: Preferred Network Access Commercial |
$1,266.62
|
| Rate for Payer: Quartz Beloit One Network |
$586.64
|
| Rate for Payer: Quartz Commercial |
$759.97
|
| Rate for Payer: The Alliance Commercial |
$666.64
|
| Rate for Payer: WEA Trust Commercial |
$733.30
|
| Rate for Payer: WPS Commercial |
$987.52
|
|
|
Hereditary Hemochromatosis DNA Analysis
|
Professional
|
Both
|
$870.00
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
1039145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.97 |
| Max. Negotiated Rate |
$859.56 |
| Rate for Payer: Aetna Commercial |
$859.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$778.13
|
| Rate for Payer: Aetna Managed Medicare |
$67.97
|
| Rate for Payer: Anthem Medicare Advantage |
$67.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$67.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$67.97
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna Commercial |
$859.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$452.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$67.97
|
| Rate for Payer: Health EOS Commercial |
$823.37
|
| Rate for Payer: HFN Commercial |
$859.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$239.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$239.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$67.97
|
| Rate for Payer: Multiplan Commercial |
$723.84
|
| Rate for Payer: NAPHCARE Commercial |
$101.96
|
| Rate for Payer: Preferred Network Access Commercial |
$859.56
|
| Rate for Payer: Quartz Beloit One Network |
$398.11
|
| Rate for Payer: Quartz Commercial |
$515.74
|
| Rate for Payer: Quartz Medicare Advantage |
$67.97
|
| Rate for Payer: The Alliance Commercial |
$268.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$67.97
|
| Rate for Payer: WEA Trust Commercial |
$497.64
|
| Rate for Payer: WPS Commercial |
$299.09
|
|
|
Hereditary Hemochromatosis DNA Analysis
|
Facility
|
OP
|
$870.00
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
1039145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.97 |
| Max. Negotiated Rate |
$832.42 |
| Rate for Payer: Aetna Commercial |
$814.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$778.13
|
| Rate for Payer: Aetna Managed Medicare |
$67.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$254.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$118.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$112.84
|
| Rate for Payer: Anthem Medicare Advantage |
$67.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$479.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$67.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$67.97
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna Commercial |
$832.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$67.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$506.34
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$67.97
|
| Rate for Payer: Health EOS Commercial |
$805.27
|
| Rate for Payer: HFN Commercial |
$832.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$252.86
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$67.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$67.97
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$67.97
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$67.97
|
| Rate for Payer: Multiplan Commercial |
$723.84
|
| Rate for Payer: NAPHCARE Commercial |
$101.96
|
| Rate for Payer: Preferred Network Access Commercial |
$832.42
|
| Rate for Payer: Quartz Beloit One Network |
$443.35
|
| Rate for Payer: Quartz Commercial |
$588.12
|
| Rate for Payer: Quartz Medicare Advantage |
$67.97
|
| Rate for Payer: The Alliance Commercial |
$271.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$67.97
|
| Rate for Payer: United Healthcare PPO |
$678.60
|
| Rate for Payer: WEA Trust Commercial |
$497.64
|
| Rate for Payer: Wellcare Medicare |
$67.97
|
| Rate for Payer: WPS Commercial |
$670.16
|
|
|
Hereditary Hemochromatosis DNA Analysis
|
Facility
|
IP
|
$870.00
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
1039145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$443.35 |
| Max. Negotiated Rate |
$832.42 |
| Rate for Payer: Aetna Commercial |
$814.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$778.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$479.54
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna Commercial |
$832.42
|
| Rate for Payer: Health EOS Commercial |
$805.27
|
| Rate for Payer: HFN Commercial |
$832.42
|
| Rate for Payer: Multiplan Commercial |
$723.84
|
| Rate for Payer: Preferred Network Access Commercial |
$832.42
|
| Rate for Payer: Quartz Beloit One Network |
$443.35
|
| Rate for Payer: Quartz Commercial |
$542.88
|
| Rate for Payer: WEA Trust Commercial |
$497.64
|
| Rate for Payer: WPS Commercial |
$670.16
|
|
|
Hereditary Hemolytic Anemia Seq, V
|
Facility
|
OP
|
$6,949.00
|
|
|
Service Code
|
CPT 81443
|
| Hospital Charge Code |
6157631
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2,546.50 |
| Max. Negotiated Rate |
$10,186.01 |
| Rate for Payer: Aetna Commercial |
$6,504.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,215.19
|
| Rate for Payer: Aetna Managed Medicare |
$2,546.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,549.38
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,456.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,227.19
|
| Rate for Payer: Anthem Medicare Advantage |
$2,546.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,830.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$2,546.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$2,546.50
|
| Rate for Payer: Cash Price |
$2,084.70
|
| Rate for Payer: Cash Price |
$2,084.70
|
| Rate for Payer: Cigna Commercial |
$6,648.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$2,546.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,044.32
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$2,546.50
|
| Rate for Payer: Health EOS Commercial |
$6,431.99
|
| Rate for Payer: HFN Commercial |
$6,648.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$9,472.99
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,546.50
|
| Rate for Payer: Independent Care Health Plan Medicare |
$2,546.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$2,546.50
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$2,546.50
|
| Rate for Payer: Multiplan Commercial |
$5,781.57
|
| Rate for Payer: NAPHCARE Commercial |
$3,819.75
|
| Rate for Payer: Preferred Network Access Commercial |
$6,648.80
|
| Rate for Payer: Quartz Beloit One Network |
$3,541.21
|
| Rate for Payer: Quartz Commercial |
$4,697.52
|
| Rate for Payer: Quartz Medicare Advantage |
$2,546.50
|
| Rate for Payer: The Alliance Commercial |
$10,186.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,546.50
|
| Rate for Payer: United Healthcare PPO |
$5,420.22
|
| Rate for Payer: WEA Trust Commercial |
$3,974.83
|
| Rate for Payer: Wellcare Medicare |
$2,546.50
|
| Rate for Payer: WPS Commercial |
$5,352.81
|
|
