|
ICD Gen Ins/Rep + Single or Dual Leads
|
Facility
|
IP
|
$8,583.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
4017928
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,205.67 |
| Max. Negotiated Rate |
$7,896.36 |
| Rate for Payer: Aetna Commercial |
$7,724.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,381.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,548.99
|
| Rate for Payer: Cash Price |
$2,574.90
|
| Rate for Payer: Cigna Commercial |
$7,896.36
|
| Rate for Payer: Health EOS Commercial |
$7,638.87
|
| Rate for Payer: HFN Commercial |
$7,896.36
|
| Rate for Payer: Multiplan Commercial |
$6,866.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,149.80
|
| Rate for Payer: Preferred Network Access Commercial |
$7,896.36
|
| Rate for Payer: Quartz Beloit One Network |
$4,205.67
|
| Rate for Payer: Quartz Commercial |
$5,149.80
|
| Rate for Payer: WEA Trust Commercial |
$4,720.65
|
| Rate for Payer: WPS Commercial |
$6,357.43
|
|
|
ICD Gen INS/REP + Single or Dual Leads
|
Facility
|
IP
|
$6,867.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
4318586
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,364.83 |
| Max. Negotiated Rate |
$6,317.64 |
| Rate for Payer: Aetna Commercial |
$6,180.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,905.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,639.51
|
| Rate for Payer: Cash Price |
$2,060.10
|
| Rate for Payer: Cigna Commercial |
$6,317.64
|
| Rate for Payer: Health EOS Commercial |
$6,111.63
|
| Rate for Payer: HFN Commercial |
$6,317.64
|
| Rate for Payer: Multiplan Commercial |
$5,493.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,120.20
|
| Rate for Payer: Preferred Network Access Commercial |
$6,317.64
|
| Rate for Payer: Quartz Beloit One Network |
$3,364.83
|
| Rate for Payer: Quartz Commercial |
$4,120.20
|
| Rate for Payer: WEA Trust Commercial |
$3,776.85
|
| Rate for Payer: WPS Commercial |
$5,086.39
|
|
|
ICD Gen INS/REP + Single or Dual Leads
|
Facility
|
OP
|
$6,867.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
4318586
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,364.83 |
| Max. Negotiated Rate |
$130,070.76 |
| Rate for Payer: Aetna Commercial |
$6,180.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,905.62
|
| Rate for Payer: Aetna Managed Medicare |
$32,517.69
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,815.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,378.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,460.00
|
| Rate for Payer: Anthem Medicare Advantage |
$32,517.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,639.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$32,517.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$32,517.69
|
| Rate for Payer: Cash Price |
$2,060.10
|
| Rate for Payer: Cash Price |
$2,060.10
|
| Rate for Payer: Cash Price |
$2,060.10
|
| Rate for Payer: Cigna Commercial |
$6,317.64
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$32,517.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$32,517.69
|
| Rate for Payer: Health EOS Commercial |
$6,111.63
|
| Rate for Payer: HFN Commercial |
$6,317.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$120,965.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$32,517.69
|
| Rate for Payer: Independent Care Health Plan Medicare |
$32,517.69
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$32,517.69
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$32,517.69
|
| Rate for Payer: Multiplan Commercial |
$5,493.60
|
| Rate for Payer: NAPHCARE Commercial |
$48,776.54
|
| Rate for Payer: Preferred Network Access Commercial |
$6,317.64
|
| Rate for Payer: Quartz Beloit One Network |
$3,364.83
|
| Rate for Payer: Quartz Commercial |
$4,463.55
|
| Rate for Payer: Quartz Medicare Advantage |
$32,517.69
|
| Rate for Payer: The Alliance Commercial |
$130,070.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,517.69
|
| Rate for Payer: United Healthcare PPO |
$11,078.00
|
| Rate for Payer: WEA Trust Commercial |
$3,776.85
|
| Rate for Payer: Wellcare Medicare |
$32,517.69
|
| Rate for Payer: WPS Commercial |
$5,086.39
|
|
|
ICD Gen Removal W/O Replacement
|
Facility
|
IP
|
$1,199.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
3052397
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$587.51 |
| Max. Negotiated Rate |
$1,103.08 |
| Rate for Payer: Aetna Commercial |
$1,079.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,031.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$635.47
|
| Rate for Payer: Cash Price |
$359.70
|
| Rate for Payer: Cigna Commercial |
$1,103.08
|
| Rate for Payer: Health EOS Commercial |
$1,067.11
|
| Rate for Payer: HFN Commercial |
$1,103.08
|
| Rate for Payer: Multiplan Commercial |
$959.20
|
| Rate for Payer: NAPHCARE Commercial |
$719.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,103.08
|
| Rate for Payer: Quartz Beloit One Network |
$587.51
|
| Rate for Payer: Quartz Commercial |
$719.40
|
| Rate for Payer: WEA Trust Commercial |
$659.45
|
| Rate for Payer: WPS Commercial |
$888.10
|
|
|
ICD Gen Removal W/O Replacement
|
Facility
|
OP
|
$1,199.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
3052397
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$587.51 |
| Max. Negotiated Rate |
$15,525.92 |
| Rate for Payer: Aetna Commercial |
$1,079.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,031.14
|
| Rate for Payer: Aetna Managed Medicare |
$3,881.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$635.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,881.48
|
| Rate for Payer: Cash Price |
$359.70
|
| Rate for Payer: Cash Price |
$359.70
|
| Rate for Payer: Cash Price |
$359.70
|
| Rate for Payer: Cigna Commercial |
$1,103.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,881.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,881.48
|
| Rate for Payer: Health EOS Commercial |
$1,067.11
|
| Rate for Payer: HFN Commercial |
$1,103.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,439.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,881.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,881.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,881.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,881.48
|
| Rate for Payer: Multiplan Commercial |
$959.20
|
| Rate for Payer: NAPHCARE Commercial |
$5,822.22
|
| Rate for Payer: Preferred Network Access Commercial |
$1,103.08
|
| Rate for Payer: Quartz Beloit One Network |
$587.51
|
| Rate for Payer: Quartz Commercial |
$779.35
|
| Rate for Payer: Quartz Medicare Advantage |
$3,881.48
|
| Rate for Payer: The Alliance Commercial |
$15,525.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,881.48
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$659.45
|
| Rate for Payer: Wellcare Medicare |
$3,881.48
|
| Rate for Payer: WPS Commercial |
$888.10
|
|
|
ICD Ins/Rep Subq w/Lead
|
Facility
|
IP
|
$6,681.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
4584634
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,273.69 |
| Max. Negotiated Rate |
$6,146.52 |
| Rate for Payer: Aetna Commercial |
$6,012.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,745.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,540.93
|
| Rate for Payer: Cash Price |
$2,004.30
|
| Rate for Payer: Cigna Commercial |
$6,146.52
|
| Rate for Payer: Health EOS Commercial |
$5,946.09
|
| Rate for Payer: HFN Commercial |
$6,146.52
|
| Rate for Payer: Multiplan Commercial |
$5,344.80
|
| Rate for Payer: NAPHCARE Commercial |
$4,008.60
|
| Rate for Payer: Preferred Network Access Commercial |
$6,146.52
|
| Rate for Payer: Quartz Beloit One Network |
$3,273.69
|
| Rate for Payer: Quartz Commercial |
$4,008.60
|
| Rate for Payer: WEA Trust Commercial |
$3,674.55
|
| Rate for Payer: WPS Commercial |
$4,948.62
|
|
|
ICD Ins/Rep Subq w/Lead
|
Facility
|
OP
|
$6,681.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
4584634
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,273.69 |
| Max. Negotiated Rate |
$130,070.76 |
| Rate for Payer: Aetna Commercial |
$6,012.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,745.66
|
| Rate for Payer: Aetna Managed Medicare |
$32,517.69
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,815.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,378.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,460.00
|
| Rate for Payer: Anthem Medicare Advantage |
$32,517.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,540.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$32,517.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$32,517.69
|
| Rate for Payer: Cash Price |
$2,004.30
|
| Rate for Payer: Cash Price |
$2,004.30
|
| Rate for Payer: Cash Price |
$2,004.30
|
| Rate for Payer: Cigna Commercial |
$6,146.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$32,517.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$32,517.69
|
| Rate for Payer: Health EOS Commercial |
$5,946.09
|
| Rate for Payer: HFN Commercial |
$6,146.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$120,965.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$32,517.69
|
| Rate for Payer: Independent Care Health Plan Medicare |
$32,517.69
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$32,517.69
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$32,517.69
|
| Rate for Payer: Multiplan Commercial |
$5,344.80
|
| Rate for Payer: NAPHCARE Commercial |
$48,776.54
|
| Rate for Payer: Preferred Network Access Commercial |
$6,146.52
|
| Rate for Payer: Quartz Beloit One Network |
$3,273.69
|
| Rate for Payer: Quartz Commercial |
$4,342.65
|
| Rate for Payer: Quartz Medicare Advantage |
$32,517.69
|
| Rate for Payer: The Alliance Commercial |
$130,070.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,517.69
|
| Rate for Payer: United Healthcare PPO |
$11,078.00
|
| Rate for Payer: WEA Trust Commercial |
$3,674.55
|
| Rate for Payer: Wellcare Medicare |
$32,517.69
|
| Rate for Payer: WPS Commercial |
$4,948.62
|
|
|
ICD Ins Subq Lead Only
|
Facility
|
IP
|
$4,945.00
|
|
|
Service Code
|
CPT 33271
|
| Hospital Charge Code |
4584633
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,423.05 |
| Max. Negotiated Rate |
$4,549.40 |
| Rate for Payer: Aetna Commercial |
$4,450.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,252.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,620.85
|
| Rate for Payer: Cash Price |
$1,483.50
|
| Rate for Payer: Cigna Commercial |
$4,549.40
|
| Rate for Payer: Health EOS Commercial |
$4,401.05
|
| Rate for Payer: HFN Commercial |
$4,549.40
|
| Rate for Payer: Multiplan Commercial |
$3,956.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,967.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,549.40
|
| Rate for Payer: Quartz Beloit One Network |
$2,423.05
|
| Rate for Payer: Quartz Commercial |
$2,967.00
|
| Rate for Payer: WEA Trust Commercial |
$2,719.75
|
| Rate for Payer: WPS Commercial |
$3,662.76
|
|
|
ICD Ins Subq Lead Only
|
Facility
|
OP
|
$4,945.00
|
|
|
Service Code
|
CPT 33271
|
| Hospital Charge Code |
4584633
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,423.05 |
| Max. Negotiated Rate |
$33,588.76 |
| Rate for Payer: Aetna Commercial |
$4,450.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,252.70
|
| Rate for Payer: Aetna Managed Medicare |
$8,397.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$8,397.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,620.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8,397.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8,397.19
|
| Rate for Payer: Cash Price |
$1,483.50
|
| Rate for Payer: Cash Price |
$1,483.50
|
| Rate for Payer: Cash Price |
$1,483.50
|
| Rate for Payer: Cigna Commercial |
$4,549.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8,397.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8,397.19
|
| Rate for Payer: Health EOS Commercial |
$4,401.05
|
| Rate for Payer: HFN Commercial |
$4,549.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31,237.55
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8,397.19
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8,397.19
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8,397.19
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8,397.19
|
| Rate for Payer: Multiplan Commercial |
$3,956.00
|
| Rate for Payer: NAPHCARE Commercial |
$12,595.78
|
| Rate for Payer: Preferred Network Access Commercial |
$4,549.40
|
| Rate for Payer: Quartz Beloit One Network |
$2,423.05
|
| Rate for Payer: Quartz Commercial |
$3,214.25
|
| Rate for Payer: Quartz Medicare Advantage |
$8,397.19
|
| Rate for Payer: The Alliance Commercial |
$33,588.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,397.19
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: WEA Trust Commercial |
$2,719.75
|
| Rate for Payer: Wellcare Medicare |
$8,397.19
|
| Rate for Payer: WPS Commercial |
$3,662.76
|
|
|
ICD Lead Removal Single or Dual Leads
|
Facility
|
IP
|
$5,485.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
4318602
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,687.65 |
| Max. Negotiated Rate |
$5,046.20 |
| Rate for Payer: Aetna Commercial |
$4,936.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,717.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,907.05
|
| Rate for Payer: Cash Price |
$1,645.50
|
| Rate for Payer: Cigna Commercial |
$5,046.20
|
| Rate for Payer: Health EOS Commercial |
$4,881.65
|
| Rate for Payer: HFN Commercial |
$5,046.20
|
| Rate for Payer: Multiplan Commercial |
$4,388.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,291.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,046.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,687.65
|
| Rate for Payer: Quartz Commercial |
$3,291.00
|
| Rate for Payer: WEA Trust Commercial |
$3,016.75
|
| Rate for Payer: WPS Commercial |
$4,062.74
|
|
|
ICD Lead Removal Single or Dual Leads
|
Facility
|
OP
|
$5,485.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
4125703
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,687.65 |
| Max. Negotiated Rate |
$15,525.92 |
| Rate for Payer: Aetna Commercial |
$4,936.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,717.10
|
| Rate for Payer: Aetna Managed Medicare |
$3,881.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,907.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,881.48
|
| Rate for Payer: Cash Price |
$1,645.50
|
| Rate for Payer: Cash Price |
$1,645.50
|
| Rate for Payer: Cash Price |
$1,645.50
|
| Rate for Payer: Cigna Commercial |
$5,046.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,881.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,881.48
|
| Rate for Payer: Health EOS Commercial |
$4,881.65
|
| Rate for Payer: HFN Commercial |
$5,046.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,439.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,881.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,881.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,881.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,881.48
|
| Rate for Payer: Multiplan Commercial |
$4,388.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,822.22
|
| Rate for Payer: Preferred Network Access Commercial |
$5,046.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,687.65
|
| Rate for Payer: Quartz Commercial |
$3,565.25
|
| Rate for Payer: Quartz Medicare Advantage |
$3,881.48
|
| Rate for Payer: The Alliance Commercial |
$15,525.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,881.48
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$3,016.75
|
| Rate for Payer: Wellcare Medicare |
$3,881.48
|
| Rate for Payer: WPS Commercial |
$4,062.74
|
|
|
ICD Lead Removal Single or Dual Leads
|
Facility
|
IP
|
$5,485.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
4125703
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,687.65 |
| Max. Negotiated Rate |
$5,046.20 |
| Rate for Payer: Aetna Commercial |
$4,936.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,717.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,907.05
|
| Rate for Payer: Cash Price |
$1,645.50
|
| Rate for Payer: Cigna Commercial |
$5,046.20
|
| Rate for Payer: Health EOS Commercial |
$4,881.65
|
| Rate for Payer: HFN Commercial |
$5,046.20
|
| Rate for Payer: Multiplan Commercial |
$4,388.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,291.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,046.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,687.65
|
| Rate for Payer: Quartz Commercial |
$3,291.00
|
| Rate for Payer: WEA Trust Commercial |
$3,016.75
|
| Rate for Payer: WPS Commercial |
$4,062.74
|
|
|
ICD Lead Removal Single or Dual Leads
|
Facility
|
OP
|
$5,485.00
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
4318602
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,687.65 |
| Max. Negotiated Rate |
$15,525.92 |
| Rate for Payer: Aetna Commercial |
$4,936.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,717.10
|
| Rate for Payer: Aetna Managed Medicare |
$3,881.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,907.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,881.48
|
| Rate for Payer: Cash Price |
$1,645.50
|
| Rate for Payer: Cash Price |
$1,645.50
|
| Rate for Payer: Cash Price |
$1,645.50
|
| Rate for Payer: Cigna Commercial |
$5,046.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,881.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,881.48
|
| Rate for Payer: Health EOS Commercial |
$4,881.65
|
| Rate for Payer: HFN Commercial |
$5,046.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,439.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,881.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,881.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,881.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,881.48
|
| Rate for Payer: Multiplan Commercial |
$4,388.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,822.22
|
| Rate for Payer: Preferred Network Access Commercial |
$5,046.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,687.65
|
| Rate for Payer: Quartz Commercial |
$3,565.25
|
| Rate for Payer: Quartz Medicare Advantage |
$3,881.48
|
| Rate for Payer: The Alliance Commercial |
$15,525.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,881.48
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$3,016.75
|
| Rate for Payer: Wellcare Medicare |
$3,881.48
|
| Rate for Payer: WPS Commercial |
$4,062.74
|
|
|
ICD/Pacemaker Check Remote 90 day
|
Facility
|
IP
|
$426.00
|
|
|
Service Code
|
CPT 93296
|
| Hospital Charge Code |
3052488
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$208.74 |
| Max. Negotiated Rate |
$391.92 |
| Rate for Payer: Aetna Commercial |
$383.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$366.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$225.78
|
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Cigna Commercial |
$391.92
|
| Rate for Payer: Health EOS Commercial |
$379.14
|
| Rate for Payer: HFN Commercial |
$391.92
|
| Rate for Payer: Multiplan Commercial |
$340.80
|
| Rate for Payer: NAPHCARE Commercial |
$255.60
|
| Rate for Payer: Preferred Network Access Commercial |
$391.92
|
| Rate for Payer: Quartz Beloit One Network |
$208.74
|
| Rate for Payer: Quartz Commercial |
$255.60
|
| Rate for Payer: WEA Trust Commercial |
$234.30
|
| Rate for Payer: WPS Commercial |
$315.54
|
|
|
ICD/Pacemaker Check Remote 90 day
|
Facility
|
OP
|
$426.00
|
|
|
Service Code
|
CPT 93296
|
| Hospital Charge Code |
3052488
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$37.27 |
| Max. Negotiated Rate |
$391.92 |
| Rate for Payer: Aetna Commercial |
$383.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$366.36
|
| Rate for Payer: Aetna Managed Medicare |
$37.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$276.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$213.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$204.48
|
| Rate for Payer: Anthem Medicare Advantage |
$37.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$225.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$37.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$37.27
|
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Cigna Commercial |
$391.92
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$37.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$238.39
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$37.27
|
| Rate for Payer: Health EOS Commercial |
$379.14
|
| Rate for Payer: HFN Commercial |
$391.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$138.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$37.27
|
| Rate for Payer: Independent Care Health Plan Medicare |
$37.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$37.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$37.27
|
| Rate for Payer: Multiplan Commercial |
$340.80
|
| Rate for Payer: NAPHCARE Commercial |
$55.90
|
| Rate for Payer: Preferred Network Access Commercial |
$391.92
|
| Rate for Payer: Quartz Beloit One Network |
$208.74
|
| Rate for Payer: Quartz Commercial |
$276.90
|
| Rate for Payer: Quartz Medicare Advantage |
$37.27
|
| Rate for Payer: The Alliance Commercial |
$149.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$37.27
|
| Rate for Payer: United Healthcare PPO |
$319.50
|
| Rate for Payer: WEA Trust Commercial |
$234.30
|
| Rate for Payer: Wellcare Medicare |
$37.27
|
| Rate for Payer: WPS Commercial |
$315.54
|
|
|
ICD Pocket Rev/Relocation
|
Facility
|
IP
|
$2,669.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
3052385
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,307.81 |
| Max. Negotiated Rate |
$2,455.48 |
| Rate for Payer: Aetna Commercial |
$2,402.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,295.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,414.57
|
| Rate for Payer: Cash Price |
$800.70
|
| Rate for Payer: Cigna Commercial |
$2,455.48
|
| Rate for Payer: Health EOS Commercial |
$2,375.41
|
| Rate for Payer: HFN Commercial |
$2,455.48
|
| Rate for Payer: Multiplan Commercial |
$2,135.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,601.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,455.48
|
| Rate for Payer: Quartz Beloit One Network |
$1,307.81
|
| Rate for Payer: Quartz Commercial |
$1,601.40
|
| Rate for Payer: WEA Trust Commercial |
$1,467.95
|
| Rate for Payer: WPS Commercial |
$1,976.93
|
|
|
ICD Pocket Rev/Relocation
|
Facility
|
OP
|
$2,669.00
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
3052385
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,307.81 |
| Max. Negotiated Rate |
$7,209.92 |
| Rate for Payer: Aetna Commercial |
$2,402.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,295.34
|
| Rate for Payer: Aetna Managed Medicare |
$1,802.48
|
| 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 |
$1,802.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,414.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,802.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,802.48
|
| Rate for Payer: Cash Price |
$800.70
|
| Rate for Payer: Cash Price |
$800.70
|
| Rate for Payer: Cash Price |
$800.70
|
| Rate for Payer: Cigna Commercial |
$2,455.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,802.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,218.22
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,802.48
|
| Rate for Payer: Health EOS Commercial |
$2,375.41
|
| Rate for Payer: HFN Commercial |
$2,455.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,705.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,802.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,802.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,802.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,802.48
|
| Rate for Payer: Multiplan Commercial |
$2,135.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,703.72
|
| Rate for Payer: Preferred Network Access Commercial |
$2,455.48
|
| Rate for Payer: Quartz Beloit One Network |
$1,307.81
|
| Rate for Payer: Quartz Commercial |
$1,734.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,802.48
|
| Rate for Payer: The Alliance Commercial |
$7,209.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,802.48
|
| Rate for Payer: United Healthcare PPO |
$3,583.00
|
| Rate for Payer: WEA Trust Commercial |
$1,467.95
|
| Rate for Payer: Wellcare Medicare |
$1,802.48
|
| Rate for Payer: WPS Commercial |
$1,976.93
|
|
|
ICD Pre/Post OP Adjust
|
Facility
|
IP
|
$423.00
|
|
|
Service Code
|
CPT 93287
|
| Hospital Charge Code |
3052480
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$207.27 |
| Max. Negotiated Rate |
$389.16 |
| Rate for Payer: Aetna Commercial |
$380.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$363.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$224.19
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Cigna Commercial |
$389.16
|
| Rate for Payer: Health EOS Commercial |
$376.47
|
| Rate for Payer: HFN Commercial |
$389.16
|
| Rate for Payer: Multiplan Commercial |
$338.40
|
| Rate for Payer: NAPHCARE Commercial |
$253.80
|
| Rate for Payer: Preferred Network Access Commercial |
$389.16
|
| Rate for Payer: Quartz Beloit One Network |
$207.27
|
| Rate for Payer: Quartz Commercial |
$253.80
|
| Rate for Payer: WEA Trust Commercial |
$232.65
|
| Rate for Payer: WPS Commercial |
$313.32
|
|
|
ICD Pre/Post OP Adjust
|
Facility
|
OP
|
$423.00
|
|
|
Service Code
|
CPT 93287
|
| Hospital Charge Code |
3052480
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$118.44 |
| Max. Negotiated Rate |
$1,692.00 |
| Rate for Payer: Aetna Commercial |
$380.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$363.78
|
| Rate for Payer: Aetna Managed Medicare |
$118.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$274.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$211.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$203.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$224.19
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Cigna Commercial |
$389.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$236.71
|
| Rate for Payer: Health EOS Commercial |
$376.47
|
| Rate for Payer: HFN Commercial |
$389.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$317.25
|
| Rate for Payer: Multiplan Commercial |
$338.40
|
| Rate for Payer: NAPHCARE Commercial |
$253.80
|
| Rate for Payer: Preferred Network Access Commercial |
$389.16
|
| Rate for Payer: Quartz Beloit One Network |
$207.27
|
| Rate for Payer: Quartz Commercial |
$274.95
|
| Rate for Payer: Quartz Medicare Advantage |
$253.80
|
| Rate for Payer: The Alliance Commercial |
$1,692.00
|
| Rate for Payer: United Healthcare PPO |
$317.25
|
| Rate for Payer: WEA Trust Commercial |
$232.65
|
| Rate for Payer: WPS Commercial |
$313.32
|
|
|
ICD Remote Eval w/o Program 90 day
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 93295
|
| Hospital Charge Code |
3052487
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$120.05 |
| Max. Negotiated Rate |
$225.40 |
| Rate for Payer: Aetna Commercial |
$220.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$210.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$129.85
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: Cigna Commercial |
$225.40
|
| Rate for Payer: Health EOS Commercial |
$218.05
|
| Rate for Payer: HFN Commercial |
$225.40
|
| Rate for Payer: Multiplan Commercial |
$196.00
|
| Rate for Payer: NAPHCARE Commercial |
$147.00
|
| Rate for Payer: Preferred Network Access Commercial |
$225.40
|
| Rate for Payer: Quartz Beloit One Network |
$120.05
|
| Rate for Payer: Quartz Commercial |
$147.00
|
| Rate for Payer: WEA Trust Commercial |
$134.75
|
| Rate for Payer: WPS Commercial |
$181.47
|
|
|
ICD Remote Eval w/o Program 90 day
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 93295
|
| Hospital Charge Code |
3052487
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$68.60 |
| Max. Negotiated Rate |
$980.00 |
| Rate for Payer: Aetna Commercial |
$220.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$210.70
|
| Rate for Payer: Aetna Managed Medicare |
$68.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$159.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$122.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$117.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$129.85
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: Cigna Commercial |
$225.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$137.10
|
| Rate for Payer: Health EOS Commercial |
$218.05
|
| Rate for Payer: HFN Commercial |
$225.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$183.75
|
| Rate for Payer: Multiplan Commercial |
$196.00
|
| Rate for Payer: NAPHCARE Commercial |
$147.00
|
| Rate for Payer: Preferred Network Access Commercial |
$225.40
|
| Rate for Payer: Quartz Beloit One Network |
$120.05
|
| Rate for Payer: Quartz Commercial |
$159.25
|
| Rate for Payer: Quartz Medicare Advantage |
$147.00
|
| Rate for Payer: The Alliance Commercial |
$980.00
|
| Rate for Payer: United Healthcare PPO |
$183.75
|
| Rate for Payer: WEA Trust Commercial |
$134.75
|
| Rate for Payer: WPS Commercial |
$181.47
|
|
|
ICD Removal Subq Lead Only
|
Facility
|
IP
|
$4,584.00
|
|
|
Service Code
|
CPT 33272
|
| Hospital Charge Code |
4584632
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,246.16 |
| Max. Negotiated Rate |
$4,217.28 |
| Rate for Payer: Aetna Commercial |
$4,125.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,942.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,429.52
|
| Rate for Payer: Cash Price |
$1,375.20
|
| Rate for Payer: Cigna Commercial |
$4,217.28
|
| Rate for Payer: Health EOS Commercial |
$4,079.76
|
| Rate for Payer: HFN Commercial |
$4,217.28
|
| Rate for Payer: Multiplan Commercial |
$3,667.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,750.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,217.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,246.16
|
| Rate for Payer: Quartz Commercial |
$2,750.40
|
| Rate for Payer: WEA Trust Commercial |
$2,521.20
|
| Rate for Payer: WPS Commercial |
$3,395.37
|
|
|
ICD Removal Subq Lead Only
|
Facility
|
OP
|
$4,584.00
|
|
|
Service Code
|
CPT 33272
|
| Hospital Charge Code |
4584632
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,246.16 |
| Max. Negotiated Rate |
$15,525.92 |
| Rate for Payer: Aetna Commercial |
$4,125.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,942.24
|
| Rate for Payer: Aetna Managed Medicare |
$3,881.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,429.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,881.48
|
| Rate for Payer: Cash Price |
$1,375.20
|
| Rate for Payer: Cash Price |
$1,375.20
|
| Rate for Payer: Cash Price |
$1,375.20
|
| Rate for Payer: Cigna Commercial |
$4,217.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,881.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,881.48
|
| Rate for Payer: Health EOS Commercial |
$4,079.76
|
| Rate for Payer: HFN Commercial |
$4,217.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,439.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,881.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,881.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,881.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,881.48
|
| Rate for Payer: Multiplan Commercial |
$3,667.20
|
| Rate for Payer: NAPHCARE Commercial |
$5,822.22
|
| Rate for Payer: Preferred Network Access Commercial |
$4,217.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,246.16
|
| Rate for Payer: Quartz Commercial |
$2,979.60
|
| Rate for Payer: Quartz Medicare Advantage |
$3,881.48
|
| Rate for Payer: The Alliance Commercial |
$15,525.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,881.48
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$2,521.20
|
| Rate for Payer: Wellcare Medicare |
$3,881.48
|
| Rate for Payer: WPS Commercial |
$3,395.37
|
|
|
ICD REM&REP Gen + AV & CS Leads
|
Facility
|
OP
|
$1,199.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
4318616
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$587.51 |
| Max. Negotiated Rate |
$15,525.92 |
| Rate for Payer: Aetna Commercial |
$1,079.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,031.14
|
| Rate for Payer: Aetna Managed Medicare |
$3,881.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$635.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,881.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,881.48
|
| Rate for Payer: Cash Price |
$359.70
|
| Rate for Payer: Cash Price |
$359.70
|
| Rate for Payer: Cash Price |
$359.70
|
| Rate for Payer: Cigna Commercial |
$1,103.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,881.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,881.48
|
| Rate for Payer: Health EOS Commercial |
$1,067.11
|
| Rate for Payer: HFN Commercial |
$1,103.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14,439.11
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,881.48
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,881.48
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,881.48
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,881.48
|
| Rate for Payer: Multiplan Commercial |
$959.20
|
| Rate for Payer: NAPHCARE Commercial |
$5,822.22
|
| Rate for Payer: Preferred Network Access Commercial |
$1,103.08
|
| Rate for Payer: Quartz Beloit One Network |
$587.51
|
| Rate for Payer: Quartz Commercial |
$779.35
|
| Rate for Payer: Quartz Medicare Advantage |
$3,881.48
|
| Rate for Payer: The Alliance Commercial |
$15,525.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,881.48
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: WEA Trust Commercial |
$659.45
|
| Rate for Payer: Wellcare Medicare |
$3,881.48
|
| Rate for Payer: WPS Commercial |
$888.10
|
|
|
ICD REM&REP Gen + AV & CS Leads
|
Facility
|
IP
|
$1,199.00
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
4318616
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$587.51 |
| Max. Negotiated Rate |
$1,103.08 |
| Rate for Payer: Aetna Commercial |
$1,079.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,031.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$635.47
|
| Rate for Payer: Cash Price |
$359.70
|
| Rate for Payer: Cigna Commercial |
$1,103.08
|
| Rate for Payer: Health EOS Commercial |
$1,067.11
|
| Rate for Payer: HFN Commercial |
$1,103.08
|
| Rate for Payer: Multiplan Commercial |
$959.20
|
| Rate for Payer: NAPHCARE Commercial |
$719.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,103.08
|
| Rate for Payer: Quartz Beloit One Network |
$587.51
|
| Rate for Payer: Quartz Commercial |
$719.40
|
| Rate for Payer: WEA Trust Commercial |
$659.45
|
| Rate for Payer: WPS Commercial |
$888.10
|
|
