|
INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUND INFECTION
|
Facility
|
OP
|
$12,227.57
|
|
|
Service Code
|
CPT 10180
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,056.89 |
| Max. Negotiated Rate |
$12,227.57 |
| Rate for Payer: Aetna Managed Medicare |
$3,056.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,056.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,056.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,056.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,371.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,056.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,056.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,056.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,056.89
|
| Rate for Payer: NAPHCARE Commercial |
$4,585.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3,056.89
|
| Rate for Payer: The Alliance Commercial |
$12,227.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,056.89
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,056.89
|
|
|
INCISION AND DRAINAGE, DEEP ABSCESS, BURSA, OR HEMATOMA, THIGH OR KNEE REGION
|
Facility
|
OP
|
$12,227.57
|
|
|
Service Code
|
CPT 27301
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,056.89 |
| Max. Negotiated Rate |
$12,227.57 |
| Rate for Payer: Aetna Managed Medicare |
$3,056.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,056.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,056.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,056.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,371.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,056.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,056.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,056.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,056.89
|
| Rate for Payer: NAPHCARE Commercial |
$4,585.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3,056.89
|
| Rate for Payer: The Alliance Commercial |
$12,227.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,056.89
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,056.89
|
|
|
INCISION AND DRAINAGE, FOREARM AND/OR WRIST; DEEP ABSCESS OR HEMATOMA
|
Facility
|
OP
|
$13,773.68
|
|
|
Service Code
|
CPT 25028
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,443.42 |
| Max. Negotiated Rate |
$13,773.68 |
| Rate for Payer: Aetna Managed Medicare |
$3,443.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,443.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,443.42
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,443.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,443.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,809.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,443.42
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,443.42
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,443.42
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,443.42
|
| Rate for Payer: NAPHCARE Commercial |
$5,165.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,443.42
|
| Rate for Payer: The Alliance Commercial |
$13,773.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,443.42
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,443.42
|
|
|
INCISION AND DRAINAGE, HEAD/NECK
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2960132
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$292.95 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Aetna Managed Medicare |
$292.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$680.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$523.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$502.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$585.49
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$784.68
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: NAPHCARE Commercial |
$627.74
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$680.06
|
| Rate for Payer: Quartz Medicare Advantage |
$627.74
|
| Rate for Payer: The Alliance Commercial |
$523.12
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
INCISION AND DRAINAGE, HEAD/NECK
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2960132
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.66 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$627.74
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
INCISION AND DRAINAGE, HIP/KNEE
|
Facility
|
IP
|
$1,084.00
|
|
| Hospital Charge Code |
2960134
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$552.41 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$676.42
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
|
INCISION AND DRAINAGE, HIP/KNEE
|
Facility
|
OP
|
$1,084.00
|
|
| Hospital Charge Code |
2960134
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$315.66 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Aetna Managed Medicare |
$315.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$732.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$563.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$541.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$630.89
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$845.52
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: NAPHCARE Commercial |
$676.42
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$732.78
|
| Rate for Payer: Quartz Medicare Advantage |
$676.42
|
| Rate for Payer: The Alliance Commercial |
$563.68
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
|
INCISION AND DRAINAGE, LEG OR ANKLE; DEEP ABSCESS OR HEMATOMA
|
Facility
|
OP
|
$12,227.57
|
|
|
Service Code
|
CPT 27603
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,056.89 |
| Max. Negotiated Rate |
$12,227.57 |
| Rate for Payer: Aetna Managed Medicare |
$3,056.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,056.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,056.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,056.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,371.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,056.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,056.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,056.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,056.89
|
| Rate for Payer: NAPHCARE Commercial |
$4,585.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3,056.89
|
| Rate for Payer: The Alliance Commercial |
$12,227.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,056.89
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,056.89
|
|
|
INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SUBCUTANEOUS ABSCESS, CYST, FURUNCLE, OR PARONYCHIA); COMPLICATED OR MULTIPLE
|
Facility
|
OP
|
$4,386.95
|
|
|
Service Code
|
CPT 10061
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$427.81 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Managed Medicare |
$427.81
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,030.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,388.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,270.32
|
| Rate for Payer: Anthem Medicare Advantage |
$427.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$427.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$427.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$427.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$427.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,591.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$427.81
|
| Rate for Payer: Independent Care Health Plan Medicare |
$427.81
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$427.81
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$427.81
|
| Rate for Payer: NAPHCARE Commercial |
$641.72
|
| Rate for Payer: Quartz Medicare Advantage |
$427.81
|
| Rate for Payer: The Alliance Commercial |
$1,711.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$427.81
|
| Rate for Payer: United Healthcare PPO |
$2,347.28
|
| Rate for Payer: Wellcare Medicare |
$427.81
|
|
|
Incision And Drainage Of Bartholin's Gland Abscess
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
1190841
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.30 |
| Max. Negotiated Rate |
$438.67 |
| Rate for Payer: Aetna Commercial |
$438.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$397.11
|
| Rate for Payer: Aetna Managed Medicare |
$96.46
|
| Rate for Payer: Anthem Medicare Advantage |
$96.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$96.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$96.46
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Cigna Commercial |
$438.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$50.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$96.46
|
| Rate for Payer: Health EOS Commercial |
$420.20
|
| Rate for Payer: HFN Commercial |
$438.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$377.36
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$377.36
|
| Rate for Payer: Independent Care Health Plan Medicare |
$96.46
|
| Rate for Payer: Multiplan Commercial |
$369.41
|
| Rate for Payer: NAPHCARE Commercial |
$144.69
|
| Rate for Payer: Preferred Network Access Commercial |
$438.67
|
| Rate for Payer: Quartz Beloit One Network |
$203.17
|
| Rate for Payer: Quartz Commercial |
$263.20
|
| Rate for Payer: Quartz Medicare Advantage |
$96.46
|
| Rate for Payer: The Alliance Commercial |
$409.95
|
| Rate for Payer: United Healthcare Medicaid |
$50.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$96.46
|
| Rate for Payer: WEA Trust Commercial |
$253.97
|
| Rate for Payer: WPS Commercial |
$434.07
|
|
|
INCISION AND DRAINAGE OF HEMATOMA, SEROMA OR FLUID COLLECTION
|
Facility
|
OP
|
$6,952.48
|
|
|
Service Code
|
CPT 10140
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,738.12 |
| Max. Negotiated Rate |
$6,952.48 |
| Rate for Payer: Aetna Managed Medicare |
$1,738.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,635.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,985.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.04
|
| Rate for Payer: Anthem Medicare Advantage |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$1,738.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$1,738.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$1,738.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$1,738.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,465.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,738.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$1,738.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$1,738.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$1,738.12
|
| Rate for Payer: NAPHCARE Commercial |
$2,607.18
|
| Rate for Payer: Quartz Medicare Advantage |
$1,738.12
|
| Rate for Payer: The Alliance Commercial |
$6,952.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,738.12
|
| Rate for Payer: United Healthcare PPO |
$3,726.32
|
| Rate for Payer: Wellcare Medicare |
$1,738.12
|
|
|
INCISION AND DRAINAGE OF PILONIDAL CYST; SIMPLE
|
Facility
|
OP
|
$4,386.95
|
|
|
Service Code
|
CPT 10080
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$745.23 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Managed Medicare |
$745.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,030.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,388.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,270.32
|
| Rate for Payer: Anthem Medicare Advantage |
$745.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$745.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$745.23
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$745.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$745.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,772.27
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$745.23
|
| Rate for Payer: Independent Care Health Plan Medicare |
$745.23
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$745.23
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$745.23
|
| Rate for Payer: NAPHCARE Commercial |
$1,117.85
|
| Rate for Payer: Quartz Medicare Advantage |
$745.23
|
| Rate for Payer: The Alliance Commercial |
$2,980.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$745.23
|
| Rate for Payer: United Healthcare PPO |
$2,347.28
|
| Rate for Payer: Wellcare Medicare |
$745.23
|
|
|
Incision And Drainage Of Pilonidal Cyst, Simple 10080
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
2957663
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$62.75 |
| Max. Negotiated Rate |
$459.20 |
| Rate for Payer: Aetna Commercial |
$418.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$379.23
|
| Rate for Payer: Aetna Managed Medicare |
$102.04
|
| Rate for Payer: Anthem Medicare Advantage |
$102.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$102.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$102.04
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cigna Commercial |
$418.91
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$62.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$102.04
|
| Rate for Payer: Health EOS Commercial |
$401.27
|
| Rate for Payer: HFN Commercial |
$418.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$362.61
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$362.61
|
| Rate for Payer: Independent Care Health Plan Medicare |
$102.04
|
| Rate for Payer: Multiplan Commercial |
$352.77
|
| Rate for Payer: NAPHCARE Commercial |
$153.07
|
| Rate for Payer: Preferred Network Access Commercial |
$418.91
|
| Rate for Payer: Quartz Beloit One Network |
$194.02
|
| Rate for Payer: Quartz Commercial |
$251.35
|
| Rate for Payer: Quartz Medicare Advantage |
$102.04
|
| Rate for Payer: The Alliance Commercial |
$433.69
|
| Rate for Payer: United Healthcare Medicaid |
$62.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$102.04
|
| Rate for Payer: WEA Trust Commercial |
$242.53
|
| Rate for Payer: WPS Commercial |
$459.20
|
|
|
INCISION AND DRAINAGE OF VAGINAL HEMATOMA; NON-OBSTETRICAL (EG, POST-TRAUMA, SPONTANEOUS BLEEDING)
|
Facility
|
OP
|
$12,227.57
|
|
|
Service Code
|
CPT 57023
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,056.89 |
| Max. Negotiated Rate |
$12,227.57 |
| Rate for Payer: Aetna Managed Medicare |
$3,056.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,056.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,056.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,056.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,056.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,371.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,056.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,056.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,056.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,056.89
|
| Rate for Payer: NAPHCARE Commercial |
$4,585.34
|
| Rate for Payer: Quartz Medicare Advantage |
$3,056.89
|
| Rate for Payer: The Alliance Commercial |
$12,227.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,056.89
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,056.89
|
|
|
Incision And Drainage Of Vulva Or Perineal Abscess 56405
|
Professional
|
Both
|
$742.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
2982412
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$83.06 |
| Max. Negotiated Rate |
$733.10 |
| Rate for Payer: Aetna Commercial |
$733.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$663.64
|
| Rate for Payer: Aetna Managed Medicare |
$112.72
|
| Rate for Payer: Anthem Medicare Advantage |
$112.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$112.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$112.72
|
| Rate for Payer: Cash Price |
$222.60
|
| Rate for Payer: Cash Price |
$222.60
|
| Rate for Payer: Cash Price |
$222.60
|
| Rate for Payer: Cigna Commercial |
$733.10
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$83.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$112.72
|
| Rate for Payer: Health EOS Commercial |
$702.23
|
| Rate for Payer: HFN Commercial |
$733.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$433.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$433.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$112.72
|
| Rate for Payer: Multiplan Commercial |
$617.34
|
| Rate for Payer: NAPHCARE Commercial |
$169.07
|
| Rate for Payer: Preferred Network Access Commercial |
$733.10
|
| Rate for Payer: Quartz Beloit One Network |
$339.54
|
| Rate for Payer: Quartz Commercial |
$439.86
|
| Rate for Payer: Quartz Medicare Advantage |
$112.72
|
| Rate for Payer: The Alliance Commercial |
$479.04
|
| Rate for Payer: United Healthcare Medicaid |
$83.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$112.72
|
| Rate for Payer: WEA Trust Commercial |
$424.42
|
| Rate for Payer: WPS Commercial |
$507.22
|
|
|
INCISION AND DRAINAGE, SCROTAL
|
Facility
|
IP
|
$1,084.00
|
|
| Hospital Charge Code |
2960141
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$552.41 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$676.42
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
|
INCISION AND DRAINAGE, SCROTAL
|
Facility
|
OP
|
$1,084.00
|
|
| Hospital Charge Code |
2960141
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$315.66 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Aetna Managed Medicare |
$315.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$732.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$563.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$541.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$630.89
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$845.52
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: NAPHCARE Commercial |
$676.42
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$732.78
|
| Rate for Payer: Quartz Medicare Advantage |
$676.42
|
| Rate for Payer: The Alliance Commercial |
$563.68
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
|
Incision and Drainage Set Up
|
Facility
|
IP
|
$213.00
|
|
| Hospital Charge Code |
1498832
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$108.54 |
| Max. Negotiated Rate |
$203.80 |
| Rate for Payer: Aetna Commercial |
$199.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$190.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$117.41
|
| Rate for Payer: Cash Price |
$63.90
|
| Rate for Payer: Cigna Commercial |
$203.80
|
| Rate for Payer: Health EOS Commercial |
$197.15
|
| Rate for Payer: HFN Commercial |
$203.80
|
| Rate for Payer: Multiplan Commercial |
$177.22
|
| Rate for Payer: Preferred Network Access Commercial |
$203.80
|
| Rate for Payer: Quartz Beloit One Network |
$108.54
|
| Rate for Payer: Quartz Commercial |
$132.91
|
| Rate for Payer: WEA Trust Commercial |
$121.84
|
| Rate for Payer: WPS Commercial |
$164.07
|
|
|
Incision and Drainage Set Up
|
Facility
|
OP
|
$213.00
|
|
| Hospital Charge Code |
1498832
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$62.03 |
| Max. Negotiated Rate |
$203.80 |
| Rate for Payer: Aetna Commercial |
$199.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$190.51
|
| Rate for Payer: Aetna Managed Medicare |
$62.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$143.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$110.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$106.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$117.41
|
| Rate for Payer: Cash Price |
$63.90
|
| Rate for Payer: Cigna Commercial |
$203.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$123.97
|
| Rate for Payer: Health EOS Commercial |
$197.15
|
| Rate for Payer: HFN Commercial |
$203.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$166.14
|
| Rate for Payer: Multiplan Commercial |
$177.22
|
| Rate for Payer: NAPHCARE Commercial |
$132.91
|
| Rate for Payer: Preferred Network Access Commercial |
$203.80
|
| Rate for Payer: Quartz Beloit One Network |
$108.54
|
| Rate for Payer: Quartz Commercial |
$143.99
|
| Rate for Payer: Quartz Medicare Advantage |
$132.91
|
| Rate for Payer: The Alliance Commercial |
$110.76
|
| Rate for Payer: WEA Trust Commercial |
$121.84
|
| Rate for Payer: WPS Commercial |
$164.07
|
|
|
INCISION AND DRAINAGE, SHOULDER
|
Facility
|
OP
|
$1,084.00
|
|
| Hospital Charge Code |
2950495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$315.66 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Aetna Managed Medicare |
$315.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$732.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$563.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$541.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$630.89
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$845.52
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: NAPHCARE Commercial |
$676.42
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$732.78
|
| Rate for Payer: Quartz Medicare Advantage |
$676.42
|
| Rate for Payer: The Alliance Commercial |
$563.68
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
|
INCISION AND DRAINAGE, SHOULDER
|
Facility
|
IP
|
$1,084.00
|
|
| Hospital Charge Code |
2950495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$552.41 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$676.42
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
|
INCISION AND DRAINAGE, UPPER EXTREMITY/ELBOW/FOREARM
|
Facility
|
IP
|
$1,084.00
|
|
| Hospital Charge Code |
2960523
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$552.41 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$676.42
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
|
INCISION AND DRAINAGE, UPPER EXTREMITY/ELBOW/FOREARM
|
Facility
|
OP
|
$1,084.00
|
|
| Hospital Charge Code |
2960523
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$315.66 |
| Max. Negotiated Rate |
$1,037.17 |
| Rate for Payer: Aetna Commercial |
$1,014.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$969.53
|
| Rate for Payer: Aetna Managed Medicare |
$315.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$732.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$563.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$541.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$597.50
|
| Rate for Payer: Cash Price |
$325.20
|
| Rate for Payer: Cigna Commercial |
$1,037.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$630.89
|
| Rate for Payer: Health EOS Commercial |
$1,003.35
|
| Rate for Payer: HFN Commercial |
$1,037.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$845.52
|
| Rate for Payer: Multiplan Commercial |
$901.89
|
| Rate for Payer: NAPHCARE Commercial |
$676.42
|
| Rate for Payer: Preferred Network Access Commercial |
$1,037.17
|
| Rate for Payer: Quartz Beloit One Network |
$552.41
|
| Rate for Payer: Quartz Commercial |
$732.78
|
| Rate for Payer: Quartz Medicare Advantage |
$676.42
|
| Rate for Payer: The Alliance Commercial |
$563.68
|
| Rate for Payer: WEA Trust Commercial |
$620.05
|
| Rate for Payer: WPS Commercial |
$835.01
|
|
|
INCISION AND DRAINAGE, VULVAR
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2962732
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.66 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$627.74
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
INCISION AND DRAINAGE, VULVAR
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2962732
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$292.95 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Aetna Managed Medicare |
$292.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$680.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$523.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$502.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$585.49
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$784.68
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: NAPHCARE Commercial |
$627.74
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$680.06
|
| Rate for Payer: Quartz Medicare Advantage |
$627.74
|
| Rate for Payer: The Alliance Commercial |
$523.12
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
