|
Anaerobic Culture
|
Facility
IP
|
$235.00
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
633881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$115.15 |
| Max. Negotiated Rate |
$216.20 |
| Rate for Payer: Aetna Commercial |
$211.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$124.55
|
| Rate for Payer: Cash Price |
$70.50
|
| Rate for Payer: Cigna Commercial |
$216.20
|
| Rate for Payer: Health EOS Commercial |
$209.15
|
| Rate for Payer: HFN Commercial |
$216.20
|
| Rate for Payer: Multiplan Commercial |
$188.00
|
| Rate for Payer: NAPHCARE Commercial |
$141.00
|
| Rate for Payer: Preferred Network Access Commercial |
$216.20
|
| Rate for Payer: Quartz Beloit One Network |
$115.15
|
| Rate for Payer: Quartz Commercial |
$141.00
|
| Rate for Payer: WEA Trust Commercial |
$129.25
|
| Rate for Payer: WPS Commercial |
$174.06
|
|
|
Anaerobic Culture
|
Facility
OP
|
$235.00
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
633881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$940.00 |
| Rate for Payer: Aetna Commercial |
$211.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$202.10
|
| Rate for Payer: Aetna Managed Medicare |
$9.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$35.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16.57
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15.72
|
| Rate for Payer: Anthem Medicaid |
$9.79
|
| Rate for Payer: Anthem Medicare Advantage |
$9.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$124.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.47
|
| Rate for Payer: Cash Price |
$70.50
|
| Rate for Payer: Cash Price |
$70.50
|
| Rate for Payer: Cigna Commercial |
$216.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9.47
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9.79
|
| Rate for Payer: Dean Health Medicaid |
$9.79
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9.47
|
| Rate for Payer: Health EOS Commercial |
$209.15
|
| Rate for Payer: HFN Commercial |
$216.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35.23
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9.47
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$9.79
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.47
|
| Rate for Payer: Managed Health Services Medicaid |
$10.18
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9.47
|
| Rate for Payer: Multiplan Commercial |
$188.00
|
| Rate for Payer: NAPHCARE Commercial |
$14.20
|
| Rate for Payer: Preferred Network Access Commercial |
$216.20
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$9.79
|
| Rate for Payer: Quartz Beloit One Network |
$115.15
|
| Rate for Payer: Quartz Commercial |
$152.75
|
| Rate for Payer: Quartz Medicare Advantage |
$9.47
|
| Rate for Payer: The Alliance Commercial |
$940.00
|
| Rate for Payer: United Healthcare Medicaid |
$9.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.47
|
| Rate for Payer: United Healthcare PPO |
$176.25
|
| Rate for Payer: WEA Trust Commercial |
$129.25
|
| Rate for Payer: Wellcare Medicare |
$9.47
|
| Rate for Payer: WMAP Medicaid |
$9.79
|
| Rate for Payer: WPS Commercial |
$174.06
|
|
|
Anaerobic Culture
|
Professional
|
$235.00
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
633881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$223.25 |
| Rate for Payer: Aetna Commercial |
$223.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$202.10
|
| Rate for Payer: Aetna Managed Medicare |
$9.47
|
| Rate for Payer: Anthem Medicare Advantage |
$9.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.47
|
| Rate for Payer: Cash Price |
$70.50
|
| Rate for Payer: Cash Price |
$70.50
|
| Rate for Payer: Cigna Commercial |
$223.25
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$117.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.47
|
| Rate for Payer: Health EOS Commercial |
$213.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$33.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$33.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.47
|
| Rate for Payer: Multiplan Commercial |
$188.00
|
| Rate for Payer: Preferred Network Access Commercial |
$223.25
|
| Rate for Payer: Quartz Beloit One Network |
$103.40
|
| Rate for Payer: Quartz Commercial |
$133.95
|
| Rate for Payer: Quartz Medicare Advantage |
$9.47
|
| Rate for Payer: The Alliance Commercial |
$37.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.47
|
| Rate for Payer: WEA Trust Commercial |
$129.25
|
| Rate for Payer: WPS Commercial |
$41.67
|
|
|
Anaerobic MIC System
|
Facility
IP
|
$353.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
1562862
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$172.97 |
| Max. Negotiated Rate |
$324.76 |
| Rate for Payer: Aetna Commercial |
$317.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$187.09
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cigna Commercial |
$324.76
|
| Rate for Payer: Health EOS Commercial |
$314.17
|
| Rate for Payer: HFN Commercial |
$324.76
|
| Rate for Payer: Multiplan Commercial |
$282.40
|
| Rate for Payer: NAPHCARE Commercial |
$211.80
|
| Rate for Payer: Preferred Network Access Commercial |
$324.76
|
| Rate for Payer: Quartz Beloit One Network |
$172.97
|
| Rate for Payer: Quartz Commercial |
$211.80
|
| Rate for Payer: WEA Trust Commercial |
$194.15
|
| Rate for Payer: WPS Commercial |
$261.47
|
|
|
Anaerobic MIC System
|
Facility
OP
|
$353.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
1562862
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$1,412.00 |
| Rate for Payer: Aetna Commercial |
$317.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$303.58
|
| Rate for Payer: Aetna Managed Medicare |
$8.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$32.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15.14
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14.36
|
| Rate for Payer: Anthem Medicaid |
$8.94
|
| Rate for Payer: Anthem Medicare Advantage |
$8.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$187.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.65
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cigna Commercial |
$324.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.94
|
| Rate for Payer: Dean Health Medicaid |
$8.94
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8.65
|
| Rate for Payer: Health EOS Commercial |
$314.17
|
| Rate for Payer: HFN Commercial |
$324.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32.18
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.65
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.65
|
| Rate for Payer: Managed Health Services Medicaid |
$9.30
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8.65
|
| Rate for Payer: Multiplan Commercial |
$282.40
|
| Rate for Payer: NAPHCARE Commercial |
$12.98
|
| Rate for Payer: Preferred Network Access Commercial |
$324.76
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.94
|
| Rate for Payer: Quartz Beloit One Network |
$172.97
|
| Rate for Payer: Quartz Commercial |
$229.45
|
| Rate for Payer: Quartz Medicare Advantage |
$8.65
|
| Rate for Payer: The Alliance Commercial |
$1,412.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.65
|
| Rate for Payer: United Healthcare PPO |
$264.75
|
| Rate for Payer: WEA Trust Commercial |
$194.15
|
| Rate for Payer: Wellcare Medicare |
$8.65
|
| Rate for Payer: WMAP Medicaid |
$8.94
|
| Rate for Payer: WPS Commercial |
$261.47
|
|
|
Anaerobic MIC System
|
Professional
|
$353.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
1562862
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$335.35 |
| Rate for Payer: Aetna Commercial |
$335.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$303.58
|
| Rate for Payer: Aetna Managed Medicare |
$8.65
|
| Rate for Payer: Anthem Medicare Advantage |
$8.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.65
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cigna Commercial |
$335.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$176.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.65
|
| Rate for Payer: Health EOS Commercial |
$321.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30.53
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$30.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.65
|
| Rate for Payer: Multiplan Commercial |
$282.40
|
| Rate for Payer: Preferred Network Access Commercial |
$335.35
|
| Rate for Payer: Quartz Beloit One Network |
$155.32
|
| Rate for Payer: Quartz Commercial |
$201.21
|
| Rate for Payer: Quartz Medicare Advantage |
$8.65
|
| Rate for Payer: The Alliance Commercial |
$34.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.65
|
| Rate for Payer: WEA Trust Commercial |
$194.15
|
| Rate for Payer: WPS Commercial |
$38.06
|
|
|
ANAL AND STOMAL PROCEDURES WITH CC
|
Facility
IP
|
$34,919.00
|
|
|
Service Code
|
MS-DRG 348
|
| Min. Negotiated Rate |
$12,560.93 |
| Max. Negotiated Rate |
$34,919.00 |
| Rate for Payer: Aetna Managed Medicare |
$12,560.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$27,274.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$20,905.30
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$19,861.40
|
| Rate for Payer: Anthem Medicare Advantage |
$12,560.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12,560.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12,560.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12,560.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$22,047.97
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12,560.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25,377.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12,560.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12,560.93
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12,560.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12,560.93
|
| Rate for Payer: NAPHCARE Commercial |
$18,841.40
|
| Rate for Payer: Quartz Medicare Advantage |
$12,560.93
|
| Rate for Payer: The Alliance Commercial |
$34,919.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,560.93
|
| Rate for Payer: United Healthcare PPO |
$19,756.55
|
| Rate for Payer: Wellcare Medicare |
$12,560.93
|
|
|
ANAL AND STOMAL PROCEDURES WITH MCC
|
Facility
IP
|
$68,091.00
|
|
|
Service Code
|
MS-DRG 347
|
| Min. Negotiated Rate |
$24,493.07 |
| Max. Negotiated Rate |
$68,091.00 |
| Rate for Payer: Aetna Managed Medicare |
$24,493.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$53,499.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41,006.55
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$38,958.90
|
| Rate for Payer: Anthem Medicare Advantage |
$24,493.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24,493.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24,493.07
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$24,493.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$43,247.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$24,493.07
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$49,707.45
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$24,493.07
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24,493.07
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$24,493.07
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$24,493.07
|
| Rate for Payer: NAPHCARE Commercial |
$36,739.60
|
| Rate for Payer: Quartz Medicare Advantage |
$24,493.07
|
| Rate for Payer: The Alliance Commercial |
$68,091.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,493.07
|
| Rate for Payer: United Healthcare PPO |
$38,697.89
|
| Rate for Payer: Wellcare Medicare |
$24,493.07
|
|
|
ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$26,263.00
|
|
|
Service Code
|
MS-DRG 349
|
| Min. Negotiated Rate |
$9,447.13 |
| Max. Negotiated Rate |
$26,263.00 |
| Rate for Payer: Aetna Managed Medicare |
$9,447.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,560.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15,759.38
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14,972.44
|
| Rate for Payer: Anthem Medicare Advantage |
$9,447.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9,447.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9,447.13
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9,447.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,620.78
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9,447.13
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19,028.10
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9,447.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9,447.13
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9,447.13
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9,447.13
|
| Rate for Payer: NAPHCARE Commercial |
$14,170.70
|
| Rate for Payer: Quartz Medicare Advantage |
$9,447.13
|
| Rate for Payer: The Alliance Commercial |
$26,263.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,447.13
|
| Rate for Payer: United Healthcare PPO |
$14,813.62
|
| Rate for Payer: Wellcare Medicare |
$9,447.13
|
|
|
ANAL CONDYLOMA, CAUTERY OF
|
Facility
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959946
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$492.94 |
| Max. Negotiated Rate |
$925.52 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$603.60
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
ANAL CONDYLOMA, CAUTERY OF
|
Facility
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959946
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$281.68 |
| Max. Negotiated Rate |
$4,024.00 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$865.16
|
| Rate for Payer: Aetna Managed Medicare |
$281.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$653.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$503.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$482.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$533.18
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$925.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$562.96
|
| Rate for Payer: Health EOS Commercial |
$895.34
|
| Rate for Payer: HFN Commercial |
$925.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$754.50
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: NAPHCARE Commercial |
$603.60
|
| Rate for Payer: Preferred Network Access Commercial |
$925.52
|
| Rate for Payer: Quartz Beloit One Network |
$492.94
|
| Rate for Payer: Quartz Commercial |
$653.90
|
| Rate for Payer: Quartz Medicare Advantage |
$603.60
|
| Rate for Payer: The Alliance Commercial |
$4,024.00
|
| Rate for Payer: WEA Trust Commercial |
$553.30
|
| Rate for Payer: WPS Commercial |
$745.14
|
|
|
Analyze Neurostim, Complex 95972
|
Professional
|
$373.00
|
|
|
Service Code
|
CPT 95972
|
| Hospital Charge Code |
3015500
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$37.83 |
| Max. Negotiated Rate |
$354.35 |
| Rate for Payer: Aetna Commercial |
$354.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$320.78
|
| Rate for Payer: Aetna Managed Medicare |
$37.83
|
| Rate for Payer: Anthem Medicare Advantage |
$37.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$37.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$37.83
|
| Rate for Payer: Cash Price |
$111.90
|
| Rate for Payer: Cash Price |
$111.90
|
| Rate for Payer: Cigna Commercial |
$354.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$186.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$37.83
|
| Rate for Payer: Health EOS Commercial |
$339.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$189.98
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$189.98
|
| Rate for Payer: Independent Care Health Plan Medicare |
$37.83
|
| Rate for Payer: Multiplan Commercial |
$298.40
|
| Rate for Payer: Preferred Network Access Commercial |
$354.35
|
| Rate for Payer: Quartz Beloit One Network |
$164.12
|
| Rate for Payer: Quartz Commercial |
$212.61
|
| Rate for Payer: Quartz Medicare Advantage |
$37.83
|
| Rate for Payer: The Alliance Commercial |
$94.58
|
| Rate for Payer: United Healthcare Medicaid |
$55.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$37.83
|
| Rate for Payer: WEA Trust Commercial |
$205.15
|
| Rate for Payer: WPS Commercial |
$151.32
|
|
|
Analyze Neurostim, No Prog 95970
|
Professional
|
$451.00
|
|
|
Service Code
|
CPT 95970
|
| Hospital Charge Code |
3015498
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.44 |
| Max. Negotiated Rate |
$428.45 |
| Rate for Payer: Aetna Commercial |
$428.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$387.86
|
| Rate for Payer: Aetna Managed Medicare |
$17.44
|
| Rate for Payer: Anthem Medicare Advantage |
$17.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.44
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cigna Commercial |
$428.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$225.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.44
|
| Rate for Payer: Health EOS Commercial |
$410.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64.28
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$64.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.44
|
| Rate for Payer: Multiplan Commercial |
$360.80
|
| Rate for Payer: Preferred Network Access Commercial |
$428.45
|
| Rate for Payer: Quartz Beloit One Network |
$198.44
|
| Rate for Payer: Quartz Commercial |
$257.07
|
| Rate for Payer: Quartz Medicare Advantage |
$17.44
|
| Rate for Payer: The Alliance Commercial |
$43.60
|
| Rate for Payer: United Healthcare Medicaid |
$18.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.44
|
| Rate for Payer: WEA Trust Commercial |
$248.05
|
| Rate for Payer: WPS Commercial |
$69.76
|
|
|
ANALYZE NEUROSTIM, SIMPLE 95971
|
Professional
|
$545.00
|
|
|
Service Code
|
CPT 95971
|
| Hospital Charge Code |
3015499
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$36.83 |
| Max. Negotiated Rate |
$517.75 |
| Rate for Payer: Aetna Commercial |
$517.75
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$468.70
|
| Rate for Payer: Aetna Managed Medicare |
$36.83
|
| Rate for Payer: Anthem Medicare Advantage |
$36.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$36.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$36.83
|
| Rate for Payer: Cash Price |
$163.50
|
| Rate for Payer: Cash Price |
$163.50
|
| Rate for Payer: Cigna Commercial |
$517.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$272.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$36.83
|
| Rate for Payer: Health EOS Commercial |
$495.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$166.72
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$166.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$36.83
|
| Rate for Payer: Multiplan Commercial |
$436.00
|
| Rate for Payer: Preferred Network Access Commercial |
$517.75
|
| Rate for Payer: Quartz Beloit One Network |
$239.80
|
| Rate for Payer: Quartz Commercial |
$310.65
|
| Rate for Payer: Quartz Medicare Advantage |
$36.83
|
| Rate for Payer: The Alliance Commercial |
$92.08
|
| Rate for Payer: United Healthcare Medicaid |
$49.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.83
|
| Rate for Payer: WEA Trust Commercial |
$299.75
|
| Rate for Payer: WPS Commercial |
$147.32
|
|
|
ANALYZE PACEMAKER SYSTEM 9372426
|
Professional
|
$2,597.00
|
|
|
Service Code
|
CPT 93724
|
| Hospital Charge Code |
3015423
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$274.17 |
| Max. Negotiated Rate |
$2,467.15 |
| Rate for Payer: Aetna Commercial |
$2,467.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,233.42
|
| Rate for Payer: Aetna Managed Medicare |
$274.17
|
| Rate for Payer: Anthem Medicare Advantage |
$274.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$274.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$274.17
|
| Rate for Payer: Cash Price |
$779.10
|
| Rate for Payer: Cash Price |
$779.10
|
| Rate for Payer: Cigna Commercial |
$2,467.15
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$1,298.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$274.17
|
| Rate for Payer: Health EOS Commercial |
$2,363.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$979.72
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$979.72
|
| Rate for Payer: Independent Care Health Plan Medicare |
$274.17
|
| Rate for Payer: Multiplan Commercial |
$2,077.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,467.15
|
| Rate for Payer: Quartz Beloit One Network |
$1,142.68
|
| Rate for Payer: Quartz Commercial |
$1,480.29
|
| Rate for Payer: Quartz Medicare Advantage |
$274.17
|
| Rate for Payer: The Alliance Commercial |
$1,041.85
|
| Rate for Payer: United Healthcare Medicaid |
$405.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$274.17
|
| Rate for Payer: WEA Trust Commercial |
$1,428.35
|
| Rate for Payer: WPS Commercial |
$1,096.68
|
|
|
Anaplasma phagocytophilum Antibody IgG
|
Facility
IP
|
$414.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
5679629
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$202.86 |
| Max. Negotiated Rate |
$380.88 |
| Rate for Payer: Aetna Commercial |
$372.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$219.42
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$380.88
|
| Rate for Payer: Health EOS Commercial |
$368.46
|
| Rate for Payer: HFN Commercial |
$380.88
|
| Rate for Payer: Multiplan Commercial |
$331.20
|
| Rate for Payer: NAPHCARE Commercial |
$248.40
|
| Rate for Payer: Preferred Network Access Commercial |
$380.88
|
| Rate for Payer: Quartz Beloit One Network |
$202.86
|
| Rate for Payer: Quartz Commercial |
$248.40
|
| Rate for Payer: WEA Trust Commercial |
$227.70
|
| Rate for Payer: WPS Commercial |
$306.65
|
|
|
Anaplasma phagocytophilum Antibody IgG
|
Facility
OP
|
$414.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
5679629
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$1,656.00 |
| Rate for Payer: Aetna Commercial |
$372.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$356.04
|
| Rate for Payer: Aetna Managed Medicare |
$10.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$38.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17.82
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16.90
|
| Rate for Payer: Anthem Medicaid |
$8.17
|
| Rate for Payer: Anthem Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$219.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.18
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$380.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10.18
|
| Rate for Payer: Health EOS Commercial |
$368.46
|
| Rate for Payer: HFN Commercial |
$380.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10.18
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.18
|
| Rate for Payer: Managed Health Services Medicaid |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10.18
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10.18
|
| Rate for Payer: Multiplan Commercial |
$331.20
|
| Rate for Payer: NAPHCARE Commercial |
$15.27
|
| Rate for Payer: Preferred Network Access Commercial |
$380.88
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.17
|
| Rate for Payer: Quartz Beloit One Network |
$202.86
|
| Rate for Payer: Quartz Commercial |
$269.10
|
| Rate for Payer: Quartz Medicare Advantage |
$10.18
|
| Rate for Payer: The Alliance Commercial |
$1,656.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.18
|
| Rate for Payer: United Healthcare PPO |
$310.50
|
| Rate for Payer: WEA Trust Commercial |
$227.70
|
| Rate for Payer: Wellcare Medicare |
$10.18
|
| Rate for Payer: WMAP Medicaid |
$8.17
|
| Rate for Payer: WPS Commercial |
$306.65
|
|
|
Anaplasma phagocytophilum Antibody IgG
|
Professional
|
$414.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
5679629
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.18 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Aetna Commercial |
$393.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$356.04
|
| Rate for Payer: Aetna Managed Medicare |
$10.18
|
| Rate for Payer: Anthem Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.18
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$393.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$207.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10.18
|
| Rate for Payer: Health EOS Commercial |
$376.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$35.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.18
|
| Rate for Payer: Multiplan Commercial |
$331.20
|
| Rate for Payer: Preferred Network Access Commercial |
$393.30
|
| Rate for Payer: Quartz Beloit One Network |
$182.16
|
| Rate for Payer: Quartz Commercial |
$235.98
|
| Rate for Payer: Quartz Medicare Advantage |
$10.18
|
| Rate for Payer: The Alliance Commercial |
$40.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.18
|
| Rate for Payer: WEA Trust Commercial |
$227.70
|
| Rate for Payer: WPS Commercial |
$44.79
|
|
|
Anaplasma phagocytophilum Antibody IgM
|
Facility
IP
|
$414.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
5679630
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$202.86 |
| Max. Negotiated Rate |
$380.88 |
| Rate for Payer: Aetna Commercial |
$372.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$219.42
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$380.88
|
| Rate for Payer: Health EOS Commercial |
$368.46
|
| Rate for Payer: HFN Commercial |
$380.88
|
| Rate for Payer: Multiplan Commercial |
$331.20
|
| Rate for Payer: NAPHCARE Commercial |
$248.40
|
| Rate for Payer: Preferred Network Access Commercial |
$380.88
|
| Rate for Payer: Quartz Beloit One Network |
$202.86
|
| Rate for Payer: Quartz Commercial |
$248.40
|
| Rate for Payer: WEA Trust Commercial |
$227.70
|
| Rate for Payer: WPS Commercial |
$306.65
|
|
|
Anaplasma phagocytophilum Antibody IgM
|
Professional
|
$414.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
5679630
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.18 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Aetna Commercial |
$393.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$356.04
|
| Rate for Payer: Aetna Managed Medicare |
$10.18
|
| Rate for Payer: Anthem Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.18
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$393.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$207.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10.18
|
| Rate for Payer: Health EOS Commercial |
$376.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$35.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.18
|
| Rate for Payer: Multiplan Commercial |
$331.20
|
| Rate for Payer: Preferred Network Access Commercial |
$393.30
|
| Rate for Payer: Quartz Beloit One Network |
$182.16
|
| Rate for Payer: Quartz Commercial |
$235.98
|
| Rate for Payer: Quartz Medicare Advantage |
$10.18
|
| Rate for Payer: The Alliance Commercial |
$40.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.18
|
| Rate for Payer: WEA Trust Commercial |
$227.70
|
| Rate for Payer: WPS Commercial |
$44.79
|
|
|
Anaplasma phagocytophilum Antibody IgM
|
Facility
OP
|
$414.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
5679630
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$1,656.00 |
| Rate for Payer: Aetna Commercial |
$372.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$356.04
|
| Rate for Payer: Aetna Managed Medicare |
$10.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$38.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17.82
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16.90
|
| Rate for Payer: Anthem Medicaid |
$8.17
|
| Rate for Payer: Anthem Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$219.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.18
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$380.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10.18
|
| Rate for Payer: Health EOS Commercial |
$368.46
|
| Rate for Payer: HFN Commercial |
$380.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10.18
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.18
|
| Rate for Payer: Managed Health Services Medicaid |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10.18
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10.18
|
| Rate for Payer: Multiplan Commercial |
$331.20
|
| Rate for Payer: NAPHCARE Commercial |
$15.27
|
| Rate for Payer: Preferred Network Access Commercial |
$380.88
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.17
|
| Rate for Payer: Quartz Beloit One Network |
$202.86
|
| Rate for Payer: Quartz Commercial |
$269.10
|
| Rate for Payer: Quartz Medicare Advantage |
$10.18
|
| Rate for Payer: The Alliance Commercial |
$1,656.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.18
|
| Rate for Payer: United Healthcare PPO |
$310.50
|
| Rate for Payer: WEA Trust Commercial |
$227.70
|
| Rate for Payer: Wellcare Medicare |
$10.18
|
| Rate for Payer: WMAP Medicaid |
$8.17
|
| Rate for Payer: WPS Commercial |
$306.65
|
|
|
Anaplasma phagocytophilum, IgG/IgM
|
Professional
|
$172.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
980022
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.18 |
| Max. Negotiated Rate |
$163.40 |
| Rate for Payer: Aetna Commercial |
$163.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$147.92
|
| Rate for Payer: Aetna Managed Medicare |
$10.18
|
| Rate for Payer: Anthem Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.18
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cigna Commercial |
$163.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$86.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$10.18
|
| Rate for Payer: Health EOS Commercial |
$156.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$35.94
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$35.94
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.18
|
| Rate for Payer: Multiplan Commercial |
$137.60
|
| Rate for Payer: Preferred Network Access Commercial |
$163.40
|
| Rate for Payer: Quartz Beloit One Network |
$75.68
|
| Rate for Payer: Quartz Commercial |
$98.04
|
| Rate for Payer: Quartz Medicare Advantage |
$10.18
|
| Rate for Payer: The Alliance Commercial |
$40.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.18
|
| Rate for Payer: WEA Trust Commercial |
$94.60
|
| Rate for Payer: WPS Commercial |
$44.79
|
|
|
Anaplasma phagocytophilum, IgG/IgM
|
Facility
IP
|
$172.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
980022
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$84.28 |
| Max. Negotiated Rate |
$158.24 |
| Rate for Payer: Aetna Commercial |
$154.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$91.16
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cigna Commercial |
$158.24
|
| Rate for Payer: Health EOS Commercial |
$153.08
|
| Rate for Payer: HFN Commercial |
$158.24
|
| Rate for Payer: Multiplan Commercial |
$137.60
|
| Rate for Payer: NAPHCARE Commercial |
$103.20
|
| Rate for Payer: Preferred Network Access Commercial |
$158.24
|
| Rate for Payer: Quartz Beloit One Network |
$84.28
|
| Rate for Payer: Quartz Commercial |
$103.20
|
| Rate for Payer: WEA Trust Commercial |
$94.60
|
| Rate for Payer: WPS Commercial |
$127.40
|
|
|
Anaplasma phagocytophilum, IgG/IgM
|
Facility
OP
|
$172.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
980022
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$688.00 |
| Rate for Payer: Aetna Commercial |
$154.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$147.92
|
| Rate for Payer: Aetna Managed Medicare |
$10.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$38.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17.82
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16.90
|
| Rate for Payer: Anthem Medicaid |
$8.17
|
| Rate for Payer: Anthem Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$91.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.18
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cigna Commercial |
$158.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicaid |
$8.17
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10.18
|
| Rate for Payer: Health EOS Commercial |
$153.08
|
| Rate for Payer: HFN Commercial |
$158.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$37.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10.18
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.18
|
| Rate for Payer: Managed Health Services Medicaid |
$8.50
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10.18
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10.18
|
| Rate for Payer: Multiplan Commercial |
$137.60
|
| Rate for Payer: NAPHCARE Commercial |
$15.27
|
| Rate for Payer: Preferred Network Access Commercial |
$158.24
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$8.17
|
| Rate for Payer: Quartz Beloit One Network |
$84.28
|
| Rate for Payer: Quartz Commercial |
$111.80
|
| Rate for Payer: Quartz Medicare Advantage |
$10.18
|
| Rate for Payer: The Alliance Commercial |
$688.00
|
| Rate for Payer: United Healthcare Medicaid |
$8.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.18
|
| Rate for Payer: United Healthcare PPO |
$129.00
|
| Rate for Payer: WEA Trust Commercial |
$94.60
|
| Rate for Payer: Wellcare Medicare |
$10.18
|
| Rate for Payer: WMAP Medicaid |
$8.17
|
| Rate for Payer: WPS Commercial |
$127.40
|
|
|
Anaplasma phagocytophilum IgM
|
Facility
IP
|
$116.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
2942861
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.84 |
| Max. Negotiated Rate |
$106.72 |
| Rate for Payer: Aetna Commercial |
$104.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$61.48
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cigna Commercial |
$106.72
|
| Rate for Payer: Health EOS Commercial |
$103.24
|
| Rate for Payer: HFN Commercial |
$106.72
|
| Rate for Payer: Multiplan Commercial |
$92.80
|
| Rate for Payer: NAPHCARE Commercial |
$69.60
|
| Rate for Payer: Preferred Network Access Commercial |
$106.72
|
| Rate for Payer: Quartz Beloit One Network |
$56.84
|
| Rate for Payer: Quartz Commercial |
$69.60
|
| Rate for Payer: WEA Trust Commercial |
$63.80
|
| Rate for Payer: WPS Commercial |
$85.92
|
|
