|
INTERROGATION DEVICE EVALUATION (IN PERSON) WITH ANALYSIS, REVIEW AND REPORT BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, INCLUDES CONNECTION, RECORDING AND DISCONNECTION PER PATIENT ENCOUNTER; SINGLE, DUAL, OR MULTIPLE LEAD PACEMAKER SYSTEM, OR LEADLESS PACEMAKER SYSTEM
|
Facility
|
OP
|
$157.12
|
|
|
Service Code
|
CPT 93288
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$157.12 |
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.28
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Quartz Medicare Advantage |
$39.28
|
| Rate for Payer: The Alliance Commercial |
$157.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.28
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
|
|
INTERROGATION DEVICE EVALUATION (IN PERSON) WITH ANALYSIS, REVIEW AND REPORT BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, INCLUDES CONNECTION, RECORDING AND DISCONNECTION PER PATIENT ENCOUNTER; SINGLE, DUAL, OR MULTIPLE LEAD TRANSVENOUS IMPLANTABLE DEFIBRILLATOR SYSTEM, INCLUDING ANALYSIS OF HEART RHYTHM DERIVED DATA ELEMENTS
|
Facility
|
OP
|
$157.12
|
|
|
Service Code
|
CPT 93289
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$157.12 |
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.28
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.28
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Quartz Medicare Advantage |
$39.28
|
| Rate for Payer: The Alliance Commercial |
$157.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.28
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
|
|
Interrogation Device Evaluation, In Person With Physician Evaluation Cardioverter-Defibrilator Syste
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
CPT 93289
|
| Hospital Charge Code |
1190896
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$58.43 |
| Max. Negotiated Rate |
$350.74 |
| Rate for Payer: Aetna Commercial |
$350.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$317.51
|
| Rate for Payer: Aetna Managed Medicare |
$71.04
|
| Rate for Payer: Anthem Medicare Advantage |
$71.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$71.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$71.04
|
| Rate for Payer: Cash Price |
$106.50
|
| Rate for Payer: Cash Price |
$106.50
|
| Rate for Payer: Cash Price |
$106.50
|
| Rate for Payer: Cigna Commercial |
$350.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$58.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$71.04
|
| Rate for Payer: Health EOS Commercial |
$335.97
|
| Rate for Payer: HFN Commercial |
$350.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$253.65
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$253.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$71.04
|
| Rate for Payer: Multiplan Commercial |
$295.36
|
| Rate for Payer: NAPHCARE Commercial |
$106.56
|
| Rate for Payer: Preferred Network Access Commercial |
$350.74
|
| Rate for Payer: Quartz Beloit One Network |
$162.45
|
| Rate for Payer: Quartz Commercial |
$210.44
|
| Rate for Payer: Quartz Medicare Advantage |
$71.04
|
| Rate for Payer: The Alliance Commercial |
$269.96
|
| Rate for Payer: United Healthcare Medicaid |
$58.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$71.04
|
| Rate for Payer: WEA Trust Commercial |
$203.06
|
| Rate for Payer: WPS Commercial |
$284.17
|
|
|
Interrogation Device Evaluation, Remote
|
Professional
|
Both
|
$538.00
|
|
|
Service Code
|
CPT 93298
|
| Hospital Charge Code |
1190889
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$29.48 |
| Max. Negotiated Rate |
$531.54 |
| Rate for Payer: Aetna Commercial |
$531.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$481.19
|
| Rate for Payer: Aetna Managed Medicare |
$102.67
|
| Rate for Payer: Anthem Medicare Advantage |
$102.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$102.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$102.67
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cash Price |
$161.40
|
| Rate for Payer: Cigna Commercial |
$531.54
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$29.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$102.67
|
| Rate for Payer: Health EOS Commercial |
$509.16
|
| Rate for Payer: HFN Commercial |
$531.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$93.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$93.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$102.67
|
| Rate for Payer: Multiplan Commercial |
$447.62
|
| Rate for Payer: NAPHCARE Commercial |
$154.00
|
| Rate for Payer: Preferred Network Access Commercial |
$531.54
|
| Rate for Payer: Quartz Beloit One Network |
$246.19
|
| Rate for Payer: Quartz Commercial |
$318.93
|
| Rate for Payer: Quartz Medicare Advantage |
$102.67
|
| Rate for Payer: The Alliance Commercial |
$390.14
|
| Rate for Payer: United Healthcare Medicaid |
$29.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$102.67
|
| Rate for Payer: WEA Trust Commercial |
$307.74
|
| Rate for Payer: WPS Commercial |
$410.68
|
|
|
Interrogation Device Evaluation, Remote
|
Facility
|
OP
|
$539.00
|
|
|
Service Code
|
CPT 93298
|
| Hospital Charge Code |
6243575
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$515.72 |
| Rate for Payer: Multiplan Commercial |
$448.45
|
| Rate for Payer: Aetna Commercial |
$504.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$482.08
|
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$364.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$280.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$269.07
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$297.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.28
|
| Rate for Payer: Cash Price |
$161.70
|
| Rate for Payer: Cash Price |
$161.70
|
| Rate for Payer: Cigna Commercial |
$515.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$313.70
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Health EOS Commercial |
$498.90
|
| Rate for Payer: HFN Commercial |
$515.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.28
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Preferred Network Access Commercial |
$515.72
|
| Rate for Payer: Quartz Beloit One Network |
$274.67
|
| Rate for Payer: Quartz Commercial |
$364.36
|
| Rate for Payer: Quartz Medicare Advantage |
$39.28
|
| Rate for Payer: The Alliance Commercial |
$157.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.28
|
| Rate for Payer: United Healthcare PPO |
$420.42
|
| Rate for Payer: WEA Trust Commercial |
$308.31
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
| Rate for Payer: WPS Commercial |
$415.19
|
|
|
Interrogation Device Evaluation, Remote
|
Facility
|
IP
|
$539.00
|
|
|
Service Code
|
CPT 93298
|
| Hospital Charge Code |
6243575
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$274.67 |
| Max. Negotiated Rate |
$515.72 |
| Rate for Payer: Aetna Commercial |
$504.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$482.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$297.10
|
| Rate for Payer: Cash Price |
$161.70
|
| Rate for Payer: Cigna Commercial |
$515.72
|
| Rate for Payer: Health EOS Commercial |
$498.90
|
| Rate for Payer: HFN Commercial |
$515.72
|
| Rate for Payer: Multiplan Commercial |
$448.45
|
| Rate for Payer: Preferred Network Access Commercial |
$515.72
|
| Rate for Payer: Quartz Beloit One Network |
$274.67
|
| Rate for Payer: Quartz Commercial |
$336.34
|
| Rate for Payer: WEA Trust Commercial |
$308.31
|
| Rate for Payer: WPS Commercial |
$415.19
|
|
|
Interrogation Device Evaluation, Remote 9329826
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
CPT 93298 26
|
| Hospital Charge Code |
6243408
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.59 |
| Max. Negotiated Rate |
$345.80 |
| Rate for Payer: Aetna Commercial |
$345.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$313.04
|
| Rate for Payer: Aetna Managed Medicare |
$24.59
|
| Rate for Payer: Anthem Medicare Advantage |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$24.59
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$345.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$29.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24.59
|
| Rate for Payer: Health EOS Commercial |
$331.24
|
| Rate for Payer: HFN Commercial |
$345.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$93.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$93.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$24.59
|
| Rate for Payer: Multiplan Commercial |
$291.20
|
| Rate for Payer: NAPHCARE Commercial |
$36.88
|
| Rate for Payer: Preferred Network Access Commercial |
$345.80
|
| Rate for Payer: Quartz Beloit One Network |
$160.16
|
| Rate for Payer: Quartz Commercial |
$207.48
|
| Rate for Payer: Quartz Medicare Advantage |
$24.59
|
| Rate for Payer: The Alliance Commercial |
$93.43
|
| Rate for Payer: United Healthcare Medicaid |
$29.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.59
|
| Rate for Payer: WEA Trust Commercial |
$200.20
|
| Rate for Payer: WPS Commercial |
$98.34
|
|
|
Interrogation Device Single, Dual 9328926
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
CPT 93289 26
|
| Hospital Charge Code |
3245519
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.66 |
| Max. Negotiated Rate |
$350.74 |
| Rate for Payer: Aetna Commercial |
$350.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$317.51
|
| Rate for Payer: Aetna Managed Medicare |
$35.66
|
| Rate for Payer: Anthem Medicare Advantage |
$35.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35.66
|
| Rate for Payer: Cash Price |
$106.50
|
| Rate for Payer: Cash Price |
$106.50
|
| Rate for Payer: Cash Price |
$106.50
|
| Rate for Payer: Cigna Commercial |
$350.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$39.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35.66
|
| Rate for Payer: Health EOS Commercial |
$335.97
|
| Rate for Payer: HFN Commercial |
$350.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$132.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$132.60
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35.66
|
| Rate for Payer: Multiplan Commercial |
$295.36
|
| Rate for Payer: NAPHCARE Commercial |
$53.49
|
| Rate for Payer: Preferred Network Access Commercial |
$350.74
|
| Rate for Payer: Quartz Beloit One Network |
$162.45
|
| Rate for Payer: Quartz Commercial |
$210.44
|
| Rate for Payer: Quartz Medicare Advantage |
$35.66
|
| Rate for Payer: The Alliance Commercial |
$135.51
|
| Rate for Payer: United Healthcare Medicaid |
$39.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.66
|
| Rate for Payer: WEA Trust Commercial |
$203.06
|
| Rate for Payer: WPS Commercial |
$142.65
|
|
|
Interrogation Eval F2F Implant Subq Lead Defib 9326126
|
Professional
|
Both
|
$926.00
|
|
|
Service Code
|
CPT 93261 26
|
| Hospital Charge Code |
5290774
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.94 |
| Max. Negotiated Rate |
$914.89 |
| Rate for Payer: Aetna Commercial |
$914.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$828.21
|
| Rate for Payer: Aetna Managed Medicare |
$35.65
|
| Rate for Payer: Anthem Medicare Advantage |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$35.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$35.65
|
| Rate for Payer: Cash Price |
$277.80
|
| Rate for Payer: Cash Price |
$277.80
|
| Rate for Payer: Cash Price |
$277.80
|
| Rate for Payer: Cigna Commercial |
$914.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$31.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$35.65
|
| Rate for Payer: Health EOS Commercial |
$876.37
|
| Rate for Payer: HFN Commercial |
$914.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$131.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$131.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$35.65
|
| Rate for Payer: Multiplan Commercial |
$770.43
|
| Rate for Payer: NAPHCARE Commercial |
$53.48
|
| Rate for Payer: Preferred Network Access Commercial |
$914.89
|
| Rate for Payer: Quartz Beloit One Network |
$423.74
|
| Rate for Payer: Quartz Commercial |
$548.93
|
| Rate for Payer: Quartz Medicare Advantage |
$35.65
|
| Rate for Payer: The Alliance Commercial |
$135.47
|
| Rate for Payer: United Healthcare Medicaid |
$31.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.65
|
| Rate for Payer: WEA Trust Commercial |
$529.67
|
| Rate for Payer: WPS Commercial |
$142.60
|
|
|
INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Facility
|
OP
|
$565.00
|
|
|
Service Code
|
CPT 93290
|
| Hospital Charge Code |
6182855
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$540.59 |
| Rate for Payer: Aetna Commercial |
$528.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$505.34
|
| Rate for Payer: Aetna Managed Medicare |
$39.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$381.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$293.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$282.05
|
| Rate for Payer: Anthem Medicare Advantage |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$311.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.28
|
| Rate for Payer: Cash Price |
$169.50
|
| Rate for Payer: Cash Price |
$169.50
|
| Rate for Payer: Cigna Commercial |
$540.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$328.83
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.28
|
| Rate for Payer: Health EOS Commercial |
$522.96
|
| Rate for Payer: HFN Commercial |
$540.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$146.12
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.28
|
| Rate for Payer: Multiplan Commercial |
$470.08
|
| Rate for Payer: NAPHCARE Commercial |
$58.92
|
| Rate for Payer: Preferred Network Access Commercial |
$540.59
|
| Rate for Payer: Quartz Beloit One Network |
$287.92
|
| Rate for Payer: Quartz Commercial |
$381.94
|
| Rate for Payer: Quartz Medicare Advantage |
$39.28
|
| Rate for Payer: The Alliance Commercial |
$157.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.28
|
| Rate for Payer: WEA Trust Commercial |
$323.18
|
| Rate for Payer: Wellcare Medicare |
$39.28
|
| Rate for Payer: WPS Commercial |
$435.22
|
|
|
INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Facility
|
IP
|
$565.00
|
|
|
Service Code
|
CPT 93290
|
| Hospital Charge Code |
6182855
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$287.92 |
| Max. Negotiated Rate |
$540.59 |
| Rate for Payer: Aetna Commercial |
$528.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$505.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$311.43
|
| Rate for Payer: Cash Price |
$169.50
|
| Rate for Payer: Cigna Commercial |
$540.59
|
| Rate for Payer: Health EOS Commercial |
$522.96
|
| Rate for Payer: HFN Commercial |
$540.59
|
| Rate for Payer: Multiplan Commercial |
$470.08
|
| Rate for Payer: Preferred Network Access Commercial |
$540.59
|
| Rate for Payer: Quartz Beloit One Network |
$287.92
|
| Rate for Payer: Quartz Commercial |
$352.56
|
| Rate for Payer: WEA Trust Commercial |
$323.18
|
| Rate for Payer: WPS Commercial |
$435.22
|
|
|
INTERSTIM - REVISION/REMOVAL OF NEUROSTIMULATOR ELECTRODE
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
CPT 64585
|
| Hospital Charge Code |
5432918
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$483.10 |
| Max. Negotiated Rate |
$14,717.04 |
| Rate for Payer: Aetna Commercial |
$887.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$847.89
|
| Rate for Payer: Aetna Managed Medicare |
$3,679.26
|
| 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 |
$3,679.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$522.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,679.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,679.26
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$907.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,679.26
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,679.26
|
| Rate for Payer: Health EOS Commercial |
$877.47
|
| Rate for Payer: HFN Commercial |
$907.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13,686.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,679.26
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,679.26
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,679.26
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,679.26
|
| Rate for Payer: Multiplan Commercial |
$788.74
|
| Rate for Payer: NAPHCARE Commercial |
$5,518.89
|
| Rate for Payer: Preferred Network Access Commercial |
$907.05
|
| Rate for Payer: Quartz Beloit One Network |
$483.10
|
| Rate for Payer: Quartz Commercial |
$640.85
|
| Rate for Payer: Quartz Medicare Advantage |
$3,679.26
|
| Rate for Payer: The Alliance Commercial |
$14,717.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,679.26
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: WEA Trust Commercial |
$542.26
|
| Rate for Payer: Wellcare Medicare |
$3,679.26
|
| Rate for Payer: WPS Commercial |
$730.24
|
|
|
INTERSTIM - REVISION/REMOVAL OF NEUROSTIMULATOR ELECTRODE
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
CPT 64585
|
| Hospital Charge Code |
5432918
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$483.10 |
| Max. Negotiated Rate |
$907.05 |
| Rate for Payer: Aetna Commercial |
$887.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$522.54
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$907.05
|
| Rate for Payer: Health EOS Commercial |
$877.47
|
| Rate for Payer: HFN Commercial |
$907.05
|
| Rate for Payer: Multiplan Commercial |
$788.74
|
| Rate for Payer: Preferred Network Access Commercial |
$907.05
|
| Rate for Payer: Quartz Beloit One Network |
$483.10
|
| Rate for Payer: Quartz Commercial |
$591.55
|
| Rate for Payer: WEA Trust Commercial |
$542.26
|
| Rate for Payer: WPS Commercial |
$730.24
|
|
|
INTERSTIM - STAGE 1 - PLACEMENT PERMANENT ELCTRODE
|
Facility
|
OP
|
$1,543.00
|
|
|
Service Code
|
CPT 64581
|
| Hospital Charge Code |
5388685
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$786.31 |
| Max. Negotiated Rate |
$26,827.47 |
| Rate for Payer: Aetna Commercial |
$1,444.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,380.06
|
| Rate for Payer: Aetna Managed Medicare |
$6,706.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,394.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,394.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,919.20
|
| Rate for Payer: Anthem Medicare Advantage |
$6,706.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$850.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,706.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,706.87
|
| Rate for Payer: Cash Price |
$462.90
|
| Rate for Payer: Cash Price |
$462.90
|
| Rate for Payer: Cash Price |
$462.90
|
| Rate for Payer: Cigna Commercial |
$1,476.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,706.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,706.87
|
| Rate for Payer: Health EOS Commercial |
$1,428.20
|
| Rate for Payer: HFN Commercial |
$1,476.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24,949.54
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,706.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,706.87
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,706.87
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,706.87
|
| Rate for Payer: Multiplan Commercial |
$1,283.78
|
| Rate for Payer: NAPHCARE Commercial |
$10,060.30
|
| Rate for Payer: Preferred Network Access Commercial |
$1,476.34
|
| Rate for Payer: Quartz Beloit One Network |
$786.31
|
| Rate for Payer: Quartz Commercial |
$1,043.07
|
| Rate for Payer: Quartz Medicare Advantage |
$6,706.87
|
| Rate for Payer: The Alliance Commercial |
$26,827.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,706.87
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$882.60
|
| Rate for Payer: Wellcare Medicare |
$6,706.87
|
| Rate for Payer: WPS Commercial |
$1,188.57
|
|
|
INTERSTIM - STAGE 1 - PLACEMENT PERMANENT ELCTRODE
|
Facility
|
IP
|
$1,543.00
|
|
|
Service Code
|
CPT 64581
|
| Hospital Charge Code |
5388685
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$786.31 |
| Max. Negotiated Rate |
$1,476.34 |
| Rate for Payer: Aetna Commercial |
$1,444.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,380.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$850.50
|
| Rate for Payer: Cash Price |
$462.90
|
| Rate for Payer: Cigna Commercial |
$1,476.34
|
| Rate for Payer: Health EOS Commercial |
$1,428.20
|
| Rate for Payer: HFN Commercial |
$1,476.34
|
| Rate for Payer: Multiplan Commercial |
$1,283.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,476.34
|
| Rate for Payer: Quartz Beloit One Network |
$786.31
|
| Rate for Payer: Quartz Commercial |
$962.83
|
| Rate for Payer: WEA Trust Commercial |
$882.60
|
| Rate for Payer: WPS Commercial |
$1,188.57
|
|
|
INTERSTIM - STAGE 2 - PLACEMENT PERMANENT NEUROSTIMULATOR
|
Facility
|
IP
|
$6,034.00
|
|
|
Service Code
|
CPT 64590
|
| Hospital Charge Code |
5375879
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,074.93 |
| Max. Negotiated Rate |
$5,773.33 |
| Rate for Payer: Aetna Commercial |
$5,647.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,396.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,325.94
|
| Rate for Payer: Cash Price |
$1,810.20
|
| Rate for Payer: Cigna Commercial |
$5,773.33
|
| Rate for Payer: Health EOS Commercial |
$5,585.07
|
| Rate for Payer: HFN Commercial |
$5,773.33
|
| Rate for Payer: Multiplan Commercial |
$5,020.29
|
| Rate for Payer: Preferred Network Access Commercial |
$5,773.33
|
| Rate for Payer: Quartz Beloit One Network |
$3,074.93
|
| Rate for Payer: Quartz Commercial |
$3,765.22
|
| Rate for Payer: WEA Trust Commercial |
$3,451.45
|
| Rate for Payer: WPS Commercial |
$4,647.99
|
|
|
INTERSTIM - STAGE 2 - PLACEMENT PERMANENT NEUROSTIMULATOR
|
Facility
|
OP
|
$6,034.00
|
|
|
Service Code
|
CPT 64590
|
| Hospital Charge Code |
5375879
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,074.93 |
| Max. Negotiated Rate |
$81,665.88 |
| Rate for Payer: Aetna Commercial |
$5,647.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,396.81
|
| Rate for Payer: Aetna Managed Medicare |
$20,416.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,607.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,113.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$18,158.40
|
| Rate for Payer: Anthem Medicare Advantage |
$20,416.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,325.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$20,416.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$20,416.47
|
| Rate for Payer: Cash Price |
$1,810.20
|
| Rate for Payer: Cash Price |
$1,810.20
|
| Rate for Payer: Cash Price |
$1,810.20
|
| Rate for Payer: Cigna Commercial |
$5,773.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$20,416.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$20,416.47
|
| Rate for Payer: Health EOS Commercial |
$5,585.07
|
| Rate for Payer: HFN Commercial |
$5,773.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$75,949.26
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$20,416.47
|
| Rate for Payer: Independent Care Health Plan Medicare |
$20,416.47
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$20,416.47
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$20,416.47
|
| Rate for Payer: Multiplan Commercial |
$5,020.29
|
| Rate for Payer: NAPHCARE Commercial |
$30,624.70
|
| Rate for Payer: Preferred Network Access Commercial |
$5,773.33
|
| Rate for Payer: Quartz Beloit One Network |
$3,074.93
|
| Rate for Payer: Quartz Commercial |
$4,078.98
|
| Rate for Payer: Quartz Medicare Advantage |
$20,416.47
|
| Rate for Payer: The Alliance Commercial |
$81,665.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$20,416.47
|
| Rate for Payer: United Healthcare PPO |
$11,521.12
|
| Rate for Payer: WEA Trust Commercial |
$3,451.45
|
| Rate for Payer: Wellcare Medicare |
$20,416.47
|
| Rate for Payer: WPS Commercial |
$4,647.99
|
|
|
INTERSTIM - TEST PHASE
|
Facility
|
OP
|
$1,258.00
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
5375878
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$641.08 |
| Max. Negotiated Rate |
$26,827.47 |
| Rate for Payer: Aetna Commercial |
$1,177.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,125.16
|
| Rate for Payer: Aetna Managed Medicare |
$6,706.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,394.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$19,394.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,919.20
|
| Rate for Payer: Anthem Medicare Advantage |
$6,706.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$693.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$6,706.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$6,706.87
|
| Rate for Payer: Cash Price |
$377.40
|
| Rate for Payer: Cash Price |
$377.40
|
| Rate for Payer: Cash Price |
$377.40
|
| Rate for Payer: Cigna Commercial |
$1,203.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$6,706.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,947.89
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$6,706.87
|
| Rate for Payer: Health EOS Commercial |
$1,164.40
|
| Rate for Payer: HFN Commercial |
$1,203.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$24,949.54
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$6,706.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$6,706.87
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$6,706.87
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$6,706.87
|
| Rate for Payer: Multiplan Commercial |
$1,046.66
|
| Rate for Payer: NAPHCARE Commercial |
$10,060.30
|
| Rate for Payer: Preferred Network Access Commercial |
$1,203.65
|
| Rate for Payer: Quartz Beloit One Network |
$641.08
|
| Rate for Payer: Quartz Commercial |
$850.41
|
| Rate for Payer: Quartz Medicare Advantage |
$6,706.87
|
| Rate for Payer: The Alliance Commercial |
$26,827.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,706.87
|
| Rate for Payer: United Healthcare PPO |
$9,979.84
|
| Rate for Payer: WEA Trust Commercial |
$719.58
|
| Rate for Payer: Wellcare Medicare |
$6,706.87
|
| Rate for Payer: WPS Commercial |
$969.04
|
|
|
INTERSTIM - TEST PHASE
|
Facility
|
IP
|
$1,258.00
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
5375878
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$641.08 |
| Max. Negotiated Rate |
$1,203.65 |
| Rate for Payer: Aetna Commercial |
$1,177.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,125.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$693.41
|
| Rate for Payer: Cash Price |
$377.40
|
| Rate for Payer: Cigna Commercial |
$1,203.65
|
| Rate for Payer: Health EOS Commercial |
$1,164.40
|
| Rate for Payer: HFN Commercial |
$1,203.65
|
| Rate for Payer: Multiplan Commercial |
$1,046.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,203.65
|
| Rate for Payer: Quartz Beloit One Network |
$641.08
|
| Rate for Payer: Quartz Commercial |
$784.99
|
| Rate for Payer: WEA Trust Commercial |
$719.58
|
| Rate for Payer: WPS Commercial |
$969.04
|
|
|
INTERSTITIAL AND ALVEOLAR LUNG DIAGNOSES
|
Facility
|
OP
|
$43.04
|
|
|
Service Code
|
EAPG 00582
|
| Min. Negotiated Rate |
$41.39 |
| Max. Negotiated Rate |
$43.04 |
| Rate for Payer: Anthem Medicaid |
$41.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$41.39
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$41.39
|
| Rate for Payer: Dean Health Medicaid |
$41.39
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$41.39
|
| Rate for Payer: Managed Health Services Medicaid |
$43.04
|
| Rate for Payer: Molina Healthcare Medicaid |
$41.39
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$41.39
|
| Rate for Payer: United Healthcare Medicaid |
$41.39
|
|
|
INTERSTITIAL AND ALVEOLAR LUNG DISEASES
|
Facility
|
IP
|
$7,803.80
|
|
|
Service Code
|
APR-DRG 1422
|
| Min. Negotiated Rate |
$6,931.82 |
| Max. Negotiated Rate |
$7,803.80 |
| Rate for Payer: Anthem Medicaid |
$7,472.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,472.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,472.56
|
| Rate for Payer: Dean Health Medicaid |
$7,472.56
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,931.82
|
| Rate for Payer: Managed Health Services Medicaid |
$7,803.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,472.56
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,472.56
|
| Rate for Payer: United Healthcare Medicaid |
$7,472.56
|
|
|
INTERSTITIAL AND ALVEOLAR LUNG DISEASES
|
Facility
|
IP
|
$6,050.13
|
|
|
Service Code
|
APR-DRG 1421
|
| Min. Negotiated Rate |
$5,374.11 |
| Max. Negotiated Rate |
$6,050.13 |
| Rate for Payer: Anthem Medicaid |
$5,793.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$5,793.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5,793.34
|
| Rate for Payer: Dean Health Medicaid |
$5,793.34
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5,374.11
|
| Rate for Payer: Managed Health Services Medicaid |
$6,050.13
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,793.34
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5,793.34
|
| Rate for Payer: United Healthcare Medicaid |
$5,793.34
|
|
|
INTERSTITIAL AND ALVEOLAR LUNG DISEASES
|
Facility
|
IP
|
$11,837.22
|
|
|
Service Code
|
APR-DRG 1423
|
| Min. Negotiated Rate |
$10,514.56 |
| Max. Negotiated Rate |
$11,837.22 |
| Rate for Payer: Anthem Medicaid |
$11,334.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$11,334.79
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$11,334.79
|
| Rate for Payer: Dean Health Medicaid |
$11,334.79
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$10,514.56
|
| Rate for Payer: Managed Health Services Medicaid |
$11,837.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,334.79
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$11,334.79
|
| Rate for Payer: United Healthcare Medicaid |
$11,334.79
|
|
|
INTERSTITIAL AND ALVEOLAR LUNG DISEASES
|
Facility
|
IP
|
$18,413.45
|
|
|
Service Code
|
APR-DRG 1424
|
| Min. Negotiated Rate |
$16,355.98 |
| Max. Negotiated Rate |
$18,413.45 |
| Rate for Payer: Anthem Medicaid |
$17,631.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$17,631.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17,631.89
|
| Rate for Payer: Dean Health Medicaid |
$17,631.89
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$16,355.98
|
| Rate for Payer: Managed Health Services Medicaid |
$18,413.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$17,631.89
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17,631.89
|
| Rate for Payer: United Healthcare Medicaid |
$17,631.89
|
|
|
INTERSTITIAL LUNG DISEASE WITH CC
|
Facility
|
IP
|
$27,913.60
|
|
|
Service Code
|
MSDRG 197
|
| Min. Negotiated Rate |
$7,775.18 |
| Max. Negotiated Rate |
$27,913.60 |
| Rate for Payer: Aetna Managed Medicare |
$7,775.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20,708.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15,872.98
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,080.36
|
| Rate for Payer: Anthem Medicare Advantage |
$7,775.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,775.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,775.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,775.18
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16,740.59
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,775.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,229.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,775.18
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,775.18
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,775.18
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,775.18
|
| Rate for Payer: NAPHCARE Commercial |
$11,662.76
|
| Rate for Payer: Quartz Medicare Advantage |
$7,775.18
|
| Rate for Payer: The Alliance Commercial |
$27,913.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,775.18
|
| Rate for Payer: United Healthcare PPO |
$15,748.77
|
| Rate for Payer: Wellcare Medicare |
$7,775.18
|
|
