|
Irradiation Fee
|
Facility
|
OP
|
$181.00
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
2949312
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.64 |
| Max. Negotiated Rate |
$166.52 |
| Rate for Payer: Aetna Commercial |
$162.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$155.66
|
| Rate for Payer: Aetna Managed Medicare |
$39.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$148.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$69.37
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$65.80
|
| Rate for Payer: Anthem Medicare Advantage |
$39.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$95.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.64
|
| Rate for Payer: Cash Price |
$54.30
|
| Rate for Payer: Cash Price |
$54.30
|
| Rate for Payer: Cigna Commercial |
$166.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$101.29
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.64
|
| Rate for Payer: Health EOS Commercial |
$161.09
|
| Rate for Payer: HFN Commercial |
$166.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$147.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.64
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.64
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.64
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.64
|
| Rate for Payer: Multiplan Commercial |
$144.80
|
| Rate for Payer: NAPHCARE Commercial |
$59.46
|
| Rate for Payer: Preferred Network Access Commercial |
$166.52
|
| Rate for Payer: Quartz Beloit One Network |
$88.69
|
| Rate for Payer: Quartz Commercial |
$117.65
|
| Rate for Payer: Quartz Medicare Advantage |
$39.64
|
| Rate for Payer: The Alliance Commercial |
$158.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.64
|
| Rate for Payer: United Healthcare PPO |
$135.75
|
| Rate for Payer: WEA Trust Commercial |
$99.55
|
| Rate for Payer: Wellcare Medicare |
$39.64
|
| Rate for Payer: WPS Commercial |
$134.07
|
|
|
IRRIGATING SLEEVE FOR PM2 58PM2SLV
|
Facility
|
IP
|
$5,632.00
|
|
| Hospital Charge Code |
6220208
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,759.68 |
| Max. Negotiated Rate |
$5,181.44 |
| Rate for Payer: Aetna Commercial |
$5,068.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,843.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,984.96
|
| Rate for Payer: Cash Price |
$1,689.60
|
| Rate for Payer: Cigna Commercial |
$5,181.44
|
| Rate for Payer: Health EOS Commercial |
$5,012.48
|
| Rate for Payer: HFN Commercial |
$5,181.44
|
| Rate for Payer: Multiplan Commercial |
$4,505.60
|
| Rate for Payer: NAPHCARE Commercial |
$3,379.20
|
| Rate for Payer: Preferred Network Access Commercial |
$5,181.44
|
| Rate for Payer: Quartz Beloit One Network |
$2,759.68
|
| Rate for Payer: Quartz Commercial |
$3,379.20
|
| Rate for Payer: WEA Trust Commercial |
$3,097.60
|
| Rate for Payer: WPS Commercial |
$4,171.62
|
|
|
IRRIGATING SLEEVE FOR PM2 58PM2SLV
|
Facility
|
OP
|
$5,632.00
|
|
| Hospital Charge Code |
6220208
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,576.96 |
| Max. Negotiated Rate |
$22,528.00 |
| Rate for Payer: Aetna Commercial |
$5,068.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,843.52
|
| Rate for Payer: Aetna Managed Medicare |
$1,576.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,660.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,816.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,703.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,984.96
|
| Rate for Payer: Cash Price |
$1,689.60
|
| Rate for Payer: Cigna Commercial |
$5,181.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,151.67
|
| Rate for Payer: Health EOS Commercial |
$5,012.48
|
| Rate for Payer: HFN Commercial |
$5,181.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,224.00
|
| Rate for Payer: Multiplan Commercial |
$4,505.60
|
| Rate for Payer: NAPHCARE Commercial |
$3,379.20
|
| Rate for Payer: Preferred Network Access Commercial |
$5,181.44
|
| Rate for Payer: Quartz Beloit One Network |
$2,759.68
|
| Rate for Payer: Quartz Commercial |
$3,660.80
|
| Rate for Payer: Quartz Medicare Advantage |
$3,379.20
|
| Rate for Payer: The Alliance Commercial |
$22,528.00
|
| Rate for Payer: WEA Trust Commercial |
$3,097.60
|
| Rate for Payer: WPS Commercial |
$4,171.62
|
|
|
IRRIGATION, MAXILLARY SINUS 31000
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
CPT 31000
|
| Hospital Charge Code |
3014367
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$68.51 |
| Max. Negotiated Rate |
$357.84 |
| Rate for Payer: Aetna Commercial |
$341.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$308.74
|
| Rate for Payer: Cash Price |
$107.70
|
| Rate for Payer: Cash Price |
$107.70
|
| Rate for Payer: Cash Price |
$107.70
|
| Rate for Payer: Cigna Commercial |
$341.05
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$68.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$215.40
|
| Rate for Payer: Health EOS Commercial |
$326.69
|
| Rate for Payer: HFN Commercial |
$341.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$357.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$357.84
|
| Rate for Payer: Multiplan Commercial |
$287.20
|
| Rate for Payer: Preferred Network Access Commercial |
$341.05
|
| Rate for Payer: Quartz Beloit One Network |
$157.96
|
| Rate for Payer: Quartz Commercial |
$204.63
|
| Rate for Payer: The Alliance Commercial |
$179.50
|
| Rate for Payer: United Healthcare Medicaid |
$68.51
|
| Rate for Payer: WEA Trust Commercial |
$197.45
|
| Rate for Payer: WPS Commercial |
$265.91
|
|
|
IRRIGATION NEZHAT-DORSEY 5102710
|
Facility
|
OP
|
$952.00
|
|
| Hospital Charge Code |
2962952
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$266.56 |
| Max. Negotiated Rate |
$3,808.00 |
| Rate for Payer: Aetna Commercial |
$856.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$818.72
|
| Rate for Payer: Aetna Managed Medicare |
$266.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$618.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$476.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$456.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$504.56
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cigna Commercial |
$875.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$532.74
|
| Rate for Payer: Health EOS Commercial |
$847.28
|
| Rate for Payer: HFN Commercial |
$875.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$714.00
|
| Rate for Payer: Multiplan Commercial |
$761.60
|
| Rate for Payer: NAPHCARE Commercial |
$571.20
|
| Rate for Payer: Preferred Network Access Commercial |
$875.84
|
| Rate for Payer: Quartz Beloit One Network |
$466.48
|
| Rate for Payer: Quartz Commercial |
$618.80
|
| Rate for Payer: Quartz Medicare Advantage |
$571.20
|
| Rate for Payer: The Alliance Commercial |
$3,808.00
|
| Rate for Payer: WEA Trust Commercial |
$523.60
|
| Rate for Payer: WPS Commercial |
$705.15
|
|
|
IRRIGATION NEZHAT-DORSEY 5102710
|
Facility
|
IP
|
$952.00
|
|
| Hospital Charge Code |
2962952
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$466.48 |
| Max. Negotiated Rate |
$875.84 |
| Rate for Payer: Aetna Commercial |
$856.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$818.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$504.56
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cigna Commercial |
$875.84
|
| Rate for Payer: Health EOS Commercial |
$847.28
|
| Rate for Payer: HFN Commercial |
$875.84
|
| Rate for Payer: Multiplan Commercial |
$761.60
|
| Rate for Payer: NAPHCARE Commercial |
$571.20
|
| Rate for Payer: Preferred Network Access Commercial |
$875.84
|
| Rate for Payer: Quartz Beloit One Network |
$466.48
|
| Rate for Payer: Quartz Commercial |
$571.20
|
| Rate for Payer: WEA Trust Commercial |
$523.60
|
| Rate for Payer: WPS Commercial |
$705.15
|
|
|
Irrigation of Bladder 51700PP
|
Professional
|
Both
|
$420.00
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
3850017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.50 |
| Max. Negotiated Rate |
$399.00 |
| Rate for Payer: Aetna Commercial |
$399.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$361.20
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cigna Commercial |
$399.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$18.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$252.00
|
| Rate for Payer: Health EOS Commercial |
$382.20
|
| Rate for Payer: HFN Commercial |
$399.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$101.56
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$101.56
|
| Rate for Payer: Multiplan Commercial |
$336.00
|
| Rate for Payer: Preferred Network Access Commercial |
$399.00
|
| Rate for Payer: Quartz Beloit One Network |
$184.80
|
| Rate for Payer: Quartz Commercial |
$239.40
|
| Rate for Payer: The Alliance Commercial |
$210.00
|
| Rate for Payer: United Healthcare Medicaid |
$18.50
|
| Rate for Payer: WEA Trust Commercial |
$231.00
|
| Rate for Payer: WPS Commercial |
$311.09
|
|
|
Irrigation of Implanted Venous Access Device for Drug Delivery
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
3451575
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$98.00 |
| Max. Negotiated Rate |
$184.00 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$172.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$106.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$184.00
|
| Rate for Payer: Health EOS Commercial |
$178.00
|
| Rate for Payer: HFN Commercial |
$184.00
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: NAPHCARE Commercial |
$120.00
|
| Rate for Payer: Preferred Network Access Commercial |
$184.00
|
| Rate for Payer: Quartz Beloit One Network |
$98.00
|
| Rate for Payer: Quartz Commercial |
$120.00
|
| Rate for Payer: WEA Trust Commercial |
$110.00
|
| Rate for Payer: WPS Commercial |
$148.14
|
|
|
Irrigation of Implanted Venous Access Device for Drug Delivery
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
3451575
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$60.46 |
| Max. Negotiated Rate |
$241.84 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$172.00
|
| Rate for Payer: Aetna Managed Medicare |
$60.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$130.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$100.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$96.00
|
| Rate for Payer: Anthem Medicare Advantage |
$60.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$106.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$60.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$60.46
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$184.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$60.46
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$111.92
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$60.46
|
| Rate for Payer: Health EOS Commercial |
$178.00
|
| Rate for Payer: HFN Commercial |
$184.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$224.91
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$60.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$60.46
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$60.46
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$60.46
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: NAPHCARE Commercial |
$90.69
|
| Rate for Payer: Preferred Network Access Commercial |
$184.00
|
| Rate for Payer: Quartz Beloit One Network |
$98.00
|
| Rate for Payer: Quartz Commercial |
$130.00
|
| Rate for Payer: Quartz Medicare Advantage |
$60.46
|
| Rate for Payer: The Alliance Commercial |
$241.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$60.46
|
| Rate for Payer: United Healthcare PPO |
$150.00
|
| Rate for Payer: WEA Trust Commercial |
$110.00
|
| Rate for Payer: Wellcare Medicare |
$60.46
|
| Rate for Payer: WPS Commercial |
$148.14
|
|
|
IRRIGATOR HYDRO-SURG PLUS NEZHAT-DORSEY 0026870
|
Facility
|
IP
|
$839.00
|
|
| Hospital Charge Code |
5178939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$411.11 |
| Max. Negotiated Rate |
$771.88 |
| Rate for Payer: Aetna Commercial |
$755.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$721.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$444.67
|
| Rate for Payer: Cash Price |
$251.70
|
| Rate for Payer: Cigna Commercial |
$771.88
|
| Rate for Payer: Health EOS Commercial |
$746.71
|
| Rate for Payer: HFN Commercial |
$771.88
|
| Rate for Payer: Multiplan Commercial |
$671.20
|
| Rate for Payer: NAPHCARE Commercial |
$503.40
|
| Rate for Payer: Preferred Network Access Commercial |
$771.88
|
| Rate for Payer: Quartz Beloit One Network |
$411.11
|
| Rate for Payer: Quartz Commercial |
$503.40
|
| Rate for Payer: WEA Trust Commercial |
$461.45
|
| Rate for Payer: WPS Commercial |
$621.45
|
|
|
IRRIGATOR HYDRO-SURG PLUS NEZHAT-DORSEY 0026870
|
Facility
|
OP
|
$839.00
|
|
| Hospital Charge Code |
5178939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$234.92 |
| Max. Negotiated Rate |
$3,356.00 |
| Rate for Payer: Aetna Commercial |
$755.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$721.54
|
| Rate for Payer: Aetna Managed Medicare |
$234.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$545.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$419.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$402.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$444.67
|
| Rate for Payer: Cash Price |
$251.70
|
| Rate for Payer: Cigna Commercial |
$771.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$469.50
|
| Rate for Payer: Health EOS Commercial |
$746.71
|
| Rate for Payer: HFN Commercial |
$771.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$629.25
|
| Rate for Payer: Multiplan Commercial |
$671.20
|
| Rate for Payer: NAPHCARE Commercial |
$503.40
|
| Rate for Payer: Preferred Network Access Commercial |
$771.88
|
| Rate for Payer: Quartz Beloit One Network |
$411.11
|
| Rate for Payer: Quartz Commercial |
$545.35
|
| Rate for Payer: Quartz Medicare Advantage |
$503.40
|
| Rate for Payer: The Alliance Commercial |
$3,356.00
|
| Rate for Payer: WEA Trust Commercial |
$461.45
|
| Rate for Payer: WPS Commercial |
$621.45
|
|
|
Isavuconazole Level
|
Facility
|
IP
|
$634.00
|
|
|
Service Code
|
CPT 80375
|
| Hospital Charge Code |
5412826
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$310.66 |
| Max. Negotiated Rate |
$583.28 |
| Rate for Payer: Aetna Commercial |
$570.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$545.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$336.02
|
| Rate for Payer: Cash Price |
$190.20
|
| Rate for Payer: Cigna Commercial |
$583.28
|
| Rate for Payer: Health EOS Commercial |
$564.26
|
| Rate for Payer: HFN Commercial |
$583.28
|
| Rate for Payer: Multiplan Commercial |
$507.20
|
| Rate for Payer: NAPHCARE Commercial |
$380.40
|
| Rate for Payer: Preferred Network Access Commercial |
$583.28
|
| Rate for Payer: Quartz Beloit One Network |
$310.66
|
| Rate for Payer: Quartz Commercial |
$380.40
|
| Rate for Payer: WEA Trust Commercial |
$348.70
|
| Rate for Payer: WPS Commercial |
$469.60
|
|
|
Isavuconazole Level
|
Facility
|
OP
|
$634.00
|
|
|
Service Code
|
CPT 80375
|
| Hospital Charge Code |
5412826
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$177.52 |
| Max. Negotiated Rate |
$2,536.00 |
| Rate for Payer: Aetna Commercial |
$570.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$545.24
|
| Rate for Payer: Aetna Managed Medicare |
$177.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$412.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$317.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$304.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$336.02
|
| Rate for Payer: Cash Price |
$190.20
|
| Rate for Payer: Cigna Commercial |
$583.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$354.79
|
| Rate for Payer: Health EOS Commercial |
$564.26
|
| Rate for Payer: HFN Commercial |
$583.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$475.50
|
| Rate for Payer: Multiplan Commercial |
$507.20
|
| Rate for Payer: NAPHCARE Commercial |
$380.40
|
| Rate for Payer: Preferred Network Access Commercial |
$583.28
|
| Rate for Payer: Quartz Beloit One Network |
$310.66
|
| Rate for Payer: Quartz Commercial |
$412.10
|
| Rate for Payer: Quartz Medicare Advantage |
$380.40
|
| Rate for Payer: The Alliance Commercial |
$2,536.00
|
| Rate for Payer: United Healthcare PPO |
$475.50
|
| Rate for Payer: WEA Trust Commercial |
$348.70
|
| Rate for Payer: WPS Commercial |
$469.60
|
|
|
Isavuconazole Level
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
CPT 80375
|
| Hospital Charge Code |
5412826
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$80.06 |
| Max. Negotiated Rate |
$602.30 |
| Rate for Payer: Aetna Commercial |
$602.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$545.24
|
| Rate for Payer: Cash Price |
$190.20
|
| Rate for Payer: Cash Price |
$190.20
|
| Rate for Payer: Cigna Commercial |
$602.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$317.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$380.40
|
| Rate for Payer: Health EOS Commercial |
$576.94
|
| Rate for Payer: HFN Commercial |
$602.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$80.06
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$80.06
|
| Rate for Payer: Multiplan Commercial |
$507.20
|
| Rate for Payer: Preferred Network Access Commercial |
$602.30
|
| Rate for Payer: Quartz Beloit One Network |
$278.96
|
| Rate for Payer: Quartz Commercial |
$361.38
|
| Rate for Payer: The Alliance Commercial |
$317.00
|
| Rate for Payer: WEA Trust Commercial |
$348.70
|
| Rate for Payer: WPS Commercial |
$469.60
|
|
|
ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC
|
Facility
|
IP
|
$50,081.00
|
|
|
Service Code
|
MSDRG 062
|
| Min. Negotiated Rate |
$18,014.89 |
| Max. Negotiated Rate |
$50,081.00 |
| Rate for Payer: Aetna Managed Medicare |
$18,014.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$39,232.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30,071.47
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28,569.86
|
| Rate for Payer: Anthem Medicare Advantage |
$18,014.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,014.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,014.89
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,014.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31,715.16
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,014.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$36,498.15
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,014.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,014.89
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,014.89
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,014.89
|
| Rate for Payer: NAPHCARE Commercial |
$27,022.34
|
| Rate for Payer: Quartz Medicare Advantage |
$18,014.89
|
| Rate for Payer: The Alliance Commercial |
$50,081.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,014.89
|
| Rate for Payer: United Healthcare PPO |
$28,414.28
|
| Rate for Payer: Wellcare Medicare |
$18,014.89
|
|
|
ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC
|
Facility
|
IP
|
$74,836.00
|
|
|
Service Code
|
MSDRG 061
|
| Min. Negotiated Rate |
$26,919.27 |
| Max. Negotiated Rate |
$74,836.00 |
| Rate for Payer: Aetna Managed Medicare |
$26,919.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$58,744.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$45,026.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$42,778.40
|
| Rate for Payer: Anthem Medicare Advantage |
$26,919.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$26,919.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$26,919.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$26,919.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$47,487.94
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$26,919.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$54,654.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$26,919.27
|
| Rate for Payer: Independent Care Health Plan Medicare |
$26,919.27
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$26,919.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$26,919.27
|
| Rate for Payer: NAPHCARE Commercial |
$40,378.90
|
| Rate for Payer: Quartz Medicare Advantage |
$26,919.27
|
| Rate for Payer: The Alliance Commercial |
$74,836.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,919.27
|
| Rate for Payer: United Healthcare PPO |
$42,549.31
|
| Rate for Payer: Wellcare Medicare |
$26,919.27
|
|
|
ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC
|
Facility
|
IP
|
$39,848.00
|
|
|
Service Code
|
MSDRG 063
|
| Min. Negotiated Rate |
$14,333.97 |
| Max. Negotiated Rate |
$39,848.00 |
| Rate for Payer: Aetna Managed Medicare |
$14,333.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$31,260.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$23,960.69
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$22,764.22
|
| Rate for Payer: Anthem Medicare Advantage |
$14,333.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$14,333.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$14,333.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$14,333.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$25,270.37
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$14,333.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28,992.60
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$14,333.97
|
| Rate for Payer: Independent Care Health Plan Medicare |
$14,333.97
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$14,333.97
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$14,333.97
|
| Rate for Payer: NAPHCARE Commercial |
$21,500.96
|
| Rate for Payer: Quartz Medicare Advantage |
$14,333.97
|
| Rate for Payer: The Alliance Commercial |
$39,848.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14,333.97
|
| Rate for Payer: United Healthcare PPO |
$22,571.11
|
| Rate for Payer: Wellcare Medicare |
$14,333.97
|
|
|
ISLAND PEDICLE FLAP GRAFT 15740
|
Professional
|
Both
|
$5,349.00
|
|
|
Service Code
|
CPT 15740
|
| Hospital Charge Code |
3013648
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$677.97 |
| Max. Negotiated Rate |
$5,081.55 |
| Rate for Payer: Aetna Commercial |
$5,081.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,600.14
|
| Rate for Payer: Cash Price |
$1,604.70
|
| Rate for Payer: Cash Price |
$1,604.70
|
| Rate for Payer: Cash Price |
$1,604.70
|
| Rate for Payer: Cigna Commercial |
$5,081.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$677.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,209.40
|
| Rate for Payer: Health EOS Commercial |
$4,867.59
|
| Rate for Payer: HFN Commercial |
$5,081.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,775.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$2,775.57
|
| Rate for Payer: Multiplan Commercial |
$4,279.20
|
| Rate for Payer: Preferred Network Access Commercial |
$5,081.55
|
| Rate for Payer: Quartz Beloit One Network |
$2,353.56
|
| Rate for Payer: Quartz Commercial |
$3,048.93
|
| Rate for Payer: The Alliance Commercial |
$2,674.50
|
| Rate for Payer: United Healthcare Medicaid |
$677.97
|
| Rate for Payer: WEA Trust Commercial |
$2,941.95
|
| Rate for Payer: WPS Commercial |
$3,962.00
|
|
|
Islet Cell Antibody
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
978000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$83.20 |
| Max. Negotiated Rate |
$231.80 |
| Rate for Payer: Aetna Commercial |
$231.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$209.84
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$231.80
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$122.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$146.40
|
| Rate for Payer: Health EOS Commercial |
$222.04
|
| Rate for Payer: HFN Commercial |
$231.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$83.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$83.20
|
| Rate for Payer: Multiplan Commercial |
$195.20
|
| Rate for Payer: Preferred Network Access Commercial |
$231.80
|
| Rate for Payer: Quartz Beloit One Network |
$107.36
|
| Rate for Payer: Quartz Commercial |
$139.08
|
| Rate for Payer: The Alliance Commercial |
$122.00
|
| Rate for Payer: WEA Trust Commercial |
$134.20
|
| Rate for Payer: WPS Commercial |
$180.73
|
|
|
Islet Cell Antibody
|
Facility
|
OP
|
$244.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
978000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.88 |
| Max. Negotiated Rate |
$224.48 |
| Rate for Payer: Aetna Commercial |
$219.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$209.84
|
| Rate for Payer: Aetna Managed Medicare |
$23.57
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$88.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41.25
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$39.13
|
| Rate for Payer: Anthem Medicaid |
$19.88
|
| Rate for Payer: Anthem Medicare Advantage |
$23.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$129.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.57
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$224.48
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$136.54
|
| Rate for Payer: Dean Health Medicaid |
$19.88
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23.57
|
| Rate for Payer: Health EOS Commercial |
$217.16
|
| Rate for Payer: HFN Commercial |
$224.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$87.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.57
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$19.88
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.57
|
| Rate for Payer: Managed Health Services Medicaid |
$20.68
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23.57
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23.57
|
| Rate for Payer: Multiplan Commercial |
$195.20
|
| Rate for Payer: NAPHCARE Commercial |
$35.36
|
| Rate for Payer: Preferred Network Access Commercial |
$224.48
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19.88
|
| Rate for Payer: Quartz Beloit One Network |
$119.56
|
| Rate for Payer: Quartz Commercial |
$158.60
|
| Rate for Payer: Quartz Medicare Advantage |
$23.57
|
| Rate for Payer: The Alliance Commercial |
$94.28
|
| Rate for Payer: United Healthcare Medicaid |
$19.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.57
|
| Rate for Payer: United Healthcare PPO |
$183.00
|
| Rate for Payer: WEA Trust Commercial |
$134.20
|
| Rate for Payer: Wellcare Medicare |
$23.57
|
| Rate for Payer: WMAP Medicaid |
$19.88
|
| Rate for Payer: WPS Commercial |
$180.73
|
|
|
Islet Cell Antibody
|
Facility
|
IP
|
$244.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
978000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$119.56 |
| Max. Negotiated Rate |
$224.48 |
| Rate for Payer: Aetna Commercial |
$219.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$209.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$129.32
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$224.48
|
| Rate for Payer: Health EOS Commercial |
$217.16
|
| Rate for Payer: HFN Commercial |
$224.48
|
| Rate for Payer: Multiplan Commercial |
$195.20
|
| Rate for Payer: NAPHCARE Commercial |
$146.40
|
| Rate for Payer: Preferred Network Access Commercial |
$224.48
|
| Rate for Payer: Quartz Beloit One Network |
$119.56
|
| Rate for Payer: Quartz Commercial |
$146.40
|
| Rate for Payer: WEA Trust Commercial |
$134.20
|
| Rate for Payer: WPS Commercial |
$180.73
|
|
|
Islet Cell Antibody Titer
|
Facility
|
IP
|
$86.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
3856694
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.14 |
| Max. Negotiated Rate |
$79.12 |
| Rate for Payer: Aetna Commercial |
$77.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$73.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.58
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$79.12
|
| Rate for Payer: Health EOS Commercial |
$76.54
|
| Rate for Payer: HFN Commercial |
$79.12
|
| Rate for Payer: Multiplan Commercial |
$68.80
|
| Rate for Payer: NAPHCARE Commercial |
$51.60
|
| Rate for Payer: Preferred Network Access Commercial |
$79.12
|
| Rate for Payer: Quartz Beloit One Network |
$42.14
|
| Rate for Payer: Quartz Commercial |
$51.60
|
| Rate for Payer: WEA Trust Commercial |
$47.30
|
| Rate for Payer: WPS Commercial |
$63.70
|
|
|
Islet Cell Antibody Titer
|
Facility
|
OP
|
$86.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
3856694
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.88 |
| Max. Negotiated Rate |
$94.28 |
| Rate for Payer: Aetna Commercial |
$77.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$73.96
|
| Rate for Payer: Aetna Managed Medicare |
$23.57
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$88.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$41.25
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$39.13
|
| Rate for Payer: Anthem Medicaid |
$19.88
|
| Rate for Payer: Anthem Medicare Advantage |
$23.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$45.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$23.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$23.57
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$79.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$23.57
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$48.13
|
| Rate for Payer: Dean Health Medicaid |
$19.88
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$23.57
|
| Rate for Payer: Health EOS Commercial |
$76.54
|
| Rate for Payer: HFN Commercial |
$79.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$87.68
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$23.57
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$19.88
|
| Rate for Payer: Independent Care Health Plan Medicare |
$23.57
|
| Rate for Payer: Managed Health Services Medicaid |
$20.68
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$23.57
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$23.57
|
| Rate for Payer: Multiplan Commercial |
$68.80
|
| Rate for Payer: NAPHCARE Commercial |
$35.36
|
| Rate for Payer: Preferred Network Access Commercial |
$79.12
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19.88
|
| Rate for Payer: Quartz Beloit One Network |
$42.14
|
| Rate for Payer: Quartz Commercial |
$55.90
|
| Rate for Payer: Quartz Medicare Advantage |
$23.57
|
| Rate for Payer: The Alliance Commercial |
$94.28
|
| Rate for Payer: United Healthcare Medicaid |
$19.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.57
|
| Rate for Payer: United Healthcare PPO |
$64.50
|
| Rate for Payer: WEA Trust Commercial |
$47.30
|
| Rate for Payer: Wellcare Medicare |
$23.57
|
| Rate for Payer: WMAP Medicaid |
$19.88
|
| Rate for Payer: WPS Commercial |
$63.70
|
|
|
Islet Cell Antibody Titer
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
3856694
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.84 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Commercial |
$81.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$73.96
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$81.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$43.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$51.60
|
| Rate for Payer: Health EOS Commercial |
$78.26
|
| Rate for Payer: HFN Commercial |
$81.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$83.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$83.20
|
| Rate for Payer: Multiplan Commercial |
$68.80
|
| Rate for Payer: Preferred Network Access Commercial |
$81.70
|
| Rate for Payer: Quartz Beloit One Network |
$37.84
|
| Rate for Payer: Quartz Commercial |
$49.02
|
| Rate for Payer: The Alliance Commercial |
$43.00
|
| Rate for Payer: WEA Trust Commercial |
$47.30
|
| Rate for Payer: WPS Commercial |
$63.70
|
|
|
ISNARE LARIAT SNARE BX00711084
|
Facility
|
OP
|
$4,309.00
|
|
| Hospital Charge Code |
5415807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,206.52 |
| Max. Negotiated Rate |
$17,236.00 |
| Rate for Payer: Aetna Commercial |
$3,878.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,705.74
|
| Rate for Payer: Aetna Managed Medicare |
$1,206.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,800.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,154.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,068.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,283.77
|
| Rate for Payer: Cash Price |
$1,292.70
|
| Rate for Payer: Cigna Commercial |
$3,964.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,411.32
|
| Rate for Payer: Health EOS Commercial |
$3,835.01
|
| Rate for Payer: HFN Commercial |
$3,964.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,231.75
|
| Rate for Payer: Multiplan Commercial |
$3,447.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,585.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,964.28
|
| Rate for Payer: Quartz Beloit One Network |
$2,111.41
|
| Rate for Payer: Quartz Commercial |
$2,800.85
|
| Rate for Payer: Quartz Medicare Advantage |
$2,585.40
|
| Rate for Payer: The Alliance Commercial |
$17,236.00
|
| Rate for Payer: WEA Trust Commercial |
$2,369.95
|
| Rate for Payer: WPS Commercial |
$3,191.68
|
|
