|
Amyloid B Protein
|
Facility
|
OP
|
$493.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
5502670
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.14 |
| Max. Negotiated Rate |
$471.70 |
| Rate for Payer: Aetna Commercial |
$461.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$440.94
|
| Rate for Payer: Aetna Managed Medicare |
$19.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$71.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$33.49
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$31.77
|
| Rate for Payer: Anthem Medicare Advantage |
$19.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$271.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19.14
|
| Rate for Payer: Cash Price |
$147.90
|
| Rate for Payer: Cash Price |
$147.90
|
| Rate for Payer: Cigna Commercial |
$471.70
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$19.14
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$286.93
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$19.14
|
| Rate for Payer: Health EOS Commercial |
$456.32
|
| Rate for Payer: HFN Commercial |
$471.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$71.19
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.14
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19.14
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$19.14
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$19.14
|
| Rate for Payer: Multiplan Commercial |
$410.18
|
| Rate for Payer: NAPHCARE Commercial |
$28.70
|
| Rate for Payer: Preferred Network Access Commercial |
$471.70
|
| Rate for Payer: Quartz Beloit One Network |
$251.23
|
| Rate for Payer: Quartz Commercial |
$333.27
|
| Rate for Payer: Quartz Medicare Advantage |
$19.14
|
| Rate for Payer: The Alliance Commercial |
$76.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.14
|
| Rate for Payer: United Healthcare PPO |
$384.54
|
| Rate for Payer: WEA Trust Commercial |
$282.00
|
| Rate for Payer: Wellcare Medicare |
$19.14
|
| Rate for Payer: WPS Commercial |
$379.76
|
|
|
Amyloidosis Transthyretin-Assoc Familial Rflx
|
Facility
|
OP
|
$217.39
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
6242817
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$208.00 |
| Rate for Payer: Aetna Commercial |
$203.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$194.43
|
| Rate for Payer: Aetna Managed Medicare |
$25.05
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$93.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$43.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$41.59
|
| Rate for Payer: Anthem Medicare Advantage |
$25.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$119.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$25.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$25.05
|
| Rate for Payer: Cash Price |
$65.22
|
| Rate for Payer: Cash Price |
$65.22
|
| Rate for Payer: Cigna Commercial |
$208.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$25.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$126.52
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$25.05
|
| Rate for Payer: Health EOS Commercial |
$201.22
|
| Rate for Payer: HFN Commercial |
$208.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$93.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$25.05
|
| Rate for Payer: Independent Care Health Plan Medicare |
$25.05
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$25.05
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$25.05
|
| Rate for Payer: Multiplan Commercial |
$180.87
|
| Rate for Payer: NAPHCARE Commercial |
$37.58
|
| Rate for Payer: Preferred Network Access Commercial |
$208.00
|
| Rate for Payer: Quartz Beloit One Network |
$110.78
|
| Rate for Payer: Quartz Commercial |
$146.96
|
| Rate for Payer: Quartz Medicare Advantage |
$25.05
|
| Rate for Payer: The Alliance Commercial |
$100.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.05
|
| Rate for Payer: United Healthcare PPO |
$169.56
|
| Rate for Payer: WEA Trust Commercial |
$124.35
|
| Rate for Payer: Wellcare Medicare |
$25.05
|
| Rate for Payer: WPS Commercial |
$167.46
|
|
|
Amyloidosis Transthyretin-Assoc Familial Rflx
|
Facility
|
IP
|
$217.39
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
6242817
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$110.78 |
| Max. Negotiated Rate |
$208.00 |
| Rate for Payer: Aetna Commercial |
$203.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$194.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$119.83
|
| Rate for Payer: Cash Price |
$65.22
|
| Rate for Payer: Cigna Commercial |
$208.00
|
| Rate for Payer: Health EOS Commercial |
$201.22
|
| Rate for Payer: HFN Commercial |
$208.00
|
| Rate for Payer: Multiplan Commercial |
$180.87
|
| Rate for Payer: Preferred Network Access Commercial |
$208.00
|
| Rate for Payer: Quartz Beloit One Network |
$110.78
|
| Rate for Payer: Quartz Commercial |
$135.65
|
| Rate for Payer: WEA Trust Commercial |
$124.35
|
| Rate for Payer: WPS Commercial |
$167.46
|
|
|
Amyloidosis Transthyretin-Assoc Familial Rflx
|
Professional
|
Both
|
$217.39
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
6242817
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$214.78 |
| Rate for Payer: Aetna Commercial |
$214.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$194.43
|
| Rate for Payer: Aetna Managed Medicare |
$25.05
|
| Rate for Payer: Anthem Medicare Advantage |
$25.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$25.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$25.05
|
| Rate for Payer: Cash Price |
$65.22
|
| Rate for Payer: Cash Price |
$65.22
|
| Rate for Payer: Cigna Commercial |
$214.78
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$113.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$25.05
|
| Rate for Payer: Health EOS Commercial |
$205.74
|
| Rate for Payer: HFN Commercial |
$214.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$88.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$88.44
|
| Rate for Payer: Independent Care Health Plan Medicare |
$25.05
|
| Rate for Payer: Multiplan Commercial |
$180.87
|
| Rate for Payer: NAPHCARE Commercial |
$37.58
|
| Rate for Payer: Preferred Network Access Commercial |
$214.78
|
| Rate for Payer: Quartz Beloit One Network |
$99.48
|
| Rate for Payer: Quartz Commercial |
$128.87
|
| Rate for Payer: Quartz Medicare Advantage |
$25.05
|
| Rate for Payer: The Alliance Commercial |
$98.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.05
|
| Rate for Payer: WEA Trust Commercial |
$124.35
|
| Rate for Payer: WPS Commercial |
$110.24
|
|
|
Anaerobic Culture
|
Facility
|
OP
|
$235.00
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
633881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$224.85 |
| Rate for Payer: Aetna Commercial |
$219.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$210.18
|
| Rate for Payer: Aetna Managed Medicare |
$9.85
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$36.93
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$17.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$16.35
|
| Rate for Payer: Anthem Medicare Advantage |
$9.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$129.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.85
|
| Rate for Payer: Cash Price |
$70.50
|
| Rate for Payer: Cash Price |
$70.50
|
| Rate for Payer: Cigna Commercial |
$224.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$136.77
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9.85
|
| Rate for Payer: Health EOS Commercial |
$217.52
|
| Rate for Payer: HFN Commercial |
$224.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$36.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.85
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9.85
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9.85
|
| Rate for Payer: Multiplan Commercial |
$195.52
|
| Rate for Payer: NAPHCARE Commercial |
$14.77
|
| Rate for Payer: Preferred Network Access Commercial |
$224.85
|
| Rate for Payer: Quartz Beloit One Network |
$119.76
|
| Rate for Payer: Quartz Commercial |
$158.86
|
| Rate for Payer: Quartz Medicare Advantage |
$9.85
|
| Rate for Payer: The Alliance Commercial |
$39.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.85
|
| Rate for Payer: United Healthcare PPO |
$183.30
|
| Rate for Payer: WEA Trust Commercial |
$134.42
|
| Rate for Payer: Wellcare Medicare |
$9.85
|
| Rate for Payer: WPS Commercial |
$181.02
|
|
|
Anaerobic Culture
|
Facility
|
IP
|
$235.00
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
633881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$119.76 |
| Max. Negotiated Rate |
$224.85 |
| Rate for Payer: Aetna Commercial |
$219.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$210.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$129.53
|
| Rate for Payer: Cash Price |
$70.50
|
| Rate for Payer: Cigna Commercial |
$224.85
|
| Rate for Payer: Health EOS Commercial |
$217.52
|
| Rate for Payer: HFN Commercial |
$224.85
|
| Rate for Payer: Multiplan Commercial |
$195.52
|
| Rate for Payer: Preferred Network Access Commercial |
$224.85
|
| Rate for Payer: Quartz Beloit One Network |
$119.76
|
| Rate for Payer: Quartz Commercial |
$146.64
|
| Rate for Payer: WEA Trust Commercial |
$134.42
|
| Rate for Payer: WPS Commercial |
$181.02
|
|
|
Anaerobic Culture
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
633881
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$232.18 |
| Rate for Payer: Aetna Commercial |
$232.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$210.18
|
| Rate for Payer: Aetna Managed Medicare |
$9.85
|
| Rate for Payer: Anthem Medicare Advantage |
$9.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.85
|
| Rate for Payer: Cash Price |
$70.50
|
| Rate for Payer: Cash Price |
$70.50
|
| Rate for Payer: Cigna Commercial |
$232.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$122.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.85
|
| Rate for Payer: Health EOS Commercial |
$222.40
|
| Rate for Payer: HFN Commercial |
$232.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$34.77
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$34.77
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.85
|
| Rate for Payer: Multiplan Commercial |
$195.52
|
| Rate for Payer: NAPHCARE Commercial |
$14.77
|
| Rate for Payer: Preferred Network Access Commercial |
$232.18
|
| Rate for Payer: Quartz Beloit One Network |
$107.54
|
| Rate for Payer: Quartz Commercial |
$139.31
|
| Rate for Payer: Quartz Medicare Advantage |
$9.85
|
| Rate for Payer: The Alliance Commercial |
$38.90
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.85
|
| Rate for Payer: WEA Trust Commercial |
$134.42
|
| Rate for Payer: WPS Commercial |
$43.33
|
|
|
Anaerobic MIC System
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
1562862
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$337.75 |
| Rate for Payer: Aetna Commercial |
$330.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$315.72
|
| Rate for Payer: Aetna Managed Medicare |
$9.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$33.73
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$15.74
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$14.93
|
| Rate for Payer: Anthem Medicare Advantage |
$9.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$194.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.00
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cigna Commercial |
$337.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$9.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$205.45
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$9.00
|
| Rate for Payer: Health EOS Commercial |
$326.74
|
| Rate for Payer: HFN Commercial |
$337.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$33.47
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$9.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.00
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$9.00
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$293.70
|
| Rate for Payer: NAPHCARE Commercial |
$13.49
|
| Rate for Payer: Preferred Network Access Commercial |
$337.75
|
| Rate for Payer: Quartz Beloit One Network |
$179.89
|
| Rate for Payer: Quartz Commercial |
$238.63
|
| Rate for Payer: Quartz Medicare Advantage |
$9.00
|
| Rate for Payer: The Alliance Commercial |
$35.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.00
|
| Rate for Payer: United Healthcare PPO |
$275.34
|
| Rate for Payer: WEA Trust Commercial |
$201.92
|
| Rate for Payer: Wellcare Medicare |
$9.00
|
| Rate for Payer: WPS Commercial |
$271.92
|
|
|
Anaerobic MIC System
|
Professional
|
Both
|
$353.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
1562862
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$348.76 |
| Rate for Payer: Aetna Commercial |
$348.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$315.72
|
| Rate for Payer: Aetna Managed Medicare |
$9.00
|
| Rate for Payer: Anthem Medicare Advantage |
$9.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$9.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$9.00
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cigna Commercial |
$348.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$183.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9.00
|
| Rate for Payer: Health EOS Commercial |
$334.08
|
| Rate for Payer: HFN Commercial |
$348.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$31.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$31.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$293.70
|
| Rate for Payer: NAPHCARE Commercial |
$13.49
|
| Rate for Payer: Preferred Network Access Commercial |
$348.76
|
| Rate for Payer: Quartz Beloit One Network |
$161.53
|
| Rate for Payer: Quartz Commercial |
$209.26
|
| Rate for Payer: Quartz Medicare Advantage |
$9.00
|
| Rate for Payer: The Alliance Commercial |
$35.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.00
|
| Rate for Payer: WEA Trust Commercial |
$201.92
|
| Rate for Payer: WPS Commercial |
$39.58
|
|
|
Anaerobic MIC System
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
1562862
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$179.89 |
| Max. Negotiated Rate |
$337.75 |
| Rate for Payer: Aetna Commercial |
$330.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$315.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$194.57
|
| Rate for Payer: Cash Price |
$105.90
|
| Rate for Payer: Cigna Commercial |
$337.75
|
| Rate for Payer: Health EOS Commercial |
$326.74
|
| Rate for Payer: HFN Commercial |
$337.75
|
| Rate for Payer: Multiplan Commercial |
$293.70
|
| Rate for Payer: Preferred Network Access Commercial |
$337.75
|
| Rate for Payer: Quartz Beloit One Network |
$179.89
|
| Rate for Payer: Quartz Commercial |
$220.27
|
| Rate for Payer: WEA Trust Commercial |
$201.92
|
| Rate for Payer: WPS Commercial |
$271.92
|
|
|
ANAL AND PERINEAL PROCEDURES
|
Facility
|
IP
|
$15,081.49
|
|
|
Service Code
|
APR-DRG 2263
|
| Min. Negotiated Rate |
$13,396.32 |
| Max. Negotiated Rate |
$15,081.49 |
| Rate for Payer: Anthem Medicaid |
$14,441.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$14,441.36
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$14,441.36
|
| Rate for Payer: Dean Health Medicaid |
$14,441.36
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$13,396.32
|
| Rate for Payer: Managed Health Services Medicaid |
$15,081.49
|
| Rate for Payer: Molina Healthcare Medicaid |
$14,441.36
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$14,441.36
|
| Rate for Payer: United Healthcare Medicaid |
$14,441.36
|
|
|
ANAL AND PERINEAL PROCEDURES
|
Facility
|
IP
|
$22,534.56
|
|
|
Service Code
|
APR-DRG 2264
|
| Min. Negotiated Rate |
$20,016.60 |
| Max. Negotiated Rate |
$22,534.56 |
| Rate for Payer: Anthem Medicaid |
$21,578.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$21,578.08
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21,578.08
|
| Rate for Payer: Dean Health Medicaid |
$21,578.08
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$20,016.60
|
| Rate for Payer: Managed Health Services Medicaid |
$22,534.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$21,578.08
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$21,578.08
|
| Rate for Payer: United Healthcare Medicaid |
$21,578.08
|
|
|
ANAL AND PERINEAL PROCEDURES
|
Facility
|
IP
|
$7,716.11
|
|
|
Service Code
|
APR-DRG 2261
|
| Min. Negotiated Rate |
$6,853.93 |
| Max. Negotiated Rate |
$7,716.11 |
| Rate for Payer: Anthem Medicaid |
$7,388.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,388.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,388.60
|
| Rate for Payer: Dean Health Medicaid |
$7,388.60
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$6,853.93
|
| Rate for Payer: Managed Health Services Medicaid |
$7,716.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,388.60
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,388.60
|
| Rate for Payer: United Healthcare Medicaid |
$7,388.60
|
|
|
ANAL AND PERINEAL PROCEDURES
|
Facility
|
IP
|
$9,645.14
|
|
|
Service Code
|
APR-DRG 2262
|
| Min. Negotiated Rate |
$8,567.42 |
| Max. Negotiated Rate |
$9,645.14 |
| Rate for Payer: Anthem Medicaid |
$9,235.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$9,235.75
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$9,235.75
|
| Rate for Payer: Dean Health Medicaid |
$9,235.75
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$8,567.42
|
| Rate for Payer: Managed Health Services Medicaid |
$9,645.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,235.75
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$9,235.75
|
| Rate for Payer: United Healthcare Medicaid |
$9,235.75
|
|
|
ANAL AND STOMAL PROCEDURES WITH CC
|
Facility
|
IP
|
$36,315.76
|
|
|
Service Code
|
MSDRG 348
|
| Min. Negotiated Rate |
$10,529.82 |
| Max. Negotiated Rate |
$36,315.76 |
| Rate for Payer: Aetna Managed Medicare |
$10,529.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$28,556.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21,888.69
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20,795.68
|
| Rate for Payer: Anthem Medicare Advantage |
$10,529.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10,529.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10,529.82
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10,529.82
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$23,085.11
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10,529.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,392.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10,529.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10,529.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10,529.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10,529.82
|
| Rate for Payer: NAPHCARE Commercial |
$15,794.73
|
| Rate for Payer: Quartz Medicare Advantage |
$10,529.82
|
| Rate for Payer: The Alliance Commercial |
$36,315.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10,529.82
|
| Rate for Payer: United Healthcare PPO |
$20,546.81
|
| Rate for Payer: Wellcare Medicare |
$10,529.82
|
|
|
ANAL AND STOMAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$70,814.64
|
|
|
Service Code
|
MSDRG 347
|
| Min. Negotiated Rate |
$18,086.93 |
| Max. Negotiated Rate |
$70,814.64 |
| Rate for Payer: Aetna Managed Medicare |
$18,086.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$50,088.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$38,392.17
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$36,475.06
|
| Rate for Payer: Anthem Medicare Advantage |
$18,086.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,086.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,086.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,086.93
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40,490.67
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,086.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$51,695.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,086.93
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,086.93
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,086.93
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,086.93
|
| Rate for Payer: NAPHCARE Commercial |
$27,130.40
|
| Rate for Payer: Quartz Medicare Advantage |
$18,086.93
|
| Rate for Payer: The Alliance Commercial |
$70,814.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,086.93
|
| Rate for Payer: United Healthcare PPO |
$40,245.81
|
| Rate for Payer: Wellcare Medicare |
$18,086.93
|
|
|
ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$27,313.52
|
|
|
Service Code
|
MSDRG 349
|
| Min. Negotiated Rate |
$7,174.00 |
| Max. Negotiated Rate |
$27,313.52 |
| Rate for Payer: Aetna Managed Medicare |
$7,174.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,995.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14,560.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$13,833.07
|
| Rate for Payer: Anthem Medicare Advantage |
$7,174.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,174.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,174.00
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,174.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15,355.97
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,174.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19,789.22
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,174.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,174.00
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,174.00
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,174.00
|
| Rate for Payer: NAPHCARE Commercial |
$10,761.00
|
| Rate for Payer: Quartz Medicare Advantage |
$7,174.00
|
| Rate for Payer: The Alliance Commercial |
$27,313.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,174.00
|
| Rate for Payer: United Healthcare PPO |
$15,406.16
|
| Rate for Payer: Wellcare Medicare |
$7,174.00
|
|
|
ANAL CONDYLOMA, CAUTERY OF
|
Facility
|
IP
|
$1,006.00
|
|
| Hospital Charge Code |
2959946
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.66 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$627.74
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
ANAL CONDYLOMA, CAUTERY OF
|
Facility
|
OP
|
$1,006.00
|
|
| Hospital Charge Code |
2959946
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$292.95 |
| Max. Negotiated Rate |
$962.54 |
| Rate for Payer: Aetna Commercial |
$941.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$899.77
|
| Rate for Payer: Aetna Managed Medicare |
$292.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$680.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$523.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$502.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.51
|
| Rate for Payer: Cash Price |
$301.80
|
| Rate for Payer: Cigna Commercial |
$962.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$585.49
|
| Rate for Payer: Health EOS Commercial |
$931.15
|
| Rate for Payer: HFN Commercial |
$962.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$784.68
|
| Rate for Payer: Multiplan Commercial |
$836.99
|
| Rate for Payer: NAPHCARE Commercial |
$627.74
|
| Rate for Payer: Preferred Network Access Commercial |
$962.54
|
| Rate for Payer: Quartz Beloit One Network |
$512.66
|
| Rate for Payer: Quartz Commercial |
$680.06
|
| Rate for Payer: Quartz Medicare Advantage |
$627.74
|
| Rate for Payer: The Alliance Commercial |
$523.12
|
| Rate for Payer: WEA Trust Commercial |
$575.43
|
| Rate for Payer: WPS Commercial |
$774.92
|
|
|
Analyze Neurostim, Complex 95972
|
Professional
|
Both
|
$373.00
|
|
|
Service Code
|
CPT 95972
|
| Hospital Charge Code |
3015500
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$34.53 |
| Max. Negotiated Rate |
$368.52 |
| Rate for Payer: Aetna Commercial |
$368.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$333.61
|
| Rate for Payer: Aetna Managed Medicare |
$34.53
|
| Rate for Payer: Anthem Medicare Advantage |
$34.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$34.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$34.53
|
| Rate for Payer: Cash Price |
$111.90
|
| Rate for Payer: Cash Price |
$111.90
|
| Rate for Payer: Cash Price |
$111.90
|
| Rate for Payer: Cigna Commercial |
$368.52
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$57.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$34.53
|
| Rate for Payer: Health EOS Commercial |
$353.01
|
| Rate for Payer: HFN Commercial |
$368.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$197.58
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$197.58
|
| Rate for Payer: Independent Care Health Plan Medicare |
$34.53
|
| Rate for Payer: Multiplan Commercial |
$310.34
|
| Rate for Payer: NAPHCARE Commercial |
$51.79
|
| Rate for Payer: Preferred Network Access Commercial |
$368.52
|
| Rate for Payer: Quartz Beloit One Network |
$170.68
|
| Rate for Payer: Quartz Commercial |
$221.11
|
| Rate for Payer: Quartz Medicare Advantage |
$34.53
|
| Rate for Payer: The Alliance Commercial |
$86.32
|
| Rate for Payer: United Healthcare Medicaid |
$57.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34.53
|
| Rate for Payer: WEA Trust Commercial |
$213.36
|
| Rate for Payer: WPS Commercial |
$138.11
|
|
|
Analyze Neurostim, No Prog 95970
|
Professional
|
Both
|
$451.00
|
|
|
Service Code
|
CPT 95970
|
| Hospital Charge Code |
3015498
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$445.59 |
| Rate for Payer: Aetna Commercial |
$445.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$403.37
|
| Rate for Payer: Aetna Managed Medicare |
$15.81
|
| Rate for Payer: Anthem Medicare Advantage |
$15.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$15.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$15.81
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cigna Commercial |
$445.59
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15.81
|
| Rate for Payer: Health EOS Commercial |
$426.83
|
| Rate for Payer: HFN Commercial |
$445.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$66.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$15.81
|
| Rate for Payer: Multiplan Commercial |
$375.23
|
| Rate for Payer: NAPHCARE Commercial |
$23.71
|
| Rate for Payer: Preferred Network Access Commercial |
$445.59
|
| Rate for Payer: Quartz Beloit One Network |
$206.38
|
| Rate for Payer: Quartz Commercial |
$267.35
|
| Rate for Payer: Quartz Medicare Advantage |
$15.81
|
| Rate for Payer: The Alliance Commercial |
$39.52
|
| Rate for Payer: United Healthcare Medicaid |
$19.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.81
|
| Rate for Payer: WEA Trust Commercial |
$257.97
|
| Rate for Payer: WPS Commercial |
$63.23
|
|
|
ANALYZE NEUROSTIM, SIMPLE 95971
|
Professional
|
Both
|
$545.00
|
|
|
Service Code
|
CPT 95971
|
| Hospital Charge Code |
3015499
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.83 |
| Max. Negotiated Rate |
$538.46 |
| Rate for Payer: Aetna Commercial |
$538.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$487.45
|
| Rate for Payer: Aetna Managed Medicare |
$33.83
|
| Rate for Payer: Anthem Medicare Advantage |
$33.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$33.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$33.83
|
| Rate for Payer: Cash Price |
$163.50
|
| Rate for Payer: Cash Price |
$163.50
|
| Rate for Payer: Cash Price |
$163.50
|
| Rate for Payer: Cigna Commercial |
$538.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$51.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$33.83
|
| Rate for Payer: Health EOS Commercial |
$515.79
|
| Rate for Payer: HFN Commercial |
$538.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$173.39
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$173.39
|
| Rate for Payer: Independent Care Health Plan Medicare |
$33.83
|
| Rate for Payer: Multiplan Commercial |
$453.44
|
| Rate for Payer: NAPHCARE Commercial |
$50.75
|
| Rate for Payer: Preferred Network Access Commercial |
$538.46
|
| Rate for Payer: Quartz Beloit One Network |
$249.39
|
| Rate for Payer: Quartz Commercial |
$323.08
|
| Rate for Payer: Quartz Medicare Advantage |
$33.83
|
| Rate for Payer: The Alliance Commercial |
$84.58
|
| Rate for Payer: United Healthcare Medicaid |
$51.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33.83
|
| Rate for Payer: WEA Trust Commercial |
$311.74
|
| Rate for Payer: WPS Commercial |
$135.32
|
|
|
ANALYZE PACEMAKER SYSTEM 9372426
|
Professional
|
Both
|
$2,597.00
|
|
|
Service Code
|
CPT 93724
|
| Hospital Charge Code |
3015423
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$279.31 |
| Max. Negotiated Rate |
$2,565.84 |
| Rate for Payer: Aetna Commercial |
$2,565.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,322.76
|
| Rate for Payer: Aetna Managed Medicare |
$279.31
|
| Rate for Payer: Anthem Medicare Advantage |
$279.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$279.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$279.31
|
| Rate for Payer: Cash Price |
$779.10
|
| Rate for Payer: Cash Price |
$779.10
|
| Rate for Payer: Cash Price |
$779.10
|
| Rate for Payer: Cigna Commercial |
$2,565.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$421.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$279.31
|
| Rate for Payer: Health EOS Commercial |
$2,457.80
|
| Rate for Payer: HFN Commercial |
$2,565.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,018.91
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$1,018.91
|
| Rate for Payer: Independent Care Health Plan Medicare |
$279.31
|
| Rate for Payer: Multiplan Commercial |
$2,160.70
|
| Rate for Payer: NAPHCARE Commercial |
$418.97
|
| Rate for Payer: Preferred Network Access Commercial |
$2,565.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,188.39
|
| Rate for Payer: Quartz Commercial |
$1,539.50
|
| Rate for Payer: Quartz Medicare Advantage |
$279.31
|
| Rate for Payer: The Alliance Commercial |
$1,061.39
|
| Rate for Payer: United Healthcare Medicaid |
$421.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$279.31
|
| Rate for Payer: WEA Trust Commercial |
$1,485.48
|
| Rate for Payer: WPS Commercial |
$1,117.25
|
|
|
Anaplasma phagocytophilum Antibody IgG
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
5679629
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.59 |
| Max. Negotiated Rate |
$396.12 |
| Rate for Payer: Aetna Commercial |
$387.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$370.28
|
| Rate for Payer: Aetna Managed Medicare |
$10.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$39.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18.53
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17.57
|
| Rate for Payer: Anthem Medicare Advantage |
$10.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$228.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$10.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$10.59
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$396.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$10.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$240.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$10.59
|
| Rate for Payer: Health EOS Commercial |
$383.20
|
| Rate for Payer: HFN Commercial |
$396.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$39.38
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$10.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$10.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$10.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$10.59
|
| Rate for Payer: Multiplan Commercial |
$344.45
|
| Rate for Payer: NAPHCARE Commercial |
$15.88
|
| Rate for Payer: Preferred Network Access Commercial |
$396.12
|
| Rate for Payer: Quartz Beloit One Network |
$210.97
|
| Rate for Payer: Quartz Commercial |
$279.86
|
| Rate for Payer: Quartz Medicare Advantage |
$10.59
|
| Rate for Payer: The Alliance Commercial |
$42.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.59
|
| Rate for Payer: United Healthcare PPO |
$322.92
|
| Rate for Payer: WEA Trust Commercial |
$236.81
|
| Rate for Payer: Wellcare Medicare |
$10.59
|
| Rate for Payer: WPS Commercial |
$318.90
|
|
|
Anaplasma phagocytophilum Antibody IgG
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
5679629
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$210.97 |
| Max. Negotiated Rate |
$396.12 |
| Rate for Payer: Aetna Commercial |
$387.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$370.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$228.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$396.12
|
| Rate for Payer: Health EOS Commercial |
$383.20
|
| Rate for Payer: HFN Commercial |
$396.12
|
| Rate for Payer: Multiplan Commercial |
$344.45
|
| Rate for Payer: Preferred Network Access Commercial |
$396.12
|
| Rate for Payer: Quartz Beloit One Network |
$210.97
|
| Rate for Payer: Quartz Commercial |
$258.34
|
| Rate for Payer: WEA Trust Commercial |
$236.81
|
| Rate for Payer: WPS Commercial |
$318.90
|
|
