|
AntibioticPocket ICD
|
Facility
OP
|
$7,927.00
|
|
| Hospital Charge Code |
2549042
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,219.56 |
| Max. Negotiated Rate |
$31,708.00 |
| Rate for Payer: Aetna Commercial |
$7,134.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,817.22
|
| Rate for Payer: Aetna Managed Medicare |
$2,219.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,152.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,963.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,804.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,201.31
|
| Rate for Payer: Cash Price |
$2,378.10
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,435.95
|
| Rate for Payer: Health EOS Commercial |
$7,055.03
|
| Rate for Payer: HFN Commercial |
$7,292.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,945.25
|
| Rate for Payer: Multiplan Commercial |
$6,341.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,756.20
|
| Rate for Payer: Preferred Network Access Commercial |
$7,292.84
|
| Rate for Payer: Quartz Beloit One Network |
$3,884.23
|
| Rate for Payer: Quartz Commercial |
$5,152.55
|
| Rate for Payer: Quartz Medicare Advantage |
$4,756.20
|
| Rate for Payer: The Alliance Commercial |
$31,708.00
|
| Rate for Payer: WEA Trust Commercial |
$4,359.85
|
| Rate for Payer: WPS Commercial |
$5,871.53
|
|
|
AntibioticPocket ICD
|
Facility
IP
|
$7,927.00
|
|
| Hospital Charge Code |
2549042
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,884.23 |
| Max. Negotiated Rate |
$7,292.84 |
| Rate for Payer: Aetna Commercial |
$7,134.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,201.31
|
| Rate for Payer: Cash Price |
$2,378.10
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: Health EOS Commercial |
$7,055.03
|
| Rate for Payer: HFN Commercial |
$7,292.84
|
| Rate for Payer: Multiplan Commercial |
$6,341.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,756.20
|
| Rate for Payer: Preferred Network Access Commercial |
$7,292.84
|
| Rate for Payer: Quartz Beloit One Network |
$3,884.23
|
| Rate for Payer: Quartz Commercial |
$4,756.20
|
| Rate for Payer: WEA Trust Commercial |
$4,359.85
|
| Rate for Payer: WPS Commercial |
$5,871.53
|
|
|
AntibioticPocket Pacemaker
|
Professional
|
$43,831.00
|
|
| Hospital Charge Code |
2549044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19,285.64 |
| Max. Negotiated Rate |
$41,639.45 |
| Rate for Payer: Aetna Commercial |
$41,639.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$37,694.66
|
| Rate for Payer: Cash Price |
$13,149.30
|
| Rate for Payer: Cigna Commercial |
$41,639.45
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$21,915.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$26,298.60
|
| Rate for Payer: Health EOS Commercial |
$39,886.21
|
| Rate for Payer: Multiplan Commercial |
$35,064.80
|
| Rate for Payer: Preferred Network Access Commercial |
$41,639.45
|
| Rate for Payer: Quartz Beloit One Network |
$19,285.64
|
| Rate for Payer: Quartz Commercial |
$24,983.67
|
| Rate for Payer: The Alliance Commercial |
$21,915.50
|
| Rate for Payer: WEA Trust Commercial |
$24,107.05
|
| Rate for Payer: WPS Commercial |
$32,465.62
|
|
|
AntibioticPocket Pacemaker
|
Facility
IP
|
$43,831.00
|
|
| Hospital Charge Code |
2549044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,477.19 |
| Max. Negotiated Rate |
$40,324.52 |
| Rate for Payer: Aetna Commercial |
$39,447.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$23,230.43
|
| Rate for Payer: Cash Price |
$13,149.30
|
| Rate for Payer: Cigna Commercial |
$40,324.52
|
| Rate for Payer: Health EOS Commercial |
$39,009.59
|
| Rate for Payer: HFN Commercial |
$40,324.52
|
| Rate for Payer: Multiplan Commercial |
$35,064.80
|
| Rate for Payer: NAPHCARE Commercial |
$26,298.60
|
| Rate for Payer: Preferred Network Access Commercial |
$40,324.52
|
| Rate for Payer: Quartz Beloit One Network |
$21,477.19
|
| Rate for Payer: Quartz Commercial |
$26,298.60
|
| Rate for Payer: WEA Trust Commercial |
$24,107.05
|
| Rate for Payer: WPS Commercial |
$32,465.62
|
|
|
AntibioticPocket Pacemaker
|
Facility
OP
|
$43,831.00
|
|
| Hospital Charge Code |
2549044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,272.68 |
| Max. Negotiated Rate |
$175,324.00 |
| Rate for Payer: Aetna Commercial |
$39,447.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$37,694.66
|
| Rate for Payer: Aetna Managed Medicare |
$12,272.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$28,490.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21,915.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21,038.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$23,230.43
|
| Rate for Payer: Cash Price |
$13,149.30
|
| Rate for Payer: Cigna Commercial |
$40,324.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$24,527.83
|
| Rate for Payer: Health EOS Commercial |
$39,009.59
|
| Rate for Payer: HFN Commercial |
$40,324.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$32,873.25
|
| Rate for Payer: Multiplan Commercial |
$35,064.80
|
| Rate for Payer: NAPHCARE Commercial |
$26,298.60
|
| Rate for Payer: Preferred Network Access Commercial |
$40,324.52
|
| Rate for Payer: Quartz Beloit One Network |
$21,477.19
|
| Rate for Payer: Quartz Commercial |
$28,490.15
|
| Rate for Payer: Quartz Medicare Advantage |
$26,298.60
|
| Rate for Payer: The Alliance Commercial |
$175,324.00
|
| Rate for Payer: WEA Trust Commercial |
$24,107.05
|
| Rate for Payer: WPS Commercial |
$32,465.62
|
|
|
Antibody ID Panel
|
Professional
|
$448.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
2955461
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$148.51 |
| Max. Negotiated Rate |
$425.60 |
| Rate for Payer: Aetna Commercial |
$425.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$385.28
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cigna Commercial |
$425.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$224.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$268.80
|
| Rate for Payer: Health EOS Commercial |
$407.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$148.51
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$148.51
|
| Rate for Payer: Multiplan Commercial |
$358.40
|
| Rate for Payer: Preferred Network Access Commercial |
$425.60
|
| Rate for Payer: Quartz Beloit One Network |
$197.12
|
| Rate for Payer: Quartz Commercial |
$255.36
|
| Rate for Payer: The Alliance Commercial |
$224.00
|
| Rate for Payer: WEA Trust Commercial |
$246.40
|
| Rate for Payer: WPS Commercial |
$331.83
|
|
|
Antibody ID Panel
|
Facility
OP
|
$448.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
2955461
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$219.52 |
| Max. Negotiated Rate |
$1,332.30 |
| Rate for Payer: Aetna Commercial |
$403.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$385.28
|
| Rate for Payer: Aetna Managed Medicare |
$355.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,332.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$621.74
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$589.76
|
| Rate for Payer: Anthem Medicare Advantage |
$355.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$237.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$355.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$355.28
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cigna Commercial |
$412.16
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$355.28
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$355.28
|
| Rate for Payer: Health EOS Commercial |
$398.72
|
| Rate for Payer: HFN Commercial |
$412.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,321.64
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$355.28
|
| Rate for Payer: Independent Care Health Plan Medicare |
$355.28
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$355.28
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$355.28
|
| Rate for Payer: Multiplan Commercial |
$358.40
|
| Rate for Payer: NAPHCARE Commercial |
$532.92
|
| Rate for Payer: Preferred Network Access Commercial |
$412.16
|
| Rate for Payer: Quartz Beloit One Network |
$219.52
|
| Rate for Payer: Quartz Commercial |
$291.20
|
| Rate for Payer: Quartz Medicare Advantage |
$355.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$355.28
|
| Rate for Payer: United Healthcare PPO |
$336.00
|
| Rate for Payer: WEA Trust Commercial |
$246.40
|
| Rate for Payer: Wellcare Medicare |
$355.28
|
| Rate for Payer: WPS Commercial |
$331.83
|
|
|
Antibody ID Panel
|
Facility
IP
|
$448.00
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
2955461
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$219.52 |
| Max. Negotiated Rate |
$412.16 |
| Rate for Payer: Aetna Commercial |
$403.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$237.44
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cigna Commercial |
$412.16
|
| Rate for Payer: Health EOS Commercial |
$398.72
|
| Rate for Payer: HFN Commercial |
$412.16
|
| Rate for Payer: Multiplan Commercial |
$358.40
|
| Rate for Payer: NAPHCARE Commercial |
$268.80
|
| Rate for Payer: Preferred Network Access Commercial |
$412.16
|
| Rate for Payer: Quartz Beloit One Network |
$219.52
|
| Rate for Payer: Quartz Commercial |
$268.80
|
| Rate for Payer: WEA Trust Commercial |
$246.40
|
| Rate for Payer: WPS Commercial |
$331.83
|
|
|
Antibody Screen
|
Facility
IP
|
$220.00
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
973764
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$107.80 |
| Max. Negotiated Rate |
$202.40 |
| Rate for Payer: Aetna Commercial |
$198.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$116.60
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cigna Commercial |
$202.40
|
| Rate for Payer: Health EOS Commercial |
$195.80
|
| Rate for Payer: HFN Commercial |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$176.00
|
| Rate for Payer: NAPHCARE Commercial |
$132.00
|
| Rate for Payer: Preferred Network Access Commercial |
$202.40
|
| Rate for Payer: Quartz Beloit One Network |
$107.80
|
| Rate for Payer: Quartz Commercial |
$132.00
|
| Rate for Payer: WEA Trust Commercial |
$121.00
|
| Rate for Payer: WPS Commercial |
$162.95
|
|
|
Antibody Screen
|
Facility
OP
|
$220.00
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
973764
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.38 |
| Max. Negotiated Rate |
$202.40 |
| Rate for Payer: Aetna Commercial |
$198.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$189.20
|
| Rate for Payer: Aetna Managed Medicare |
$53.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$200.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$93.73
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$88.91
|
| Rate for Payer: Anthem Medicaid |
$5.38
|
| Rate for Payer: Anthem Medicare Advantage |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$116.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$53.56
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cigna Commercial |
$202.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$53.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$5.38
|
| Rate for Payer: Dean Health Medicaid |
$5.38
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$53.56
|
| Rate for Payer: Health EOS Commercial |
$195.80
|
| Rate for Payer: HFN Commercial |
$202.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$199.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$53.56
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5.38
|
| Rate for Payer: Independent Care Health Plan Medicare |
$53.56
|
| Rate for Payer: Managed Health Services Medicaid |
$5.60
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$53.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$53.56
|
| Rate for Payer: Multiplan Commercial |
$176.00
|
| Rate for Payer: NAPHCARE Commercial |
$80.34
|
| Rate for Payer: Preferred Network Access Commercial |
$202.40
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$5.38
|
| Rate for Payer: Quartz Beloit One Network |
$107.80
|
| Rate for Payer: Quartz Commercial |
$143.00
|
| Rate for Payer: Quartz Medicare Advantage |
$53.56
|
| Rate for Payer: United Healthcare Medicaid |
$5.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.56
|
| Rate for Payer: United Healthcare PPO |
$165.00
|
| Rate for Payer: WEA Trust Commercial |
$121.00
|
| Rate for Payer: Wellcare Medicare |
$53.56
|
| Rate for Payer: WMAP Medicaid |
$5.38
|
| Rate for Payer: WPS Commercial |
$162.95
|
|
|
Anti-C Bir1
|
Facility
OP
|
$72.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2770811
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna Commercial |
$64.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$61.92
|
| Rate for Payer: Aetna Managed Medicare |
$17.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$64.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28.67
|
| Rate for Payer: Anthem Medicaid |
$17.85
|
| Rate for Payer: Anthem Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$38.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.27
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cigna Commercial |
$66.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17.85
|
| Rate for Payer: Dean Health Medicaid |
$17.85
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.27
|
| Rate for Payer: Health EOS Commercial |
$64.08
|
| Rate for Payer: HFN Commercial |
$66.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.27
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.27
|
| Rate for Payer: Managed Health Services Medicaid |
$18.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$57.60
|
| Rate for Payer: NAPHCARE Commercial |
$25.90
|
| Rate for Payer: Preferred Network Access Commercial |
$66.24
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17.85
|
| Rate for Payer: Quartz Beloit One Network |
$35.28
|
| Rate for Payer: Quartz Commercial |
$46.80
|
| Rate for Payer: Quartz Medicare Advantage |
$17.27
|
| Rate for Payer: The Alliance Commercial |
$288.00
|
| Rate for Payer: United Healthcare Medicaid |
$17.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.27
|
| Rate for Payer: United Healthcare PPO |
$54.00
|
| Rate for Payer: WEA Trust Commercial |
$39.60
|
| Rate for Payer: Wellcare Medicare |
$17.27
|
| Rate for Payer: WMAP Medicaid |
$17.85
|
| Rate for Payer: WPS Commercial |
$53.33
|
|
|
Anti-C Bir1
|
Facility
IP
|
$72.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2770811
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.28 |
| Max. Negotiated Rate |
$66.24 |
| Rate for Payer: Aetna Commercial |
$64.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$38.16
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cigna Commercial |
$66.24
|
| Rate for Payer: Health EOS Commercial |
$64.08
|
| Rate for Payer: HFN Commercial |
$66.24
|
| Rate for Payer: Multiplan Commercial |
$57.60
|
| Rate for Payer: NAPHCARE Commercial |
$43.20
|
| Rate for Payer: Preferred Network Access Commercial |
$66.24
|
| Rate for Payer: Quartz Beloit One Network |
$35.28
|
| Rate for Payer: Quartz Commercial |
$43.20
|
| Rate for Payer: WEA Trust Commercial |
$39.60
|
| Rate for Payer: WPS Commercial |
$53.33
|
|
|
Anti-C Bir1
|
Professional
|
$72.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2770811
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$75.99 |
| Rate for Payer: Aetna Commercial |
$68.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$61.92
|
| Rate for Payer: Aetna Managed Medicare |
$17.27
|
| Rate for Payer: Anthem Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.27
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cigna Commercial |
$68.40
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$36.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.27
|
| Rate for Payer: Health EOS Commercial |
$65.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$60.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$60.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$57.60
|
| Rate for Payer: Preferred Network Access Commercial |
$68.40
|
| Rate for Payer: Quartz Beloit One Network |
$31.68
|
| Rate for Payer: Quartz Commercial |
$41.04
|
| Rate for Payer: Quartz Medicare Advantage |
$17.27
|
| Rate for Payer: The Alliance Commercial |
$68.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.27
|
| Rate for Payer: WEA Trust Commercial |
$39.60
|
| Rate for Payer: WPS Commercial |
$75.99
|
|
|
Anti Endomysial IgA
|
Facility
IP
|
$427.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
2770807
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$209.23 |
| Max. Negotiated Rate |
$392.84 |
| Rate for Payer: Aetna Commercial |
$384.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$226.31
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cigna Commercial |
$392.84
|
| Rate for Payer: Health EOS Commercial |
$380.03
|
| Rate for Payer: HFN Commercial |
$392.84
|
| Rate for Payer: Multiplan Commercial |
$341.60
|
| Rate for Payer: NAPHCARE Commercial |
$256.20
|
| Rate for Payer: Preferred Network Access Commercial |
$392.84
|
| Rate for Payer: Quartz Beloit One Network |
$209.23
|
| Rate for Payer: Quartz Commercial |
$256.20
|
| Rate for Payer: WEA Trust Commercial |
$234.85
|
| Rate for Payer: WPS Commercial |
$316.28
|
|
|
Anti Endomysial IgA
|
Professional
|
$427.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
2770807
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.43 |
| Max. Negotiated Rate |
$645.30 |
| Rate for Payer: Aetna Commercial |
$405.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$367.22
|
| Rate for Payer: Aetna Managed Medicare |
$146.66
|
| Rate for Payer: Anthem Commercial |
$33.43
|
| Rate for Payer: Anthem Medicare Advantage |
$146.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$146.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$146.66
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cigna Commercial |
$405.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$213.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$146.66
|
| Rate for Payer: Health EOS Commercial |
$388.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$488.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$488.69
|
| Rate for Payer: Independent Care Health Plan Medicare |
$146.66
|
| Rate for Payer: Multiplan Commercial |
$341.60
|
| Rate for Payer: Preferred Network Access Commercial |
$405.65
|
| Rate for Payer: Quartz Beloit One Network |
$187.88
|
| Rate for Payer: Quartz Commercial |
$243.39
|
| Rate for Payer: Quartz Medicare Advantage |
$146.66
|
| Rate for Payer: The Alliance Commercial |
$579.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$146.66
|
| Rate for Payer: WEA Trust Commercial |
$234.85
|
| Rate for Payer: WPS Commercial |
$645.30
|
|
|
Anti Endomysial IgA
|
Facility
OP
|
$427.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
2770807
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$168.82 |
| Max. Negotiated Rate |
$633.08 |
| Rate for Payer: Aetna Commercial |
$384.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$367.22
|
| Rate for Payer: Aetna Managed Medicare |
$168.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$633.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$295.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$280.24
|
| Rate for Payer: Anthem Medicare Advantage |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$226.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$168.82
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cigna Commercial |
$392.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$168.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$168.82
|
| Rate for Payer: Health EOS Commercial |
$380.03
|
| Rate for Payer: HFN Commercial |
$392.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$168.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$168.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$168.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$168.82
|
| Rate for Payer: Multiplan Commercial |
$341.60
|
| Rate for Payer: NAPHCARE Commercial |
$253.23
|
| Rate for Payer: Preferred Network Access Commercial |
$392.84
|
| Rate for Payer: Quartz Beloit One Network |
$209.23
|
| Rate for Payer: Quartz Commercial |
$277.55
|
| Rate for Payer: Quartz Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare PPO |
$320.25
|
| Rate for Payer: WEA Trust Commercial |
$234.85
|
| Rate for Payer: Wellcare Medicare |
$168.82
|
| Rate for Payer: WPS Commercial |
$316.28
|
|
|
Anti-Enterocyte Antibodies
|
Professional
|
$1,047.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
5150631
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.43 |
| Max. Negotiated Rate |
$994.65 |
| Rate for Payer: Aetna Commercial |
$994.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$900.42
|
| Rate for Payer: Aetna Managed Medicare |
$146.66
|
| Rate for Payer: Anthem Commercial |
$33.43
|
| Rate for Payer: Anthem Medicare Advantage |
$146.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$146.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$146.66
|
| Rate for Payer: Cash Price |
$314.10
|
| Rate for Payer: Cash Price |
$314.10
|
| Rate for Payer: Cigna Commercial |
$994.65
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$523.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$146.66
|
| Rate for Payer: Health EOS Commercial |
$952.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$488.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$488.69
|
| Rate for Payer: Independent Care Health Plan Medicare |
$146.66
|
| Rate for Payer: Multiplan Commercial |
$837.60
|
| Rate for Payer: Preferred Network Access Commercial |
$994.65
|
| Rate for Payer: Quartz Beloit One Network |
$460.68
|
| Rate for Payer: Quartz Commercial |
$596.79
|
| Rate for Payer: Quartz Medicare Advantage |
$146.66
|
| Rate for Payer: The Alliance Commercial |
$579.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$146.66
|
| Rate for Payer: WEA Trust Commercial |
$575.85
|
| Rate for Payer: WPS Commercial |
$645.30
|
|
|
Anti-Enterocyte Antibodies
|
Facility
OP
|
$1,047.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
5150631
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$168.82 |
| Max. Negotiated Rate |
$963.24 |
| Rate for Payer: Aetna Commercial |
$942.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$900.42
|
| Rate for Payer: Aetna Managed Medicare |
$168.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$680.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$523.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$502.56
|
| Rate for Payer: Anthem Medicare Advantage |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$168.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$168.82
|
| Rate for Payer: Cash Price |
$314.10
|
| Rate for Payer: Cash Price |
$314.10
|
| Rate for Payer: Cigna Commercial |
$963.24
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$168.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$168.82
|
| Rate for Payer: Health EOS Commercial |
$931.83
|
| Rate for Payer: HFN Commercial |
$963.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$628.01
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$168.82
|
| Rate for Payer: Independent Care Health Plan Medicare |
$168.82
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$168.82
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$168.82
|
| Rate for Payer: Multiplan Commercial |
$837.60
|
| Rate for Payer: NAPHCARE Commercial |
$253.23
|
| Rate for Payer: Preferred Network Access Commercial |
$963.24
|
| Rate for Payer: Quartz Beloit One Network |
$513.03
|
| Rate for Payer: Quartz Commercial |
$680.55
|
| Rate for Payer: Quartz Medicare Advantage |
$168.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.82
|
| Rate for Payer: WEA Trust Commercial |
$575.85
|
| Rate for Payer: Wellcare Medicare |
$168.82
|
| Rate for Payer: WPS Commercial |
$775.51
|
|
|
Anti-Enterocyte Antibodies
|
Facility
IP
|
$1,047.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
5150631
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$513.03 |
| Max. Negotiated Rate |
$963.24 |
| Rate for Payer: Aetna Commercial |
$942.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$554.91
|
| Rate for Payer: Cash Price |
$314.10
|
| Rate for Payer: Cigna Commercial |
$963.24
|
| Rate for Payer: Health EOS Commercial |
$931.83
|
| Rate for Payer: HFN Commercial |
$963.24
|
| Rate for Payer: Multiplan Commercial |
$837.60
|
| Rate for Payer: NAPHCARE Commercial |
$628.20
|
| Rate for Payer: Preferred Network Access Commercial |
$963.24
|
| Rate for Payer: Quartz Beloit One Network |
$513.03
|
| Rate for Payer: Quartz Commercial |
$628.20
|
| Rate for Payer: WEA Trust Commercial |
$575.85
|
| Rate for Payer: WPS Commercial |
$775.51
|
|
|
Anti-Factor Xa
|
Professional
|
$188.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
977870
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$178.60 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$161.68
|
| Rate for Payer: Aetna Managed Medicare |
$13.09
|
| Rate for Payer: Anthem Medicare Advantage |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.09
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cigna Commercial |
$178.60
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$94.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$13.09
|
| Rate for Payer: Health EOS Commercial |
$171.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.21
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$46.21
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.09
|
| Rate for Payer: Multiplan Commercial |
$150.40
|
| Rate for Payer: Preferred Network Access Commercial |
$178.60
|
| Rate for Payer: Quartz Beloit One Network |
$82.72
|
| Rate for Payer: Quartz Commercial |
$107.16
|
| Rate for Payer: Quartz Medicare Advantage |
$13.09
|
| Rate for Payer: The Alliance Commercial |
$51.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.09
|
| Rate for Payer: WEA Trust Commercial |
$103.40
|
| Rate for Payer: WPS Commercial |
$57.60
|
|
|
Anti-Factor Xa
|
Facility
IP
|
$188.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
977870
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$92.12 |
| Max. Negotiated Rate |
$172.96 |
| Rate for Payer: Aetna Commercial |
$169.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$99.64
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cigna Commercial |
$172.96
|
| Rate for Payer: Health EOS Commercial |
$167.32
|
| Rate for Payer: HFN Commercial |
$172.96
|
| Rate for Payer: Multiplan Commercial |
$150.40
|
| Rate for Payer: NAPHCARE Commercial |
$112.80
|
| Rate for Payer: Preferred Network Access Commercial |
$172.96
|
| Rate for Payer: Quartz Beloit One Network |
$92.12
|
| Rate for Payer: Quartz Commercial |
$112.80
|
| Rate for Payer: WEA Trust Commercial |
$103.40
|
| Rate for Payer: WPS Commercial |
$139.25
|
|
|
Anti-Factor Xa
|
Facility
OP
|
$188.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
977870
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$752.00 |
| Rate for Payer: Aetna Commercial |
$169.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$161.68
|
| Rate for Payer: Aetna Managed Medicare |
$13.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$49.09
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22.91
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$21.73
|
| Rate for Payer: Anthem Medicaid |
$13.53
|
| Rate for Payer: Anthem Medicare Advantage |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$99.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13.09
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cigna Commercial |
$172.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13.09
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$13.53
|
| Rate for Payer: Dean Health Medicaid |
$13.53
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13.09
|
| Rate for Payer: Health EOS Commercial |
$167.32
|
| Rate for Payer: HFN Commercial |
$172.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.09
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$13.53
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13.09
|
| Rate for Payer: Managed Health Services Medicaid |
$14.07
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13.09
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13.09
|
| Rate for Payer: Multiplan Commercial |
$150.40
|
| Rate for Payer: NAPHCARE Commercial |
$19.64
|
| Rate for Payer: Preferred Network Access Commercial |
$172.96
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$13.53
|
| Rate for Payer: Quartz Beloit One Network |
$92.12
|
| Rate for Payer: Quartz Commercial |
$122.20
|
| Rate for Payer: Quartz Medicare Advantage |
$13.09
|
| Rate for Payer: The Alliance Commercial |
$752.00
|
| Rate for Payer: United Healthcare Medicaid |
$13.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.09
|
| Rate for Payer: United Healthcare PPO |
$141.00
|
| Rate for Payer: WEA Trust Commercial |
$103.40
|
| Rate for Payer: Wellcare Medicare |
$13.09
|
| Rate for Payer: WMAP Medicaid |
$13.53
|
| Rate for Payer: WPS Commercial |
$139.25
|
|
|
Antiglomerular Basement Membrane Antibody
|
Facility
IP
|
$463.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
633654
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$226.87 |
| Max. Negotiated Rate |
$425.96 |
| Rate for Payer: Aetna Commercial |
$416.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$245.39
|
| Rate for Payer: Cash Price |
$138.90
|
| Rate for Payer: Cigna Commercial |
$425.96
|
| Rate for Payer: Health EOS Commercial |
$412.07
|
| Rate for Payer: HFN Commercial |
$425.96
|
| Rate for Payer: Multiplan Commercial |
$370.40
|
| Rate for Payer: NAPHCARE Commercial |
$277.80
|
| Rate for Payer: Preferred Network Access Commercial |
$425.96
|
| Rate for Payer: Quartz Beloit One Network |
$226.87
|
| Rate for Payer: Quartz Commercial |
$277.80
|
| Rate for Payer: WEA Trust Commercial |
$254.65
|
| Rate for Payer: WPS Commercial |
$342.94
|
|
|
Antiglomerular Basement Membrane Antibody
|
Professional
|
$463.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
633654
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$439.85 |
| Rate for Payer: Aetna Commercial |
$439.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$398.18
|
| Rate for Payer: Aetna Managed Medicare |
$17.27
|
| Rate for Payer: Anthem Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.27
|
| Rate for Payer: Cash Price |
$138.90
|
| Rate for Payer: Cash Price |
$138.90
|
| Rate for Payer: Cigna Commercial |
$439.85
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$231.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.27
|
| Rate for Payer: Health EOS Commercial |
$421.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$60.96
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$60.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$370.40
|
| Rate for Payer: Preferred Network Access Commercial |
$439.85
|
| Rate for Payer: Quartz Beloit One Network |
$203.72
|
| Rate for Payer: Quartz Commercial |
$263.91
|
| Rate for Payer: Quartz Medicare Advantage |
$17.27
|
| Rate for Payer: The Alliance Commercial |
$68.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.27
|
| Rate for Payer: WEA Trust Commercial |
$254.65
|
| Rate for Payer: WPS Commercial |
$75.99
|
|
|
Antiglomerular Basement Membrane Antibody
|
Facility
OP
|
$463.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
633654
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$1,852.00 |
| Rate for Payer: Aetna Commercial |
$416.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$398.18
|
| Rate for Payer: Aetna Managed Medicare |
$17.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$64.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.22
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$28.67
|
| Rate for Payer: Anthem Medicaid |
$17.85
|
| Rate for Payer: Anthem Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$245.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.27
|
| Rate for Payer: Cash Price |
$138.90
|
| Rate for Payer: Cash Price |
$138.90
|
| Rate for Payer: Cigna Commercial |
$425.96
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.27
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$17.85
|
| Rate for Payer: Dean Health Medicaid |
$17.85
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.27
|
| Rate for Payer: Health EOS Commercial |
$412.07
|
| Rate for Payer: HFN Commercial |
$425.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$64.24
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.27
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$17.85
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.27
|
| Rate for Payer: Managed Health Services Medicaid |
$18.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.27
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$370.40
|
| Rate for Payer: NAPHCARE Commercial |
$25.90
|
| Rate for Payer: Preferred Network Access Commercial |
$425.96
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$17.85
|
| Rate for Payer: Quartz Beloit One Network |
$226.87
|
| Rate for Payer: Quartz Commercial |
$300.95
|
| Rate for Payer: Quartz Medicare Advantage |
$17.27
|
| Rate for Payer: The Alliance Commercial |
$1,852.00
|
| Rate for Payer: United Healthcare Medicaid |
$17.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.27
|
| Rate for Payer: United Healthcare PPO |
$347.25
|
| Rate for Payer: WEA Trust Commercial |
$254.65
|
| Rate for Payer: Wellcare Medicare |
$17.27
|
| Rate for Payer: WMAP Medicaid |
$17.85
|
| Rate for Payer: WPS Commercial |
$342.94
|
|
