|
Lyme Disease Serology/C6 Peptide
|
Facility
|
OP
|
$132.00
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
6170288
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.71 |
| Max. Negotiated Rate |
$126.30 |
| Rate for Payer: Aetna Commercial |
$123.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.06
|
| Rate for Payer: Aetna Managed Medicare |
$17.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$66.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$30.99
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.40
|
| Rate for Payer: Anthem Medicare Advantage |
$17.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.71
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna Commercial |
$126.30
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.71
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$76.82
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.71
|
| Rate for Payer: Health EOS Commercial |
$122.18
|
| Rate for Payer: HFN Commercial |
$126.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$65.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.71
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.71
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.71
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.71
|
| Rate for Payer: Multiplan Commercial |
$109.82
|
| Rate for Payer: NAPHCARE Commercial |
$26.57
|
| Rate for Payer: Preferred Network Access Commercial |
$126.30
|
| Rate for Payer: Quartz Beloit One Network |
$67.27
|
| Rate for Payer: Quartz Commercial |
$89.23
|
| Rate for Payer: Quartz Medicare Advantage |
$17.71
|
| Rate for Payer: The Alliance Commercial |
$70.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.71
|
| Rate for Payer: United Healthcare PPO |
$102.96
|
| Rate for Payer: WEA Trust Commercial |
$75.50
|
| Rate for Payer: Wellcare Medicare |
$17.71
|
| Rate for Payer: WPS Commercial |
$101.68
|
|
|
Lyme Disease Serology/C6 Peptide
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
6170288
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.27 |
| Max. Negotiated Rate |
$126.30 |
| Rate for Payer: Aetna Commercial |
$123.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.76
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna Commercial |
$126.30
|
| Rate for Payer: Health EOS Commercial |
$122.18
|
| Rate for Payer: HFN Commercial |
$126.30
|
| Rate for Payer: Multiplan Commercial |
$109.82
|
| Rate for Payer: Preferred Network Access Commercial |
$126.30
|
| Rate for Payer: Quartz Beloit One Network |
$67.27
|
| Rate for Payer: Quartz Commercial |
$82.37
|
| Rate for Payer: WEA Trust Commercial |
$75.50
|
| Rate for Payer: WPS Commercial |
$101.68
|
|
|
Lyme IgM/IgG, Whole Cell ELISA
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
6170289
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.11 |
| Max. Negotiated Rate |
$114.61 |
| Rate for Payer: Aetna Commercial |
$114.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$103.75
|
| Rate for Payer: Aetna Managed Medicare |
$16.11
|
| Rate for Payer: Anthem Medicare Advantage |
$16.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.11
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cigna Commercial |
$114.61
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$60.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$16.11
|
| Rate for Payer: Health EOS Commercial |
$109.78
|
| Rate for Payer: HFN Commercial |
$114.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$56.87
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$56.87
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.11
|
| Rate for Payer: Multiplan Commercial |
$96.51
|
| Rate for Payer: NAPHCARE Commercial |
$24.16
|
| Rate for Payer: Preferred Network Access Commercial |
$114.61
|
| Rate for Payer: Quartz Beloit One Network |
$53.08
|
| Rate for Payer: Quartz Commercial |
$68.76
|
| Rate for Payer: Quartz Medicare Advantage |
$16.11
|
| Rate for Payer: The Alliance Commercial |
$63.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.11
|
| Rate for Payer: WEA Trust Commercial |
$66.35
|
| Rate for Payer: WPS Commercial |
$70.88
|
|
|
Lyme IgM/IgG, Whole Cell ELISA
|
Facility
|
OP
|
$116.00
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
6170289
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.11 |
| Max. Negotiated Rate |
$110.99 |
| Rate for Payer: Aetna Commercial |
$108.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$103.75
|
| Rate for Payer: Aetna Managed Medicare |
$16.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$60.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28.19
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$26.74
|
| Rate for Payer: Anthem Medicare Advantage |
$16.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$63.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$16.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$16.11
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cigna Commercial |
$110.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$16.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$67.51
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$16.11
|
| Rate for Payer: Health EOS Commercial |
$107.37
|
| Rate for Payer: HFN Commercial |
$110.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$59.93
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$16.11
|
| Rate for Payer: Independent Care Health Plan Medicare |
$16.11
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$16.11
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$16.11
|
| Rate for Payer: Multiplan Commercial |
$96.51
|
| Rate for Payer: NAPHCARE Commercial |
$24.16
|
| Rate for Payer: Preferred Network Access Commercial |
$110.99
|
| Rate for Payer: Quartz Beloit One Network |
$59.11
|
| Rate for Payer: Quartz Commercial |
$78.42
|
| Rate for Payer: Quartz Medicare Advantage |
$16.11
|
| Rate for Payer: The Alliance Commercial |
$64.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.11
|
| Rate for Payer: United Healthcare PPO |
$90.48
|
| Rate for Payer: WEA Trust Commercial |
$66.35
|
| Rate for Payer: Wellcare Medicare |
$16.11
|
| Rate for Payer: WPS Commercial |
$89.35
|
|
|
Lyme IgM/IgG, Whole Cell ELISA
|
Facility
|
IP
|
$116.00
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
6170289
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$59.11 |
| Max. Negotiated Rate |
$110.99 |
| Rate for Payer: Aetna Commercial |
$108.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$103.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$63.94
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cigna Commercial |
$110.99
|
| Rate for Payer: Health EOS Commercial |
$107.37
|
| Rate for Payer: HFN Commercial |
$110.99
|
| Rate for Payer: Multiplan Commercial |
$96.51
|
| Rate for Payer: Preferred Network Access Commercial |
$110.99
|
| Rate for Payer: Quartz Beloit One Network |
$59.11
|
| Rate for Payer: Quartz Commercial |
$72.38
|
| Rate for Payer: WEA Trust Commercial |
$66.35
|
| Rate for Payer: WPS Commercial |
$89.35
|
|
|
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR
|
Facility
|
IP
|
$12,626.37
|
|
|
Service Code
|
APR-DRG 6943
|
| Min. Negotiated Rate |
$11,215.53 |
| Max. Negotiated Rate |
$12,626.37 |
| Rate for Payer: Anthem Medicaid |
$12,090.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$12,090.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$12,090.44
|
| Rate for Payer: Dean Health Medicaid |
$12,090.44
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$11,215.53
|
| Rate for Payer: Managed Health Services Medicaid |
$12,626.37
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,090.44
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$12,090.44
|
| Rate for Payer: United Healthcare Medicaid |
$12,090.44
|
|
|
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR
|
Facility
|
IP
|
$6,400.87
|
|
|
Service Code
|
APR-DRG 6941
|
| Min. Negotiated Rate |
$5,685.65 |
| Max. Negotiated Rate |
$6,400.87 |
| Rate for Payer: Anthem Medicaid |
$6,129.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$6,129.18
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$6,129.18
|
| Rate for Payer: Dean Health Medicaid |
$6,129.18
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$5,685.65
|
| Rate for Payer: Managed Health Services Medicaid |
$6,400.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,129.18
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$6,129.18
|
| Rate for Payer: United Healthcare Medicaid |
$6,129.18
|
|
|
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR
|
Facility
|
OP
|
$100.89
|
|
|
Service Code
|
EAPG 00804
|
| Min. Negotiated Rate |
$97.01 |
| Max. Negotiated Rate |
$100.89 |
| Rate for Payer: Anthem Medicaid |
$97.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$97.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$97.01
|
| Rate for Payer: Dean Health Medicaid |
$97.01
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$97.01
|
| Rate for Payer: Managed Health Services Medicaid |
$100.89
|
| Rate for Payer: Molina Healthcare Medicaid |
$97.01
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$97.01
|
| Rate for Payer: United Healthcare Medicaid |
$97.01
|
|
|
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR
|
Facility
|
IP
|
$20,868.58
|
|
|
Service Code
|
APR-DRG 6944
|
| Min. Negotiated Rate |
$18,536.77 |
| Max. Negotiated Rate |
$20,868.58 |
| Rate for Payer: Anthem Medicaid |
$19,982.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$19,982.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$19,982.81
|
| Rate for Payer: Dean Health Medicaid |
$19,982.81
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$18,536.77
|
| Rate for Payer: Managed Health Services Medicaid |
$20,868.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$19,982.81
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$19,982.81
|
| Rate for Payer: United Healthcare Medicaid |
$19,982.81
|
|
|
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR
|
Facility
|
IP
|
$8,329.89
|
|
|
Service Code
|
APR-DRG 6942
|
| Min. Negotiated Rate |
$7,399.13 |
| Max. Negotiated Rate |
$8,329.89 |
| Rate for Payer: Anthem Medicaid |
$7,976.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$7,976.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$7,976.33
|
| Rate for Payer: Dean Health Medicaid |
$7,976.33
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$7,399.13
|
| Rate for Payer: Managed Health Services Medicaid |
$8,329.89
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,976.33
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$7,976.33
|
| Rate for Payer: United Healthcare Medicaid |
$7,976.33
|
|
|
Lymphocyte Absolute CD19 Count
|
Facility
|
OP
|
$547.00
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
2942947
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$523.37 |
| Rate for Payer: Aetna Commercial |
$511.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$489.24
|
| Rate for Payer: Aetna Managed Medicare |
$39.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$147.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$68.67
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$65.14
|
| Rate for Payer: Anthem Medicare Advantage |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$301.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.24
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cigna Commercial |
$523.37
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$318.35
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.24
|
| Rate for Payer: Health EOS Commercial |
$506.30
|
| Rate for Payer: HFN Commercial |
$523.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$145.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$455.10
|
| Rate for Payer: NAPHCARE Commercial |
$58.86
|
| Rate for Payer: Preferred Network Access Commercial |
$523.37
|
| Rate for Payer: Quartz Beloit One Network |
$278.75
|
| Rate for Payer: Quartz Commercial |
$369.77
|
| Rate for Payer: Quartz Medicare Advantage |
$39.24
|
| Rate for Payer: The Alliance Commercial |
$156.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.24
|
| Rate for Payer: United Healthcare PPO |
$426.66
|
| Rate for Payer: WEA Trust Commercial |
$312.88
|
| Rate for Payer: Wellcare Medicare |
$39.24
|
| Rate for Payer: WPS Commercial |
$421.35
|
|
|
Lymphocyte Absolute CD19 Count
|
Facility
|
IP
|
$547.00
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
2942947
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$278.75 |
| Max. Negotiated Rate |
$523.37 |
| Rate for Payer: Aetna Commercial |
$511.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$489.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$301.51
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cigna Commercial |
$523.37
|
| Rate for Payer: Health EOS Commercial |
$506.30
|
| Rate for Payer: HFN Commercial |
$523.37
|
| Rate for Payer: Multiplan Commercial |
$455.10
|
| Rate for Payer: Preferred Network Access Commercial |
$523.37
|
| Rate for Payer: Quartz Beloit One Network |
$278.75
|
| Rate for Payer: Quartz Commercial |
$341.33
|
| Rate for Payer: WEA Trust Commercial |
$312.88
|
| Rate for Payer: WPS Commercial |
$421.35
|
|
|
Lymphocyte Absolute CD19 Count
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
2942947
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$540.44 |
| Rate for Payer: Aetna Commercial |
$540.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$489.24
|
| Rate for Payer: Aetna Managed Medicare |
$39.24
|
| Rate for Payer: Anthem Medicare Advantage |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.24
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cash Price |
$164.10
|
| Rate for Payer: Cigna Commercial |
$540.44
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$284.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$39.24
|
| Rate for Payer: Health EOS Commercial |
$517.68
|
| Rate for Payer: HFN Commercial |
$540.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$138.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$138.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$455.10
|
| Rate for Payer: NAPHCARE Commercial |
$58.86
|
| Rate for Payer: Preferred Network Access Commercial |
$540.44
|
| Rate for Payer: Quartz Beloit One Network |
$250.31
|
| Rate for Payer: Quartz Commercial |
$324.26
|
| Rate for Payer: Quartz Medicare Advantage |
$39.24
|
| Rate for Payer: The Alliance Commercial |
$154.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.24
|
| Rate for Payer: WEA Trust Commercial |
$312.88
|
| Rate for Payer: WPS Commercial |
$172.65
|
|
|
Lymphocyte Abssolute Natural Killer (CD16 & CD56) Count
|
Facility
|
IP
|
$443.00
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
2942946
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$225.75 |
| Max. Negotiated Rate |
$423.86 |
| Rate for Payer: Aetna Commercial |
$414.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.18
|
| Rate for Payer: Cash Price |
$132.90
|
| Rate for Payer: Cigna Commercial |
$423.86
|
| Rate for Payer: Health EOS Commercial |
$410.04
|
| Rate for Payer: HFN Commercial |
$423.86
|
| Rate for Payer: Multiplan Commercial |
$368.58
|
| Rate for Payer: Preferred Network Access Commercial |
$423.86
|
| Rate for Payer: Quartz Beloit One Network |
$225.75
|
| Rate for Payer: Quartz Commercial |
$276.43
|
| Rate for Payer: WEA Trust Commercial |
$253.40
|
| Rate for Payer: WPS Commercial |
$341.24
|
|
|
Lymphocyte Abssolute Natural Killer (CD16 & CD56) Count
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
2942946
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$437.68 |
| Rate for Payer: Aetna Commercial |
$437.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.22
|
| Rate for Payer: Aetna Managed Medicare |
$39.24
|
| Rate for Payer: Anthem Medicare Advantage |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.24
|
| Rate for Payer: Cash Price |
$132.90
|
| Rate for Payer: Cash Price |
$132.90
|
| Rate for Payer: Cigna Commercial |
$437.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$230.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$39.24
|
| Rate for Payer: Health EOS Commercial |
$419.26
|
| Rate for Payer: HFN Commercial |
$437.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$138.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$138.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$368.58
|
| Rate for Payer: NAPHCARE Commercial |
$58.86
|
| Rate for Payer: Preferred Network Access Commercial |
$437.68
|
| Rate for Payer: Quartz Beloit One Network |
$202.72
|
| Rate for Payer: Quartz Commercial |
$262.61
|
| Rate for Payer: Quartz Medicare Advantage |
$39.24
|
| Rate for Payer: The Alliance Commercial |
$154.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.24
|
| Rate for Payer: WEA Trust Commercial |
$253.40
|
| Rate for Payer: WPS Commercial |
$172.65
|
|
|
Lymphocyte Abssolute Natural Killer (CD16 & CD56) Count
|
Facility
|
OP
|
$443.00
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
2942946
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$423.86 |
| Rate for Payer: Aetna Commercial |
$414.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.22
|
| Rate for Payer: Aetna Managed Medicare |
$39.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$147.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$68.67
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$65.14
|
| Rate for Payer: Anthem Medicare Advantage |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.24
|
| Rate for Payer: Cash Price |
$132.90
|
| Rate for Payer: Cash Price |
$132.90
|
| Rate for Payer: Cigna Commercial |
$423.86
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$257.83
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.24
|
| Rate for Payer: Health EOS Commercial |
$410.04
|
| Rate for Payer: HFN Commercial |
$423.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$145.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$368.58
|
| Rate for Payer: NAPHCARE Commercial |
$58.86
|
| Rate for Payer: Preferred Network Access Commercial |
$423.86
|
| Rate for Payer: Quartz Beloit One Network |
$225.75
|
| Rate for Payer: Quartz Commercial |
$299.47
|
| Rate for Payer: Quartz Medicare Advantage |
$39.24
|
| Rate for Payer: The Alliance Commercial |
$156.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.24
|
| Rate for Payer: United Healthcare PPO |
$345.54
|
| Rate for Payer: WEA Trust Commercial |
$253.40
|
| Rate for Payer: Wellcare Medicare |
$39.24
|
| Rate for Payer: WPS Commercial |
$341.24
|
|
|
Lymphocyte Mitogen Screen,CC
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
3315519
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.32 |
| Max. Negotiated Rate |
$81.33 |
| Rate for Payer: Aetna Commercial |
$79.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.85
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cigna Commercial |
$81.33
|
| Rate for Payer: Health EOS Commercial |
$78.68
|
| Rate for Payer: HFN Commercial |
$81.33
|
| Rate for Payer: Multiplan Commercial |
$70.72
|
| Rate for Payer: Preferred Network Access Commercial |
$81.33
|
| Rate for Payer: Quartz Beloit One Network |
$43.32
|
| Rate for Payer: Quartz Commercial |
$53.04
|
| Rate for Payer: WEA Trust Commercial |
$48.62
|
| Rate for Payer: WPS Commercial |
$65.48
|
|
|
Lymphocyte Mitogen Screen,CC
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
3315519
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.32 |
| Max. Negotiated Rate |
$203.96 |
| Rate for Payer: Aetna Commercial |
$79.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.02
|
| Rate for Payer: Aetna Managed Medicare |
$50.99
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$191.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$89.23
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$84.65
|
| Rate for Payer: Anthem Medicare Advantage |
$50.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$46.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$50.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$50.99
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cigna Commercial |
$81.33
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$50.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$49.47
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$50.99
|
| Rate for Payer: Health EOS Commercial |
$78.68
|
| Rate for Payer: HFN Commercial |
$81.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$189.69
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$50.99
|
| Rate for Payer: Independent Care Health Plan Medicare |
$50.99
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$50.99
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$50.99
|
| Rate for Payer: Multiplan Commercial |
$70.72
|
| Rate for Payer: NAPHCARE Commercial |
$76.49
|
| Rate for Payer: Preferred Network Access Commercial |
$81.33
|
| Rate for Payer: Quartz Beloit One Network |
$43.32
|
| Rate for Payer: Quartz Commercial |
$57.46
|
| Rate for Payer: Quartz Medicare Advantage |
$50.99
|
| Rate for Payer: The Alliance Commercial |
$203.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$50.99
|
| Rate for Payer: United Healthcare PPO |
$66.30
|
| Rate for Payer: WEA Trust Commercial |
$48.62
|
| Rate for Payer: Wellcare Medicare |
$50.99
|
| Rate for Payer: WPS Commercial |
$65.48
|
|
|
Lymphocyte Mitogen Screen,CC
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
3315519
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.90 |
| Max. Negotiated Rate |
$224.36 |
| Rate for Payer: Aetna Commercial |
$83.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.02
|
| Rate for Payer: Aetna Managed Medicare |
$50.99
|
| Rate for Payer: Anthem Medicare Advantage |
$50.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$50.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$50.99
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cigna Commercial |
$83.98
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$44.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$50.99
|
| Rate for Payer: Health EOS Commercial |
$80.44
|
| Rate for Payer: HFN Commercial |
$83.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$180.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$180.00
|
| Rate for Payer: Independent Care Health Plan Medicare |
$50.99
|
| Rate for Payer: Multiplan Commercial |
$70.72
|
| Rate for Payer: NAPHCARE Commercial |
$76.49
|
| Rate for Payer: Preferred Network Access Commercial |
$83.98
|
| Rate for Payer: Quartz Beloit One Network |
$38.90
|
| Rate for Payer: Quartz Commercial |
$50.39
|
| Rate for Payer: Quartz Medicare Advantage |
$50.99
|
| Rate for Payer: The Alliance Commercial |
$201.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$50.99
|
| Rate for Payer: WEA Trust Commercial |
$48.62
|
| Rate for Payer: WPS Commercial |
$224.36
|
|
|
Lymphocyte panel T cell
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
4746613
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$49.43 |
| Max. Negotiated Rate |
$92.81 |
| Rate for Payer: Aetna Commercial |
$90.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$53.47
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$92.81
|
| Rate for Payer: Health EOS Commercial |
$89.78
|
| Rate for Payer: HFN Commercial |
$92.81
|
| Rate for Payer: Multiplan Commercial |
$80.70
|
| Rate for Payer: Preferred Network Access Commercial |
$92.81
|
| Rate for Payer: Quartz Beloit One Network |
$49.43
|
| Rate for Payer: Quartz Commercial |
$60.53
|
| Rate for Payer: WEA Trust Commercial |
$55.48
|
| Rate for Payer: WPS Commercial |
$74.72
|
|
|
Lymphocyte panel T cell
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
4746613
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$172.65 |
| Rate for Payer: Aetna Commercial |
$95.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.76
|
| Rate for Payer: Aetna Managed Medicare |
$39.24
|
| Rate for Payer: Anthem Medicare Advantage |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.24
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$95.84
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$50.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$39.24
|
| Rate for Payer: Health EOS Commercial |
$91.80
|
| Rate for Payer: HFN Commercial |
$95.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$138.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$138.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$80.70
|
| Rate for Payer: NAPHCARE Commercial |
$58.86
|
| Rate for Payer: Preferred Network Access Commercial |
$95.84
|
| Rate for Payer: Quartz Beloit One Network |
$44.39
|
| Rate for Payer: Quartz Commercial |
$57.50
|
| Rate for Payer: Quartz Medicare Advantage |
$39.24
|
| Rate for Payer: The Alliance Commercial |
$154.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.24
|
| Rate for Payer: WEA Trust Commercial |
$55.48
|
| Rate for Payer: WPS Commercial |
$172.65
|
|
|
Lymphocyte panel T cell
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
4746613
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$156.96 |
| Rate for Payer: Aetna Commercial |
$90.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$86.76
|
| Rate for Payer: Aetna Managed Medicare |
$39.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$147.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$68.67
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$65.14
|
| Rate for Payer: Anthem Medicare Advantage |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$53.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.24
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cigna Commercial |
$92.81
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$56.45
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.24
|
| Rate for Payer: Health EOS Commercial |
$89.78
|
| Rate for Payer: HFN Commercial |
$92.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$145.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$80.70
|
| Rate for Payer: NAPHCARE Commercial |
$58.86
|
| Rate for Payer: Preferred Network Access Commercial |
$92.81
|
| Rate for Payer: Quartz Beloit One Network |
$49.43
|
| Rate for Payer: Quartz Commercial |
$65.57
|
| Rate for Payer: Quartz Medicare Advantage |
$39.24
|
| Rate for Payer: The Alliance Commercial |
$156.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.24
|
| Rate for Payer: United Healthcare PPO |
$75.66
|
| Rate for Payer: WEA Trust Commercial |
$55.48
|
| Rate for Payer: Wellcare Medicare |
$39.24
|
| Rate for Payer: WPS Commercial |
$74.72
|
|
|
Lymphocyte Subset Panel 1
|
Professional
|
Both
|
$344.00
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
983312
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$339.87 |
| Rate for Payer: Aetna Commercial |
$339.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$307.67
|
| Rate for Payer: Aetna Managed Medicare |
$39.24
|
| Rate for Payer: Anthem Medicare Advantage |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.24
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cigna Commercial |
$339.87
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$178.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$39.24
|
| Rate for Payer: Health EOS Commercial |
$325.56
|
| Rate for Payer: HFN Commercial |
$339.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$138.52
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$138.52
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$286.21
|
| Rate for Payer: NAPHCARE Commercial |
$58.86
|
| Rate for Payer: Preferred Network Access Commercial |
$339.87
|
| Rate for Payer: Quartz Beloit One Network |
$157.41
|
| Rate for Payer: Quartz Commercial |
$203.92
|
| Rate for Payer: Quartz Medicare Advantage |
$39.24
|
| Rate for Payer: The Alliance Commercial |
$154.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.24
|
| Rate for Payer: WEA Trust Commercial |
$196.77
|
| Rate for Payer: WPS Commercial |
$172.65
|
|
|
Lymphocyte Subset Panel 1
|
Facility
|
OP
|
$344.00
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
983312
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.24 |
| Max. Negotiated Rate |
$329.14 |
| Rate for Payer: Aetna Commercial |
$321.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$307.67
|
| Rate for Payer: Aetna Managed Medicare |
$39.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$147.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$68.67
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$65.14
|
| Rate for Payer: Anthem Medicare Advantage |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$189.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$39.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$39.24
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cigna Commercial |
$329.14
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$39.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$200.21
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$39.24
|
| Rate for Payer: Health EOS Commercial |
$318.41
|
| Rate for Payer: HFN Commercial |
$329.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$145.97
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$39.24
|
| Rate for Payer: Independent Care Health Plan Medicare |
$39.24
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$39.24
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$286.21
|
| Rate for Payer: NAPHCARE Commercial |
$58.86
|
| Rate for Payer: Preferred Network Access Commercial |
$329.14
|
| Rate for Payer: Quartz Beloit One Network |
$175.30
|
| Rate for Payer: Quartz Commercial |
$232.54
|
| Rate for Payer: Quartz Medicare Advantage |
$39.24
|
| Rate for Payer: The Alliance Commercial |
$156.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.24
|
| Rate for Payer: United Healthcare PPO |
$268.32
|
| Rate for Payer: WEA Trust Commercial |
$196.77
|
| Rate for Payer: Wellcare Medicare |
$39.24
|
| Rate for Payer: WPS Commercial |
$264.98
|
|
|
Lymphocyte Subset Panel 1
|
Facility
|
IP
|
$344.00
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
983312
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$175.30 |
| Max. Negotiated Rate |
$329.14 |
| Rate for Payer: Aetna Commercial |
$321.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$307.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$189.61
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cigna Commercial |
$329.14
|
| Rate for Payer: Health EOS Commercial |
$318.41
|
| Rate for Payer: HFN Commercial |
$329.14
|
| Rate for Payer: Multiplan Commercial |
$286.21
|
| Rate for Payer: Preferred Network Access Commercial |
$329.14
|
| Rate for Payer: Quartz Beloit One Network |
$175.30
|
| Rate for Payer: Quartz Commercial |
$214.66
|
| Rate for Payer: WEA Trust Commercial |
$196.77
|
| Rate for Payer: WPS Commercial |
$264.98
|
|
